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  • 专利说明
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    • 专利摘要:
    CLIP APPLICATOR ADAPTED FOR USE WITH A SURGICAL ROBOT. The present invention relates to a clip applicator adapted for use with a surgical robot. The clip applicator comprises a stem that has clips stored in it and grips adapted to receive a clip from the stem. The rod is in mechanical communication with the robotic portion of the assembly. The robotic assembly portion contains a gear drive assembly for rotating the stem, feeding the clips inside the jaws and forming clips on the jaws.
    公开号:BR112014009401B1
    申请号:R112014009401-2
    申请日:2012-10-18
    公开日:2021-02-17
    发明作者:Shailendra K. Parihar；David T. Martin；James A. Woodard Jr.；Wells D. Haberstich
    申请人:Ethicon Endo-Surgery, Inc.；
    IPC主号:
    专利说明:

    [0001] [001] This application claims the benefit of provisional application of serial number No. 61 / 548,989, filed on October 19, 2011. BACKGROUND
    [0002] [002] The present description refers, in general, to the field of robotic surgery. In particular, the present description is related, although not exclusively, to robot-controlled surgical instruments. More particularly, the present description relates, although not exclusively, to robotically controlled clip applicator instruments that have robotically controlled features for feeding and forming robotic clips on the surgical instrument.
    [0003] [003] Many surgical procedures require the connection of blood vessels or other internal tissue. Many surgical procedures are performed using minimally invasive techniques, in which a hand instrument is used by the surgeon to perform the cut or ligation. BRIEF DESCRIPTION OF THE DRAWINGS
    [0004] [004] The invention will be more fully understood from the following detailed description, taken in conjunction with the accompanying drawings, in which:
    [0005] [005] Figure 1 is an isometric perspective view of a robotic master control station;
    [0006] [006] Figure 2 is an isometric perspective view of a robotic armored car;
    [0007] [007] Figure 3 is a cross-sectional view of a robotic arm assembly;
    [0008] [008] Figure 4 is an isometric perspective view of an alternative robotic arm car;
    [0009] [009] Figure 5 is a top isometric view of a surgical tool drive set adapted for use with a robotic surgical system;
    [0010] [010] Figure 6 is a lower isometric perspective view of a surgical tool drive set adapted for use with a robotic surgical system;
    [0011] [011] Figure 7 is an exploded view of a clip applicator rod adapted for use with a surgical tool drive assembly;
    [0012] [012] Figure 8 is an exploded view of a first expression of a surgical tool drive set adapted for use with a robotic surgical system;
    [0013] [013] Figure 9A is a joint view of the rotation mechanism of the expression of Figure 8;
    [0014] [014] Figure 9B is an isometric perspective view of the rotation mechanism of Figure 8 in operation;
    [0015] [015] Figure 10A is an overall view of the expression clip feeding mechanism in Figure 8;
    [0016] [016] Figure 10B is an isometric perspective view of the clip feeding mechanism of Figure 8 in operation;
    [0017] [017] Figure 11A is an overall view of the expression clip forming mechanism in Figure 8;
    [0018] [018] Figure 11B is an isometric view of the clip-forming mechanism of Figure 8 in operation;
    [0019] [019] Figure 12 is an exploded view of a second expression of a surgical tool drive set adapted for use with a robotic surgical system;
    [0020] [020] Figure 13A is a joint view of the expression rotation mechanism in Figure 12;
    [0021] [021] Figure 13B is an isometric perspective view of the rotation mechanism of Figure 12 in operation;
    [0022] [022] Figure 14A is an overall view of the expression clip feeding mechanism in Figure 12;
    [0023] [023] Figure 14B is an isometric perspective view of the clip feeding mechanism of Figure 12 in operation;
    [0024] [024] Figure 15A is an overall view of the expression clip forming mechanism in Figure 12;
    [0025] [025] Figure 15B is an isometric view of the clip-forming mechanism of Figure 12 in operation;
    [0026] [026] Figure 16 is an exploded view of a third expression of a surgical tool drive set adapted for use with a robotic surgical system;
    [0027] [027] Figure 17A is an overall view of the expression rotation mechanism in Figure 16;
    [0028] [028] Figure 17B is an isometric perspective view of the rotation mechanism of Figure 16 in operation;
    [0029] [029] Figure 18A is an overall view of the expression clip feeding mechanism in Figure 16;
    [0030] [030] Figure 18B is an isometric perspective view of the clip feeding mechanism of Figure 16 in operation;
    [0031] [031] Figure 19A is an overall view of the expression clip forming mechanism in Figure 16; and
    [0032] [032] Figure 19B is an isometric perspective view of the clip-forming mechanism of Figure 16 in operation. DETAILED DESCRIPTION
    [0033] [033] The uses of the phrases "in various modalities", "in some modalities", "in a (numeral) modality" or "in a (indefinite article) modality", or in "an expression" or similar, throughout descriptive report are not necessarily referring to the same modality. Furthermore, the particular resources, structures or characteristics of one or more modalities can be combined in any suitable way into one or more other modalities. Such modifications and variations are designed to be included within the scope of the present invention.
    [0034] [034] The present invention generally presents a surgical clip applicator and methods for using a surgical clip applicator for applying surgical clips to a blood vessel, duct, anastomosis, etc., during a surgical procedure. An exemplary surgical clip applicator may include a variety of features to facilitate the application of a surgical clip, as described in the present invention and illustrated in the drawings. However, the person skilled in the art will understand that the surgical clip applicator may include only some of these features and / or may include a variety of other features known in the art. The surgical clip applicator described here is intended merely to represent certain exemplifying modalities.
    [0035] [035] Over the years, a variety of minimally invasive (or "telesurgical") robotic systems have been developed to increase surgical dexterity, as well as to allow a surgeon to operate on a patient in an intuitive manner. Many of these systems are presented in the following US patents, which are each incorporated by reference in their respective entirety: US Patent No. 5,792,135, entitled "Articulated Surgical Instrument For Performing Minimally Invasive Surgery With Enhanced Dexterity and Sensitivity", US Patent No. 6,231,565, entitled "Robotic Arm DLUS For Performing Surgical Tasks", US Patent No. 6,783,524, entitled "Robotic Surgical Tool With Ultrasound Cauterizing and Cutting Instrument", US Patent No. 6,364,888, entitled " Alignment of Master and Slave In a Minimally Invasive Surgical Apparatus ", US patent No. 7,524,320, entitled" Mechanical Actuator Interface System For Robotic Surgical Tools ", US patent No. 7,691,098, entitled Platform Link Wrist Mechanism", US patent No. 7,806,891, entitled "Repositioning and Reorientation of Master / Slave Relationship in Minimally Invasive Telesurgery", and US Patent No. 7,824,401, entitled "Surgical Tool With Wristed Monopolar Electr osurgical End Effectors ". Many of these systems, however, have been unable in the past to mechanically link vessels and tissue.
