Electrosurgical instrument and movable electrosurgical energy transmission cable assembly, particularly for robotic teleoperation

Abstract

An assembly (1) comprising an electrosurgical instrument (2) having an elongated positioning element (3) and an electrosurgical end (4) at the distal end (5) of the elongated positioning element (3); and an electrosurgical energy transmission cable (8) operatively connected to the electrosurgical end (4); the elongated positioning element (3) comprises a body extending along a longitudinal direction (X-X); said electrosurgical end (4) is adapted to rotate in a rolling rotation (ROLL) around the longitudinal direction (X-X) of the elongated positioning element (3); said elongated positioning element (3) comprises at least one electrically conductive path in electric conduction communication with the electrosurgical end (4); said electrically conductive path of the elongated positioning element (3) of the electrosurgical instrument (2) comprises at least one contact surface (10) thereof; said transmission cable (8) comprises at least one electrically conductive contact element (9) thereof arranged in electric conduction contact with said at least one contact surface (10) of the electrically conductive path of the elongated positioning element (3) of the electrosurgical instrument (2); the elongated positioning element (3) with the at least one contact surface (10) thereof is adapted to rotate around the longitudinal direction (X-X) thereof with respect to the at least one contact element (9) of the electrosurgical energy transmission cable (8), creating an electrically conductive sliding contact.

Description

"ELECTROSURGICAL INSTRUMENT AND MOVABLE ELECTROSURGICAL ENERGY TRANSMISSION CABLE ASSEMBLY, PARTICULARLY FOR ROBOTIC TELEOPERATION"DESCRIPTION

[0001] . Field of the invention

[0002] . The present invention relates to an assembly comprising an electrosurgical instrument and an electrical cable for transmitting electrosurgical energy.

[0003] . Furthermore, the present invention relates to a robotic teleoperation system comprising said assembly.

[0004] . Background art

[0005] . Robotic surgery apparatuses are generally known in the art and typically comprise a central robotic tower and one or more robotic arms extending from the central robotic tower. Each arm comprises a motorized positioning system (or robotic manipulator) for moving a surgical instrument distally attachable thereto, in order to perform surgical procedures on a patient.

[0006] . The patient typically lies on an operating bed located in the operating room, in which sterility is ensured to avoid bacterial contamination due to non-sterile parts of the robotic apparatus.

[0007] . Generally, known surgical instruments for teleoperated robotic surgery comprise a proximal transmission interface (or "backend", according to terminology commonly adopted in the field) having an interface intended to be operated by a robotic manipulator.

[0008] . Extending from the proximal transmission interface of the surgical instrument is an elongated element such as a rod or shaft or stick having at the distal end thereof an articulated device (e.g . , an articulated cuff) with an operative final end (e.g . , needle-driver, sutures-cutter, dilator, scalpel).

[0009] . In the known surgical instruments having an articulated cuff, it typically consists of a plurality of links moved by a plurality of tendons (or actuation cables) .

[0010] . Unlike the known surgical instruments comprising an articulated cuff , surgical instruments having an articulated device of the"snake" type are also known, i.e. , comprising a plurality of stacked vertebrae which are movable with respect to each other by m eans of a plurality of actuation cables or tendons.

[0011] . The provision of said articulated cuff links, as well as said stacked vertebrae, with the actuation tendons thereof allows moving the operative final end of the instrument, according to various degrees of freedom .

[0012] . In fact, articulated ends typically have at least three degrees of freedom of movement commonly referred to as roll, pitch and yaw. In addition , where at least two end tips or jaws are provided, there is a further degree of freedom of opening / closing between the tips or jaws.

[0013] . The degree of freedom of roll allows the articulated end to make a rotation about a generally longitudinal axis which typically extends along the longitudinal extension of th e positioning rod or stick or shaft. A roll joint can be provided within the articulated end, as shown, for example, in US- 6676684. In this case, a pair of actuation tendons can be dedicated to the rolling movement of the end tips or jaws.

[0014] . According to other known examples, a roll joint is interposed between the proximal transmission interface and the positioning rod or shaft or stick. Also in this case, a pair of actuation tendons is dedicated to the rolling movement of the end tips or jaws together with the positioning rod or stick or shaft.

[0015] . Otherwise, as shown for example in WO-2021 -161 161 (on behalf of the same Applicant) the rolling rotation can involve the entire surgical instrument about a definable longitudinal axis of the positioning stick or rod or shaft. In this case, the roll drive of the articulated end imposes the rolling rotation of the entire surgical instrument. A known related solution is shown in US-10786329.

[0016] . Active surgical instruments of the type adapted to transmit electrical energy to tissues, such as electro-cauterizing surgical instruments for robotic surgery, are also known . Some known examples of such instruments are shown in prior art documents US-6840938, US- 7824401 , US-10376331 , US-8398634, US-10716617, and US-2022-133388.

[0017] . The known active electrosurgical instruments typically comprise one or more conductors for transmitting electrical energy from the robotic manipulator, by means of the transmission interface portion of thesurgical instrument, to the articulated ends of the end-effector of the instrument itself .

[0018] . To electrically insulate such articulating ends of the active electrosurgical instrument, insulating sleeves are typically fitted onto the entire end-effector, so as to form an electrically insulating barrier with respect to the patient's tissue close to or in contact with the end -effector itself.

[0019] . In the known active electrosurgical instruments, and in particular for endoscopic or minimally invasive applications, they have an internally hollow positioning shaft or rod or stick made of non-conductive plastic or composite materials, to avoid unwanted lateral discharges, and only the electrical conductor cables which run therein in specific channels carry the electrical potential to the application terminals (e.g . , the tips or jaws) which act as electrodes.

