ELECTROMECHANICAL SURGICAL STAPLING DEVICES INCLUDING AN ARTICULATING TOOL ASSEMBLY
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Provisional Patent Application Serial No. 63/564,027, filed March 12, 2024, the entire content of each of which is incorporated herein by reference.
TECHNICAL FIELD
[0002] The disclosure is directed to surgical stapling devices and, more particularly, to surgical stapling devices with articulating tool assemblies.
BACKGROUND
[0003] Surgical stapling devices for simultaneously stapling and cutting tissue are well known in the art and include a tool assembly and a drive assembly. The tool assembly includes an anvil assembly and a cartridge assembly having a channel member and a staple cartridge that is received within the channel member. Typically, the staple cartridge includes a cartridge body that defines a knife slot and supports staples, pushers, and an actuation sled. The drive assembly is movable through the cartridge body to move the actuation sled into sequential engagement with the pushers to sequentially eject the staples from the cartridge body.
[0004] In some stapling devices, the drive assembly includes a laminated beam that is coupled to an I-beam that includes a vertical strut that is movable through the knife slot and defines a cutting edge for cutting tissue. Stapling devices with laminated beams are typically limited to articulation about a single axis and are typically limited to the amount of articulation achievable.
[0005] A continuing need exists for a wristed stapling device with a wrist assembly and a drive assembly capable of achieving greater degrees of articulation.
SUMMARY [0006] According to an aspect of the present disclosure, a tool assembly is provided for connection to a handle assembly of a surgical device. The tool assembly includes: an end effector including an anvil assembly and a staple cartridge channel; an elongated body having a proximal portion and a distal portion and defining a central longitudinal axis; and an articulation joint coupling the end effector with the elongated body.
[0007] The articulation joint includes: a distal articulation member supported at a proximal end of the end effector, the distal articulation member defining a central longitudinally extending through-slot formed therein; a proximal articulation member supported at a distal end of the elongated body, the proximal articulation member defining a central longitudinally extending through-slot formed therein; and a yaw coupler pivotably coupled to the distal articulation member and the proximal articulation member, the yaw coupler defining a central longitudinally extending through-slot formed therein.
[0008] The yaw coupler includes: a distal pivot boss that defines a first yaw pivot axis which is orthogonal to the central longitudinal axis, the distal pivot boss pivotally connecting a distal end of the yaw coupler to the distal articulation member; and a proximal pivot boss that defines a second yaw pivot axis which is orthogonal to the central longitudinal axis and parallel to the first yaw pivot axis, the proximal pivot boss pivotally connecting a proximal end of the yaw coupler to the proximal articulation member, the second yaw pivot axis being longitudinally spaced from the first yaw pivot axis.
[0009] The tool assembly further includes a drive assembly slidably supported within the elongated body and extending along the central longitudinal axis. The drive assembly includes: an I-beam disposed within the end effector; and a flexible drive beam having a distal end supporting the I-beam and a proximal end extending through the through-slot of the distal articulation member, through the through-slot of the yaw coupler, and through the through-slot of the proximal articulation member.
[0010] The tool assembly further includes: a first articulation cable slidably supported within the elongated body and spaced a transverse distance from the central longitudinal axis, the first articulation cable including a distal end secured to the distal articulation member and a proximal end extending through the proximal articulation member; and a second articulation cable slidably supported within the elongated body and spaced a transverse distance from the central longitudinal axis on a side opposite the first articulation cable, the second articulation cable including a distal end secured to the distal articulation member, on a side opposite the first articulation cable, and a proximal end extending through the proximal articulation member.
[0011] The distal articulation member may include: a first angled surface on a first side of the central longitudinal axis, wherein the first angled surface of the distal articulation member defines a first angle relative to the central longitudinal axis, and wherein the distal end of the first articulation cable is secured to the first angled surface of the distal articulation member; and a second angled surface on a second side of the central longitudinal axis, opposite the first angled surface of the distal articulation member, wherein the second angled surface of the distal articulation member defines a second angle relative to the central longitudinal axis, and wherein the distal end of the second articulation cable is secured to the second angled surface of the distal articulation member.
