Cable and wire routing in mechanical arm of surgical apparatus

Abstract

To provide a device for routing a mechanical cable and an electric wire.SOLUTION: An apparatus for performing electrosurgical operations using an electrosurgical power generator comprises an articulated mechanical arm, an electrosurgical grasper connected to the mechanical arm at a distal end thereof, a flexible sleeve at least partly disposed in a bendable portion of the arm, an outer surface of the sleeve comprising a plurality of surface features that define a helical wire-path around a central longitudinal axis of the sleeve, an actuation-cable passing through an inner conduit of the sleeve and mechanically coupled to the grasper to open and shut the grasper, and an electrically conductive wire for providing electrical connectivity from the power generator to the grasper. The wire is disposed on the outside of the sleeve and engaged with one or more of the surface features so as to follow therethrough the helical wire-path.SELECTED DRAWING: Figure 4

Description

[Technical Field]

[0001] The present invention relates to surgical and electrosurgical devices used for grasping, coagulating, sealing, manipulating, and / or cutting tissue. In particular, the present invention relates to electrosurgical devices including mechanical arms and devices for routing mechanical cables and electrical wires necessary for the operation of such devices and arms in pathways within and through such arms. In particular, the present invention is suitable for separating and retaining mechanical cables and electrical wires in such pathways within bendable sections of mechanical surgical arms. [Background technology]

[0002] The advantages of minimally invasive surgery are well established. Such surgical instruments typically comprise surgical end effectors located at the distal end of articulated surgical arms (preferably having minimal diameters) that are inserted through small openings (e.g., body wall incisions, natural orifices) to reach the surgical site. In some instances, the surgical instruments are passed through cannulas, and an endoscope can be used to provide imaging of the surgical site.

[0003] For both convenience and cutting precision, surgical instruments have been developed that utilize end effectors that integrate the use of tissue welding and cutting. In some cases, articulated surgical arms have one or more bending sections controlled by mechanical cables, where longitudinal movement of the mechanical arm affects the bending, ultimately controlling the position and orientation of the end effector relative to the longitudinal axis of the surgical arm. In some cases, the surgical arm is capable of bending backward relative to the longitudinal axis of the surgical arm.

[0004] The current state of the art lacks devices and methods that can provide optimal routing of mechanical wires and electrical cables, respectively, through sections of a surgical arm, particularly through bendable sections thereof. In devices and methods that can provide optimal routing, the electrical wires are separated from the mechanical cables to avoid electrical and / or magnetic interference without stressing the electrical wires when a portion of the arm is bent, and the electrical wires are not subjected to excessive tension or given excessive slack that could lead to fouling and misrouting when the corresponding portion of the arm is bent to a small radius of curvature. Such devices and methods allow electrical wires within a surgical arm to be optimally retained therein with safe and efficient routing. Summary of the Invention

[0005] According to embodiments disclosed herein, an apparatus for performing electrosurgery using an electrosurgical generator includes: (a) an articulated mechanical arm; (b) an electrosurgical grasper having a plurality of jaws and connected to the mechanical arm at a distal end thereof; (c) a flexible sleeve at least a portion of which is disposed on a bendable section of the arm, the outer surface of the sleeve having a plurality of surface features defining a helical wire path about a central longitudinal axis of the sleeve; (d) an actuation cable passing through an inner conduit of the sleeve and mechanically coupled to the grasper to effect movement of at least one jaw; and (e) a conductive wire for providing electrical connectivity from the generator to the grasper, the wire being disposed on the exterior of the sleeve and engaging one or more of the surface features to follow the helical wire path.

[0006] In some embodiments, the plurality of surface features may comprise discontinuous protrusions, with the helical wire path passing between the protrusions.

[0007] In some embodiments, the plurality of surface features comprise alternating longitudinally parallel ribs and troughs, the ribs and troughs being helically aligned about a central longitudinal axis of the sleeve for at least a portion of the length of the sleeve, and the helical wire path can pass through one of the troughs.

[0008] In some embodiments, the plurality of surface features can comprise at least three ribs and at least three troughs. In some embodiments, for a first length of the sleeve, the parallel ribs and troughs can be parallel to the central longitudinal axis, and for a second length of the cable-sleeve, the parallel ribs can helically wrap around the central axis.

[0009] In some embodiments, the helical pitch of the helical wire path can have a variability of less than ±50% along the length of the helical wire path, hi some embodiments, the helical pitch of the helical wire path is constant or has a variability of less than ±10% along the length of the helical wire path.

[0010] In some embodiments, the helical pitch of the helical wire path can be at least 1 / 3 of the length of the central axial path of the corresponding sleeve portion. In some embodiments, the helical pitch of the helical wire path is at least 1 / 2 of the length of the central axial path of the corresponding sleeve portion. In some embodiments, the helical pitch of the helical wire path is at most 1.5 times the length of the central axial path of the corresponding sleeve portion, or at most 1.25 times the length, or at most equal to the length itself.

[0011] In some embodiments, the ratio of helix pitch to helix amplitude of the helical wire path can be at least 10, or at least 20, or at least 50.

[0012] In some embodiments, the bendable portion of the arm may comprise a plurality of bendable segments. In some embodiments, the bendable portion of the arm may comprise non-contiguous segments.

[0013] In some embodiments, the sleeve is constrained to bend and / or straighten with the bendable portion of the arm, and the electrical wire path can be maintained helically relative to the bent and / or straightened path of the central longitudinal axis of the sleeve. In some embodiments, the electrical wire path can be maintained helically relative to the bent and / or straightened path of the central axis of the sleeve for any bend of the bendable portion of the arm to a radius of curvature greater than two times the diameter of the bendable portion. In some embodiments, the electrical wire path can be maintained helically relative to the bent and / or straightened path of the central axis of the sleeve for any bend of the bendable portion of the arm to a radius of curvature greater than 1.5 times the diameter of the bendable portion.