[0020] . In fact, in monopolar-type active electrosurgical instruments, an electrical cable is typically provided, which extends into the positioning shaft or rod or stick of the surgical instrument from the transmission interface portion to the articulated cuff . In such known monopolar electrosurgical instruments, the electrical circuit is closed by virtue of a return electrode (typically a plate) after having crossed a part of the patient's body.

[0021] . Otherwise, in bipolar-type active electrosurgical instruments the two tips or jaws of the instrument are polarized with a different charge, such as to form two electrodes, one of which forms the return electrode. In this type of electrosurgical instruments, it is necessary to avoid short circuits between the various parts of the articulated end which have a different electrical charge (e.g . , between the two tips or jaws as well as between the respective electrical conductors) .

[0022] . The rigidity and size of conductor cables connected to the articulated end jaws or tips compromise the movement, closing / opening and gripping performance, particularly in the case of miniaturized articulated ends, i.e. , with sections of the order of millimeters, where slight tensile forces applied to the conductor cables can cause a non-negligible positioning error at the level of the tips or jaws of the miniaturized articulated end.

[0023] . Robotic movement along numerous degrees of freedom androtation axes of electrified surgical instruments is limited by the presence of external electrical transmission cables which can move in unwanted positions, obstruct the point of view, intertwine along the axes until they break, wear or generate resistance.

[0024] . The need is therefore felt to propose an improved active electrosurgical instrument solution , which is capable of safely and effectively conducting the electrical polarization at the end tips or jaws and which at the same time is capable of high movement dexterity when in operating conditions, while maintaining minimum dimensions and footprint to promote a boosted miniaturization of the electrosurgical instrument.

[0025] . The need is felt for a solution which reduces or eliminates the risk of traction or intertwining of electrical transmission cables for electrified surgical instruments.

[0026] . Solution

[0027] . It is an object of the present invention to obviate the drawbacks complained of with reference to the prior art and suggest a solution to the needs mentioned above.

[0028] . This and other objects are achieved by an assembly according to claim 1 , as well as by a system according to claim 19.

[0029] . Some advantageous embodiments are the subject of the dependent claims.

[0030] . According to an aspect of the invention , an electrosurgical instrument and transmission cable assembly comprises an electrosurgical instrument having an elongated positioning element and an electrosurgical end at the distal end of the elongated positioning element, and an electrosurgical energy transmission cable operatively connected to the electrosurgical end.

[0031] . The elongated positioning element comprises a body extending along a longitudinal direction thereof and said electrosurgical end is adapted to rotate by a rolling rotation around the longitudinal direction of the elongated positioning element.

[0032] . The elongated positioning element comprises at least one electrically conductive path in electric conduction communication with the electrosurgical end, said electrically conductive path comprising at least one contact surface thereof.

[0033] . The transmission cable comprises at least one electricallyconductive contact element thereof arranged in electric conduction contact with said at least one contact surface of the electrically conductive path of the elongated positioning element of the electrosurgical instrument.

[0034] . The elongated positioning element with the at least one contact surface thereof is adapted to rotate around the longitudinal direction thereof with respect to the at least one contact element of the electrosurgical energy transmission cable.

[0035] . In accordance with an embodiment, the at least one contact element of the transmission cable is elastically preloaded against said at least one contact surface of the elongated positioning element of the electrosurgical instrument. Preferably, the at least one contact element of the transmission cable creates a spring co ntact, and for example comprises an elastic leaf and / or band and / or flap, which preferably extends cantilevered, forming a free end.

[0036] . In accordance with an embodiment, said at least one contact surface of the electrically conductive path of the elongated po sitioning element of the electrosurgical instrument comprises a cylindrical surface, and preferably a substantially circular cylindrical surface extending as a closed ring around the longitudinal extension direction of the elongated positioning element.

[0037] . The elongated positioning element of the electrosurgical instrument can comprise an electrically conductive body which forms per se said at least one electrically conductive path and said at least one contact surface.

[0038] . The elongated positioning element of the electrosurgical instrument can comprise at least one electrically insulating coating , e.g . , at least one sleeve and / or a cap, which exposes said at least one contact surface, and preferably also said electrosurgical end, out of said electrically insulating coating . Preferably, the electrically insulating coating is impermeable to fluids, thereby creating a waterproof coating .

[0039] . In accordance with an embodiment, the transmission cable comprises a plug having a body which encloses or houses said at least one contact element.

[0040] . Preferably, said plug comprises a body delimiting a through channel which receives the elongated positioning element of the electrosurgical instrument in a fluid-tight manner.

[0041] . In accordance with an embodiment, the transmission cable comprises a cable-guiding bracket for constraining a segment of the transmission cable in a predeterminable position with respect to the elongated positioning element of the electrosurgical instrument. The cableguiding bracket can be constrained to a robotic man ipulator and / or to said plug .

[0042] . In accordance with an embodiment, the electrosurgical instrument is, in its entirety, integral in rolling rotation around the longitudinal direction and is adapted to rotate in its entirety with respect to the cable-guiding bracket.

[0043] . Brief description of the figures

[0044] . Further features and advantages of the invention will become apparent from the following description of preferred embodiments, given by way of non-limiting indication , with reference to the accompanying drawings which are briefly described below. Note that references to “an” embodiment in this disclosure do not necessarily refer to the same embodiment and are to be understood as at least one. Moreover, for reasons of conciseness and reduction of the total number of figures, a certain figure can be used to illustrate the features of more than one embodiment, and not all the elements in the figure can be necessary for a certain embodiment.

[0045] . Figure 1 is a diagrammatic axonometric view of a robotic system , according to an embodiment.

[0046] . Figure 2 is an axonometric view of an electrosurgical instrument and electrical transmission cable assembly, according to an embodiment.

[0047] . Figure 3 is an axonometric view showing a portion of an electrosurgical instrument and electrical transmiss ion cable assembly, according to an embodiment.

[0048] . Figure 4 shows an axonometric view of the portion of the assembly in Figure 3 in which some parts are transparent for clarity.