[0012] The proximal articulation member may include: a first angled surface on a first side of the central longitudinal axis, wherein the first angled surface of the proximal articulation member defines a first angle relative to the central longitudinal axis, and wherein the proximal end of the first articulation cable slidably extends through the first angled surface of the proximal articulation member; and a second angled surface on a second side of the central longitudinal axis, opposite the first angled surface of the proximal articulation member, wherein the second angled surface of the proximal articulation member defines a second angle relative to the central longitudinal axis, and wherein the proximal end of the second articulation cable slidably extends through the second angled surface of the proximal articulation member,
[0013] The first angled surface of the distal articulation member may be in apposition to the first angle surface of the proximal articulation member, and the second angled surface of the distal articulation member may be in apposition to the second angle surface of the proximal articulation member. [0014] The first angled surface of the distal articulation member may be angled 45 degrees relative to the central longitudinal axis and the second angled surface of the distal articulation member may be angled 45 degrees relative to the central longitudinal axis. The first angled surface of the proximal articulation member may be angled 45 degrees relative to the central longitudinal axis, and the second angled surface of the proximal articulation member may be angled 45 degrees relative to the central longitudinal axis.
[0015] The first angled surface of the distal articulation member may define a flared cone shaped through bore, wherein the distal end of the first articulation cable is received within the flared cone shaped through bore of the first angled surface of the distal articulation member.
[0016] The second angled surface of the distal articulation member may define a flared cone shaped through bore, wherein the distal end of the second articulation cable is received within the flared cone shaped through bore of the second angled surface of the distal articulation member.
[0017] The first angled surface of the proximal articulation member may define a flared cone shaped through passage, wherein the proximal end of the first articulation cable extends through the flared cone shaped through passage of the first angled surface of the proximal articulation member, wherein an enlarged portion of the flared cone shaped through bore of the first angled surface of the distal articulation member is in apposition to an enlarged portion of the flared cone shaped through passage of the first angled surface of the proximal articulation member.
[0018] The second angled surface of the proximal articulation member may define a flared cone shaped through passage, wherein the proximal end of the second articulation cable extends through the flared cone shaped through passage of the second angled surface of the proximal articulation member, wherein an enlarged portion of the flared cone shaped through bore of the second angled surface of the distal articulation member is in apposition to an enlarged portion of the flared cone shaped through passage of the second angled surface of the proximal articulation member. [0019] The tool assembly may further include a cable drive assembly supported at a proximal end of the elongated body. The cable drive assembly may include a first cable worm wheel rotatably supported in a housing of the tool assembly. The first cable worm wheel may include a first gear and a first capstan supported on and extending from the first gear, wherein the proximal end of the first articulation cable is wrapped at least partially around the first capstan.
[0020] The cable drive assembly may include a second cable worm wheel rotatably supported in the housing of the tool assembly. The second cable worm wheel may include a second gear and a second capstan supported on and extending from the second gear, wherein the proximal end of the second articulation cable is wrapped at least partially around the second capstan.
[0021] The cable drive assembly may include a worm gear rotatably supported in the housing of the tool assembly, the worm gear meshingly engaged with the first gear of the first cable worm wheel and with the second gear of the second worm wheel.
[0022] The first gear of the first cable worm wheel, the second gear of the second cable worm wheel, and the worm gear may be configured such that rotation of the worm gear in a first direction results in rotation of the first gear of the first cable worm wheel in a first direction and rotation of the second gear of the second cable worm wheel in a second direction, wherein the first direction is opposite the second direction.
[0023] The proximal end of the first articulation cable may be wound around the first capstan of the first cable worm wheel and the proximal end of the second articulation cable may be wound around the second capstan of the second cable worm wheel.
