ROBOTICALLY-CONTROLLED SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR

• US 20160192996A1
• Filed: 03/14/2016
• Published: 07/07/2016
• Est. Priority Date: 03/23/2006
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery LLC (Johnson & Johnson)
• Inventors: Spivey, James T., Ortiz, Mark S., Shelton, Frederick E. IV, Morgan, Jerome R.
• Granted Patent: US 10,213,262 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 1/00042 for mechanical operation
• CPC Class Codes: A61B 1/0052 Constructional details of control elements, e.g. handles
• CPC Class Codes: A61B 1/0058 using shape-memory elements
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 2017/00057 Light
• CPC Class Codes: A61B 2017/00199 with a console, e.g. a control panel with a display
• CPC Class Codes: A61B 2017/0023 disposable
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• CPC Class Codes: A61B 2017/00314 Separate linked members
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/00327 with actuating members moving in opposite directions
• CPC Class Codes: A61B 2017/00367 Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
• CPC Class Codes: A61B 2017/0042 with special provisions for gripping
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/00477 : Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00685 : Archimedes screw
• CPC Class Codes: A61B 2017/00734 : battery operated
• CPC Class Codes: A61B 2017/0688 : Packages or dispensers for surgical staplers
• CPC Class Codes: A61B 2017/07235 : containing different staples, e.g. staples of different shapes, sizes or materials
• CPC Class Codes: A61B 2017/07242 : achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes
• CPC Class Codes: A61B 2017/07264 : characterised by its staple forming cavities, e.g. geometry or material
• CPC Class Codes: A61B 2017/07271 : characterised by its cartridge
• CPC Class Codes: A61B 2017/07278 : characterised by its sled or its staple holder
• CPC Class Codes: A61B 2017/2905 : flexible
• CPC Class Codes: A61B 2017/291 : the position of the handle being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2919 : details of linkages or pivot points
• CPC Class Codes: A61B 2017/2923 : Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2927 : the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2933 : camming or guiding means
• CPC Class Codes: A61B 2017/2937 : with flexible part
• CPC Class Codes: A61B 2017/2946 : Locking means
• CPC Class Codes: A61B 2017/2947 : Pivots
• CPC Class Codes: A61B 2017/320052 : Guides for cutting instruments
• CPC Class Codes: A61B 2034/306 : Wrists with multiple vertebrae
• CPC Class Codes: A61B 2090/0811 : for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 2090/372 : Details of monitor hardware
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 50/30 : Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments for wound clamps A61B17/10; for ligaturing clips A61B17/122; packages or dispensers for surgical gloves or finger-stalls A61B42/40
• CPC Class Codes: A61B 50/36 : for collecting or disposing of used articles
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation

Abstract

Devices and systems are provided for controlling movement of a working end of a surgical device by means of a robotic system. In one embodiment, systems and devices are provided for moving an end effector on a distal end of a surgical fastening device. Movement can include rotational movement of the end effector about an axis of the shaft, articulation of the end effector relative to the shaft, and actuation of an end effector, e.g., closing, firing, and/or cutting.

Claims

1. A surgical tool for use with a robotic system that has a tool drive assembly that is operatively coupled to a control unit of the robotic system that is operable by inputs from an operator and is configured to provide at least one rotary output motion to at least one rotatable body portion supported on the tool drive assembly, said surgical tool comprising:

a surgical end effector configured to perform a surgical procedure in response to control motions applied thereto from the robotic system;

an elongated shaft assembly operably coupled to said surgical end effector and defining a longitudinal tool axis, said elongated shaft having an articulation joint operably supported therein configured to enable said surgical end effector to be selectively articulated about a first tool articulation axis relative to the longitudinal tool axis and about a second tool articulation axis relative to said longitudinal tool axis; and

a tool mounting portion operably coupled to said elongated shaft and configured to operably interface with the tool drive assembly of the robotic system, said tool mounting portion operably supporting a transmission arrangement comprising an articulation transmission configured to apply articulation control motions to said articulation joint in response to said at least one rotary output motion applied thereto from the tool drive assembly.

2. The surgical tool of claim 1 wherein:

said first tool articulation axis is substantially transverse to said longitudinal tool axis; and

said second tool articulation axis is substantially transverse to said first tool articulation axis and said longitudinal tool axis.

3. The surgical tool of claim 1 wherein said articulation transmission comprises:

an articulation control member movably supported within said tool mounting portion and being selectively movable in a plurality of directions in response to actuation motions applied thereto from an articulation drive assembly operably interfacing with the tool drive assembly of the robotic system; and

a plurality of articulation elements coupled to said surgical end effector and being operably attached to said articulation control member such that movement of said articulation control member is transferred to said surgical end effector by at least two of said articulation elements.

4. The surgical tool of claim 3 wherein said articulation control member comprises an articulation control ring movably supported on a ball-shaped member supported within said tool mounting portion such that said articulation control ring is capable of rotary movement thereon in said plurality of directions.

