 surgical instrument
专利摘要:
TERMINAL PERFORMER WITH REDUNDANT CLOSING MECHANISMS. The present invention relates to terminal effectors with redundant closing mechanism, related tools and related methods are described. The described terminal effectors can be particularly beneficial when used for minimally invasive surgery. An exemplary surgical tool comprises an elongated shaft having a proximal end and a distal end, a tool body disposed at the distal end of the shaft, a movable jaw with respect to the tool body between a clamped configuration and an open configuration, a first locking mechanism actuation coupled with the clamp and operable to vary the position of the clamp with respect to the tool body between the clamped configuration and the open configuration, and a second actuation mechanism coupled with the clamp. The second actuation mechanism has the first configuration having a first configuration where the clamp is kept in the clamped configuration and a second configuration where the position of the clamp with respect to the tool body is not restricted by the second actuation mechanism. 公开号:BR112012011424B1 申请号:R112012011424-7 申请日:2010-11-12 公开日:2020-10-20 发明作者:William A. Burbank 申请人:Intuitive Surgical Operations, Inc； IPC主号:
专利说明:
CROSS REFERENCE WITH RELATED ORDER This application claims the benefit under 35 U.S. C. § 119 (e) of U.S. Patent Application No. 61 / 260,907 (filed on November 13, 2009; entitled "End Effector with Redundant Closing Mechanisms"), which is incorporated by reference. This application is also related to U.S. Patent Application No. xx / xxx.xxx (filed concurrently; entitled "Wrist Articulation By Linked Pull Rods") [Legal Document N °. ISRG 02320 / US], U.S. Patent Application No. xx / xxx.xxx (filed concurrently; entitled "Double Universal Joint") [Legal Document N °. ISRG 02340 / US], U.S. Patent Application No. xx / xxx.xxx (filed concurrently; entitled "Surgical Tool Containing Two Degree of Freedom Wrist") [Legal Document N °. ISRG 02350 / US], and U.S. Patent Application No. xx / xxx.xxx (filed concurrently; entitled "Motor Interface For Parallel Drive Shafts Within an Independently Rotating Member") [Legal Document N °. ISRG 02360 / US], all of which are incorporated by reference. BACKGROUND [002] Minimally invasive surgical techniques aim to reduce the amount of foreign tissue that is damaged during diagnosis or surgical procedures, thereby reducing the patient's recovery time, discomfort and deleterious side effects. As a consequence, the average length of hospital stay for standard surgery can be significantly shortened using minimally invasive surgical techniques. Also, the patient's recovery time, patient discomfort, surgical side effects, and time off work can also be reduced with minimally invasive surgery. [003] A common form of minimally invasive surgery is endoscopy, and a common form of endoscopy is laparoscopy, which is inspection and minimally invasive surgery within the abdominal cavity. In standard laparoscopic surgery, a patient's abdomen is insufflated with gas, and cannula gloves are passed through small incisions (approximately half an inch or less) to provide entry holes for laparoscopic instruments. [004] Laparoscopic surgical instruments generally include an endoscope (for example, laparoscope) to view the surgical field and tools for working in the operating room. Work tools are typically similar to those used in conventional (open) surgery, except that the working end or end effector of each tool is separated from its handle by an extension tube (also known as, for example, an axis instrument or a main axis). The terminal effector may include, for example, a clamp, claw, scissors, stapler, cauterization tool, linear cutter, or needle holder. [005] To perform surgical procedures, the surgeon passes the work tools through the cannula gloves to an internal surgical site and manipulates them from the outside of the abdomen. The surgeon sees the procedure through a monitor that displays an image of the surgical site, taken from the endoscope. Similar endoscopic techniques are employed, for example, in arthroscopy, retroperomyoscopy, pelviscopy, nephroscopy, cystoscopy, cisternoscopy, syncope, hysteroscopy, urethroscopy, and the like. [006] Minimally invasive telesurgical robotic systems are being developed to increase the surgeon's dexterity when working in an internal surgical location, as well as allowing a surgeon to operate on a patient from a remote location (outside the sterile field). In a telesurgery system, the surgeon is often provided with an image of the surgical site on a control console. Each of the main input devices controls the movement of a servo-mechanically actuated / articulated surgical instrument. During the surgical procedure, the telesurgical system can provide mechanical actuation and control of a variety of surgical instruments or tools having terminal effectors that perform various functions for the surgeon, for example, to hold or activate the needle, grab a blood vessel, dissect tissue, or similar, in response to manipulation the main input devices. [007] Non-robotic linear clamping, cutting and stapling devices have been used in many very different surgical procedures. For example, such a device can be used to resect cancerous or abnormal tissue in the gastrointestinal tract. Unfortunately, many known surgical devices, including known linear clamping, cutting and clamping devices have opposite jaws that can generate less than a desired clamping force, which can reduce the efficiency of the surgical device. Alternative devices may provide sufficient mechanical advantage to generate a desired level of clamping force for applicable surgical procedures (for example, tissue stapling), but may have an actuation response rate that is less than desirable for manipulating telesurgical tissue. Furthermore, exchange tools having such high-force jaw actuation mechanisms can be more complex (and potentially more prone to failure) than would be ideal. [008] Thus, tools with improved terminal effectors are believed to be a necessity. Enhanced end effectors that provide sufficient clamping force, provide a quick response / low-force articulation mode, and are at least partially actionable backwards may also be desirable. Such tools can be beneficial in surgical applications, particularly in minimally invasive surgical applications. BRIEF SUMMARY [009] Enhanced terminal effectors, related tools, and related methods are provided. In many surgical applications, for example, many minimally invasive surgical applications, the size of a terminal surgical tool holder is substantially restricted by applicable space restrictions. While such a size restriction mitigates in favor of using an actuation mechanism, in many modalities, the described terminal effectors use two independent mechanisms to articulate a terminal effector jaw. In many embodiments, a first actuation mechanism provides a quick / low force response mode that varies the position of the articulated jaw between a clamped and an open configuration. In many modalities, the