阅读说明：本技术 带有可切换传动装置的外科手术器械 (Surgical instrument with switchable transmission ) 是由 D·W·贝利 T·W·罗杰斯 R·杰亚诺夫 R·索普 G·F·布里森 于 2015-03-31 设计创作，主要内容包括：本发明涉及带有可切换传动装置的外科手术器械,公开了一种具有延长轴的外科手术工具,该延长轴具有近端和远端。外科手术末端执行器被定位在该远端周围。外科手术末端执行器具有包括多个自由度的多个执行器机构。在近端定位有执行器主体。执行器主体包括用于驱动多个执行器机构的多个马达接口。传动装置被耦连至执行器主体。(A surgical tool having an elongated shaft with a proximal end and a distal end is disclosed. A surgical end effector is positioned about the distal end. The surgical end effector has a plurality of effector mechanisms including a plurality of degrees of freedom. An actuator body is positioned proximally. The actuator body includes a plurality of motor interfaces for driving a plurality of actuator mechanisms. The transmission is coupled to the actuator body.)

1. In a surgical device including a first motor interface, a transmission, and a surgical end effector including a first component and a second component, a method comprising:

operating the transmission in a first state;

causing the transmission to switch from the first state to a second state;

operating the transmission in the second state; and

switching the transmission from the second state to the first state;

the first state is a state in which the transmission couples the first motor interface to a first component of the surgical end effector and decouples the first motor interface from a second component of the surgical end effector; and is

The second state is a state in which the transmission couples the first motor interface with the second component of the surgical end effector and decouples the first motor interface from the first component of the surgical end effector.

2. The method of claim 1, further comprising driving at least one of a plurality of non-switchable effector outputs of the surgical end effector with a non-switchable motor.

3. The method of claim 1, wherein shifting the transmission comprises driving a camshaft of the transmission with a second motor.

4. The method of claim 3, wherein driving the camshaft comprises rotating the camshaft to sequentially engage one of a plurality of gear trains.

5. The method of claim 4, wherein driving the camshaft causes the unengaged gear train to be locked.

6. The method of claim 5, wherein driving the camshaft comprises rotating the camshaft to move a plurality of rocker arms that engage a plurality of gear trains of the transmission.

7. The method of claim 1, wherein the plurality of effector switchable outputs comprises a first switchable output for actuating a roll end effector mechanical degree of freedom, a high force grip end effector mechanical degree of freedom, and a tool actuation end effector mechanical degree of freedom.

8. The method of claim 2, wherein the plurality of non-switchable actuators drive a roll end effector mechanical degree of freedom, a pitch end effector mechanical degree of freedom, and a low-force grip end effector mechanical degree of freedom.

Background

Minimally invasive medical techniques aim to reduce the amount of external tissue that is damaged during diagnostic or surgical procedures, thereby reducing patient recovery time, discomfort, and harmful side effects. For example, one effect of minimally invasive surgery is to reduce the post-operative hospital recovery time. Because the average hospital stay for standard surgery is typically significantly longer than that for similar minimally invasive surgery, the increased use of minimally invasive techniques can save millions of dollars in hospital costs each year. While many surgical procedures performed annually in the united states may be able to be performed in a minimally invasive manner, only a portion of current surgical procedures use these advantageous techniques due to limitations in minimally invasive surgical instruments and the additional surgical training involved in mastering these techniques.

Minimally invasive telesurgical systems have been developed to increase the surgeon's dexterity and avoid some of the limitations of traditional minimally invasive techniques. In telesurgery, the surgeon uses some form of remote control (e.g., servomechanism, etc.) to manipulate the movement of the surgical instrument, rather than directly holding and moving the instrument by hand. In a telesurgical system, a surgeon may be provided with an image of a surgical site at a surgical workstation. While viewing a two-dimensional or three-dimensional image of the surgical site on the display, the surgeon performs the surgical procedure on the patient by manipulating master control devices, which in turn control the movement of the servo-mechanically operated instruments.

Servomechanism for telesurgery in generalInput from two master controllers (one for each hand of the surgeon) is received and may include two or more robotic arms, each having a surgical instrument mounted thereon. Operative communication between the master controller and the associated robotic arm and instrument assembly is typically accomplished through a control system. The control system typically includes at least one processor that forwards input commands from master controllers to associated robotic arm and instrument assemblies and from the instrument and arm assemblies back to the associated master controllers, provided there is force feedback or the like. One example of a robotic surgical system is

A system, commercially available from intuitive surgical, Inc. of Sunnyvale, California, USA (intuitive surgical, Inc. of Senneville, Calif.).

In robotic surgery, a variety of structural arrangements may be used to support the surgical instrument at the surgical site. Driven linkages or "slaves" are often referred to as robotic surgical manipulators, as described in U.S. patent nos. 7,594,912; 6,758,843; 6,246,200; and 5,800,423, which are incorporated herein by reference, describe exemplary linkage arrangements for use as robotic surgical manipulators in minimally invasive robotic surgery. These linkages typically use a parallelogram arrangement to support an instrument having a shaft. Such a manipulator structure may constrain movement of the instrument such that the instrument pivots about a remote center of manipulation that is positioned in a space along the length of the rigid shaft. By aligning the remote center of manipulation with an incision point leading to an internal surgical site (e.g., with a trocar or cannula at the abdominal wall in laparoscopic surgery), the end effector of the surgical instrument can be safely positioned without potentially applying dangerous forces to the abdominal wall by moving the proximal end of the shaft using the manipulator linkage. Alternative manipulator structures are described, for example, in U.S. patent nos. 7,763,015, 6,702,805, 6,676,669, 5,855,583, 5,808,665, 5,445,166, and 5,184,601, which are incorporated herein by reference.