[0014] In some embodiments, bending and / or straightening the sleeve assembly may not substantially increase tension in the wire.

[0015] In some embodiments, the inner conduit may have a circular cross section. In some embodiments, the inner conduit may have an inner diameter of at least 0.5 mm and at most 2.0 mm.

[0016] In some embodiments, the surface features comprise helical ribs, the maximum helical amplitude of the ribs on the outer surface of the sleeve can be at least 1.0 mm and at most 2.0 mm, hi some embodiments, the maximum helical amplitude of the ribs on the outer surface of the sleeve can be at least 1.25 mm and at most 1.5 mm.

[0017] In some embodiments, the surface features can be integrally formed with the sleeve.

[0018] In some embodiments, the sleeve may comprise a thermoplastic elastomer comprising a hard polyamide and a soft polyether.

[0019] In some embodiments, the electrosurgical grasper is capable of providing at least a bipolar electrosurgical mode when electrically connected to the electrosurgical generator.

[0020] In some embodiments, the actuation cable can be mechanically coupled to the grasper such that rotation of the actuation cable about a central axis of the actuation cable controls movement of the at least one jaw, hi some embodiments, the actuation cable can be mechanically coupled to the grasper such that longitudinal movement of the actuation cable within the arm controls movement of the at least one jaw.

[0021] In some embodiments, the surgical device can further include the electrosurgical generator, and a conductive wire can provide electrical connectivity from the generator to the grasper.

[0022] According to embodiments disclosed herein, a surgical apparatus for use with a power source comprises: (a) an articulated mechanical arm; (b) a tool connected to the mechanical arm at a distal end thereof, the tool being powered or having at least one powered assist device attached thereto; (c) a flexible sleeve at least a portion of which is disposed on a bendable section of the arm, the outer surface of the sleeve having a plurality of surface features defining a helical wire path about a central longitudinal axis of the sleeve; and (d) a conductive wire for providing electrical connectivity from the power source to the tool or the attached assist device, the wire being disposed on the exterior of the sleeve and engaging one or more of the surface features to follow the helical wire path.

[0023] In some embodiments, the tool is a surgical tool.

[0024] In some embodiments, the surgical tool is selected from the group consisting of graspers, forceps, scissors, clamps, hooks, and lasers.

[0025] In some embodiments, the tool and / or the auxiliary device is a camera, i.e., the conductive wire is for providing electrical connectivity from the power source to the camera.

[0026] In some embodiments, the tool and / or the auxiliary device is a data acquisition tool, and the conductive wire is for providing electrical connectivity from the power source to the data acquisition tool.

[0027] In some embodiments, the data acquisition tool is or comprises at least one of a powered thermometer, a camera, and a powered microphone.

[0028] In some embodiments, the tool and / or the auxiliary device comprises a powered illumination source (e.g., a light emitting diode (LED)), i.e., the conductive wire is for providing electrical connectivity from the power source to the illumination source.

[0029] In some embodiments, the tool has at least one internal degree of freedom.

[0030] In some embodiments, the device further comprises an actuation cable passing through an inner conduit of the sleeve and mechanically coupled to the tool, the actuation cable being mechanically coupled to the tool to (i) alter an inner configuration of the tool with respect to one or more of the degrees of freedom and / or (ii) mechanically manipulate or actuate the tool.

[0031] In some embodiments, the plurality of surface features comprise discontinuous protrusions, and the helical wire path passes between the protrusions.

[0032] In some embodiments, the plurality of surface features comprise alternating longitudinally parallel ribs and troughs, the ribs and troughs being helically aligned about a central longitudinal axis of the sleeve for at least a portion of the length of the sleeve, and the helical wire path passing through one of the troughs.

[0033] In some embodiments, the plurality of surface features comprises at least three ribs and at least three troughs.

[0034] In some embodiments, for a first lengthwise portion of the sleeve, the parallel ribs and troughs are parallel to the central longitudinal axis, and for a second lengthwise portion of the cable-sleeve, the parallel ribs helically wrap around the central axis.

[0035] In some embodiments, the helical pitch of the helical wire path has a variability of less than ±50% along the length of the helical wire path.

[0036] In some embodiments, the helical pitch of the helical wire path is constant or has a variability of less than ±10% along the length of the helical wire path.

[0037] In some embodiments, the helical pitch of the helical wire path is at least 1 / 3 of the length of the central axial path of the corresponding portion of the sleeve.

[0038] In some embodiments, the helical pitch of the helical wire path is at least half the length of the central axial path of the corresponding portion of the sleeve.

[0039] In some embodiments, the helical pitch of the helical wire path is at most 1.5 times the length of the central axial path of the corresponding portion of the sleeve, or at most 1.25 times the length, or at most equal to the length itself.

[0040] In some embodiments, the ratio of helix pitch to helix amplitude of the helical wire path is at least 10, or at least 20, or at least 50.

[0041] In some embodiments, the bendable portion of the arm comprises a plurality of bendable segments.

[0042] In some embodiments, the bendable portion of the arm comprises a non-contiguous segment.

[0043] In some embodiments, the sleeve is constrained to bend and / or straighten with the bendable portion of the arm, and the path of the electrical wire is maintained helically relative to the curved and / or straightened path of the central longitudinal axis of the sleeve.

[0044] In some embodiments, the path of the electrical wire remains helical relative to the curved and / or straightened path of the central axis of the sleeve for any bending of the bendable portion of the arm to a radius of curvature greater than twice the diameter of the bendable portion.

[0045] In some embodiments, the helical path of the electrical wire remains helical relative to the curved and / or straightened path of the central axis of the sleeve for any bending of the bendable portion of the arm to a radius of curvature greater than 1.5 times the diameter of the bendable portion.

[0046] In some embodiments, bending and / or straightening the sleeve assembly does not substantially increase tension in the wire.

[0047] In some embodiments, the inner conduit has a circular cross section.

[0048] In some embodiments, the inner diameter of the inner conduit is at least 0.5 mm and at most 2.0 mm.

