Articulable mechanisms with movable actuation element path piece, and related devices and methods

Abstract

An articulable mechanism includes a first end link, a second end link, and a joint structure coupling the first and second end links. The first and second end links are articulable relative to each other about the joint structure. An actuation element extends through the first end link, spans across the joint structure, and through the second end link to cause articulation of the first and second end links relative to each other about the joint structure in response to tension applied to the actuation element. A third intermediate link is moveably coupled between the first and second end links and comprises a guide surface. The actuation element extends along the guide surface as it spans across the joint structure. The third intermediate link alters a path of the actuation element based on a state of articulation of the first and second end links relative to each other.

Description

PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304ARTICULABLE MECHANISMS WITH MOVABLE ACTUATION ELEMENT PATH PIECE, AND RELATED DEVICES AND METHODSCROSS-REFERENCE TO RELATED APPLICATION

[0001] This application claims the benefit of U.S. Provisional Application 63 / 716,810, filed November 6, 2024, the entirety of which is incorporated by reference herein.TECHNICAL FIELD

[0002] Aspects of the present disclosure relate to instruments having articulable mechanisms incorporating joint structures, such as wrists, and related devices, systems, and methods. In particular, aspects of the present disclosure relate to instruments with joint structures that are articulable in response to forces transmitted by actuation elements extending through links coupled together at joints.INTRODUCTION

[0003] Various instruments, such as medical (e.g., surgical) or other industrial instruments, include articulable mechanisms including joint structures that impart one or more degrees of freedom of movement to such instruments. These articulable mechanisms can include one or more joint structures, each of which can articulate in one or more degrees of freedom, which can be the same or different.

[0004] Articulation can be controlled by one or more actuation elements, such as, for example, cables, coupled through various components to a manipulator system that receives inputs from a user, such as a surgeon or other operator, to orient portions of the instrument as desired. Such manipulator systems can include a teleoperated (e.g., computer-controlled) manipulator system. In other applications, the instrument and articulable mechanism can be actuated manually. In some cases, it is desirable that anPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 articulable mechanism exhibit a relatively high stiffness in any given articulation position to facilitate the instrument’s ability to maintain a given position under reaction forces, such as those resulting from operation of a working end component, or end effector, of the instrument.

[0005] An instrument can include one or more articulable mechanisms, which can be used to couple an end effector coupled to the distal end portion of a shaft of the instrument so as to provide orientation in one or two-degrees of freedom (e.g., pitch and yaw) of the end effector. Other articulable mechanisms can be provided along a length of the shaft to achieve various poses of the shaft of instrument. The one or more actuation elements extend from a transmission mechanism coupled to the shaft proximally of the articulable mechanism, through the instrument shaft and to link(s) of the joint structure(s) of the articulable mechanism. Forces transmitted by the one or more actuation elements impart articulating movement of the link(s) relative to each other about the joint structures, thereby allowing remote “steering” of the articulable mechanism. For example, actuation elements can transmit forces through selective tensioning of flexible, cable-like actuation elements and / or through push / pull forces of stiffer, compressive rod-like actuation elements. Those having ordinary skill in the art have familiarity with various types of actuation elements used to transmit forces to articulate articulable mechanisms.

[0006] Because the actuation elements are generally routed in an off-centerline position through a joint structure (i.e. , across a joint connecting two links of the articulable mechanism), articulating (bending) an articulable mechanism also results in bending ofPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 the actuation element(s). Such repeated bending at the joint structure (e.g, where the links making up the joint join and pivot) can lead to changes that affect the integrity of the actuation elements (i.e. , reduce cable life), the path length of the actuation element(s), and can impact other characteristics of the articulable mechanism (e.g., wrist), such as the ability of the articulated joint structure to withstand externally applied loads without deflecting from an intended position. Actuation elements, for example, generally experience more friction and stress in areas where the guide surfaces for the actuation elements are interrupted (e.g., where the cable guide surfaces transfer from one link to the next across a joint).

[0007] There exists a need to provide joint structures for articulable mechanisms in instruments that maximize cable life, without sacrificing the motion quality of the joint structure or increasing the complexity of the joint features. There also exists a need to provide articulatable mechanisms, which address friction and design tolerance issues when routing actuation elements, such as cables, through the joint structure of the mechanism.SUMMARY

[0008] Exemplary embodiments of the present disclosure may solve one or more of the above-mentioned problems and / or may demonstrate one or more of the above- mentioned desirable features. Other features and / or advantages may become apparent from the description that follows.

[0009] In accordance with at least one exemplary embodiment, an articulable mechanism comprises a first end link, a second end link, and a joint structure couplingPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 the first end link and the second end link. The first end link and the second end link are articulable relative to each other about the joint structure. An actuation element extends through the first end link, spans across the joint structure, and through the second end link. The actuation element causes articulation of the first end link and the second end link relative to each other about the joint structure in response to tension applied to the actuation element. A third intermediate link is moveably coupled between the first end link and the second end link and comprises a guide surface. The actuation element extends along the guide surface as it spans across the joint structure. The third intermediate link alters a path of the actuation element based on a state of articulation of the first end link and the second end link relative to each other.

[0010] In accordance with at least another exemplary embodiment, a method of articulating an articulable mechanism comprises applying tension to an actuation element extending through a first end link of the articulable mechanism, spanning across a joint structure of the articulable mechanism, and through a second end link of the articulable mechanism. The joint structure coupling the first end link and the second end link to each other. The method also comprises articulating the first end link and the second end link relative to each other about the joint structure in response to the tension applied to the actuation element. The method further comprises altering a radius of curvature of the actuation element as the actuation element spans across the joint structure via a guide surface between the first end link and the second end link based on an amount of articulation of the first end link and the second end link relative to each other about the joint structure.PCT PATENT APPLICATION Attorney Docket No. P06896-WO Alternate Attorney Docket No. 1084.0246.00304

[0011] In accordance with at least a further exemplary embodiment, an articulable mechanism comprises a first end link, a second end link, and a joint mechanism coupling the first link and the second link. The first link and the second link are articulable relative to each other about the joint mechanism. An actuation element extends through the first end link, spans across the joint mechanism, and through the second end link. The actuation element causes articulation of the first end link and the second end link relative to each other about the joint mechanism in response to tension applied to the actuation element. A guide surface is between the first end link and the second end link. The actuation element extends along the guide surface as it spans across the joint mechanism. The guide surface alters a radius of curvature of the actuation element based on an amount of articulation of the first end link and the second end link relative to each other about the joint mechanism.

[0012] Additional objects, features, and / or advantages will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the present disclosure and / or claims. At least some of these objects and advantages may be realized and attained by the elements and combinations particularly pointed out in the appended claims.

[0013] It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the claims; rather the claims should be entitled to their full breadth of scope, including equivalents.PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304BRIEF DESCRIPTION OF THE DRAWINGS

[0014] The present disclosure can be understood from the following detailed description, either alone or together with the accompanying drawings. The drawings are included to provide a further understanding of the present disclosure, and they are incorporated in and constitute a part of this specification. The drawings illustrate one or more exemplary embodiments of the present disclosure and, together with the description, explain certain principles and operation. In the drawings,

[0015] FIG. 1 is a schematic view of an embodiment of an instrument comprising an articulable mechanism;

[0016] FIG. 2 is a diagrammatic view of an embodiment of a computer-assisted medical system employing robotic technology and including the instrument of FIG. 1 ;

[0017] FIG. 3 is a partial perspective view of an embodiment of a distal end portion of an instrument comprising an articulable mechanism and end effector;

[0018] FIG. 4 is an isolated, perspective view of an embodiment of an articulable mechanism;

[0019] FIG. 5 is another isolated, perspective view of the articulable mechanism of FIG. 4;

[0020] FIG. 6 is an exploded, perspective view of the articulable mechanism of FIG. 4 showing a third intermediate link that is moveable coupled between a first end link and a second end link of the articulable mechanism;

[0021] FIG. 7 is a side view of the articulable mechanism of FIG. 4;PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304

[0022] FIG. 8A is a cross-sectional view taken through section 8-8 of FIG. 7, showing the end links of the articulable mechanism in a neutral position;

[0023] FIG. 8B is a cross-section view taken through section 8-8 of FIG. 7, showing the end links of the articulable mechanism in an articulated position;

[0024] FIG. 9 is an exploded, perspective view of another embodiment of an articulable mechanism, showing a third intermediate link that is moveable coupled between a first end link and a second end link of the articulable mechanism;

[0025] FIG. 10A is a top, cross-sectional view of the embodiment of FIG. 9, showing the end links of the articulable mechanism in a neutral position;