first actuation mechanism is actionable backwards. In many embodiments, a second actuation mechanism provides a high holding force that has a first configuration where the articulated jaw is held in a secured configuration and a second configuration where the articulated jaw is not restricted by the second actuation mechanism. In many embodiments, the second actuation mechanism is not actionable backwards. [0010] Such terminal effectors, tools and methods provide a number of benefits, particularly with respect to minimally invasive surgical applications. For example, in many embodiments, the high-clamping articulation mode allows for proper tissue compression and resists jaw movement, for example, during staple firing. In many modalities, the fast response / low force mode is useful for manipulating tissue, is useful for finding optimal tissue acquisition, and provides a more responsive articulation of the articulated jaw. In many embodiments, a first action mechanism that can be actuated backwards allows the articulated jaw to move in heavy contact with the patient's tissue, which can help prevent injury to the patient's tissue, and / or allows the articulated jaw to close on contact with a cannula glove, which can help remove the surgical tool from the patient. In addition, the described terminal effectors can provide compression detection of improved tissue and / or tissue space because the redundant actuation mechanisms can provide additional feedback data for analysis and, in many modalities, the first actuation mechanism can be made to work efficiently with low frictional losses, which can improve the detection capacity. While the various modalities described here are described primarily for surgical applications, these surgical applications are merely exemplary applications, and the described terminal effectors, tools, and methods can be used in other suitable applications, both inside and outside a human body, as well as in non-surgical applications. [0011] In a first aspect, a minimally invasive surgical method is provided. The method includes introducing a tool clamp to an internal surgical site within a patient through a minimally invasive opening or natural orifice, manipulating tissue in an internal surgical site with a gripping force by articulating the clamp with a first actuation mechanism, and treating a target tissue at the internal surgical site using a clamping force by articulating the tool jaw with a second actuation mechanism. The first and second actuation mechanisms extend along an axis from outside the patient to the jaw. The gripping force is greater than the gripping force. [0012] In many modalities, the first actuation mechanism comprises cable segments and the second actuation mechanism comprises a drive shaft. In many embodiments, tissue manipulation is accomplished by closing the clamp using tension on a first cable segment and opening the clamp using tension on a second cable segment. In many embodiments, fabric treatment is performed by closing the jaw using a rotation of the drive shaft within the tool axis. In many embodiments, the second actuation mechanism drives back the first mechanism such that the articulation of the second actuation mechanism to close the jaw will trigger the cable segments for a closed jaw configuration and articulation of the second actuation mechanism for a configuration of open jaw will not drive back the first mechanism or open the jaw if the cable segments remain in a closed jaw configuration. [0013] In another aspect, a surgical tool is provided. The tool includes an elongated shaft having a proximal end and a distal end, a tool body disposed at the distal end of the shaft, a movable jaw with respect to the tool body between a clamped configuration and a closed configuration, a first coupling actuation mechanism with the clamp, and a second actuation mechanism coupled with the clamp. The first actuation mechanism is operable to vary the position of the jaw with respect to the tool body between the clamped configuration and the open configuration. The second actuation mechanism has a first configuration in which the clamp is kept in the secured configuration and a second configuration in which the position of the clamp with respect to the tool body is not restricted by the second actuation mechanism. [0014] The first actuation mechanism may include one or more additional components and / or have one or more additional characteristics. For example, in many modalities, the first actuation mechanism is actionable backwards. In many embodiments, the first actuation mechanism includes cables. In many embodiments, a pulling motion of a first cable segment of the first actuation mechanism moves the jaw to the open configuration and a pulling motion of the second cable segment of the first actuation mechanism moves the jaw to the stuck configuration. The first actuation mechanism can include a first connection coupling the first cable segment with the jaw and the tool body. The first actuation mechanism may include a second connection coupling the second cable segment with the clamp to the tool body. [0015] The second actuation mechanism may include one or more additional components and / or have one or more additional characteristics. For example, in many modalities, the second actuation mechanism is not actionable backwards. The second actuation mechanism can be operable to produce a clamping force between the jaw and the tool body of at least 9.07 kg. In many embodiments, the second actuation mechanism includes a lead screw. The second actuation mechanism may include a lead screw cam operatively coupled with the lead screw and the jaw may include an interface cam surface for contact with the lead screw cam. [0016] The surgical tool may include one or more additional components. For example, the actuated device can be a cutting device, a stapling device or a cutting and stapling device. [0017] In another aspect, a robotic tool is provided for mounting on a manipulator having a first drive. The robotic tool includes a proximal tool chassis releasably mounted on the manipulator; a drive motor coupled to the tool chassis and disposed adjacent to the tool chassis; a distal terminal effector comprising a movable jaw; an instrument axis having a proximal end adjacent to the chassis, and a distal end adjacent to the terminal effector; a first actuation mechanism coupling the first drive to the terminal effector when the chassis is mounted on the manipulator in order to articulate the terminal effector between an open configuration and a fixed configuration; and a second actuation mechanism coupling the drive motor to the end effector in order to articulate the end effector in the configuration secured from the open configuration. [0018] The first actuation mechanism may include one or more additional components and / or have one or more additional characteristics. For example, in many modalities, the first actuation mechanism is activated backwards. The first actuation mechanism may include cables extending from the chassis distally into a hole