[0049] . Figure 5 is a vertical elevation view of a detail shown in Figure 4.

[0050] . Figure 6 shows an axonometric view of the portion of the assembly in Figure 4 in which some further parts are transparent for clarity.

[0051] . Figure 7 A diagrammatically shows a vertical elevation of an assembly, according to an embodiment.

[0052] . Figure 7 B pictorially shows a vertical elevation of an assembly, according to an embodiment.

[0053] . Figure 8 shows an axonometric view of an assembly portion, according to an embodiment.

[0054] . Figure 9 A shows an axonometric view of a portion of an electrosurgical instrument and electrical transmission cable assembly, according to an embodiment.

[0055] . Figure 9 B shows an axonometric view of the electrical transmission cable in Figure 9 A, with separate parts.

[0056] . Figure 9 C is a diagrammatic section view of a detail of the portion of the electrosurgical instrument and electrical transmission cable assembly in Figure 9 A.

[0057] . Figure 1 0 shows a vertical elevation of an electrosurgical instrument and an electrical transmission cable assembly connected to a robotic manipulator, according to an embodiment, in which some parts are transparent for clarity.

[0058] . Figure 1 1 A shows a vertical elevation of an electrosurgical instrument and electrical transmission cable assembly, according to an embodiment.

[0059] . Figure 1 1 shows an axonometric view of an assembly potion , according to an embodiment.

[0060] . Figure 12 shows a diagrammatic section of a detail of an electrosurgical instrument and electrical transmission cable assembly, according to an embodiment, in which the electrosurgical instrument is a bipolar electrosurgical instrument.

[0061] . Figure 13 A shows a vertical elevation of an assembly, according to an embodiment.

[0062] . Figure 13 B pictorially shows an axonometric view of a detail of the assembly portion in Figure 13 A.

[0063] . Figure 14 shows a vertical elevation of an electrosurgical instrument and electrical transmission cable assembly, according to an embodiment.

[0064] . Detailed description of some embodimentsReference throughout this description to "an embodiment" means that a particular feature, structure or function described in relation to the embodiment is included in at least one embodiment of the present invention .Therefore, the formulation “in an embodiment” in various parts of this description do not necessarily all refer to the same embodiment. Moreover, particular features, structures or functions such as those shown in different drawings can be combined in any suitable manner in one or more embodiments.

[0065] . In accordance with a general embodiment, an assembly 1 is provided, comprising an electrosurgical instrument 2 and an electrosurgical energy transmission cable 8 which is operatively connectable to an electrosurgical power generator 6.

[0066] . The electrosurgical instrument and transmission cable assembly 1 is particularly suitable for a robotic electrosurgical teleoperation system 20 comprising said electrosurgical power generator 6.

[0067] . The electrosurgical instrument 2 comprises an elongated positioning element 3, such as a shaft, a rod or a stick, and an electrosurgical end 4 at the distal end 5 of the elongated positioning element 3.

[0068] . The transmission cable 8 can be a transmission cable for powering the electrosurgical end 4 with electrosurgical energy.

[0069] . The electrosurgical instrument 2 preferably further comprises a proximal actuation interface 13, or backend 13, for receiving the actuation action exerted by a robotic manipulator 1 1 by means of the one or more motorized actuators thereof, in which the elongated positioning element 3 extends distally DISTAL from said actuation interface 13. Of course, a segment of the elongated positioning element 3 can extend proximally, i.e. , in a proximal direction , from said portion of the actuation interface 13 which in such a case is crossed by the elongated positioning element 3.

[0070] . The electrosurgical end 4 can comprise an articulated cuff provided with a plurality of links defining rotational joints for movement about a plurality of rotation axes, and preferably said articulated cuff of the electrosurgical end 4 comprises a pitch joint and a yaw joint. Other types of joints can be present, such as prismatic sliding joints. Internally, the elongated positioning element 3 is preferably hollow, i.e. , it has a longitudinal cavity which receives one or more actuation tendons of the links, i.e. , the degrees of freedom of the electrosurgical end 4.

[0071] . The elongated positioning element 3 comprises a body extending along a longitudinal direction X-X thereof . The longitudinaldirection X-X of longitudinal extension of the elongated positioning element 3 is preferably a straight direction, although in accordance with an embodiment said longitudinal direction X-X of longitudinal extension of the elongated positioning element 3 is a non -straight direction , and for example is a curved direction .

[0072] . In accordance with a preferred embodiment, the elongated positioning element 3 comprises a rigid body extending substantially straight along the longitudinal direction X-X which is a substantially straight direction .

[0073] . The electrosurgical end 4 is adapted to rotate by a rolling rotation ROLL around the longitudinal direction X-X of the elongated positioning element 3.

[0074] . The rolling rotation ROLL of the electrosurgical end 4 also involves the elongated positioning element 3, i.e., in other words, s aid elongated positioning element 3 and said electrosurgical end 4 are mutually integral in rolling rotation ROLL around the longitudinal direction X -X.

[0075] . To achieve the rolling rotation ROLL, a rotary motorized rolling actuator 15 is preferably provided ins ide the robotic manipulator 1 1 operatively connected to a motor 22. A transmission belt can be arranged between the motor and the rotary rolling actuator 15. I n particular, the robotic manipulator 1 1 preferably comprises an outer case 1 1 0 which does not rotate in rolling ROLL, in which inside the outer case 1 10 the rotary rolling actuator 15 is arranged, as shown, for example, in Fig ure 7-A.

[0076] . The rolling rotation ROLL of the elongated positioning element 3 and of the electrosurgical end 4 can also involve th e transmission interface portion 13 of the electrosurgical instrument 2, so that the electrosurgical instrument 2 is adapted to rotate in its entirety by rolling around the longitudinal direction X-X.