[0024] The worm gear may be oriented so as to define a longitudinal axis which is parallel with the central longitudinal axis of the elongated body, and the first cable worm wheel and the second cable worm wheel may each be oriented so as to define a respective longitudinal axis which is oriented orthogonal to the central longitudinal axis of the elongated body.
[0025] According to another aspect of the disclosure, a tool assembly is provided for connection to a handle assembly of a surgical device. The tool assembly includes: an end effector including an anvil assembly and a staple cartridge channel; an elongated body having a proximal portion and a distal portion and defining a central longitudinal axis; and an articulation joint coupling the end effector with the elongated body. The articulation joint includes: a distal articulation member supported at a proximal end of the end effector; a proximal articulation member supported at a distal end of the elongated body; and a yaw coupler pivotably coupled to the distal articulation member and the proximal articulation member.
[0026] The tool assembly further includes a drive assembly including a drive assembly slidably supported within the elongated body and extending along the central longitudinal axis. The drive assembly includes: an I-beam disposed within the end effector; and a flexible drive beam having a distal end supporting the I-beam and a proximal end extending through the distal articulation member, through the yaw coupler, and through the proximal articulation member.
[0027] The tool assembly further includes a first articulation cable slidably supported within the elongated body and spaced a transverse distance from the central longitudinal axis. The first articulation cable includes a distal end secured to the distal articulation member and a proximal end extending through the proximal articulation member.
[0028] The tool assembly further includes a second articulation cable slidably supported within the elongated body and spaced a transverse distance from the central longitudinal axis on a side opposite the first articulation cable. The second articulation cable includes a distal end secured to the distal articulation member, on a side opposite the first articulation cable, and a proximal end extending through the proximal articulation member.
[0029] The tool assembly further includes a cable drive assembly supported at a proximal end of the elongated body. The cable drive assembly includes a first cable worm wheel rotatably supported in a housing of the tool assembly. The first cable worm wheel includes a first gear and a first capstan supported on and extending from the first gear, wherein the proximal end of the first articulation cable is wrapped at least partially around the first capstan. The cable drive assembly also includes a second cable worm wheel rotatably supported in the housing of the tool assembly. The second cable worm wheel includes a second gear and a second capstan supported on and extending from the second gear, wherein the proximal end of the second articulation cable is wrapped at least partially around the second capstan.
[0030] The cable drive assembly includes a worm gear rotatably supported in the housing of the tool assembly, the worm gear meshingly engaged with the first gear of the first cable worm wheel and with the second gear of the second worm wheel.
[0031] The first gear of the first cable worm wheel, the second gear of the second cable worm wheel, and the worm gear may be configured such that rotation of the worm gear in a first direction results in rotation of the first gear of the first cable worm wheel in a first direction and rotation of the second gear of the second cable worm wheel in a second direction, wherein the first direction is opposite the second direction.
[0032] The proximal end of the first articulation cable may be wound around the first capstan of the first cable worm wheel and the proximal end of the second articulation cable may be wound around the second capstan of the second cable worm wheel.
[0033] The worm gear may be oriented so as to define a longitudinal axis which is parallel with the central longitudinal axis of the elongated body, and the first cable worm wheel and the second cable worm wheel may each be oriented so as to define a respective longitudinal axis which is oriented orthogonal to the central longitudinal axis of the elongated body.
[0034] The distal articulation member may define a central longitudinally extending through-slot formed therein, the proximal articulation member may define a central longitudinally extending through-slot formed therein, and the yaw coupler may define a central longitudinally extending through-slot formed therein.
[0035] The yaw coupler may include: a distal pivot boss defining a first yaw pivot axis which is orthogonal to the central longitudinal axis, wherein the distal pivot boss pivotally connects a distal end of the yaw coupler to the distal articulation member; and a proximal pivot boss defining a second yaw pivot axis which is orthogonal to the central longitudinal axis and parallel to the first yaw pivot axis, wherein the proximal pivot boss pivotally connects a proximal end of the yaw coupler to the proximal articulation member, the second yaw pivot axis being longitudinally spaced from the first yaw pivot axis.