[0026] FIG. 10B is another top, cross-sectional view of the articulable mechanism of FIG. 9, showing the end links of the articulable mechanism in an articulated position;

[0027] FIG. 11 is an isolated, perspective view of yet another embodiment of an articulable mechanism;

[0028] FIG. 12 is another isolated, perspective view of the articulable mechanism ofFIG. 11 ;

[0029] FIG. 13 is an exploded, perspective view of the articulable mechanism of FIG. 11 showing a third intermediate link that is moveable coupled between a first end link and a second end link of the articulable mechanism;

[0030] FIG. 14 is a side view of the articulable mechanism of FIG. 11 ;

[0031] FIG. 15A is a cross-sectional view taken through section 15-15 of FIG. 14, showing the end links of the articulable mechanism in a neutral position;PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304

[0032] FIG. 15B is a cross-section view taken through section 15-15 of FIG. 14, showing the end links of the articulable mechanism in an articulated position;

[0033] FIG. 16 is a partial perspective view of another embodiment of a distal end portion of an instrument comprising an articulable mechanism and end effector;

[0034] FIG. 17 is an isolated, perspective view the articulable mechanism of FIG. 16;

[0035] FIG. 18 is an exploded, perspective view of the articulable mechanism of FIG. 17 showing a third intermediate link that is moveable coupled between a first end link and a second end link of the articulable mechanism;

[0036] FIG. 19 is a side view of the articulable mechanism of FIG. 17;

[0037] FIG. 20A is a cross-sectional view taken through section 20-20 of FIG. 19, showing the end links of the articulable mechanism in a neutral position;

[0038] FIG. 20B is a cross-section view taken through section 20-20 of FIG. 19, showing the end links of the articulable mechanism in an articulated position;

[0039] FIG. 21 is an isolated, perspective view of yet another articulable mechanism;

[0040] FIG. 22 is an exploded, perspective view of the articulable mechanism of FIG. 21 showing a third intermediate link that is moveable coupled between a first end link and a second end link of the articulable mechanism;

[0041] FIG. 23 is a side view of the articulable mechanism of FIG. 21 ;

[0042] FIG. 24A is a cross-sectional view taken through section 24-24 of FIG. 23, showing the end links of the articulable mechanism in a neutral position;

[0043] FIG. 24B is a cross-section view taken through section 24-24 of FIG. 23, showing the end links of the articulable mechanism in an articulated position;PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304

[0044] is an isolated, perspective view of yet another articulable mechanism;

[0045] FIG. 25 is an isolated, perspective view of yet another articulable mechanism;

[0046] FIG. 26 is an exploded, perspective view of the articulable mechanism of FIG. 25 showing a third intermediate link that is moveable coupled between a first end link and a second end link of the articulable mechanism;

[0047] FIG. 27 is a side view of the articulable mechanism of FIG. 25;

[0048] FIG. 28A is a cross-sectional view taken through section 28-28 of FIG. 27, showing the end links of the articulable mechanism in a neutral position;

[0049] FIG. 28B is a cross-section view taken through section 28-28 of FIG. 27, showing the end links of the articulable mechanism in an articulated position.DETAILED DESCRIPTION

[0050] The present disclosure contemplates articulable mechanisms including joint structures, such as, but not limited to wrists, that include features that can provide desired stiffness and predictable movement, e.g., during articulation, in combination with features to extend the life of actuation elements routed through the joint structure (i.e., which help maximize cable life during articulation). Contemplated articulable mechanisms may, for example, include features that are configured to reduce friction between the actuation elements and surfaces of the links making up the articulable mechanisms, as the actuation elements pass through the joint structure and move relative to the joint structure during articulation.

[0051] In accordance with various embodiments, an articulable mechanism can include a third intermediate link that is moveably coupled between a first end link and a secondPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 end link of the articulable mechanism, such as, for example, an intermediate link that is positioned between a proximal and distal clevis forming a joint structure of the articulable mechanism. The third intermediate link can, for example, include a guide surface that is configured to guide an actuation element across the joint structure, such that the actuation element may extend along the guide surface as it spans across the joint structure. In this manner, the third intermediate link can alter a path of the actuation element based on a state of articulation of the first end link and the second end link relative to each other. In various embodiments, the third intermediate link can transition the path of the actuation element from a relatively straight path to an arced path in response to articulation of the first end link and the second end link relative to each other from a neutral position to an articulated position. For example, in some embodiments, the arced path of the actuation element can approach a circular arced path as an amount of articulation of the first end link and the second end link relative to each other from the neutral position increases (e.g., during wrist pitch, as the joint structure rotates away from the neutral position, the arced path can approach a circular arced path as the pitch increases).

[0052] In some embodiments, as described further below, the guide surface of the third intermediate link is a portion of an outer peripheral surface of the third intermediate link. In such embodiments, for example, the outer peripheral surface of the third intermediate link has a radially outward concave curvature, such as, for example, a non-circular segment. In one embodiment, the third intermediate link has an oblong shape that is elongated along a longitudinal axis of the articulable mechanism in a neutral state of thePCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 first end link and the second end link articulated relative to each other, and the guide surface of the third intermediate link is an elongated side peripheral surface of the oblong shape. In another embodiment, the third intermediate link has a prolate spheroid shape elongated along the longitudinal axis of the articulable mechanism in the neutral state of the first end link and the second end link articulated relative to each other, and the guide surface of the third intermediate link is an elongated side peripheral surface of the prolate spheroid shape.

[0053] In some other embodiments, as also described further below, the guide surface of the third intermediate link instead defines a portion of a channel extending through the third intermediate link. In one embodiment, for example, the channel extends along an oblong shaped central portion of the third intermediate link (e.g., the oblong shaped central portion being elongated along the longitudinal axis of the articulable mechanism in the neutral state of the first end link and the second end link articulated relative to each other), and the guide surface of the third intermediate link is an elongated side surface of the oblong shaped central portion. While in another embodiment, the channel extends along a prolate spheroid shaped central portion of the third intermediate link (e.g., the prolate spheroid shaped central portion being elongated along the longitudinal axis of the articulable mechanism in the neutral state of the first end link and the second end link articulated relative to each other), and the guide surface of the third intermediate link is an elongated side surface of the prolate spheroid shaped central portion.PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304

[0054] In this manner, the contemplated intermediate link functions to guide actuation elements across the joint, either along an outer peripheral surface of the third intermediate link or through a channel extending through the third intermediate link, thereby preventing interruption of the guide surfaces as the actuation elements transfer from one link to the next across the joint. The intermediate links may therefore provide guide surfaces across joints, which are optimized for both straight (i.e. , neutral) and pitched over positions of the joint, such that the intermediate links reduce friction and stress between the actuation elements and the links at the joint during the repetitive movements of the articulable mechanism.

[0055] Referring now to FIG. 1 , a schematic side view of an embodiment of an instrument 100 (such as, for example, a medical instrument) is shown. The directions “proximal” and “distal” are used herein to define the directions as shown in FIG. 1 , with distal generally being in a direction further along a kinematic arm or closest to the worksite in the intended operational use of the instrument 100. While aspects of the present disclosure are discussed in the context of medical or surgical instruments with joint structures in the form of wrists supporting an end effector of the instrument, embodiments of the present disclosure can be used with various instruments used in medical procedures. For example, such instruments include those used for diagnosis, therapy, and sensing, including, for example, imaging instruments such as endoscopes and other imaging instruments. Accordingly, medical instruments as used herein encompasses a variety of instruments used in surgical, diagnostic, and therapeutic applications. In addition, aspects of the disclosure can have non-surgical applications,PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 such as in other remotely-actuatable instruments for inspection and other industrial uses, general robotic uses, manipulation of non-tissue work pieces, etc.

[0056] The instrument 100 includes a shaft 104 with a transmission mechanism 102 at a proximal end portion of the shaft 104 and an end effector 106 at a distal end portion 107 of the shaft. In an exemplary embodiment, the transmission mechanism 102 is configured to interface with a manipulating system, such as manipulating systems shown below in connection with FIG. 2. Alternatively, the transmission mechanism 102 can be configured to be operated manually such as for a manual, laparoscopic instrument, which can have a handle or other arrangement configured to be manipulated directly by a user.

[0057] The end effector 106 is coupled at the distal end portion 107 of the shaft 104 by an articulable mechanism 105, which can include one or more articulatable joint structures to impart one or more degrees of freedom of movement to the end effector 106 relative to the shaft 104 (for example, to move the end effector 106 in one or more of pitch and yaw). Thus, an articulable mechanism 105 can include two links coupled together by a joint structure, or a series of more than two links coupled by a series of joint structures. For ease and simplification, the embodiments discussed below show two links and a single joint structure referred to below as an articulatable mechanism, but the principles disclosed herein can be applied to articulatable mechanisms that have more than two links and more than one joint structure, as those having ordinary skill in the art would be familiar with. Moreover, articulatable mechanisms in accordance with exemplary embodiments can include a series of links connected with joint structuresPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 wherein one or more of the joint structures have the same or different axes about which they articulate the joined links.