[0049] In some embodiments, the maximum helical amplitude of the ribs on the outer surface of the sleeve is at least 1.0 mm and at most 2.0 mm.

[0050] In some embodiments, the maximum helical amplitude of the ribs on the outer surface of the sleeve is at least 1.25 mm and at most 1.5 mm.

[0051] In some embodiments, the surface features are integrally formed with the sleeve.

[0052] In some embodiments, the sleeve comprises a thermoplastic elastomer comprising a hard polyamide and a soft polyether.

[0053] A teleoperated robotic surgical system includes any of the devices disclosed herein, a patient-side console configured to interface with the surgical tools, actuate the surgical tools, and perform one or more surgical procedures, and a surgeon-side console including one or more input devices operated by a surgeon and configured to send signals to control the surgical tools on the patient-side console. [Brief explanation of the drawings]

[0054] The invention will now be further described, by way of example only, with reference to the accompanying drawings, in which: Dimensions of components and features shown in the figures have been chosen for convenience and clarity of presentation and are not necessarily to scale; Also, in some of the figures, relative sizes of objects, and relative distances between objects, may be exaggerated or reduced for convenience and clarity of presentation.

[0055] [Figure 1] FIG. 1 shows a simplified schematic diagram of a surgical system according to an embodiment of the present invention.

[0056] [Figure 2] Figure 2A shows a surgical arm unit according to an embodiment of the present invention. Figure 2B shows a mechanical arm having a bendable section with laminated links and end effector tooling according to an embodiment of the present invention. Figure 2C shows the result of bending the bendable section of the mechanical arm according to an embodiment of the present invention. Figure 2D shows a schematic diagram illustrating the central axis of the mechanical arm, the diameter of a section of the mechanical arm, and the radius of curvature of the bendable section of the mechanical arm used in the present disclosure.

[0057] [Figure 3] FIG. 3 is a longitudinal cross-sectional projection of a portion of a mechanical arm showing a cable routing sleeve and a wire routing sleeve according to an embodiment of the present invention.

[0058] [Figure 4] FIG. 4 shows a schematic representation of the bent mechanical arm of FIG. 2C with a similarly bent cable sleeve overlay, according to an embodiment of the present invention.

[0059] [Figure 5] 5A and 5B are schematic illustrations of a sleeve having spiral ribs and troughs as surface features and a close-up of the same, according to an embodiment of the present invention.

[0060] [Figure 6] FIG. 6 illustrates a sleeve having protrusions as surface features according to an embodiment of the present invention.

[0061] [Figure 7] FIG. 7 shows the sleeve of FIG. 5A with wires in a helical wire path, according to an embodiment of the present invention.

[0062] [Figure 8] Figure 8A is a two-dimensional projection of the wire of Figure 7. Figures 8B and 8C are respective two-dimensional projections of wires having different helical pitches.

[0063] [Figure 9] FIG. 9 shows a schematic diagram illustrating helix pitch and helix amplitude as used in this disclosure.

[0064] [Figure 10] FIG. 10 illustrates an embodiment of a sleeve having linear ribs and troughs on the outer surface of a first portion of the sleeve section and helical ribs and troughs on the outer surface of a second portion of the sleeve section, in accordance with an embodiment of the present invention. DETAILED DESCRIPTION OF THE INVENTION

[0065] According to embodiments, the mechanical surgical arm can house a "mechanical" or "actuation" cable for actuating and controlling the movement of a surgical tool located at the distal end of the arm. One example of a surgical tool is a multi-jaw grasper used in electrosurgery. The grasper preferably provides at least a bipolar electrosurgical mode, typically used for welding tissue (e.g., blood vessels) or general tissue bundle coagulation, cold cutting, tissue dissection, and tissue manipulation / tissue retraction. The grasper can also provide a monopolar electrosurgical mode.

[0066] The "distal" end of the arm is defined herein as the end to which a surgical tool is connected, i.e., the end that is furthest from the operator or user of the surgical apparatus that includes the arm in a typical surgical procedure. The term "mechanical" is used herein to indicate that the cable is not generally used to carry electricity and that the cable does not generally carry data. However, in some embodiments, the "mechanical" cable can be used to carry data and / or as a ground return to complete an electrical circuit.

[0067] Mechanical or actuation wires can run the entire length or a portion of the arm and can be connected, directly or indirectly, to one or more mechanical and / or electronic control elements (such as gearing or actuators) at or near the proximal end of the arm. Depending on the mechanical arrangement of the arm and / or tool, the surgical tool may be controlled directly or indirectly by longitudinal force applied by the actuation cable (i.e., causing back and forth movement) or by rotational torque applied through the cable. It may be desirable to route the actuation cable through a longitudinal conduit, such as a tube or sleeve, disposed around the central axis of the arm to maintain a straight routing path. This allows for maximum control of movement.

[0068] The mechanical surgical arm may further accommodate electrical wires that conduct electricity from a power source, such as, but not limited to, an electrosurgical generator, to the same surgical tools controlled by the actuation cable during the operating state of the surgical device. The wires may be single-wire or double-wire (or triple-wire). If a single wire is used, the electrical circuit may be completed by using a separate return path (e.g., a metal arm housing or actuation cable). It may be desirable to physically separate the electrical wire path from the actuation cable path, particularly to avoid potential tangling, which could interfere with the function of the actuation cable and / or threaten the physical integrity of a less robust electrical wire. The electrical wires are preferably physically separated and electrically insulated from the actuation cable, which is preferably coaxial with the central axis of the arm for maximum functionality. Therefore, if the electrical wires were to follow a linear path through the arm, they would necessarily be off-center. Maintaining the electrical wire in an off-center routing path requires complex mechanical schemes and, in some cases, can subject the portion of the electrical wire passing through the bendable portion of the arm to excessive strain, stress and / or shear forces, even leading to rupture, especially when the arm is placed in a position where it is repeatedly retroflexed.