In robotic surgery, a variety of structural arrangements may also be used to support and position the robotic surgical manipulator and surgical instrument at the surgical site. A support linkage mechanism (sometimes referred to as a set-up joint, or set-up joint arm) is often used to position and align each manipulator relative to a corresponding cut-out point in the patient's body. The support linkage mechanism facilitates alignment of the surgical manipulator relative to a desired surgical incision point and a target anatomy. Exemplary support linkage mechanisms are described in U.S. Pat. Nos. 6,246,200 and 6,788,018, which are incorporated herein by reference.

While new telesurgical systems and devices have proven to be efficient and advantageous, further improvements are still needed. In general, improved minimally invasive robotic surgical systems are desired. Typically, new surgical instruments are developed for use with existing telesurgical system platforms. Therefore, the instruments are required to be adapted to the telesurgical system, because the cost of developing new telesurgical systems for individual surgical applications is high. However, problems arise when existing telesurgical platforms do not have the required motor output for all of the mechanisms of a particular surgical instrument. Accordingly, there is a need to adapt new surgical devices to existing telesurgical systems without limiting surgical functionality and without requiring modifications to the existing telesurgical systems.

Disclosure of Invention

Many embodiments are directed to a surgical tool including an elongate shaft having a proximal end and a distal end. A surgical end effector is positioned about the distal end. The surgical end effector may include a plurality of effector mechanisms, each having one or more degrees of freedom (DOF). The actuator body may also be positioned proximally. The actuator body may include a plurality of motor interfaces for driving a plurality of actuator mechanisms. For example, the plurality of motor interfaces may include a first motor interface. The transmission may be coupled between the effector body and the surgical end effector. The transmission may be configured to switch the coupling of the first motor interface between only a portion of the plurality of actuator mechanisms and the associated DOF.

Many embodiments are directed to a surgical tool including an elongate shaft having a proximal end and a distal end. A surgical end effector is positioned at a distal end of the shaft. The surgical end effector has a plurality of end effector components, each end effector component associated with a unique mechanical degree of freedom. The plurality of end effector components has a first end effector component and a second end effector component. A drive mechanism is positioned at the proximal end of the shaft. The drive mechanism has a first motor interface and a transmission. The transmission includes a switching mechanism movable between a first state and a second state. In a first state, the first motor interface is coupled via a transmission to drive the first end effector component and not the second end effector component. In a second state, the first motor interface is coupled via a transmission to drive the second end effector component and not the first end effector component.

In many embodiments, the plurality of motor interfaces includes a second motor interface coupled to switch the switching mechanism between the first state and the second state.

In many embodiments, the plurality of end effector components includes a third end effector component. The switching mechanism may be movable to a third state. In the first state and in the second state, the first motor interface does not drive the third end effector component. In a third state, the first motor interface is coupled via a transmission to drive the third end effector component and not the first and second end effector components.

In many embodiments, the plurality of motor interfaces includes a second motor interface coupled to switch the switching mechanism between the first state, the second state, and the third state.

In many embodiments, the first end effector component may be associated with a first end effector mechanical degree of freedom and the second end effector component is associated with a second end effector mechanical degree of freedom. The drive mechanism may include a second motor interface coupled to drive a third end effector mechanical degree of freedom, a third motor interface coupled to drive a fourth end effector mechanical degree of freedom, and a fourth motor interface coupled to drive a fifth end effector mechanical degree of freedom. The first, second, third, fourth, and fifth mechanical degrees of freedom of the end effector are each unique.

In many embodiments, the plurality of end effector components includes a third end effector component associated with a sixth end effector mechanical degree of freedom. The first, second, third, fourth, fifth, and sixth mechanical degrees of freedom of the end effector are each unique.

In many embodiments, the plurality of motor interfaces includes a fifth motor interface coupled to switch the switching mechanism between the first state and the second state.

In many embodiments, the switching mechanism can include a rotatable camshaft, wherein a first position of the camshaft corresponds to the first state and a second position of the camshaft corresponds to the second state.

In many embodiments, the plurality of motor interfaces further includes a second motor interface coupled to drive the camshaft.

In many embodiments, the transmission may include a rotatable camshaft. The camshaft may include a first camshaft position for switching coupling of the first motor interface to a first DOF of the multiple DOFs; a second camshaft position for switching coupling of the first motor interface to a second DOF of the plurality of DOFs; and a third camshaft position for switching the coupling of the first motor interface to a third DOF of the multiple DOFs.

In many embodiments, the plurality of motor interfaces further comprises a second, third, fourth, and fifth motor interface, wherein the camshaft is driven by the second motor interface.

In many embodiments, the plurality of DOFs further includes a fourth DOF specifically coupled with the third motor interface; a fifth DOF exclusively coupled with the fourth motor interface; and a sixth DOF exclusively coupled with the fifth motor interface.

In many embodiments, the surgical end effector may include a grasping device having a surgical tool, wherein the surgical end effector includes a wrist that enables the grasping device to pitch, roll, and pitch relative to the remotely controlled arm.

In many embodiments, the first DOF is a mechanism for rolling the wrist; the second DOF is a mechanism for actuating a surgical tool; the third DOF is a mechanism for actuating the grasping device with a large force (high force) relative to the sixth DOF; the fourth DOF is a mechanism for swinging the wrist; the fifth DOF is a mechanism for pitching the wrist; and the sixth DOF is a mechanism for actuating the grasping device with a small force (low force) relative to the third DOF.

In many embodiments, the camshaft includes a plurality of camshaft lobes.

In many embodiments, the plurality of camshaft lobes includes a pair of lobes for powering and locking each of the first, second, and third DOF.

In many embodiments, the transmission includes a first gear train for driving the first DOF, a second gear train for driving the second DOF, and a third gear train for driving the third DOF.