[0058] Certain coordinated movements of multiple joint structures can enable, for example, articulating the end effector 106 relative to the shaft, longitudinal translations, combined movement in pitch and yaw directions, or other compound movements of the end effector 106 in multiple degrees of freedom relative to the instrument shaft 104. While a single actuation element 108 is shown in connection with FIG. 1 , as discussed further below, other, additional actuation elements can also be operably coupled between the transmission mechanism 102 and the articulable mechanism 105 to actuate articulation D of the articulable mechanism 105 along various degrees of freedom associated with individual joint structures.

[0059] Operation of the end effector 106 can be controlled by manipulation of the transmission mechanism 102, either manually or through drives of a manipulating system (e.g., the manipulating system shown in FIG. 2). The transmission mechanism 102 includes various mechanical and / or electromechanical devices that transmit motion, energy, and / or signals, e.g., from the manipulating system, or from inputs at the transmission mechanism 102 operable by a user, to the end effector 106. For example, one or more actuation elements (one actuation element 108 shown in FIG. 1 ) can extend from the transmission mechanism 102, through the shaft 104, and to the end effector 106, to operably couple the transmission mechanism 102 (or a component therein) to the end effector 106. Force applied to the actuation element 108 by thePCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 transmission mechanism 102 can actuate (e.g., close, open, or otherwise control) the end effector 106.

[0060] While the end effector 106 shown in FIG. 1 , and in additional embodiments discussed below, comprises a jaw mechanism including a pair of opposing jaw members, other end effector configurations, such as staplers, clip appliers, ligation tools, and other tools are considered within the scope of this disclosure. Furthermore, an exemplary instrument can similarly include an end effector in the form of an imaging device, such as, for example, an endoscopic camera and the instrument 100 can similarly operate to position a distal end of the camera for viewing of a work site and the operation of surgical instruments within a patient.

[0061] In various embodiments, actuation elements can comprise flexible members, such as polymer or metal (e.g., tungsten) solid or braided actuation elements, such as cables. Selective tensioning of the actuation elements can cause transmission of feree to the links of an articulatable mechanism to cause articulation in a given direction (i.e., to control articulation of the links relative to each other from a neutral, unarticulated state about the joint structure). Those of ordinary skill in the art are generally familiar with such components and they are thus not described in detail here.

[0062] In various embodiments, the transmission mechanism 102 is configured to operably couple to and receive drive inputs from a manipulator system of a teleoperable, computer-assisted medical system that operates at least in part with robotic technology (sometimes referred to as a robotic surgical system). One embodiment of such a computer-assisted medical system is illustrated in the schematicPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 diagram of FIG. 2, depicting a manipulator system 1000 comprising a plurality of manipulator arms 1002 to which the transmission mechanism 102 of instrument 100 can operably couple, a surgeon side console 2000 comprising various master inputs 52 and a surgeon viewer 2006 which can include video images of the remote worksite taken through an endoscopic imaging device, and / or other graphical information, and a vision / control console 4000 which can also have a display 4006 presenting similar images as the viewer 2006 or other information relating to a procedure.

[0063] The vision / control console 4000 also can in some embodiments comprise components that supply auxiliary functionality to instruments, such as via an auxiliary unit 80, which can be, for example, insufflation gas, vacuum for evacuation, electrosurgical energy, and similar flux supply units. Such units can be controlled through a controller integrated with the system and / or can be separately controlled at a stand-alone input unit 90, rather than through the surgeon side console 2000. A nonlimiting embodiment of a computer-assisted, teleoperable medical system with which the instrument 100 and various instrument embodiments described herein can be utilized are the da Vinci® Surgical Systems commercialized by Intuitive Surgical, Inc., of Sunnyvale, California.

[0064] In various other embodiments contemplated within the scope of the present disclosure, the medical instrument 100 can be configured to be manually actuated, with the proximally located, transmission mechanism 102 having inputs that are configured to be manually actuated rather than coupled to a manipulator arm. Yet otherPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 embodiments contemplate the instrument can have both manually actuated inputs and inputs configured to be driven by drive outputs of a manipulator system.

[0065] As discussed above, the present disclosure contemplates medical instruments (e.g., instrument 100) including articulable mechanisms (e.g., articulable mechanism 105) incorporating joint structures, such as, but not limited to wrist assemblies, which are configured to provide various degrees of rotation relative to an end effector connected to the wrist assembly. Such wrist assemblies can, for example, be similar to those shown and described in International Patent Application Publication No. WO 2023 / 177565 A1 (filed internationally on March 8, 2023), entitled “Medical Devise Wrist,” and International Patent Application Publication No. WO 2019 / 173267 A1 (filed internationally on May 3, 2019), entitled “Low-Friction, Small Profile Medical Tools having Easy-to-Assemble Components,” each of which is incorporated herein by reference in its entirety.

[0066] FIG. 3, for example, illustrates an instrument 200 incorporating an articulable mechanism, in the form of a wrist assembly 205, in accordance with various embodiments. The instrument 200 includes a proximal mechanical structure (e.g., transmission mechanism 102), a shaft 204, a wrist assembly 205, an end effector 206, and a set of actuation elements 208. As discussed above, the actuation elements (e.g., cables 208) function as tension elements that couple the proximal mechanical structure to the wrist assembly 205 and end effector 206. The instrument 200 is configured such that movement of one or more of the cables produces rotation of the end effector 206 about a first axis of rotation A1 (which may function as a yaw axis),PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 rotation of the wrist assembly 205 about a second axis of rotation A2 (which may function as a pitch axis), a cutting rotation of tool members 206a and 206b of the end effector 206 (e g., which is in the form of a jaw mechanism 206) about the first axis of rotation A1 , or any combination of these movements.

[0067] The wrist assembly 205 includes a first end link 210 (which functions as a proximal wrist link), a second end link 212 (which functions as a distal wrist link), and a joint structure 214 coupling the end first link 210 and the second end link 212 to each other, such that the first end link 210 and the second end link 212 are articulable relative to each other about the joint structure 214. For example, the actuation elements 208 can extend through the first end link 210, span across the joint structure 214, and through the second end link 212 to cause articulation of the first end link 210 and the second end link 212 relative to each other about the joint structure 214 in response to tension applied to one of more of the actuation elements 208.

[0068] As illustrated in FIG. 3, in accordance with various embodiments, the joint structure 214 includes a pinned joint, having a forked end portion 216 including a joint feature 218 that is rotatably coupled to a hub structure 220 of a mating joint feature 222 of the second end link 212 via, for example, a pin 224. In this manner, the first end link 210 and the second end link 212 form a pinned wrist assembly 205, having a second axis of rotation A2 (also referred to as the pitch axis) about which the second end link 212 can rotate relative to the first end link 210, with the pin 224 extending through the aligned joint features 218 and 222 to rotatably couple the second end link 212 to the first end link 210.PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304

[0069] In such embodiments, as discussed further below, the first end link 210 may include a proximal clevis 225 that is configured to couple to the instrument shaft 204 and the second end link 212 may include a distal clevis 227 that is configured to couple to the end effector 206. As further shown in FIG. 3, the first end link (e.g., proximal clevis) 210 and the second end link (e.g., distal clevis) 212 define a longitudinal centerline CL that intersects the pitch axis A2 when the instrument 200 is in a neutral, unarticulated state about the joint structure 205 (e.g., a "straight" configuration).

[0070] To reduce friction and stress between the actuation elements 208 and the end links (e.g., the proximal and distal clevises) 210 and 212 at the joint structure 205 during articulation of the links 210 and 212 relative to each other (e.g., when the instrument 200 is in an articulated state about the joint structure 205 (e.g., a "bent" configuration), various embodiments further contemplate a moveable actuation element path piece, such as, for example, a third intermediate link that is moveably coupled between the first end link 210 and the second end link 212, and which is configured to guide the actuation elements 208 across the joint 214. In this manner, the intermediate link may provide an uninterrupted guide surface for the actuation elements 208 across the joint 214.

