Articulated surgical instrument for robotic surgery or microsurgery, manufacturing method, and assembly method

Abstract

A surgical instrument (1) is provided that includes a first support link (11), a second link (12) articulated to the first support link (11) so as to be rotatable about a rotation axis (Y-Y), and transmission cables (15, 16) fixed to the second link (12). In the surgical instrument (1), the first support link includes at least one convex first wire-woven sliding surface (17, 19) composed of straight generatrices all parallel to each other, and a convex second wire-woven sliding surface (18) composed of straight generatrices all parallel to each other. The transmission cables are configured to slide on both at least one first wire-woven sliding surface and the second wire-woven sliding surface of the first support link when the second link rotates with respect to the first support link. The straight generatrices of at least one first wire-woven sliding surface (17, 19) are orthogonal to the straight generatrices of the second wire-woven sliding surface (18).

Description

Technical Field

[0001] The present invention relates to surgical instruments.

[0002] More specifically, the surgical instrument of the present invention comprises an articulated end.

[0003] The surgical instrument according to the present invention is particularly suitable for an assembly for remote operation of surgical and / or microsurgical procedures.

[0004] The present invention also relates to a method for manufacturing at least a part of the articulated end of a surgical instrument.

[0005] Furthermore, the present invention relates to a method for assembling a surgical instrument.

Background Art

[0006] Robotic surgical devices are generally known in the art and typically comprise a central robotic tower (or cart) and one or more robotic arms extending from the central robotic tower. Each arm comprises an electric positioning system (or manipulator) for moving a surgical instrument that can be detachably attached distally to perform a surgical procedure on a patient. The patient is usually lying on an operating table in the operating room, and a sterile state is ensured in the operating room to avoid bacterial contamination by non-sterile parts of the robotic device.

Summary of the Invention

Problems to be Solved by the Invention

[0007] To open a scenario that is advantageous for both the minimal invasiveness of the patient undergoing surgery and the function of incising tissue of millimeters and less than millimeters, miniaturization of surgical instruments for robotic surgery, particularly its articulated end (the "end effector"), is particularly desirable.

[0008] For example, U.S. Patent No. US 10582975, International Patent Application Publication No. WO 2017 / 064303, and International Patent Application Publication No. WO 2018 / 18972 by the same applicant disclose various embodiments of surgical instruments suitable for robotic surgery and microsurgery. To miniaturize the joint, without providing holes or concave guide channels, the tendon slides and is guided by its sliding motion. In contrast, the actuating tendon is supported by a suitable convex sliding surface and held in a predetermined position. The convex sliding surface is a ruled surface where all generator lines are parallel to each other, and the ruled sliding surface is parallel to a predetermined axis.

[0009] Furthermore, International Patent Application Publication No. WO 2017 / 064305, European Patent No. EP 3362218, and European Patent No. EP 3597340 by the same applicant disclose several methods for manufacturing such types of surgical instruments, particularly the links of the articulated end of the surgical instrument, by wire electrical discharge machining (WEDM) that performs continuous cutting in an orthogonal plane with a cutting wire. In such manufacturing techniques, it is necessary to drill a hole in the pin joint, that is, to form a hole suitable for receiving the pin, and the hole is provided with a channel for passing the cutting wire, and the channel has a size smaller than the diameter of the pin received in the hole.

[0010] International Patent Application Publication No. WO 2018 / 189722 by the same applicant discloses a surgical instrument in which the tendon that actuates the degree of freedom of opening and closing of the hinged end effector not only slides on the convex ruled sliding surface of the end effector link but also wraps around the convex ruled sliding surface and follows an arcuate path, particularly at a high wrapping angle. In fact, due to the low sliding friction of the tendon, the tendon can remain in contact with the convex ruled surface of the link over a relatively long, arcuate longitudinal segment.

[0011] Furthermore, U.S. Patent Application No. US 2021 / 0106393 by the same applicant discloses some embodiments of tendons composed of intertwined polymer fibers. By using polymer tendons, sliding friction can be reduced compared to using metal tendons, and at the same time, with the appropriate dimensions of the tendons, it becomes possible to move along a tortuous longitudinal path within a small hinged end effector.

[0012] Surgical instruments with an articulated cutting end actuated by an operating cable wrapped around at least two pulleys are also known, and the blade holder thereof includes a distal pulley that is larger in diameter than the proximal pulley of the same articulated end, and attempts to increase the cutting force by increasing the radius of the distal operating pulley. Usually, it is desirable to maintain the diameter of the blade operating pulley within the overall size of the articulated end positioning rod or shaft so as not to increase the longitudinal size of the surgical instrument.

[0013] Even when the surgical instrument is not intended to perform a cutting operation, there is a felt need to maximize the closing torque and the closing force applied between the tips (jaws) of the articulated instrument and minimize the stress on the operating cable. For example, there may be a requirement to apply a stable and durable gripping operation to the surgical instrument. This need is particularly felt in small instruments where the operating cable operating lever is very small. This need is particularly felt in small instruments that use small-gauge cables or polymer cables that have limited cutting force and / or low rigidity and / or apparent plasticity when loaded.

[0014] To guide the operating cable towards a distal operating pulley with a relatively large diameter, for example, International Patent Application Publication No. WO 2017 / 098279 employs an intermediate guide pulley with an inclined axis that is rotationally driven by the cable itself when the pulley operates.

[0015] Another known solution according to U.S. Patent No. 9,186,221 shows an actuating cable deflected from the inner distal wall of a support link (a "clevis" or a "straddle"). In other words, this document shows an example where the support link houses the actuating cable within a guide channel, and the outer wall of the channel facing the longitudinal centerline of the surgical instrument functions as a direction-changing portion of the cable path, and the cable can be wound around a distal actuating pulley.

[0016] Such known solutions require many parts for assembly and are not suitable for miniaturization, especially because they further require idle return pulleys to maintain the actuating cable in place. Alternatively, solutions with difficult-to-implement undercuts or guide channels have problems where the actuating cable is pressed against the wall of the cavity, shortening the service life of the cable, and high friction occurs where relative movement occurs between the actuating cable and the pulley or other articulated end members.

[0017] Another type of surgical instrument is constituted by an electrosurgical instrument, and the electrosurgical instrument includes one or more power cables for electrically actuating a typical end portion, i.e., a free end, of an articulated surgical instrument. In such known electrosurgical instruments, typically, electrical energy is conducted by connecting an electrical cable to a distal portion of an object. Since the electrical cable typically has no flexibility, it cannot follow the tortuous path of an articulated end actuating cable, and when the articulated end undergoes articulation, i.e., movement, large bends and loops usually occur in the electrical cable. Such results caused by the power cable are particularly prominent in the case of miniaturized surgical instruments and are not desirable. This is because the formation of "curls" or "flying" portions that are cantilevered laterally towards the outside of the power cable hinders the design efforts aimed at obtaining the minimum volume of the components and parts of the miniaturized articulated end. The formation of bends and loops that extend far beyond the volume of the articulated end poses a risk of causing undesirable interference with the patient's anatomical structure and / or other surgical instruments and / or other elements of the surgical site. To avoid this, an attempt has been made to minimize the joints of the electrosurgical instrument and keep the articulated instrument in a straight and elongated position at all times in order to avoid the formation of bends and loops that extend far beyond the volume of the articulated end.

[0018] Therefore, there is a strong need to provide a solution that can increase the closing torque of a small articulated surgical instrument without increasing the gauge of the instrument itself and without reducing the mobility of the joints.