in the instrument shaft, operatively coupling the terminal actuator to the first drive. [0019] The second actuation mechanism may include one or more additional components and / or have one or more additional characteristics. For example, in many modalities, the first actuation mechanism is not driven backwards. The second actuation mechanism can include a lead screw driven cam. The second actuation mechanism can have a first configuration where the jaw is kept in the secured configuration and a second configuration where the position of the jaw with respect to the tool body is not restricted by the second actuation mechanism. The second actuation mechanism can include a drive shaft mounted by rotation within a hole in the instrument shaft and operatively couple the terminal actuator to the drive motor. [0020] In another aspect, the surgical instrument is provided. The surgical instrument includes a terminal effector comprising a movable jaw, a first jaw actuation mechanism coupled to the movable jaw, and a second jaw actuation mechanism coupled to the movable jaw. The first jaw actuation mechanism moves the jaw from an open position to a closed position independently of the second jaw actuation mechanism. The second jaw actuation mechanism moves the jaw from the open to the closed position independently of the first jaw actuation mechanism. [0021] The second jaw mechanism can restrict the range of movement in which the first actuation mechanism can move the jaw, for example, the second actuation mechanism can have a first configuration in which the movable jaw is held in a clamped position and wherein the first actuation mechanism is prevented from moving the movable jaw. [0022] The first actuation mechanism can provide a fast response / low force articulation mode, and the second actuation mechanism can provide a high holding force mode. For example, in many embodiments, the maximum clamping force of the clamp provided by the second actuation mechanism is greater than the maximum clamping force provided by the first actuation mechanism. [0023] The first and second actuation mechanisms may employ different force transmission mechanisms. For example, a force used by the first jaw actuation mechanism to move the jaw from the open position to the closed position may include a linear force, and a force used by the second jaw actuation mechanism to move the jaw from the open position. for the closed one it can include a torque. In many embodiments, the first jaw actuation mechanism includes a cable-driven mechanism. In many embodiments, the second jaw actuation mechanism includes a lead screw driven mechanism. [0024] For a more complete understanding of the nature and advantages of the present invention, reference should be made to the following detailed description and accompanying drawings. Other aspects, objectives and advantages of the invention will be evident from the drawings and the detailed description that follows. BRIEF DESCRIPTION OF THE DRAWINGS [0025] Figure 1 is a plan view of a minimally invasive robotic surgery system being used to perform surgery, according to many modalities. [0026] Figure 2 is a perspective view of a surgeon's control console for a robotic surgery system [0027] Figure 3 is a perspective view of an electronic instrument cart for a robotic surgery system, according to many modalities. [0028] Figure 4 illustrates diagrammatically a robotic surgery system, according to many modalities. [0029] Figure 5A is a front view of a patient side cart (surgical robot) of a surgery system, according to many modalities. [0030] Figure 5B is a front view of a robotic surgery tool, according to many modalities. [0031] Figure 6A is a perspective view of a terminal effector having an articulated jaw, according to many modalities. [0032] Figure 6B is a perspective view of the end effector of figure 6A (with the articulated jaw removed to better illustrate the components of the lead screw actuation mechanism), according to many modalities. [0033] Figures 7A and 7B illustrate components of a lead screw actuation mechanism, according to many modalities. [0034] Figure 8A illustrates components of a cable actuation mechanism, according to many modalities. [0035] Figure 8B is a perspective view of the end effector of figure 8A with a part of the articulated jaw removed to show the components of the cable actuation mechanism arranged behind the articulated jaw, according to many modalities. [0036] Figures 8C to 8F illustrate opposite side components of the cable actuation mechanism of figure 8A. [0037] Figure 9A is a perspective view illustrating a cable actuation mechanism, showing a cable used to articulate the jaw for a fixed configuration, according to many modalities. [0038] Figure 9B is a perspective view illustrating the cable actuation mechanism of figure 9A, showing a cable used to articulate the jaw for an open configuration. [0039] Figure 10 is a cross-sectional view illustrating components of a lead screw actuation mechanism according to many modalities. [0040] Figure 11 is a simplified diagrammatic illustration of a tool assembly, according to many modalities. [0041] Figure 12 is a simplified diagrammatic illustration of a robotic tool mounted on a robotic tool manipulator, in color with many modalities. DETAILED DESCRIPTION [0042] Enhanced terminal effectors, related tools, and related methods are provided. In many embodiments, the described terminal effectors use two independent mechanisms to articulate a terminal effector jaw. In many embodiments, a first actuation mechanism provides a fast response / low force mode that varies the position of the air-linked jaw between a fixed and an open configuration. In many modalities, the first actuation mechanism is actionable backwards. The first actuation mechanism can be designed to provide, for example, 2.27 kg of clamping force at the tip of the articulated jaw of the terminal effector. In many embodiments, a second actuation mechanism provides a high clamping force mode that has a first configuration where the articulated jaw is held in a secured configuration and a second configuration where the articulated jaw is not restricted by the second actuation mechanism. In many embodiments, the second actuation mechanism is not actionable backwards. In many embodiments, the second actuation mechanism converts a relatively weak force or torque (but with a large available displacement) into a relatively high torque by turning the terminal effector jaw. The second actuation mechanism can be designed to provide, for example, 22.7 kg of clamping force at the tip of the articulated jaw of the terminal effector, the described terminal effectors, tools and methods can be used in a variety of applications, and can be particularly beneficial when used in minimally invasive surgery applications. While the various modalities described here are primarily described for surgical applications, these surgical applications are merely exemplary applications, and the terminal effectors, tools and methods described can be used in other suitable applications, within