In many embodiments, the first gear train includes a first input gear; a first output gear eventually coupled with the first input gear; a first rocker arm movably engaged with the camshaft for engaging or disengaging the first input gear with the first output gear; a first lock arm movably engaged with the camshaft for locking and unlocking the first output gear.

In many embodiments, the second gear train includes a second input gear; a second output gear eventually coupled with the second input gear; a second rocker arm movably engaged with the camshaft for engaging or disengaging the second input gear with the second output gear; and a second lock arm movably engaged with the camshaft for locking and unlocking the second output gear.

In many embodiments, the third gear train includes a third input gear; a third output gear eventually coupled with the third input gear; a third rocker arm movably engaged with the camshaft for engaging or disengaging the third input gear with the third output gear; a third locking arm movably engaged with the camshaft for locking and unlocking the third output gear.

In many embodiments, the first output gear may be coupled to a main shaft extending along and rotatable about an axis, and wherein the second and third output gears are held within the main shaft and rotate with the main shaft about the axis.

In many embodiments, the second output gear may be coupled to a first output shaft extending within the main shaft, and the third output gear may be coupled to a second output shaft extending within the main shaft.

In many embodiments, the first, second, and third gear trains may be arranged along a common axis parallel to the camshaft.

Many embodiments are directed to a method for shifting a transmission of a remotely controlled surgical device. In the method, a transmission of a surgical device is switched to engage one of a plurality of switchable effector outputs to a surgical end effector of the surgical device. The surgical device may comprise a plurality of non-switchable outputs. The surgical device may be connected to a remote control arm. The remote control arm may have a plurality of motors including a first motor for driving the transmission and a plurality of dedicated motors for driving the plurality of non-switchable outputs. A first motor may be used to drive an engaged switchable effector output to drive a corresponding effector mechanism of the surgical end effector.

Many embodiments are directed to a method in a surgical device that includes at least one of a first motor interface, a transmission, and an end effector that includes first and second components. The method includes operating the transmission in a first state, causing the transmission to switch from the first state to a second state, operating the transmission in the second state, and causing the transmission to switch from the second state to the first state. In a first state, the transmission couples the first motor interface to the first component of the end effector and decouples the first motor interface from the second component of the end effector. In a second state, the transmission couples the first motor interface to the second component of the end effector and decouples the first motor interface from the first component of the end effector.

In many embodiments, at least one of the plurality of non-switchable effector outputs of the surgical end effector may be driven by a dedicated motor.

In many embodiments, the transmission is shifted by driving a camshaft of the transmission using a second motor.

In many embodiments, the camshaft is driven by rotating the camshaft to sequentially engage one of a plurality of gear trains.

In many embodiments, the camshaft is rotated to move a plurality of rocker arms that engage a plurality of gear trains of the transmission.

In many embodiments, rotating the camshaft causes at least one of the unengaged gear trains to be locked.

In many embodiments, the switching may occur sequentially only along the plurality of gear trains.

In many embodiments, the plurality of actuator switchable outputs includes a first switchable output for actuating a roll DOF, and a high force grip DOF, and a tool actuation DOF.

In many embodiments, among others, the multiple dedicated DOFs include a yaw DOF, a pitch DOF, and a low-force grip DOF.

Drawings

FIG. 1 is a plan view of a surgical system for performing minimally invasive telesurgical control of a surgical procedure, in accordance with many embodiments.

Fig. 2 is a perspective view of a surgeon console of a surgical system for telesurgical control, in accordance with many embodiments.

FIG. 3 is a perspective view of an electronics cart (electronics cart) of a telesurgically controlled surgical system in accordance with many embodiments.

Fig. 4 schematically illustrates a telesurgically controlled surgical system in accordance with many embodiments.

Fig. 5A is a partial view of a patient side cart of a telesurgically controlled surgical system in accordance with many embodiments.

Fig. 5B is a front view of a surgical tool for a telesurgical procedure, in accordance with many embodiments.

Fig. 6 is a simplified schematic diagram of a telesurgically-controlled surgical system in accordance with many embodiments.

Fig. 7A-7H are longitudinal and axial cross-sections of a transmission assembly of a surgical tool for a telesurgical procedure, according to many embodiments.

FIG. 8 illustrates a cam state diagram of the operation of a transmission assembly of a surgical tool of a telesurgical operation, in accordance with various embodiments.

Detailed Description

In the following description, various embodiments of the invention will be described. For purposes of explanation, specific configurations and details are set forth in order to provide a thorough understanding of the embodiments. However, it will also be apparent to one skilled in the art that the present invention may be practiced without these specific details. Furthermore, well-known features may be omitted or simplified in order not to obscure the described embodiments.

I. Minimally invasive remote assistance surgical system

Referring now to the drawings, in which like reference numerals refer to like parts throughout the several views, FIG. 1 is a plan view illustration of a Minimally Invasive Robotic Surgical (MIRS) system 10 that is generally used to perform minimally invasive diagnostic or surgical procedures on a patient 12 lying on a table 14. The system generally includes a surgeon console 16 used by a surgeon 18 in a procedure. One or more assistants 20 may also participate in the procedure. The MIRS system 10 may further include a patient side cart 22 (surgical robot) and an electronics cart 24. The patient side cart 22 may maneuver at least one removably coupled tool assembly 26 (hereinafter simply "tool") through a minimally invasive incision in the body of the patient 12 while the surgeon 18 views the surgical site through the console 16. Images of the surgical site may be acquired by an endoscope 28 (e.g., a stereo endoscope) that may be manipulated by the patient side cart 22 to orient the endoscope 28. The electronics cart 24 may be used to process images of the surgical site for subsequent display to the surgeon 18 via the surgeon console 16. The number of surgical tools 26 used at one time will generally depend on the diagnostic or surgical procedure and space constraints within the operating room, among other factors. If it is necessary to change one or more tools 26 used in a procedure, the assistant 20 may 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.