[0019] Therefore, there is a strong demand to provide a solution that can minimize the stress on the actuating cable of a small articulated surgical instrument that uses a small-gauge cable or a polymer cable that has limited cutting force and / or low rigidity and / or obvious plasticity when loaded.

[0020] Furthermore, there is a need to provide a cable for an articulated surgical instrument that is durable and reliable, even when it is necessary to slide on an articulated end under operating conditions.

Means for Solving the Problems

[0021] An object of the present invention is to improve the above-mentioned drawbacks with respect to the prior art.

[0022] A further object of the present invention is to provide an articulated surgical instrument suitable for miniaturization.

[0023] This object and other objects are achieved by the surgical instrument according to claim 1, the manufacturing method according to claim 16, and the assembling method according to claim 17.

[0024] Some advantageous embodiments are the subject matter of the dependent claims.

[0025] According to one aspect of the present invention, a surgical instrument includes an articulated end, and the articulated end includes a support structure, a second link configured to articulate relative to the support structure about a rotation axis, and a transmission cable fixed to the second link.

[0026] The support structure includes at least a first sliding surface that is convex and a second sliding surface that is convex, and the first sliding surface and the second sliding surface are each a line-woven surface defined by a straight generatrix that is parallel to each other.

[0027] The support structure can include a support link, and both the at least first surface and the second surface can be formed integrally with the support link.

[0028] The transmission cable is configured to slide on at least both the first surface and the second surface when the second link rotates relative to the support structure.

[0029] The straight generatrix of at least the first convex line-woven sliding surface is orthogonal to the straight generatrix of the second convex line-woven sliding surface.

[0030] The second convex wire-woven surface may be parallel to the relative rotation axis between the second link and the support structure.

[0031] At least one of the sliding surfaces of at least the first surface and the second surface can face the definable longitudinal center line of the articulated end.

[0032] The transmission cable can be wound around the winding pulley of the second link.

[0033] The transmission cable can be fixed to the winding pulley.

[0034] The transmission cable has an operating distal end for pulling the second link, and the operating distal end is received in a terminal seat within the disc-shaped volume of the winding pulley.

[0035] The winding pulley has a winding surface for the transmission cable, and the winding surface is a convex wire-woven surface, all of which are parallel to each other and have a linear generatrix parallel to the linear generatrix of the second sliding surface.

[0036] The winding pulley of the second link can project laterally with respect to the second convex wire-woven sliding surface.

[0037] The radius of the winding pulley may be equal to or greater than the distance between the first or second convex wire-woven surface and the central axis of the surgical instrument.

[0038] Preferably, the sliding contact angle between the transmission cable and at least one of the at least first surface and the second surface does not change in any operating configuration of the articulated end.

[0039] At least the first sliding surface and the second sliding surface are preferably spaced apart from each other in the longitudinal direction.

[0040] The proposed solution provides a small surgical instrument with maximized closing torque.

[0041] The proposed solution provides a small surgical instrument with optimized load on the operating cable.

[0042] The proposed solution provides a small surgical instrument having a cable attached to slide on the surface of the articulated end of the instrument under operating conditions, and the small surgical instrument can maintain the cable within the volume of the articulated end while minimizing the sliding friction of the cable surface.

[0043] According to one aspect of the present invention, a manufacturing method by wire electrical erosion is provided for at least the first support link of the articulated end of the surgical instrument. The first support link includes both of the convex wire-woven sliding surfaces having straight generatrices perpendicular to each other. The method includes (1) preparing a wire electrical discharge machining machine having a cutting wire, (2) attaching at least one workpiece to the wire electrical discharge machining machine, (3) performing a first through cut on at least one workpiece using the cutting wire of the wire electrical discharge machining machine to form the at least first convex wire-woven sliding surface, (4) rotating at least one workpiece 90° with respect to the cutting wire, (5) performing a second through cut on at least one same workpiece using the cutting wire of the wire electrical discharge machining machine to form a second convex wire-woven sliding surface, and includes.

[0044] The first support link can be formed simultaneously or subsequently by wire electrical erosion.

[0045] According to one aspect of the present invention, an assembly method of a surgical instrument is provided. The assembly method includes (1) inserting an articulation pin into the through holes of the first support link and the second link, and preferably also into the through hole of the third link, (2) Fix the operating distal end of the traction transmission cable to the terminal seat provided on the main body of the take-up pulley of the second link; (3) Wrap the distal portion adjacent to the operating distal end of the transmission cable around the surface of the take-up pulley; It includes.

[0046] The step of fixing the operating distal end of the transmission cable further includes configuring the terminal sheet of the take-up pulley of the second link to be axially aligned with the assembly window of the protrusion of the first support link, and inserting the operating distal end of the transmission cable axially into the assembly window of the protrusion of the support link and the terminal sheet of the take-up pulley of the second link and axially aligning them.

[0047] Such an assembly method provides a robust assembly with a simple solution.

[0048] Further features and advantages of the present invention will become apparent from the following description of the preferred embodiments, which are shown by way of non-limiting example with reference to the accompanying drawings briefly described below. It should be noted that the reference to "one" embodiment in this disclosure does not necessarily refer to the same embodiment, but is understood to refer to at least one embodiment. Furthermore, for the sake of brevity and reducing the total number of figures, certain figures may be used to show the features of multiple embodiments, and not all of the elements shown are essential to a particular embodiment.

Brief Description of the Drawings

[0049]

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Mode for Carrying Out the Invention

[0050] Throughout this specification, references to "embodiments" mean that the specific features, configurations, or effects described in connection with the embodiments are included in at least one embodiment of the present invention. Thus, the expression "embodiments" in various parts of this specification does not necessarily refer to all the same embodiments. Furthermore, the specific features, configurations, or effects shown in different drawings can be combined in any suitable way in one or more embodiments.

[0051] According to a general embodiment, a surgical instrument 1 including an articulated end 10 or an articulated end effector 10 is provided. The articulated end 10 can include at least one free end and / or at least one opening / closing joint G (grasping and / or cutting).

[0052] The surgical instrument 1 is particularly adapted to be attached to a robotic assembly 2 for remote operation in medical or surgical or microsurgical procedures.

[0053] The articulated end 10 can include a plurality of links 11, 12, 13, 20 that are jointed to each other by providing one or more rotational joints. Preferably, the articulated end 10 has a plurality of degrees of freedom that are moved by providing a plurality of transmission cables of a traction motion 15 (or an actuating tendon 15), and the traction motion 15 (or the actuating tendon 15) extends from a proximal transmission interface portion 23 along the longitudinal extension of the positioning rod or shaft 21 of the surgical instrument 1 and reaches the articulated end 10.

[0054] The articulated end 10 of the surgical instrument 1 includes a support structure 31, and the support structure 31 includes at least a first support link 11 and a second link 12 that is articulately joined to the first link 11 of the support structure 31. Accordingly, the first support link 11 and the second link 12 are articulately joined so as to be rotatable relative to each other about the rotation axis Y-Y. For example, the rotation axis Y-Y is the yaw axis of the articulated end 10. For example, the first support link 11 and the second link 12 form a rotary pin joint.

[0055] The second link 12 can include a terminal free end 33 that forms the terminal end of the surgical instrument 1.