[0036] The distal articulation member may include: a first angled surface on a first side of the central longitudinal axis, wherein the first angled surface of the distal articulation member defines a first angle relative to the central longitudinal axis, and wherein the distal end of the first articulation cable is secured to the first angled surface of the distal articulation member; and a second angled surface on a second side of the central longitudinal axis, opposite the first angled surface of the distal articulation member, wherein the second angled surface of the distal articulation member defines a second angle relative to the central longitudinal axis, and wherein the distal end of the second articulation cable is secured to the second angled surface of the distal articulation member.
[0037] The proximal articulation member may include: a first angled surface on a first side of the central longitudinal axis, wherein the first angled surface of the proximal articulation member defines a first angle relative to the central longitudinal axis, and wherein the proximal end of the first articulation cable slidably extends through the first angled surface of the proximal articulation member; and a second angled surface on a second side of the central longitudinal axis, opposite the first angled surface of the proximal articulation member, wherein the second angled surface of the proximal articulation member defines a second angle relative to the central longitudinal axis, and wherein the proximal end of the second articulation cable slidably extends through the second angled surface of the proximal articulation member.
[0038] The first angled surface of the distal articulation member may be in apposition to the first angle surface of the proximal articulation member, and the second angled surface of the distal articulation member may be in apposition to the second angle surface of the proximal articulation member.
[0039] The first angled surface of the distal articulation member may be angled 45 degrees relative to the central longitudinal axis, and the second angled surface of the distal articulation member may be angled 45 degrees relative to the central longitudinal axis. The first angled surface of the proximal articulation member may be angled 45 degrees relative to the central longitudinal axis, and the second angled surface of the proximal articulation member may be angled 45 degrees relative to the central longitudinal axis.
[0040] The first angled surface of the distal articulation member may define a flared cone shaped through bore, wherein the distal end of the first articulation cable is received within the flared cone shaped through bore of the first angled surface of the distal articulation member. The second angled surface of the distal articulation member may defines a flared cone shaped through bore, wherein the distal end of the second articulation cable is received within the flared cone shaped through bore of the second angled surface of the distal articulation member. The first angled surface of the proximal articulation member may define a flared cone shaped through passage, wherein the proximal end of the first articulation cable extends through the flared cone shaped through passage of the first angled surface of the proximal articulation member, and an enlarged portion of the flared cone shaped through bore of the first angled surface of the distal articulation member is in apposition to an enlarged portion of the flared cone shaped through passage of the first angled surface of the proximal articulation member. The second angled surface of the proximal articulation member defines a flared cone shaped through passage, wherein the proximal end of the second articulation cable extends through the flared cone shaped through passage of the second angled surface of the proximal articulation member, and an enlarged portion of the flared cone shaped through bore of the second angled surface of the distal articulation member is in apposition to an enlarged portion of the flared cone shaped through passage of the second angled surface of the proximal articulation member.
[0041] According to a further aspect of the disclosure, a surgical device is provided and includes a handle assembly including a motor and a battery for powering the motor, and a tool assembly selectively connectable to the handle assembly and configured to receive rotary forces from the motor and electrical power from the battery.
[0042] The tool assembly includes: an end effector including an anvil assembly and a staple cartridge channel; an elongated body having a proximal portion and a distal portion and defining a central longitudinal axis; and an articulation joint coupling the end effector with the elongated body. The articulation joint includes: a distal articulation member supported at a proximal end of the end effector; a proximal articulation member supported at a distal end of the elongated body; and a yaw coupler pivotably coupled to the distal articulation member and the proximal articulation member.
[0043] The tool assembly includes a drive assembly slidably supported within the elongated body and extending along the central longitudinal axis. The drive assembly includes an I-beam disposed within the end effector, and a flexible drive beam having a distal end supporting the I-beam and a proximal end extending through the distal articulation member, the through the yaw coupler, and through the proximal articulation member.
