Surgical cutting instruments and methods for robotic surgery

Abstract

A surgical cutting instrument is disclosed that includes a rod and an articulated end effector connected to a distal end of the rod. The articulated end effector includes a connecting link, a support link articulated to the connecting link and having a convex ruled surface, a blade holder link articulated to the support link, a blade link that rotates together with the blade holder link, and a reaction link articulated to the support link and the group formed by the blade link and the blade holder link. The blade holder link and the reaction link have terminal seats that receive antagonistic tendon pairs of the surgical cutting instrument, the cutting edge of the blade link is elastically bendable in a direction parallel to a distal common axis of rotation (YY), and a first distance and a second distance parallel to the distal common axis of rotation (YY) between each of the terminal seats of the blade holder link and the reaction link and the convex ruled surface of the support link are constant in any cutting state.

Description

[Technical field]

[0001] The present invention relates to surgical instruments.

[0002] In particular, the present invention relates to surgical instruments adapted to perform cutting operations.

[0003] The surgical cutting instrument of the present invention is particularly suited for robotic surgery.

[0004] The present invention further relates to a rotary joint for a surgical cutting instrument.

[0005] Furthermore, the present invention relates to a method. [Background technology]

[0006] Robotic surgical devices are generally known in the art and typically include 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 moving a distally mountable surgical instrument to perform a surgical procedure on a patient. The patient typically lies on an operating table located in an operating room, where sterility is ensured to avoid bacterial contamination from non-sterile parts of the robotic device.

[0007] In conventional, i.e. non-robotic surgery, needle driver / suture cutter type instruments are generally known, which comprise, at opposite ends of an operating ring, a needle driver / suture cutter formed by two free ends having a gripping surface for a surgical needle and a blade for cutting a suture. In some cases, the blade is made in a seat or recess formed in the body of the gripper and is accessible through a separate access opening different from the opening for accessing the gripping surface of the needle.

[0008] Surgical scissors are also known in the art, which include two opposing blades at the free end, at the ends opposite a manipulation ring. The manipulation ring may be provided with a spring. Typically, the opening angle of the free end useful for performing a cutting action with such conventional surgical scissors must be less than 25°.

[0009] Furthermore, in the field of robotic surgery, laparoscopic needle driver / suture cutter end-effectors have been proposed having opposing gripping surfaces and respective blades disposed at the distal end of an elongated rod or shaft. Typically, the blades are co-molded with the respective gripping surfaces for the needles, and a cantilever projection is formed for the gripping surfaces proximal to the gripping surfaces, i.e., between the gripping surfaces and the pivot hinge of the gripping surfaces. Thus, a single molded part usually comprises a root portion for forming part of the hinge, a free end, the gripping surface, and the blade extending in a closing direction relative to the gripping surfaces towards the other blade facing the opposite side of the needle driver / suture cutter end-effector.

[0010] Scissor-type end effectors have also been proposed for robotic surgery, in which a blade is provided at each free end of the end effector, as shown, for example, in US Patent Application Publication No. 2008 / 0119870.

[0011] In both the needle driver / suture cutter type robotic surgical instruments and the scissors type surgical instruments, multiple "Belleville washer" type elastic washers ensure a preload between the roots of the two parts forming the end effector when closing the mechanical interference between the blades intended to make the cut. Thus, when the end effector closes, the opposing blades enter the interference and slide laterally between their respective roots, counteracting the elastic influence exerted on the hinge by said elastic Belleville washers.

[0012] Also, US2019 / 0105032 shows a cutting end effector in which each blade is integrally provided with an elastic cantilever tab, the two elastic cantilever tabs extending towards each other in a direction parallel to the pin, whereby an elastic preload is provided by the contact between the two cantilever beam tabs, which avoids assembling a Belleville type elastic washer on the hinge, thus leaving an axial space in the hinge between the two blades to accommodate its sliding against the variation of the elastic reaction force exerted by the mutually contacting cantilever-like elastic tabs.

[0013] Another known example is given by US Patent Application Publication No. 2020-0107894, which shows a needle driver / suture cutter solution in which the blade is housed in a longitudinal pocket of the gripping link and is independently rotatable relative to the pocket, thereby allowing the blade to be withdrawn as needed.

[0014] In addition to or instead of the "Belleville" type washers, the hinge can be provided with an adjustment screw, which usually forms the articulation pin itself, to adjust the cutting interference between the blades. If an adjustment screw is provided in combination with the "Belleville" type elastic washers, it counteracts the elastic action of the spring and allows the end adjustment of the elastic preload.

[0015] Typically, known surgical scissors of the aforementioned type have two blades that are both axially curved in the same direction to ensure mutual contact of the cutting interference, and these blades are adjusted in such a way that they can cut satisfactorily only for small opening angles, for example not exceeding 25°, i.e. the blades cut satisfactorily only near or at the distal free ends, where the curvature is more pronounced axially (i.e. in the direction of the hinge axis), while in their respective proximal parts these blades are axially spaced apart and therefore not suitable for performing precise cuts (the tissue to be cut bends between the blades without separation). Conversely, if the blades are adjusted in their proximal parts, i.e. at large opening angles, for example exceeding 15°, the blades are not suitable for completely closing, because the distal curvature of the blades actually generates a closing stroke end and prevents the cutting ability at small opening angles. If the clamping force of the blades is strongly increased, the blades can close, but they inevitably again axially space in the proximal parts, losing their cutting ability in the proximal area. For these reasons, it is usually chosen to tighten the adjustment screws of the blades of known surgical scissors so that the mechanical interference condition is achieved only near the free end, since this allows the blades to be more visible, require a smaller opening angle and therefore have a smaller footprint.

[0016] Miniaturization of surgical instruments for robotic surgery, especially their ends or end effectors, is particularly desirable as it allows for accessibility in complex areas and opens up advantageous scenarios of potential minimal invasiveness for the patient undergoing surgery.

[0017] Known solutions of the aforementioned kind are not suitable for further miniaturization, since they impose impossible processes for the manufacture of the parts, as well as complex assembly strategies of the parts to obtain an assembled end effector. One can think, for example, of the necessity to assemble the micro-parts on the hinge while countering the elastic reaction forces of the Belleville-type elastic washers, as well as the objective extreme difficulties of manufacture due to the co-molding of micro-ridges and micro-undercuts, which must be robust enough to withstand rather high stresses during operation and at the same time be geometrically shaped to minimize friction. Indeed, as is well known, at the microscale, surface forces such as friction dominate over volume forces.

[0018] Furthermore, in surgical instruments with cutting end effectors actuated by actuation cables or tendons, in order to ensure high closure forces, such as accurate cutting action without damaging the actuation tendons, it is typically necessary to make reducers, i.e. pulleys, with a relatively large diameter, which limits the miniaturization of parts, especially close to the distal end of the end effector. Otherwise, in order to maintain a compact size of the end effector, it is necessary to increase the tensile strength of the actuation tendons at the expense of their longitudinal bending properties, which in either case results in the fitting of a relatively large diameter distal pulley, or attempts can be made to reinforce the tendons by increasing their diameter, but both of these options are significant obstacles to miniaturization, as will be clear to those skilled in the art.

[0019] Furthermore, as the scale decreases, it becomes increasingly complicated to accurately size the elements that are intended to be formed when a rotary joint is assembled, such as the end effector gripping end of a surgical instrument, because small machining uncertainties at the level of the fulcrum, i.e., hinge, impose great imprecision close to the free ends of each cantilever and therefore on the cutting blades in the case of scissor-type instruments, or on the gripping surfaces in the case of tools such as needle drivers / suture cutters.

[0020] The provision of a linkage associated with the blade (a solution known in the art per se) would also be an obstacle in an attempt to transmit high closing forces, such as a precise cutting action without damaging the working tendons. Miniaturization is necessary, even if only for the objective difficulty of making parts on such a small scale that they prove robust under operating conditions, due to the footprint in the area close to the common axis of rotation of the free ends, as well as the difficulties of assembly.

[0021] The end effector located distal to the hinge, whether it be just a cutting blade or a cutting blade and a gripping surface, is typically designed to perform very precise tasks while at the same time the cutting blade must ensure an accurate and clean cutting action.

[0022] Commonly owned U.S. Pat. No. 10,864,051, WO 2017-064301, WO 2019-220407, WO 2019-220408, WO 2019-220409 and U.S. Patent Publication No. 2021-059776 disclose teleoperated robotic surgical systems having one or more surgical instruments controlled by one or more master interfaces. Furthermore, US Patent No. 10582975, EP Patent No. 3586780, WO 2017-064303, WO 2018-189721, WO 2018-189729, US Patent Application Publication No. 2020-0170727 and US Patent Application Publication No. 2020-0170726 of the same applicant disclose various embodiments of surgical instruments suitable for robotic surgery and microsurgery. These types of surgical instruments generally comprise a proximal interface actuation part (or back end part) having an interface adapted to be driven by a robotic manipulator, a rod and an articulating cuff at the distal end of the rod. The articulating cuff is composed of multiple links that are moved by multiple tendons (or actuation cables). The two terminal links have free ends and are adapted to act directly on the patient's anatomy and / or to manipulate needles and sutures to perform an anastomosis or other surgical procedure.

[0023] For example, WO 2017-064306 of the same applicant shows a surgical instrument in which a tendon for actuating the open / close degree of freedom of an articulated end effector link slides on a convex textured sliding surface of the end effector link, while avoiding routing the tendon in a guide groove or channel having a recess, thereby minimizing the cross section of the sliding contact between the tendon and the link, thus reducing sliding friction and facilitating the miniaturization of the articulated end effector while ensuring the high dexterity provided by end effector joints such as pitch and yaw revolute joints.

[0024] Furthermore, WO 2018-189722 of the same applicant discloses a surgical instrument in which a tendon for actuating the open / close degree of freedom of an articulated end effector is wound on a convexly textured sliding surface of an end effector link in addition to sliding on said convexly textured sliding surface, as previously discussed, and presents an arcuate path underlying a particularly high winding angle. Indeed, due to the low sliding friction of the tendon, the tendon can remain in contact with the convexly textured surface of the link over a relatively long, arcuate longitudinal cross section.

[0025] Additionally, commonly owned U.S. Patent Application Publication No. 2021-0106393 discloses several embodiments of tendons made of entangled polymer fibers. The use of polymer tendons allows for reduced sliding friction relative to the use of metal tendons, while proper sizing of the tendons allows for tortuous longitudinal path movement in articulating end effectors.

[0026] Furthermore, US2020 / 0390507 discloses a solution in which rollers are rotatably attached to the articulating end link of the surgical instrument to guide the tendon. The provision of such rollers represents a clear obstacle to the miniaturization of the articulating end. Summary of the Invention [Problem to be solved by the invention]

[0027] There is therefore a strong felt need to provide a surgical instrument solution having an articulated end effector that is suitable for extreme miniaturization without compromising the dexterity of the articulated end effector and at the same time is robust, reliable and capable of providing a precise and repeatable cutting action.

[0028] Furthermore, a need is felt to propose a surgical instrument solution for teleoperated robotic microsurgery, which is simple to assemble and construct, reliable, accurate and robust under operating conditions, and adapted to allow a desired controlled spatial orientation of the cutting action relative to the main longitudinal extension of the surgical instrument body, which may be useful, for example, to facilitate surgical observation.

[0029] There is a felt need to propose a solution that consists of a minimum number of components, so that it is possible to assemble an articulated tip surgical microinstrument with grips and / or scissors, and that can be assembled in an easy and cost-affordable manner.

[0030] For the formation of articulated tip microinstruments with grippers and pincers, a need is felt to propose a solution that allows micromechanical parts, in particular sharp micromechanical parts, to be manufactured with high geometrical precision and high reproducibility.

[0031] The object of the present invention is to obviate the drawbacks mentioned in the background art. [Means for solving the problem]

[0032] This and other objects are achieved by a surgical instrument according to claim 1, as well as a method according to claim 10 and a rotary joint according to claim 12.

[0033] Some advantageous embodiments are the subject matter of the dependent claims.

[0034] According to one aspect of the invention, a surgical cutting instrument includes a rod or shaft having a distal end and an articulated end effector connected to the distal end of the rod.

[0035] The articulated end effector has a body integral with one or more convex ruled surfaces of a connecting link having parallel generatrices and a first distal connecting portion, the connecting link being connected to a distal end of a rod.

[0036] The articulated end effector comprises a support link articulated to a connecting link and having a body, the body integrally comprising one or more convex ruled surfaces of the support link having parallel generatrices, a proximal connecting portion articulated to a first distal connecting portion of a first connecting link defining a proximal rotation joint for the connecting link and the support link such that the connection link and the support link can rotate relatively about a proximal common rotation axis, and a second distal connecting portion.

[0037] The articulated end effector includes a blade holder link articulated to a support link having a body, the body integrally including a blade holder link attachment root having a pulley portion formed by one or more convex ruled surfaces of the blade holder root having parallel generatrices, and a reaction portion.

[0038] The articulated end effector includes a blade link that rotates with the blade holder link and has a body integral with the blade holder link and having a cutting edge and a drag counter portion that is engaged with the drag portion of the blade holder link;

[0039] The articulated end effector includes a reaction link having a body integral with a mounting root having a pulley portion formed by one or more convex ruled surfaces of the reaction link root having parallel generatrices, the reaction link being articulated to the support link and the group formed by the blade link and the blade holder link.

[0040] According to one aspect of the invention, the blade holder attachment root and the reaction link attachment root, together with the second distal connection of the support link, define a distal rotation joint for the blade holder link, the reaction link and the support link, thereby allowing the blade holder link, the reaction link and the support link to rotate relatively about a distal common axis of rotation that is orthogonal to the proximal common axis of rotation.

[0041] According to one aspect of the invention, an opposing blade is included which rotates integrally with the mounting base of the reaction link.

[0042] The surgical cutting instrument further comprises a first antagonistic tendon pair extending along a rod and connected to a blade holder link for moving a blade link about the distal common axis of rotation, and a second antagonistic tendon pair extending along a rod and connected to the reaction link for moving an opposing blade about the distal common axis of rotation, and a mounting root of the blade holder link integrally includes at least a first terminal seat for receiving the first antagonistic tendon pair, and a mounting root of the reaction link integrally includes at least a second terminal seat for receiving the second antagonistic tendon pair.

[0043] According to one aspect of the present invention, the one or more convex ruled surfaces with parallel generatrix of the connection links are parallel to the proximal common axis of rotation, at least one of the one or more convex ruled surfaces with parallel generatrix of the support links is parallel to the proximal common axis of rotation, the one or more convex ruled surfaces of the blade holder root part with parallel generatrix of the blade holder link and the one or more convex ruled surfaces with parallel generatrix of the reaction link are parallel to the distal common axis of rotation, and a first antagonistic tendon pair and a second antagonistic tendon pair are adapted to slide longitudinally on the one or more convex ruled surfaces of the connection links and on the one or more convex ruled surfaces of the support links, and are adapted to wrap / unwrap without sliding on the respective convex ruled surfaces of the blade holder link or the root part of the reaction link to open / close the blade link and the opposing blade, respectively.

[0044] Preferably, the cutting edge of the blade link is adapted to abut said opposing blade during movement in the open / close degree of freedom in a mechanical interference contact state to perform a cutting action, and the cutting edge of the blade link is elastically flexible in a direction parallel to the distal common axis of rotation.

[0045] A first distance in a direction parallel to the distal common axis of rotation can be identified between a first terminal seat of the blade holder link root and one or more of the convex ruled surfaces of the support link, the distance being constant in any cutting condition.

[0046] A second distance in a direction parallel to the distal common axis of rotation can be detected between the second root termination seat of the further link and one or more of the convex ruled surfaces of the support link, this distance being constant in any cutting condition.

[0047] According to one embodiment, the blade holder link includes a first cantilever drag leg extending from a blade holder link root, the first cantilever drag leg forming a free end of the first leg and axially delimiting the first termination seat. The reaction link includes a second cantilever drag leg extending from a reaction link root, the second cantilever drag leg forming a free end of the second leg and axially delimiting the second termination seat. The first cantilever drag leg and the second cantilever drag leg each include an abutment wall and a reaction wall that are undercut relative to the respective termination seats and act as reaction abutments for the respective tendon terminations. In such a case, it may be possible to identify that a first axial distance between a first cantilever drag leg of a blade holder link and, for example, one or more of the convex ruled surfaces of a support link is constant in any cutting state, and a second distance in a direction parallel to the distal common axis of rotation between a second cantilever drag leg and one or more of the convex ruled surfaces of a support link is constant in any cutting state.

[0048] The first distance and the second distance may be equal to each other.

[0049] The first distance and / or the second distance may be zero.

[0050] The mounting root of the blade holder link can have a first axially outward facing surface and the root of the reaction link can have a second axially outward facing surface, and a further axial distance can be detected between the first mounting root surface of the blade holder link and the second mounting root surface of the reaction link, which distance is constant in any disconnection condition.

[0051] According to one embodiment, the blade holder link integrally comprises a first cantilever drag leg forming a free end of the first leg and extending from the blade holder link root and axially defining said first terminal seat, and the reaction link integrally comprises a second cantilever drag leg forming a free end of the second leg and extending from the reaction link root and axially defining said second terminal seat, the first cantilever drag leg and the second cantilever drag leg each comprising an abutment wall and a reaction wall acting as a reaction abutment for the respective tendon terminus and arranged undercut relative to the respective terminal seat. In such a case, it may be possible to identify that a first axial distance between a first cantilever drag leg of a blade holder link and, for example, one or more of the convex ruled surfaces of a support link is constant in any cut state, and a second distance in a direction parallel to the distal common axis of rotation between a second cantilever drag leg and one or more of the convex ruled surfaces of a support link is constant in any cut state.