[0056] The articulated end 10 can further include a third link 13, and the third link 13 is articulately joined to the first link 11 of the support structure 31 and forms an opening / closing joint G together with the second link 12. In this case, the third link 13 and the second link 12 are articulately joined to each other about a rotation axis (which can coincide with the above-described yaw rotation axis Y-Y). The third link 13 can include a terminal free end 39, and the terminal free end 39 forms the terminal end of the surgical instrument 1 together with the terminal free end 33 of the second link 12, for example. The terminal free ends 33, 39 of the respective links 12, 13 are movable relative to each other at the opening / closing joint G by rotating relative to each other about the yaw axis Y-Y, for example. Other configurations are also possible. For example, the third link 13 can be articulately joined to the second link 12 about a rotation axis more distal than the yaw rotation axis Y-Y.

[0057] The support link 11 preferably includes two protrusions 34, and the two protrusions 34 extend in the distal direction and form an assembly seat portion for the articulation pin 35 and at least the winding pulley 14 of the second link.

[0058] The winding pulley 14 preferably defines a through-axis hole 36 for receiving the articulation pin 35. Through holes 40 for receiving the articulation pin 35 may also be provided in the two protrusions 34 of the support link 11, respectively.

[0059] According to an embodiment, the articulation pin 35 is rotationally integrated with the take-up pulley 14 of the second link 12. For example, the articulation pin 35 is keyed to the through-hole of the take-up pulley 14.

[0060] By providing an articulation pin rotationally integrated with the take-up pulley, a configuration is provided in which the yaw axis of the articulated end portion and the rotation axis of the opening / closing (grip) degree of freedom coincide, and preferably the rotation axes of the articulation pins also coincide. In this case, the cutting reaction in the articulation pin 35 itself can be reduced. Thereby, in a situation where the articulated end portion 10 of the surgical instrument grips, or compresses, or cuts, the movement of the yaw joint can be facilitated.

[0061] Actually, in the operating state, in a situation of compressing or gripping or cutting, due to the reaction to the gripping force of the respective links 12, 13, two equally opposing cutting forces are generated in the articulation pin 35, whereby rotational friction occurs between the articulation pin 35 and the take-up pulleys of the respective links 12, 13. This tends to "bind", that is, to rotate the three elements (pin 35, link 12, and link 13) integrally with respect to the support link 11. Therefore, when the articulation pin 35 is rotationally integrated with the support link 11 (for example, when keyed at the protrusion 34), the elongated bodies of the link 12 and the link 13 will substantially form a clamp at the articulation pin. Alternatively, by rotationally integrating the articulation pin 35 with the take-up pulley 14 of the second link 12, the above-described effects can be advantageously utilized. In particular, it is aimed at rotationally integrating the link 12 and the link 13 only during the gripping, or cutting, or compressing operation while maintaining free rotation between the pin and the protrusion 34 of the support link 11. This is because the deformation of the pin and the protrusion in the mutual coupling region is minimized.

[0062] Preferably, the axial through-hole 36 of the take-up pulley 14 of the second link 12 is provided with at least one elastically deformable wall 37. The at least one elastically deformable wall 37 is formed by, for example, a cantilever tab 37 and is used to elastically sandwich the articulation pin 35. Thereby, the second link 12 rotates integrally with the articulation pin 35, for example, during the movement of the opening / closing degree of freedom G and during the assembly of the links 11, 12, 13 of the articulated end 10 and, for example, a yaw rotation joint.

[0063] The support structure 31 including the first support link 11 has an articulation structure, that is, at least one internal degree of freedom formed by an articulation joint between two or more links, and can include a further link (for example, a proximal link 20) articulated to the first support link 11. For example, the support structure 31 includes a pitch joint portion centered on a pitch rotation axis P-P between the proximal link 20 and the support link 11, and at the same time, can form a yaw joint portion with the second link 12 and the third link 13 centered on a yaw rotation axis Y-Y orthogonal to the pitch rotation axis P-P. The proximal link 20 can be fixed to a shaft or rod 21.

[0064] According to a preferred embodiment, it is clear that the terms pitch and yaw are arbitrarily used for clearer explanation. According to another embodiment, for example, the pitch rotation axis P-P and the yaw rotation axis Y-Y may form an angle other than 90° therebetween.

[0065] The articulated end 10 further includes transmission cables 15, 16 fixed to the second link 12.

[0066] According to a preferred embodiment, the transmission cable is a traction operation transmission cable 15 configured to apply a traction action to the second link 12 to rotate the second link 12 with respect to the first support link 11. The traction action transmission cable is configured and provided to apply a traction action to the third link 13 to rotate the third link 13 with respect to the first support link 11 and preferably also with respect to the second link 12.

[0067] Preferably, the support link 11, the second link 12, and the third link 13 are each moved by a pair of antagonistic operating cables 151, 152, and these cables can be received, for example, in respective end seats 26 provided on the body of the take-up pulley 14 of the second link 12 as shown in FIG. 21. Other configurations are possible. For example, the end seat 26 can be created on the radially outer surface of the take-up pulley 14, for example, by providing radial reliefs extending from the pulley to form an undercut seat for the transmission cable 15 of the traction operation TR. Thus, the transmission cable 15 of the traction operation TR can apply the traction action TR to the second link 12, whereby the take-up pulley 14 and the terminal free end 33 (if present) of the opening and closing joint G are rotationally driven by the undercut contact portion 42.

[0068] The third link 13 can also be provided with a take-up pulley as described with reference to the take-up pulley 14 of the second link 12.

[0069] According to a preferred embodiment, the take-up pulley 14 comprises a substantially disc-shaped body defining at least one end seat 26 for the operating distal end 41 of the transmission cable 15. The operating distal end 41 of the transmission cable 15 can be, for example, an enlarged operating distal end 41 formed by a knot in the transmission cable 15, and at the entrance 43 of the end seat 26, the contact surface with the undercut dragging wall 42 formed by the body of the take-up pulley 14 can be increased. The mouth 43 or the entrance 43 of the end seat 26 can face outward in the radial direction, for example, as shown in FIG. 21, that is, it can extend in the radial direction R-R from the disc-shaped body of the take-up pulley 14 with respect to the radius of the disc. The mouth 43 or the entrance 43 of the end seat 26 can also face axially, that is, it can open in a direction parallel to the rotation axis Y-Y to form an axially penetrating seat.

[0070] The operating distal end 41 of the transmission cable 15 abuts against the undercut wall 42 to rotationally drive the take-up pulley 14 of the second link 12. The undercut wall 42 is formed by a cantilevered circumferential protrusion 44 (i.e., extending in the circumferential direction and forming a free end) of the disc-shaped body of the take-up pulley 14, and delimits the radially open mouth 43 of the terminal seat portion 26. Therefore, preferably, the contact surface 45 of the cantilevered circumferential protrusion 44 that contacts a portion adjacent to the distal end 41 of the transmission cable 15 is a convex curved surface, and has no edges facing the circumferential direction and / or the radial direction with respect to the disc-shaped body of the take-up pulley 14 of the second link 12. For example, the contact surface 45 of the take-up pulley 14 is a convex line-woven surface formed by generatrices that are parallel to the rotation axis Y-Y of the take-up pulley 14 of the second link 12 and are all parallel to each other.

[0071] Alternatively or additionally, a power transmission cable 16 configured to transmit power to the second link 12 can be provided. In this case, the surgical instrument 1 may be an electrosurgical instrument or a microelectrosurgical instrument. A power transmission cable 16 configured to transmit power to the third link 13 may be provided. In this case, the second link 12 may be a link adapted to perform a gripping operation and having a gripping surface 32.