Fig. 2 is a perspective view of the surgeon's console 16. The surgeon console 16 includes a left eye display 32 and a right eye display 34 for presenting the surgeon 18 with coordinated stereoscopic views of the surgical site enabling a depth perception. The console 16 further includes one or more input controls 36, which in turn cause the patient side cart 22 (shown in fig. 1) to maneuver one or more tools. The input control device 36 may provide the same degrees of freedom as its associated tool 26 (shown in fig. 1) to provide the surgeon with telepresence, or the input control device 36 may be integral with the tool 26, so that the surgeon has a strong sense of directly controlling the tool 26. To this end, position, force and tactile feedback sensors (not shown) may be used to transmit position, force and tactile sensing from the tool 26 back into the surgeon's hand through the input control device 36.

The surgeon's console 16 is typically located in the same room as the patient so that the surgeon can monitor the procedure directly, be physically present when necessary, and speak directly with the assistant rather than through a telephone or other communication medium. However, the surgeon may be located in a different room, in a completely different building, or other remote location from the patient that allows for the performance of the telesurgical procedure.

Fig. 3 is a perspective view of the electronics cart 24. The electronics cart 24 may be coupled with the endoscope 28 and may include a processor that processes the captured images for subsequent display, such as on a surgeon console or on another suitable display located locally and/or remotely to the surgeon. For example, if a stereoscopic endoscope is used, the electronic cart 24 may process the captured images in order to present the surgeon with a coordinated stereoscopic image of the surgical site. Such coordination may include alignment between the opposing images and may include adjusting a stereoscopic working distance of the stereoscopic endoscope. As another example, image processing may include using previously determined camera calibration parameters to compensate for imaging errors of the image capture device, such as optical aberrations.

Fig. 4 schematically illustrates a robotic surgical system 50 (e.g., the MIRS system 10 of fig. 1). As described above, a surgeon may use a surgeon console 52 (such as surgeon console 16 in fig. 1) to control a patient side cart (surgical robot) 54 (such as patient side cart 22 in fig. 1) in a minimally invasive procedure. The patient side cart 54 may use an imaging device, such as a stereoscopic endoscope, to capture images of the procedure site and output the captured images to an electronic cart 56 (such as electronic cart 24 in fig. 1). As discussed above, the electronic cart 56 may process the captured image in a variety of ways prior to any subsequent display. For example, the electronic cart 56 may overlay the captured images with a virtual control interface before displaying the combined images for the surgeon via the surgeon console 52. The patient side cart 54 may output the captured images for processing outside the electronic cart 56. For example, the patient side cart 54 may output the captured images to a processor 58, which is used to process the captured images. These images may also be processed by a combination of electronic cart 56 and processor 58, which may be coupled together to process the captured images collectively, sequentially, and/or combinations thereof. One or more separate displays 60 may also be coupled with processor 58 and/or electronics cart 56 for local and/or remote display of images (e.g., images of the procedure site, or other related images).

Fig. 5A and 5B show patient side cart 22 and surgical tool 62, respectively. Surgical tool 62 is an example of surgical tool 26. The illustrated patient side cart 22 provides for the manipulation of three surgical tools 26 and an imaging device 28, such as a stereoscopic endoscope for the capture of images of a procedure site. The steering is provided by a robotic mechanism having a plurality of robotic joints. The imaging device 28 and the surgical tool 26 may be positioned and maneuvered through an incision in the patient such that the dynamic remote center is maintained at the incision to minimize the size of the incision. When the distal end of the surgical tool 26 is positioned within the field of view of the imaging device 28, the image of the surgical site may include an image of the distal end of the surgical tool 26. Each tool 26 may be detached from and carried by a corresponding surgical manipulator 31, which is located distal to one or more robotic joints. The surgical manipulator 31 provides a movable platform for moving the entire tool 26 relative to the patient side cart 22 through movement of the robotic joints. Surgical manipulator 31 also provides power to operate tool 26 with a mechanical and/or electrical interface. An example of such a carriage assembly can be found in U.S. patent publication No. US 2013/0325034 (attorney docket number ISRG04330/US), which is incorporated herein by reference.

Fig. 6 is a simplified schematic diagram of a telesurgically-controlled surgical system 100. Surgical system 100 includes a surgeon console 102, which may be, for example, surgeon console 52. The surgeon console 102 drives a patient side cart 104, which may be, for example, the patient side cart 22. Patient side cart 104 includes a surgical manipulator 106, which may be, for example, surgical manipulator 31.

Surgical manipulator 106 includes a motor unit 108 and a surgical tool 110. The motor unit 108 is a carriage assembly that holds 5 motors. In some embodiments, only 5 motors are used, however in other embodiments more or less than 5 motors may be used. The motor unit 108 here comprises a plurality of motors, which can be assigned to different mechanisms. Here, the motor unit 108 includes a power motor 112, a camshaft motor 114, a pitch motor 116, a yaw motor 118, and a low-force grip motor 120, but these motors may be used for different purposes depending on the attached instrument. Typically, each motor is an electric motor mechanically and electrically coupled to a respective input of the surgical tool 110. In some embodiments, the motor unit 108 may be located at the proximal end of the surgical tool 110 in a common chassis with the surgical tool, as depicted by the proximal housing shown in fig. 5B.

Tool 110 may be, for example, tool 26 described above. An example of a tool that may be used as tool 110 is disclosed in International publication No. WO 2011/060318 (attorney docket number: ISRG02360/PCT), which is incorporated herein by reference. Here, tool 110 is an elongated effector unit 122 that includes three discrete inputs that are each mechanically coupled to pitch motor 116, yaw motor 118, and low-force grip motor 120 by surgical manipulator 106. The tool 110 may also include a transmission 124 that is mechanically coupled to the power motor 112 and the camshaft motor 114.