[0071] With reference now to the embodiment of FIGS. 4-8, an articulable mechanism, in the form of a wrist assembly 305, incorporating a movable actuation element path piece in the form of a third intermediate link 315 is illustrated. Similar to the embodiment of FIG. 3, the wrist assembly 305 includes a first end link 310 (which functions as a proximal wrist link), a second end link 312 (which functions as a distalPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 wrist link), and a pinned joint structure 314 coupling the end first link 310 and the second end link 312 to each other, such that the first end link 310 and the second end link 312 are articulable relative to each other about a pin 324 of the joint structure 314. In various embodiments, the third intermediate link 315 is moveably coupled between the first end link 310 and the second end link 312. For example, in some embodiments, the third intermediate link 315 is a discrete link that is positioned between a proximal clevis 325 forming the first end link 310 and a distal clevis 327 forming the second end link 312 and is coaxial with a pivot axis A2 of the pinned joint 314 (also referred to as the pitch axis of the wrist assembly 305). As best illustrated in the exploded view of FIG. 6, in various embodiments, the third intermediate link 315 is a discrete link having an oblong shape, such as, for example, a prolate spheroid shape, that is elongated along a longitudinal axis or longitudinal centerline CL of the articulable mechanism 305 (i.e. , in a neutral state of the first end link 310 and the second end link 312 relative to each other (see FIG. 5)). In some embodiments, as illustrated in FIG. 6, the third intermediate link 315 includes first and second planar, oblong shaped ends 317a and 317b, which are connected by a curved, outer peripheral surface 318. The outer peripheral surface 318 can, for example, have a radially outward concave curvature, such as, for example, a non-circular segment.

[0072] In further embodiments, the third intermediate link 315 includes a boss 336 extending from one or both of the first and / or second planar, oblong shaped ends 317a and 317b (i.e., perpendicular to the longitudinal centerline CL of the articulable mechanism 305), which is configured to be received in and moveable along aPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 corresponding slot 326 in a respective one of the first and second end links 310 and 312. For example, as illustrated in the embodiment of FIG. 6, a first boss 336 can extend from the first end 317a to be received within a corresponding slot 326 in a first fork portion 329a of the clevis 327 and a second boss 336 can extend from the second end 317b to be received within a corresponding slot 326 in a second, opposite fork portion 329b of the clevis 327. Thus, upon assembly of the articulable mechanism 305, in such embodiments, the pin 324 (which may be comprised of separate pin portions 324 extending from each of the first and second fork portions 329a, 329b) can be received within a slot 334 in the third intermediate link 315, while each of the bosses 336 is received within a corresponding slot 329a and 329b.

[0073] In this manner, the intermediate link 315 is configured to pivot about the axis A2 (the same axis as the pinned joint structure 314) to provide a moveable guide surface 316 (i.e. , for actuation elements 308 across the joint structure 314) between the end links 310 and 312. In accordance with various embodiments, the guide surface 316 of the third intermediate link 315 is a portion of the outer peripheral surface 318 (see FIG. 6) of the third intermediate link 315. For example, in some embodiments, the guide surface 316 of the third intermediate link 315 is an elongated side peripheral surface 318a of the oblong shape of the third intermediate link 315, such as, for example, an elongated side peripheral surface 318a of the prolate spheroid shape of the third intermediate link 315 (see FIGS. 8A and 8B). Thus, as shown in the cross sectional views of FIGS. 8A and 8B, actuation elements 308 can extend through guide channels 330 extending through the first end link 310, span across the joint structurePCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304314 along the outer peripheral surface 318 of the a third intermediate link 315, and through guide channels 332 extending through the second end link 312 to cause articulation of the first end link 310 and the second end link 312 relative to each other about the joint structure 314 in response to tension applied to one of more of the actuation elements 308 (see FIG. 8B).

[0074] As further shown in the views of FIGS. 8A and 8B, in accordance with various embodiments, the third intermediate link 315 is therefore configured to alter a path of the actuation elements 308 based on a state of articulation of the first end link 310 and the second end link 312 relative to each other. The third intermediate link 315 may transition the path of the actuation elements 308 from a relatively straight path (see FIG. 8A) to an arced path (see FIG. 8B), in response to articulation of the first end link 310 and the second end link 312 relative to each other from a neutral position to an articulated position. For example, as the first end link 310 and the second end link 312 articulate further away from the neutral position (i.e. , an amount of articulation of the end links 310 and 312 relative to each other from the neutral position increases), the arced path of the actuation elements 308 may approach a circular arced path 340. In some embodiments, a radius r of the arced path 340 of at least one of the actuation elements 308 may approach about 0.5 inches. In other words, the third intermediate link 315 provides a guide surface (e.g., the outer peripheral surface 318) between the first end link 310 and the second end link 312 for the actuation elements 308 to span across the joint mechanism 314, and the guide surface 318 can alter a radius of curvature of the actuation elements 308 based on an amount of articulation of the firstPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 end link 310 and the second link 312 relative to each other about the joint mechanism 314.

[0075] In accordance with various embodiments, control over the third intermediate link 315 can be fully passive such that only the forces that one or more of the actuation elements 308 impart on the third intermediate link 315 dictate its position. In such embodiments, for example, the articulable mechanism 305 employs slots 326 that are sized large enough to not impede the movement of the bosses 336 (i.e. , the slots 326 are configured such that the bosses 336 may freely slide back and forth within the slots 326 without hitting an end of the slots 326), or the articulable mechanism 305 is devoid of slots 326 / bosses 336 altogether.

[0076] In various additional embodiments, control over the third intermediate link 315 can be fully active, such that the third intermediate link 315 is mechanically linked to the position of the neighboring links (i.e., the first end link 310 or the second end link 312) and rotates when the neighboring links rotate. In such embodiments, for example, the articulable mechanism 305 employs slots 326 that are sized small enough to fully impede the movement of the bosses 336 (i.e., the slots 326 are configured such that the bosses 336 are not able to slide freely back and forth within the slots 326 without hitting an end of the slots 326).

[0077] In still further embodiments, as illustrated in the embodiment of FIGS. 4-8, control over the third intermediate link 315 can be both passive and active (i.e., a combination of both passive and active), such that the intermediate link 315 is passively driven for one part of its range and actively driven for another part of itsPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 range. In such embodiments, for example, the articulable mechanism 305 employs slots 326 that are intermediately sized, such that the slots 326 are configured to initially allow the bosses 336 to slide freely within the slots 326 via the forces applied by the actuation elements 308 on the intermediate link 315 (i.e. , through a first passive range of motion) until the bosses 336 contact an end of the slots 326 (i.e., which impede further movement of the bosses 336). The third intermediate link 315 then becomes mechanically linked to the position of the neighboring links (i.e., the first end link 310 or the second end link 312) and rotates when the neighboring links rotate (i.e., through a second active range of motion).

[0078] As illustrated in FIG. 8B, in some embodiments, the third intermediate link 315 is configured to begin to rotate about the pivot axis A2 in response to a force applied by the actuation elements 308 on the outer peripheral surface 318, such that the third intermediate link 315 is initially passively driven by the cable forces on the outer peripheral surface 318. Once the bosses 336 run into the ends of the slots 326, the third intermediate link 315 is then configured to continue to rotate about the pivot axis A2 in response to forces applied by the slots 326 in one of the first end link 310 or the second end link 312 on the bosses 336 of the third intermediate link 315 in response to articulation of the first end link 310 and the second end link 312 relative to each other, such that the third intermediate link 315 is actively driven by the bosses 336 within the slots 326.

[0079] With reference now to FIGS. 9, 10A, and 10B, another embodiment of an articulable mechanism 305 is illustrated. In this embodiment, a location of the bossesPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304336 on the third intermediate link 315 is moved to an opposite side of the slot 334 within the intermediate link 315 (i.e., the bosses 336 are flipped to the other side of the slot 334). In this manner, the slots 326 are also positioned on an opposite side of the pins 324 (i.e., the slots 326 are flipped to the other side of the pins 324, such that each of the first and second fork portions 329a, 329b of the clevis 327 are elongated a bit more (in comparison to the embodiment of FIGS. 6-8) to accommodate the adjusted location of the bosses 336).

[0080] Those of ordinary skill in the art will understand that that the articulable mechanisms 305, including third intermediate links 315, discussed and illustrated with reference to FIGS. 4-10, are exemplary only and that articulable mechanisms in accordance with the present disclosure can have various types of joint structures and links, which utilize various types of third intermediate links between the primary first and second links, which have various shapes and are configured to engage with various slots (having various configurations and geometries) within the first and second links, without departing from the scope of the present disclosure and claims. Indeed, those of ordinary skill in the art would understand that a particular application (e.g., type of articulable mechanism / joint structure), with a defined set of design considerations, may dictate the type and configuration of any given third intermediate link, the corresponding slots within the first or second links, and whether the third intermediate link is passive, active, or a combination thereof. As would be understood, for example, the geometry of the slot (e.g., slot 326) within the first or second links can be designed to dictate how active (i.e., actively driven) the third intermediate link is.PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304

[0081] To increase design flexibility (i.e., provide more design options for a given articulable mechanism), various additional embodiments contemplate, for example, an articulable mechanism, which utilizes a third intermediate link that pivots about an axis A3 that is not coaxial with a pivot axis A2 of a pinned joint of the articulable mechanism. In such embodiments, the pivot axis A3 of the third intermediate link is shifted from the pivot axis A2 of the joint and can move relative to the pivot axis A2.