[0052] According to one embodiment, when in operation, the total sliding friction force exchanged between each tendon and all the ruled surfaces of the links on which it slides is much smaller than the tensile force transmitted by the same tendon to achieve the elastic bending deformation of the blade of the blade link when the open / close degree of freedom moves in the closing direction to perform the cutting action. In other words, said sliding friction force of the tendon can be much smaller than the mechanical interference contact friction force between the blade link and the opposing blade. For this purpose, the tendons can be made of a polymer material and the links can be made of a metallic material, and the convex ruled surfaces with parallel generatrices of the links are smooth, which can reduce the longitudinal sliding friction of the tendons on the links. For example, the ruled surfaces of the links are obtained by wire electroerosion.

[0053] The distal rotary joint may be an axially rigid rotary joint. Preferably, no elastic element is included in the coupling, but the elasticity is provided distal to the rotary joint, i.e. in the blade.

[0054] Preferably, the convex ruled surfaces of the connecting links, the support links, the pulley portions of the blade holder links and the pulley portions of the reaction links are all free of longitudinal channels, so that the actuating tendons do not slide within the concave channels.

[0055] A third antagonistic tendon pair may be provided for moving the supporting link about said proximal common axis of rotation relative to the connecting link, the supporting link comprising at least a third end seat for receiving a tendon end of said third antagonistic tendon pair. Preferably, the working tendons of the supporting links of said third antagonistic tendon pair wind / unwind on said one or more convex ruled surfaces of the supporting links without longitudinal sliding, so that the convex ruled surfaces act as pulley surfaces for the working tendons of the third antagonistic tendon pair.

[0056] In accordance with one aspect of the present invention, a method of cutting a surgical instrument includes providing an articulated end effector articulated at a distal end of a rod, the articulated end effector comprising a connecting link and a support link articulated to one another at a proximal rotary joint, the support link articulated at a distal rotary joint with a blade link having a cutting edge, a blade holder link rotating integrally with the blade link, and a reaction link having an opposing blade.

[0057] The method further includes the steps of sliding actuating tendons of at least one pair of antagonistic tendon pairs longitudinally on one or more convex ruled surfaces having parallel generatrix of at least one of the connecting link and the supporting link to orient the cutting edge of the blade link in a desired orientation, and sliding actuating tendons of at least one pair of antagonistic tendon pairs of the distal rotating joint longitudinally on one or more convex ruled surfaces having parallel generatrix of the connecting link and the supporting link to bring the cutting edge into contact with the opposing blade.

[0058] The method further includes the step of resiliently bending at least one of the cutting edge and the opposing blade to create mechanical interference contact therebetween to effect the cutting action.

[0059] The step of sliding the working tendons of at least one antagonistic tendon pair of the distal rotating joint longitudinally on a convex ruled surface having parallel generatrices of the connecting link and the supporting link can include winding at least one working tendon of the distal rotating joint on the convex ruled surface on which it slides with a wrap angle of 60° to 300°, preferably greater than 120°.

[0060] According to one aspect of the present invention, a rotary joint of a cutting joint having a rotation axis actuated by an actuating tendon includes a distal connection portion of a support link, a mounting root portion of a blade link having an axially elastically bendable body, a mounting root portion of a blade holder link rotating together with the blade link, and a mounting root portion of a reaction link rotating together with an opposing blade, wherein a cutting edge of the blade link is adapted to abut against said opposing blade during movement of an open / close degree of freedom in a mechanical interference contact state to perform a cutting action.

[0061] The root of the blade holder link integrally comprises at least a first end seat for a first antagonistic tendon pair and the root of the reaction link integrally comprises at least a second end seat for a second antagonistic tendon pair.The support link integrally comprises one or more convex ruled surfaces having parallel generatrices over which the tendons of the first and second antagonistic tendon pairs slide during a cutting action.

[0062] The rotary joint is configured such that a first distance in a direction parallel to the distal common axis of rotation between a first terminal seat of a blade holder link root and one or more of the convex ruled surfaces of a support link is constant in any cut state, and a second distance in a direction parallel to the distal common axis of rotation between a second terminal seat of a reaction link root and one or more of the convex ruled surfaces of a support link is constant in any cut state, and is axially stiff.

[0063] Thanks to the proposed solution, an extreme and substantial miniaturization of the articulated end effector is possible. For example, a wrist can be reproduced without pulleys, which have a very small radius and are replaced by textured surfaces in one piece with links. Thus, the known metal tendons can be replaced by miniaturized polymer tendons that, due to their low friction, slide on a textured surface that defines their movements.

[0064] It is possible to create a minimal size surgical cutting instrument with a simplified opening / closing and cutting mechanism, which includes a resilient blade (and preferably a curved opposing blade) instead of a regulating dowel and / or a Belleville spring train, whose interference closure induces deformation and performs the cutting action.

[0065] Components that are relatively bulky and / or difficult to assemble as the scale goes down (pulleys rotatably connected to keyed pulleys or links, Belleville-type springs on distal articulating pins, metal actuated tendons) are obstacles to miniaturization with the resulting risk of unacceptable clearances. They are practically eliminated.

[0066] The mounting root having a winding surface which is a convex ruled surface for each tendon forming a pulley section without a longitudinal channel is preferably provided with a geometrical reaction element adapted to allow the connection of a further component which is a planar elastic blade, such that said geometrical element integrally guides said blade relative to the opposing blade during opening / closing movements.

[0067] Further features and advantages of the surgical instrument will become apparent from the following description of preferred embodiments, given by way of non-limiting example, with reference to the accompanying drawings (references to "one" embodiment in this disclosure do not necessarily refer to the same embodiment, but should be understood as at least one, and further, it should be noted that for purposes of brevity and reducing the total number of drawings, a given drawing may be used to show features of more than one embodiment, and not all elements of a drawing are required for a given embodiment). [Brief description of the drawings]

[0068] [Figure 1A] An axonometric view of a robotic surgical system according to one embodiment. [Figure 1B] An axonometric view of a surgical instrument according to one embodiment. [Diagram 2] FIG. 1 is an axonometric view of a portion of a needle driver / suture cutter type surgical instrument with an end effector at the distal end of a rod according to one embodiment, showing a schematic of an actuating tendon; [Diagram 3] FIG. 1 is an axonometric view of a portion of a surgical scissors-type surgical instrument with an end effector at the distal end of a rod according to one embodiment, showing a schematic of an actuating tendon; [Figure 4] FIG. 1 is an axonometric view of an end effector of a needle driver / suture cutter surgical instrument according to one embodiment, showing generally the actuating tendons; [Diagram 5] FIG. 1 is an axonometric view of an end effector of a scissor-type surgical instrument according to one embodiment, showing generally the actuating tendons; [Figure 6A] FIG. 1 is an axonometric view of a portion of an end effector of a needle driver / suture cutter surgical instrument according to one embodiment, showing the parts assembled; [Figure 6B] 1 is an axonometric view of a portion of an end effector of a needle driver / suture cutter surgical instrument according to one embodiment, showing parts in an exploded view; [Figure 7A] FIG. 1 is an axonometric view of a portion of an end effector of a surgical scissors-type surgical instrument according to one embodiment, showing the assembled parts; [Figure 7B] FIG. 1 is an axonometric view of a portion of an end effector of a surgical scissors-type surgical instrument according to one embodiment, showing parts in an exploded view; [Figure 8A] FIG. 1 is an axonometric view of a portion of an end effector of a surgical scissors-type surgical instrument according to one embodiment, showing the assembled parts; [Figure 8B] FIG. 1 is an axonometric view of a portion of an end effector of a surgical scissors-type surgical instrument according to one embodiment, showing parts in an exploded view; [Figure 9A] 1A-1D are schematic diagrams of an end effector of a surgical instrument in one of two operating configurations according to one embodiment, showing schematic actuation tendons; [Figure 9B] 1A-1D are schematic diagrams of an end effector of a surgical instrument in two operating configurations according to one embodiment, showing schematic actuation tendons; [Figure 10]FIG. 1 is a top view of one embodiment of a portion of an end effector of a surgical instrument; [Figure 11] FIG. 13 is a top view of another embodiment of a portion of an end effector of a surgical instrument; [Figure 12] FIG. 13 is a top view of a further embodiment of a portion of an end effector of a surgical instrument; [Figure 13] FIG. 1 is a top view of a distal rotation joint of an end effector of a surgical instrument according to one embodiment; [Figure 14] FIG. 13 is a top view of a distal rotation joint of an end effector of a surgical instrument according to another embodiment; [Figure 15A] FIG. 1 is a top view of a distal rotation joint of an end effector of a surgical instrument in a cutting configuration; [Figure 15B] FIG. 13 is a top view of a distal rotation joint of an end effector of a surgical instrument in an alternative cutting configuration; [Figure 16] FIG. 1 is an axonometric view of a needle driver / suture cutter surgical instrument according to one embodiment during severing of a suture; [Figure 17] FIG. 1 is a top view in exploded view of a portion of an end effector of a needle driver / suture cutter surgical instrument according to one embodiment; [Figure 18] FIG. 1 is a vertical elevation view of a blade link, according to one embodiment; [Figure 19] 18A-18C are schematic diagrams illustrating top views of the configurations assumed by blades and opposing blade surfaces of a portion of the end effector of FIG. 17 in various mechanical cutting interference configurations, according to one embodiment; [Figure 20] FIG. 18 is an axonometric view of a portion of the end effector of FIG. 17 in an exploded view. [Figure 21] FIG. 1 is a top view in exploded view of a portion of an end effector of a needle driver / suture cutter surgical instrument according to one embodiment; [Figure 22] FIG. 1 is a top view of a portion of an end effector of a needle driver / suture cutter type surgical instrument according to one embodiment; [Diagram 23] FIG. 1 is an axonometric view of a portion of an end effector of a needle driver / suture cutter type surgical instrument according to one embodiment. [Figure 24]FIG. 1 is a top view in exploded view of a portion of an end effector of a needle driver / suture cutter surgical instrument according to one embodiment; [Diagram 25] FIG. 1 is a vertical elevation view of an opposed blade link according to an embodiment; [Figure 26] FIG. 24 is an axonometric view of a portion of the end effector of FIG. 23 in an exploded view. [Figure 27] Electron microscope image showing the blade links and opposing blade links arranged on the face of a 5 euro cent coin [Figure 28] FIG. 1 is a vertical elevation view of a blade link according to an embodiment; [Figure 29] FIG. 1 is a vertical elevation view of an opposed blade link according to an embodiment; [Diagram 30] FIG. 1 is an axonometric view of an exploded view of a portion of an end effector of a surgical scissors-type surgical instrument, according to one embodiment; [Diagram 31] FIG. 1 is an axonometric view of a portion of an end effector of a surgical scissors-type surgical instrument according to one embodiment, with the open / close degree of freedom partially open; [Diagram 32] FIG. 1 is a vertical elevation view of a portion of an end effector of a surgical scissors-type surgical instrument according to one embodiment, with the open / close degree of freedom closed; [Diagram 33] FIG. 1 is a plan view in exploded view of a portion of an end effector of a surgical scissors-type surgical instrument according to one embodiment; [Diagram 34] FIG. 13 is a plan view of a link having an integral blade and termination seats for a pair of antagonistic tendons according to another embodiment; [Diagram 35] 34A-34C are schematic diagrams illustrating top views of the configurations assumed by blades and opposing blade surfaces of a portion of the end effector of FIG. 33 in various mechanical cutting interference configurations, according to one embodiment; [Diagram 36] FIG. 1 is a vertical elevation view of a blade link according to an embodiment; [Figure 37] FIG. 1 is an axonometric view of an exploded view of a portion of an end effector of a surgical scissors-type surgical instrument according to one embodiment; [Figure 38] FIG. 1 is a plan view in exploded view of a portion of an end effector of a surgical scissors-type surgical instrument according to one embodiment; [Figure 39A] 39A-39C are schematic diagrams illustrating the configurations assumed by blades and opposing blade surfaces of a portion of the end effector of FIG. 38 in various mechanical cutting interference configurations, according to one embodiment; [Figure 39B] 39A-39C are schematic diagrams illustrating the configurations assumed by blades and opposing blade surfaces of a portion of the end effector of FIG. 38 in various mechanical cutting interference configurations, according to one embodiment; [Figure 39C] 39A-39C are schematic diagrams illustrating the configurations assumed by blades and opposing blade surfaces of a portion of the end effector of FIG. 38 in various mechanical cutting interference configurations, according to one embodiment; [Diagram 40] Axonometric view of the reaction link of the end effector of Figure 38 [Figure 41A] FIG. 1 is an axonometric view of a portion of an end effector of a scissor-type surgical instrument in a closed configuration with the open / close degree of freedom, according to one embodiment; [Figure 41B] FIG. 41B is a plan view of the end effector of FIG. [Figure 41C] Axonometric view of the end effector of FIG. [Diagram 42] Electron micrograph image showing an articulating end effector of a needle driver / scissor type surgical instrument according to one embodiment [Diagram 43] An electron micrograph image of an articulating end effector of a surgical scissors-type surgical instrument according to one embodiment, with a "2.00 mm" scale shown in the bottom right of the image. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0069] References to "an embodiment" throughout this specification are meant to indicate that a particular feature, structure, or function described in connection with the embodiment is included in at least one embodiment of the invention. Thus, the appearances of "in one embodiment" in various parts of this specification do not necessarily all refer to the same embodiment. Furthermore, certain features, structures, or functions, such as those illustrated in different figures, may be combined in any suitable manner in one or more modes of operation.

[0070] According to a general embodiment, there is provided a surgical cutting instrument 1. For example, said surgical cutting instrument 1 is a scissor type surgical instrument. For example, said surgical cutting instrument 1 is a needle driver / suture cutter type instrument.

[0071] The surgical instrument 1 comprises a rod 7 or shaft 7 having a distal end 8 and an articulated end effector 9 (in other words an articulated end device 9 connected to the distal end 8 of the rod 7).

[0072] The surgical instrument 1 is particularly suited, but not uniquely intended for, robotic surgery and may be connectable to a robotic manipulator 103 with motorized actuators of a robotic surgery system 101, for example as shown in Figure 1A. For example, the surgical instrument 1 may be associated with mechanical and manual controls and actuation devices.

[0073] The robotic surgical system 101 comprising said surgical instrument 1 is particularly suited for, but not exclusively intended for, robotic microsurgical operations. The robotic surgical system 101 may be intended for robotic laparoscopic surgery.

[0074] According to a preferred embodiment, the shaft 7 is a rigid shaft, although the shaft 7 or rod 7 is not necessarily a rigid shaft, for example it may be a bendable shaft and / or an articulated shaft. For example, as shown in FIG. 1B, a proximal interface part 104 or a back end part 104 of the surgical instrument 1 can be provided at the proximal end 102 of the rod 7 to form an interface with a robotic manipulator 103 of a robotic surgery system 101. A sterile barrier can be interposed between the robotic manipulator and the proximal interface part 104 of the surgical instrument. For example, the proximal interface part 104 can comprise a set of interface transmission elements for receiving the drive movements applied by the robotic manipulator 103 and transmitting them to the articulated end effector 9. According to an embodiment, the surgical instrument 1 is detachably associated with the robotic manipulator 103 of the robotic surgery system 101.

[0075] The articulated end effector 9 at the distal end 8 of the rod 7 may comprise a number of links articulated to one another at one or more revolute joints. The links are movable within the rod 7 by pairs of antagonistic actuating tendons that extend from the proximal interface 104 to the articulated end effector 9 and terminate in termination seats on at least some of the links of the articulated end effector 9. A pair of actuating tendons of one or more of the antagonistic tendon pairs may consist of a single tendon that forms a round trip path from the proximal interface 104 of the instrument to the links of the articulated end effector of the instrument.

[0076] Preferably, the term "link" refers to a body made in a single piece, ie a monobloc body.

[0077] Not all links making up the articulated end effector 9 are necessarily articulated to one another, i.e. movable relative to one another and / or relative to the distal end 8 of the rod 7 .

[0078] For example, the end effector 9 may be a "roll-pitch-yaw" type articulated cuff, according to the terminology widely adopted in the art. For example, the end effector 9 may be a "snake" type articulated end effector 9, i.e., equipped with a number of coplanar and / or non-planar rotational joints.

[0079] The articulated end effector 9 comprises a (first) connecting link 90 connected to the distal end 8 of the rod 7, the connecting link 90 having a body integrally comprising one or more convex ruled surfaces of connecting links 97, 99 with parallel generatrix lines. The connecting link 90 further comprises an integral first distal connecting part 95. Preferably, the first distal connecting part 95 of the first connecting link 90 comprises two protrusions 91, 92 and is adapted to form a proximal rotation joint with a proximal rotation axis PP. According to a preferred embodiment, the convex ruled generatrix lines 97, 99 of the connecting link 90 are all parallel to the proximal rotation axis PP.

[0080] The connecting link 90 can be firmly fixed to the distal end 8 of the rod 7 by a fixing device 94 (in the illustrated example shown as a pair of fixing pins 94, but alternatively the fixing device 94 can comprise a pin, a rivet, a staple, one or more screw elements, a connecting profile, etc.) and has two protrusions 91, 92 forming distal connection parts 91, 92, forming a proximal rotation joint 509 or pitch rotation joint 509 having a proximal common rotation axis PP or pitch axis PP.

[0081] The articulated end effector 9 comprises a (second) support link 2 articulated to a first connecting link 90 and having a body integral with one or more convex ruled surfaces of support links 96, 98 having parallel generatrices.

[0082] The support link 2 further integrally comprises a proximal connection portion 13 articulated to the first distal connection portion 95 of the first connecting link 90 and defining a proximal rotation joint 509 for the connecting link 90 and the support link 2, whereby the connecting link 90 and the support link 2 can rotate relative to each other about a proximal common rotation axis PP.

[0083] The support link 2 further comprises an integral second distal connection part 17. The distal connection part 17 of the support link 2 preferably comprises a support structure with two protrusions 3, 4, for example, for defining a distal rotation axis YY, i.e. for forming a distal rotation joint 502 or a yaw rotation joint 502 having a distal common rotation axis YY or a yaw axis YY that can be perpendicular to the pitch proximal rotation axis PP.