[0069] Therefore, it may be desirable to wrap electrical wires around a sleeve or tube through which the actuation cable passes. According to embodiments disclosed herein, surface features on the outer surface of the sleeve can be used to create a stable wire path around the outer surface. A helical wire path around the outer surface of the sleeve can be desirable because the central axis of the helix can be coaxial with the central axis of the sleeve through which the actuation cable passes through the center of the arm. As described below, the central axes of the sleeve and arm remain coaxial, or if not coaxial, at least parallel, with each other during bending and straightening of the bendable portion of the arm. While seemingly distorted by bending, the helical wire path remains helical relative to the path of the central axis of the sleeve. Bending of the bendable portion of the arm can also include "extreme" bends, such as backbend configurations or S-curves, and the sleeve remains coaxial (or parallel) with the arm during any such use. Creating a stable helical wire path centered on the central axis of the arm can have the advantage of reducing tension in the wire when the wire path is bent with the bendable portion of the arm and / or reducing the amount of slack imparted to the wire when assembled. Because the wire can slide longitudinally within this helical wire path, the "extra" wire "inside" the curve or bend can slide toward the "outside" of the curve or bend. Otherwise, the wire would be subjected to greater tension, stretched, or even broken. This sliding helical movement of the electrical wire within this helical wire path is preferably smooth, or at least sufficiently smooth, so that bending and / or straightening of the sleeve assembly does not substantially increase tension in the wire. As a counterexample, if the wire were wrapped or tied around surface features on the outer surface of the sleeve, this sliding would likely be overly hindered, resulting in a substantial increase in tension in portions of the wire (such as the portion "outside" the curve or bend during operation).

[0070] FIG. 1 shows a schematic diagram of a typical prior art surgical system 100 according to an embodiment. The system 100 includes two surgical mechanical arms 102. In other embodiments, a single surgical arm is provided. The surgical mechanical arms 102 are preferably sized and / or shaped for insertion into a human body or patient 106. Each surgical mechanical arm 102 is actuated by a respective motor unit 108. The surgical arms 102 and / or motor units 108 are supported by attachment to a patient support 116 (e.g., a bed) in this example, but could also be supported by a patient side cart.

[0071] Power to the arm 102 and motor unit 108 is supplied by an electrosurgical generator 112. As is known in the electrosurgery arts, electrosurgical generators provide high frequency (e.g., radio frequency), alternating polarity, current. The electrosurgical generator 112 can be configured to provide various frequencies and / or power levels suitable, for example, for cutting and / or coagulating and / or sealing and / or desiccating and / or fulgurating tissue. One suitable example of a commercially available electrosurgical generator 112 is the Covidien Force FX ESU Electrosurgical Generator. Power is supplied to the motor unit 108 via one or more cables 114 configured to transmit radio frequency electrosurgical power.

[0072] Movement of the surgical arms 102 and / or electrosurgical charging is controlled by a control console 118. The control console 118 comprises multiple user interfaces, including one or more of the following: an input device (e.g., an input device arm 120 where the control console is configured to generate control signals based on movement of the input device arm 120), a touchscreen display 128 configured to receive user input and / or display images of the surgical zone (e.g., displaying images collected by a camera inserted into the patient 106 using one of the surgical arms 102), and one or more additional user interfaces 130 (e.g., buttons, switches, etc.).

[0073] Control console 118 includes a processor (not shown) configured to receive signals from one or more user inputs and send control signals to motor unit 108 and / or electrosurgical generator 112. Foot pedal 126 and / or electrosurgical generator 112 include a processor (not shown) configured to receive a control signal (e.g., generated by a user pressing a portion of foot pedal 126) and vary the power supplied to motor unit 108 based on the control signal. The foot pedal control signal does not necessarily pass through the control unit processor.

[0074] Movement of the input device arm 120 controls the movement of the respective surgical device arm 102. A user 124 can position and / or move the input arm 120 by grasping an input device arm handle 127.

[0075] It may be desirable for the surgical arm to be sized and / or shaped to be suitable for insertion into the human body. For example, the arm can be sized and / or shaped to be suitable for insertion through a laparoscopic port and / or for performing laparoscopic surgery. For example, the arm can be sized and / or shaped to be suitable for insertion through a natural body orifice (e.g., vagina, anus, trachea, esophagus, ear canal).

[0076] Referring now to FIG. 2A , the arm unit 204 includes a proximal end at which a support unit 223 is attached to the arm 102 and a distal end at which an electrosurgical tool 224, such as the illustrated multi-jaw grasper, is attached to the arm 102. The example of a multi-jaw grasper is intended to be non-limiting, and any suitable surgical tool may be used. Various non-limiting examples of grasper tool designs are shown in the accompanying figures. Any powered surgical tool actuated by an actuation cable may be suitable for use as the electrosurgical tool in the disclosed embodiments. A bendable section 200 of the arm 102 is located along the length of the arm, closer to the distal end. The bendable section 200 may include a series of laminated links 199 that provide external flexibility to the arm 102; an example of multiple laminated links 199 in the bendable section 200 of the arm 102 is shown in FIG. 2B . As shown in FIG. 2B, one or more segments of the arm 102 or bendable section 200 can have different diameters while sharing the same central longitudinal axis.

[0077] The bendable section 200 of the arm 102 can comprise discontinuous segments. In other words, the bendable section 200 can actually comprise multiple bendable sections, which may or may not have non-bendable segments sandwiched between them. FIG. 2C illustrates an exemplary arm 102 bent at multiple locations along the bendable section 200. A clockwise "wrap" in FIG. 2C represents the following: rigid section 202 (the most proximal portion of the arm 102 illustrated in FIG. 2C ), bendable segment 208 comprising a first bendable segment within the section of bendable section 200, rigid connecting segment 212, bendable segment 220 comprising a second bendable segment within the section of bendable section 200, and rigid segment 216 to which surgical tool 224 is connected. Rigid segment 216 can house a mechanical mechanism for translating controlled movement of an actuation cable to surgical tool 224.