[0072] According to an embodiment, the support structure 31 of the articulated end 10 includes at least first convex surfaces 17, 19 woven with straight generatrices π that are all parallel to each other, and at least a second convex surface 18 woven with straight generatrices υ that are all parallel to each other.

[0073] According to an embodiment, the first support link 11 of the articulated end 10 includes at least first convex surfaces 17, 19 woven with straight generatrices π that are all parallel to each other, and at least a second convex surface 18 woven with straight generatrices υ that are all parallel to each other.

[0074] Advantageously, at least the linear generatrices π of the first convex wire-woven surfaces 17, 19 are orthogonal to the linear generatrix υ of the second convex wire-woven surface 18. According to an embodiment, at least all of the first convex wire-woven surfaces 17, 19 have linear generatrices π parallel to the pitch rotation axis P-P, and all of the second convex wire-woven surfaces 18 have linear generatrices υ parallel to the yaw rotation axis Y-Y. Therefore, the convex wire-woven surfaces 17, 18, 19 are curved surfaces, and each is parallel to the direction of the generatrices π, υ.

[0075] As a further advantage, the transmission cable 15 or the power transmission cable 16 is configured to slide on at least both of the first surfaces 17, 19 and the second surface 18 of the first support link 11 when the second link 12 rotates relative to the first support link 11.

[0076] The sliding direction of the transmission cable 15 or the power transmission cable 16 on each of the convex wire-woven surfaces 17, 18, 19 is always orthogonal to the generatrix of the convex wire-woven surface on which the transmission cable slides. Thereby, the curvature of the convex wire-woven surfaces 17, 18, 19 faces the transmission cable 15 or the power transmission cable 16 sliding on the convex wire-woven surface, and the convex wire-woven surfaces 17, 18, 19 are substantially flat in the lateral direction with respect to the transmission cables 15, 16. Thereby, the transmission cables slide orthogonally to the generatrices of the respective convex wire-woven surfaces.

[0077] The proximal link 20 can include a third convex wire-woven surface 30 having linear generatrices all parallel to each other for the sliding of the proximal portions of the transmission cables 15, 16.

[0078] Preferably, the linear generatrices of the third convex wire-woven surface 30 are all parallel to at least the generatrices of the first convex wire-woven surfaces 17, 19, for example, parallel to the pitch rotation axis P-P.

[0079] The linear generatrices of the third convex wire-woven surface 30 may all be parallel to the generatrix of the second convex wire-woven surface 18, for example, parallel to the yaw rotation axis Y-Y of the articulated end 10.

[0080] Instead of being provided on the first support link 11, at least the first and / or second convex wire-woven sliding surfaces 17, 18, 19 can be provided on the proximal link 20. According to one embodiment, the proximal link 20 can include a third wire-woven surface 30 and a fourth convex wire-woven surface that are perpendicular to each other. Since there is also one or more convex wire-woven sliding surfaces on the proximal link 20, it is ensured that the operating cable contacts the link forming the articulated end throughout the entire range of motion.

[0081] Preferably, the transmission cable 15 or 16 does not slide on the second link 12. According to a preferred embodiment, the second link 12 is provided with a winding pulley 14, and the transmission cable 15 for the traction action is wound around the winding pulley 14. In the operating state, when the transmission cable 15 for the traction action is pulled, the second link 12 rotates about the rotation axis Y-Y with respect to the first support link 11. The pulling of the transmission cable 15 means that the transmission cable 15 slides on both at least the first convex wire-woven surfaces 17, 19 having a generatrix parallel to the pitch axis P-P and the second convex wire-woven surface 18 having a generatrix parallel to the yaw axis Y-Y. Otherwise, if the transmission cable 15 is wound around or unwound from the pulley 14 without sliding, the transmission cable 15 will not slide on the winding pulley 14 of the second link 11. The transmission cable 15 preferably terminates at a terminal seat 26 integrated with the winding pulley 14 of the second link 11.

[0082] The take-up pulley 14 is preferably configured integrally with the main body of the second link 12 and its end 33. Alternatively, the second link 12 is formed by assembling at least two rotationally integrated parts, and the at least two parts of the second link 12 can include the take-up pulley 14 and the blade link 25, and the take-up pulley forms a kind of blade holder link. Alternatively, the second link 12 is formed by assembling at least two parts that are rotatable relative to each other, and the at least two parts of the second link 12 can include the take-up pulley 14 and the blade link 25 that is rotatable relative to the take-up pulley. The free end 33 of the second link 12 may be formed integrally with the take-up pulley 14 or the blade link 25.

[0083] The assembly of the transmission cable 15 for the traction action TR can be performed by axially inserting the end 41 of the transmission cable 15 into the end seat 26 of the take-up pulley 14 of the second link 12. Next, the second link 12 can be assembled to the first support link 11 and / or the third link 13 by inserting the articulation pin 35 into the respective through-holes of the links 11, 12, 13. If an elastic tab 37 is provided for clamping the articulation pin 35, the articulation pin 35 can be first assembled to the second link 12.

[0084] The protrusion 34 of the support link 11 has an assembly window 48, that is, a through-opening in the direction of the rotation axis Y-Y. Specifically, the assembly window 48 is provided at the same radial height of the end seat 26 of the second link 12 (that is, along the radius of the pulley 14 of the second link 12). Thereby, at least the relative arrangement between the first support link 11 and the second link 12 is defined, and the assembly window 48 of the link 11 and the end seat 26 of the second link 12 are aligned. Thereby, when assembling the second link 12 to the first support link 11, the enlarged distal end 41 of the transmission cable 15 for the traction operation TR can be axially inserted and assembled into both the assembly window 48 of the first support link 11 and the end seat 26 of the take-up pulley 14 of the second link.

[0085] The convex wire-woven surfaces 17, 18, 19, 30, 45 can be produced by a manufacturing process using wire electrical erosion on two cutting surfaces. For example, the two cutting surfaces may be two orthogonal cutting surfaces, and the cutting wire 51 of the wire electrochemical machining machine 50 can be made parallel to the pitch rotation axis P-P or the yaw rotation axis Y-Y in each cutting configuration.

[0086] For example, by a manufacturing process using wire electrical erosion in which the cutting wire also depicts a continuous cutting path forming a through hole, the through hole 26 of the second link 12 for receiving the articulation pin 35 can communicate with the through hole forming the terminal seat 26.

[0087] According to a preferred embodiment, the support link 11 is integrally made by wire electrical erosion, in particular by two cuts on respective cutting surfaces orthogonal to each other. Thus, in one link, it is possible to create convex wire-woven sliding surfaces that are orthogonal to each other and arranged along the path of the transmission cable.

[0088] According to a preferred embodiment, the take-up pulley 14 projects laterally with respect to the second convex wire-woven surface 18 of the first support link 11.

[0089] Preferably, the take-up pulley 14 of the second link 12 has a lateral extension that defines the maximum lateral dimension of the articulated end 10.

[0090] The diameter of the take-up pulley 14 of the second link 12 may be larger than the lateral extension of the positioning rod or shaft 21 of the surgical instrument 1, but preferably, the diameter of the take-up pulley 14 is equal to or less than the lateral extension of the positioning rod or shaft 21.