[0084] The support structure of the support link 2 is preferably a rigid support structure, i.e. for example a rigid support fork, and the relative positions of the projections 3, 4 are rigidly determined, as are the relative positions of the projections 3, 4 and the ruled surfaces 96, 98. According to one embodiment, the distal rotation axis YY is the yaw rotation axis YY and the proximal rotation axis PP is the pitch rotation axis PP, the yaw rotation axis YY and the pitch rotation axis PP being mutually orthogonal. The connection link 2 with the proximal connection part 13 and the distal connection part 17 thereby integrally defines two revolute joints 509, 502 with mutually orthogonal rotation axes PP, YY.

[0085] The articulated end effector 9 further comprises a (third) blade holder link 50 articulated to the support link 2. The (third) blade holder link 50 has a body integral with a mounting root of the blade holder link 51 having a pulley portion 79 formed by one or more convex ruled surfaces 79 of the blade holder root having parallel generatrices. The blade holder link 50 also comprises a proximal mounting root 51 articulated to said distal rotation joint 502.

[0086] Preferably, the articulated end effector 9 further comprises a (fourth) blade link 30 which rotates together with said blade holder link 50 and has a body with an integral cutting edge 34. The cutting edge 34 is adapted to perform a cutting action. The blade link 30 comprises an integral proximal mounting root 31 which is articulated to said distal rotation joint 502. The blade link 30 preferably comprises an integral mounting root 31 which is arranged adjacent to the root 51 of the blade holder link 50, preferably the root 31 of the blade link 30 is adjacent and in direct close contact with the root 51 of the blade holder link 50.

[0087] The body of the blade holder link 50 further comprises an integral reaction part 57, and the body of the blade holder link 30 further comprises an integral reaction part 37 which engages with said reaction part of the blade holder link 50. The reaction engagement can be obtained by the engagement of the blade link 30 with the blade holder link 50. The reaction engagement between the blade link 30 and the blade holder link 50 can be located distally with respect to the common rotation axis YY, i.e. distally with respect to the mounting roots 31 and 51. In such a case, the reaction part 37 (or the reaction part 37) of the blade link 30 can be located at the blade link root 31 to achieve a more favorable mechanical transmission, but it is preferable to locate it far away from the blade link root 31 to ensure a correct reaction.

[0088] The articulated end effector 9 further comprises a (fifth) further reaction link 20 articulated to the support link 2, and the blade holder link 50 has a body integral with a further mounting root portion 21 of the reaction link 20 having a pulley portion 80 having one or more convex ruled surfaces 80 with parallel generatrices.

[0089] The group formed by the support link 2, the blade holder link 50 and the blade link 30, and the second tip are articulated to one another at said common axis of rotation YY, defining an axial direction coincident with or parallel to said common axis of rotation YY. In other words, the distal connection 17 of the support link 2 is articulated to the group formed by the root 51 of the blade holder link 50 and the root 31 of the blade link 30, and the root 21 of the fifth further reaction link 20, at said distal common axis of rotation YY. Preferably, for clarity of presentation, an axial direction coincident with or parallel to the direction of the common axis of rotation YY is defined.

[0090] Preferably, for clarity of presentation, for the blade link 30 and / or the blade holder link 50, an inner axial direction is further defined which faces said fifth further reaction link 20 along the axial direction, and similarly, for the second tip 20, said inner axial direction is opposite, i.e. facing the blade link 30 and / or the blade holder link 50.

[0091] The proximal and distal directions (or senses) are understood to refer according to the common meaning of the terms, as indicated by the arrows in FIG. 1B.

[0092] Preferably, for clarity of presentation, the term "radial" refers to a direction substantially perpendicular to and incident on the common axis of rotation YY.

[0093] Preferably, for clarity of presentation, this also means a longitudinal direction that may substantially coincide overall with the longitudinal extension of the surgical instrument 1, as well as a longitudinal direction that may locally coincide with the longitudinal extension of the elongated body of the blade link 30 and / or the blade holder link 50 and / or the reaction link 20.

[0094] The group formed by the root portion 21 of the further fifth reaction link 20, the root portion 51 of the blade holder link 50 and the root portion 31 of the blade link 30 is articulated to the distal portion 17 of the support link 2 about said common axis of rotation YY, which defines a degree of freedom in the yaw Y direction. The common axis of rotation YY (or a linear extension thereof) thus intersects said two lugs 3, 4 and said root portions 21, 31, 51 and can be defined by an articulation pin 5.

[0095] Furthermore, the root portion 21 of the further fifth reaction link 20 is articulated to the group formed by the root portion 51 of the blade holder link 50 and the root portion 31 of the blade link 30 about said common rotation axis YY to define a relative opening / closing degree of freedom G for performing a cutting action (or cutting degree of freedom G, or gripping degree of freedom G in the widely adopted terminology, although actuation of this degree of freedom does not necessarily result in a gripping action).

[0096] A further advantage includes the inclusion of an opposing blade 24 which rotates integrally with said mounting root 21 of the reaction link 20. Thus, the reaction link 20 rotates integrally with the opposing blade 24. Although the reaction link 20 is not necessarily integral with the opposing blade 24, according to a preferred embodiment, the reaction link 20 includes the mounting root 21 and the opposing blade 24 integrally.

[0097] The surgical cutting instrument 1 further comprises a first antagonistic tendon pair 71, 72 extending along the shaft 7 and connected to the blade holder link 50 for moving the blade link 30 about said distal common axis of rotation YY. The mounting root 51 of the blade holder link 50 integrally comprises at least a first terminal seat 15 for receiving said first antagonistic tendon pair 71, 72.

[0098] The surgical cutting instrument 1 further comprises a second antagonistic tendon pair 73, 74 extending along the shaft 7 and connected to said further reaction link 20 for moving the opposing blade 24 about the yaw axis YY of said common axis of rotation. The mounting root 21 of the reaction link 20 integrally comprises at least a second terminal seat 25 for receiving said second antagonistic tendon pair 73, 74.

[0099] Each tendon has a main longitudinal extension and is adapted to act in tension only.

[0100] Each tendon is preferably in contact with the links 90, 2, 20, 30, 50 of the articulating end effector 9 only on said convex ruled surfaces 79, 80, 96, 97, 98, 99 of at least a portion of the connecting link 90, the support link 2, the blade holder link 50 (particularly the root portion 51 of the blade holder link 50), and the reaction link 20 (particularly the root portion 21 of the reaction link 20). Preferably, the actuating tendons avoid contact with the blade link 30, which is dragged in rotation by the blade holder link 50.

[0101] Preferably, the one or more convex ruled surfaces 97, 99 with parallel generatrix of the connecting link 90 are parallel to the proximal common axis of rotation PP and at least one of the one or more convex ruled surfaces 96, 98 with parallel generatrix of the support link 2 is parallel to the proximal common axis of rotation PP. Furthermore, the one or more convex ruled surfaces 79 of the blade holder root part 51 with parallel generatrix of the blade holder link 50 and the one or more convex ruled surfaces 80 of the pulley part of the further root part 21 with parallel generatrix of the further reaction link 20 are parallel to the distal common axis of rotation YY.

[0102] As a further advantage, the first antagonistic tendon pair 71, 72 and the second antagonistic tendon pair 73, 74 are adapted to slide longitudinally over one or more of said convex ruled surfaces 97, 99 of the connecting link 90 and one or more of said convex ruled surfaces 96, 98 of the supporting link 2, and are adapted to wind / unwind without longitudinal sliding over the respective convex ruled surfaces of the blade holder link 50 or the root portion 79 or 80 of the further reaction link 20 to open / close the blade link 30 and the opposing blade 24, respectively.

[0103] As shown diagrammatically in Figures 9A and 9B, the actuating tendons 71, 72, 73, 74 of the antagonistic tendon pair are adapted to actuate the distal revolute joint 502 of the end effector 9 and to slide longitudinally on one or more convex ruled surfaces 97, 99 of the connecting link 90 and to slide longitudinally on one or more convex ruled surfaces 96, 98 of the supporting link 2. In other words, the sliding of the actuating tendons on the ruled surfaces results in the longitudinal extension of the tendons themselves 71, 72, 73, 74. The path of each tendon 71, 72, 73, 74 is stationary with respect to the convex ruled surfaces they slide on, i.e., each tendon slides longitudinally but not axially, and the longitudinal extension of each tendon does not change in any operating state. In addition, preferably, the operating tendons 71, 72, 73, 74 of the antagonistic tendon pair adapted to operate the distal rotation joint 502 of the end effector 9 include tendons 71, 72 of a first antagonistic tendon pair terminating on the root portion 51 of the blade holder link 50 and tendons 73, 74 of a second antagonistic tendon pair terminating on the root portion 21 of the reaction link 20, wherein the tendons 71, 72 of the first antagonistic tendon pair wind without longitudinal sliding on a pulley surface 79 formed by one or more convex ruled surfaces 79 having a generator parallel to the distal rotation axis YY, and the tendons 73, 74 of the second antagonistic tendon pair wind without longitudinal sliding on a pulley surface 80 formed by one or more convex ruled surfaces 80 having a generator parallel to the distal rotation axis YY.

[0104] On the other hand, the convex ruled surfaces 97, 99 of the connecting link 90 and the convex ruled surfaces 96, 98 of the supporting link 2 do not include guide channels or grooves for holding the tendons in the guide grooves. The geometric relationship between the end seats 15, 25 of the tendons 71, 72, 73, 74 and the ruled surfaces 79, 80, 96, 97, 98, 99 along which the working tendons of the distal revolute joint 502 slide longitudinally without sliding or wrap around without sliding favors the constancy of the path of each tendon, even in the absence of guide channels or grooves in the body of the end effector links. Moreover, the absence of guide channels or grooves for guiding the tendons allows the contact surface between the cross section of each tendon and the convex ruled surface along which it slides to be kept to a minimum, while keeping the sliding friction to a minimum.

[0105] According to one embodiment, as shown diagrammatically in Figures 9A and 9B, the antagonistic actuating tendons 75, 76 adapted to actuate the proximal revolute joint 509 of the articulated end effector 9 terminate on the support link 2 and do not slide longitudinally relative to it, i.e. do not slide longitudinally on one or more of said ruled surfaces 96, 98 of the support link 2, but wrap around it without sliding, while sliding longitudinally on one or more of said ruled surfaces 97, 98 of the link 90 to actuate the proximal revolute joint PP. Preferably, the body of the support link 2 integrally comprises at least a third terminal seat 6 for receiving a third antagonistic actuating tendon pair 75, 76, as described below.

[0106] Thus, the longitudinal extension of the tendon is locally perpendicular to the line that creates the ruled surface with which the tendon is locally in contact.

[0107] As previously mentioned, the distal rotation joint 502 can effect the cutting action.

[0108] According to an alternative embodiment, for example as shown in FIG. 41, the cutting action is performed by a blade 14 acting as a hammer abutting an opposing blade acting as an anvil.

[0109] The cutting edge 34 of the blade link 30 is adapted to abut the opposing blade 24 which rotates together with the reaction link 20 during open / close degree of freedom G movement under mechanical interference contact to provide a cutting action.

[0110] Preferably, the cutting edge 34 of the blade link 30 is elastically bendable in a direction parallel to the distal common axis of rotation YY. The blade 14, which rotates together with the first end seat 15 for the first antagonistic tendon pair 71, 72, is elastically bendable in the axial direction, said opposing blade 24 being adapted to abut said cutting edge 34 and elastically bend the body of the blade link 30 in the axial direction. The blade 14 is part of the body of the blade link 30 which integrally comprises said cutting edge 34, i.e. the cutting edge 34 is included in the blade 14.

[0111] Thereby, the axial elasticity for obtaining the cutting action is at least partly provided by the elasticity of the blade 14, whereas the distal rotation joint 502 to which the root 31 of the blade link 30 is articulated is axially rigid, i.e. not elastically loaded, since relative displacement between the distal connection 17 of the support link 2 and the roots 21, 31, 51 of the reaction links, and between the blade and the blade holder link on the distal rotation axis YY, is avoided.

[0112] Thus, the cutting edge 34 of the blade 14 of the blade link 30 and the opposing blade 24 which rotates together with the reaction link 20 reach a mechanical interference contact to effect a cutting action.

[0113] The mechanical interference contact between the cutting edge 34 and the opposing blade 24 which rotates together with the reaction link 20 provides a cutting action while simultaneously bending the body of the blade link 30. The bending deformation of the blade 14 of the body of the blade link 30 during the cutting action is axially directed, i.e. substantially parallel to the common axis of rotation YY.

[0114] The opposing blade 24 preferably includes an axially inwardly facing surface adapted to form a mechanical interference contact abutment with the cutting edge 34 of the blade link 30 to axially bend the blade 14 of the blade link 30. And, the reaction link 20 provides an axial reaction to the elastic bending of the blade link 30 during the cutting operation. The body of the reaction link 20 may be elastically deformable.

[0115] The deformed configuration of the blade 14 when the blade link 30 and reaction link 20 are in a substantially closed configuration is maximally bent and, in any case, more bent than the configuration of the blade 14 when the blade link 30 and reaction link 20 are in a partially closed and partially open configuration. Preferably, but not necessarily, when the opening angle is maximally open and the blade 14 is free, the cutting edge 34 is straight and the blade link body 30 has a substantially flat configuration at least at that blade 14.

[0116] At least one contact point POC between the cutting edge 34 and the opposing blade 24 preferably changes position and / or size as a function of the opening angle of the open / close degree of freedom G, and preferably tends to move distally as the opening angle decreases, thereby enhancing bending due to elastic deformation of the body of the blade link 30.

[0117] "Point of contact POC" preferably means the distal most portion of the contact area between the cutting edge 34 and the opposing blade 24, although the contact area may be similar in some configurations of the embodiment.

[0118] The elastically deformable bent cutting edge 34 can be sharp, i.e. it can be subjected to sharpening so as to have a locally reduced thickness compared to the thickness of the body of the blade 14 and / or a sharp shape in its cross section. For example, the cross section of the blade link 30 has a pointed shape in which at the cutting edge 34 the faces of the blade 14 of the blade link form an angle with each other in the range of 30°-60°. Preferably, the cutting edge 34 is sharpened so as to be flush with the axially facing blade surface 35 of the blade 14 of the blade link 30 arranged axially facing the opposing blade 24. In other words, the blade 14 of the blade link body 30 comprises an axially inwardly facing blade surface 35, said cutting edge 34 forming the edge of the blade surface 35.

[0119] During a cutting operation, the blade surface 35 of the blade link 30 can come into contact, at least in part, with the opposing blade 24 which rotates integrally with the reaction link 20, exchanging frictional forces substantially directed in the opening / closing direction G.

[0120] Preferably, when in operation, the total sliding friction force exchanged between each tendon and all the ruled surfaces of the links on which it slides is much smaller (e.g., one to three orders of magnitude smaller) than the tensile force required in the tendon to achieve an elastic bending deformation of the blade 14 of the blade link 30 when the open / close degree of freedom G moves in the closing direction to perform a cutting action. That is, the sliding friction force of the tendon is much lower than the mechanical interference contact friction force between the blade link 30 and the opposing blade 24. For this purpose, the tendons can be made of a polymer material and the links can be made of a metallic material, and the convex ruled surfaces with parallel generatrices of the links are smooth, which can reduce the longitudinal sliding friction of the tendons on the links. For example, the ruled surfaces of the links are obtained by wire electroerosion.

[0121] According to one embodiment, said opposing blade 24, which rotates together with the reaction link 20, comprises a curved protruding surface having a concave surface facing axially inwards, whereby the protrusion of the opposing blade 24 is obtained by its curvature having a concave surface facing axially inwards.

[0122] According to one embodiment, the opposing blade 24, which rotates together with the reaction link 20, protrudes towards the rotation footprint of the blade link 30 so as to elastically bend the body of the blade link 30 when the opposing blade 24 is in mechanical interference contact with the cutting edge 34. In other words, the opposing blade 24 protrudes axially inwards. According to one embodiment, said protrusion of the opposing blade 24 is accentuated towards the distal direction along the longitudinal extension of the reaction link 20, i.e. away from the common axis of rotation YY, and preferably said protrusion is maximum near or at the distal end 32 of the body of the blade link 30.

[0123] Preferably, the term "close rotational footprint" is meant to indicate the volume of space that can be occupied by the body of the element during a relative rotational movement in the closing direction of the gripping degree of freedom G.

[0124] The blade surface 35 is not necessarily a flat portion, i.e. not necessarily lying on a plane, but may be a curved or arched portion, but according to one embodiment is a flat portion.

[0125] According to one embodiment, the body of the blade link 30 has a two-dimensional main extension, i.e., a thickness that is substantially reduced relative to the extension on said preferably flat or arched lying surface, said main extension being disposed on said flat or arched lying surface.

[0126] According to one embodiment, the cutting edge 34 is substantially straight, preferably with a flat or arcuate lying surface, to avoid providing a concave surface in the lying surface of the body of the blade link 30 .

[0127] Preferably, the thickness of the blade link 30 is significantly smaller than the thickness of the mounting root 51 of the blade holder link 50 and the mounting root 21 of the reaction link 20, and is selected so that the blade 14 of the body of the blade link 30 is elastically bendable in a direction transverse to the longitudinal extension of the cutting edge 34, in particular in the direction of the thickness of the blade link 30, when in the operating state. In particular, the body of the blade link 30 is preferably more bendable than the body of the reaction link 20 and is preferably more flexible than the body of the opposing blade 24. The flexibility of the blade link 30, and therefore the flexibility of the cutting edge 34, is intended to be in the direction of its thickness, i.e. in a direction perpendicular to the lying surface, whether the blade link 30 is flat or arched. For example, the blade link 30 has an arched, i.e. concave, shape with a concave surface facing out of / into the lying surface, in such a case the lying surface of the body of the blade link 30 is an arched surface, similar to the blade surface 35.