[0078] Any portion or segment of the bendable section 200 of the arm 102 can be bent to a radius of curvature R. For purposes of this disclosure, the radius of curvature R is calculated as the radius of curvature about a central axis, or centerline CL, as illustrated in FIG. 2D for clarity. In embodiments, a lower limit for the radius of curvature R can be defined by the size and particular design of the bendable section and its constituent links, as well as the diameter D of the arm 102. For example, the radius of curvature R can be limited to be at least three times the diameter of the arm 102, or at least two times the diameter of the arm 102, or at least 1.5 times the diameter of the arm 102, or at least 1.25 times the diameter of the arm 102.

[0079] The diameter D of the bendable section 200 (or any segment thereof) of the mechanical surgical arm 102 suitable for electrosurgery, and particularly for minimally invasive surgery, can range from 6 to 12 mm, or 7 to 11 mm, or 8 to 10 mm, or 8 to 9 mm. Different segments can be designed to have different D values. The "length" of the link 199 (i.e., when assembled into the unbent bendable section 200) can range from 1.5 to 4 mm, or 2.0 to 3.25 mm, or 2.25 to 2.75 mm. Each link 199 can accommodate an arc of 5° to 15°, or 6° to 13°, or 7° to 11°, or 8° to 10° when the corresponding bendable section 200 (or segment thereof) is maximally flexed or bent. The resulting radius of curvature R can be in the range of 10-20 mm, or 11-16 mm, or 12-15 mm, or 13-14 mm.

[0080] 3, which shows a cross-sectional view of the distal portion of arm 102. A cable and wire routing sleeve 210 (not in cross-section) is shown disposed within bendable section 200 of arm 102.

[0081] Use of the term “disposed within” throughout this disclosure and the appended claims should be understood to interchangeably include either “disposed completely within” or “disposed partially within.” For example, FIG. 3 illustrates the entire length of sleeve 210 as being encompassed by the marked section of bendable section 200. Even if there is overlap between a section of sleeve 210 and a section of bendable section 200, such that one or both ends of the sleeve extend beyond the marked section of bendable section 200, sleeve 210 in FIG. 3 would still be “disposed within” bendable section 200. Furthermore, the section marked as bendable section 200 may include one or more rigid sections (e.g., rigid section 212), as discussed in connection with FIG. 2C . The purpose, function, shape, and manufacture of sleeve 210 are discussed further below. As shown in FIG. 3 , it may be desirable for the sleeve to have a central longitudinal axis that is coaxial with central longitudinal axis CL of arm 102.

[0082] FIG. 4 schematically illustrates the effect of bending the bendable portion 200 of the arm 102 on the sleeve 210. The sleeve 210 will obviously bend to the extent that the bendable portion 200 is bent. However, the sleeve 210 is desirably adequately constrained within the arm and sufficiently flexible so that the central axis of the sleeve and the central axis CL of the arm remain coaxial (i.e., parallel) throughout the bending range associated with the range of radius of curvature R of the bendable portion 200, as described herein above. While FIG. 4 appears to show a single sleeve 210 through which a section of the bendable portion 200 of the arm 102 extends, in some embodiments there can be more than one sleeve 210. For example, there can be one sleeve for each bendable segment of the bendable portion 200 (e.g., segments 208 and 220). The thermoplastic elastomer can be selected to have physical properties that allow for repeated bending and straightening as described herein. The inventors have found that suitable materials for fabricating sleeve 210 are thermoplastic elastomers, including rigid polyamides and flexible polyethers. One example is the PEBAX® compound, available from Arkema, Colombes-Cedex, France. The sleeve can be manufactured using any method known in the art, including, but not limited to, molding, extrusion, and 3D printing. Additionally or alternatively, a sleeve having helically arranged surface features can be fabricated from an "untwisted" sleeve having surface features that are not yet helically arranged.

[0083] A sleeve can be deployed within the arm to route mechanical cables (such as actuation cables used to transmit or generate movement in a surgical tool connected to the distal end of the arm) as well as electrical wires (such as wires that provide electrical connectivity between a power source and a surgical tool). According to embodiments, the sleeve has an inner or central longitudinal conduit through which the mechanical cables pass and multiple surface features on the outer surface of the sleeve through which the electrical wires can be routed. The surface features can be useful for retaining the wires in a path, such as a helical path.

[0084] A non-limiting example of a sleeve 210 having an inner conduit 110 and surface features on its outer surface 211 is shown in FIGS. 5A and 5B. The inner conduit 110 can have a circular cross-section. Not only does this facilitate providing a regular helical wire path on the outer surface of the sleeve 210, but the circular cross-section is also beneficial in the assembly and operation of the mechanical arm 102. For example, a sleeve 210 having a circular cross-section inner conduit 110 does not require a specific orientation during assembly, allowing the sleeve 210 to bend with equal ease (force) in all directions. Different shapes may complicate assembly and / or affect the bending behavior of the sleeve 210. As shown in FIG. 5A, the actuation cable 240 passes through the inner conduit 110. Exemplary surface features shown in FIGS. 5A and 5B include parallel helical ribs 248 alternating with helical troughs 249. The ribs 248 and troughs 249 are aligned along the central longitudinal axis CL of the sleeve 210. スリーブThe ribs 248 and troughs 249 are formed to wrap helically around the outer surface 211 and run along the entire length of the outer surface 211. In some embodiments, the ribs 248 and troughs 249 run along at least 70%, or at least 80%, or at least 90% of the section of the outer surface 211. As described below, a wire (e.g., a segment of wire) can be held in the helical wire path defined by one of the troughs with the wire under at most moderate tension. The illustrated examples accompanying this disclosure uniformly show four ribs and four troughs. However, any reasonable number of ribs and troughs (a minimum of three to a maximum of six or eight (or even ten) ribs and troughs) can be implemented as surface features. If there are too few ribs, i.e., fewer than three, the wire may not be held in the helical path. If there are too many ribs, there may not be enough space for the wire within the trough, depending on the physical dimensions of the wire. Although not shown, one or more troughs 249 not occupied by electrical wires can be used as paths for additional cables, such as mechanical, data, and / or electrical cables.