[0091] According to an embodiment, as shown in FIG. 10 for example, the take-up pulley 14 of the second link 12 has a radius R14 that is greater than the lateral distance P1 between the path depicted by the transmission cables 15, 16 on the at least first surfaces 17, 19 and the at least second surface 18, and the longitudinal center line 22 of the articulated end 10. In other words, as shown in FIG. 10 for example, the diameter of the take-up pulley 14 is greater than the lateral distance P2 measured along the pitch axis P-P, and is greater than, for example, the distance between the path depicted by the transmission cable and the paths depicted by the antagonistic transmission cables on the respective at least first convex woven surfaces 17, 19 and the respective second woven surfaces 18. For example, when the transmission cable 15 is the transmission cable for the traction action TR, the diameter of the take-up pulley 14 is greater than the lateral distance P2 between the forward path 151 and the return path 152 depicted by the antagonistic transmission cable and / or by the same transmission cable configured to act in two opposite antagonistic directions.

[0092] According to an embodiment, the pulley radius R14 of the take-up pulley 14 is equal to the maximum dimension of the articulated end 10, i.e., the thickness of the articulated end 10.

[0093] According to a preferred embodiment, the second link 12 is moved in antagonistic directions by two transmission cables 15 for the traction action TR, and each transmission cable has an enlarged distal end received in a respective terminal seat 26 of the take-up pulley 14 of the second link 12.

[0094] According to a preferred embodiment, the first support link 11 is provided with two opposing second convex wire-woven sliding surfaces 18, and both of the two second convex wire-woven sliding surfaces 18 face the center line 22 of the articulated end 10. The lateral distance P2 between the two opposing second surfaces 18 is measured, for example, along the pitch axis P-P and is smaller than the diameter of the take-up pulley 14 of the second link 12. Thereby, the opposing second surfaces 18 respectively form a diverter, and by means of this diverter, the path of the transmission cable 15 is diverted and wound around the take-up pulley 14. In practice, the path of the transmission cable 15 is preferably straight along the articulated end 10 and is substantially parallel to the longitudinal center line X-X of the positioning shaft 21. This is because there are no concave guide holes or concave guide channels for the transmission cables 15, 16 in the articulated end 10, and the provision of the two opposing second convex wire-woven sliding surfaces 18 of the first support link 11 causes the path of the transmission cable 15 to deviate from the center line 22.

[0095] By providing an enlarged take-up pulley 14, that is, a take-up pulley 14 protruding with respect to the second wire-woven surface 18 of the support link 11, even if the traction action TR acting on the transmission cable 15 is the same, the tightening force of the opening and closing freedom G can be increased. Therefore, this configuration can be advantageous when provided in combination with a cutting blade 25 provided on the second link 12 (preferably the third link 13).

[0096] According to an embodiment, the first support link 11 includes at least a second surface cantilever 28 forming a free end 29, and the second surface 18 belongs to the second cantilever 28 of the first support link 11. Preferably, the cantilever 28 extends substantially in the distal direction, that is, when the winding pulley 14 of the second link 12 is provided, it extends toward the winding pulley 14 and forms a free end facing at least distally. Preferably, the cantilever 28 of the first support link 11 extends in the radial direction R-R outside the winding pulley 14 of the second link 12 in a state where the articulated end 10 is assembled. The free end 29 can also extend in a direction away from the center line 22 in the lateral direction, for example, along the direction of the pitch axis P-P. In this case, preferably, the second convex wire-woven surface 18 in sliding contact with the transmission cables 15, 16 faces the longitudinal center line 22 of the surgical instrument, functions as a lateral accommodation element for the cables, and, if necessary, that is, when a protruding winding pulley 14 exists, functions as a direction-changing portion for the transmission cables 15, 16. The accommodation function and the direction-changing function can be executed in both a substantially linear state of the articulated end 10 and a bent state of one or more degrees of freedom (for example, the degrees of freedom of the yaw axis Y-Y and opening / closing G) determined by the movement of the second link 12.

[0097] The shape of the second cantilever 28 of the support link 11 can follow the cross-sectional shape of the protrusion 34, for example, when the support link 11 is integrally made by a wire electrical discharge machining (WEDM) process on two cutting planes perpendicular to each other.

[0098] The second support link 11 can be moved by including the actuating tendon 46 with P-P degrees of freedom, preferably by including two antagonistic actuating tendons 46. Accordingly, the body of the support link 11 can include a terminal seat 47 for receiving the operating distal end of at least one actuating tendon 46 for moving the support link 11 around the axis of rotation P-P relative to the proximal link 20. The terminal seat 47 of the first support link 11 is preferably provided along the center line 22 of the articulated end 10 and along the center line of the support link 11, and is substantially aligned with the position of the through hole 40 along the longitudinal axis X-X. The terminal seat 47 may be delimited between the distal-direction cantilever and the base of the protrusion 34 of the support link 11 in a direction parallel to the axis of rotation P-P. For this reason, the protrusion 34 of the support link 11 can include a narrow, i.e., narrow, base portion in the direction of the axis of rotation Y-Y and a wider distal portion for operating the blade. According to an embodiment, the narrow base of the protrusion 34 is also not aligned with the longitudinal center line 22 of the support link 11, whereby the terminal seat 47 of the actuating tendon 46 of the support link 11 is formed outside the body of the protrusion 34, and it is possible to avoid structurally weakening the protrusion 34.

[0099] The actuating tendon 46 of the support link 11 and the traction action transmission cable 15 of the second link 12 can be made substantially the same. For example, both of them can be made of braided polymer cables.

[0100] At least the first surfaces 17, 19 can include a first surface 19 provided distally with respect to the second surface 18. According to a preferred embodiment, the first support link 11 includes a cantilever 27 forming a free end, and the first surface 19 belongs to the first cantilever 27. Preferably, at least the first surface 19 faces the longitudinal center line 22 of the surgical instrument.

[0101] At least the first surfaces 17, 19 can include a first surface 17 provided proximal to the second surface 18. For example, the at least first surface 17 at least partially surrounds the pitch rotation axis P-P and faces away from the pitch rotation axis P-P.

[0102] Preferably, at least one of at least the first surfaces 17, 19 and the second surface 18 belongs to a bulge or protrusion of the body of the first support link 11. By providing such a bulge, the sliding surface is configured as a cantilever type, whereby the length of the contact portion between the transmission cable and the convex wire-woven sliding surface on which the transmission cable slides is limited, and the sliding friction is reduced.

[0103] Each convex wire-woven sliding surface defines a contact angle α with the transmission cable sliding thereon.

[0104] According to an embodiment, the sliding contact angle α between the transmission cable and at least one of at least the first surfaces 17, 19 and the second surface 18 does not change in any kinematic operating configuration of the articulated end 10.

[0105] The contact angle α between the second surface 18 and the transmission cable 15 may be constant in each operating configuration of the articulated end 10.

[0106] The contact angle α between at least the first surfaces 17, 19 and the transmission cables 15, 16 can vary according to the operating configuration of the articulated end 10. For example, in some operating configurations, the transmission cables 15, 16 may not come into contact with the contact surface between at least the first surfaces 17, 19 and the second surface 18.

[0107] According to an embodiment, the sliding contact angle α between the transmission cables 15, 16 and at least one of the at least first surfaces 17, 19 and the second convex surface 18 is less than 90 degrees. Preferably, the contact angle α is less than 45 degrees. In one embodiment, the contact angle α is less than 30 degrees in each movement configuration.