    [0036] [036] Figure 1 shows a version of a master controller 1001 that can be used in connection with a 2001 robotic arm slave car of the type shown in Figure 2. The master controller 1001 and the robotic arm slave car 2001, as well as their respective components and control systems are collectively referred to herein as a robotic system 1000. Examples of such systems and devices are set out in US Patent No. 7,524,320 which has been incorporated herein by reference. Accordingly, various details of such devices will not be described in detail in this document beyond what may be necessary to understand various modalities and forms of the present invention. As you know, master controller 1001 generally includes controllers (generically represented as 1003 in Figure 1) that are held by the surgeon and manipulated in space while the surgeon observes the procedure through a stereo display 1002. Master controllers 1001 generally comprise manual insertion devices that move, preferably with multiple degrees of freedom and that often have an actionable handle to act on tools (for example, to close apprehension instruments, apply an electrical potential to an electrode or the like ).
    [0037] [037] As can be seen in Figure 2, in one form, the 2001 robotic arm car is configured to operate a plurality of surgical tools, generically referred to as 2002. Various robotic surgery systems and methods that employ master controller and robotic arm carriages are disclosed in US Patent No. 6,132,368 entitled "Multi-Component Telepresence System and Method", the complete description of which is hereby incorporated by reference. In various forms, the 2001 robotic arm vehicle includes a 2008 base from which, in the illustrated modality, three 2002 surgical tools are supported. In various forms, the surgical tools 2002 are each supported by a series of manually articulated connections, in general, called adjustment joints 2004, and a robotic manipulator 2006. These structures are illustrated in the present invention with protective covers that are extend over much of the robotic link. These protective covers can be optional and can be limited in size or eliminated entirely in some ways to minimize the inertia that is found by the servo mechanisms used to manipulate such devices, to limit the volume of moving components in order to avoid collisions and to limit the total weight of the 2001 car. The 2001 car has, in general, adequate dimensions for its transport between operating rooms. The 2001 car can be configured to typically fit on operating room doors and standard hospital elevators. In various forms, the 2001 car would preferably have a weight and would include a wheel system (or other transport) that allows the 2001 car to be positioned adjacent to an operating table by a single operator.
    [0038] [038] Now, referring to Figure 3, in at least one way, robotic manipulators 2006 can include a 3008 connection that restricts the movement of the 2002 surgical tool. In several embodiments, connection 3008 includes rigid coupled connections joined by joints rotatable in a parallelogram arrangement, so that the 2002 surgical tool rotates around a point in space 3010, as more fully described in US Patent No. 5,817,084 granted, the full description of which is incorporated herein by reference. The parallelogram arrangement restricts rotation to rotate about a 3012a axis, sometimes called a breath axis. The links that support the parallelogram connection are articulated in the 2004 adjustment joints (Figure 2) so that the surgical tool 2002 additionally rotates around a 3012b axis, sometimes called a yaw axis. The yaw and pitch axes 3012a, 3012b intersect at the remote center 3014, which is aligned along a rod 3008 of the surgical tool 12002. The surgical tool 2002 can have additional degrees of freedom driven as sustained by the 2006 handler, including the movement of slip of the 2002 surgical tool along the longitudinal axis of the "LT-LT" tool. As the surgical tool 2002 slides along the axis of the LT-LT tool in relation to the 2006 manipulator (arrow 3012c), the remote center 3014 remains attached to the base 3016 of the 2006 manipulator. Therefore, the entire manipulator is, in general, moved to reposition the remote center 3014. Link 3008 of manipulator 2006 is driven by a series of engines 3020. These engines actively move link 3008 in response to commands from a processor in a control system. As will be discussed in more detail below, 3020 engines are also used to handle the 2002 surgical tool.
    [0039] [039] An alternative fitting joint structure is illustrated in Figure 4. In this modality, a 2002 surgical tool is supported by an alternative manipulator structure 2006 'between two tissue manipulation tools. Those skilled in the art will appreciate that various embodiments of the present invention can incorporate a wide variety of alternative robotic structures including those described in US Patent No. 5,878,193 entitled "Automated Endoscope System For Optimal Positioning", the entire description of which is here incorporated by reference. Additionally, although data communication between a robotic component and the processor of the robotic surgical system is primarily described in this document with reference to the communication between the 2002 surgical tool and the master controller 1001, it should be understood that similar communication can occur between the circuits of a manipulator, an adjustment joint, an endoscope or other image capture device or the like and the processor of the robotic surgical system for the verification of component compatibility, identification of the type of component, communication of component calibration (such as displacement or similar), confirmation of coupling the component to the robotic surgical system or similar.
    [0040] [040] An exemplary 2002 non-limiting surgical tool that is well adapted for use with a robotic system 1000 that has a tool drive set 5000 that is operationally coupled to a master controller 1001 that is operable through operator inputs (ie , a surgeon) is shown in Figure 5. As can be seen in that Figure, the surgical tool 5000 includes a surgical end actuator 5004 that comprises a clip applicator. In at least one form, the surgical tool 5000 generally includes an elongated shank assembly 5001 that has a distal jaw assembly 5004. The surgical tool 5000 is operably coupled to the manipulator by a tool assembly portion, in general designated as 5003. The surgical tool 5000 additionally includes a 6010 interface (see Figure 6) that mechanically and electrically couples the tool mounting portion 5003 to the manipulator. In various embodiments, the tool mounting portion 5003 includes a tool mounting plate 5003a that operationally supports a plurality of (four are shown in Figure 6) rotating body portions, elements or driven discs 6020, which each include one, a pair of pins 6030 extending from a surface of the driven element 6020. One pin 6030 may be closer to a axis of rotation of each of the driven elements 6020 than the other pin 6030 on the same driven element 6020, the which can help to ensure positive angular alignment of the driven element 6020. The 6010 interface is adapted to engage a mounting surface on the arm 2006. The mounting portion 5003 may include an array of electrical connecting pins (not shown) that can be coupled to an electrical connection in the 2006 arm, as it is known and understood in the art. Although the 5003 interface is described herein with reference to mechanical, electrical and magnetic coupling elements, it should be understood that a wide variety of telemetry modalities can be used, including infrared, inductive coupling or the like.
    [0041] [041] Figure 7 illustrates an exploded view of an exemplary surgical clip applicator rod 5001 and claw set 5004. These clip applicator sets were previously described in US Patent Nos. 7,261,724 entitled "Surgical clip Advancement Mechanism" , 7,288,098 entitled "Force Limiting Mechanism For Medical Instrument", 7,297,149 entitled "Surgical clip Applier Methods", 7,686,820 entitled "Surgical clip Applier Ratchet Mechanism", 7,699,860 titled "Surgical clip", and 7,731,724 entitled "Surgical clip Advancement and Alignment Mechanism", whose contents are incorporated here, in their entirety, as a reference. The various components will be as described in detail below.
    [0042] [042] The stem 5001 includes an outer tube 7010 that houses the stem components, which may include a 7020 claw retainer assembly that has a 7030 claw retainer stem with a 7040 clip rail and a 7050 rod channel formed about the same. The 7060 jaws can be configured to fit to a distal end of the 7040 clip rail. The 5001 shank assembly can also include a clip advance assembly which, in an exemplary embodiment, can include a 7070 feed shoe that is adapted to be slidably arranged inside the 7040 clip rail to advance a series of 7080 clips positioned therein, and a 7090 feed bar that is adapted to guide the 7070 feed shoe through the 7040 clip rail. feeder 7090 may include a 7100 lead assembly that is adapted to fit at a distal end thereof, so as to advance the most distal clip into the 7060 jaws. The stem assembly 5001 may also include an assembly clip-forming device or a cam assembly which, in an exemplary embodiment, may include a 7120 cam which is adapted to fit slidably to the claws s 7060, and a rod 7130 that can be coupled to cam 7120 to move said cam 7120 with respect to jaws 7060. The stem assembly may also include a tissue blocker 7140 that can fit to a distal end of the 7040 clip rail, in order to facilitate the positioning of the 7060 jaws in relation to a surgical site.