[0128] It is not necessarily the case that the blade link 30, and therefore the cutting edge 34, is elastically deformable at the overlying surface, i.e., bending capability perpendicular to its thickness is not necessarily included.

[0129] The ratio between the thickness of the body of the blade link 30 at the height of the blade 14 (excluding in this assessment the thickness of the cutting edge 34, which is preferably sharp as described above) and the thickness of the root portion 51 of the link 50 and / or the thickness of the second root portion 21 of the reaction link 20 may be between 1 / 5 and 1 / 20. In absolute values, the thickness of the blade link 30 may be between 0.1 mm and 0.5 mm, and according to one embodiment the thickness of the blade link 30 is substantially equal to 0.2 mm.

[0130] As mentioned above, the blade link 30 rotates together with the blade holder link 50. This causes the cutting edge 34 to rotate together with the body of the blade holder link 50 and / or the distal free end, which may be formed by the body of the blade link 30. If the free end is formed by the body of the blade link 30, it may coincide with the distal end 32 of the blade link 30. Being elastically flexible, the cutting edge 34 can be elastically deformed with respect to the blade holder link 50, with which it is integral in rotation, when in an operating state. The elastic deformation of the cutting edge 34 preferably occurs transversely to the longitudinal extension of the body of the blade holder link 50, i.e., transversely to the direction connecting the proximal mounting root 51 and the free end, which rotates together with the cutting edge 34, in other words, in the thickness direction of the body of the blade link 30.

[0131] According to one embodiment, the blade link 30 is substantially flat when in an undeformed configuration, i.e. when lying on a definable lying surface. Elastic bending of the blade link 30 tends to return the blade 14 to said undeformed planar configuration. The axially inwardly facing blade surface 35 is therefore parallel to the axially facing inner contact surface 83 of the root portion 51 of the blade holder link 50, and preferably can also be aligned, for example seamlessly. Preferably, the cutting edge 34 is straight when in the undeformed state, i.e. extends substantially linearly as a preferably straight extension parallel to the axially facing inner contact surface 83 of the root portion 51 of the link 50. In other words, according to one embodiment, the cutting edge 34 extends parallel to the definable lying surface of the blade link 30.

[0132] The cutting edge 34 can be aligned with the longitudinal extension XX of the rod 7 in at least one operating configuration, for example, when the shaft 7 is a straight, rigid shaft and the cutting edge 34 is not in contact with the protruding portion of the opposing blade 24.

[0133] According to one embodiment, said opposing blade 24 can project laterally, preferably perpendicularly, to the longitudinal extension of the reaction link body 20 and can project laterally, preferably perpendicularly, to the common axis of rotation YY. It should be noted that the opposing blade 24 can be inclined even in the projected state.

[0134] According to one embodiment, said counter blade 24 has a curved surface, which makes it protrude due to its arch shape. The concave surface of the counter blade 24 preferably faces axially and inwardly, i.e. in a direction parallel to the common axis of rotation YY, facing the rotation footprint of the cutting edge 34.

[0135] The opposing blade 24 can act as a wedge to appropriately bend the cutting edge 34 and the body of the blade link 30 to provide a cutting action substantially along the entire longitudinal extension of the opposing blade 24 .

[0136] The mounting root 31 of the blade link 30 in the operating state does not bend elastically in the operating state, for example because the mounting root 31 of the blade link 30 is firmly interposed axially between the projections 3, 4 of the support link 2 and has opposing contact surfaces 81, 82 in direct and intimate contact with respective axially inwardly facing opposing contact surfaces of other links, for example the contact surface 83 of the root 51 of the blade holder link 50 and the opposite contact surface 84 of the root 21 of the reaction link 20. During the movement of the opening / closing degree of freedom G, there is direct and intimate contact between the axially inwardly facing contact surface 84 of the root 21 of the reaction link 20 and the contact surface 82 of the root 31 of the blade link 30, resulting in relative sliding. According to a preferred embodiment, the mounting root 31 of the blade link 30 is interposed axially between the root 51 of the blade holder link 50 and the root 21 of the reaction link 20. Preferably, the contact surface 82 of the root portion 31 of the blade link 30 is axially aligned with the blade surface 35 and is joined seamlessly thereto. And the protrusions 3, 4 of the distal connection portion 17 of the support link 2 are provided with opposing axially inwardly facing contact surfaces 87, 88 which are in direct contact with axially outwardly facing surfaces 85, 86. Preferably, said axially outwardly facing surfaces 85, 86 belong to the blade holder link 50 and the reaction link 20. If a further opposing blade link 40 is included, as explained below, it may for example comprise its root portion 41 having two opposing contact surfaces of the opposing blade link, which for example are in direct contact with the contact surface 82 of the blade link 30 and the axially inwardly facing contact surface of the reaction link 20.

[0137] Such a pack arrangement of the root portions 21, 31, 51 between the projections 3, 4 of the distal connection portion 17 of the support link 2 forms an axially rigid rotational joint Y, i.e. relative displacement between the root portions 21, 31, 51 of the reaction links 20, 30, 50 in the direction of the common rotation axis YY is avoided.

[0138] During the cutting operation, resilience is provided at least in part by the resilient flexibility of the body of the blade link 30 at the blade 14 distal to the attachment root 31 of the blade link 30 .

[0139] The axial distance Y5 in a direction parallel to the distal common axis of rotation YY between the first end seat 15 of the root portion 51 of the blade holder link 50 and the surface 96 of one or more of the convex ruled surfaces 96, 98 of the support link 2 is constant in any cutting state.

[0140] Similarly, the axial distance Y5' in a direction parallel to the distal common axis of rotation YY between the second end seat 25 of the root portion 21 of the further reaction link 20 and the surface 98 of one or more of the convex ruled surfaces 96, 98 of the support link 2 is constant in any cutting state.

[0141] That is, as the opening angle of the open / close degree of freedom G changes, the axial distances Y5, Y5' between the convex ruled surfaces 96, 98 of the support link 2 and the terminal seats 15, 25 of the tendons 71, 72, 73, 74 of the first antagonistic tendon pair or the second antagonistic tendon pair are maintained the same.

[0142] According to one embodiment, the first distance Y5 is 0, i.e. the end seat 15 is longitudinally aligned with the convex ruled surface 96 of the support link 2. In such a case, the actuating tendons 71, 72 of the blade holder link 50 can have their respective distal paths parallel to each other. Similarly, according to one embodiment, the second distance Y5' is 0, i.e. the end seat 25 is longitudinally aligned with the convex ruled surface 98 of the support link 2. In such a case, the actuating tendons 73, 74 of the reaction link 20 can have their respective distal paths parallel to each other.

[0143] Such or other axial distances can be evaluated between different points of the articulated end effector 9, since the axial distances Y5, Y5' remain unchanged in any cutting state, i.e. no sliding of the distal rotation axis YY along the articulation pin 5 is provided. According to one embodiment, the mounting root 51 of the blade holder link 50 comprises a first surface 85 facing axially outward and the further root 21 of the further reaction link 20 comprises a second surface 86 facing axially outward, such that the axial distance Y8 between said first surface 85 of the mounting root 51 of the blade holder link 50 and said second surface 86 of the further mounting root 21 of the reaction link 20 is constant in any cutting state. The surfaces 85, 86 can be flat surfaces perpendicular to the distal rotation axis YY.

[0144] According to a preferred embodiment, the axial distance Y5 between the first end seat 15 of the root portion 51 of the blade holder link 50 and the surface 96 of one or more of said convex ruled surfaces 96, 98 of the support link 2 is equal to the axial distance Y5' between the second end seat 25 of the root portion 21 of the further reaction link 20 and the surface 98 of one or more of said convex ruled surfaces 96, 98 of the support link 2.

[0145] Thus, axial sliding between the roots and between the roots and the protrusions along the articulation pin 5 is avoided, and the tendons 71, 72, 73, 74 of the first or second antagonistic tendon pair slide longitudinally to actuate the opening / closing degree of freedom G. That is, the geometric relationship between the ruled surfaces 96, 98 of the support link 2 performing the cutting action and the terminal seats 15, 25 of the respective tendons made integral with the root 51 of the blade holder link 50 or the root 21 of the reaction link 20, respectively, is maintained, thereby making it possible to avoid hindering the relative rotation between the multiple links around the distal common rotation axis YY.

[0146] In the direction parallel to the axis of rotation, the tendons do not slide against their respective ruled surfaces.

[0147] A cutting joint rigid axial rotation joint 502 is thus formed. A blade having a cutting edge 34 and an opposing blade 24 are provided which rotate together with the axial rigid rotation joint 502 to jointly perform cutting action during closing movement of the open / close degree of freedom.

[0148] It is thus possible to avoid the provision of a Belleville type elastic element attached to the articulation pin 5 or otherwise interposed between the projections 3, 4 of the distal portion 17 of the support link 2. Furthermore, it is also avoided to provide an adjusting screw adapted to clamp the roots together axially.

[0149] The axially rigid distal rotation joint 502 also allows the cutting edge 34 to be oriented by rotating it about the yaw YY axis of rotation, allowing controlled adjustment of the cutting direction.

[0150] Such a distal revolute joint 502 is also axially rigid with respect to any orientation of the yaw Y degree of freedom, i.e. any movement of the assembly formed by the blade holder link 50, the blade link 30 and the reaction link 20 relative to the distal portion 17 of the support link 2, as well as with respect to any orientation of the pitch P degree of freedom of the proximal revolute joint 509, i.e. any movement of the assembly formed by the support link 2, the blade holder link 50, the blade link 30 and the reaction link 20 relative to the connecting link 90 to the shaft. Preferably, the connecting link 90 to the shaft is rigidly fixed to the distal end 8 of the rod 7, for example by a pair of pins 94, in which case the pitch P degree of freedom can be understood as the orientation of the support link 2 relative to the shaft 7, especially in case the shaft 8 is a rigid shaft.

[0151] As mentioned above, in order to activate the degrees of freedom of the articulated end effector 9 by moving the links of the articulated end effector 9 about said common axes of proximal rotation PP and / or distal YY, i.e., pitch PP and / or yaw YY, the surgical instrument 1 preferably comprises multiple pairs of antagonistic actuating tendons extending through the shaft 9 from the back end portion 104 to the articulated end effector 9 and terminating in at least some of the links of the articulated end effector 9.

[0152] According to a preferred embodiment, the root portion 51 of the blade holder link 50 is integral with a first end seat 15 for receiving a first antagonistic tendon pair 71, 72, and the root portion 21 of the reaction link 20 is integral with a second end seat 25 for receiving a second antagonistic tendon pair 73, 74. As will be appreciated by those skilled in the art, in this preferred embodiment, the first and second antagonistic tendon pairs, which are antagonistic actuating tendons, are respectively provided with an open actuating tendon 71, 73 and a closed actuating tendon 72, 74. By forming the end seats 15, 25 integrally with the respective links 20, 50, the number of parts can be minimized, facilitating assembly and facilitating compactness. Furthermore, the root portion 31 of the blade link 30, as a bendable part, can be very thin, or at least thin, elastically simplifying the fabrication of the blade link 30 and at the same time allowing precise characterization of its mechanical properties in function of the cutting action. Furthermore, in accordance with the preferred embodiment, each end seat 15, 25 serves as an end seat for both antagonistic tendons of a respective antagonistic tendon pair, helping to keep the number of movements to be made for each of the links 20, 50 to a minimum, thus facilitating compactness. Also, the blade link 30 does not have an end seat and is dragged into rotation by the blade holder link 50. This allows the number of working tendons to be kept low and the number of end seats to be kept to a minimum, thus facilitating compactness.

[0153] According to one embodiment, the first end seat 15 of the blade holder link 50 and the second end seat 25 of the reaction link 20 are each defined by a cantilever drag leg 77, 78 extending longitudinally from a respective root adjacent the body of the respective link. Each cantilever leg 77, 78 is preferably formed integrally with its respective link and attached proximally to the respective root 51, 21 and cantilevers longitudinally along the body of the blade holder link 50 or the body of the reaction link 20, respectively, forming a free end 77.1, 78.1 of the leg. Each end seat 15, 25 of the blade holder link 50 and the reaction link 20 is thereby substantially a radial slot, preferably also a longitudinal slot, having a radially facing bottom wall defined by the respective attachment root.

[0154] Preferably, the extensions of the cantilever drag legs 77, 78 and the extensions of the adjacent parts of the body of the blade holder link 50 or the reaction link 20, respectively, are substantially identical, facing the abutment and reaction walls 15.1, 25.1 of the edge of the respective end seats 15, 25. They are arranged side by side at the same level in the opening / closing direction and act as abutments and reaction abutments of the respective tendon ends 70 of each working tendon 71, 72, 73, 74 of a pair of antagonistic tendons received in the first or second end seats 15, 25, respectively. The tendon ends 70 of each working tendon can be, for example, enlarged portions formed by knots or bosses abutting against said abutment and reaction walls 15.1, 25.1 of the edge of the respective end seats 15, 25. In other words, said abutment walls 15.1 and reaction walls 25.1 of the edge of each termination seat 15, 25 comprise an edge wall acting as a closed reaction abutment and an opposing counter edge wall acting as an open reaction abutment. The abutment walls and reaction walls 15.1, 25.1 of the termination seats 15 and 25 are thus arranged as undercuts of the respective tendon termini 70 of the respective termination seats 15, 25, each termination seat 15, 25 being a through termination seat, preferably having an access opening facing longitudinally towards the free end of the respective link. Thus, the distal portions of each working tendon 71, 72, 73, 74 of the first and second antagonistic tendon pairs cross and / or overlap within their respective end seats 15, 25 to abut their respective tendon ends 70 against abutment and reaction walls 15.1, 25.1 arranged circumferentially therewith as undercuts thereagainst, providing a reaction force to the blade holder link 50 and / or the reaction link 20 when rotating in the open / close direction of the open / close degree of freedom G.

[0155] Thus, in this case, the first axial distance Y5 can be defined as the distance in the direction of the rotation axis YY between the first cantilever leg 77 of the blade holder link 50 and the surface 96 of one or more of the convex ruled surfaces 96, 98 of the support link 2, and such first axial distance is constant in any cutting state. Similarly, in this case, the second distance Y5' can be defined as the distance in the direction parallel to the distal common rotation axis YY between the second cantilever leg 78 and the surface 98 of one or more of the convex ruled surfaces 96, 98 of the support link 2, and such distance is constant in any cutting state.

[0156] According to a preferred embodiment, as mentioned above, the root portion 51 of the blade holder link 50 and the root portion 21 of the reaction link 20 each comprise at least one pulley surface 79,80 facing in opposite directions with respect to the common axis of rotation YY, which wraps around the respective reaction seat 15,25 from opposite circumferential directions and continues in the respective end seat 15,25 forming a bottom wall facing in the radial direction thereof, i.e. facing in opposite directions with respect to the common axis of rotation YY, so that when the tendon end 70 abuts against its abutment wall 15.1 and reaction wall 25.1 of the respective end seat 15,25, the distal portions of the tendons 71,72,73,74 of the first and second antagonistic tendon pairs close to each tendon end 70 wrap around the at least one pulley surface 79,80.

[0157] According to a preferred embodiment, at least one pulley surface 79 of the root portion 51 of the blade holder link 50 and at least one pulley surface 80 of the root portion 21 of the reaction link 20 are all convex ruled surfaces with parallel generatrices and parallel to the common axis of rotation YY, without circumferential channels or grooves for guiding or retaining tendons. At least one pulley surface 79, 80, if present, may be interrupted by radial cut channels 19, 29.

[0158] According to one embodiment, the surgical instrument 1 further comprises a third antagonistic tendon pair 75, 76 for moving the support link 2 around said proximal common axis of rotation PP. The support link 2 can thus comprise at least a third end seat 6 for receiving a tendon end 70 of said third antagonistic tendon pair 75, 76. For example, according to the embodiment shown in Figures 6A and 6B, said at least a third end seat 6 of the support link 2 is a single end seat passing through the support link 2 axially through the body of the support link 2, i.e. parallel to the distal common axis of rotation YY, forming an abutment wall and a reaction wall 6.1 for the tendon end 70 arranged as an undercut for each working tendon 75, 76 of the third antagonistic tendon pair, similar to what has been described above with reference to the first end seat 15 and the second end seat 25. According to one embodiment, the support link 2 comprises two separate and distinct third end seats 6, one seat for each tendon 75, 76 of the third antagonistic tendon pair.

[0159] According to a preferred embodiment, the support link 2 comprises one or more convex ruled surfaces 96, 98 having parallel generatrices and all parallel to the proximal common axis of rotation PP. The working tendons 71, 72, 73, 74 of the first and second antagonistic tendon pairs slide longitudinally on said one or more convex ruled surfaces 84, 86 of the support link 2 during actuation of the blade holder link 50 and / or the reaction link 20, and said one or more convex ruled surfaces 96, 98 of the support link 2 do not include guide channels or grooves for receiving and guiding the tendons. The support link 2 can also include one or more convex ruled surfaces parallel to the distal common axis of rotation YY (not shown) on which the working tendons 71, 72, 73, 74 of the first and second antagonistic tendon pairs slide longitudinally during actuation of the blade holder link 50 and / or the reaction link 20.

[0160] Similar one or more convex ruled surfaces 96, 98 having parallel generatrices and all parallel to the proximal common axis of rotation PP of the support link 2 can also serve as pulley surfaces for the working tendons 75, 76 of the third antagonistic tendon pair. Said one or more convex ruled surfaces 96, 98 of the support link 2 extend on both sides of the support link 2. According to one embodiment, the pulley surfaces for the working tendons 75, 76 of the third antagonistic tendon pair are formed by the inner surface of the end seat 6 of the support link 2.