and in the shape of a human body, as well as in non-surgical applications. Minimally Invasive Robotic Surgery [0043] Referring now to the drawings, in which equal reference numerals represent equal parts for all the various views, figure 1 is a plan view illustration of a Minimally Invasive Robotic Surgical system (MIRS) 10, typically used to perform a minimally invasive diagnosis or surgical procedure on a Patient 2 who is lying on an Operating Table 14. The system may include a Surgeon Console 16 for use by a Surgeon 18 during the procedure. One or more Assistants 20 can also participate in the procedure. The MIRS 10 system can also include a Patient Side Cart 22 (surgical robot), and an Electronic Instrument Cart 24. Patient Side Cart 22 can handle at least one removably attached tool assembly 26 (hereinafter referred to simply as a "tool") through a minimally invasive incision in the body of Patient 12 while Surgeon 18 visualizes the surgical site through Console 16. An image of the surgical site can be obtained by an endoscope 28, such as a stereoscopic endoscope , which can be manipulated by the Patient Side Cart 22 in order to orient the endoscope 28. The Electronic Instrument Cart 24 can be used to process the images of the surgical site for subsequent display to Surgeon 18 through the Surgeon Console 16. The number of surgical tools 26 used at once will generally depend on the diagnosis or surgical procedure and space restrictions within the salt operation among other factors. If it is necessary to change one or more of the tools 26 being used during the procedure, an Assistant 20 can remove the tool 26 from the Patient Side Cart 22, and replace it with another tool 26 from a tray 30 in the operating room. [0044] Figure 2 is a perspective view of the Surgeon Console 16. The Surgeon Console 16 includes a left eye viewfinder 32 and a right eye viewfinder 34 to present Surgeon 18 with a coordinated stereo view of the surgical site that allows depth perception. Console 16 also includes one or more input control devices 36, which in turn makes the Patient Side Cart 22 (shown in figure 1) manipulate one or more tools. The entry control devices 36 will provide the same degrees of freedom as their associated tools 26 (shown in figure 1) in order to provide the Surgeon with telepresence, or the perception that the entry control devices 36 are integral with the tools 26 , so that the Surgeon has a strong sense of directly controlling the tools 26. For this purpose, sensors of position, force and tactile feedback (not shown) can be used to transmit sensations of position, force and tactile of the tools 26 of back into the Surgeon's hands through the input control devices 36. [0045] The Surgeon Console 16 is usually located in the same room as the patient so that the Surgeon can directly monitor the procedure, be physically present if necessary, and speak to an Assistant directly instead of over the phone or other means of communication . However, the Surgeon may be located in a different room, a completely different building, or another remote location for the Patient allowing remote surgical procedures (ie operating from outside the sterile field). [0046] Figure 3 is a perspective view of the Electronic Instrument Cart 24. The Electronic Instrument Cart 24 can, are, be coupled with the endoscope 28 and can include a processor to process captured images for subsequent hot display, such as to a Surgeon at the Surgeon's Console, or any other suitable monitor located on-site and / or remotely. For example, where a stereoscopic endoscope is used, the Electronic Instrument Cart 24 can process the captured images in order to present the coordinated stereo images of the surgical site to the Surgeon. Such coordination may include alignment between opposing images and may include adjusting the stereo working distance of the stereoscopic endoscope. As another example, image processing may include the use of previously determined camera calibration parameters in order to compensate for image capture device image errors, such as optical aberrations. [0047] Figure 4 diagrammatically illustrates a robotic surgery system 50 (such as MIRS 10 system in figure 1). As discussed above, a Surgeon Console 52 (such as Surgeon Console 16 in figure 1) can be used by a Surgeon to control a Patient Side Cart (Surgical Robot) 54 (such as Patient Side Cart 22 in figure 1) during a minimally invasive procedure. The Patient Side Cart 54 can use an imaging device, such as a stereoscopic endoscope, to capture images of the procedure site and output captured images to an Electronic Instrument Cart 56 (such as the Electronic Instrument Cart 24 on figure 1). As discussed above, the Electronic Instrument Cart 56 can process the captured images in a variety of ways before any subsequent display. For example, the Electronic Instrument Cart 56 can overlay captured images with a virtual control panel interface before displaying the combined images to the Surgeon via the Surgeon Console 52. The Patient Side Cart 54 can output the images captured for processing outside the Electronic Instrument Cart 56. For example, the Patient Side Cart 54 can output the captured images to a processor 58, which can be used to process the captured images. The images can also be processed by a combination of the Electronic Instrument Cart 56 and the processor 48, which can be coupled in order to process the captured images together, sequentially and / or combinations thereof. One or more separate monitors 60 can also be coupled with the processor 58 and / or the Electronic Instrument Cart 56 for displaying local and / or remote images of images, such as images of the procedure site, or any other related images. [0048] Figures 5A and 5B show a Patient Side Trolley 22 and a surgical tool 62, respectively. Surgical tool 62 is an example of surgical tools 26. The Patient Side Cart 22 shown provides the manipulation of three surgical tools 26 and an imaging device 28, such as a stereoscopic endoscope used for image capture the location of the procedure. Manipulation is provided by robotic mechanisms having a number of robotic joints. The imaging device 28 and surgical tools 26 can be positioned and manipulated through incisions in the patient so that a remote kinematic center is maintained in the incision in order to minimize the size of the incision. Images of the surgical site may include images of the distal ends of the surgical tools 26 when they are positioned within the field of view of the imaging device 28. End effector clamp articulation with independent actuation mechanisms [0049] In many modalities, two independent actuation mechanisms are used to control the articulation of an articulated jaw of a terminal effector. A first actuation mechanism can be used to provide a fast response / low force mode, and a second actuation mechanism can be used to provide a high hold force mode. In many embodiments, the first actuation mechanism used to provide the quick response / low force articulation mode is actionable backwards. In many embodiments, the second