At the distal end of the effector unit 122 is located a surgical end effector 126. The surgical end effector 126 and effector unit 122 are connected by a moveable wrist. An example of such a wrist is shown in U.S. patent publication No. US2011/0118709 (attorney docket ISRG02350/US), which is incorporated herein by reference. In brief, the surgical end effector may be characterized by a plurality of discrete but interrelated mechanisms, wherein each mechanism provides a degree of freedom (DOF) for the surgical end effector 126. As used herein, a DOF is one or more interrelated mechanisms for affecting a respective motion. These DOFs give the surgical end effector 126 different modes of operation, which may be operated simultaneously or discretely. For example, the wrist enables the surgical end effector 126 to pitch and yaw relative to the surgical manipulator 106, and accordingly includes a pitch DOF128 and a yaw DOF 130. The surgical end effector 126 also includes a roll DOF 132 that rotates the surgical end effector about an elongated axis.

Surgical end effector 126 may include a clamping and cutting mechanism, such as a surgical stapler. An example of such a clamping mechanism is shown in U.S. patent publication No. 2011-0118778a1 (attorney docket ISRG02330/US), which is incorporated herein by reference. The clamping mechanism can grip according to two modes and accordingly includes two DOF. The low-force DOF 132 (e.g., a cable-actuated mechanism) operates to toggle (toggle) the clamp with a low force in order to gently manipulate tissue. The low-force DOF 132 is useful for staging a surgical end effector to perform a cutting or stapling operation. The high force DOF 134 (e.g., a lead screw actuated mechanism) operates to further open or close the clamp with relatively large force onto tissue, such as tourniquet (tourniquet) tissue, in preparation for a cutting or stapling operation. Once clamped, the surgical end effector 126 uses the tool actuation DOF138 to further affect tissue, such as an anastomosis, cutting, and/or cauterizing device.

As shown, pitch motor 116, yaw motor 118, and low-force grip motor 120 drive pitch DOF128, yaw DOF 130, and low-force grip DOF 139, respectively. Accordingly, each of the pitch DOF128, yaw DOF 130, and low-force grip DOF 139 are paired separately with the motor and can be operated independently and simultaneously with respect to the other DOFs.

However, the high force DOF 126, the roll DOF 132, and the tool actuation DOF138 share a single input with the power motor 112 via the transmission. Accordingly, only one of the high force DOF 126, the roll DOF 132, and the tool actuation DOF138 may be operated at a time, as the coupling to the power motor 112 occurs separately. The camshaft motor 114 is actuated for switching the output of the power motor 112 between the high force DOF 126, the roll DOF 132, and the tool actuation DOF 138. Thus, the transmission 124 advantageously allows for a greater number of DOF than arrangements where each motor is dedicated to a single DOF.

Exemplary Transmission

Embodiments of the invention relate to a system and method of controlling 6 degrees of freedom (6 DOF) of a stapling instrument with 5 inputs allowable from a motor carriage. One of the five inputs acts as a switch which can then allow the other input to be selectively engaged to three different stapler DOF. The six DOF of the stapling instrument may include wrist roll, wrist pitch, wrist roll, low force grip (toggle), high force grip (clamp), and tool actuation (stapler fire). Wrist pitch, roll, and low force grip may be cable actuated, however roll, grip, and launch are driven by separate coaxial gear sets. In use, the transmission may comprise three main modes: roll, clamped/unclamped, and fire. Wrist rotation, pitch, roll, and low force grips are all under active servo control, and high force grips and launch DOF are coupled to the roll axis.

In many embodiments, the driven input is selectively coupled to the wrist roll, grip, and/or launch. This is accomplished through the use of idler gears that can be rotated to engage and disengage the appropriate stapler DOF. Additionally, there is a method of locking each DOF to rest by using a lever arm. These lever arms are controlled by a switching input, which may be a camshaft with the appropriate number and shape of lobes. In a roll motion of the wrist, the clamp and the launch input ring are necessarily rotated with the roll gear. Because of this limitation, the gear ratios between the instrument input and the input ring and the roll gear are all the same. In that way, in the next state, all the rings/gears are engaged and thus rotate together, so that the launch and high force grip drive shaft does not rotate relative to the wrist. The system may be configured so that all transitions move only one function at a time. In this way, all transitions can be tested for security. If the transition is not engaged, the roll gear is locked. To avoid the need for the wrist to be positioned so that the roll gear is aligned with the teeth of the lock arm, there is a secondary friction lock on this DOF.

Fig. 7A-7H show perspective and cross-sections, respectively, of the transmission assembly 140. The transmission includes a gear train for each of the high force DOF 126, the roll DOF 132, and the tool actuation DOF 138.

A. First gear train

Directing attention to fig. 7A, a first gear train 142 is positioned at a proximal end of the transmission assembly 140. The first gear train 142 drives the roll DOF 132 by axially rotating the main shaft 144. The main shaft 144 includes an axial passageway 146 for routing control cables to the surgical end effector 126. The main shaft 144 is directly rotated by driving the external gear teeth 147 of the proximal gear 148.

B. Second gear train

The second gear train 150 is positioned in the middle of the transmission assembly 140 directly adjacent the first gear train 142. The second gear train 150 drives a large force capture DOF 126 through rotation of the intermediate shaft 152 relative to the main shaft 144. The intermediate shaft 152 is held by the main shaft 144 and correspondingly rotates with the main shaft 144. In other words, the axis of rotation of the intermediate shaft 152 may orbit about the axis of rotation of the main shaft 144.