[0077] . The elongated positioning element 3 comprises at least one electrically conductive path having at least one contact surface 1 0 thereof in electric conduction communication with both the electrosurgical end 4 and said electrosurgical energy transmission cable 8.

[0078] . In particular, the transmission cable 8 comprises a contact element 9 thereof which is in contact with said at least one contact surface 10 of said at least one electrically conductive path of the elongated positioning element 3 of the electrosurgical instrument 2.

[0079] . The electrically conductive path can be formed by the body of the elongated positioning element 3 itself, which for this purpose can be made of electrically conductive material, e.g . , surgical steel. The electrosurgical end 4 is preferably also made of electrically conductive material, e.g . , su rgical steel, so as to ensure electric conduction communication with the transmission cable 8 and therefore with the electrosurgical power generator 6, through the body of the elongated positioning element 3.

[0080] . The electrosurgical instrument 2 can be a monopolar electrosurgical instrument comprising a forward electrode, i.e. , for the supply of electrosurgical energy, belonging to said electrosurgical end 4 and arranged in electric conduction communication with the electrically conductive path having the contact surface 1 0, in which the elongated positioning element 3 and the electrosurgical end 4 are both made of electrically conductive material to implement a conduction of electrosurgical energy from the generator 6 to the electrosurgical end 4.

[0081] . An electrically insulating coating 18 (e.g . , a sleeve made of dielectric material such as silicone) can be provided, which covers a portion of the elongated positioning element 3 and / or the electrosurgical end 4. In accordance with a preferred embodiment, the electrically insulating coating 18 covers a portion of the elongated positioning element 3 exposing said at least one contact surface 10 to allow the electric conduction contact with the at least one contact element 9 of the electrical transmission cable 8.

[0082] . The electrically insulating coating 1 8, such as a silicone sleeve or cap, can be fitted onto a portion of the electrosurgical end 4.

[0083] . In accordance with a preferred embodiment, the electrically insulating coating 1 8 also has impermeable properties, thereby prevent ing vapors and liquids of the surgical site from penetrating or percolating to reach the contact surface 1 0 and / or the contact element 9, creating a waterproof coating 37.

[0084] . The electrically insulating and waterproof coating is adapted to be fitted onto the electrosurgical end 4 particularly where articulated joints are provided in the electrosurgical end (e.g . , rotational joints of pitch / yaw I grip G) .

[0085] . In accordance with an embodiment, the electrically insulating and waterproof coating comprises conductive paths therein which form atleast one part of the conductive path to the electrosurgical end 4.

[0086] . The elongated positioning element 3 of the electrosurgical instrument 2, with the contact surface 10 thereof , is adapted to rotate in rolling rotation ROLL around the longitudinal direction X-X thereof , being rotatable with respect to the at least one contact element 9 of the transmission cable 8.

[0087] . When in operation, the rolling rotation ROLL of the electrosurgical end 4 also involves the elongated positioning el ement 3 which rotates around the longitudinal extension direction X-X thereof integral with the electrosurgical end 4, creating , with the contact element 9 of the transmission cable 8, a sliding electric conduction contact.

[0088] . The sliding electric conduction contact between the contact element 9 of the electrosurgical energy transmission cable 8 and the contact surface 1 0 of the at least one electrically conductive path of the elongated positioning element 3 of the electrosurgical instrument 2 allows maintaini ng the electric conduction between the electrosurgical power generator 6 and the electrosurgical end 4 even during the rolling movement ROLL of the electrosurgical end 4 with the elongated positioning element 3.

[0089] . The relative rotational movement between the contact element 9, i.e., stationary with respect to the outer case 1 10 of the robotic manipulator 1 1 , and the elongated positioning element 3, rotating by rolling ROLL, generates sliding friction which allows removing any patinas which could form , such as oxide patinas, as well as debris and / or organic material, maintaining efficient electrical conduction even during long electrosurgical interventions.

[0090] . In other words, the rotation of the contact surface 10 of the at least one electrically conductive path of the elongated positioning element 3 of the electrosurgical instrument 2 with respect to the at least one contact element 9 of the transmission cable 8 allows maintaining efficient electrical conduction to the electrosurgical end 4 as a result of the relative rolling rotation ROLL around the longitudinal direction X-X.

[0091] . The at least one contact element 9 of the transmission cable 8 can comprise one or more leaves and / or one or more flaps and / or one or more bands made of electrically conductive material, such as copper, silver, gold or others.

[0092] . In accordance with an embodiment, the at least one contactelement 9 is made of electrically conductive and elastically deformable material, e.g . , copper, silver, gold, aluminum and the like. Preferably, the at least one contact element 9 of the transmission cable 8 is elastically preloaded against the contact surface 10 of the elongated positioning element 3. The elastic preload can be obtained by employing a contact element which is elastically deformable towards an operative contact configuration with the contact surface 1 0 of the elongated positioning element. For example, the at least one contact element 9 comprises an elastic leaf extending cantilevered abutting against the contact surface 10 of the elongated positioning element 3 of the electrosurgical instrument 2.

[0093] . The contact surface 10 of the elongated positioning element 3 of the electrosurgical instrument 2 is preferably a cylindrical surface extending around the longitudinal direction X-X, and even more preferably is a substantially circular cylindrical surface extending in a closed ring around the longitudinal d irection X-X.

[0094] . The at least one contact element 9 of the transmission cable 8 can be obtained from an electrically conductive plate 17 by incision processing , such as to leave an attachment root to the plate 1 7 and forming a cantilevered free end of the contact element 9, as shown for example in Figure 6. The cantilevered free end does not necessarily make the sliding contact, which for example is made by the body of the cantilevered leaf.

[0095] . The elasticity of the electrically conductive contact element can be conferred by the choice of the thickness of the plate 17 which for example is a thickness of about 0.5-5 millimeters. The contact element 9, as well as the plate 1 7, can be shaped so as to shape the contact surface substantially concave to maximize the electric conduction contact area with the contact surface 10 of the elongated positioning element 3 of the surgical instrument 2.