    [0043] [043] First with reference to Figure 7, the jaw retainer assembly 7020 is shown and it includes an elongated and substantially flat jaw retainer 7030, with a proximal end 7030a that fits the outer tube 7010, and an end distal 7030b which is adapted to fit the 7060 claws. Although a variety of techniques can be used to fit the 7030a proximal end of the 7030 claw retainer rod to the 7010 outer tube, in the illustrated embodiment the 7030a proximal end includes formed 7035 teeth on opposite sides thereof, which are adapted to be received inside corresponding holes or openings (not shown) formed in the outer tube 7010, and a cutout 7036 formed therein that allows the opposite sides of the proximal end 7030a to bend or form a spring. In particular, the cutout 7036 allows the opposite sides of the proximal end 7030a of the jaw retainer 7030 to be compressed towards each other when the jaw retainer 7030 is inserted into the outer tube 7010. Since the teeth 7035 are aligned with the corresponding openings in the outer tube 7010, the proximal end 7030a of the claw retainer rod 7030 will return to its original uncompressed configuration, thus causing the 7035 teeth to extend into the corresponding openings to engage with the outer tube 7010.
    [0044] [044] A variety of techniques can also be used to fit the distal end 7030b of the claw retainer 7030 to the 7060 claws, however, in the illustrated embodiment, the distal end 7030b of the claw retainer 7030 includes several indentations or teeth 7035 formed therein to fit with the corresponding protrusions or teeth 7060b formed on the claws 7060. The teeth 7035 allow a proximal portion of the claws 7060 to be substantially coplanar with the stem of the claw retainer 7030.
    [0045] [045] The 7020 jaw retainer assembly may also include a 7050 rod channel formed to receive the 7130 rod, which is used to advance the 7120 cam over the 7060 jaws. The 7050 rod channel can be formed using a variety of techniques, and can have any shape and size, depending on the shape and size of rod 7130. As shown, the channel of rod 7050 is fixedly fixed, for example, by welding, to a surface upper part of the retaining rod 7030, has a substantially rectangular shape and defines a route extending through it. The dipstick channel 7050 may also extend over all or only a portion of the retaining rod 7030. The skilled person will understand that the gripper retaining assembly 7020 does not need to include a channel of the dipstick 7050 to facilitate the movement of the dipstick 7130. inside the elongated nail 5001 of the surgical clip applicator 5000.
    [0046] [046] The 7020 grapple retainer assembly may also include a 7040 clip rail fitted to or formed on it. The 7040 clip rail is shown attached to a lower surface of the 7030 clip retainer rod, and extends distally beyond the 7030b distal end of the 7030 clip retainer rod, to allow a distal end of the 7040 clip rail to remain substantially aligned with the 7060 jaws. During use, the 7040 clip rail is configured to accommodate at least one and, preferably, a series of clips. Consequently, the clip rail 7040 may include opposite side rails which are adapted to accommodate opposite legs of one or more clips therein, so that the clip legs are axially aligned with each other. In an exemplary embodiment, the 7040 clip rail can be configured to accommodate about twenty clips that are pre-arranged inside the 7040 clip rail during manufacture. The person skilled in the art will understand that the shape, size and configuration of the 7040 clip track may vary depending on the shape, size, number and configuration of the clips, or other closing devices such as clips, adapted to be received there. In addition, a variety of other techniques can be used, instead of a 7040 clip rail, to secure a clip supply with the 5001 elongated shank.
    [0047] [047] The 7040 clip rail may also include several openings formed there to receive a 7070a lock formed on a 7070 feeding shoe adapted to be arranged inside the 7040 clip rail. In an exemplary embodiment, the 7040 clip rail includes an amount of openings corresponding to at least the number of clips adapted to be pre-arranged inside the device 5000 and applied during use. The openings are preferably equidistant from each other to ensure that the latch 7070a on the 7070 supply shoe engages with an opening each time the 7070 supply shoe is advanced. Although not shown, the 7040 clip rail can include holders instead of openings, or it can include other features that allow the 7040 clip rail to engage the 7070 feed shoe and prevent distal movement, but allow proximal movement, of the 7070 feed shoe. The 7040 clip rail may also include a locking latch formed thereon, which is effective to be engaged by a corresponding locking latch formed on the 7070 feed shoe to prevent movement of the 7070 feed shoe. beyond a more distal position. The locking latch can have a variety of configurations, but in an exemplary embodiment it is in the form of two adjacent flaps that extend towards each other to enclose a portion of the clip track, thus allowing the clips to pass through it .
    [0048] [048] In order to facilitate the proximal movement of the 7070 feeding shoe within the 7040 clip rail, the 7070 feeding shoe can also include a 7070a lock formed on the lower surface thereof, to allow the 7070 feeding shoe to be engaged by the 7090 feed bar as the 7090 feed bar moves distally. The lower latch 7070b is similar to the upper latch 7070a in that it can be placed proximally at an angle. During use, each time the 7090 feed bar is moved distally, a stopper formed on the 7090 feed bar can engage the lower latch 7070b and move the 7070 feed shoe distally by a predetermined distance within the 7040 clip rail. The 7090 feed bar can then be moved proximally to return to its initial position, and the angle of the lower 7070b lock will allow the lock to slide into the next stop formed on the 7090 feed bar. other resources, other than locks and openings or holders, to control the movement of the 7070 feed shoe within the 7040 clip rail.
    [0049] [049] As previously mentioned, the 7070 feeding shoe can also include a lock formed thereon that is adapted to block the movement of the 7070 feeding shoe when it is in the most distal position and there are no clips left on the 5000 device. the lock can have a variety of configurations, a third lock can be formed on the 7070 feed shoe and extend in a lower direction to interconnect a lock lock formed on the 7040 clip rail, as is known and understood in the art . The third latch is positioned in such a way that it will engage the lock latch 7090a on the 7040 clip rail when the 7070 feed shoe is in a more distal position, thereby preventing movement of the 7070 feed shoe and 7090 feed bar when the clip supply is depleted.
    [0050] [050] As shown, the 7090 feed bar has a generally elongated shape with proximal and distal ends. The proximal end of the feed bar 7090 can be adapted to fit a feed bar coupler 7200. The feed bar coupler 7200 can couple a variety of feed connections that are effective, after actuation, to slide the feed bar 7090 in a distal direction on the elongated stem 5001, 7010, thus advancing a clip into the 7060 jaws.