[0161] According to one embodiment, the links 97, 99 have parallel generatrices and comprise one or more convex ruled surfaces 71, 72, 73, 74, 75, 76 all parallel to the proximal common axis of rotation PP, and the working tendons 97, 99 of the first, second and third antagonistic tendon pairs slide longitudinally on the one or more convex ruled surfaces 90 of the link 90. ​​The one or more convex ruled surfaces 97, 99 of the connecting link 60 extend on both sides of the connecting link 90, and between the connecting link 90 and the supporting link 2, the tendons 71, 72, 73, 74, 75, 76 of the first, second and third antagonistic tendon pairs, respectively, wrap, with or without crossing each other, on one or more convex ruled surfaces 96, 98 of the supporting link 2 facing the opposite side to the convex ruled surfaces 97, 99 of the connecting link 90 along which they slide proximally. For example, one or more of the convex ruled surfaces 96, 98 of the support link 2 are interposed between the projections 91, 92 of the link 90 and oriented in opposite directions relative to the proximal common axis of rotation PP.

[0162] The convex ruled surfaces 79, 80, 96, 97, 98, 99 having parallel generatrices of the links, on which the tendons 71, 72, 73, 74, 75, 76 slide or wrap around in contact, are preferably all outer surfaces of the respective links.

[0163] The actuating tendons 71, 72, 73, 74, 75, 76 are preferably polymeric tendons formed by intertwined polymeric fibers, for example comprising high molecular weight polyethylene (UHMWPE) fibers.

[0164] According to a preferred embodiment, the group formed by said root portion 51 of the blade holder link 50, said root portion 31 of the blade link 30 and said root portion 21 of the reaction link 20 is entirely interposed between said two projections 3, 4 of the support link 2 and directly in close contact with the two projections 3, 4. This avoids relative movements between the root portions and between each root portion and the projection. Thus, if an articulation pin 5 is included, relative sliding along the articulation pin 5 between the root portion and the projection is avoided during elastic deformation of the blade link 30. In other words, the root portions and the projections are preferably directly in close contact adjacent to each other and there is no elastic reaction force between them. Even if distal, i.e. at a given longitudinal distance relative to the common axis of rotation YY, the geometry of the respective links may cause the rotational approach dimensions of the respective links to overlap or interfere, so that a cutting interference contact may occur, for example, between the cutting edge 34 of the blade link 30 and the opposing blade portion 24 which rotates together with the reaction link 20.

[0165] This packaging arrangement of the roots provides a counterforce to the elastic bending of the blade body during the cutting action, while avoiding the provision of elastic elements between the roots, which in turn simplifies assembly and facilitates extreme compactness.

[0166] Such a packing configuration of the roots avoids collisions of the roots 31 of the blade links 30, which are preferably thinner than the articulating pin 5. It is thereby possible to provide sufficient certainty of positioning of the cutting edge 34 relative to the opposing blade 24 at each opening angle of the gripping degree of freedom G, and therefore to achieve a very high cutting accuracy.

[0167] The root portion preferably has a cylindrical shape centered on the common axis of rotation YY, and the third root portion 31 has a disk-shaped cylindrical shape if the third root portion 31 has a substantially smaller thickness than the first root portion 11 and the second root portion 21. Similarly, this can also apply to the fourth root portion 41 of the opposing blade link 40, if provided.

[0168] The manufacture of the parts by wire electroerosion process allows to obtain increased tolerances, but provides for a minimum local microclearance of the order of tenths of a millimeter between at least some of said contact surfaces of the roots and / or protrusions in the direction of the common rotation axis YY to ensure direct close contact. At the same time, a relative rotation about the common rotation axis YY can be allowed during actuation of the open / close degree of freedom G and / or the yaw degree of freedom Y. The articulation pin 5 can interfere with at least one of the roots and / or protrusions, i.e. rotate integrally with the roots and / or at least one of the protrusions.

[0169] In particular, the fact that the support link 2, the blade holder link 50, the blade link 30 and the reaction link 20 are made of separate parts necessarily involves in each case a minimum microclearance in the axial direction, i.e. in the direction of the common rotation axis YY between the respective contact surfaces, and said microclearance as a whole is in the range of 1 / 20 to 1 / 5 of the thickness of the root part 31 of the blade link 30 according to the embodiment, and is divided, i.e. distributed locally between the protrusions 3, 4 of the support link 2 and the contact surfaces of the root parts of the respective links, where the contact surfaces of the protrusions and the root parts of the blade holder link 50 and the reaction link 20 are made by wire electrolytic erosion (WEDM), respectively.

[0170] The expression "directly in close contact" is therefore also intended to indicate an embodiment in which a minimum microclearance is in each case included between the projection and the entire contact surface of the root of the respective link, not just at least a part of them. Thus, during the cutting operation, especially at relatively large opening angles of the opening / closing degree of freedom G (e.g. angles of more than 20°-30°), the mechanical interference contact between the cutting edge 34 of the blade link 30 and the opposing blade 24 can generate a minimum microdisplacement of the root 31 of the blade link 30 along the articulation pin 5, of the order of one hundredth of a millimeter.

[0171] For example, as is evident from the analysis carried out by the inventors, according to one embodiment, the thickness of the root portion 31 of the blade link 30 is about 0.2 mm, the overall microclearance in the direction of the common axis of rotation YY in the operative state, locally distributed between the contact surfaces of the protrusions and the root portion of the respective link, is generally about 0.02 mm, and the local microclearance in the direction of the common axis of rotation YY between the root portion 31 of the blade link 30 and the root portion 21 of the reaction link 20, when in the operative state, is about 0.01 mm, i.e. substantially equal to 1 / 20 of the thickness of the root portion 31 of the blade link 30.

[0172] The support link 2 with its two protrusions 3, 4, the root 51 of the blade holder link 50, the root 21 of the reaction link 20 and the root 31 of the blade link 30 are made of separate parts both imposing a minimum clearance in the direction of the common rotation axis YY as explained above, thereby allowing the opening and closing rotational degree of freedom G to be operated in a precise and controlled manner in both the opening and closing directions, while performing the gripping and / or cutting actions.

[0173] According to a preferred embodiment, the root portion 51 of the blade holder link 50 comprises a first through hole 16, the root portion 21 of the reaction link 20 comprises a second through hole 26, and the root portion 31 of the blade link 30 comprises a third through hole 36, the first through hole 16 of the root portion 51, the second through hole 26 of the root portion 21 and the third through hole 36 of the root portion 31 being axially aligned with the common rotation axis YY. According to an embodiment, an articulating pin 5 is received inside the first, second and third through holes 16, 26, 36. In this case, the articulating pin 5 can be made as a single cantilever leg with one of the projections 3, 4 of the support structure, or the articulating pin 5 can be made as two parts in the form of two oppositely aligned cantilever legs, each of the two parts being a single part with one of the projections 3, 4 of the support structure. However, according to a preferred embodiment, the articulating pin 5 is a separate part with respect to its root 11, 21, 31 and also with respect to its prongs 3, 4. According to one embodiment, each of the two prongs 3, 4 is provided with a prong through-hole that is axially aligned with said common rotation axis YY and aligned with each and every of said first, second and third through-holes 16, 26, 36.

[0174] According to one embodiment, the first through hole 16 of the root portion 51, the second through hole 26 of the root portion 21 and the third through hole 36 of the root portion 31 are all circular through holes, coaxial with the common axis of rotation YY and receive a single articulation pin 5 extending in the direction of the common axis of rotation YY from a first protrusion 3 of the distal connection portion 17 of the support link 2 to a second protrusion 4 of the distal connection portion 17 of the support link 2. According to one embodiment, the first through hole 16 of the first root portion 51, the second through hole 26 of the second root portion 21 and the third through hole 36 of the third root portion 31 all have substantially the same diameter and receive the articulation pin 5 in direct close contact over the entire circumferential extension of the respective hole edges.

[0175] The provision of said circular third through hole 36 of the root 31 of the blade link 30 in direct close contact with the articulation pin 5 over the entire circumferential extension of its hole edge makes it possible to provide a counterforce to the cutting action exerted by the cutting edge 34 of the blade link 30. In particular, during the cutting action, the opening angle of the gripping degree of freedom G gradually decreases, resulting in a mechanical interference contact between the cutting edge 34 (and preferably also the blade surface 35) of the blade link 30 and the counter blade 24 rotating together with the reaction link 20, so that a direct friction force in the opening direction occurs on the cutting edge 34 (and preferably also the blade surface 35) of the body of the blade link 30 in contact with the counter blade 24, which is balanced by a counterforce to the friction of the cutting action exchanged in the area of ​​mutual contact between the hole edge of the third through hole 36 of the root 31 of the blade link 30 and the articulation pin 5. The frictional reaction force of the cutting action is preferably directed substantially along a radial direction with respect to the common axis of rotation YY. The reaction force against friction of the cutting action preferably acts on the arcuate surface 38 of the thickness of the hole edge of the circular third through hole 36 of the root portion 31 of the blade link 30 facing the circular through hole 36 .

[0176] In case at least some but also all of the through holes of the root section are made by wire electroerosion (WEDM), as an effect of the successive cutting paths of the cutting wire used to make the through holes by wire electroerosion, radial cut channels 19, 29, 39 are provided in each root section between the hole edge and the outer edge of the respective root section. Preferably, the arrangement of the radial cut channels on each root section is studied based on the static or dynamic behavior of each link when in operation. In particular, according to a preferred embodiment, the cut channels 39 of the root section 31 of the blade link 30 are radially offset with respect to the cut channels 29 of the root section 21 of the link 20 to prevent the edges of the cut channels from interlocking with each other during opening / closing operations.

[0177] According to one embodiment, the through-hole of each of said two protrusions 3, 4 of the distal connection part 17 of the support link 2 is a circular through-hole coaxial with said common axis of rotation YY. If the protrusions 3, 4 are made by wire electroerosion, they can be provided with at least one radial channel between the hole edge and the outer edge of each protrusion.

[0178] As mentioned above, the articulated end effector 9 of the surgical instrument 1 further comprises a blade link 30 integrally comprising a third proximal attachment root 31 and a cutting edge 34 that is elastically deformable by bending. The cutting edge 34 can be sharpened, i.e. the cutting edge 34 can be subjected to a sharpening process to have a locally reduced thickness and / or a sharply shaped cross section with respect to the thickness of the body of the blade link 30.

[0179] According to one embodiment, said blade link 30 is made by shaping, i.e. cutting, a suitably substantially flat elastic sheet or strip. For example, the elastic sheet or strip is made of spring steel as for the blade and can be shaped by wire electroerosion (WEDM) and / or photo-etching and / or laser cutting and / or chemical etching. Preferably, the elastic sheet or strip is sharpened at one edge thereof to form the cutting edge 34 of the blade link 30. The sharpening can be performed by wire electroerosion (WEDM) and / or grinding, for example stone or diamond grinding. According to one embodiment, one or more edges of the shaped sheet or strip are sharpened by wire electroerosion (WEDM) in a step in which the cutting wire flows in a direction not perpendicular to the lying surface of the sheet or strip.

[0180] According to one embodiment, the body of the blade link 30 has a two-dimensional main extension, i.e., a thickness that is substantially reduced relative to the extension on said preferably flat or arched lying surface, said main extension being disposed on said preferably flat or arched lying surface.

[0181] According to one embodiment, the cutting edge 34 of the blade link 30 is substantially straight, preferably with a flat or arcuate lying surface, to avoid providing a concave surface in the lying surface of the body of the blade link 30 .

[0182] Preferably, the thickness of the blade link 30 is significantly smaller than that of said links 20, 50 and is selected so that, when in the operating state, the blade is elastically bendable in a direction transverse to the longitudinal extension of the blade link 30, i.e. in the direction of the thickness. In particular, the blade link 30 must be more bendable than the reaction link 20 and preferably more bendable than the blade holder link 50. The flexibility of the blade link 30, and therefore of the cutting edge 34 of the blade link 30, is intended in the direction of its thickness, i.e. in a direction perpendicular to the lying surface of the blade link. According to a possible embodiment, the body of the blade link 30 is forced to have an arched, i.e. concave, shape with a concave surface facing out of / into the lying surface of the starting elastic strip or sheet, but such lying surface of the body of the blade link 30 can substantially correspond to the lying surface of the starting metal strip or sheet that is suitably processed to form the blade link 30, in which case the lying surface of the blade link body is an arched surface.

[0183] It is not necessarily the case that the blade link 30, and thus the cutting edge 34 of the blade link 30, is elastically deformable at the lying surface, i.e., it does not necessarily include bendability perpendicular to its thickness.

[0184] The material of the blade link 30 can be different relative to the material of the support link 2, the reaction link 20 and / or the blade holder link 50. For example, the blade link 30 can be made of blade steel. For example, the blade link 30 can include one or more surface treatments, such as, for example, a coating and / or a heat treatment, to make the cutting edge 34 harder and more wear resistant when in an operating state. According to one embodiment, the cutting edge 34 includes a surface treatment on at least a surface 35 adapted to function by mechanical interference contact with an opposing blade when in an operating state.

[0185] The blade link 30 can be bent, for example, by press-bending. The press-bending curvature can impart desired elastic properties to the blade link 30. For example, the blade link 30 can be bent axially toward the opposing blade to locally modify mechanical interference effects.

[0186] The ratio between the thickness of the blade link 30 at the level of the root 31 (excluding in this evaluation the thickness of the cutting edge 34, which is preferably sharp as described above) and the thickness of the root 51 of the blade holder link 50 and / or the thickness of the root 21 of the reaction link 20 may be between 1 / 5 and 1 / 20. In absolute values, the thickness of the blade link 30 may be in the form of between 0.1 mm and 0.5 mm, preferably between 0.1 mm and 1 mm.

[0187] As mentioned above, the support link 2, the blade holder link 50, the blade link 30 and the reaction link 20 are formed of separate parts, preferably four separate parts articulated to a common axis of rotation YY, i.e. constrained to rotate about a common axis of rotation YY or a common axis of rotation yaw YY. According to one embodiment, the articulated end effector 9 is composed precisely of the four parts (i.e. the four links 2, 20, 30, 50) articulated together at said common axis YY, plus a further part which is an articulation pin 5 defining said common axis YY, plus a further connecting link 90 with a shaft 7 articulated to the support link 2 at the proximal common axis of rotation of pitch PP by a further proximal articulation pin 93 defining said proximal common axis of rotation of pitch PP (seven parts in total, the working tendons being excluded from the count). This embodiment, in which the pitch PP common rotation axis is non-parallel (preferably perpendicular) to the yaw YY common rotation axis, makes it possible to obtain an articulated cuff at the distal end of the rod 7, which, when the pitch PP rotation axis is non-parallel and preferably perpendicular to the yaw YY common rotation axis, is given a pitch, yaw and gripping degree of freedom G, which is adapted to manage gripping and cutting. If the connecting link 90 is formed integrally with the distal end 8 of the rod 7 (not shown), the articulated end effector 9 is still constituted by said seven parts, which are the distal end 8 of the rod 7, the support link 2, the blade link 30, the blade holder link 50, the reaction link 20 and said two articulated pins 5, 93.

[0188] A degree of freedom of roll R, which is integral with the shaft 7 and preferably also with the back end portion 104, can be provided, for example allowing the entire surgical instrument 1 to be rotated around the longitudinal extension axis XX of the rod 7.

[0189] It will be appreciated by those skilled in the art that by minimizing the number of parts, the assembly of the articulated end effector 9 of the surgical instrument 1 is significantly simplified and suitable for extreme miniaturization. In particular, the avoidance of providing elastic preload elements in the axial direction (such as Belleville type elastic washers attached to the articulation pins 5), i.e. in the direction of the common axis of rotation YY between the distal connections 17 of the support links 2, simplifies the assembly of parts and thus facilitates extreme miniaturization of the articulated end effector 9 and thus of the cross section of the rods 7, while ensuring sufficient strength and resistance to stresses that may occur in the operating state.

[0190] According to a preferred embodiment, at least one of the blade link 30 and the blade holder link 50 comprises a distal free end. The distal end 32 of the body of the blade link 30 may form the distal free end of the assembly formed by the blade link 30 and the blade holder link 50. Alternatively, the distal end 32 of the blade link 30 may be rotationally constrained to the reaction portion 57 of the blade holder link 50 which acts as the reaction engagement portion 37 of the blade link 30, i.e. the reaction portion 37 of the blade link 30 may coincide with its distal end 32.

[0191] According to one embodiment, the reaction link includes a distal free end 22 .

[0192] According to another embodiment, the blade link 30 and the blade holder link 50 are integrally formed, so that the root portion 31 and the root portion 51 are integrally formed, for example as shown in FIG.

[0193] (Scissor-type surgical instrument) Referring to the above description of the embodiments of the present invention, the surgical instrument 1 may be, for example, a scissor-type surgical instrument as shown in Figures 3, 5, 7-8, 11-12, 15, 30-40 and 43. The embodiments of the surgical instrument 1 are described below, and in the embodiments, the surgical instrument 1 is a scissor-type surgical instrument.

[0194] According to a preferred embodiment, the distal end 32 of the blade link forms the distal free end.

[0195] Preferably, the opposing blade 24 is integrally formed with the body of the reaction link 20 .

[0196] According to a preferred embodiment, the body of the reaction link 20 is also elastically bendable in the axial direction to effect the cutting action. Thus, during a cutting operation, mechanical interference contact between the cutting edge 34 of the blade link 30 and the opposing blade 24 of the reaction link 20 results in an elastically bent deformation of the blade link 30 directed axially outward, and simultaneously an elastically bent deformation of the reaction link 20 directed axially outward. Note that the outer axial direction of the blade 14 is intended to be opposite to the outer axial direction of the reaction link 20.

[0197] For example, as shown in FIG. 35, the opposing blade 24 of the reaction link 20 is a curved protruding surface with a concave surface facing axially inward, i.e., facing the blade link 30. In this case, the protrusion is accentuated as it approaches or in the distal direction toward the distal free end 22 of the reaction link 20. During a cutting operation, preferably during a cutting operation having a small opening angle, i.e., an opening angle less than a predetermined threshold, e.g., less than 5°, the contact point POC between the cutting edge 34 and the opposing blade 24 is close to the free end 32, 22, so that the blade link 30 is elastically bent in the outward axial direction relative to its undeformed configuration, and the reaction link 20 is also elastically bent in the outward axial direction relative to its undeformed configuration. In other words, the blade link 30 and the reaction link 20 reach an equilibrium configuration for performing a cutting operation at a small opening angle, with both the body of the blade link 30 and the body of the reaction link 20 being elastically bent in the outward axial direction relative to their respective undeformed configurations.