[0108] According to an embodiment, the sliding contact angle α between the transmission cables 15, 16 and each of the at least first surfaces 17, 19 and the second convex surface 18 is less than 90 degrees. Preferably, the contact angle α is less than 45 degrees. In one embodiment, the contact angle α is less than 30 degrees in each movement configuration.

[0109] The sliding contact angle α with a predetermined convex wire-woven surface can vary under operating conditions corresponding to the movement configurations assumed by the link chain of the articulated end 10.

[0110] As illustrated in FIG. 4, when the degree of freedom of pitch is activated, the sliding contact angle between the transmission cable 15 and the first wire-woven surface 17 may change.

[0111] As illustrated in FIG. 17, when the degree of freedom of pitch is activated, the sliding contact angles between the transmission cables 15, 16 and the first wire-woven surface 19 may change. For example, when the articulated end 10 is in a configuration extending in alignment with the longitudinal axis X-X of the shaft 21, the sliding contact angle with the first wire-woven surface 19 is minimized, but the sliding contact angle increases as the bend of the pitch joint increases. Thereby, the convex wire-woven surface 19 can function as a receiving abutment portion for holding the transmission cable within the volume of the articulated end 10 while avoiding the formation of loops or curls of the cable.

[0112] According to a preferred embodiment, the sliding contact angle between the second wire-woven surface 18 having a generatrix parallel to the yaw rotation axis Y-Y and the transmission cables 15, 16 is constant in any operating configuration of the articulated end 10.

[0113] As described above, according to an embodiment, the sliding contact angle α between the transmission cable and at least the first surfaces 17, 19 changes according to the pitch joint configuration, and the sliding contact angle α between the transmission cable and the second surface 18 is constant in any configuration of the articulated end 10.

[0114] The contact angle α can be defined for each sliding contact surface with the same transmission cable.

[0115] According to an embodiment, in each configuration of the articulated end 10, the sum of (i) the sliding contact angle α between the transmission cable and at least the first convex surfaces 17, 19, and (ii) the sliding contact angle α between the same transmission cable and the second convex surface 18 is less than 180°. According to an embodiment, two first surfaces 17 and 19 exist, and it is also possible that the total sliding contact angle is less than 180°. The total sliding contact angle of the same transmission cable may be the sum of three or more local contact angles for each of three or more convex wire-woven surfaces of the articulated end 10, and in this case, according to an embodiment, the total sliding contact angle is less than 180°.

[0116] There may be cases where it is desirable to increase the contact angle. According to an embodiment, in each configuration of the articulated end 10, the sum of (i) the sliding contact angle α between the transmission cable and at least the first convex surfaces 17, 19, and (ii) the sliding contact angle α between the same transmission cable and the second convex surface 18 is 180° or more. According to an embodiment, two first surfaces 17 and 19 exist, and it is also possible that the total sliding contact angle is 180° or more.

[0117] The transmission cable is preferably a cable made at least partially of a polymer material. For example, the transmission cable is a cable coated with a polymer material. For example, the transmission cable is a polymer cable made of braided fibers. Polymer cables, for example, polymer cables made of UHMWPE, have lower friction compared to cables made of other materials.

[0118] According to an embodiment, the first cable segment 24 between the at least first surfaces 17, 19 and the second surface 18 extends parallel to the longitudinal center line 22 and / or the longitudinal axis X-X of the surgical instrument 1. Preferably, the second segment 38 of the same cable extending distally with respect to both the at least first surfaces 17, 19 and the second surface 18 extends obliquely with respect to the longitudinal center line 22 and / or the longitudinal axis X-X of the surgical instrument 1, for example, extending obliquely away from the center line 22. The segment 24 of the same cable can extend straight between the third convex wire-woven surface 30 of the proximal link 20 of the support structure 31 and the most distal surface between the at least first surfaces 17, 19 and the second surface 18.

[0119] According to a preferred embodiment, at least the first surfaces 17, 19 and the second surface 18 are longitudinally spaced apart from each other. Thereby, the occurrence of the cross-section of the same part of the tendon sliding in contact with two orthogonal surfaces simultaneously can be avoided.

[0120] As described above, according to an embodiment, the first support link 11 includes at least two longitudinally spaced-apart first surfaces 17, 19. For example, the first surface 19 is disposed on a cantilever 27 extending in a cantilever manner in the distal direction, and the other first surface 17 is disposed on the proximal portion of the support link 11 surrounding the rotation axis P-P. The actuating tendon 46 of the support link 11 is wound around without sliding on the first proximal surface 17 of the support link 11. On the other hand, the transmission cable 15 for the traction action TR is in longitudinal sliding contact on the first proximal surface 17 of the support link 11, for example, as shown in FIG. 20.

[0121] A longitudinal space can be provided between the proximal link 20 and the first convex wire-woven surface 17 of the support link 11. In this space, the antagonistic transmission cables 151, 152 of the traction action TR to the second link 12 and / or the antagonistic actuating tendon 46 of the first support link 11 cross each other (each of the transmission cables crosses the antagonistic tendon).

[0122] According to an embodiment, the first surfaces 17, 19 of the support structure 31 are also intended as the third surface 30 of the proximal link 20. Therefore, at least two of the first surfaces of the support structure 31 can include at least two of the first surfaces 17, 19 of the support link 11 and the third surface 30 of the proximal link 20. The transmission cables 15, 16 can be configured to slide across all of the at least two first surfaces. The support structure 31 is provided with at least three convex wire-woven surfaces 17, 18, 19, 30 including the second surface 18, and the transmission cables 15, 16 are configured to slide in all three of the at least three wire-woven surfaces. The at least three convex wire-woven surfaces are preferably arranged spaced apart from each other in the longitudinal direction.

[0123] By arranging the convex wire-woven sliding surfaces of the transmission cable spaced apart in the longitudinal direction, it is possible to prevent a cross-section of one location of the transmission cable from sliding, that is, from making sliding / frictional contact with the links on both sides. As a result, the stress due to sliding friction is dispersed in the longitudinal direction, so that the service life of the transmission cables 15, 16 can be extended to the maximum extent. In other words, the cross-section of a predetermined location of the transmission cables 15, 16 contacts only a small portion of the outer surface of the link of the articulated end 10, and it is avoided that the cross-section of the predetermined location contacts two separate portions.

[0124] Next, a method for manufacturing at least a part of the articulated end 10 according to any one of the above embodiments by wire electrical erosion will be described.

[0125] According to a general embodiment, a method for manufacturing at least one support link 11 of the articulated end 10 by wire electrical erosion includes the following steps. That is, Provide a wire electrical discharge machining machine 50 having a cutting wire 51. The wire electrical discharge machining machine 50 is shown in FIGS. 22A - 22B. Attach at least one workpiece 111, 112, 113, 120 to a wire electrical discharge machining machine. For example, use a predetermined jig 52 having one or more seating portions for receiving one or more workpieces 111, 112, 113, 120 respectively to attach at least one workpiece 111, 112, 113, 120 to the wire electrical discharge machining machine. Using the cutting wire 51 of the wire electrical discharge machining machine, perform a first through cut on at least one workpiece. Rotate at least one workpiece by 90° with respect to the cutting wire. Preferably, rotate without removing the jig 52 from the machining machine 50 or without removing the workpiece from the tool. Using the cutting wire 51 of the wire electrolytic machining machine, perform a second through cut on the same workpiece among at least one workpiece 111, 112, 113, 120.