[0085] Another non-limiting example of a sleeve having surface features on the inner conduit 110 and outer surface 211 is shown in FIG. 6. In this example, the surface features include a plurality of protrusions 215. The wire can be held in a helical wire path by threading the wire between the appropriate protrusions 215. In another example (not shown), the protrusions 215 can have mushroom-like "caps" to better hold the wire in the helical wire path. In yet another example (also not shown), only those protrusions 215 necessary to define the helical wire path can be provided.

[0086] The number of wire wraps, or wraps per unit length (i.e., the length of either the wire or the central shaft), should be limited so as not to generate magnetic fields that could interfere with proper operation of the arm and / or surgical tool or that could magnetize the actuation cable. The aforementioned benefits of helically wrapping the wire in a stable helical wire path can be realized with a small number of wraps. For example, a 100 mm long sleeve can be wrapped with three or fewer, two or fewer, or even fewer helical turns. Thus, the helical pitch (whether for a single sleeve passing through the entire bendable section of the arm or for any one sleeve or portion of multiple sleeves in multiple segments of the bendable section of the arm) can be at least one-third the length of, or at least one-half the length of, the corresponding portion of the central shaft path of the sleeve. In some embodiments, at least one complete helical turn of the wire is required to enable helical sliding within the wire path and other benefits of employing a helical wire path, including avoidance of electrical resonance. In other embodiments, four-fifths, three-quarters, or even two-thirds turns may be sufficient. In some embodiments, the helical pitch is at most 1.5 times, or at most 1.25 times, or at most equal to the length of the central axial path of the corresponding portion of the sleeve.

[0087] Referring now to FIG. 7, sleeve 210 of FIGS. 5A and 5B is shown with wire 255 disposed in a corresponding portion of one helical wire path in trough 249. As noted above, a moderate number of wire wraps is preferred to avoid generating potentially problematic magnetic fields around actuation cable 240. In the particular example of FIG. 7, the helical pitch is such that there are fewer than two wire wraps around this particular sleeve. (The usage of the terms helical pitch and helical amplitude as used in this disclosure and the appended claims is illustrated for further clarity in FIG. 9.) The helical pitch employed preferably has at most a moderate amount of variability along the length of sleeve 210, such as less than ±50%, or less than ±10%, or 0% (i.e., constant) variability (where "constant" means within a ±2% tolerance).

[0088] A two-dimensional projection of the actual shape of wire 255 from FIG. 7 is shown in FIG. 8A. Here, it is easy to see that wire 255 wraps (but not completely) around sleeve 210 approximately twice. Since helical pitch HP is defined (in this disclosure, as in normal scientific usage) as the linear distance between adjacent "peaks" of the helix, as shown in FIG. 9, the helical pitch HP of wire 255 from FIG. 8A can be said to be slightly longer than half the central axis (CL) length of the corresponding sleeve 210. That is, if sleeve 210 from FIG. 7 had a length of 100 mm, the corresponding HP value would be greater than 50 mm. Examples of wire 255 having alternative helical pitches HP are shown (in two-dimensional projection) in FIGS. 8B and 8C. Wire 255 from FIG. 8B has a helical pitch equal to approximately one-third the length of sleeve 210, while wire 255 from FIG. 8C has a helical pitch approximately equal to the length of sleeve 210. It will be apparent to those skilled in the art that the wire 255 of Figures 8B and 8C would require a sleeve 210 having ribs 248 and troughs 249 formed differently than the sleeve 210 of Figures 5A, 5B and 7, or a sleeve 210 having alternative surface features (such as, for example, protrusions 215 of Figure 6).

[0089] FIG. 9 illustrates the terms helical pitch HP and helical amplitude HA as used herein. As previously discussed, HP is the linear distance between successive helical peaks. HA is the distance (height) of a helical loop above the central axis CL of the helix. A sleeve 210 having ribs 248 and troughs 249, as shown in FIG. 7 among others, can have an HA value between 1.0 and 2.0 mm, between 1.1 and 1.7 mm, or between 1.25 and 1.5 mm. The ratio of helical pitch HP to helical amplitude HA of a helically ribbed sleeve can be at least 10, at least 20, or at least 50.

[0090] 10 shows an embodiment of a sleeve 210 in which parallel alternating ribs 248 and troughs 249 are "straight," i.e., parallel to the central axis of the sleeve, for a first portion of the sleeve length, and "helical" for a second portion of the sleeve length. Such an embodiment may be particularly suitable for use in a mechanical arm when one or both ends of the sleeve are not housed in a bendable portion of the arm, but instead are housed in a rigid section adjacent to the bendable portion.

[0091] The present invention has been described using detailed descriptions, which are provided by way of example only and are not intended to limit the scope of the invention. The described embodiments have different features, not all of which are required in all embodiments of the invention. Some embodiments of the invention utilize only some of the features or possible combinations of the features. Those skilled in the art to which the present invention pertains will recognize variations of the described embodiments of the invention and embodiments of the invention having various combinations of the features noted in the described embodiments.

[0092] Any feature or combination of features described herein can be combined with any feature or combination of features described below: U.S. Patent Application No. 15 / 915,237, filed March 8, 2018 (published as U.S. Patent Application Publication No. 2018 / 0256246), U.S. Patent Application No. 15 / 454,123, filed March 9, 2017 (published as U.S. Patent Application Publication No. 2017 / 0258539), and U.S. Patent Application No. 15 / 501,862, filed February 6, 2017 (published as U.S. Patent Application Publication No. 20170239005), all of which are incorporated herein by reference as if fully set forth in their entireties.