    [0051] [051] Referring still to Figure 7, an exemplary embodiment of the 7060 jaws is shown. As previously mentioned, the 7060 jaws can include a proximal portion that has 7060b teeth for coupling with corresponding 7035 teeth formed on the 7030 jaw retainer stem However, other techniques can be used to fit the 7060 claws to the 7030 claw retainer rod. For example, a dovetail fitting, a male-female connection, etc. can be used. Alternatively, the 7060 jaws can be integrally formed with the retaining rod 7030. The distal portion of the 7060 jaws can be adapted to receive a clip between them, and thus the distal portion can include first and second opposing jaw elements that are movable. relative to each other. In an exemplary embodiment, the claw elements are forced into an open position, and a force is required to move the claw elements towards each other. Each of the claw elements can include a groove formed on opposite internal surfaces thereof, intended to receive the legs of a clip in alignment with the claw elements. Each of the clamping elements may also include a cam track, formed thereon to allow the cam 7120 to engage with the clamping elements and move them towards each other. In an exemplary embodiment, the cam track is formed on an upper surface of the claw elements.
    [0052] [052] An example 7120 cam for sliding coupling and engagement with the claw elements, as shown in Figure 7. The 7120 cam can have a variety of configurations, but in the illustrated mode it includes a proximal end 7120a which is adapted to fit a rod 7130, and a distal end which is adapted to engage the claw elements. A variety of techniques can be used to fit the cam 7120 to the rod 7130, but in the illustrated example, the cam 7120 includes a female or locking element formed therefrom and adapted to receive a male or key element 7130a formed at the end distal from rod 7130. As shown, the male element 7130a has a shape that corresponds to the shape of the cutout, to allow the two elements 7120 and 7130 to fit together. The person skilled in the art will understand that the cam 7120 and the rod 7130 can optionally be integrally formed with each other. The proximal end 7130b of rod 7130 can be adapted to fit a closing link assembly to move rod 7130 and cam 7120 with respect to grips 7060.
    [0053] [053] Although a variety of techniques can be used, in the exemplary embodiment illustrated, the distal end 7120b includes a cam channel or a tapered recess formed therein to receive the cam track in the claw elements slidingly. During use, the cam 7120 can be advanced from a proximal position in which the claw elements are spaced apart from one another, to a distal position in which the claw elements are positioned adjacent to each other and in a closed position. As the cam 7120 is advanced over the clamping elements, the tapered recess will push the clamping elements towards each other, thus crimping a clip arranged between them.
    [0054] [054] Now with reference to Figure 8, an exploded view of a 5000 clip applicator expression is shown. In this expression, the 5000 clip applicator includes rotating bodies or coils 8010a, 8010b, 8010c and are coupled to the rotating bodies or elements driven 6020. The coils 8010a, b, c can be formed integrally with the driven elements 6020. In other expressions, the coils can be formed separately from the driven elements 6020 provided that the coils 8010a, b, c and the 6020 elements are fixedly coupled. such that the insertion of the elements 6020 causes the coils to rotate 8010a, b, c. Each coil 8010a, b, c is coupled to a gear train or drive assembly for converting movement to the 7010 axis (or external tube) to rotate the axis, advancing a clip and forming a clip. As shown, coils 8010a, b, c interface with coil bearings 8030 seated between coils 8010a, b, c and mounting plates 5003a to facilitate smooth transfer of the forced rotation of the corresponding drive elements over the 2006 robotic arm The 8030 bearings can also be supplied to support and stabilize the assembly of the 8010a, b, c, and c coils to reduce the rotational friction of the rod and gears, for example.
    [0055] [055] In the expression of Figure 8, the tool mounting portion 5003 of the clip applicator 5000 comprises a rod assembly rotation mechanism. In the illustrated expression, for example, the surgical tool 5000 comprises a first spiral worm gear 8020 coupled to a rotating body 6020 and a second spiral worm gear 8015 coupled to the stem assembly 5001. A bearing 8030 is coupled to the coil 8010a and is supplied between a driven element 8010a and the mounting plate 6010. The first spiral worm gear 8020 is attached to the second spiral worm gear 8015, which is coupled to the rod assembly 5001 , to control the rotation of the stem assembly 5001 in a clockwise and counterclockwise direction based on the rotational direction of the first and second spiral worm gears 8015 and 8020. Consequently, the rotation of the first worm gear Spiral worm 8020 around the first axis is converted into rotation of the second screw gear Spiral worm 8015 around the second axis, which is orthogonal to the first axis. As shown in Figures 9A and 9B, for example, a counterclockwise rotation of the coil 8010a results in the rotation of the first spiral worm gear 8020 in a counterclockwise direction which, in turn, rotates the stem assembly 5001 in the direction indicated in Figure 9A, that is, hourly. It is understood that the coil can be rotated gradually to provide a precise rotation of the rod. This precise rotation can be activated by an electrical interface between the user console 1000 and the clip applicator 5000 driven by a software algorithm, as it is known and understood in the art. The rod 5001 can be rotatably attached to the mounting set 5010 by means of the bearing jaw 8040, comprised of the jaw halves 8040a and 8040b. The stem 5001 is provided with a stem collar 8050 fixed firmly to stem 5001 and worm gear 8015 that allows the transfer of rotational force from worm gear 8015 to stem 5001. The halves of claw 8040a and 8040b act as a bearing and involve the stem collar 8050 and are provided with recesses to allow free rotation of stem 5001, while preventing the linear movement of stem 5001. In this expression, the claw collar 8050 is equipped with an annular flange 8050b to fit into the recesses of the 8040 jaw and prevent axial movement.
    [0056] [056] Still referring to the expression in Figure 8, the tool mounting portion 5003 of the clip applicator 5010 comprises a clip feeding mechanism for feeding clips inside the claws 7060. In the expression illustrated in the example, the surgical tool 5000 comprises a rack gear mechanism to provide clip feeding functionality. An 8100 feed gear is coupled to a coil 8010c so that rotation of the corresponding driven element 6020 causes the coil 8010c and the feed gear 8100 to rotate in a first direction. In the expression of Figure 8, the feed gear 8100 is a pinion gear coupled to a feed rack gear 8110, which moves in a linear direction. The rack gear 8110 is coupled to the feed bar coupler 7200 by pins 8110a, which are firmly attached to the feed bar 7030, as described above. As shown, feed rack 8110 is provided with cut-out portions configured to nest with a similar cutting portion on training rack 8200 so that the feed and training rack together surround rod 5001 and have a contiguous outside diameter , although they move independently of each other. The feeding rack 8110 is configured with an annular portion in which the portion of the external annular surfaces comprises the teeth of the rack. The feed rack 8110 additionally comprises a flange portion adapted to slide into a similar flange on the forming rack 8200. The tool mounting portion is additionally provided with a 8210 rack blade and rack groove (no shown on the cover 8000 adapted to receive the feed rack 8110 and the flanges of the training rack 8200 together and adapted to hold the feed rack 8110 and the training rack 8200 in a fixed rotational position relative to the mounting portion of the tool 5003, while allowing linear movement.