[0044] The tool assembly includes: a first articulation cable slidably supported within the elongated body and spaced a transverse distance from the central longitudinal axis, the first articulation cable including a distal end secured to the distal articulation member and a proximal end extending through the proximal articulation member; and a second articulation cable slidably supported within the elongated body and spaced a transverse distance from the central longitudinal axis on a side opposite the first articulation cable, the second articulation cable including a distal end secured to the distal articulation member, on a side opposite the first articulation cable, and a proximal end extending through the proximal articulation member.
[0045] The tool assembly includes a cable drive assembly supported at a proximal end of the elongated body. The cable drive assembly includes a first cable worm wheel rotatably supported in a housing of the tool assembly. The first cable worm wheel includes a first gear and a first capstan supported on and extending from the first gear, wherein the proximal end of the first articulation cable is wrapped at least partially around the first capstan. The cable drive assembly also includes a second cable worm wheel rotatably supported in the housing of the tool assembly. The second cable worm wheel includes a second gear and a second capstan supported on and extending from the second gear, wherein the proximal end of the second articulation cable is wrapped at least partially around the second capstan. The cable drive assembly further includes a worm gear rotatably supported in the housing of the tool assembly, the worm gear meshingly engaged with the first gear of the first cable worm wheel and with the second gear of the second worm wheel. [0046] The surgical device includes a staple cartridge selectively connectable within the staple cartridge channel of the end effector.
[0047] The distal articulation member of the articulation joint of the tool assembly may define a central longitudinally extending through-slot formed therein. The proximal articulation member of the articulation joint of the tool assembly may define a central longitudinally extending through-slot formed therein. The yaw coupler of the articulation joint of the tool assembly may define a central longitudinally extending through-slot formed therein.
[0048] The yaw coupler may include: a distal pivot boss that defines a first yaw pivot axis which is orthogonal to the central longitudinal axis, the distal pivot boss pivotally connecting a distal end of the yaw coupler to the distal articulation member; and a proximal pivot boss that defines a second yaw pivot axis which is orthogonal to the central longitudinal axis and parallel to the first yaw pivot axis, the proximal pivot boss pivotally connecting a proximal end of the yaw coupler to the proximal articulation member, the second yaw pivot axis being longitudinally spaced from the first yaw pivot axis.
[0049] Other aspects, features, and advantages will be apparent from the description, the drawings, and the claims that follow.
BRIEF DESCRIPTION OF THE DRAWINGS
[0050] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the disclosure and, together with a general description of the disclosure given above, and the detailed description of the embodiment(s) given below, serve to explain the principles of the disclosure, wherein:
[0051] FIG. 1 is a perspective view of an electromechanical surgical stapling device in accordance with the principles of the disclosure, the electromechanical surgical stapling device having an end effector of a tool assembly shown in an unarticulated and unclamped position;
[0052] FIG. 2 is a rear, perspective view of the tool assembly of the electromechanical surgical stapling device of FIG. 1 with an end effector thereof shown in an unclamped and with a cartridge assembly separated from the end effector; [0053] FIG. 3 is a perspective view of the tool assembly shown in FIG. 2, with parts separated;
[0054] FIG. 4 is an enlarged, perspective view of the indicated area of detail of FIG. 2;
[0055] FIG. 5 is an enlarged, perspective view of the articulation joint of the tool assembly illustrating a pivot housing separated therefrom;
[0056] FIG. 6 is an enlarged, perspective view of the indicated area of detail of FIG. 3;
[0057] FIG. 7 is a cross-sectional view of the tool assembly as taken through 7-7 of FIG.