5. The surgical tool of claim 4 wherein said plurality of articulation elements comprises:

a first pair of first articulation cables coupled to said articulation control ring, each said first articulation cable being movably supported by said elongated shaft assembly on a first side of said longitudinal tool axis and being coupled to said surgical end effector; and

a second pair of second articulation cables coupled to said articulation control ring, each said second articulation cables being movably supported by said elongated shaft assembly on a second side of said longitudinal tool axis and being coupled to said surgical end effector.

6. The surgical tool of claim 5 wherein:

said first pair of first articulation cables are attached to said articulation control ring at separate first points that are on a common plane; and

said second pair of second articulation cables are attached to said articulation control ring at separate second points that are on said common plane and spaced from said first points.

7. The surgical tool of claim 1 wherein said articulation transmission is configured to operably interface with a single rotatable body portion supported on the tool drive assembly of the robotic system.

8. The surgical tool of claim 3 wherein said articulation transmission further comprises:

a horizontal articulation assembly operably interfacing with said articulation control member;

a vertical articulation assembly operably interfacing with said articulation control member; and

an articulation shifter assembly communicating with the control unit of the robotic system and operably interfacing with a single one of the rotatable body portions supported on the tool drive assembly of the robotic system for receiving a rotary output motion therefrom, said articulation shifter assembly configured to shift between first and second positions in response to control inputs from the control unit such that when said articulation shifter assembly is in said first position, said rotary output motion is applied to said horizontal articulation assembly and when said shifter assembly is in said second position, said rotary output motion is applied to said vertical articulation assembly.

9. The surgical tool of claim 8 wherein said articulation shifter assembly comprises:

a articulation drive gear operably interfacing with said single rotatable body portion for receiving said rotary output motion therefrom;

a shifter shaft in meshing engagement with said articulation drive gear; and

a shifter driven gear mounted on said shifter shaft such that rotation of said shifter shaft rotates said shifter driven gear and wherein said shifter driven gear is selectively movable on said shifter shaft between said first position wherein said shifter driven gear is in driving engagement with said horizontal articulation assembly and said second position wherein said shifter driven gear is in driving engagement with said vertical articulation assembly in response to said control inputs.

10. The surgical tool of claim 9 wherein said shifter driven gear is selectively movable on said shifter shaft to an intermediate locked position wherein said shifter driven gear is in meshing engagement with said horizontal articulation assembly and said vertical articulation assembly to thereby prevent articulation of said surgical end effector.

11. The surgical tool of claim 10 wherein said horizontal articulation assembly comprises:

a horizontal push member coupled to said articulation control member;

a horizontal driven gear operably coupled to said horizontal push member; and

a horizontal gear arrangement in meshing engagement with said horizontal driven gear and said shifter driven gear when said shifter driven gear is in said first or said intermediate locked position and wherein said vertical articulation assembly comprises;

a vertical push member coupled to said articulation control member;

a vertical driven gear operably coupled to said vertical push member; and

a vertical gear arrangement in meshing engagement with said vertical driven gear and said shifter driven gear when said shifter driven gear is in said second or said intermediate locked position.

12. The surgical tool of claim 10 wherein said shifter driven gear is axially movable on said shifter shaft by a shifter solenoid communicating with the control unit.

13. The surgical tool of claim 1 wherein said surgical end effector comprises:

a surgical staple cartridge; and

an anvil selectively movable relative to said surgical staple cartridge between an open position and a closed position.

14. The surgical tool of claim 13 wherein said surgical end effector further comprises a cutting instrument that is axially movable within said surgical staple cartridge between a starting position and an ending position in response to a firing motion applied thereto by said transmission arrangement.

15. The surgical tool of claim 13 wherein said surgical staple cartridge is supported in an elongated channel of said surgical end effector and wherein said elongated shaft assembly comprises:

a spine assembly comprising;

a proximal spine portion having a proximal end portion operably supported on said tool mounting portion and a distal end; and

a distal spine portion pivotally coupled to said distal end of said proximal spine portion for selective pivotal travel relative thereto about said first tool articulation axis and wherein said distal spine portion is pivotally coupled to said elongated channel to facilitate pivotal travel of said elongated channel relative to said distal spine portion about said second tool articulation axis and wherein said elongated shaft assembly further comprises;

a closure tube assembly movably supported on said spine assembly, said closure tube assembly comprising;

a proximal closure tube having a proximal end portion configured for operable interaction with said transmission arrangement and a distal end;

an intermediate closure tube joint pivotally coupled to said distal end of said proximal closure tube portion for pivotal travel relative thereto; and

a distal closure tube pivotally coupled to said intermediate closure tube joint for pivotal travel relative thereto, said distal closure tube portion configured for operable interaction with said anvil.

16. The surgical tool of claim 15 wherein said transmission arrangement comprises a closure transmission assembly supported on said tool mounting portion in operable engagement with the tool drive assembly of the robotic system for receiving a rotary output motion therefrom, said closure transmission in operable engagement with said proximal closure tube such that upon application of said rotary output motion in a first direction to said closure transmission assembly, said closure tube assembly is driven distally on said spine assembly into closing engagement with said anvil to move said anvil from said open position to said closed position and upon application of said rotary output motion in a second direction to said closure transmission assembly, said closure tube assembly is driven proximally on said spine assembly to enable said anvil to move to said open position.