[0096] . In accordance with a preferred embodiment, the at least one contact element 9 of the transmission cable 8 comprises a pair of electrically conductive flaps and / or leaves and / or bands 9. I n other words, there are at least two contact elements 9 and both are arranged in contact with the same contact surface 10. The inclusion of two electrically conductive contact elements 9 in electric conduction contact with the same contact surface 10 of the elongated positioning element 3 allows increasing the contact surface, improving the transmission reliability between thetransmission cable and the elongated positioning element 3 of the electrosurgical instrument.

[0097] . Preferably, the elongated positioning element 3, or at least the contact surface 10 thereof, has a substantially cylindrical body extending circumferentially around the longitudinal direction X-X, to promote the sliding contact during the rotation thereof . The angular extension of the cylindrical contact surface 10 is preferably at least 1 80° and even more preferably 360°, forming a conductive closed ring around the longitudinal direction of the elongated positioning element 3.

[0098] . The distal end of the transmission cable 8 preferably comprises a plug 14 for electrically conductive connection to the elongated positioning element 3, said plug 14 having a box-like body which encloses therein said at least one electrically conductive contact element 9. The plug 14 of the transmission cable 8 can comprise a box-like body which encloses, in addition to said at least one contact element 9, also said plate 17.

[0099] . The box-like body of the plug 14 can be made of rigid plastics, e.g . , by molding , and preferably consists two pieces 141 , 142 or half -shells 141 , 142 or valves 141 , 142, so as to allow assembling the plug 14 around the contact surface 1 0 of the elongated positioning element 3. In this case, the through channel 35 can be delimited by both said two pieces 141 , 142 or half-shells 141 , 142 of the plug 14 which have a respective abutment surface substantially parallel or coinciding with the longitudinal direction X - X. To assemble the two half-shells 141 , 142 to the contact surface 10 of the elongated positioning element 3, threaded and / or interlocking fastening elements can be included. By virtue of the inclusion of said two half -shells 141 , 142, it is possible to assemble and disassemble the plug 14 to the elongated positioning element if necessary even after the electrosurgical instrument 2 has been arranged in operating conditions, i .e. , after the engagement or assembly of the electrosurgical instrument 2 to the robotic manipulator 1 1 of the robotic system 20.

[0100] . The body of the plug 14 of the transmission cable 8 can comprise a through channel 35 which crosses the plug 14 and houses the elongated positioning element 3 in a through manner, in which the respective abutment surface between the two half -shells 141 , 142 is directed transversely to the long itudinal direction X-X. In this case, the plug 14 can be fitted onto the elongated positioning element 3 of theelectrosurgical instrument 2 by inserting the elongated positioning element into the through channel 35.

[0101] . In accordance with an embodiment, said plug 14 comprises a body delimiting the through channel 35 and which receives in a fluid -tight manner the elongated positioning element 3 of the electrosurgical instrument in which the fluid tightness is obtained by p roviding one or more gaskets 36, e.g. , of the O-ring type, sandwiched between the plug 14 and the elongated positioning element 3.

[0102] . Alternatively or in addition, a waterproof coating 37 can be provided on the elongated positioning element 3. In particular, as shown for example in Figure 9-C, the fluid tightening can be made by jointly providing said tight gaskets 36 (e.g . , O-rings) which abut against the waterproof coating 37 of the elongated positioning element 3 of the instrument 2. The elongated positioning element 3 can comprise an electrically insulating coating interposed between an electrically conductive inner body forming the conductive path and the waterproof coating 37.

[0103] . The plug 14 of the transmission cable 8 can comprise an elastic body which snap-fits with the contact surface 1 0 of the elongated positioning element 3 of the electrosurgical instrument 2. For example, the elastic body of the plug 14 is “C”-shaped (not shown) and receives the contact surface 1 0 of the elongated positioning element 3 , delimiting the through channel 35 with the "C"-shaped body thereof .

[0104] . In accordance with a preferred embodiment, the contact surface 1 0 of the elongated positioning element 3 is exposed out the body of the proximal actuation interface 13 (backend 13) of th e electrosurgical instrument 2 and is preferably arranged distally with respect thereto. The plug 14 with the at least one contact element 9 thereof is therefore fastened distally with respect to the actuation interface portion 13.

[0105] . As shown for example in Figure 14, the elongated positioning element 3 can extend through the body of the actuation interface portion 13 (backend 13) of the electrosurgical instrument 2, and the proximal segment 19 of the elongated positioning element 3 can extend proximally with respect to the backend 13.

[0106] . In accordance with a preferred embodiment, the contact surface 1 0 is located on a proximal segment 19 of the elongated positioning element 3, said proximal segment 19 comprising said proximal end 16. Theproximal segment 19 of the elongated positioning element 3 can be hous ed within the body of the actuation interface portion 13 (backend 13) of the electrosurgical instrument 2. It is thus possible to keep the electrical connection away from the surgical site by sandwiching the actuation interface portion 13 (backend) between the contact surface 1 0 and the electrosurgical end 4.

[0107] . As mentioned above, the electrosurgical instrument 2 is preferably adapted to rotate in its entirety about the longitudinal axis by performing the rolling rotation ROLL. In other words, the actuation i nterface portion 13 (backend), the elongated positioning element 3 and the electrosurgical end 4 are all integral in rolling rotation ROLL. In other words, no internal degrees of freedom of roll are provided in the electrosurgical instrument 2.