[0198] As previously mentioned, "point of contact POC" preferably refers to the distal-most portion of the contact area between the cutting edge 34 and the opposing blade 24.

[0199] When the contact point POC between the cutting edge 34 and the opposing blade 24 is located more rearward, i.e., more proximal, relative to the configuration described above, for example, at an opening angle of about 10°-25°, the configuration of the reaction link 20 can exhibit a more pronounced curvature than when the contact point POC is closer to or at the free distal end 22 (when the opening angle is less than a threshold value, e.g., less than 5° or less than 10°). This is because the reaction link 20 is more stiff proximally and more flexible closer to or at the free distal end 22. However, it should be noted that this does not necessarily mean that the body of the blade link 30 deforms or bends to exhibit a more pronounced curvature when the contact point POC is closer to or at the free distal end 22 of the reaction link 20 (when the opening angle is less than a threshold value, e.g., less than 5° or less than 10°). 2, the curvature of the opposing blade 24 may be selected to be more pronounced at the distal free end 22 of the reaction link 20. In accordance with a preferred embodiment, the body of the reaction link 20 is tapered in the longitudinal direction, thinning axially as it approaches the distal free end 22 of the reaction link 20, to facilitate bendability of the reaction link 20.

[0200] According to one embodiment, the opposing blade 24 of the reaction link 20 is a curved protruding surface having a concave surface facing axially inward, i.e., toward the blade link 30, and the protrusion of the opposing blade 24 is accentuated as it approaches or at the distal side of the distal free end 22 of the reaction link 20. Also, the body of the blade link 30 is a curved protruding surface having a blade with a cutting edge 34 facing axially inward, i.e., toward the opposing blade 24, and the protrusion of the blade link 30 is accentuated as it approaches or at the distal side of its distal free end 32. In other words, in this embodiment, the axially inward facing blade surface 35 of the blade link 30 is a concave protruding surface having a concave surface facing axially inward, i.e., toward the opposing blade, and the protrusion is accentuated as it approaches or at the first free distal end 32 of the first tip 30. In this embodiment, the cutting edge 34 also preferably describes a curved path having an axially inwardly facing concave surface.

[0201] According to an embodiment in which the blade link 30 and the blade holder link 50 further comprise respective reaction engagement portions 37, 57 for rotating the blade link 30 and the blade holder link 50 together, the reaction engagement portion 57 of the blade holder link 50 is formed as an inner axial projection 57, i.e. an axial ridge 57 extending axially inwardly with an open reaction face 57.2 and an opposite closed reaction face 57.1. The reaction engagement portion 37 of the blade link 30 is formed as an axial through slot 37 which receives said axial ridge 57 of the blade holder link 50. Said axial through slot 37 is defined by an open reaction face 37.2 in reaction contact with said open reaction face 57.2 of the axial ridge 57 of the blade holder link 50 and an opposite closed reaction face 37.1 in reaction contact with said closed reaction face 57.2 of the axial ridge 57 of the blade holder link 50. Thus, in this case, the axial ridge 57 of the blade holder link 50 is inserted into the slot 37 of the blade link 30 by the inlet opening 37.0, then extends through the inlet channel and is then rotated relative to the blade link 30 to obtain the drag engagement. In other words, in this case, the blade 30 is provided with an open drag leg extending longitudinally, for example cantilevered, oriented proximally towards the common axis of rotation YY and not functional for obtaining a cutting action, said cantilever open drag leg comprising said open drag surface 37.2 and defining at its edge the inlet opening 37.0.

[0202] The axial ridge 57 of the reaction engagement portion of the blade holder link 50 may be obtained at the distal end 52 of the blade holder link 50. This causes the blade holder link 50 to have an aquat shape with an enlarged and / or curved distal end 52 forming said axial ridge 57.

[0203] Although not necessarily, during a cutting operation in which the blade link 30 elastically bends, the axially outward bending deformation of the blade link 30 can only occur distal to said drag engagement slot 37, so that the blade link 30 slides axially outward against the axial ridge 57 of the blade holder link 50. The blade holder link 50 can include an axially inward facing surface 58 between its root 51 and the axial ridge 57 that contacts the blade link 30.

[0204] The location of the axial ridge 57 of the blade holder link 50 and its extension in the inner axial direction can be selected such that the axially inner portion of the axial ridge 57 relative to the closing reaction surface 57.1 forms a closing stroke end face 54 for the second tip 20. The closing stroke end face 54 acts as a closing stroke end for the opening / closing degree of freedom G and is adapted to abut and receive a surface of the reaction link 20. Thus, the axial ridge 57 of the blade holder link 50 can perform both a reaction engagement function with the blade link 30 and a closing stroke abutment function.

[0205] Preferably, the closing stroke end face 54 extends at the longitudinal level where the cutting edge 34 already exists, i.e. the closing stroke end face 54 extends axially cantilevered from the blade surface 35 .

[0206] For example, according to an embodiment such as that shown in FIG. 34, the blade link 30 and blade holder link 50 are integrally formed to form a tip link, providing a closed stroke end abutment that cantilevers axially from the blade surface 35.

[0207] The closing stroke end face 54 preferably extends from the blade holder link 50 within the rotational approach footprint of the reaction link 20 .

[0208] For example, according to the embodiment shown in Fig. 38, the elongated body of the reaction link 20 is elastically bendable in the axial direction to perform the cutting action, the body of the reaction link 20 comprises a connecting stem 23 extending distally from a root portion 21 and terminating in a cutting interface portion 27 of the body of the reaction link 20, said cutting interface portion 27 having a longitudinally and axially inner elongated body with two longitudinally opposed free ends and said opposed blades 24 therebetween. Preferably, the distal free end of the cutting interface portion 27 coincides with said distal free end 22 of the reaction link 20, and the opposite proximal free end 27.0 of the cutting interface portion 27 extends in a cantilever manner towards the common axis of rotation YY, i.e. towards the root portion 21 of the reaction link 20. Thereby, the connecting stem 23 and the cutting interface portion 27 of the reaction link 20 form a kind of "T" structure. In this "T" structure, two cantilever arms 27.1 and 27.2 protrude longitudinally from the distal upper portion of the connecting stem 23 of the cutting interface portion 27 on opposite sides, each having a free end, and opposing blades 2424 belong to both cantilever arms 27.1 and 27.2 of the cutting interface portion and face in opposite directions relative to the connecting stem 23.

[0209] Thereby, an opposing blade deformation seat 28 is formed between the proximal arm 27.1 of the cutting interface 27 and the connecting stem 23, which accommodates the axial deformation of the opposing blade 24, i.e. the axial deformation of the proximal arm 27.1 of the cutting interface 27 having the proximal free end 27.0. According to one embodiment, a second terminal seat 25 for the antagonistic actuating tendons 73, 74 of the second antagonistic tendon pair is axially arranged between the connecting stem 23 and the proximal arm 27.1 of the cutting interface 27. According to one embodiment, the distal cantilever leg 78 of the second end seat 25 cantilevers distally between the connection stem 23 and the proximal arm 27.1 of the disconnection interface 27, so that the connection stem 23 defines the second end seat 25 of the reaction link 20 axially outwardly and the distal cantilever leg 78 of the second end seat 25 defines at least a portion of the opposing blade deformation seat 28 axially outwardly. According to one embodiment, the second end seat 25 opens into said opposing blade deformation seat 28, so that in this embodiment the antagonistic actuating tendons 73, 74 can each be inserted into the second end seat 25 opening in the distal direction. The antagonistic tendons 73, 74 are inserted axially into the opening formed between the proximal free end 27.0 of the proximal arm 27.1 of the cutting interface section 27 and the root section 21, and then guided distally along the axial inner side of the cantilever leg 78 into the opposing blade deformation seat 28, and then inserted into the entrance of the second end seat 25. Thus, in this embodiment, the assembly of the antagonistic tendons 73, 74 is preferably performed when the reaction link 20 and the blade link 30 form an opening angle (e.g., an opening angle of about 90°) such that the opposing blade 24 of the proximal arm 27.1 of the body of the reaction link 20 does not contact the cutting edge 34 of the blade link 30, and the axial access is released in the opening formed between the proximal free end 27.0 and the root section 21.

[0210] By providing such a reaction link 20 with said connecting stem 23 terminating at said cutting interface 27, i.e. said counter blade 24 having a proximal arm 27.1 belonging to said cutting interface 27 and having a proximal free end 27.0 and a longitudinally opposite distal arm 27.2 having a distal free end coinciding with said second free end of the reaction link 20, a reaction link 20 elastically bendable in the outward direction can be formed along substantially the entire longitudinal extension of the counter blade 24. This allows a precise cutting action also for large opening angles, for example in the range of 25°-60°, preferably in the range of 28°-58°. This condition corresponds to a situation in which the contact point POC belongs to said proximal arm 27.1 of the cutting interface, preferably close to or at the proximal free end 27.0 of the cutting interface 27. In this case, i.e. at large opening angles, the blade of the blade link 30 does not necessarily bend elastically to perform the cutting action, the elasticity can be provided only by the reaction link 20. In particular, according to one embodiment, when the contact point POC is at the proximal free end 27.0 of the proximal arm 27.1, the opening angle is about 58° and the cutting action is still performed.

[0211] Thus, by providing such a reaction link 20 including the connection stem 23 terminating in the cutting interface portion 27, a solution adapted to perform accurate cutting at opening angles in the range of 0°-60° is made possible while minimizing the actuation forces on the blade holder link 50 or the reaction link 20 caused by the pulling action on the respective actuating tendon, and making it possible to minimize the radius of the pulley faces 79, 80 of the respective root portions 51, 21 at the tendon ends 15, 25, thus simultaneously allowing extreme compactness.

[0212] For example, as shown in FIG. 39A, at relatively high opening angles (e.g., angles in the range of 50°-60°), contact between the cutting edge 34 and the opposing blade 24 occurs close to or at the proximal free end 27.0 of the cutting interface portion 27 of the reaction link 20, and thus the cutting mechanical interference contact results in an outward axial deformation of the proximal arm 27.1 inside the deformation seat 28 of the reaction link 20, but the blade link 30 remains substantially deformed, i.e., does not bend elastically, since it is supported in the outward axial direction by, for example, the blade holder link 50. This allows the cutting action to be performed even at large opening angles, for example, up to an opening angle of about 60°. As the opening angle decreases, the contact point POC moves in the distal direction.

[0213] For example, as shown in FIG. 39B, for smaller opening angles, i.e., for example, in the range of 10°-25°, the contact point POC between the cutting edge 34 and the opposing blade 24 is located at or near the cutting interface 27 where the connecting stem 23 terminates. The cutting mechanical interference contact results in an outward axial deformation of the connecting stem 23 that returns the cutting interface 25 axially outward, while the blade link 30 can bend without elasticity, but is preferably bent axially outward, especially in the case of extremely miniaturized parts. Thus, for intermediate opening angles, for example, in the range of 10°-25°, the outward axial deformation of the reaction link 20 can be used to perform the cutting action. In this case, the proximal part of the blade link 30 can still be in interference contact with the opposing blade 24 of the proximal arm 27.1 of the cutting interface 27 of the reaction link 20.

[0214] For example, as shown diagrammatically in Figures 39 to 39C, for small opening angles, e.g., in the range of 0°-5° and / or 0°-10°, the contact point POC between the cutting edge 34 and the opposing blade 24 is close to or at the distal free end 22, 32, and cutting mechanical interference contact results in outward axial deformation of both the blade link 30 and the cutting interface 27 and connecting stem 23 of the reaction link 20.

[0215] The curvature of the opposing blade 24, as well as the structural and elastic properties of the cutting interface 27 and connecting stem 23, can be selected to optimize cutting performance over a very wide range of opening angles, for example in the range of 0°-60°.

[0216] An opposed blade link 40 may further be provided. The opposed blade link 40 includes a rotating opposed blade 2 and can rotate together with the reaction link 20. Preferably, the opposed blade link 40 includes a root portion 41 of the opposed blade link 40 that is adjacent to the root portion 21 of the reaction link 20 and the root portion 31 of the blade link 30, integrally therewith.

[0217] According to one embodiment, opposed blade link 40 preferably comprises an opposed blade cutting edge disposed opposite cutting edge 34 of blade link 30 .

[0218] (Needle driver / suture cutter type surgical instrument) With reference to the above description of the embodiments of the present invention, the surgical instrument 1 may be a needle driver / suture cutter type surgical instrument (or a "needle holder / cutter" according to commonly adopted terminology), for example, as shown in Figures 2, 4, 6, 10, 16-29, and 42. In the following, an embodiment of the surgical cutting instrument 1 is described, where the surgical instrument 1 is a needle driver / suture cutter type surgical instrument.

[0219] According to a preferred embodiment, the distal end 32 of the blade link 30 does not form a free end, while the distal end 52 of the blade holder link 50 forms a distal free end.

[0220] According to one embodiment, distal end 32 and distal end 52 are integrally formed. In this case, as shown for example in FIGURE 21, distal end 32 of blade link 30 is a longitudinally retracted free end, i.e., is more proximal than free end 52 of blade holder link 50. In this embodiment, blade link 30 and blade holder link 50 are integrally formed, i.e., configured as a single link.

[0221] According to one embodiment, the blade holder link 50 comprises a stroke end face 54 between the root portion 51 and the free end 52, which also functions as a gripping surface in cooperation with an opposing faceable gripping surface 53 of the reaction link 20, which is disposed between the root portion 21 and the free end 22 of the reaction link 20. In use, the gripping surface 54 of the blade holder link 50 and the gripping surface 53 of the reaction link 20 face each other and are intended to move in contact with each other, facing each other upon rotation, to grip, for example, a surgical needle. Each gripping surface 53, 54 can be machined according to known techniques and can be provided with reliefs and recesses to enhance the gripping ability.

[0222] According to one embodiment, the body of the blade link 30 includes a distal end 32 which preferably acts as a reaction force engagement portion 37 such that when the blade link 30 is assembled to the blade holder link 50, the distal end 32 is not a free end.

[0223] According to one embodiment, the body of the blade holder link 50 and the body of the reaction link 20 each have a longitudinally elongated shape extending from their respective mounting roots to their respective free ends, with their respective gripping faces located near their respective free ends, and the roots of the blade holder link 50, the blade link 30 and the reaction link 20 are adjacent to one another, while the blade 14 of the blade link 30 is received in an axial seat between the body of the blade holder link 50 and the reaction link 20. In other words, the elongated body of the blade holder link 50 and the reaction link 20 are adjacent to one another at their respective roots and their respective gripping faces, while the blade link 30 is adjacent to the roots of the blade holder link 50 and the reaction link 20 at its root 31 and is adjacent to and interposed between the bodies of the blade holder link 50 and the reaction link 20 along its entire longitudinal extension.

[0224] According to one embodiment, the root of the blade link 31 is interposed between the roots of the blade holder link 50 and the reaction link 20. Preferably, the body of the blade link 30 is also elongated in the longitudinal direction, including the blade link end 32, and is shorter than the bodies of the blade holder link 50 and the reaction link 20. The body of the blade link 30 extends substantially longitudinally from the adjacent attachment roots to the region of the gripping surfaces 53, 54 of the blade holder link 50 and the reaction link 20. That is, the distal end 32 of the blade link 30 extends longitudinally to a level close to the proximal edges of the gripping surfaces 53, 54.

[0225] The gripping surfaces 53, 54 preferably function as the closing stroke ends for the open / close degree of freedom G.

[0226] According to one embodiment, the blade holder link 50 comprises an axially inwardly facing surface 58, which is inclined axially inwardly away from the body of the blade link 30 and defines an axial deformation recess 44 (or deformation seat 44) adapted to receive the blade portion 14 of the body of the blade link 30 elastically bent by the action of the protruding surface of the opposing blade 24 during the cutting operation. Thus, the opposing blade 24 and the axially inwardly facing surface 58 both face the blade 14 of the blade link 30 and both contact the blade 14 during the cutting operation. Preferably, the axially inwardly facing surface 58 of the blade holder link 50 serves as an axial stroke end abutment surface for the deformation of the blade 14 of the blade link 30 when it is deformed by bending by the opposing blade 24 during the cutting operation. The contours of the protruding surface of the opposing blade 24 and the axially facing surface 58 of the blade holder link 50 may be parallel to each other, and in one embodiment they are correspondingly identical.

[0227] At least one contact point POC between the cutting edge 34 and the opposing blade 24 preferably changes in position and / or size as a function of the opening angle of the open / close degree of freedom G, as shown, for example, diagrammatically in FIG. 19. In particular, at relatively large opening angles (e.g., angles in the range of 20°-30°), the contact occurs closer to the cutting edge 34, i.e., closer to the attachment root 31 of the blade link 30. As the opening angle decreases, the contact moves distally, and the elastic deformation bending of the blade 14 of the blade link 30 relative to the root 31 of the blade link 30 is intensified. Thus, the deformed configuration of the blade link 30, the blade holder link 50 and the reaction link 20 is substantially in a closed configuration and is maximally bent. At this time, the deformed configuration of the blade link 30 is bent more than the deformed configuration of the blade link 30 when the blade holder link 50 and the reaction link 20 are in a partially closed and partially open configuration. Preferably, when the opening angle is at its maximum and the blade is free, the blade is straight and the blade link has a substantially planar configuration.