2;
[0058] FIG. 8 is a cross-sectional view of the tool assembly as taken through 8-8 of FIG. 7;
[0059] FIG. 9 is a cross-sectional view of the articulation joint of the tool assembly as taken through 9-9 of FIG. 2;
[0060] FIG. 10 is an enlarged, perspective view of the indicated area of detail of FIG. 7;
[0061] FIG. 11 is an enlarged, perspective view of the indicated area of detail of FIG. 8;
[0062] FIG. 12 is a perspective view of a distal end of the tool assembly of FIGS 1 and 2, illustrating the end effector in a fully articulated position;
[0063] FIG. 13 is a cross-sectional view of the distal end of the tool assembly as taken through 13-13 of FIG. 12;
[0064] FIG. 14 is a cross-sectional view of the distal end of the tool assembly as taken through 14-14 of FIG. 12;
[0065] FIG. 15 is the cross-sectional view of FIG. 14 with cables and a drive beam removed therefrom for clarity; [0066] FIG. 16 is a top, perspective view of a housing assembly of a proximal end portion of the tool assembly with a top housing half removed therefrom for clarity;
[0067] FIG. 17 is a bottom, perspective view of a housing assembly of a proximal end portion of the tool assembly with a bottom housing half removed therefrom for clarity;
[0068] FIG. 18 is an enlarged view of the indicated area of detail of FIG. 3;
[0069] FIG. 19 is an enlarged view of the indicated area of detail of FIG. 3;
[0070] FIG. 20 is an enlarged view of the indicated area of detail of FIG. 7;
[0071] FIG. 21 is a bottom, perspective view of the housing assembly of FIG. 17, with the bottom housing half, with worm wheels and with coil springs removed for clarity;
[0072] FIG. 22 is a top, plan view the housing assembly of FIG. 21;
[0073] FIG. 23 is a top, plan view the housing assembly of FIG. 22, illustrating an operation thereof;
[0074] FIG. 24 is an enlarged view of the indicated area of FIG. 11 ;
[0075] FIG. 25 is a perspective view of the gear assembly of the housing assembly of the tool assembly;
[0076] FIG. 26 is a front, perspective view of the circuit board assembly of the tool assembly;
[0077] FIG. 27 is a front, perspective view of the circuit board assembly of FIG. 26 illustrated in place in the housing assembly;
[0078] FIG. 28 is a perspective view, with parts removed, of a guide of the tool assembly;
[0079] FIG. 29 is a perspective view of the pneumo-seal of the tool assembly; and [0080] FIG. 30 is a schematic illustration of a medical work station and operating console in accordance with the present disclosure.
DETAILED DESCRIPTION
[0081] The disclosed electromechanical surgical stapling device will now be described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. However, it is to be understood that aspects of the disclosure are merely exemplary of the disclosure and may be embodied in various forms. Well-known functions or constructions are not described in detail to avoid obscuring the disclosure in unnecessary detail. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the disclosure in virtually any appropriately detailed structure.
[0082] As used herein, the term “distal” refers to that portion of the system, assembly, device, and/or component thereof, farther from the user, while the term “proximal” refers to that portion of the system, assembly, device, and/or component thereof, closer to the user. As used herein, the term “clinician” refers to a doctor, nurse, or other care provider and may include support personnel. In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail.
[0083] The disclosed electromechanical surgical stapling device includes a tool assembly, an articulation joint, and a drive assembly including a flexible drive beam. The articulation joint includes a distal articulation member, a middle articulation link or coupler, and a proximal articulation member that are configured to facilitate articulation of the tool assembly about spaced articulation axes in a yaw direction and provide support and guidance to the drive beam during firing of the stapling device.
[0084] FIG. 1 illustrates an electromechanical surgical stapling device according to aspects of the disclosure shown generally as stapling device 10. The stapling device 10 includes a handle assembly 12, and a tool assembly 14 having an elongated body 14a, and an articulation joint 16. The articulation joint 16 couples the tool assembly 14 to the elongated body 14a for articulation of the tool assembly 14 about an articulation axis. The elongated body 14a defines a longitudinal axis “X” (FIG. 1).
[0085] The handle assembly 12 includes a body 19 that defines a hand grip 19a, a plurality of actuator buttons 20, and a housing assembly 22. The housing assembly 22 is rotatably supported on a distal portion of the body 19 of the handle assembly 12 and supports the elongated body 14a to facilitate rotation of the elongated body 14a and the tool assembly 14 in relation to the handle assembly 12 about the longitudinal axis “X”. The actuator buttons 20 control operation of the various functions of the stapling device 10 including articulation, clamping, firing, and cutting of tissue.