[0082] FIGS. 11 -15, for example, illustrate an articulable mechanism, in the form of a pinned wrist assembly 405, which utilizes a third intermediate link 415 that pivots about an axis A3 that is shifted from (i.e., is not coaxial with) a pivot axis A2 of a pinned joint 414 of the wrist assembly 405. The wrist assembly 405 includes a first end link 410 and a second end link 412, which are coupled together and articulatable relative to each other about a pin 424 of the joint 414. Similar to the above-described embodiments, the third intermediate link 415 is moveably coupled between the first end link 410 and the second end link 412, such that the third intermediate link 415 is a discrete link that is positioned between a proximal clevis 425 forming the first end link 410 and a distal clevis 427 forming the second end link 412. As best illustrated in the exploded view of FIG. 13, also similar to the embodiments of FIGS. 4-10, in some embodiments, the third intermediate link 415 has an oblong shape, such as, for example, a prolate spheroid shape, that is elongated along a longitudinal axis or longitudinal centerline CL of the articulable mechanism 405 (i.e., in a neutral state of the first end link 410 and the second end link 412 relative to each other (see FIG. 15A)). The third intermediate link 415 can, for example, include first and second planar, oblongPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 shaped ends 417a and 417b, which are connected by a curved, outer peripheral surface 418.

[0083] The third intermediate link 415 includes a boss 436 extending from each of the first and second planar, oblong shaped ends 417a and 417b (i.e., perpendicular to the longitudinal centerline CL of the articulable mechanism 405), which are configured to be received in and moveable along corresponding respective slots 426 in one of the first and second end links 410 and 412. For example, as illustrated in the embodiment of FIG. 13, a first boss 436 can extend from the first end 417a to be received within a corresponding slot 426 in a first fork portion 429a of the clevis 425 (i.e., forming the first end link 410) and a second boss 436 can extend from the second end 417b to be received within a corresponding slot 426 in a second, opposite fork portion 429b of the clevis 425. In such embodiments, the first end link 410 also includes a boss 446 extending from each of the first and second fork portions 429a and 429b of the clevis 425, which are configured to be received and pivot within a corresponding slot 431 in the third intermediate link 415.

[0084] Thus, upon assembly of the articulable mechanism 405, in such embodiments, the pin 424 (which may be comprised of separate pin portions 424 extending from each of the first and second fork portions 429a, 429b) can be received within a corresponding slot 434 in each of a first fork portion 439a and a second fork portion 439b of the clevis 427 (i.e., forming the second end link 412) to pivot about a pivot axis A2, while each of the bosses 436 is received within a corresponding slot 426 in each of the first forkPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 portion 429a and the second fork portion 429b of the clevis 425 to pivot about a separate pivot axis A3.

[0085] To actively drive the third intermediate link 415, upon assembly, the bosses 436 of the third intermediate link 415 are received within a corresponding slot 426 of the clevis 425 and are configured to move within the slot 426 as the third intermediate link pivots about the axis A3. In some embodiments, the bosses 436 are also received within a respective slot 434 of the clevis 427 (i.e., adjacent to a respective pin portion 424). For example, each slot 434 may comprise a first, rounded slot portion 433 configured to receive a pin portion 424 and a second, linear slot portion 435 configured to receive a boss 436, such that, upon assembly, each boss 436 first passes through a corresponding slot 426 in the clevis 425 and then pass through a corresponding slot 434 in the clevis 427.

[0086] In this manner, the intermediate link 415 is configured to pivot about the axis A3, while the pinned joint structure 414 pivots about the axis A2, to provide a moveable guide surface (i.e., for actuation elements 408 across the joint structure 414) between the end links 410 and 412. In accordance with various embodiments, the guide surface is a portion of the outer peripheral surface 418 (see FIG. 13) of the third intermediate link 415. Thus, as shown in the cross sectional views of FIGS. 15A and 15B, actuation elements 408 can extend through guide channels 430 extending through the first end link 410, span across the joint structure 414 along the outer peripheral surface 418 of the a third intermediate link 415, and through guide channels 432 extending through the second end link 412 to cause articulation of the first endPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 link 410 and the second end link 412 relative to each other about the joint structure414 in response to tension applied to one of more of the actuation elements 408 (see FIG. 15B).

[0087] Since, in such embodiments, the third intermediate link 415 pivots about a different axis than the joint structure 414 itself (e.g., axis A3 instead of axis A2), the third intermediate link 415 has more design flexibility (i.e. , the design is not constrained by the location of the joint’s pivot axis A2). As above, those of ordinary skill in the art would understand that the articulable mechanism 405 of FIGS. 11 -15, including the third intermediate links 405, is exemplary only and that articulable mechanisms in accordance with the present disclosure can have various types of joint structures and links, which utilize various types of third intermediate links between the first and second links, which have various shapes and are configured to engage with various slots (having various configurations and geometries) within the first and second links, without departing from the scope of the present disclosure and claims. As would be understood, for example, the location of the bosses 446 and corresponding slot 431 can be designed to dictate the location of the pivot axis A3 of the third intermediate link415 and the geometry of the slots 426 within the first or second links can be designed to dictate how far the third intermediate link 415 can be driven back and forth (i.e., during articulation of the joint 414).

[0088] As illustrated in FIGS. 8B, 10B, and 15B (which show the articulable mechanisms 305 and 405 in an articulated position), in each of the above embodiments, the intermediate links 314 and 414 are configured to provide a guidePCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 surface (i.e. , across the respective joints) along an outer path of the cables 308, 408 (paths 370, 470 in the articulated position of the mechanisms 305, 405), while allowing the cables 308, 408 to go slack along an inner path (paths 375, 475 in the articulated position of the mechanisms 305, 405). In this manner, the contemplated articulable mechanisms 305 and 405 are configured to dictate a path of one or more outer cables 308, 408 (i.e., to dictate the outer paths 370, 470) during articulation of the mechanisms 305 and 405. Additional embodiments contemplate articulable mechanisms that are configured to dictate the paths of both the outer cables and the inner cables (i.e., both the outer paths 370, 470 and the inner paths 375, 475).

[0089] FIGS. 16-24, for example, illustrate an articulable mechanism, in the form of a pinned wrist assembly, which utilizes a third intermediate link having guide surfaces (i.e., for actuation elements extending across the joint) extending internally through a body of the third intermediate link. In other words, in such embodiments, the guide surfaces of the third intermediate link define a portion of a channel (i.e., for the actuation elements) extending through the third intermediate link. As illustrated in FIGS. 16-20, in some embodiments the intermediate link is configured to pivot about the same axis as the pinned joint structure (i.e., like the embodiments of FIGS. 4-10), while, as illustrated in FIGS. 21-24, in some other embodiments the intermediate link is configured to pivot about a different (i.e., shifted) axis than the pinned joint structure (i.e., like the embodiments of FIGS. 11 -15).

[0090] With reference now to FIGS. 16-20, a distal end portion of an instrument 500 comprising an articulable mechanism 505 and end effector 506 is shown. ThePCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 articulable mechanism 505 is in the form of a wrist assembly 505, which incorporates a movable actuation element path piece in the form of a third intermediate link 515. The wrist assembly 505 includes a first end link 510 (which functions as a proximal wrist link), a second end link 512 (which functions as a distal wrist link), and a pinned joint structure 514 coupling the end first link 510 and the second end link 512 to each other, such that the first end link 510 and the second end link 512 are articulable relative to each other about a pin (not shown) of the joint structure 514. In various embodiments, the third intermediate link 515 is moveably coupled between the first end link 510 and the second end link 512. Similar to the embodiments of FIGS. 4-10, in some embodiments, the third intermediate link 515 is a discrete link that is positioned between a proximal clevis 525 forming the first end link 510 and a distal clevis 527 forming the second end link 512 and is coaxial with a pivot axis A2 of the pinned joint 514 (also referred to as the pitch axis of the wrist assembly 505).