[0108] . Alternatively, as shown for example in Figure 10, the elongated positioning element 3 can be movable in rolling rotation ROLL around the longitudinal direction X-X with respect to the actuation interface portion 13 (backend 13) of the electrosurgical instrument 2, i. e. , a degree of freedom of roll is provided between the actuation interface portion 13 and the elongated positioning element 3 of the electrosurgical instrument 2. To this end, in the actuation interface portion 13, a rotary transmission element 21 , such as a winch 21 , can be provided to move the elongated positioning element in rolling rotation with respect to the actuation interface portion 13 (in a manner known per se) . In this case, the robotic manipulator 1 1 preferably comprises a rotary motorized actu ator 1 5 with a drive motor 22 thereof for driving the rotary transmission element 21 in rotation through the sterile barrier 24, in which the rotary transmission element 21 in turn is connected to a tendon or cable or transmission belt 23 which, winding on / unwinding from the elongated positioning element 3 determines the rolling rotation ROLL with respect to the actuation interface portion 13.

[0109] . In accordance with a preferred embodiment, the transmission cable 8 further comprises a cable-guiding bracket 12 for constraining a segment of the transmission cable 8 in a predeterminable position during the rolling rotation ROLL of the elongated positioning element 3 of the electrosurgical instrument 2 around the longitudinal direction X -X thereof.[001 10]. In particular, the cable-guiding bracket 12 can be mounted on a portion of the robotic manipulator 1 1 which is substantially stationary inrolling rotation during the rolling rotation ROLL to the elongated positioning element 3 of the electrosurgical instrument 2, keeping the transmission cable 8 with the plug 14 thereof substantially stationary in rolling rotation with respect to the elongated positioning element 3. This allows preventing the inertia of rotation from dragging said at least one contact element 9 into rolling rotation ROLL with the plug 14 of the transmission cable 8, which could be twisted even partially around the electrosurgical instrument 2 generating shear stresses on the elongated positioning element 3. To secure the cable-guiding bracket 1 2 to the body of the robotic manipulator 1 1 , fastening means 39 can be provided, such as adhesive tape, Velcro, laces or the like.[001 11 ]. The cable-guiding bracket 12 preferably comprises an elongated body delimiting an operating seat 31 adapted to place a segment of the transmission cable 8 in an operating configuration, i.e. , close to or at the contact surface 10 of the elongated positioning element 3 of the electrosurgical instrument 2. The operating seat 31 can be a closed through channel or it can be an open groove.[001 12]. As shown for example in Figure 8, the cable-guiding bracket 12 can further comprise a resting seat 32 which houses the cable in a resting configuration, out of contact with the contact surface 10 of the elongated positioning element 3 of the electrosurgical instrument 2 which, for example, is arranged entirely on the robotic manipulator 1 1 , which is stationary in rolling rotation with respect to the elongated positioning element 3. The resting configuration is preferably a folded or wound configuration and the resting seat 32 can have a folded body for this purpose. The inclusion of the resting seat 32 together with said operating seat 31 on the same cable-guiding bracket 12 allows the transmission cable 8 to be selectively arranged in electric conduction communication with the contact surface 10 of the elongated positioning element 3 of the electrosurgical instrument 2. It is thus allowed for an easy and ready replacement of the electrosurgical instrument 2 with another electrosurgical instrument or with a non-active, i.e. , non-electrosurgical, surgical instrument, if necessary.[001 13]. The cable-guiding bracket 12 cannot be in contact with the elongated positioning element 3 of the instrument 2, and can be configured to arrange a distal segment of the transmission cable 8 at the plug 14.[001 14]. The operating seat 31 of the bracket 1 2 preferably comprises snap-fit elements 33, such as elastic tongues or "C" -shaped clips, for snapfitting the transmission cable 8 to the cable-guiding bracket 12.[001 15]. As shown for example in Figure 9-A, the cable-guiding bracket 12 can be made integral with the plug 14. The body of the cable-guiding bracket 12 can be flexible, and preferably selectively flexible so as not to deform in the transverse direction with respect to the longitudinal direction X-X, opposing the rolling drag ROLL which could be exerted by the rolling rotation of the elongated positioning element 3. The flexibility of the cable guiding bracket 1 2 can be a torsional flexibility.[001 16]. The plug 14 can comprise, in addition to said half -shells 141 , 142, a further insert 143 which for example comprises housing seats for fluid-tight gaskets 36.[001 17]. In accordance with an embodiment, the electrosurgical instrument 2 is a bipolar electrosurgical instrument, in which the electrosurgical end 4 comprises a forward electrode and a return electrode. The return electrodes can be formed, for example, by the jaws 41 , 42 or tips 41 , 42 of the electrosurgical end 4 which are movable with respect to each other in approaching / distancing G, i.e. , in opening / closing G (e.g . , degree of freedom of grip G). The return electrodes can be formed, for example, by moving parts mounted on the jaws 41 , 42 or tips 41 , 42 of the electrosurgical end 4 and movable with respect thereto.[001 18]. In the case of bipolar electrosurgical instru ment 2, as shown for example in Figure 12, the elongated positioning element 3 comprises two distinct electrically conductive paths electrically insulated from each other with respective contact surfaces 10, 10’ electrically insulated from each other and placed in electric conduction communication with said forward electrode and said return electrode of the electrosurgical end 4, respectively. The electrical insulation between the two contact surfaces 1 0 and 10’ can be made by interposing electrically insu lating material such as air, plastic, rubber, glue, ceramic material , or the like.[001 19]. For example, the elongated positioning element 3 comprises two coaxial concentric bodies 3, 3’ which are electrically conductive, each having a contact surface 10, 10’ thereof . Between the two coaxial concentric bodies 3, 3’ of the elongated positioning element of the bipolar electrosurgical instrument 2, and electrically insulating (dielectric) materialsuch as air, plastic, rubber, glue, ceramic material, or the like can be provided to maintain the electrical insulation between the two coaxial concentric bodies 3, 3’, which thus form the conductive forward and return paths or tracks. In accordance with another embodiment, the conductive forward and return paths or tracks are formed by electrical conductors 7, such as electrical wires fastened to the respective contact portions 10, 10’ and to the respective electrodes of the electrosurgical end 4, for example.