    [0057] [057] In operation, with reference to Figures 10A and 10B, the feed pinion 8100 is fitted to the feed rack 8110 in the mounting portion of the tool 5003. The feed coil 8010c is rotated in a counterclockwise direction that, for example, turn the 8100 feed pinion in a counterclockwise direction. In the present expression, the drive pinion 8100 is rotated sufficiently to advance the 8110 rack distally enough to advance a clip completely into the 7060 jaws. The travel distance of the 8110 rack can vary based on several factors, for example example, clip leg length, claw length. In the present expression, the feed rack travels approximately 0.64 centimeters (0.25 inches). The rotation of the 8100 feed pinion can be precisely controlled by an electrical and software interface to provide the exact path of the 8110 feed rack needed to feed a clip inside the 7060 jaws. After applying a clip inside the jaws or after a predetermined amount of rotation of the feed pinion 8100, the rotation of the pinion 8100 is reversed in a clockwise direction to move the feed rack 8110 in a proximal direction, and in turn move the feed bar coupler 7200 proximally , which in turn moves the feed bar 7030 proximally, as described above. This process can be repeated several times to accommodate a predetermined number of clips resident on the axis. The software interface can be programmed to count the number of clips fed into the claws and display it to the user, and can also prevent the user from trying to feed another clip when the rod is empty. It is contemplated that the software interface can alert the user when the rod contains a predetermined number of clips.
    [0058] [058] Again with reference to Figure 8, the tool mounting portion 5003 of the clip applicator 5000 comprises a clip forming mechanism for feeding clips into the jaws 7060. In the expression illustrated for example, the surgical tool 5000 comprises a mechanism rack gear to provide clip-forming functionality. A forming gear 8300 is coupled to a coil 8010b so that rotation of the corresponding driven element 6020 causes coil 8010b and forming gear 8300 to rotate in a first direction. In the expression of Figure 8, the forming gear 8300 is a pinion gear fitted to a feed rack gear 8200, which moves in a linear direction. The rack gear 8200 is coupled to the male end 7130b of the drive rod 7130, as described above and is locked in place around the rod 5001 with a lock assembly 8400. As shown, the training rack 8200 is configured to nest with the feed rack 8110, so that the feed and training racks surround the rod 5001, but move independently of each other. The training rack 8200 is configured with an external annular surface on which a portion of the external annular surfaces comprise rack teeth which are adapted to fit the pinion gear 8300. The training rack 8200 additionally comprises a flange portion adapted to fit sliding on a similar flange on the 8110 forming rack, as described above. Together, the flanges of the feed rack 8010 and the training rack 8200 fit into the groove through the cover 8000 to allow linear movement while preventing lateral or pivoting movement.
    [0059] [059] In operation, now with reference to Figures 11A and 11B, the forming pinion 8300 is rigidly fixed to the coil 8010b and is fitted to the rack 8200 in the mounting portion of the tool 5003. Once the feeding function is complete and if a clip is present in the claws, the coil 8010b rotates in a clockwise direction, giving pinion 8300 a clockwise rotation, which in turn drives rack 8200 in a distal linear direction. This linear distal movement of the rack 8200 drives the drive rod 7130 in a distal linear direction that drives the cam 7120 over the claws 7060 by forming or crimping a clip on the claws 7060, as described above.
    [0060] [060] The rotation of the 8300 pinion can be precisely controlled to give a sufficient number of revolutions to advance the rack 8200 at a predetermined distance to form a complete clip. Alternatively, the 8300 pinion can be rotated slowly and stopped to allow the partial formation of a clip around an anatomical structure that allows the movement of the clip in a state inferior to that completely formed around an anatomical structure. After the location of the clip's position is selected, the pinion 8300 can be rotated so that a clip is completely formed, causing the occlusion of an anatomical structure. When a clip is installed, the pinion 8300 is rotated in a counterclockwise direction, which activates the rack 8200 in a proximal direction, moving the 7130 drive rod proximally, which activates the cam 7120 proximally, allowing the 7060 claws to open. It is contemplated that the opening and closing of the 7060 jaw can be done independently of the clip feed, thus allowing stability tests to be carried out to allow the user to use the 7060 jaws of the 5000 clip applicator as a dissector.
    [0061] [061] Now with reference to Figure 12, a second expression of clip applicator 5000 is shown. In the expression of Figure 12, the tool mounting portion 5003 of the clip applicator 5000 comprises a mechanism for rotating the shank assembly. In the expression illustrated in the example, surgical tool 5000 comprises a pivot point 12100 coupled to coil 8101a. A first end of a 12150 cable is firmly attached to the rotating core of the upper portion 12100a. The 12150 cable encircles and rotates the 12115 rod or coil coupler where the rod coupler is firmly attached to the 5001 rod. A second end of the 12150 cable is firmly attached to an inner portion 12100b of the 12100 core. As shown, the 12150 cable it twice surrounds the 12115 stem coupler to allow 720 ° rotation in one direction. The cable-core coupler assembly controls the rotation of the stem assembly 5001 in a clockwise and counterclockwise direction based on the rotational direction of the core 12100. Consequently, the rotation of the core 12100 around the outside diameter of a first axis is converted into rotation of the 12115 coupler around the outside diameter of a second geometry axis, which is orthogonal to the first geometry axis. As shown in Figures 13A and 13B, for example, a counterclockwise rotation of the coil 8010a results in the rotation of the core 12100 in a counterclockwise direction which, in turn, applies tension to the cable 12150 in the lower portion of the core 12100b. This tension on cable 12110 at the bottom of core 12100b causes the stem coupler to rotate in a clockwise direction as shown in Figure 13A. Similarly, the clockwise rotation of the core 12100 applies tension to the cable 12150 at the upper end of the core 12100a, causing the counterclockwise rotation of the coil 12115, and causing the counterclockwise rotation of the 8050 coupler and the concomitant counterclockwise rotation of the rod. 5001. It is understood that the coil 8010a can be rotated gradually to provide a precise rotation of the rod. This precise rotation can be activated by an electrical interface between the user console 1000 and the clip applicator 5000 driven by a software algorithm, as it is known and understood in the art. The rod 5001 can be rotatably attached to the mounting set 5010 by means of the claw 8040, comprised of the claw halves 8040a and 8040b. The stem 5001 is provided with a stem collar 8050 firmly attached to stem 5001 and coupler 12115 that allows the transfer of rotational force to stem 5001. The halves of claw 8040a and 8040b surround the stem collar 8050 and are provided with recesses to allow free rotation of the stem 5001, while preventing the linear movement of the stem 5001. In the present expression, the collar of the claw 8050 is provided with an annular flange 8050b to fit in the recesses of the claw 8040 and prevent axial movement .