[0091] As best illustrated in the exploded view of FIG. 18, in some embodiments, the third intermediate link 515 includes a boss 536 extending from one or both of first and / or second planar ends 517a and 517b (i.e., perpendicular to the longitudinal centerline CL of the articulable mechanism 505), which is configured to be received in and moveable along a corresponding slot 526 in a respective one of the first and second end links 510 and 512. For example, as illustrated in the embodiment of FIG. 18, a first boss 536 can extend from the first end 517a to be received within a corresponding slot 526 in a first fork portion 529a of the clevis 527 and a second boss 536 can extend from the second end 517b to be received within a corresponding slot 526 in a second, opposite forkPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 portion 529b of the clevis 527. Thus, upon assembly of the articulable mechanism 505, in such embodiments, a pin or separate pin portions (not shown), extending through aligned holes 535, 537 within each of the first and second clevises 525, 527, can be received within a slot 534 in the third intermediate link 515, while each of the bosses 536 is received within a corresponding slot 529a and 529b.

[0092] Thus, the intermediate link 515 is configured to pivot about the axis A2 (the same axis as the pinned joint structure 514) and to provide a moveable guide surface 516 that runs through the intermediate link 515 (i.e. , for actuation elements (not shown) across the joint structure 514) between the end links 510 and 512. In accordance with various embodiments, the guide surface 516 of the third intermediate link 515 defines a portion of a channel 518 extending through the third intermediate link 515.

[0093] For example, in some embodiments, the guide surface 516 can include a pair of guide surfaces 516 defining a pair of channels 518 extending through the third intermediate link 515, such that each channel 518 extends along an oblong shaped central portion 519, including, for example, a prolate spheroid shaped central portion 519 of the third intermediate link 515. The oblong shaped central portion 519 (e.g., prolate spheroid shaped central portion 519) is elongated along a longitudinal axis (or longitudinal CL) of the articulable mechanism 505 in a neutral state of the first end link 510 and the second end link 512 relative to each other, and the guide surfaces 516 comprise elongated side surfaces 519a and 519b of the oblong shaped central portion 519 (see FIG. 20A). Thus, actuation elements (not shown for clarity purposes) can span across the joint structure 514 through the channels 518 in the intermediate linkPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304515, along the elongated side surfaces 519a and 519b of the central portion 519, to cause articulation of the first end link 510 and the second end link 512 relative to each other about the joint structure 514 in response to tension applied to one of more of the actuation elements (see FIG. 20B).

[0094] Thus, similar to the embodiment of FIGS. 4-10, as further shown in the views of FIGS. 20A and 20B, in accordance with various embodiments, the third intermediate link 515 is configured to alter a path of the actuation elements based on a state of articulation of the first end link 510 and the second end link 512 relative to each other. The third intermediate link 515 may, for example, transition (i.e. , dictate) the paths of both the outer cables and the inner cables (i.e., both an outer path 570 and an inner path 575) during articulation of the first and second end links 510 and 512 relative to each other (see FIG. 20B).

[0095] With reference now to FIGS. 21 -24, for more design flexibility, similar to the embodiment of FIGS. 11-15, an articulable mechanism 605 in the form of a wrist assembly 605 may incorporate a third intermediate link 615 that pivots about a shifted axis A3 (i.e., that is not coaxial with a pivot axis A2 of a pinned joint 614). The wrist assembly 605 includes a first end link 610 and a second end link 612, which are coupled together and articulatable relative to each other about a pin 624 of the joint 614. Similar to the above-described embodiments, the third intermediate link 615 is moveably coupled between the first end link 610 and the second end link 612, such that the third intermediate link 615 is a discrete link that is positioned between aPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 proximal clevis 625 forming the first end link 610 and a distal clevis 627 forming the second end link 612.

[0096] As best illustrated in the exploded view of FIG. 22, similar to the embodiments of FIGS. 11 -15, in some embodiments, the third intermediate link 615 includes a boss 636 extending from each of first and second planar ends 617a and 617b (i.e., perpendicular to the longitudinal centerline CL of the articulable mechanism 605), which are configured to be received in and moveable along corresponding respective slots 626 in one of the first and second end links 610 and 612. For example, as illustrated in the embodiment of FIG. 22, a first boss 636 can extend from the first end 617a to be received within a corresponding slot 626 in a first fork portion 629a of the clevis 625 (i.e., forming the first end link 610) and a second boss 636 (not shown in the view of FIG. 22) can extend from the second end 617b to be received within a corresponding slot 626 in a second, opposite fork portion 629b of the clevis 625. In such embodiments, the third intermediate link also includes a boss 646 extending from each of the first and second planar ends 617a and 617b (i.e., perpendicular to the longitudinal centerline CL of the articulable mechanism 605 and adjacent to the respective bosses 636), which are configured to be received and pivot within a corresponding slot 631 in each of the first and second fork portions 629a and 629b of the clevis 625.

[0097] Thus, upon assembly of the articulable mechanism 605, in such embodiments, the pin 624 (which may be comprised of separate pin portions 624 extending from each of the first and second fork portions 629a, 629b) can be received within a corresponding slot 634 in each of a first fork portion 639a and a second fork portion 639b of the clevisPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304627 (i.e. , forming the second end link 612) to pivot about a pivot axis A2, while each of the bosses 636 is received within a corresponding slot 626 in each of the first fork portion 629a and the second fork portion 629b of the clevis 625 to pivot about a separate pivot axis A3.

[0098] To actively drive the third intermediate link 615, upon assembly, the bosses 636 of the third intermediate link 615 are received within a corresponding slot 626 of the clevis 625 and are configured to move within the slot 626 as the third intermediate link pivots about the axis A3 (i.e., a pivot created by the bosses 646 received within corresponding slots 631 ). In some embodiments, the bosses 636 are also received within a respective slot 634 of the clevis 627 (i.e., adjacent to a respective pin portion 624 as shown in FIG. 21 ). For example, each slot 634 may comprise a first, rounded slot portion 633 configured to receive a pin portion 624 and a second, linear slot portion 635 configured to receive a boss 636, such that, upon assembly, each boss 636 first passes through a corresponding slot 626 in the clevis 625 and then passes through a corresponding slot 634 in the clevis 627.

[0099] In this manner, the intermediate link 615 is configured to pivot about the axis A3, while the pinned joint structure 614 pivots about the axis A2, to provide a moveable guide surface 616 (i.e., for actuation elements across the joint structure 614) between the end links 610 and 612. Like the embodiment of FIGS. 16-20, in various embodiments, the guide surface 616 can include a pair of guide surfaces 616 defining a pair of channels 618 extending through the third intermediate link 615, such that each channel 618 extends along an oblong shaped central portion 619, including, forPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 example, a prolate spheroid shaped central portion 619 of the third intermediate link 615. The oblong shaped central portion 619 (e.g., prolate spheroid shaped central portion 619) is elongated along a longitudinal axis (or longitudinal CL) of the articulable mechanism 605 in a neutral state of the first end link 610 and the second end link 612 relative to each other, and the guide surfaces 616 comprise elongated side surfaces 619a and 619b of the oblong shaped central portion 619 (see FIG. 24A). Thus, actuation elements (not shown for clarity purposes) can span across the joint structure 614 through the channels 618 in the intermediate link 615, along the elongated side surfaces 619a and 619b of the central portion 619, to cause articulation of the first end link 610 and the second end link 612 relative to each other about the joint structure 614 in response to tension applied to one of more of the actuation elements (see FIG. 24B). In this manner, the third intermediate link 615 can transition (i.e., dictate) the paths of both the outer cables and the inner cables (i.e. , both an outer path 670 and an inner path 675) during articulation of the first and second end links 610 and 612 relative to each other (see FIG. 24B)

[0100] Although the embodiments of FIGS. 3-24 all illustrate articulable mechanisms in the form of pinned wrist assemblies, which utilize a third intermediate link between first and second end links of the pinned wrist, those of ordinary skill in the art would understand that the present disclosure contemplates incorporating a movable actuation element path piece, such as a third intermediate link, into various types of articulable mechanisms, including various types of wrist assemblies, which employ various types of joint structures.PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304

[0101] Various additional embodiments contemplate, for example, incorporating a moveable actuation path piece, such as a third intermediate link, into a wrist assembly employing a “snake” type joint structure, as illustrated in FIGS. 25-28. A wrist assembly 705 includes, for example, a first end link 710 and a second end link 712, which are coupled together and articulatable relative to each other about a joint structure 714. In such embodiments, to enable timed articulation between the first link 710 and the second link 712 the joint structure 714 of the wrist assembly 705 may further include one or more joint features 714a and 714b, including, for example, complementary rolling contact surfaces 716 and / or complementary and intermeshing joint features (not shown). In various embodiments, as illustrated in FIGS. 25-28, a distal portion 729 of the first link 710 includes joint features 714a (each joint feature 714a comprising a first curved contact surface 716) rotatably coupled to mating joint features 714b (each joint feature 714b comprising a second curved contact surface 716) of a proximal portion 739 of the second link 712. In this manner, when the second link 712 rotates relative to the first link 710 (i.e., pitch rotation about a rotation axis A2), the curved contact surfaces 716 of the first link 710 are in rolling contact with the corresponding curved contact surfaces 716 of the second link 712. As those of ordinary skill in the art would be familiar with the different types of mating joint features that can be incorporated into such joint structures to enable timed articulation of the first link and the second link relative to each other, such joint features will not be discussed in further detail herein.PCT PATENT APPLICATION Attorney Docket No. P06896-WO Alternate Attorney Docket No. 1084.0246.00304