[0126] By such a method, it is possible to manufacture a support link 11 having at least two sliding surfaces 17, 18, 19 respectively formed by two sweeping operations of the cutting wire 51. Thus, the cutting wire functions as a straight generatrix of the convex wire woven surfaces 17, 18, 19.

[0127] Preferably, at least one through cut of the first through cut and the second through cut forms at least one hole suitable for receiving an articulation pin. Thus, the wall of the hole is made parallel to at least one sliding surface and perpendicular to the other sliding surfaces.

[0128] This method can also be used to manufacture at least one (but all may be) of the second link 12, the third link 13, and the proximal link 20 provided with the take-up pulley 14. According to a possible operating mode, a plurality of workpieces, for example, four workpieces 111, 112, 113, 120 are attached to the tool, and these workpieces are arranged such that the cutting wire 51 intersects at most one at a time both during the first through cut and during the second through cut (thereby, the rotation angle of the rotation step can be determined). As a result, four different links, for example, the support link 11, the second link 12, the third link 13, and the proximal link 20 are formed. Therefore, by simply assembling the workpieces to the wire electrical discharge machine 50 once, all the links of the articulated end 10 of the surgical instrument 1 can be produced.

[0129] According to a possible operating mode, the links are formed by the first through cut and the second through cut in planes orthogonal to each other.

[0130] According to a possible operating mode, the cutting wire 51 performs more sweeping operations on the portions of the workpiece that form the at least first and second convex line woven sliding surfaces having linear generatrices orthogonal to each other compared to the number of sweep operations used to form other portions of the link, such as the protruding portion of the first support link and / or the through holes for receiving each articulation pin.

[0131] Hereinafter, a method for assembling the surgical instrument 1 will be described.

[0132] The method for assembling the surgical instrument 1 includes the following steps. That is, Insert the articulation pin 35 into the through holes of the first support link 11 and the second link 12, and preferably also into the through hole of the third link 13. Fix the operating distal end 41 of the transmission cable 15 of the traction action TR to the terminal seat 26 provided on the main body of the take-up pulley 14 of the second link 12. Wrap the distal portion adjacent to the operating distal end 41 of the transmission cable 15 around the surface of the take-up pulley 14.

[0133] According to a possible operating mode, the insertion, fixing, and winding steps are executed continuously such that the insertion step is first executed, then the fixing step is executed, and finally the winding step is executed.

[0134] According to a preferred operating mode, the step of fixing the operating distal end 41 of the transmission cable 15 includes the following further steps. That is, Form a configuration of axial alignment (axial alignment with respect to the rotation axis Y-Y of the second link 12) between the end seat portion 26 of the take-up pulley 14 of the second link 12 and the assembly window 48 of the protrusion 34 of the first support link 11. Axially insert the operating distal end 41 of the transmission cable 15, which includes an enlarged portion for example, into the assembly window 48 of the protrusion 34 of the support link 11, and then axially align and insert it into the end seat portion 26 of the take-up pulley 14 of the second link 12.

[0135] The step of forming the configuration of axial alignment can include rotating the take-up pulley 14 of the second link 12 about the rotation axis Y-Y defined by the articulation pin 35.

[0136] According to a possible operating mode, the step of inserting the articulation pin first includes fixing the rotation pin 35 in the through hole 36 of the second link 12 to integrally rotate the articulation pin 35 and the take-up pulley 14 of the second link 12 with each other. This step can be executed by elastically fixing the articulation pin 35 in the through hole 36 of the second link 12 by the tab 37. Alternatively, or additionally, the articulation pin 35 can be keyed to the through hole 36 of the second link 12.

[0137] According to a possible operating mode, the insertion, fixing, and winding steps may be executed in order such that the fixing step is first executed, then the winding step, and finally the insertion step.

[0138] This method can further include arranging the transmission cable 15 in contact with at least first and second sliding surfaces 17, 18, 19 of the support structure 31.

[0139] This method can further include arranging the transmission cable 15 along the positioning shaft of the surgical instrument 1 and fixing it to the proximal transmission interface portion of the surgical instrument 1.

[0140] This method can be repeatedly executed a plurality of times for each of the plurality of transmission cables 15 assembled to the second link 12 and / or the third link 13.

[0141] This assembly method can be used to assemble the surgical instrument 1 according to any one of the foregoing embodiments.

[0142] With the features provided in combination with each other or the features provided in a predetermined embodiment as described above, it is possible to satisfy the foregoing needs and achieve the foregoing advantages. In particular By using a sliding contact portion formed by a convex wire woven surface having a bus bar with a predetermined direction without providing holes or guide channels, it is possible to guide and / or bypass the transmission cable. In particular, as described, by providing at least two sliding contact portions formed by wire woven surfaces having bus bars orthogonal to each other, it is possible to improve the control of the trajectory of the transmission cable. Without increasing the size of the articulated end, a larger take-up pulley can be manufactured, and a contact portion for guiding the sliding of the tendon can be provided. Thereby, the closing force of the opening and closing joint of the articulated end can be increased. Between such a sliding surface and the transmission cable, relative movement occurs along the longitudinal axis of the transmission cable, generating a sliding frictional force, and preventing the transmission cable from being rotationally driven at any of the sliding surfaces or being rotationally driven by any of the sliding surfaces. The end seat of the support link for the actuating tendon can be slightly offset with respect to the central line. The articulation pin can be rotationally integrated with the blade of the second link. The second link of the articulated end may be an end link forming a free end, or an intermediate link that is further articulated to a distal link distally. A robust surgical instrument suitable for extreme miniaturization of the articulated end can be provided.

[0143] It is to be understood that the combinations of the features of the appended claims form an essential part of this specification.

[0144] To meet certain contingent needs, those skilled in the art can make several changes and adaptations to the above embodiments without departing from the scope of the appended patent claims and can replace them with other functionally equivalent elements.

Description of the Reference Numerals

[0145] 1 Surgical or microsurgical instrument 2 Robot assembly for remote operation of medical, surgical, and microsurgical procedures 10 Articulated end of the surgical instrument 11 First support link 12 Second link 13 Third link 14 Take-up pulley 15 Traction operation transmission cable 16 Power transmission cable 17 First sliding surface or first convex wire-woven surface of the support link 18 Second sliding surface or second convex wire-woven surface of the support link 19 First sliding surface or first convex wire-woven surface of the support link 20 Even more proximal link 21 Positioning rod or shaft of the surgical instrument 22 Central line of the instrument 23 Proximal transmission interface portion of the surgical instrument 24 Tendon segment 25 blades or blade tips 26 terminal seat of the second link 27 cantilever on the first surface 28 cantilever on the second surface 29 free end 30 third convex wire-woven sliding surface 31 support structure of the articulated end 32 gripping surface 33 distal free end of the second link 34 protrusion 35 articulation pin 36 hole for the pin 37 elastically deformable wall 38 inclined portion of the transmission cable 39 end of the third link 40 through hole of the support link protrusion 41 distal end of the transmission cable 42 undercut wall of the terminal seat 43 radial mouth or inlet of the terminal seat 44 circumferential protrusion of the terminal seat 45 contact surface 46 actuating tendon of the first support link 47 terminal seat of the first support link 48 assembly window of the support link protrusion 50 wire electrical discharge machining machine 51 cutting wire 52 jig 111 first workpiece 112 second workpiece 113 third workpiece 120 additional workpiece 151 forward path of the cable 152 return path of the cable R14 pulley radius P1, P2 lateral distance P-P pitch axis Y-Y yaw axis G opening and closing degree of freedom X-X longitudinal axis of the instrument α sliding contact angle π generatrix of the first wire-woven surface υ Bus bar of the second wire woven surface R-R Radial direction of the take-up pulley of the second link TR Traction action W-W Rotation axis of the wire electrical discharge machining machine