    [0062] [062] Still referring to the expression in Figure 12, the tool 5003 mounting portion of the clip applicator 5000 comprises a clip feeding mechanism for feeding clips into the grips 7060, as shown in Figures 14A and 14B. In the expression illustrated in the example, surgical tool 5000 comprises a rack 12110 and worm gear mechanism 12210 to provide the clip feeding functionality. The worm gear 12210 is comprised of helical threads mounted on a shank, the shank being rotatably attached to the shank of the 14110 shank. The 14110 shanks allow free rotation and prevent axial movement of the shank from the shank. worm thread 12210. Worm gear 12210 is coupled to a coil 8010c by a cable attached to coil 8010c in the upper and lower locations (not shown), so that the rotation of the corresponding driven element 6020 causes the 8010c coil rotates by selectively applying tension to the worm gear cable 12210 in both the upper and lower positions of the 8010c coil, depending on the direction of rotation of the coil. As shown in this expression, rack 12110 moves in a linear direction and is attached to feed bar coupler 7200. In the expression in Figure 12, worm gear 12210 is fitted to a feed rack gear 12110 , which moves in a linear direction. As shown, the feed rack 12110 is provided with a cutout portion configured to nest with a similar cutout portion on the forming rack. The feed rack 12110 is configured with a rectangular outer surface with one side of the rectangular outer portion comprising the teeth of the rack. The feed rack 12110 additionally comprises a flange portion with a groove. The tool mounting portion is additionally provided with a rectangular pin located on the cover 8000 adapted to fit in the slot of the feed rack 12110b so that it fits the pin and the groove 12110b, keeping the rack 12110 in a fixed lateral position in relation to the mounting portion of tool 5003, while allowing linear movement.
    [0063] [063] In operation, worm gear 12210 is fitted to feed rack 12110 so that when worm gear 12210 is rotated in a first or second direction, rack 12110 is moved linearly in one corresponding first or second direction. As shown in Figure 14A, counterclockwise rotation of coil 8010c selectively applies tension to the worm gear cable causing the worm gear 12210 to rotate in a clockwise direction. The hourly rotation of the worm gear 12210 provides linear distal movement to the rack 12110, which in turn moves the feed bar coupler, causing the feed bar 7030 to move in the distal position, as described above. In the present expression, worm gear 12210 is rotated sufficiently to advance rack 12110 distally enough to fully advance a clip into the 7060 jaws. The travel distance of rack 12110 may vary based on several factors, for example, clip leg length, claw length. In the present expression, the feed rack travels approximately 0.64 centimeter (0.25 inch). The rotation of the 12110 worm gear can be precisely controlled by an electrical and software interface to provide the exact path of the 12210 feed rack needed to feed a clip inside the 7060 jaws. After applying a clip inside of the jaws or after a predetermined amount of rotation of the worm gear 12210, the rotation of the worm gear 12210 is reversed in a clockwise direction to move the feed rack 12110 in a proximal direction, and in turn move the feed bar coupler 7200 proximally, which in turn moves the feed bar 7030 proximally, as described above. This process can be repeated several times to accommodate a predetermined number of clips resident on the axis. The software interface can be programmed to count the number of clips fed into the claws and display it to the user, and can also prevent the user from trying to feed another clip when the rod is empty. It is contemplated that the software interface can alert the user when the rod contains a predetermined number of clips.
    [0064] [064] Again with reference to Figures 12 and 15A and 15B, the tool mounting portion 5003 of the clip applicator 5010 comprises a clip forming mechanism for feeding clips into the claws 7060. In the expression illustrated expression for example, the surgical tool 5000 comprises a rack and worm gear mechanism to provide clip forming functionality. A worm gear forming 12300 is comprised of helical teeth mounted on a rod 12330 (see Figure 15A) where the rod 12330 is mounted on a crank 12320. The worm gear 12300 is coupled to a coil 8010b in the upper and lower portions of the coil rod 8010b by a cable 12310, so that rotation of the corresponding driven element 6020 causes the coil 8010b and the worm gear 12300 to rotate in a first direction. In the expression of Figure 12, the worm gear 12300 is fitted to a feed rack gear 12200, which moves in a linear direction. This locking arrangement prevents crank 12320 and worm gear 12300 from rotating when coil 8010b is rotated. Rack gear 12200 is coupled to male end 7130b of drive rod 7130. Forming rack 12200 is configured with a rectangular outer surface on which one side of the outer surface comprises rack teeth that are adapted to fit the helical teeth of the gear worm thread 12300. The forming rack 12200 additionally comprises a flange portion with a groove 12200b. The mounting portion of the tool is additionally provided with a rectangular pin located on the cover 8000 adapted to fit in the slot of the feed rack 12200b so that the socket of the pin and the groove 12200b keeps the rack 12200 in a fixed lateral position in relation to a central axis of the stem 5001.
    [0065] [065] In operation, now with reference to Figures 15A and 15B, the forming worm gear 12300 is surrounded by a cable that is fixedly connected to the lower and upper portions of the coil 8010b and is fitted to the rack 12200 in the portion mounting tool 5003. Once the feed function is complete and a clip is present on the claws, the 8010b coil rotates in a counterclockwise direction, providing an anti-clockwise rotation in relation to the 12300 worm gear which in turn drives rack 12200 in a distal linear direction. This linear distal movement of the rack 12200 drives the drive rod 7130 in a distal linear direction that drives the cam 7120 over the claws 7060 by crimping a clip, as described above.
    [0066] [066] The rotation of the worm gear 12300 can be precisely controlled to give a sufficient number of revolutions to advance the rack 12200 by a predetermined distance to form a complete clip. Alternatively, the worm gear 12300 can be rotated slowly and stopped to allow the partial formation of a clip around an anatomical structure that allows the movement of the clip in a lower state than that completely formed around an anatomical structure. After the location of the clip position is selected, the worm gear 12300 can be rotated so that a clip is fully formed, causing an anatomical structure to occlude. When a clip is installed, coil 8010b is driven in a clockwise direction, which in turn rotates worm gear 12300 in a clockwise direction, which drives rack 12200 in a proximal direction, moving the drive 7130 proximally, which drives the cam 7120 proximally, allowing the claws 7060 to open. It is contemplated that the opening and closing of the 7060 jaw can be done independently of the clip feed, thus allowing stability tests to be carried out to allow the user to use the 5000 clip applicator as a dissector.
    [0067] [067] Now with reference to Figure 16, an exploded view of a third expression of the present clip applicator 5000 is shown. In this expression, the clip applicator 5000 includes rotating bodies or coils 8010a, 8010b, 8010c and are coupled to the rotating bodies or driven elements 6020. The coils 8010a, b, c can be formed integrally with the driven elements 6020. In other expressions, the coils can be formed separately from the driven elements 6020 provided that the coils 8010a, b, c and the 6020 elements are coupled fixed so that the insertion of the elements 6020 causes the coils 8010a, b, c to rotate. Each coil 8010a, b, c is coupled to a gear train or drive assembly for converting movement to the 7010 axis to rotate the axis, advancing a clip and forming a clip. As shown, coils 8010a, b, c interface with coil bearings 8030 seated between coils 8010a, b, c and mounting plates 5003 to facilitate smooth transfer of the forced rotation of the corresponding drive elements over the 2006 robotic arm The 8030 bearings can also be supplied to support and stabilize the assembly of the 8010a, b, c, and c coils to reduce the rotational friction of the rod and gears, for example.