actuation mechanism used to provide the high clamping force articulation mode is not actionable backwards. Such use of two independent actuation mechanisms can be beneficial in some surgical applications, for example, electrocautery sealing, stapling, etc., which may require multiple low-strength jaw clamps before a high-strength jaw clamp is used to perform the task of the surgical tool. [0050] In many modalities, the fast response / low force mode is provided by a cable actuation mechanism that includes a pair of pull cables. In some embodiments, a pulling motion of a first pair cable articulates the articulated jaw for a closed (clamped) configuration and a pulling motion of a second pair cable articulates the articulated jaw for an open configuration. In many embodiments, the cable actuation mechanism is operable backwards. [0051] In many embodiments, the high clamping force mode is provided by a lead screw actuation mechanism that includes a lead driven by lead screw. The driven cam interfaces with a corresponding cam surface on the articulated jaw in order to keep the articulated jaw in a locked configuration when the lead driven cam is at the first end of its range of motion. In addition, the driven cam does not restrict the movement of the articulated jaw when the lead driven by the lead screw is at a second end (opposite end) of its range of motion. In other words, the corresponding meat surfaces are arranged such that the movement of the meat driven by the lead screw in one direction will cause the articulated jaw to close, and the movement of the meat driven by the lead screw in the reverse direction will allow (but not will force) the articulated jaw to open to a limit provided by the meat surfaces. In many embodiments, the lead screw actuation mechanism cannot be actuated backwards. [0052] Figure 6A is a perspective view of a terminal effector 70 having a jaw 72 articulated by two independent actuation mechanisms, according to many modalities. The terminal effector 70 includes a terminal effector base 74, the articulated jaw 72, and a detachable stationary jaw 76. The terminal effector 70 is actuated by means of a first drive shaft 78, a second drive shaft 80, and two cables (not shown). The first drive shaft 78 rotates a lead screw 82 of a lead screw actuation mechanism. The second drive shaft 80 rotates another lead screw (not shown) of the detachable stationary jaw 76. [0053] In many embodiments, the first drive shaft 78 and / or the second drive shaft 80 are driven by drive resources located in a proximal tool chassis to which the end effector 70 is coupled via an instrument shaft . In many embodiments, the proximal tool chassis is configured to be releasably mounted on a robotic tool manipulator. In many embodiments, the first drive shaft 78 and the second drive shaft 80 are actuated by means of respective drive resources located on the proximal tool chassis. In many embodiments, these drive features are driven by motors that are located on the proximal tool chassis. [0054] Figure 6B is a perspective view of the end effector 70 of figure 6A (with the articulated jaw 72 removed to better illustrate the components of the lead screw actuation mechanism), according to many modalities. Lead screw 82 is mounted for rotation with respect to end effector base 74. A cam driven by lead screw 84 is coupled with lead screw 82 so that selective rotation of lead screw 82 can be used to translate selectively the lead driven meat 84 along a meat slit 86 in the end effector base 74. The end effector 70 includes a pivot pin 88 which is used to rotationally couple the articulated jaw 72 with the effector base terminal 74. [0055] Figures 7A and 7B illustrate the lead screw actuation mechanism of figures 6A and 6B. The lead screw 82 has a distal trunnion surface 96 and a proximal trunnion surface that interfaces with a proximal bearing 98. In many embodiments, the distal trunnion surface 96 is received within a cylindrical receptacle located at the distal end of the slot meat 86. Such a distal support for lead screw 82 can be configured to prevent lead screw 82 from oscillating excessively, and with relatively large clearance (s) between the distal trunnion surface 96 and the cylindrical receptacle. The proximal bearing 98 is supported by the effector base 74 to support the proximal end of the lead screw 82. The proximal bearing 98 can be a ball bearing, which can help to reduce friction and wear. A distal bearing (not shown) can be supported by the terminal effector base 74 so as to support the distal end of the lead screw 82, and the distal bearing can be a spherical bearing. The lead screw cam 84 includes a threaded hole configured to correspond with the outer threads of the lead screw 82. The lead screw cam 84 includes top and bottom surfaces configured to interact with corresponding top and bottom surfaces of the meat slit 86. The interaction between the lead screw 84 meat and the meat slit 86 prevents the lead screw 84 meat from rotating in relation to the meat slit 86, which makes the meat screw driven meat 86 advance 84 move along the meat slit 86 in response to the rotation of the lead screw. [0056] The articulated jaw 72 includes corresponding cam surfaces 94 which are configured so that the position of the driven screw screw 84 along the cam slit 86 determines the extent to which the pivoting jaw 72 rotates in around the pivot pin 88 is restricted by the cam driven by lead screw 84. The articulated jaw 72 includes a first proximal side 100 and a second proximal side 102 which are separated by a central slot. The first and second proximal sides are disposed on opposite sides of the end effector base 74 when the articulated jaw 72 is coupled with the end effector base 74 by means of pivot pin 88. Each of the first and second proximal sides 100, 102 includes a recessed area defining a corresponding cam surface 94 and providing clearance between the lead screw 84 and the proximal sides 100, 102. When the lead screw 84 is positioned at or near the proximal end of the slit cam 86 (close to its position illustrated in figures 7A to 7B), the contact between the lead screw driven meat 84 and the corresponding meat surfaces 94 of the articulated jaw around the pivot pin 88 is not restricted by the screw driven cam feed 84 for a range of rotational positions between a fixed configuration (where there is a space between the meat driven by lead screw 84 and the colored meat surfaces respondents 94 of the articulated jaw 72). For lead screw driven meat positions 84 between the proximal and distal ends of the meat slot 86, the range of unrestricted movement may vary according to the meat surfaces used. [0057] The use of a recess on each of the proximal sides 100, 102 to define the corresponding meat surfaces 94 of the articulated jaw 72 provides a number of benefits. For example, the use of recesses when opposed to the transverse slits extending through the proximal sides provides a continuous outer surface for the proximal sides 100, 102 of the hinged jaw, which is less likely to cut the patient's tissue