[0228] According to one embodiment, the opposing blade 24 can at least partially overlap on the rotational proximity footprint of the body of the blade holder link 50 and the blade portion 14 of the blade link 30. When in the elastically deformed configuration, the opposing blade 24 translates locally relative to the rotational footprint of the blade holder link 50 in a direction transverse to the longitudinal extension of the blade holder link 50, i.e., in the outward axial direction. However, according to a preferred embodiment, the axially inward facing surfaces 58 of the opposing blade 24 and the blade holder link 50 are geometrically shaped such that they do not overlap in their respective rotational clearances.

[0229] 22, the root 31 of the blade link 30 is interposed between and in direct intimate contact with the first projection 3 of the support structure and the root 51 of the blade holder link 50. By providing a transverse bridge 33 in the body of the blade link 30 that crosses the rotational approach footprint of the body of the opposing blade holder link 50, the blade 14 contacts the opposing blade 24 at its cutting edge 34, i.e., between the blade holder link 50 and the reaction link 20.

[0230] According to one embodiment, an opposed blade link 40 is provided, which integrally comprises said opposed blade 24, and which rotates together with the reaction link 20. Preferably, the opposed blade link 40 integrally comprises a proximal mounting root 41 and said opposed blade 24, and the reaction link 20 integrally comprises a root 21, a gripping surface 53 and a distal free end 22, and the root 41 of the opposed blade link 40 and the root 21 of the reaction link 20 are adjacent to each other and in direct contact with each other. When said opposed blade link 40 is provided, the group formed by the root 51 of the blade holder link 50 and the root 31 of the blade link 30, as well as the root 41 of the opposed blade link 40 and the root 21 of the reaction link 20, is entirely interposed between the two protrusions 3, 4 of the distal connection part 17 of the support link 2 and in direct contact with them. In other words, when the opposed blade link 40 is provided, the axially stiff distal rotation joint 502 is further formed by the root portion 41 of the opposed blade link 40 .

[0231] Such a packing arrangement of the roots avoids the preferably thinner roots 31 of the blade link 30 and the roots 41 of the opposing blade link 40 from colliding with the articulating pin 5, thereby providing sufficient certainty of positioning of the cutting edge 34 relative to the opposing blade 24 at each opening angle of the opening / closing degree of freedom G, and thus providing extreme cutting precision.

[0232] In accordance with the embodiment with opposing blade 24 formed on a separate opposing blade link 40 having a proximal mounting root 41, the root 31 of the blade link 30 is axially interposed between and in direct contact with said root 41 of the opposing blade link 40 and a root 51 of the blade holder link 50, and said root 41 of the opposing blade link 40 is axially interposed between and in direct contact with said root 31 of the blade link 30 and said root 21 of the reaction link 20 to provide a reaction force against the elastic bending of the blade 14 during the cutting action.

[0233] As mentioned above, the root portion preferably has a cylindrical shape centered on the common axis of rotation YY, and the root portion 41 of the opposing blade link 40 has a thickness significantly smaller than the root portion 51 of the blade holder link 50 and the root portion 21 of the reaction link 20, and said root portion 41 of the opposing blade link 40 can have a disk-shaped cylindrical shape similar to the root portion 31 of the blade link 30.

[0234] Said root part 41 of the opposing blade link 40, if provided, is provided with a through hole 46 which is coaxial with and has an equal diameter to the through holes 16, 26, 26. According to one embodiment, said through hole 46 of the root part 41 of the opposing blade link 40 has a hole edge which is in direct close contact with the articulation pin 5 over the entire extension of the hole edge, exerting on a circular arc surface in the thickness of the hole edge a reaction force against the friction exchanged between the blade link 30 and the opposing blade 24 of the opposing blade link 40 during the cutting operation.

[0235] According to an embodiment in which the blade link 30 and the blade holder link 50 further comprise respective reaction engagement portions 37, 57 for rotating the blade link 30 and the blade holder link 50 together, the reaction engagement portion 57 of the blade holder link 50 is configured as a reaction seat 57 defined by a reaction tooth facing the rotation axis YY forming an undercut seat with respect to the gripping surface 54. That is, the seat 57 opening in the proximal direction and extending in the axial direction receives the distal end 32 of the blade link 30 in a rotational reaction contact while receiving the axial deformation of the distal end 32 of the blade link 30. In other words, in this embodiment, the portion of the blade link 30 close to or at the distal end 32 serves as the reaction engagement portion 37 of the blade holder link 30 that is received inside the reaction seat 57 of the blade link 50 in a rotational reaction contact, i.e. in the opening / closing direction. At the same time, the distal end 32 of the blade link 30 is free to deform axially outwardly inside the same reaction seat 57, thus forming part of the axial deformation seat 44 of the blade 14. In other words, the reaction seat 57 extends distally relative to the axially inwardly facing surface 58 of the first tip link 10, i.e. to a surface 58 that can act as an axial abutment for the bending of the blade 14. In such a case, the reaction seat 57 has an axial extension to receive the distal end 32 of the blade link 30, and thus receives the deformation of the blade link 30 during the cutting operation together with said deformation seat 44. The distal end 32 of the blade link 30 can include a distal portion of said cutting edge 34, which in such a case acts as a reaction counter surface in the opening direction 37.2 cooperating with the respective opening reaction surface 57.2 of the reaction tooth that defines the reaction seat 57 of the blade holder link 50.

[0236] According to an embodiment in which the blade link 30 and the blade holder link 50 further comprise respective drag engagement portions 37, 57 for rotating the blade link 30 and the blade holder link 50 together, the drag engagement portion 57 of the blade holder link 50 is formed as two separate and different drag surfaces. In other words, the open drag surface 57.2 and the closed drag surface 57.1 of the blade holder link 50 can be arranged at different distances from the common axis of rotation YY, and the open drag surface 37.2 and the closed drag surface 37.1 of the blade link 30 can be arranged at different distances from the common axis of rotation YY, for example, at different protrusions of the blade link 30, as shown in FIG. 28. In particular, referring to such FIG. 28, the root portion 31 of the blade link 30 can comprise a radial drag ear 37.4 folded over the root portion 51 of the blade holder link 50, said drag ear 37.4 comprising said open drag surface 37.2.

[0237] According to one embodiment, the blade holder link 50 and the blade link 30 are made of separate parts and releasably rotate together, with release preferably only being achieved by disassembling the articulated end effector 9.

[0238] According to one embodiment, the reaction link 20 includes a threaded wall 48 facing the common axis of rotation YY, which defines a threaded recess for receiving the suture 68 to maintain the suture 68 in contact with the cutting edge 34 of the blade of the blade link 30 during cut closure. The provision of the threaded wall 48 prevents the suture 68 from sliding distally past the distal end 32 of the blade during the cut operation as a result of the closing operation.

[0239] For example, the threaded wall 48 is an arched wall having a concave surface defining a recess facing the cutting edge 34. The recess can be made in the form of a notch in the body of the reaction link 20, in which case the threaded wall 48 is the wall defining said notch. The recess can be made in the form of an undercut wall in a protrusion in the body of the reaction link 20, in which case the threaded wall 48 is the undercut wall of said protrusion facing the common axis of rotation YY.

[0240] According to one embodiment, the threaded wall 48 defines the opposing blade 24 at its axially inner edge. If the opposing blade 24 is made in a separate piece to the reaction link 20, the threaded wall 48 and recess may be formed in the body of the opposing blade link 40.

[0241] According to one embodiment, the reaction link 20 includes an axial recess 45 forming a housing seat 45 for the opposing blade link 40. Said axial recess 45 is preferably defined axially by an axially inwardly facing surface 43 of the reaction link 20.

[0242] According to a preferred embodiment, the opposed blade link 40 is elastically deformable by bending, such that when the cutting edge 34 of the blade link 30 mechanically interferes with the opposed blade 24 of the opposed blade link 40 to perform a cutting action, the body of the opposed blade link 40 also elastically bends in the axial direction.

[0243] The opposing blade link 40 is preferably made from an elastic sheet or strip and is pre-curved to form a curved protruding opposing blade 24 with an axially inwardly facing concave surface for elastically bending the blade link 30 during the cutting action. Providing an opposing blade link 40 with a curved protruding opposing blade 24 that is elastically deformable by bending makes it possible to obtain an elastic reaction force between the axially inwardly facing surface 43 of the axial recess 45 of the reaction link 20 and the cutting edge 34 of the blade link 30 during the cutting action. In particular, the opposing blade link 40 comprises an axially oriented stationary surface 64 facing the opposing blade 24, which abuts against said axially inwardly facing surface 43 of the axial recess 45 of the reaction 20. This allows the opposing blade link 40 to provide an elastic action on the cutting edge 34 of the blade link 30 for elastically bending the blade link 30 during the cutting action. For example, the opposing blade link 40, if present, can be made of spring steel.

[0244] The opposed blade link 40 may have at least some, but may have all, of the features and characteristics described above with reference to the blade link 30. The thickness of the opposed blade link 40 may be substantially the same or equal to the thickness of the blade link 30, as described above. According to one embodiment, the opposed blade link 40 comprises an opposed blade cutting edge preferably disposed opposite the cutting edge 34 of the blade link 30. The proximal attachment root 41 of the opposed blade link 40 may have at least some, but may have all, of the features and characteristics described above with reference to the root 31 of the blade link 30. The root 41 of the opposed blade link 40 may comprise a radial cut channel 49 misaligned with the radial cut channel 39 of the blade link 30 to prevent engagement of the edges of the cut channels 39, 49 during opening / closing operations.

[0245] According to one embodiment, a reaction engagement is provided along or distal to the longitudinal extension of the opposing blade surface 24 for rotating the opposing blade link 40 and the reaction link 20 together. Preferably, the reaction engagement is obtained near or at the distal end 42 of the opposing blade link 24. According to one embodiment, the reaction link 20 is provided with a reaction seat 67, which acts essentially as an opposing blade holder link and has an open reaction face and an opposite closed reaction face for rotating the opposing blade link 40 together. The reaction seat 67 is located distal to the reaction seat undercut with respect to the gripping face 53 of the reaction link 20 to receive the distal end 42 of the opposing blade link 40. According to one embodiment, said distal end 42 of the opposing blade link 40 is provided with an open reaction face 47.2 in reaction contact with said open reaction face of the reaction link 20 and an opposite closed reaction face 47.1 in reaction contact with said closed reaction face. In other words, in this embodiment, the reaction force engagement portion 47 of the opposed blade link 40 is located near or at the distal end 42 of the opposed blade link 40. The distal end 42 of the opposed blade link 40 is preferably the distal end that is constrained to the reaction link 20.

[0246] For example, according to the embodiment shown in FIG. 29, the opposing blade link 40 comprises a radial drag ear 47.4 folded over the root portion 21 of the reaction link 20, said drag ear 47.4 of the opposing blade link 40 comprising an open drag surface 47.2 in drag contact with an open drag surface 67.2, for example located at the rear of the body of the reaction link 20, and the opposing blade link 40 further comprises a closed drag surface 47.1 located adjacent to the distal end 42 of the opposing blade link 40 in drag contact with a closed drag surface 67.1 of the opposing blade holder link 60.

[0247] According to one embodiment, the opposing blade cutting edge may have a concave shape relative to the opening / closing direction.

[0248] According to a general embodiment, there is provided a robotic surgical system 101 comprising at least one surgical instrument 1 according to any one of the previous embodiments. The robotic surgical system 101 is thus capable of performing surgical or microsurgical procedures including cutting of biological tissue and / or cutting of sutures.

[0249] According to one embodiment, the robotic surgery system 101 comprises at least two surgical instruments, at least one of which is a surgical instrument 1 according to any one of the previous embodiments, and the other surgical instrument can be a needle driver type surgical instrument or a dilator type surgical instrument, but according to one embodiment, both surgical instruments are surgical instruments 1 according to any one of the previous embodiments, and are not necessarily identical to each other. For example, one surgical instrument of the at least two surgical instruments can be a surgical scissors type surgical instrument, and another surgical instrument of the at least two surgical instruments can be a needle driver / scissors type surgical instrument.

[0250] The robotic surgery system 101 preferably comprises at least one robotic manipulator 103, to which at least one surgical instrument 1 is operatively connected. For example, a sterile surgical barrier (not shown), such as a sterile surgical drape, is interposed between the at least one robotic manipulator 103 and a back end 104 of the at least one surgical instrument 1. The robotic manipulator 103 may comprise motorized actuators for stressing the actuation tendons of the pitch P, yaw Y and gripping degrees of freedom G, i.e., for gripping and cutting the surgical instrument 1, and for rotating the surgical instrument 1 around a shaft 7, which defines a rolling degree of freedom. The robotic surgery system 101 may comprise a support 106 (cart or tower), for example with wheels or other ground-mounted units, and an articulated positioning arm 105, for example manually movable, i.e. passive, extending between the support 106 and the at least one robotic manipulator 103. According to one embodiment, the robotic surgery system 101 comprises at least one master console 107 for controlling at least one surgical instrument 1, preferably a respective robotic manipulator 103, according to a master-slave architecture, and preferably the robotic surgery system 101 further comprises a control unit operatively connected to the master console 107 and to the robotic manipulator 103 for determining the tracking of the surgical instrument 1 relative to the at least one master control device 108 of the master console 107. According to one embodiment, the master console 107 comprises at least one master control device 108 that is untethered, i.e. mechanically decoupled from the ground, and a tracking system, e.g. optical and / or magnetic.

[0251] The cutting method using the surgical instrument will be described below.

[0252] The method of cutting with a surgical instrument may include the following steps.

[0253] The method includes a step of sliding the tendons 71, 72, 75, 76 of at least one pair of antagonist tendons longitudinally on a convex ruled surface having parallel generatrices of at least one of the connecting link 90 and the supporting link 2 so as to orient the cutting edge 34 in a desired direction.

[0254] The method includes a step of sliding the tendons 71, 72, 73, 74 of at least one pair of antagonistic actuating tendons of the distal revolute joint 502 longitudinally on the convex ruled surfaces of the connection link 90 and the support link 2 to bring the cutting edge 34 into contact with the opposing blade 24. This step can be performed by relatively approaching the blade link 30 and the reaction link 20, i.e., by moving said tendons 71, 72, 73, 74 by the open / close degree of freedom G while sliding them on the convex ruled surfaces of the connection link 90 and the support link 2.

[0255] According to a preferred mode of operation, the step of sliding the tendons 71, 72, 73, 74 of at least one pair of antagonistic actuating tendons of the distal revolute joint 502 longitudinally on the convex ruled surfaces of the connecting link 90 and the supporting link 2 comprises wrapping at least one actuating tendon 71, 72, 73, 74 of the distal revolute joint 502 on the ruled surfaces of the links 2 and 90 on which they slide with a wrap angle between 60° and 300°, preferably greater than 120°. In other words, each actuating tendon 71, 72, 73, 74 of the distal revolute joint 502 describes an arcuate longitudinal sliding path defining a local wrap angle on each of the convex ruled surfaces 96, 97, 98, 99 of the links 2 and 90 on which they slide, the sum of all the local wrap angles of the at least one actuating tendon of the distal revolute joint 502 providing a value between 60° and 300°, preferably greater than 120°. It should be noted that the convex ruled surfaces 79, 80 of the pulley portions of the blade holder link 50 and reaction link 20, where the tendon does not slide, do not participate in the count.

[0256] According to a preferred mode of operation, the step of sliding the tendons longitudinally is performed to slide each tendon along a fixed longitudinal path, preventing the tendon from translating in a direction parallel to the distal axis of rotation YY and preventing the tendon from translating in a direction parallel to the proximal axis of rotation PP.

[0257] The method further includes the step of resiliently bending at least one of the cutting edge 34 and the opposing blade 24 to form a mechanical interference contact therebetween to effect the cutting action.

[0258] According to a preferred mode of operation, the method is carried out using a surgical instrument 1 according to any one of the previously described embodiments.

[0259] It will be fully understood that any combination of features, structures, or functions disclosed in one or more of the appended claims forms an integral part of this specification.

[0260] Thanks to the above features, provided separately or in combination with one another in specific embodiments, the aforementioned needs can be met and the aforementioned advantages can be obtained, in particular the following advantages:

[0261] - The open / close degree of freedom makes it possible to perform cutting actions.

[0262] - An axially rigid rotary joint is provided, the cutting action being carried out by the elements forming the rotary joint.

[0263] The tendon termination seats and textured pulley surfaces made integral with each link are advantageous for compactness, helping to keep the number of parts small and keeping the articulated end effector compact.

[0264] The degree of freedom of the open / close actuated tendon slides longitudinally on the ruled surfaces of the connecting and supporting links during the movement of the open / closed degree of freedom, and is able to avoid axial sliding on such ruled surfaces even though the ruled surfaces do not have guiding channels or grooves for guiding the tendon, i.e. in other words the sliding path of the tendon remains constant in any operating configuration.

[0265] -Preferably, the paths of the tendons are all parallel to each other.

[0266] The same convex ruled surface of the supporting link can be both a sliding surface for an actuating tendon with open / close degree of freedom and a wrapping surface, i.e. a pulley part, for an actuating tendon with pitch degree of freedom.

[0267] -The pulley portions of the blade holder link and the reaction link are formed by convex ruled surfaces that do not include guide channels or grooves onto which the ends (or portions near their respective terminations) of the respective actuating tendons wrap without sliding either longitudinally or axially.

[0268] - Extreme miniaturization of the articulated end effector of the surgical instrument is possible compared to known solutions.

[0269] It is possible to stack the roots of the links between the protrusions of the distal connections of the support links, while avoiding the installation of elastic washers and adjustment screws, as well as tapping or thread machining at the level of the mounting roots, thereby allowing an extreme miniaturization of the articulated end effector.

[0270] In particular, the articulating pin 5 is not threaded.

[0271] - Neither the hole edge surfaces of the through holes of the respective root parts nor the inner surfaces of the through holes of the projections which pass through the projections of the distal connecting parts of the support links are tapped, i.e. not internally threaded.

[0272] - The articulating pin is not fitted with elastic elements, such as the "Belleville washer" type.