    [0068] [068] In the expression of Figure 16, the tool mounting portion 5003 of the clip applicator 5000 comprises a rod assembly rotation mechanism. In the expression illustrated in the example, the surgical tool 5000 comprises a rotation core 16100 coupled to the coil or pulley 16110 by the cable 17150 (see Figure 17A). A first end of a 17150 cable is firmly attached to the rotating core of the upper portion 16100a. The 17150 cable encircles and rotates the 16110 rod or coil coupler where the rod coupler is firmly attached to the 5001 rod. A second end of the 17150 cable is firmly attached to an inner portion 16100b of the 16100 core. As shown, the 17150 cable it twice surrounds the 16110 stem coupler to allow 720 ° rotation in one direction. The cable-core coupler assembly controls the rotation of the stem assembly 5001 in a clockwise and counterclockwise direction based on the rotational direction of the core 16100. Consequently, the rotation of the central part 16100 around the outside diameter of a first axis is converted in rotation of the 16110 coupler around the outside diameter of a second geometry axis, which is orthogonal to the first geometry axis. As shown in Figures 17A and 17B, for example, a counterclockwise rotation of the coil 8010a results in the rotation of the core 16100 in a counterclockwise direction which, in turn, applies tension to the cable 17150 in the lower portion of the core 16100b. This tension on the 17150 cable at the bottom of the 16100b core causes the stem coupler to rotate in a clockwise direction as shown in Figure 17A. Similarly, clockwise rotation of core 16100 applies tension to cable 12110 at the upper end of core 16100a, causing counterclockwise rotation of coil 16100, and counterclockwise rotation of coupler or coil 16110 and concomitant counterclockwise rotation. hourly spindle 5001. It is understood that the coil 8010a can be rotated gradually to provide a precise rotation of the spindle. This precise rotation can be activated by an electrical interface between the user console 1000 and the clip applicator 5000 driven by a software algorithm, as it is known and understood in the art. The rod 5001 can be rotatably attached to the mounting set 5010 by means of the claw 16040, comprised of the claw halves 16040aa and 16040b. The stem 5001 is provided with a stem collar 16050 firmly attached to stem 5001 and the coupler or coil 16110 that allows the transfer of rotational force to stem 5001. The halves of claw 16040a and 16040b surround the stem collar 16050 and are provided recesses to allow free rotation of stem 5001, while preventing linear movement of stem 5001. In this expression, claw collar 16050 is provided with an annular flange 16050b to fit into the recesses in claw 8040 and avoid axial movement while allowing rotation.
    [0069] [069] Still referring to the expression in Figure 16, the tool mounting portion 5003 of the clip applicator 5010 comprises a clip feeding mechanism for feeding clips inside the claws 7060. In the expression illustrated in the example, the surgical tool 5000 comprises a feed crank, connecting rod and sliding element assembly to provide clip feeding functionality. A feed handle 16200 is coupled to a coil 8010b by a pin 16200b, so that rotation of the corresponding driven element 6020 causes coil 8010b and feed handle 16200 to rotate in a first direction. In the expression of Figure 16, the feed handle 16200 is a circular crank connected to the feed slide element 16500 through a feed connection rod 16300, in which the angular movement of the feed handle 16200 is converted to the linear movement of the element feed slider 16500 via connecting rod 16300. The feed slider 16500 is coupled to the feed bar coupler 7200 to substantially circulate the coupler 7200 where sliding element 16500 is provided with angular recesses that fit into the angular flanges of the coupler 7200. Coupler 7200 is firmly attached to feed bar 7030, as described above.
    [0070] [070] In operation, with reference to Figures 18A and 18B, the feed handle 16200 is connected to the feed slide element 16500 by the connecting rod 16300 in the mounting portion of the tool 5003. The feed coil 8010b is rotated in one direction counterclockwise, which in turn turns the 16200 feeder in a counterclockwise direction. In the expression in Figure 18A, the feed connection rod 16300 is connected to the feed handle 16200 on a side opposite to a geometric axis defined by the rod 5001. In this arrangement, the counterclockwise rotation of the crank 16200 causes the connection 16300 moves in a distal direction, thus causing the sliding element 16500 to move in the distal position, causing the feed bar 7030 to move in the distal position, advancing one into the 7060 jaws. expression, the feed handle 16200 is rotated sufficiently to move the connecting rod 16300 and the sliding element 16500 in a distal position enough to fully advance a clip into the 7060 jaws. The travel distance of the sliding element 16500 can vary based on several factors, for example, clip leg length, claw length. In the present expression, the feed rack travels approximately 0.64 centimeter (0.25 inch). The feed handle 16200 can be precisely controlled by an electrical and software interface to provide the 16500 feed sliding element needed to feed a clip inside the 7060 jaws. After applying a clip inside the jaws or after an amount predetermined rotation of the feed handle 16200, the crank rotation 16200 is reversed in a clockwise direction to move the feed connection rod 16300 and the sliding element 16500 in a proximal direction, in turn moving the coupler of the feed bar feed 7200 proximally, which in turn moves the feed bar 7030 proximally, as described above. This process can be repeated several times to accommodate a predetermined number of clips resident on the axis. The software interface can be programmed to count the number of clips fed into the claws and show it to the user, and can also prevent the user from trying to feed another clip when the rod is empty. It is contemplated that the software interface can alert the user when the rod contains a predetermined number of clips.
    [0071] [071] Again with reference to Figure 16, the tool 5003 mounting portion of the clip applicator 5000 comprises a clip forming mechanism for feeding clips into the claws 7060. In the expression illustrated in the example, the surgical tool 5000 comprises a crank, connecting rod and sliding forming element to provide clip forming functionality. A forming crank 16600 is coupled to a coil 8010c by pin 16600b, so that rotation of the corresponding driven element 6020 causes coil 8010b and forming crank 16600 to rotate in a first direction. In the expression of Figure 16, the forming crank 1600 is in mechanical communication with the forming sliding element 16700 through the forming crank. The angular rotation of the crank 16600 causes the linear movement of the connecting rod 16800 which moves from the forming slide member 16700 in a linear direction. The forming slide element 16700 is comprised of the halves of the slide element 16700a and 16700b that substantially encircle and couple the male end 7130b of the drive rod 7130, as described above.
    [0072] [072] In operation, now with reference to Figures 19A and 19B, the forming crank 16600 is rigidly attached to coil 8010b by pin 16600 in the mounting portion of tool 5003. Once the feed function is complete and a clip is present in the claws, the 8010c coil rotates in a counterclockwise direction, giving the 16600 forming crank a counterclockwise rotation. The connecting rod 16800 is attached to the 16600 crank on a surface between the coil rod 8010c and the rod of the 5001 clip applicator, so that the counterclockwise rotation of the 16600 crank provides distal linear movement (in a direction facing the 7060 jaws) to form the connecting rod 16800. The distal linear movement of the connecting rod 16800 pushes the element forming slide 16700 in a distal linear direction that drives the 7130 drive rod in a distal linear direction that drives the 7120 cam over the 7060 claws, thereby crimping a clip on the 7060 claws, as was described above.
    [0073] [073] Crank rotation 16600 can be precisely controlled to provide a sufficient number of revolutions to move connecting rod 16800 and sliding element 16700 by a predetermined distance to form a complete clip. Alternatively, the 16600 crank can be rotated slowly and stopped to allow the partial formation of a clip around an anatomical structure that allows the movement of the clip in a state lower than that completely formed around an anatomical structure. After the clip's location is selected, the 16600 crank can be rotated so that a clip is fully formed, causing an anatomical structure to occlude. When a clip is installed, crank 16600 is rotated in a clockwise direction, connecting rod 16800 and slide element 16700 in a proximal direction, moving the 7130 drive rod proximally, which drives the cam 7120 proximally, allowing the 7060 jaws to open. It is contemplated that the opening and closing of the 7060 jaw can be done independently of the clip feed, thus allowing stability tests to be carried out to allow the user to use the 5000 clip applicator as a dissector.