The intermediate shaft 152 is directly connected to an intermediate internal gear 154 which is in turn driven by internal gear teeth (not shown in this view) of an intermediate gear 156. The intermediate gear 156 also includes external gear teeth 158 for ultimately driving the intermediate gear 156 directly through the power motor 112. The outer gear teeth 158 of the intermediate gear 156 are identically configured to the outer gear teeth 147 of the proximal gear 148. Thus, if driven synchronously, with the same input gears, there is no relative movement between intermediate gear 156 and proximal gear 148, and correspondingly intermediate shaft 152 is not driven relative to main shaft 144.

The outer portion of the main shaft 144 holds the intermediate gear 156 by two bearings. In the first disengaged state of the second gear train 150, the intermediate gear 156 (along with the distal gear 166 described below) may be configured to rotate synchronously with the main shaft 144 when the intermediate gear 156 and the proximal gear 148 are synchronously engaged with the power motor 112. In the first disengaged state, rotation of idler gear 156 does not result in rotation of idler inner gear 154 because idler gear 156 is not permitted to roll relative to main shaft 144. In other words, in the first disengaged state, the intermediate gear 156 is locked with the main shaft 144 and therefore cannot move asynchronously relative to the main shaft 144 to move the intermediate shaft 152. As discussed further below, the second gear train 150 includes a second disengaged state in which the intermediate gear 156 is physically disengaged from the power motor 112 and physically locked, and therefore cannot rotate and cannot drive the intermediate internal gear 154.

In the engaged state of the second gear train 150 (with the power motor 112), the proximal gear 148 and the main shaft 144 are locked and thus cannot rotate. In other words, the axis of rotation of the intermediate annulus gear 154 cannot orbit around the axis of rotation of the main shaft 144. However, the intermediate inner gear 154 may spin around its own axis of rotation. Accordingly, in the engaged state, the intermediate gear 156 rotates relative to the main shaft 144, ultimately driving the intermediate internal gear 154 via the power motor 112.

C. Third gear train

The third gear train 160 is positioned at the distal end of the transmission assembly 140 and is mostly configured in the same manner as the second gear train 150. The third gear train 160 drives the tool actuation DOF138 by rotation of the distal shaft 162 relative to the main shaft 144. The distal shaft 162 is retained by the main shaft 144 and correspondingly rotates with the main shaft 144. In the general manner as the second gear train 150, the axis of rotation of the distal shaft 162 may orbit about the axis of rotation of the main shaft 144.

Distal shaft 162 is directly connected to a distal internal gear 164, which in turn is driven by internal gear teeth (not shown in this view) of distal gear 166. The distal gear 166 also includes external gear teeth 168 for ultimately driving the distal gear 166 directly by the power motor 112. The outer teeth 168 of the distal gear 162 are configured in the same manner as the outer gear teeth 147 of the proximal gear 148 and the outer gear teeth 158 of the intermediate gear 156. Thus, when driven synchronously, there is no relative movement between the distal gear 166, the intermediate gear 156, and the proximal gear 148.

The exterior of the main shaft 144 holds the distal gear 166 by two bearings. In the first disengaged state of the third gear train 160, the distal gear 166 (along with the intermediate gear 156) may be configured to rotate synchronously with the main shaft 144 when the distal gear 166 and the proximal gear 148 are synchronously engaged with the power motor 112. In the first disengaged state, rotation of the distal gear 166 does not result in rotation of the distal internal gear 164 because the distal gear 166 is not allowed to roll relative to the main shaft 144. In other words, in the first disengaged state, distal gear 166 is locked with main shaft 144 and therefore cannot move asynchronously relative to main shaft 144 to move distal shaft 162. As discussed further below, the third gear train 160 includes a second disengaged state in which the distal gear 166 is physically disengaged from the power motor 112 and physically locked, and therefore cannot rotate and drive the distal internal gear 164.

In the engaged state of the third gear train 160 (with the power motor 112), the proximal gear 148 and the main shaft 144 are locked and therefore cannot rotate. In this manner, the rotational axis of distal annulus gear 164 cannot orbit about the rotational axis of main shaft 144. However, the distal annulus gear 164 may spin about its own axis of rotation. Accordingly, in the engaged state, the distal gear 166 rotates relative to the main shaft 144, ultimately driving the distal internal gear 164 via the power motor 112.

D. Gear train structure

Directing attention to FIGS. 7B-7D, representative cross-sections and perspective views of the second gear train 150 are shown. Fig. 7C and 7D have other gear train portions removed to allow a better understanding of how the individual gear trains are configured. The first gear train 142 and the third gear train 160 are configured in the same manner, and therefore, the following description applies in the same manner to fig. 7E and 7F, which respectively show representative cross-sectional views of those gear trains. To avoid unnecessary repetition, common numbering is used for similar parts between the gear trains. For example, the lock arm 188(II) refers to a lock arm of the second gear train 150, and the lock arm 188(III) refers to a lock arm of the third gear train. However, each gear train operates in substantially the same manner, with differing timings determined by the corresponding cam lobes of the common camshaft described below.

The larger housing 170 of the surgical tool 110 holds the transmission assembly 140. The power motor 112 drives the first input gear 172(II) via the input shaft 173, which is shared by the gear trains, as shown in fig. 7C and 7D. The first input gear 172(II) meshes with an idler gear 174(II) which in turn meshes with a second input gear 176(II) which may mesh with the intermediate gear 156. The idler gear 174(II) and the second input gear 176(II) are on an arm 177(II), which arm 177(II) rotates about the first input gear 172(II) as shown in fig. 7C and 7D. As shown, the second input gear 176(II) is positioned in a downward portion of the arc so as not to mesh with the intermediate gear 156. The second input gear 176(II) may be moved to engage the second input gear 176(II) with the intermediate gear 156. A compression spring (not shown) is loaded between the second input gear shaft and the housing 170 for biasing the second input gear 176(II) toward the intermediate gear 156 such that the intermediate gear 156 is engaged to the power motor 112.