[0093] In the specification and claims of this disclosure, the verbs "comprise," "include," and "have," and their conjugations, are used to indicate that the object or objects of the verb are not necessarily an exhaustive list of components, constituents, elements, or parts of the subject or subjects of the verb. As used herein, the singular forms "a," "an," and "the" include plural references unless the context clearly dictates otherwise. For example, the terms "marking" or "at least one marking" can include a plurality of markings.

Claims

1. 1. A surgical apparatus for use with a power source, the surgical apparatus comprising: a. an articulated mechanical arm; b. a tool connected to the mechanical arm at a distal end of the mechanical arm; c. a flexible sleeve disposed at least partially within the bendable portion of the arm; and d. conductive wires for providing electrical connectivity from the power source to the tool or attached auxiliary device; the tool is electrically powered or has at least one electrically powered auxiliary device attached to it; an outer surface of the sleeve having a plurality of surface features defining a helical wire path about a central longitudinal axis of the sleeve; The wire is disposed outside the sleeve and engages one or more of the surface features to follow the helical wire path.

2. The surgical apparatus of claim 1 , wherein the tool is a surgical tool.

3. The surgical apparatus of claim 2 , wherein the surgical tool is selected from the group consisting of graspers, forceps, scissors, clamps, hooks, and lasers.

4. The surgical apparatus of any one of claims 1 to 3, wherein the tool and / or the auxiliary device is a camera, and the conductive wire is for providing electrical connectivity from the power source to the camera.

5. The surgical apparatus according to any one of claims 1 to 4, wherein the tool and / or the auxiliary device is a data acquisition tool.

6. The surgical apparatus of claim 5, wherein the data acquisition tool is or comprises at least one of a powered thermometer, a camera, and a powered microphone.

7. The surgical apparatus according to any one of claims 1 to 6, wherein the tool and / or the auxiliary device comprises a powered illumination source.

8. The surgical apparatus of any one of claims 1 to 7, wherein the tool has at least one internal degree of freedom.

9. further comprising an actuation cable; 9. The surgical apparatus of claim 1, wherein the actuation cable passes through an inner conduit of the sleeve and is mechanically coupled to the tool to (i) alter an inner configuration of the tool with respect to one or more of the degrees of freedom and / or (ii) mechanically manipulate or actuate the tool.

10. The surgical apparatus of any one of claims 1 to 9, wherein the plurality of surface features comprise discontinuous protrusions, and the helical wire path passes between the protrusions.

11. the plurality of surface features comprising alternating longitudinally parallel ribs and troughs; 11. The surgical apparatus of claim 1, wherein the ribs and troughs are helically aligned about a central longitudinal axis of the sleeve for at least a portion of the length of the sleeve, and the helical wire path passes through one of the troughs.

12. The surgical apparatus of claim 11 , wherein the plurality of surface features comprises at least three ribs and at least three troughs.

13. 13. The surgical apparatus of claim 11, wherein for a first lengthwise portion of the sleeve, the parallel ribs and troughs are parallel to the central longitudinal axis, and for a second lengthwise portion of the cable-sleeve, the parallel ribs helically wrap around the central axis.

14. The surgical apparatus of any preceding claim, wherein the helical pitch of the helical wire path has a variability of less than ±50% along the length of the helical wire path.

15. 14. The surgical apparatus of claim 1, wherein the helical pitch of the helical wire path is constant or has a variability of less than ±10% along the length of the helical wire path.

16. The surgical apparatus of any one of claims 1 to 15, wherein the helical wire path has a helical pitch that is at least one-third of the length of the central axial path of the corresponding portion of the sleeve.

17. The surgical apparatus of any one of claims 1 to 15, wherein the helical wire path has a helical pitch that is at least half the length of the central axial path of the corresponding portion of the sleeve.

18. 16. The surgical device of claim 1, wherein the helical wire path has a helical pitch that is at most 1.5 times the length of the central axial path of the corresponding portion of the sleeve, or at most 1.25 times the length, or at most equal to the length itself.

19. The surgical apparatus of any one of claims 1 to 18, wherein the ratio of helical pitch to helical amplitude of the helical wire path is at least 10, or at least 20, or at least 50.

20. The surgical apparatus of any preceding claim, wherein the bendable portion of the arm comprises a plurality of bendable segments.

21. The surgical apparatus of any preceding claim, wherein the bendable portions of the arms comprise discontinuous segments.

22. the sleeve is constrained to bend and / or straighten with the bendable portion of the arm; The surgical apparatus of any one of claims 1 to 21, wherein the path of the electrical wire is maintained helically relative to the curved and / or straightened path of the central longitudinal axis of the sleeve.

23. 23. The surgical apparatus of claim 22, wherein the path of the electrical wire is maintained helically relative to the curved and / or straightened path of the central axis of the sleeve for any bending of the bendable portion of the arm to a radius of curvature greater than twice the diameter of the bendable portion.

24. 24. The surgical apparatus of claim 23, wherein the helical path of the electrical wire remains helical relative to the curved and / or straightened path of the central axis of the sleeve for any bending of the bendable portion of the arm to a radius of curvature greater than 1.5 times the diameter of the bendable portion.

25. The surgical apparatus of any one of claims 1 to 24, wherein bending and / or straightening of the sleeve assembly does not substantially increase tension in the wire.

26. The surgical apparatus of any one of claims 1 to 25, wherein the inner conduit has a circular cross section.

27. The surgical apparatus of any one of claims 1 to 26, wherein the inner conduit has an inner diameter of at least 0.5 mm and at most 2.0 mm.

28. The surgical apparatus of any one of claims 11 to 27, wherein the maximum helical amplitude of the ribs on the outer surface of the sleeve is at least 1.0 mm and at most 2.0 mm.

29. The surgical apparatus of any one of claims 11 to 27, wherein the maximum helical amplitude of the ribs on the outer surface of the sleeve is at least 1.25 mm and at most 1.5 mm.