    [0074] [074] Some aspects can be described using the expression "coupled" and "connected" together with their derivatives. It must be understood that these terms are not conceived as synonymous with each other. For example, some aspects can be described using the term "connected" to indicate that two or more elements are in direct physical contact or in electrical contact with each other. In another example, some aspects can be described using the term "coupled" to indicate that two or more elements are in direct physical contact or in electrical contact. The term "coupled", however, can also mean that two or more elements are not in direct contact with each other, but still cooperate or interact with each other.
    [0075] [075] Although the examples of the present invention are described primarily in the context of mechanical clip-applying instruments, it should be understood that the teachings of the present invention can be easily applied to a variety of other types of medical instruments. Just as an example, the teachings of the present invention can easily be applied to tissue claws, tissue scissors, surgical dissectors, or a variety of energy-based surgical instruments, etc. It should also be understood that the teachings of the present invention can be easily applied to any of the instruments described in any of the references cited in the present invention, so that the teachings of the present invention can be easily combined with the teachings of any of the references cited in the present invention in various ways. Other types of instruments in which the teachings of the present invention can be incorporated will be apparent to those skilled in the art.
    [0076] [076] It is understood that any patent, publication, or other description material, in whole or in part, which is said to be incorporated into the present invention for reference purposes, is incorporated into the present invention only if the incorporated material does not enter in conflict with existing definitions, statements, or other description material presented in this description. Accordingly, and as far as necessary, the description as explicitly stated herein replaces any conflicting material incorporated herein by way of reference. Any material, or portion thereof, that is deemed to be incorporated by reference in the present invention, but which conflicts with definitions, statements, or other description materials existing herein will be incorporated here only to the extent that no conflict will appear between the embedded material and the existing description material.
    [0077] [077] Modalities or expressions of devices and components of the same disclosed in the present invention have application in conventional open and endoscopic surgical instrumentation, as well as in robot assisted surgery.
    [0078] [078] Modalities of the devices described in the present invention can also be designed to be discarded after a single use, or to be used multiple times. Modalities can, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning can include any combination of steps to disassemble the device, followed by cleaning or replacing particular parts, and subsequent reassembly. In particular, modalities of the device can be disassembled, in any number of particular parts or parts of the device can be selectively replaced or removed in any combination. With the cleaning and / or replacement of particular parts, modalities of the device can be reassembled for subsequent use in a reconditioning facility or by a surgical team immediately before a surgical procedure. Those skilled in the art will understand that the reconditioning of a device can use a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques, and the resulting refurbished device are all within the scope of the present application.
    [0079] [079] Just as an example, the modalities described here can be processed before surgery. First, a new or used instrument can be obtained and, if necessary, cleaned. The instrument can then be sterilized. In a sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK pouch. The container and instrument can then be placed in a radiation field, which can penetrate the container, such as gamma radiation, X-rays or high-energy electrons. The radiation can exterminate bacteria on the instrument and the container. The sterile instrument can then be stored in a sterile container. The sealed container can keep the instrument sterile until it is opened at the medical facility. The device can also be sterilized using any other known technique, including, but not limited to, beta or gamma radiation, ethylene oxide or water vapor.
    [0080] [080] Having shown and described various modalities of devices and components of the present invention, further adaptations of the methods and systems described in the present invention can be made by means of suitable modifications by an element skilled in the art without departing from the scope of the present invention. Several of these possible modifications have been mentioned, and others will be evident to the elements versed in the technique. For example, the examples, modalities, geometry, materials, dimensions, proportions, steps and the like discussed above are illustrative and are not necessary. Consequently, the scope of the present invention should be considered in accordance with the terms of the following claims and it is understood that it is not limited to the details of the structure and operation shown and described in the specification and drawings.
    [0081] [081] Although certain features of the aspects have been illustrated as described here, many modifications, substitutions and equivalent changes will now be evident to those skilled in the art. Therefore, it should be understood that the appended claims are designed to cover all such modifications and changes as being within the true scope of the disclosed modalities.
    权利要求:
    Claims (2)
    [0001]
    Surgical fixation instrument (5000), characterized by the fact that it comprises: an end actuator having a claw assembly (5004) capable of holding and implanting a clip in the fabric; a stem assembly (5001) capable of rotating about an axis that interfaces operationally with the end actuator for transmitting an actuating motion to the end actuator where the stem assembly (5001) contains at least one clip; and a gear drive train connected to the rod assembly (5001), the gear drive train is configured to receive power and control from a robotic system, the gear drive train being adapted to separately control the rotation from the stem set (5001), opening and closing the claws (7060) and advancing the stem clip to the claw set; on what the gear drive train comprises a pinion (8020) in mechanical communication with a worm gear (8015) in which the worm gear (8015) is attached to the rod assembly (5001) so that the rotation of the pinion (8020) in a first direction rotates the stem assembly (5001) in a first direction; and in what the gear drive train still comprises a second pinion (8100) in mechanical communication with the first rack (8110), the first rack (8110) being in mechanical communication with a clip feeding set, so that rotation of the pinion (8100) in a first direction moves the first rack (8110) in a first linear direction, advancing the clip on the stem assembly (5001).
    [0002]
    Instrument according to claim 1, characterized by the fact that the gear drive train still comprises a third pinion (8300) in mechanical communication with a third rack (8200), where the third rack (8200) is in mechanical communication with the opening and closing assembly of the claw so that the rotation of the third pinion (8300) in a first direction moves the second rack (8200) in a first linear direction acting on the opening and closing set of the claw.
    类似技术:
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    同族专利:
    公开号 | 公开日
    EP2768418A1|2014-08-27|
    US10039548B2|2018-08-07|
    JP6129859B2|2017-05-17|
    US20130282021A1|2013-10-24|
    US20160287252A1|2016-10-06|
    US11191544B2|2021-12-07|
    EP2768418B1|2017-07-19|
    US9370400B2|2016-06-21|
    WO2013059432A1|2013-04-25|
    CN103889359B|2017-02-15|
    BR112014009401A2|2017-04-18|
    JP2015502771A|2015-01-29|
    CN103889359A|2014-06-25|
    US20180325521A1|2018-11-15|
    PL2768418T3|2017-12-29|
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    法律状态:
    2018-03-27| B15K| Others concerning applications: alteration of classification|Ipc: A61B 17/10 (2006.01), A61B 34/30 (2016.01), A61B 3 |
    2018-12-04| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|
    2019-11-05| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2020-12-08| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    2021-02-17| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 18/10/2012, OBSERVADAS AS CONDICOES LEGAIS. |
    优先权:
    申请号 | 申请日 | 专利标题
    US201161548989P| true| 2011-10-19|2011-10-19|
    US61/548,989|2011-10-19|
    PCT/US2012/060784|WO2013059432A1|2011-10-19|2012-10-18|Clip applier adapted for use with a surgical robot|
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