A camshaft 180 is disposed along the gear train. The camshaft 180 typically includes at least two cam lobes per drive chain. These lobes rotate to engage and disengage the DOF mechanism from the gear train. The camshaft 180 is rotated by the camshaft motor 114 to selectively place the cam lobes in the desired positions.

The first cam lobe 182(II) rotates to engage the bearing 183(II) of the rocker arm 184 (II). The rocker arm 184(II) is movable about a rocker pivot 184p (II). The rocker arm 184(II) extends to engage the gear shaft 176s (II) of the second input gear 176(II), as shown in fig. 7C and 7D. When the lower portion of the first cam lobe 182(II) is engaged with the rocker arm 184(II), the second input gear 176(II) is engaged with the idler gear 156 as shown due to the biasing action of a compression spring (not shown).

As shown, when the high portion of the first cam lobe 182(II) engages the bearing 183(II), the rocker arm 184(II) moves downward about the rocker pivot 184p (II). This downward movement disengages the second input gear 176(II) from the intermediate gear 156(II) due to the engagement of the rocker arm 184(II) with the second input gear shaft 176s (II). Thus, in this position of the first cam lobe 182(II), power applied to the first input gear is not transferred to the idler gear 156.

The second cam lobe 186(II) rotates to engage a surface 187(II) of a locking arm 188(II) that pivots about a locking arm pivot 190 (II). The locking arm 188(II) includes a tooth 192(II) that can be moved to engage the tooth 192(II) with the intermediate gear 156. As shown in fig. 7D, the spring 157 is loaded between the latch arm 188(II) and the housing 170 to bias the tooth 192(II) away from the idler gear 156.

As shown, when the lower portion of the second cam lobe 186(II) engages the surface 187(II) of the locking arm 188(II), the tooth 192(II) is moved away from the idler gear 156. Thus, in this position, the intermediate gear 156 is unlocked and allowed to rotate.

In the event of a failure of the system by which the stapler is clamped to the tissue, a manual release feature is provided. In some embodiments, this may be accomplished by a user manually rotating the cam shaft 180 to a high force grip DOF state, as described below. As shown in fig. 7G, the interlock cam lobe 194 of the camshaft 180 may be moved to a high state to move the interlock flag 196, which may be rotated and connected to the one-way clutch 198, which ultimately engages the intermediate shaft 152. The end of the one-way clutch 198 is accessible with a hand tool (e.g., a wrench) through a passage in the housing 170. The interlock symbol 196 blocks the passage unless the high portion of the interlock cam lobe 194 is lifting the interlock symbol 196 as shown. In the clamped state, the interlock flag 196 provides a user access to drive the intermediate shaft 152 via the one-way clutch 198 in a direction that only allows the jaws to be released.

FIG. 7H depicts the friction lock mechanism 200 acting as a secondary axle braking system with respect to the locking arm 188 (I-III). Friction lock arm 202 pivots about pivot 204 and includes a braking surface 206. The friction locking arm 202 is biased by a spring 208 to place a braking surface 206 against a portion of the shaft 144, as shown. In this position, the shaft 144 cannot roll. The friction lock cam lobe 210 of the camshaft 180 includes a high portion and a low portion. Shaft 144 remains braked as long as the lower portion of friction lock cam lobe 210 abuts bearing 212, which is positioned on friction lock arm 202. The high portion may be rotated to lift the bearing 212 to position the friction locking arm away from the shaft 144. In that position, the shaft 144 is allowed to roll.

Transmission switching method

When the high portion of the second cam lobe 186(I-III) engages the surface 187(I-III) of the locking arm 188(I-III), the tooth 192(I-III) is moved to engage the corresponding proximal gear 148, intermediate gear 156, or distal gear 166. This position locks the intermediate gear 156 with the locking arm 188 and, therefore, the intermediate gear 156 cannot move. One purpose of locking the intermediate gear 156 is to lock the last position of the high force capture DOF into a locked state. In general, each gear train is locked in a similar manner, preventing undesired movement.

The camshafts 180 are configured to operate the gear trains in coordination, which is achieved by camshaft timing. Fig. 8 shows a cam state diagram of the operation of the transmission 140. As previously discussed, the gear trains share a common camshaft, such as the camshaft 180 shown in FIGS. 7B-7D. The camshaft 180 provides at least two lobes for each gear train, such as a first cam lobe 182(I-III) and a second cam lobe 186(I-III) that operate with the first, second, and third gear trains. However, some gear trains may include more lobes. For example, in some embodiments, the first gear train includes a third lobe that operates a friction lock. And as shown in fig. 7G, additional lobes may be included as a safety mechanism to back-drive the DOF in the event of a system failure.

Typically, for each gear train, one cam lobe is operable to control power engagement and the other cam lobe is operable to lock the gear train. Thus, each gear train is operated by the power cam and the lock cam. Briefly, each cam has a low state and a high state with a transition ramp therebetween. The duration of each of the low and high states is based on the desired duration of operation of the lifted objects, e.g., the latch arms 188(I-III) and the swing arms 184 (I-III). For the purposes of this disclosure, the high state of the first cam lobe 182(I-III) means that the first cam lobe 182(I-III) is positioned such that the associated gear train is engaged with the power motor 112, while the low state of the first cam lobe 182(I-III) means disengaged. Similarly, the high state of the second cam lobe 186(I-III) means that the second cam lobe 186(I-III) is positioned such that the associated gear train is engaged with the associated locking arm 188(I-III), while the low state of the second cam lobe 186(I-III) means disengaged. It should also be understood that the outputs of the intermediate and distal gear trains are not necessarily tied to the DOF shown, and are therefore interchangeable.