[0120] . Therefore, in the case of bipolar electrosurgical instrument 2, the transmission cable 8 can comprise two terminals 81 and 82, i.e. , a forward end 81 and a return end 82, and two contact elements 9 and 9’ in contact with the two contact surfaces 10 and 10’, respectively. I n this case, the plate 1 7, if provided, can be fo rmed by two electrically conductive semi plates 17, 17’ in which electrically insulating material 34 (dielectric) is interposed therebetween. Therefore, in the case of bipolar electrosurgical instrument 2, the transmission cable 8 also acts as a return cab le. In the case of bipolar electrosurgical instrument 2, the plug 14 can comprise two ports for receiving the forward path and the return path of the transmission cable.

[0121] . As mentioned above and irrespective of whether the electrosurgical instrument 2 is of the monopolar or bipolar type, the plug 14 can comprise a portion thereof which is housed inside the box -like body of the backend 13, i.e., inside the actuation interface portion 13 of the instrument 2, in which a portion of the elongated positioning eleme nt 3 is also received, e.g . , a proximal segment 1 9 thereof . By making the electric conduction contact inside the box-like body of the backend 13, a waterproof protection is provided.

[0122] . In accordance with a general embodiment, a robotic electrosurgical teleoperation system 20 comprises at least one assembly 1 comprising said electrosurgical instrument 2 and said electrosurgical energy transmission cable 8, according to any of the embodiments described above.

[0123] . The robotic system 20 preferably comprises a sterile barrier 24 comprising a sterile drape covering the robotic manipulator 1 1 and which can be fastened to the case 1 1 0 of the robotic manipulator. The sterile barrier can further comprise a sterile adapter 32 having a fastening seat for the electrosurgical instrument 2. The sterile adapter 32 is preferablyadapted to rotate by rolling ROLL together with the electrosurgical instrument 2 around the longitudinal direction X-X of the elongated positioning element 3 of the electrosurgical instrument 2 with respect to the robotic manipulator 1 1 (and in particular with respect to the case 1 1 0) and with respect to the cable-guiding bracket 12.

[0124] . The robotic system 20 preferably comprises at least one articulated positioning arm 30 for positioning the robotic manipulator 1 1 and the electrosurgical instrument 2 in the area of interest.

[0125] . The robotic system 20 for electrosurgical teleoperation preferably comprises a master control console (not shown), such as a control gripper, having an actuation device, such as one or more buttons, for the delivery of electrosurgical energy from the electrosurgical end 4. The actuation device can be arranged on a control pedalboard. A wired control connection is preferably provided between the actuation device and the electrosurgical power generator 6. In accordance with a preferred embodiment, the master control console comprises at least one master control device suitable for handling in a sterile environment and comprising at least one sterile handling accessory (e.g . , a sterile case or jaw made by molding plastic material) comprising at least one portion of the actuation device of the electrosurgical power generator 6. Preferably, the master control device is of the type which is not constrained to the operating console and comprises one or more tracking sensors and a data connection to the robotic system .

[0126] . The robotic system 20 for electrosurgical teleoperation can further comprise other instruments which are not electrosurgical.

[0127] . By virtue of the features described above, provided in mutua l combination or not in particular embodiments, it is possible to meet to the aforementioned needs, thus achieving the aforementioned advantages, and in particular:

[0128] . - it is possible to transmit electrosurgical energy to the electrosurgical end of the electrosurgical instrument by means of a sliding contact with a rotating rolling part of the instrument itself, said rotating part being the elongated positioning element of the electrosurgical operating end itself, i.e. , a rod, a stick, a shaft;

[0129] . - the rotating sliding contact allows improving the electrical conductivity because the surface of the contact surface of the elongatedpositioning element is periodically abraded, preventing the formation of oxides or other patinas which could reduce cond uctivity;

[0130] . - it allows making a simple and reversible connection between the electrosurgical power generator and the elongated positioning element rotating rolling .

[0131] . It is well understood that the combinations of features disclosed in the appended claims form an integral part of the present disclosure.

[0132] . In order to meet specific, contingent needs, those skilled in the art may make several changes and adaptations to the above-described embodiments and can replace elements with others which are functionally equivalent, without departing from the scope of the appended claims.LIST OF REFERENCE SIGNS

Claims

CLAIMS1. An assembly ( 1 ) comprising :- an electrosurgical instrument (2) having an elongated positioning element (3) and an electrosurgical end (4) at the distal end (5) of the elongated positioning element (3) ; and- an electrosurgical energy transmission cable (8) operatively connected to the electrosurgical end (4) ; wherein :- the elongated positioning element (3) comprises a body extending along a longitudinal direction (X-X) thereof ;- said electrosurgical end (4) is adapted to rotate by a rolling rotation (ROLL) around the longitudinal direction (X-X) of the elongated positioning element (3) ; and wherein :- the elongated positioning element (3) comprises at least one electrically conductive path in electric conduction communication with the electrosurgical end (4) ;- said electrically conductive path of the elongated positioning element (3) of the electrosurgical instrument (2) comprises at least one contact surface (1 0) thereof ;- said transmission cable (8) comprises at least one electrically conductive contact element (9) thereof arranged in electric conduction contact with said at least one contact surface (10) of the electrically conductive path of the elongated positioning element (3) of the electrosurgical instrument (2) ;- the elongated positioning element (3) with the at least one contact surface (1 0) thereof is adapted to rotate around the longitudinal direction (X -X) thereof with respect to the at least one contact element (9) of the electrosurgical energy transmission cable (8).