[0273] - making it possible to provide substantially all of the elasticity required for the cutting action concentrated on the outside of the root, i.e. on the blade of the blade link and, if necessary, on the opposing blade surface of the reaction link, making it possible to perform a precise cutting action while forming a very miniaturized articulated end effector;

[0274] In particular for relatively large opening angles of the opening / closing degree of freedom, it is preferred that the blades are free, i.e. do not elastically deform, and are straight in such a configuration.

[0275] As the opening angle of the open / close degree of freedom is closed, the blade is elastically bent and elastically pushes against the opposing blade.

[0276] The elasticity required for the cutting action is concentrated distal to the root, making it possible to provide a deformation seat that can accommodate relatively large axial bending of the blade or counterblade.

[0277] - The root parts stacked in a pack between the projections provide a reaction force against the elastic bending deformation of the blade, avoiding axial sliding at the articulating pin and thus enabling a precise and effective cutting action of the cutting edge.

[0278] The blade link and opposing blade link are resisted in rotation by the blade holder link and reaction link, if present.

[0279] The provision of all coaxial through-holes in contact with the articulating pins in the receiving roots makes it possible to avoid undesired relative rotation between the roots, providing a certainty of the positioning of the cutting edge with respect to the opposing blade and thus allowing an extremely compact articulated end effector, since small rotational movements close to the level of the roots, i.e. the common axis of rotation, would result in relatively large cutting imprecisions.

[0280] Furthermore, the hole in the blade link has a proximal edge which presses against the pin, thereby creating a counter force against the friction between the blade and the opposing blade during the cutting action, which helps to obtain a precise cutting action.

[0281] The cutting edge of the blade link can be straight, i.e. without concavity, facilitating serial production, for example starting from a single band or strip.

[0282] By providing a single drag engagement for rotation between the blade link and the blade holder link, drag clearances can be minimized, facilitating compactness.

[0283] The revolute joint 502, which defines the common rotation axis YY, may be a hinge.

[0284] To meet certain contingent needs, those skilled in the art can make some modifications and adaptations to the above-described embodiments and replace elements with other functionally equivalent ones without departing from the scope of the appended claims. [Explanation of symbols]

[0285] 1 surgical cutting instruments 2 Support Links 3 First support link protrusion 4 Second support link protrusion 5 Articulation pin or pivot pin 6. Third support link end seat for actuating tendon pair or third support link end seat 6.1 Third end seat resistance abutment wall 7 Surgical instrument rods or shafts 8 Rod Distal End 9 Articulated end effector or articulated terminal 13 Proximal connection of supporting link 14 Bridge section 15 First End Seat 15.1 First end seat reaction abutment wall 16 First through hole 17 Distal connection of support link 19 Radial cut channel 20 Reaction Links 21 Proximal attachment root of reaction link 22 Distal free end of reaction link 23 Reaction Link Connection Stem 24 Opposed Blades 25 Second End Seat 25.1 Second end seat reaction abutment wall 26 Reaction link base through hole 27 Reaction Link Disconnection Interface 27.0 Proximal free end of cut interface 27.1 First Proximal Arm of Cutting Interface 27.2 Second Distal Arm of Cutting Interface 28 Axial deformation seat of reaction link or axial deformation seat of opposing blade 29 Radial cut channel 30 Blade Link 31 Proximal attachment root of blade link or blade link root 32 End of tip blade link 33 Horizontal Blade Link Bridge 34 Cutting edge of blade link 35 Axial inward facing blade surface 36 Through hole at the base of the blade link 37 Blade link drag engagement part 37.0 Blade link drag seat inlet opening 37.1 Blade Link Closure Drag Surface 37.2 Blade link opening drag surface 37.4 Cantilever Blade Link Ear 38 Circular arc surface of hole edge at root of blade link 39 Cut channel at the base of the blade link 40 Opposed Blade Link 41 Proximal attachment root of opposing blade link or opposing blade link root 42 distal opposing blade link end 43 Axial inward facing surface of opposing blade holder link recess 44 Axial deformation seat for the blade of the blade holder link 45 Axial opposing blade link recess 46 Opposing blade link root through hole 47 opposing blade link drag engagement part 47.1 Closing drag surface of opposed blade links 47.2 Opening drag surface of opposed blade links 47.4 Opposed Blade Link Drag Ear 48 Screw-fixed wall 49 Radial cut channel in opposed blade link 50 Blade holder link 51 Proximal attachment root of blade holder link or blade holder link root 52 Distal Blade Holder Link End 54 Blade holder link closing stroke end face 57 Blade holder link drag engagement part 57.1 Blade holder link closing drag surface 57.2 Blade holder link opening resistance surface 58 Axial inward facing surface of blade holder link 64 Opposing blade link support surface 67 Reaction link drag engagement part 68 Sutures 70 Tendon End 71 First tip release tendon 72 First tip closure actuation tendon 73 Second tip release tendon 74 Second tip closure actuated tendon 75 Operating tendon of supporting link 76 Support Link Operation Opposite Tendon 77 first cantilever drag leg at first end seat at first tip 77.1 Free end of first leg 78 second cantilever drag leg at second end seat at second tip 78.1 Free end of second leg 79 Blade holder link pulley section line ruled surface 80 Reaction link pulley surface 81 Contact surface of the blade link root 82 Contact surface on the opposite side of the blade link root 83 Internal contact surface of blade holder link root 84 Reaction link root internal contact surface 85 External contact surface of blade holder link root 86 External contact surface of reaction link root 87 Internal contact facing surface of first projection 88 Internal contact facing surface of second projection 90 Connecting Links 91 First prong of connecting link 92 Second prong of connecting link 93 Proximal joint pin 94 Fixation device 95 Distal connection of connecting link 96 Convex ruled surface of support link 97 Convex ruled surface of connecting link 98 Convex ruled surface of support link 99 Convex ruled surface of connecting link 101 Robotic Surgery System 102 Rod proximal end 103 Robot Manipulator 104 Proximal interface portion of a surgical instrument or back end portion of a surgical instrument 105 Positioning Arm 106 Supports, carts, or towers 107 Master Console 108 Master Control Device 502 Distal Rotation Joint 509 Proximal Rotation Joint XX Rod Longitudinal Axis YY common rotation axis, or distal common rotation axis, or common yaw rotation axis PP Proximal common axis of rotation, or common pitch axis of rotation Y Yaw Degree of Freedom P pitch freedom G Degree of freedom in opening / closing direction, degree of freedom in cutting R Roll freedom POC At least one point of contact between a blade and an opposing blade Y5 First axial distance Y5' Second axial distance Y8 Further axial distance

Claims

Claim 1 A surgical cutting instrument, comprising a rod (7) having a distal end (8), and an articulated end effector (9) connected to the distal end (8) of the rod (7), wherein the articulated end effector (9) is a connecting link (90) connected to the distal end (8) of the rod (7) having a body, wherein the body is one or more convex wire-woven surfaces of connecting links (97, 99) having parallel generatrices, a first distal connection portion (13), and integrally includes the connecting link (90), a support link (2) having a body and articulated to the connecting link (90), wherein the body is one or more convex wire-woven surfaces of support links (96, 98) having parallel generatrices, a proximal connection portion defining a proximal rotation joint (509) for the connecting link (90) and the support link (2) such that the connecting link (90) and the support link (2) can rotate relative to each other about a proximal common rotation axis (P - P), which is articulated to the first distal connection portion of the connecting link (90), a second distal connection portion (17), and integrally includes the support link (2), a blade holder link (50) having a body and articulated to the support link (2), wherein the body is a blade holder link attachment base portion (51) having a pulley portion formed by one or more convex wire-woven surfaces (79) of a blade holder base portion having parallel generatrices, a reaction force portion (57), and integrally includes the blade holder link (50), a blade link (30) having a body that rotates integrally with the blade holder link (50) and integrally includes a cutting edge (34) and a reaction force opposing portion (37) that engages with the reaction force portion of the blade holder link (50), a reaction link (20) having a body that is articulated to a group formed by the support link (2), the blade link (30) and the blade holder link (50) and integrally includes an attachment base portion having a pulley portion formed by one or more convex wire-woven surfaces (80) of a reaction link base portion having parallel generatrices, and is provided with The attachment root portion (51) of the blade holder link and the attachment root portion (21) of the reaction link (20), together with the second distal connection portion (17) of the support link (2), define a distal rotation joint (502) of the blade holder link (50), the reaction link (20), and the support link (2), whereby the blade holder link (50), the reaction link (20), and the support link (2) are relatively rotatable about a distal common rotation axis (Y - Y) orthogonal to the proximal common rotation axis (P - P). An opposing blade (24) that rotates integrally with the attachment root portion (21) of the reaction link (20) is provided. The surgical cutting instrument A first antagonistic tendon pair (71, 72) that extends along the rod (7) and is connected to the blade holder link (50) to move the blade link (30) around the distal common rotation axis (Y - Y). A second antagonistic tendon pair (73, 74) that extends along the rod (7) and is connected to the reaction link (20) to move the opposing blade (24) around the distal common rotation axis (Y - Y). Further includes Each tendon (71, 72, 73, 74) has a longitudinal extension. The attachment root portion (51) of the blade holder link (50) integrally includes at least a first terminal seat portion (15) for receiving the first antagonistic tendon pair (71, 72). The attachment root portion (21) of the reaction link (20) integrally includes at least a second terminal seat portion (25) for receiving the second antagonistic tendon pair (73, 74). One or more of the convex wire woven surfaces (97, 99) of the connection link (90) having parallel generatrices are parallel to the proximal common rotation axis (P - P). At least one of one or more of the convex wire woven surfaces (96, 98) of the support link (2) having parallel generatrices is parallel to the proximal common rotation axis (P - P). One or more of the convex wire woven surfaces (79) of the blade holder root portion of the blade holder link (50) having parallel generatrices and one or more of the convex wire woven surfaces (80) of the further root portion of the reaction link (20) having parallel generatrices are parallel to the distal common rotation axis (Y - Y). The first pair of antagonistic tendons (71, 72) and the second pair of antagonistic tendons (73, 74) are adapted to slide longitudinally on one or more of the convex woven surfaces (97, 99) of the connection link (90) and on one or more of the convex woven surfaces (96, 98) of the support link (2), and are wound / wound back without sliding on the respective convex woven surfaces (79 or 80) at the root portions of the blade holder link (50) or the reaction link (20), so as to open / close the blade link (30) and the opposing blade (24) respectively. The cutting edge (34) of the blade link (30) is adapted to contact the opposing blade (24) during movement of the opening / closing freedom (G) in a mechanically interfering contact state to perform a cutting action. The cutting edge (34) of the blade link (30) is elastically bendable in a direction parallel to the distal common rotation axis (Y - Y). A first distance (Y5) in a direction parallel to the distal common rotation axis (Y - Y) between the first terminal seat portion (15) of the root portion (51) of the blade holder link (50) and the surface (96) of one or more of the convex woven surfaces (96, 98) of the support link (2) is constant in any cutting state. A second distance (Y5') in a direction parallel to the distal common rotation axis (Y - Y) between the second terminal seat portion (25) of the root portion (21) of the further link (20) and the surface (98) of one or more of the convex woven surfaces (96, 98) of the support link (2) is constant in any cutting state. Surgical instrument (1). Claim 2 When in the operating state, the overall sliding frictional force exchanged between each tendon and all of the woven surfaces of the link on which the tendon slides is Much smaller than the tensile force transmitted by the same tendon to achieve the elastic bending deformation of the blade (14) of the blade link (30) when the opening / closing freedom (G) moves in the closing direction to perform a cutting action. The surgical instrument (1) according to claim 1. Claim 3 The distal rotary joint (502) is a rigid rotary joint in the axial direction. The surgical instrument (1) according to claim 1 or 2. Claim 4 All of the convex wire-woven surfaces (79, 80, 96, 97, 98, 99) of the connecting link (90), the support link (2), the pulley portion of the blade holder link (50), and the pulley portion of the reaction link (20) do not have longitudinal channels. The surgical instrument (1) according to claim 1.

5. The attachment base portion (51) of the blade holder link (50) includes a first surface (85) facing axially outward, the base portion (21) of the reaction link (20) includes a second surface (86) facing axially outward, and the axial distance (Y8) between the first surface (85) of the attachment base portion (51) of the blade holder link (50) and the second surface (86) of the attachment base portion (21) of the reaction link (20) is constant in any cutting state. The surgical instrument (1) according to claim 1.

6. The blade holder link (50) integrally includes a first cantilever drag leg (77) extending from the base portion (51) of the blade holder link (50). The first cantilever drag leg (77) forms a free end (77.1) of the first leg and defines the first terminal seat portion (15) axially. The reaction link (20) integrally includes a second cantilever drag leg (78) extending from the base portion (21) of the reaction link (20). The second cantilever drag leg (78) forms a free end (78.1) of the second leg and defines the second terminal seat portion (25) axially. The first cantilever drag leg (77) and the second cantilever drag leg (78) each include an abutment wall and a resistance wall. The abutment wall and the resistance wall are arranged to be undercut with respect to their respective terminal seat portions (15, 25) and act as resistance abutment portions for their respective tendon terminals (70). The axial first distance between the first cantilever drag leg (77) of the blade holder link (50) and the surface (96) of one or more of the convex wire-woven surfaces (96, 98) of the support link (2) is constant in any cutting state. The second distance in a direction parallel to the distal common rotation axis (Y - Y) between the second cantilever drag leg (78) and the surface (98) of one or more of the convex wire - woven surfaces (96, 98) of the support link (2) is constant in any cutting state. The surgical instrument (1) according to claim 1.

7. At least one of the blade - holder link (50) and the blade link (30) integrally includes a free distal end. The surgical instrument (1) according to claim 1.

8. The opposing blade (24) protrudes axially inward and preferably has an inwardly curved protruding surface with a concave surface facing axially inward. The surgical instrument (1) according to claim 1.

9. The connection link (90) further includes a third pair of antagonistic tendons (75, 76) for moving the support link (2) around the proximal common rotation axis (P - P). The support link (2) includes at least a third end seat (6) for receiving the tendon ends (70) of the third pair of antagonistic tendons (75, 76). Preferably, The actuating tendons (75, 76) of the third pair of antagonistic tendons wrap / unwrap longitudinally without sliding on one or more of the convex wire - woven surfaces (96, 98) of the support link (2), and the convex wire - woven surfaces (96, 98) act as pulley surfaces for the actuating tendons (75, 76) of the third pair of antagonistic tendons. The surgical instrument (1) according to claim 1.

10. A cutting method using a surgical instrument, comprising: providing an articulated end - effector (9) at the distal end of a rod (7), wherein the articulated end - effector (9) comprises a connection link (90) and a support link (2) that are articulately coupled to each other at a proximal rotation joint (509), the support link (2) a blade link (30) having a cutting edge (34), a blade - holder link (50) that rotates integrally with the blade link (30), a reaction link (20) having an opposing blade (24), and is articulately coupled at a distal rotation joint (502), providing an articulated end - effector (9) at the distal end of the rod (7); Sliding at least one pair of actuating tendons (71, 72; 75, 76) of the antagonistic tendon pairs longitudinally on one or more convex wire-woven surfaces (97, 99; 96, 98) having parallel generatrices, of at least one of the connecting link (90) and the support link (2), to orient the cutting edge (34) of the blade link (30) in a desired direction; Sliding at least one actuating tendon (71, 72; 73, 74) of at least one antagonistic actuating tendon pair of the distal rotary joint (502) longitudinally on one or more convex wire-woven surfaces (97, 99; 96, 98) having parallel generatrices, of the connecting link (90) and the support link (2), to bring the cutting edge (34) into contact with the opposing blade (24); Elastically bending at least one of the cutting edge (34) and the opposing blade (24) to mechanically interfere and contact between the cutting edge (34) and the opposing blade (24) to perform a cutting action; comprising a cutting method.

11. The step of sliding the actuating tendon (71, 72; 73, 74) of at least one antagonistic actuating tendon pair of the distal rotary joint (502) longitudinally on the convex wire-woven surface (97, 99; 96, 98) having parallel generatrices, of the connecting link (90) and the support link (2), includes the step of winding at least one actuating tendon (71, 72; 73, 74) of the distal rotary joint (502) around the convex wire-woven surface on which it slides at a winding angle of 60° to 300°, preferably greater than 120°; The cutting method according to claim 10.

12. A rotary joint (502) of a cutting joint having a rotary axis (Y - Y) actuated by an actuating tendon, a distal connection portion (17) of the support link (2), a mounting base portion (31) of the blade link (30) having a body elastically bendable in the axial direction, a mounting base portion (51) of the blade holder link (50) rotating integrally with the blade link (30), a mounting base portion (21) of the reaction link (20) rotating integrally with the opposing blade (24), comprising the cutting edge (34) of the blade link (30) being adapted to contact the opposing blade (24) during movement of the opening / closing degree of freedom (G) in a mechanically interfering contact state to perform a cutting action. The root portion (51) of the blade holder link (50) integrally includes at least a first terminal seat portion (15) for the first antagonistic tendon pair (71, 72). The root portion (21) of the reaction link (20) integrally includes at least a second terminal seat portion (25) for the second antagonistic tendon pair (73, 74). The support link (2) integrally includes one or more convex wire-woven surfaces (96, 98) having parallel generatrices on which the tendons of the first antagonistic tendon pair and the second antagonistic tendon pair slide during the cutting operation. The rotary joint (502) is axially rigid, whereby a first distance (Y5) in a direction parallel to the distal common rotation axis (Y - Y) between the first terminal seat portion (15) of the root portion (51) of the blade holder link (50) and the surface (96) of one or more of the convex wire-woven surfaces (96, 98) of the support link (2) is constant in any cutting state. a second distance (Y5') in a direction parallel to the distal common rotation axis (Y - Y) between the second terminal seat portion (25) of the root portion (21) of the further link (20) and the surface (98) of one or more of the convex wire-woven surfaces (96, 98) of the support link (2) is constant in any cutting state. Rotary joint (502).

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