[0102] Similar to the above-described pinned embodiments, a third intermediate link 715 is moveably coupled between the first end link 710 and the second end link 712, such that the third intermediate link 715 is a discrete link that is positioned between a proximal clevis 725 forming the first end link 710 and a distal clevis 727 forming the second end link 712. As best illustrated in the exploded view of FIG. 26, in some embodiments, the third intermediate link 715 includes a pair of bosses 736 extending from each of first and second planar ends 717a and 717b (i.e. , perpendicular to the longitudinal centerline CL of the articulable mechanism 705), which are configured to be received in and rotatable within corresponding respective slots 726 in the first and second end links 710 and 712. For example, as illustrated in FIG. 26, a first pair of bosses 736 can extend from the first end 717a to be received within respective corresponding slots 726 in fork portions 729, 739 of the clevises 725, 727 (i.e., forming the first and second end links 710, 712) and a second pair of bosses 736 can extend from the second end 717b to be received within respective corresponding slots 726 in opposite fork portions 729, 739 of the clevises 725, 727.

[0103] Thus, upon assembly of the articulable mechanism 705, in such embodiments, the curved contact surfaces 716 of the first link 710 are placed in rolling contact with the corresponding curved contact surfaces 716 of the second link, such that the joint 714 can pivot about the pivot axis A2, while each of the bosses 736 is received within a corresponding slot 726 in each of the clevises 725, 727 to pivot about separate pivot axes A3 and A4.PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304

[0104] In this manner, the intermediate link 715 is configured to pivot about the axes A3 and A4, while the snake joint structure 714 pivots about the axis A2, to provide a moveable guide surface 716 (i.e., for actuation elements across the joint structure 714) between the end links 710 and 712. In various embodiments, the guide surface 716 can include a pair of guide surfaces 716 defining a pair of channels 718 extending through the third intermediate link 715, such that each channel 718 extends along an oblong shaped central portion 719, including, for example, a prolate spheroid shaped central portion 719 of the third intermediate link 715. The oblong shaped central portion 719 (e.g., prolate spheroid shaped central portion 719) is elongated along a longitudinal axis (or longitudinal CL) of the articulable mechanism 705 in a neutral state of the first end link 710 and the second end link 712 relative to each other, and the guide surfaces 716 comprise elongated side surfaces 719a and 719b of the oblong shaped central portion 719 (see FIG. 28A). Thus, actuation elements (not shown for clarity purposes) can span across the joint structure 714 through the channels 718 in the intermediate link 715, along the elongated side surfaces 719a and 719b of the central portion 719, to cause articulation of the first end link 710 and the second end link 712 relative to each other about the joint structure 714 in response to tension applied to one of more of the actuation elements (see FIG. 28B). In this manner, the third intermediate link 715 can transition (i.e., dictate) the paths of both the outer cables and the inner cables (i.e., both an outer path 770 and an inner path 775) during articulation of the first and second end links 710 and 712 relative to each other (see FIG. 28B)PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304

[0105] The articulable mechanisms 300, 400, 500, 600, and 700 and the various third intermediate links discussed and illustrated with reference to the embodiments of FIGS. 4-28, are exemplary only and, as discussed above, articulable mechanisms in accordance with the present disclosure can have various types of joint structures and links, which utilize various types and configurations of intermediate links, without departing from the scope of the present disclosure and claims. Based on a particular application, further modifications and alternative embodiments will be apparent to those of ordinary skill in the art in view of the disclosure herein. Different configurations and arrangements of intermediate links may, for example, be substituted for those illustrated and described herein, parts and processes may be reversed, and certain features of the present teachings may be utilized independently, all as would be apparent to one skilled in the art after having the benefit of the description herein.

[0106] The embodiments described herein can be well suited for use in medical applications. In particular, some embodiments are suitable for use in, for example, surgical, teleoperated surgical, diagnostic, therapeutic, and / or biopsy procedures. Such procedures could be performed, for example, on human patients, animal patients, human cadavers, animal cadavers, and portions or human or animal anatomy. Some embodiments can also be suitable for use in, for example, for non-surgical diagnosis, cosmetic procedures, imaging of human or animal anatomy, gathering data from human or animal anatomy, training medical or non-medical personnel, and procedures on tissue removed from human or animal anatomies (without return to the human or animal anatomy). Even if suitable for use in such medical procedures, the embodiments canPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 also be used for benchtop procedures on non-living material and forms that are not part of a human or animal anatomy. Moreover, some embodiments are also suitable for use in non-medical applications, such as industrial robotic uses. In non-limiting embodiments, the techniques, methods, and devices described herein can be used in, or can be part of, a computer-assisted surgical system employing robotic technology such as the da Vinci® Surgical Systems commercialized by Intuitive Surgical, Inc., of Sunnyvale, California. Those skilled in the art will understand, however, that aspects disclosed herein can be embodied and implemented in various ways and systems, including manually operated instruments and computer-assisted, teleoperated systems, in both medical and non-medical applications. Reference to the daVinci® Surgical Systems are illustrative and not to be considered as limiting the scope of the disclosure herein.

[0107] As used herein and in the claims, terms such as computer-assisted or teleoperable in referencing manipulator systems, or the like should be understood to refer broadly to any system comprising one or more controllable kinematic structures (“manipulators”) that are movable and controllable at least in part through the aid of an electronic controller (with or without human inputs). Such systems can occasionally be referred to in the art and in common usage as robotically assisted systems or robotic systems. Such systems include systems that are controlled by a user (for example through teleoperation), by a computer automatically (so-called autonomous control), or by some combination of these. In examples in which a user controls at least some of the operations of the manipulator, an electronic controller (e.g., a computer) can facilitate orPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 assist in the operation. The term “computer” as used in “computer-assisted manipulator systems” refers broadly to any electronic control device for controlling, or assisting a user in controlling, operations of the manipulator, and is not intended to be limited to things formally defined as or colloquially referred to as “computers.” For example, the electronic control device in a computer-assisted manipulator system could range from a traditional “computer” (e.g., a general-purpose processor plus memory storing instructions for the processor to execute) to a low-level dedicated hardware device (analog or digital) such as a discrete logic circuit or application specific integrated circuit (ASIC), or anything in between. Further, manipulator systems can be implemented in a variety of contexts to perform a variety of procedures, both medical and non-medical. Thus, although some examples described in greater detail herein can be focused on a medical context, the devices and principles described herein are also applicable to other contexts, such as industrial manipulator systems.

[0108] This description and the accompanying drawings that illustrate various aspects and embodiments should not be taken as limiting — the claims define the scope of protection. Various mechanical, compositional, structural, electrical, and operational changes can be made without departing from the spirit and scope of this description and the claims. In some instances, well-known structures, components, and techniques have not been shown or described in detail in order not to obscure the present disclosure. Like numbers in two or more figures that end in the same two digits but begin with a different series, such as 8xx, 10xx, etc. are as best as possible used to represent the same or similar elements.PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304

[0109] Elements and their associated aspects that are described in detail with reference to one embodiment can, whenever practical, be included in other embodiments in which they are not specifically shown or described. For example, if an element is described in detail with reference to one embodiment and is not described with reference to a second embodiment, the element can nevertheless be claimed as included in the second embodiment.

[0110] Further, this description’s terminology is not intended to be limiting. For example, spatially relative terms — such as “beneath”, “below”, “lower”, “above”, “upper”, “proximal”, “distal”, and the like — can be used to describe one element’s or feature’s relationship to another element or feature as illustrated in the figures. These spatially relative terms are intended to encompass different positions (i.e. , locations) and orientations (i.e., rotational placements) of a device in use or operation in addition to the position and orientation shown in the figures. For example, if a device in the figures is turned over, elements described as “below” or “beneath” other elements or features would then be “above” or “over” the other elements or features. Thus, the exemplary term “below” can encompass both positions and orientations of above and below. A device can be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. Likewise, descriptions of movement along and around various axes includes various special device positions and orientations. In addition, the singular forms “a”, “an”, and “the” are intended to include the plural forms as well, unless the context indicates otherwise. And, the terms “comprises”, “comprising”, “includes”, and the like specify the presence of statedPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 features, steps, operations, elements, and / or components but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and / or groups. Components described as coupled can be electrically or mechanically directly coupled, or they can be indirectly coupled via one or more intermediate components. Mathematical and geometric terms are not necessarily intended to be used in accordance with their strict definitions unless the context of the description indicates otherwise, because a person having ordinary skill in the art would understand that, for example, a substantially similar element that functions in a substantially similar way could easily fall within the scope of a descriptive term even though the term also has a strict definition.