17. The surgical tool of claim 1 wherein said elongated shaft assembly has a proximal end portion rotatably supported on said tool mounting portion and wherein said transmission arrangement comprises a rotational transmission assembly operably coupled to one of the at least one rotatable body portions supported on the tool drive assembly such that upon application of a rotary output motion in a first direction to said rotational transmission by said at least one rotatable body portion, said rotational transmission assembly rotates said elongated shaft assembly and said surgical end effector in a first rotary direction about said longitudinal tool axis and upon application of said rotary output motion in a second direction to said rotational transmission assembly, said rotational transmission assembly rotates said elongated shaft assembly and said surgical end effector about said longitudinal tool axis in a second rotary direction.

18. A surgical tool for use with a robotic system that has a tool drive assembly that is operatively coupled to a controller of the robotic system that is operable by inputs from an operator and is configured to provide a plurality of rotary output motions to a plurality of corresponding rotatable body portions supported on the tool drive assembly, said surgical tool comprising:

an end effector, comprising;

an elongated channel;

a surgical staple cartridge operably supported within said elongated channel;

a cutting instrument axially movable within said surgical staple cartridge between a starting position and an ending position; and

an anvil movably supported relative to said elongated channel and being selectively movable between an open position relative to said surgical staple cartridge and a closed position relative to said surgical staple cartridge and wherein said surgical tool further comprises;

an elongated shaft assembly comprising;

a spine assembly defining a longitudinal tool axis and comprising;

a proximal spine portion; and

a distal spine portion pivotally coupled to a distal end of said proximal spine portion for selective pivotal travel relative thereto about a first tool articulation axis that is substantially transverse to said longitudinal tool axis and wherein said distal spine portion is pivotally coupled to said elongated channel to facilitate pivotal travel of said elongated channel relative to said distal spine portion about a second tool articulation axis that is substantially transverse to said longitudinal tool axis and said first tool articulation axis and wherein said elongated shaft assembly further comprises;

a closure tube assembly movably supported on said spine assembly, said closure tube assembly comprising;

a proximal closure tube having a proximal end portion and a distal end;

an intermediate closure tube joint pivotally coupled to said distal end of said proximal closure tube portion for pivotal travel relative thereto; and

a distal closure tube pivotally coupled to said intermediate closure tube joint for pivotal travel relative thereto, said distal closure tube portion configured for operable interaction with said anvil and wherein said surgical tool further comprises;

a tool mounting portion coupled to a proximal end portion of said proximal spine portion and configured to operably interface with the tool drive assembly of the robotic system when coupled thereto, said tool mounting portion comprising;

an articulation transmission operably interfacing with a single one of the rotatable body portions on the tool drive assembly of the robotic system, said articulation transmission further communicating with said elongated channel such that when said articulation transmission is in a first position, a first rotary output motion applied thereto by said single rotatable body portion will cause said surgical end effector to pivot about said first tool articulation axis and when said articulation transmission is in a second position, said first rotary output motion applied thereto causes said surgical end effector to pivot about said second tool articulation axis;

a closure transmission assembly operably interfacing with a second one of the rotatable body portions on the tool drive assembly of the robotic system for receiving a second rotary output motion therefrom, said closure transmission in operable engagement with said proximal closure tube such that upon application of said second rotary output motion in a first direction to said closure transmission assembly, said closure tube assembly is driven distally on said spine assembly into closing engagement with said anvil to move said anvil from said open position to said closed position and upon application of said second rotary output motion in a second direction to said closure transmission assembly, said closure tube assembly is driven proximally on said spine assembly to enable said anvil to move to said open position;

a rotational transmission assembly operably interfacing with a third one of the rotatable body portions on the tool drive assembly of the robotic system for receiving a third rotary output motion therefrom, said rotational transmission in operable engagement with said proximal closure tube such that upon application of said third rotary output motion in a first direction to said rotational transmission by said third rotatable body portion, said rotational transmission assembly rotates said elongated shaft assembly and said surgical end effector in a first rotary direction about said longitudinal tool axis and upon application of said third rotary output motion in a second direction to said rotational transmission assembly, said rotational transmission assembly rotates said elongated shaft assembly and said surgical end effector about said longitudinal tool axis in a second rotary direction; and

a cutting instrument drive assembly operably interfacing with a fourth one of the rotatable body portions on the tool drive assembly of the robotic system for receiving a fourth rotary output motion therefrom such that upon application of said fourth rotary output motion in a first direction to said cutting instrument drive assembly by said fourth rotatable body portion, said cutting instrument drive assembly causes said cutting instrument to move from said starting position to said ending position and upon application of said fourth rotary output motion in a second direction to said cutting instrument drive assembly by said fourth rotatable body portion, said cutting instrument drive assembly causes said cutting instrument to be retracted from said ending position to said starting position.