2. An assembly according to claim 1 , wherein the at least one contact element (9) of the transmission cable (8) is elastically preloaded against said at least one contact surface (10) of the elongated positioning element (3) of the electrosurgical instrument; and wherein , preferably, the at least one contact element (9) of the transmission cable (8) creates a spring contact, for example comprising an elastic leaf and / or band and / or flap which preferably extends cantilevered, forming a free end.

3. An assembly according to claim 1 or 2, wherein said at least one contactsurface (1 0) of the electrically conductive path of the elongated positioning element (3) of the electrosurgical instrument (2) comprises a cylindrical surface, and preferably a substantially circular cylindri cal surface extending as a closed ring around the longitudinal direction (X -X) of the elongated positioning element (3) .

4. An assembly according to any one of the preceding claims, wherein the elongated positioning element (3) of the electrosurgical instrument (2) comprises a rigid body extending substantially straight along the longitudinal direction (X-X), which is a substantially straight direction ; and wherein, preferably, the elongated positioning element (3) of the electrosurgical instrument (2) has a cylindrical body extending around the longitudinal direction (X-X) having a substantially circular cross-section.

5. An assembly according to any one of the preceding claims, wherein the elongated positioning element (3) of the electrosurgical instrument (2) comprises an electrically conductive body which forms per se said at least one electrically conductive path and said at least one contact surface ( 10).

6. An assembly according to any one of the preceding claims, wherein the elongated positioning element (3) of the electrosurgical instrument (2) comprises at least one electrically insulating coating , such as at least one sleeve and / or a cap, which exposes said at least one contact surface ( 10), and preferably also said electrosurgical end (4), out of s aid electrically insulating coating .

7. An assembly according to claim 6, wherein the electrically insulating coating is impermeable to fluids, thus creating a waterproof coating .

8. An assembly according to any one of the preceding claims, wherein the transmission cable (8) comprises a plug (14) having a body which encloses said at least one contact element (9) .

9. An assembly according to claim 8, wherein said plug ( 14) comprises a body which delimits a through channel (35) which receives in a fluid -tight manner the elongated positioning element (3) of the electrosurgical instrument (2) ; and wherein , preferably, the fluid tightening is made by providing one or more gaskets (36) sandwiched between the plug (14) and the elongated positioning element (3) and / or by providing a waterproof coating arranged on the elongated positioning element (3).

10. An assembly according to any one of the preceding claims, wherein the elongated positioning element (3) comprises a proximal segment ( 19)thereof, and wherein said contact surface ( 10) belongs to said proximal segment.11 . An assembly according to any one of the preceding claims, wherein the electrosurgical instrument (2) comprises an actuation interface (13) thereof , and wherein the elongated positioning element (3) extends in the distal direction from the actuation interface ( 13) ; and wherein- the contact surface ( 10) of the elongated positioning element (3) is received within the body of the actuation interface (13) of the electrosurgical instrument (2) ; or wherein- the contact surface ( 10) of the elongated positioning element (3) is exposed out the body of the actuation interface (13) of the electrosurgical instrument (2).

12. An assembly according to any one of the preceding claims, wherein the transmission cable (8) comprises a cable-guiding bracket (1 2) to constrain a segment of the transmission cable (8) in a predetermined position with respect to the elongated positioning element (3) of the electrosurgical instrument (2) also during the rolling rotation (ROLL) of the elongated positioning element (3) of the electrosurgical instrument (2) ; and wherein, preferably, the cable-guiding bracket (1 2) is constrained to a robotic manipulator ( 1 1 ) and / or to said plug (14).

13. An assembly according to claim 12, wherein the cable-guiding bracket (1 2) comprises an elongated body delimiting an operating seat (31 ), adapted to arrange a segment of the transmission cable (8) close to or at the contact surface (1 0) of the elongated positioning element (3) of the electrosurgical instrument (2) ; and wherein, preferably, the operating seat (31 ) comprises snap-fit elements (33), such as elastic tongues or “C”- shaped clips, to snap-fit the transmission cable (8) to the cable-guiding bracket (1 2) .

14. An assembly according to claim 12 or 13, wherein the cable-guiding bracket (1 2) comprises a resting seat (32) which receives the transmission cable (8) in a resting configuration, such as a folded configuration , out of contact with the contact surface (1 0) of the elongated positio ning elementconfiguration arranges the transmission cable (8) around a portion of the robotic manipulator ( 1 1 ).

15. An assembly according to claim 12, 13 or 14, wherein the electrosurgical instrument (2) is, in its entirety, integral in rolling rotation (ROLL) around the longitudinal direction (X-X) and is adapted to rotate in its entirety with respect to the cable-guiding bracket ( 12) .

16. An assembly according to any one of clai ms 12 to 15, wherein the cableguiding bracket ( 12) is fitted onto the elongated positioning element (3) of the electrosurgical instrument (2) and comprises a proximal plug (38) thereof for the connection with an electrosurgical power generator which can be associated with said assembly and / or a constraining portion such as a portion of the case (1 1 0) of the robotic manipulator ( 1 1 ).

17. An assembly according to any one of the preceding claims, wherein the electrosurgical instrument (2) is a bipolar electrosurgical instrument, wherein the electrosurgical end (4) comprises both a supply electrode (41 ) and a return electrode (42), and wherein the elongated positioning element (3) comprises two separated electrically conductive paths with respective contact surfaces (10, 10’) in electric conduction communication with said supply electrode and said return electrode, respectively; and wherein the transmission cable (8) comprises two electrically conductive contact elements (9, 9’) in contact with said two contact surfaces (10, 10’) , respectively.

18. An assembly according to any one of the preceding clams, wherein the at least one electrically conductive path comprises an electric conductor extending along the elongated positioning element (3) of the electrosurgica l instrument (2).

19. A robotic system (20) of electrosurgical teleoperation comprising :- at least one assembly (1 ) according to any one of the preceding claims, and- at least one electrosurgical power generator (6) connected to said transmission cable (8) .

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