[0111] Other embodiments in accordance with the present disclosure will be apparent to those skilled in the art from consideration of the specification and figures, and practice of the embodiments disclosed herein. It is intended that the specification and embodiments be considered as illustrative only, with the following claims being entitled to their fullest breadth, including equivalents, under the applicable law.

Claims

PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304What is claimed is:

1. An articulable mechanism, comprising: a first end link; a second end link; a joint structure coupling the first end link and the second end link, wherein the first end link and the second end link are articulable relative to each other about the joint structure; an actuation element extending through the first end link, spanning across the joint structure, and through the second end link, wherein the actuation element causes articulation of the first end link and the second end link relative to each other about the joint structure in response to tension applied to the actuation element; and a third intermediate link moveably coupled between the first end link and the second end link and comprising a guide surface, wherein the actuation element extends along the guide surface as it spans across the joint structure, and wherein the third intermediate link alters a path of the actuation element based on a state of articulation of the first end link and the second end link relative to each other.

2. The articulable mechanism of claim 1 , wherein the third intermediate link transitions the path of the actuation element from a relatively straight path to an arced path in response to articulation of the first end link and the second end link articulating relative to each other from a neutral position to an articulated position.PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.003043. The articulable mechanism of claim 2, wherein the arced path of the actuation element approaches a circular arced path as an amount of articulation of the first end link and the second end link relative to each other from the neutral position increases.

4. The articulable mechanism of claim 3, wherein a radius of the arced path of the actuation element approaches about .5 inches as a degree of articulation between the first end link and the second end link increases.

5. The articulable mechanism of any of claims 1 -4, wherein the joint structure comprises a pinned joint, and wherein the third intermediate link is pivotable about an axis coaxial with a pivot axis of the pinned joint.

6. The articulable mechanism of any of claims 1 -4, wherein the joint structure comprises a pinned joint, and wherein the third intermediate link is pivotable about an axis not coaxial with a pivot axis of the pinned joint.

7. The articulable mechanism of claim 1 , wherein the guide surface of the third intermediate link is a portion of an outer peripheral surface of the third intermediate link.PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.003048. The articulable mechanism of claim 7, wherein the outer peripheral surface of the third intermediate link has a radially outward concave curvature.

9. The articulable mechanism of claim 8, wherein the radially outward concave curvature is a non-circular segment.

10. The articulable mechanism of any of claims 7-9, wherein the third intermediate link rotates about a pivot axis in response to force applied by the actuation element on the outer peripheral surface of the third intermediate link as the actuation element is placed in a tensioned state.11 . The articulable mechanism of any of claims 7-9, wherein the third intermediate link has an oblong shape elongated along a longitudinal axis of the articulable mechanism in a neutral state of the first end link and the second end link articulated relative to each other, and the guide surface of the third intermediate link is an elongated side peripheral surface of the oblong shape.

12. The articulable mechanism of any of claims 7-9, wherein the third intermediate link has a prolate spheroid shape elongated along a longitudinal axis of the articulable mechanism in a neutral state of the first end link and the second end link articulated relative to each other, and the guide surface of the third intermediate link is an elongated side peripheral surface of the prolate spheroid shape.PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.0030413. The articulable mechanism of claim 1 , wherein the third intermediate link comprises a boss received in and moveable along a slot in one of the first end link or the second end link.

14. The articulable mechanism of claim 13, wherein the third intermediate link is rotatable in response to a force applied by the slot in the one of the first end link or the second end link on the boss of the third intermediate link in response to articulation of the first end link and the second end link relative to each other.

15. The articulable mechanism of any of claims 13 and 14, wherein the first end link comprises a proximal clevis configured to couple to an instrument shaft and the second end link comprises a distal clevis configured to couple to an instrument end effector, and wherein the slot is in the distal clevis.

16. The articulable mechanism of any of claims 13 and 14, wherein the first end link comprises a proximal clevis configured to couple to an instrument shaft and the second end link comprises a distal clevis configured to couple to an instrument end effector, and wherein the slot is in the proximal clevis.PCT PATENT APPLICATION Attorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.0030417. The articulable mechanism of claim 1 , wherein the guide surface of the third intermediate link defines a portion of a channel extending through the third intermediate link.

18. The articulable mechanism of claim 17, wherein the channel extends along an oblong shaped central portion of the third intermediate link, the oblong shaped central portion being elongated along a longitudinal axis of the articulable mechanism in a neutral state of the first end link and the second end link relative to each other, and wherein the guide surface of the third intermediate link comprises an elongated side surface of the oblong shaped central portion.

19. The articulable mechanism of any of claims 17 and 18, wherein the channel extends along a prolate spheroid shaped central portion of the third intermediate link, the prolate spheroid shaped central portion being elongated along a longitudinal axis of the articulable mechanism in a neutral state of the first end link and the second end link relative to each other, and wherein the guide surface of the third intermediate link comprises an elongated side surface of the prolate spheroid shaped central portion.

20. The articulable mechanism of claim 1 , wherein the joint structure comprises a pinned joint, the first end link comprising a first clevis including a first component of thePCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 pinned joint and the second end link comprising a second clevis including a second component of the pinned joint.

21. A medical instrument comprising: a shaft having a proximal end portion and a distal end portion; the articulable mechanism of claim 1 coupled to the shaft; and an end effector coupled to the distal end portion of the shaft.

22. The medical instrument of claim 21 , wherein the end effector comprises a jaw mechanism coupled to the articulable mechanism.

23. The medical instrument of claim 22, wherein the articulable mechanism comprises a pinned joint.

24. A method of articulating an articulable mechanism, the method comprising: applying tension to an actuation element extending through a first end link of the articulable mechanism, spanning across a joint structure of the articulable mechanism, and through a second end link of the articulable mechanism, the joint structure coupling the first end link and the second end link to each other; articulating the first end link and the second end link relative to each other about the joint structure in response to the tension applied to the actuation element; and altering a radius of curvature of the actuation element as the actuation element spans across the joint structure via a guide surface between the first end link and thePCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 second end link based on an amount of articulation of the first end link and the second end link relative to each other about the joint structure.

25. The method of claim 24, wherein altering the radius of curvature of the actuation element comprises transitioning a path of the actuation element from a relatively straight path to an arced path in response to articulation of the first end link and the second end link relative to each other from a neutral position to an articulated position.

26. The method of claim 25, wherein transitioning the path of the actuation element from the relatively straight path to the arced path comprises transitioning the path of the actuation element to approach a circular arced path as the amount of articulation of the first end link and the second end link relative to each other from the neutral position increases.

27. The method of claim 24, wherein altering the radius of curvature of the actuation element as the actuation element spans across the joint structure via the guide surface comprises extending the actuation element along a portion of an outer peripheral surface of a third intermediate link between the first end link and the second end link, wherein the portion of the outer peripheral surface of the third intermediate link has a radially outward concave curvature.PCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.0030428. The method of claim 27, further comprising rotating the third intermediate link about a pivot axis in response to force applied by the actuation element on the outer peripheral surface of the third intermediate link as tension is applied to the actuation element.

29. The method of any of claims 27 and 28, further comprising rotating the third intermediate link about a pivot axis in response to a force applied by a slot in one of the first end link or the second end link on a boss of the third intermediate link in response to the articulating of the first end link and the second end link relative to each other.

30. An articulable mechanism, comprising: a first end link; a second end link; a joint mechanism coupling the first end link and the second end link, wherein the first end link and the second end link are articulable relative to each other about the joint mechanism; an actuation element extending through the first end link, spanning across the joint mechanism, and through the second end link, wherein the actuation element causes articulation of the first end link and the second end link relative to each other about the joint mechanism in response to tension applied to the actuation element; and a guide surface between the first end link and the second end link, wherein the actuation element extends along the guide surface as it spans across the jointPCT PATENT APPLICATIONAttorney Docket No. P06896-WOAlternate Attorney Docket No. 1084.0246.00304 mechanism, and wherein the guide surface alters a radius of curvature of the actuation element based on an amount of articulation of the first end link and the second end link relative to each other about the joint mechanism.

Images