Claims

1. A surgical instrument (1) comprising an articulated end (10), a first support link (11), a second link (12) articulated to the first support link (11) so as to be rotatable about a rotation axis (Y-Y), transmission cables (15, 16) fixed to the second link (12), comprising, wherein the first support link (11) is a wire-woven surface composed of straight generatrices (π) all parallel to each other, having at least one convex first sliding surface (17, 18), a wire-woven surface composed of straight generatrices (υ) all parallel to each other, having a convex second sliding surface (18), including, wherein the transmission cables (15, 16) are configured to slide on both at least one of the first sliding surfaces (17, 19) of the first support link (11) and the second sliding surface (18) when the second link (12) rotates relative to the first support link (11), the straight generatrix (π) of at least one of the first sliding surfaces (17, 19) is orthogonal to the straight generatrix (υ) of the convex second sliding surface (18) which is a wire-woven surface, a surgical instrument (1).

2. The second link (12) comprises a winding pulley (14), the transmission cable is wound around the winding pulley (14) of the second link (12), the winding pulley (14) has a radius (R14), and the radius (R14) is greater than or equal to the distance between at least one of the first sliding surfaces (17, 19) or the second sliding surface (18) and the central line of the surgical instrument, The surgical instrument (1) according to claim 1.

3. The second link (12) comprises a winding pulley (14), the transmission cable is wound around the winding pulley (14) of the second link (12), the winding pulley protrudes laterally with respect to the second sliding surface (18) of the first support link (11), The surgical instrument (1) according to claim 1.

4. The second sliding surface (18) is parallel to the rotation axis (Y-Y) between the second link (12) and the first support link (11), The surgical instrument (1) according to any one of claims 1 to 3.

5. All of the linear generatrices (π) of at least one of the first sliding surfaces (17, 19) and the linear generatrix (υ) of the second sliding surface (18) are perpendicular to the longitudinal axis of the surgical instrument, and preferably perpendicular to the longitudinal axis of the positioning shaft (21) of the surgical instrument along which the transmission cable extends. The surgical instrument (1) according to any one of claims 1 to 4.

6. At least one of at least one of the first sliding surfaces (17, 19) and the second sliding surface (18) faces the definable longitudinal center line of the articulated end (10), for example, faces the longitudinal center line of the positioning shaft (21) of the surgical instrument along which the transmission cable extends. The surgical instrument (1) according to any one of claims 1 to 5.

7. The first support link (11) includes at least one cantilever (27, 28) forming a free end. At least one of at least one of the first sliding surfaces (17, 19) and the second sliding surface (18) belongs to at least one of the cantilevers (27, 28) of the first support link (11). The surgical instrument (1) according to any one of claims 1 to 6.

8. The sliding contact angle (α) between the transmission cable and at least one of at least one of the first sliding surfaces (17, 19) and the second sliding surface (18) does not change in any operating configuration of the articulated end (10). The surgical instrument (1) according to any one of claims 1 to 7.

9. The sliding contact angle (α) between the transmission cable and at least one of at least one of the first sliding surfaces (17, 19) and the second sliding surface (18) is less than 90 degrees, preferably less than 45 degrees, and more preferably less than 30 degrees in any operating configuration of the articulated end (10). The surgical instrument (1) according to any one of claims 1 to 8.

10. In any operating configuration of the articulated end (10), the sum of the sliding contact angle (α) between the transmission cable and at least one of the first sliding surfaces (17, 19) and the sliding contact angle (α) between the same transmission cable and the second sliding surface (18) is less than 180 degrees, and / or In at least one operating configuration of the articulated end (10), the sum of the sliding contact angle (α) between the transmission cable and at least one of the first sliding surfaces (17, 19) and the sliding contact angle (α) between the same transmission cable and the second sliding surface (18) is 180 degrees or more. The surgical instrument (1) according to any one of claims 1 to 9.

11. At least one of the first sliding surfaces (17, 19) and the second sliding surface (18) are arranged spaced apart in the longitudinal direction. The surgical instrument (1) according to any one of claims 1 to 10.

12. The first support link (11) is integrally formed. The surgical instrument (1) according to any one of claims 1 to 11.

13. The articulated end (10) further comprises a proximal link (20). The proximal link (20) is arthroscopically joined proximally to the first support link (11) and rotates about a common axis of rotation (P-P). The proximal link (20) comprises a convex third sliding surface (30) for sliding of the transmission cables (15, 16). The third sliding surface (30) is a wire-woven surface having a linear generatrix parallel to either the linear generatrix (π) of at least one of the first sliding surfaces (17, 19) or the linear generatrix (υ) of the second sliding surface (18). The surgical instrument (1) according to any one of claims 1 to 12.

14. The transmission cable includes an operating distal end (41) for pulling the second link (12). The operating distal end (41) is received in a terminal seat (26) made in the disc-shaped volume of the take-up pulley (14). Preferably, the transmission cable is at least partially made of polymer fibers. The surgical instrument (1) according to any one of claims 1 to 13.

15. Comprising an articulation pin (35) extending along the axis of rotation (Y-Y), the second link (12) being arthroscopically joined to the first support link (11) by the articulation pin (35). The articulation pin (35) is rotationally integrated with the take-up pulley (14) of the second link (12). The surgical instrument (1) according to any one of claims 1 to 14.

16. A manufacturing method by wire electrical erosion for manufacturing at least the support link (11) of the articulated end (10) of the surgical instrument (1). The support link (11) is a wire-woven surface having parallel linear generatrices, and includes at least one convex first sliding surface and a wire-woven surface having parallel linear generatrices and a convex second sliding surface. The first sliding surface and the second sliding surface are configured such that a transmission cable can slide thereon. The linear generatrix of at least one of the first sliding surfaces is orthogonal to the linear generatrix of the second sliding surface. The manufacturing method is as follows: providing a wire electrical discharge machining machine (50) having a cutting wire (51); attaching at least one workpiece (111) to the wire electrical discharge machining machine; performing a first through cut on at least one of the workpieces (111) using the cutting wire to form at least one of the first sliding surfaces; rotating at least one of the workpieces 90° with respect to the cutting wire; performing a second through cut on at least one of the same workpieces (111) using the cutting wire to form the second sliding surface; including method.

17. A method for assembling the surgical instrument (1) according to any one of Claims 1 to 15, inserting an articulation pin (35) into the through holes of the first support link (11) and the second link (12); fixing the operating distal end (41) of the transmission cable to a terminal seat portion (26) formed inside the winding pulley (14) of the second link; wrapping the distal portion of the transmission cable adjacent to the operating distal end (41) around the winding pulley (14); including Fixing the operating distal end (41) of the transmission cable to the terminal seat portion (26) formed inside the winding pulley (14) of the second link includes: forming a configuration of axial alignment between the terminal seat portion (26) of the winding pulley (14) of the second link (12) and the assembly window (48) of the first support link (11); axially inserting the operating distal end (41) of the transmission cable into the assembly window (48) of the first support link (11), and further axially inserting it into the terminal seat portion (26) of the winding pulley (14) of the second link (12); further including assembly method.

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