A. Cam state for first drive mode

The cam state diagram shows the low and high states of each cam over a 360 degree rotation. In the 0 degree position of rotation, the transmission 140 is configured to power operation of the ROLL DOF 132 (ROLL). As shown, cam lobe 182(I-III) of each gear train is in the high state and cam lobe 186(I-III) of each gear train is in the low state. Thus, the first gear train 142 is unlocked and engaged with the power motor 112. In this manner, the locking arm 188(I) of the first gear train 142 is disengaged from the proximal gear 148 and the second input gear is engaged with the proximal gear 148. The second gear train 150 and the third gear train 160 are also unlocked and the intermediate gear 156 and the distal gear 166 remain in contact with the power motor. In addition, the friction cam lobe 210 used to actuate the friction lock arm 202 is driven to a low position to allow rotation of the shaft 144.

As described above, during engagement of the roll DOF 132, the intermediate gear 156 and the distal gear 166 are required to rotate synchronously with the proximal gear 148 because the intermediate internal gear 154 and the distal internal gear 164 are held within the shaft 144 and rotate with the shaft 144. In this manner, relative movement between intermediate gear 156/intermediate internal gear 154 and distal gear 166/distal internal gear 164 is avoided, thereby preventing operation of intermediate shaft 152 and distal shaft 162. Thus, while the intermediate gear 156 and the distal gear 166 remain engaged with the power motor 112 and thus rotate in a rolling operation, the second gear train 150 and the third gear train 160 do not operate respective DOFs.

Further, the "brake in sleeve check" may be performed when the camshaft 180 is rotated about 40 degrees. In this mode, the friction lock arm 202 remains engaged with the shaft 144, but the first gear train lock arm 188(I) becomes disengaged, whereas the first gear train 142 remains engaged with the power motor 112. This allows the system to self-test the friction lock mechanism 200 by attempting to roll the braked shaft 144 because the lock arm 188(I) is disengaged. If the shaft 144 is able to roll under such conditions, it may indicate that the friction locking mechanism 200 is malfunctioning.

B. Cam state for second drive mode

At approximately-150 degrees of rotation of the camshaft 180, the transmission is switched to power the tool actuation DOF138 (launch). Here, the first cam lobe 182(I) of the first gear train 142 and the first cam lobe 182(III) of the third gear train 160 are in the low state, and the first cam lobe 182(II) of the second gear train 150 is in the high state. In this way, the second input gears of the first gear train 142 and the third gear train 160 are disengaged from the proximal gear 148 and the distal gear 166, respectively, while the second input gear of the second gear train 150 is engaged with the intermediate gear 156. Thus, only the intermediate gear 156 receives power from the power motor 112.

As shown, the second cam lobe 186(I) of the first gear train 142 and the second cam lobe 186(III) of the third gear train 160 are in the high state and the second cam lobe 186(II) of the second gear train 150 is in the low state. In this manner, the locking arm 188(I) of the first gear train 142 and the locking arm 188(III) of the third gear train 160 are engaged with the proximal gear 148 and the distal gear 166, respectively, while the locking arm 188(II) of the second gear train 150 is disengaged from the intermediate gear 156. Therefore, only the intermediate gear 156 is free to rotate.

C. Cam state for third gear mode

At about 170 degrees of rotation of the camshaft 180, the transmission is configured to power the high force grip DOF 136 (clamping). Here, the first cam lobe 182(I) of the first gear train 142 and the first cam lobe 182(II) of the second gear train 150 are in the low state, and the first cam lobe 182(III) of the third gear train 160 is in the high state. In this way, the second input gears of the first gear train 142 and the second gear train 150 are disengaged from the proximal gear 148 and the intermediate gear 156, respectively, while the second input gear of the second gear train 150 is engaged with the intermediate gear 156. Thus, only the distal gear 166 receives power from the power motor 112.

Further, the second cam lobe 186(I) of the first gear train 142 and the second cam lobe 186(II) of the second gear train 150 are in the high state and the second cam lobe 186(III) of the third gear train 160 is in the low state. In this way, the locking arm 188(I) of the first gear train 142 and the locking arm 188(II) of the second gear train 150 are engaged with the proximal gear 148 and the distal gear 156, respectively, while the locking arm 188(III) of the third gear train 160 is disengaged from the distal gear 166. Further, the interlock cam lobe 194 is driven to the high state, as described above with reference to fig. 7G. This moves the interlock flag 196 and allows the user access to manually back drive the second gear train in the event of a system failure.

Other variations are within the spirit of the invention. Thus, while the invention is susceptible to various modifications and alternative forms, specific illustrated embodiments thereof are shown in the drawings and have been described above in detail. It should be understood, however, that there is no intention to limit the invention to the specific form or forms disclosed, but on the contrary, the intention is to cover all modifications, alternative constructions, and equivalents falling within the spirit and scope of the invention as defined by the appended claims.

The use of the terms "a" and "an" and "the" and similar referents in the context of describing the invention (especially in the context of the following claims) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The terms "comprising," "having," "including," and "containing" are to be construed as open-ended terms (i.e., meaning "including, but not limited to,") unless otherwise noted. The term "connected" is to be construed as partially or wholly contained within, attached to, or joined together, even if intervening. Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., "such as") provided herein, is intended merely to better illuminate embodiments of the invention and does not pose a limitation on the scope of the invention unless otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the invention.

Preferred embodiments of this invention are described herein, including the best mode known to the inventors for carrying out the invention. Variations of those preferred embodiments may become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventors expect skilled artisans to employ such variations as appropriate, and the inventors intend for the invention to be practiced otherwise than as specifically described herein. Accordingly, this invention includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, any combination of the above-described elements in all possible variations thereof is encompassed by the invention unless otherwise indicated herein or otherwise clearly contradicted by context.

All references, including publications, patent applications, and patents, cited herein are hereby incorporated by reference to the same extent as if each reference were individually and specifically indicated to be incorporated by reference and were set forth in its entirety herein.