or a sales opening. transversal. The absence of transverse slits also helps to strengthen proximal sides 100, 102 when compared to proximal sides with transverse slits, and therefore provides increased clamping rigidity. Such proximal sides 100, 102 can have increased stiffness in two planes, which can help maintain alignment of the articulated jaw 72 in the presence of external forces. Such increased rigidity in two planes can be beneficial in some surgical applications, for example, in tissue stapling where it is beneficial to maintain alignment between the staples and anvil pockets that form the staples. In addition, the use of recesses instead of transverse slits also provides an actuation mechanism that is less likely to be obstructed by foreign material when compared to one having proximal sides with open transverse slits. [0058] The lead screw actuation mechanism can be configured to provide a desired holding force between the articulated jaw and an opposite jaw of the end effector. For example, in many embodiments, the lead screw actuation mechanism is configured to provide at least 9.08 kg of clamping force at the tip of the pivot jaw 72 (approximately 5.08 cm from pivot pin 88). In many embodiments, the lead screw actuation mechanism is configured to provide at least 22.7 kg of clamping force at the tip of the pivot jaw 72. In many embodiments, to produce 22.7 kg of clamping force at the tip of the articulated jaw 72, the input torque for lead screw 82 is approximately 0.2 Nm and lead screw 82 has 29 turns. [0059] The lead screw actuation mechanism can be manufactured using available materials and components. For example, many components of the lead screw actuation mechanism can be manufactured from available stainless steel. The lead-driven cam 84 can be coated (for example, TiN) to reduce friction against the surfaces rubbed against (for example, lead screw 82; terminal effector base 74; proximal sides 100, 102 of the articulated jaw 72). Twisted cables can be used to drive the first actuation mechanism. [0060] Figures 8A and 8B illustrate components of a cable actuation mechanism 110, according to many modalities. As described above, the lead screw 84 can be positioned at the distal end of the meat slot 86 (i.e., near the pivot pin 88). For such a distal position of the cam driven by lead screw 84, as discussed above, the rotational position of the articulated jaw 72 around pivot pin 88 is not restricted by a range of rotational positions of the articulated jaw 72. Consequently, the rotational position of the articulated jaw 72 around pivot pin 88 can be controlled by the cable actuation mechanism 110. The cable actuation mechanism 110 is operable to vary the rotational position of the articulated jaw between the attached configuration and the open configuration. The cable actuation mechanism 110 includes a pair of pull cables 112, 114. The cable actuation mechanism 110 also includes a first pivot 116 which is used to rotate the pivot jaw 72 around the pivot pin 88 for the secured configuration. , and a second analogous joint 118 which is used to rotate the articulated jaw 72 around the pivot pin 88 for the open configuration. The first joint 116 (shown in figures 8A and 8B) includes a rotary connection 120 which is mounted for rotation with respect to the terminal effector base 74 by means of a pivot pin 122. A connection connection 124 couples the rotating connection 20 to the jaw articulated 72 by means of a pivot pin 126 and the pivot pin 128. The first articulation 116 is articulated by a pulling movement of the pulling cable 112. In operation, a pulling movement of the pulling cable 112 rotates the rotating connection 120 in a clockwise direction around the pivot pin 122. The movement resulting from the rotating connection 120 in the counterclockwise direction around the pivot pin 122. The movement resulting from the connection connection 124 rotates the pivot jaw 72 in a counterclockwise direction around pivot pin 88 for the stuck configuration. [0061] The second joint 118 (shown in figures 8C to 8F) of the cable actuation mechanism 110 includes components analogous to the first joint 116, for example, a rotary connection 130 mounted for rotation with respect to the terminal effector base 74 by means of of a pivot pin 132, and a connection connection 134 that couples the rotating connection 130 to the articulated jaw 72 by means of two pivot pins 136, 138. The second articulation 118 is articulated by means of a pulling movement of the pulling cable 114 The second hinge 118n is configured such that a pull movement of the pull cable 114 rotates the hinge jaw 72 around pivot pin 88 for the open configuration. In many embodiments, the pivot pin 136 between the connection link 134 and the rotary link 130m of the second link 118 is 180 degrees out of phase with the pivot pin 126 between the link link 124 and the rotary link 120 of the first link 116. A coordinated pull and extension of the pull cables 112, 114 of the cable actuation mechanism 110 are used to articulate the pivot jaw 72 between the open and clamped configurations. In order to provide equal and opposite cable movement (and thereby maintain cable tension in a capstan driven system described below), a common axis of rotation for pivot pins 122, 132 is configured to extend in a plane containing the rotational axis for pivot pins 128, 138 when the articulated jaw 72 is closed (or almost closed) and again when the articulated jaw 72 is open (or almost open). The connection connections 124, 134 are mounted symmetrically opposed around this same plane for the first and second joints 116, 118. The distance between the pivot pins 122, 126 and between the pivot pins 132, 136 is the same for the first and second second joints 116, 118, and the distance between pivot pins 126, 128 and between pivot pins 136, 138 is the same for the first and second joints 116, 118. [0062] Figures 9A and 9B illustrate an articulation of the articulated jaw 72 by means of another cable actuation mechanism 140, according to many modalities. In the modality 140 of the cable actuation mechanism, a first traction cable 142 and a second traction cable 144 are directly coupled with the proximal end of the articulated jaw 72. The first traction cable 142 winds around a first pulley 146 of so that a pulling movement of the first pulling cable 142 rotates the articulated jaw 72 around the pivot pin 88 for the secured configuration. The second traction cable 144 winds around a second pulley 148 so that a movement of the second traction cable 144 rotates the pivot jaw 72 around the pivot pin 88 for the open configuration. Consequently, the coordinated pull and extension of the first and second pull cables of the cable actuation mechanism 140 are used to articulate the pivot jaw 72 between the open and clamped configurations. In order to provide equal or opposite cable movement (and thereby maintain cable tension in the capstan driven system described below), the air radius prescribed by cable 142 around pivot 88 is substantially the same as the radius prescribed