30. The surgical apparatus of any preceding claim, wherein the surface features are integrally formed with the sleeve.

31. The surgical apparatus of any one of claims 1 to 30, wherein the sleeve comprises a thermoplastic elastomer comprising a hard polyamide and a soft polyether.

32. 1. A teleoperated robotic surgical system comprising:

32. A device according to any one of claims 1 to 31, a patient-side console configured to interface with the surgical tools and actuate the surgical tools to perform one or more surgical procedures; and A system comprising a surgeon-side console comprising one or more input devices operated by a surgeon and configured to send signals to control the surgical tools at the patient-side console.

33. 1. An apparatus for performing electrosurgery using an electrosurgical generator, comprising: a. an articulated mechanical arm; b. an electrosurgical grasper having a plurality of jaws connected to said mechanical arm at a distal end thereof; c. a flexible sleeve disposed at least partially within the bendable portion of the arm; d. an actuation cable that passes through an inner conduit of the sleeve and is mechanically coupled to the grasper to effect movement of at least one jaw; e. A conductive wire for providing electrical connectivity from the generator to the grasper; an outer surface of the sleeve having a plurality of surface features defining a helical wire path about a central longitudinal axis of the sleeve; The wire is disposed outside the sleeve and engages one or more of the surface features to follow the helical wire path.

34. 34. The apparatus of claim 33, wherein the plurality of surface features comprise discontinuous protrusions and the helical wire path passes between the protrusions.

35. the plurality of surface features comprising alternating longitudinally parallel ribs and troughs; 34. The device of claim 33, wherein the ribs and troughs are helically aligned about a central longitudinal axis of the sleeve for at least a portion of the length of the sleeve, and the helical wire path passes through one of the troughs.

36. 36. The apparatus of claim 35, wherein the plurality of surface features comprises at least three ribs and at least three troughs.

37. 37. The apparatus of claim 35 or 36, wherein for a first lengthwise portion of the sleeve, the parallel ribs and troughs are parallel to the central longitudinal axis, and for a second lengthwise portion of the cable-sleeve, the parallel ribs helically wrap around the central axis.

38. 38. Apparatus according to any one of claims 33 to 37, wherein the helical pitch of the helical wire path has a variability of less than ±50% along the length of the helical wire path.

39. 38. Apparatus according to any one of claims 33 to 37, wherein the helical pitch of the helical wire path is constant or has a variability of less than ±10% along the length of the helical wire path.

40. 40. Apparatus according to any one of claims 33 to 39, wherein the helical pitch of the helical wire path is at least one third of the length of the central axial path of the corresponding portion of the sleeve.

41. 40. Apparatus according to any one of claims 33 to 39, wherein the helical pitch of the helical wire path is at least half the length of the central axial path of the corresponding portion of the sleeve.

42. 40. The device of any one of claims 33 to 39, wherein the helical pitch of the helical wire path is at most 1.5 times the length of the central axial path of the corresponding portion of the sleeve, or at most 1.25 times the length, or at most equal to the length itself.

43. 43. Apparatus according to any one of claims 33 to 42, wherein the ratio of helical pitch to helical amplitude of the helical wire path is at least 10, or at least 20, or at least 50.

44. 44. Apparatus according to any one of claims 33 to 43, wherein the bendable portion of the arm comprises a plurality of bendable segments.

45. An apparatus according to any one of claims 33 to 44, wherein the bendable portion of the arm comprises a discontinuous segment.

46. the sleeve is constrained to bend and / or straighten with the bendable portion of the arm; 46. ​​The device of any one of claims 33 to 45, wherein the path of the electrical wire is maintained helically relative to the curved and / or straightened path of the central longitudinal axis of the sleeve.

47. 47. The device of claim 46, wherein the path of the electrical wire is maintained helically relative to the curved and / or straightened path of the central axis of the sleeve for any bending of the bendable portion of the arm to a radius of curvature greater than twice the diameter of the bendable portion.

48. 48. The device of claim 47, wherein the helical path of the electrical wire remains helical relative to the curved and / or straightened path of the central axis of the sleeve for any bending of the bendable portion of the arm to a radius of curvature greater than 1.5 times the diameter of the bendable portion.

49. An apparatus according to any one of claims 33 to 48, wherein bending and / or straightening of the sleeve assembly does not substantially increase tension in the wire.

50. 50. Apparatus according to any one of claims 33 to 49, wherein the inner conduit has a circular cross section.

51. 51. Apparatus according to any one of claims 33 to 50, wherein the inner diameter of the inner conduit is at least 0.5mm and at most 2.0mm.

52. 52. Apparatus according to any one of claims 35 to 51, wherein the maximum helical amplitude of the ribs on the outer surface of the sleeve is at least 1.0 mm and at most 2.0 mm.

53. 52. Apparatus according to any one of claims 33 to 51, wherein the maximum helical amplitude of the ribs on the outer surface of the sleeve is at least 1.25mm and at most 1.5mm.

54. An apparatus according to any one of claims 33 to 53, wherein the surface features are integrally formed with the sleeve.

55. 55. The apparatus of any one of claims 33 to 54, wherein the sleeve comprises a thermoplastic elastomer comprising a hard polyamide and a soft polyether.

56. An apparatus according to any one of claims 33 to 55, wherein the electrosurgical grasper, when electrically connected to the electrosurgical generator, provides at least a bipolar electrosurgical mode.

57. 57. The apparatus of any one of claims 33 to 56, wherein the actuation cable is mechanically coupled to the grasper such that rotation of the actuation cable about a central axis of the actuation cable controls movement of the at least one jaw.

58. 57. The apparatus of any one of claims 33 to 56, wherein the actuation cable is mechanically coupled to the grasper such that longitudinal movement of the actuation cable within the arm controls movement of the at least one jaw.

59. further comprising said electrosurgical generator; 59. The apparatus of any one of claims 33 to 58, wherein the conductive wire provides electrical connectivity from the generator to the grasper.

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