by cable 144 around pivot 88. [0063] In many modalities, the cable actuation mechanism (ie, low force) comprises a pair of traction cables that are actuated by means of an actuation feature disposed in a proximal tool chassis. The proximal tool chassis can be configured to be releasably mounted on a robotic tool manipulator having a drive mechanism that operatively engages with the actuation feature. For example, the pair of traction cables can be wrapped around a capstan, located on the proximal tool chassis. The capstan can be operatively coupled with the capstan drive servo motor of the robotic tool manipulator when the proximal tool chassis is mounted on the robotic tool manipulator. The selective rotation of the capstan drive motor can be used to produce a corresponding capstan rotation. The capstan rotation can be used to produce a coordinated extension and retraction of the pull cables. As discussed above, the coordinated actuation of the pull cables can be used to produce a corresponding articulation of the articulated jaw of the terminal effector. [0064] In many modalities, the quick response / low force mode is provided by a cable actuation mechanism that is actionable backwards. For example, an external force applied to the pivot jaw can be used to rotate the pivot jaw into the attached configuration and drive the cable actuation mechanism backwards. With a cable actuation mechanism comprising a pair of traction cables wrapped around a capstan, an external force that rotates the articulated jaw for the attached configuration produces an increase in tension in one of the traction cables and a decrease in tension on the other pull cable, thereby making the capstan turn in response. As is known, such a cable-driven system can be configured to be sufficiently efficient to drive backwards. Likewise, an external force applied to the articulated jaw can be used to rotate the articulated jaw for the open configuration and to drive the cable actuation mechanism backwards. As discussed above, a rapid / low-force response mechanism provides a number of benefits. [0065] Alternative mechanisms can be used to provide a rapid response / low force articulation mode. For example, an actuation mechanism comprising push / pull rods can be used. [0066] Figure 10 is a cross-sectional view illustrating components of the lead screw actuation mechanism discussed above. The components illustrated include the lead screw 82, the lead driven by lead screw 84, the meat slit 86 in the terminal effector base 74, the distal trunnion surface 96, the cylindrical receptacle 154 in the terminal effector base, and the bearing proximal 98 supported by terminal effector base 74. [0067] Figure 11 is a simplified perspective view of a diagrammatic illustration of a tool assembly 170, according to many modalities. Tool set 170 includes a proximal actuation mechanism 172, an elongated shaft 174 having a proximal end and a distal end, a tool body 176 disposed at the distal end of the shaft, a movable jaw 178 with respect to tool body 176 between a stuck configuration and an open configuration, a first actuation mechanism coupled with the clamp, and a second actuation mechanism coupled with the clamp. The first actuation mechanism is operable to vary the position of the jaw with respect to the tool body between the clamped configuration and the open configuration. The second actuation mechanism has a first configuration where the clamp is kept in the clamped configuration and a second configuration where the position of the clamp with respect to the tool body is not restricted by the second actuation mechanism. The first actuation mechanism is operatively coupled with the proximal actuation mechanism. In many embodiments, the second actuation mechanism includes a cam driven by a lead screw located in the tool body which is actuated by the proximal actuation mechanism by means of a drive shaft extending through the elongated axis 174 from the actuation mechanism proximal. [0068] Tool assembly 170 can be configured for use in a variety of applications. For example, tool assembly 170 can be configured as a manual device with manual and / or automatic actuation used in the proximal actuation mechanism. Tool assembly 170 can also be configured for use in surgical applications, for example, electrocautery sealing, stapling, etc. Tool assembly 170 can have applications in addition to minimally invasive robotic surgery, for example, minimally invasive non-robotic surgery, non-minimally invasive robotic surgery, non-minimally invasive non-robotic surgery, as well as other applications where the use of described redundant jaw performance it would be beneficial. [0069] The actuation of a redundant jaw can be used to articulate a jaw of a robotic tool terminal effector. For example, figure 12 schematically illustrates a robotic tool 180 employing the actuation of a redundant jaw. The robotic tool 180 includes a proximal tool chassis 182, a drive motor 184, an instrument shaft 186, a distal terminal maker 188, a part of the first actuation mechanism 190 and a second actuation mechanism 192. The effector distal terminal 188 comprises an articulated jaw 194. The proximal tool chassis 182 is reliably mounted on a robotic tool manipulator 196 having a first drive 198, and a first actuation mechanism part 200 that engages with the first actuation mechanism part 190 of the robotic tool 180 when the proximal tool chassis 182 is mounted on the robotic tool manipulator 196. The axis of the instrument 186 has a proximal end adjacent to the tool chassis 182, and a distal end adjacent to the end effector 188. the first mechanism actuation (comprising part 200 and part 190) couples the first drive 198 to the articulated jaw 194 when the chassis of tool 182 is mounted on tool manipulator 196 in order to articulate end effector 188 between an open configuration and a fixed configuration. The second actuation mechanism 192 engages the drive motor 184 in the articulated jaw 194 in order to articulate the end effector in the configuration secured from the open configuration. The first actuation mechanism can be a cable actuation mechanism, for example, a cable actuation mechanism discussed above that provides a fast / low force response mode. In many modalities, the first actuation mechanism is actionable backwards. The second actuation mechanism may include a drive shaft that couples the drive motor 184 with the lead screw drive mechanism, for example, a lead screw drive mechanism discussed above that provides the high clamping force mode . In many embodiments, the second actuation mechanism is not actionable backwards. [0070] It is understood that the examples and modalities described here are for illustrative purposes and that various modifications or changes in the light of the same will be suggested to persons skilled in the art and should be included within the spirit and scope of this application and the scope of the attached claims . Numerous different combinations are possible, and such combinations are considered to be part of the present invention.
权利要求:
Claims (17) [0001] 1. Surgical instrument (26, 62, 170, 180) characterized by the fact that it comprises: a terminal effector (70, 188) comprising a movable jaw (72) and an opposite jaw (76), the movable jaw (72) being articulated mounted for rotation in relation to the opposite jaw (76) around a pivot jaw (88); a cable actuation mechanism (110) comprising cables (112, 114) coupled in an actuated manner to the movable jaw (72); and a lead screw actuation mechanism comprising a lead screw (82) and a cam (84) which is translated by rotation of the lead screw (82), in which the cam (84) is selectively engaged with the mobile jaw (72) through selective translation of the meat (84); wherein the cable actuation mechanism (110) is operable to articulate cables (112, 114) to move the clamp from an open position to a closed position independently of the lead screw actuation mechanism and cause the movable clamp ( 72) apply a gripping force to a fabric arranged between the movable jaw (72) and the opposite jaw (76); and wherein the lead screw actuation mechanism is operable to move the movable jaw (72) from the open to the closed position independently of the cable actuation mechanism (110), and apply force to the movable jaw (72) in a proximal side of the pivot jaw (88) to cause the movable jaw (72) to apply a clamping force to the fabric with a magnitude that exceeds any magnitude of the gripping force that can be applied to the fabric via the cable actuation mechanism ( 110). [0002] 2. Surgical instrument (26, 62, 170, 180), according to claim 1, characterized by the fact that the cable actuation mechanism (110) is operable backwards. [0003] 3. Surgical instrument (26, 62, 170, 180), according to claim 1, characterized by the fact that: a pulling motion of a first cable segment of the cable actuation mechanism (110) moves the movable jaw (72) for the open position; and a pulling motion of the second cable segment of the cable actuation mechanism (110) moves the movable jaw (72) to the closed position. [0004] 4. Surgical instrument (26, 62, 170, 180), according to claim 3, characterized by the fact that the cable actuation mechanism (110) still comprises: a first connection coupling the first cable segment with the jaw movable (72) and the opposite jaw (76); and a second connection coupling the second cable segment with the movable jaw (72) and the opposite jaw (76). [0005] 5. Surgical instrument (26, 62, 170, 180), according to claim 1, characterized by the fact that the lead screw actuation mechanism cannot be actuated backwards. [0006] 6. Surgical instrument (26, 62, 170, 180), according to claim 1, characterized by the fact that the lead screw actuation mechanism is operable to produce a clamping force between the movable jaw (72) and the opposite jaw (76) of at least 9.07 kg (20lbs). [0007] 7. Surgical instrument (26, 62, 170, 180), according to claim 1, characterized by the fact that the lead screw actuation mechanism comprises a lead screw (82). [0008] 8. Surgical instrument (26, 62, 170, 180), according to claim 7, characterized by the fact that: the lead screw actuation mechanism still comprises a cam (84) driven by lead screw (82) operatively coupled to the lead screw (82); and the movable jaw (72) comprises an interface meat surface for contact with the meat (84) driven by lead screw (82). [0009] 9. Surgical instrument (26, 62, 170, 180), according to claim 1, characterized by the fact that it still comprises an actuated device coupled with the movable jaw (72). [0010] 10. Surgical instrument (26, 62, 170, 180), according to claim 1, characterized by the fact that it still comprises: an elongated axis (174) having a proximal end and a distal end; a proximal tool chassis (182) releasably mounted to a manipulator (196) having a first drive (198), in which the elongated shaft (174) couples the proximal tool chassis (182) with the end effector (70, 188); a drive motor (184) coupled with the proximal tool chassis (182) and disposed adjacent to the proximal tool chassis (182), in which the lead screw actuation mechanism couples the drive motor (184) to the movable jaw (72). [0011] 11. Surgical instrument (26, 62, 170, 180), according to claim 10, characterized by the fact that the cable actuation mechanism (110) is activated backwards. [0012] 12. Surgical instrument (26, 62, 170, 180), according to claim 10, characterized by the fact that the handles (112, 114) extend from the proximal tool chassis (182) distally within a hole in the shaft elongated (174) by operatively coupling the movable jaw (72) to the first drive (198). [0013] 13. Surgical instrument (26, 62, 170, 180), according to claim 10, characterized by the fact that the lead screw actuation mechanism is not driven backwards. [0014] 14. Surgical instrument (26, 62, 170, 180), according to claim 10, characterized by the fact that the lead screw actuation mechanism comprises a cam (84) driven by lead screw (82). [0015] 15. Surgical instrument (26, 62, 170, 180), according to claim 10, characterized by the fact that the lead screw actuation mechanism has a first configuration where the movable jaw (72) is kept in the closed position and a second configuration in which the movable jaw (72) is not restricted by the lead screw actuation mechanism. [0016] 16. Surgical instrument (26, 62, 170, 180), according to claim 10, characterized by the fact that the lead screw actuation mechanism comprises an elongated shaft (174) mounted by rotation within a shaft hole elongated (174) and operatively coupling the movable jaw (72) to the drive motor (184). [0017] 17. Surgical instrument (26, 62, 170, 180), according to claim 1, characterized by the fact that the lead screw actuation mechanism in a first configuration holds the movable jaw (72) in a closed position that prevents the cable actuation mechanism (110) for moving the movable jaw (72).
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同族专利:
公开号 | 公开日 US20210106330A1|2021-04-15| EP3639783A1|2020-04-22| US20190021733A1|2019-01-24| KR102009224B1|2019-08-09| JP2015131160A|2015-07-23| EP2467065A2|2012-06-27| US20160106429A1|2016-04-21| CN102596058A|2012-07-18| KR20190095529A|2019-08-14| KR101859032B1|2018-05-18| JP6553232B2|2019-07-31| WO2011060311A2|2011-05-19| US20110118778A1|2011-05-19| JP5774019B2|2015-09-02| JP2013510682A|2013-03-28| US20150142047A1|2015-05-21| JP6312907B2|2018-04-18| US8876857B2|2014-11-04| KR20200017546A|2020-02-18| US10098635B2|2018-10-16| JP2018099561A|2018-06-28| CN105193469B|2018-12-04| KR102077004B1|2020-02-13| KR20180128087A|2018-11-30| CN102596058B|2015-10-21| EP2467065B1|2020-01-08| JP6163177B2|2017-07-12| KR102109626B1|2020-05-12| US10898188B2|2021-01-26| BR112012011424A2|2016-05-03| WO2011060311A3|2011-08-18| JP2017154019A|2017-09-07| KR20170039772A|2017-04-11| KR20180053770A|2018-05-23| KR101923049B1|2018-11-28| KR20120101631A|2012-09-14| KR101764780B1|2017-08-03| US9226761B2|2016-01-05| CN105193469A|2015-12-30|
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法律状态:
2018-03-27| B15K| Others concerning applications: alteration of classification|Ipc: A61B 17/072 (2006.01), A61B 17/285 (2006.01), A61B | 2019-01-08| B06F| Objections, documents and/or translations needed after an examination request according art. 34 industrial property law| 2019-07-16| B06T| Formal requirements before examination| 2020-02-04| B07A| Technical examination (opinion): publication of technical examination (opinion)| 2020-05-26| B09A| Decision: intention to grant| 2020-10-20| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 12/11/2010, OBSERVADAS AS CONDICOES LEGAIS. |
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申请号 | 申请日 | 专利标题 US26090709P| true| 2009-11-13|2009-11-13| US61/260,907|2009-11-13| PCT/US2010/056601|WO2011060311A2|2009-11-13|2010-11-12|End effector with redundant closing mechanisms| 相关专利
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