[0086] The handle assembly 12 may include a rechargeable battery “B” (FIG. 1) configured to supply power to any of the electrical components of surgical stapler 10, a battery circuit board (not shown), and a controller circuit board (not shown). The handle assembly 12 may further include three motors (one motor “M” illustrated in FIG. 1) each electrically connected to the controller circuit board and the battery. Each motor includes a respective motor shaft extending therefrom for transmitting rotative forces or torque. The motors of the handle assembly 12 are configured to drive shafts and/or gear components of tool assembly 14 in order to selectively operate tool assembly 14 and/or the end effector 18.
[0087] Although the stapling device 10 is illustrated as an electrically powered stapling device, it is envisioned that the disclosed tool assembly 14 would also be suitable for use with manually powered surgical stapling devices and robotically operated stapling devices. U.S. Patent No. 9,055,943 discloses a surgical stapling device including a powered handle assembly, U.S. Patent No. 6,241,139 discloses a surgical stapling device including a manually actuated handle assembly, and U.S Patent No. 9,962,159 discloses a stapling device that is configured for use with a robotic system.
[0088] FIG. 2 illustrates the tool assembly 14 which is supported on or connectable to handle assembly 12, and which defines the longitudinal axis “X”. The tool assembly 14 includes an end effector 18 having an anvil assembly 30 and a staple cartridge channel 32 configured to selectively receive a staple cartridge assembly 38. The anvil assembly 30 is fixedly secured to the articulation joint 16 via screws or pins (not shown), and the staple cartridge channel 32 is pivotably secured to the anvil assembly 30 by pins or screws 34 (FIG. 4). The staple cartridge channel 32 defines a cavity 32a configured for receiving the staple cartridge assembly 38 therein. The staple cartridge channel 32 defines an elongated slot (not shown) that facilitates passage of an I-beam 150 (FIG. 6) of a drive assembly 110 of the stapling device 10 as described below. In aspects of the disclosure, the staple cartridge assembly 38 is releasably received within the cavity 32a of the staple cartridge channel 32 to facilitate replacement of the staple cartridge assembly 38 and reuse of the stapling device 10. The staple cartridge assembly 38 defines a longitudinal knife slot and a plurality of staple receiving pockets.
[0089] In aspects of the disclosure, the anvil assembly 30 includes a proximal portion that includes spaced wings that extend downwardly about a proximal portion of the staple cartridge channel 32. The spaced wings of the anvil assembly define openings that receive the pins 34 to secure the anvil assembly 30 to the articulation joint 16 and to rotatably secure the anvil assembly 30 to the staple cartridge channel 32. The staple cartridge channel 32 includes corresponding openings that receive the pins 34.
[0090] FIGS. 3-15 illustrate the articulation joint 16 which includes a proximal articulation member 50 supported at the distal end of elongated body 14a, a distal articulation member 54 supported in a proximal end of the staple cartridge channel 32, and a yaw coupler 58 pivotally connected to each of the proximal articulation member 50 and the distal articulation member 54.
[0091] In aspects of the disclosure, a proximal portion of the distal articulation member 54 defines a bore 54a that defines a first yaw pivot axis “Yl” (FIGS. 5 and 6) that is perpendicular to the longitudinal axis “X” of the anvil assembly 30 and perpendicular to a pivot axis of the staple cartridge channel 32 relative to the anvil assembly 30. The proximal portion 62 of the distal articulation member 54 also defines longitudinally extending through bores 70 (see FIGS. 14 and 15) formed on opposed lateral sides of the longitudinal axis “X”. Specifically, the through bores 70 are longitudinally aligned with the longitudinal axis “X” of the anvil assembly 30 and are positioned on opposite sides of the distal articulation member 54. The longitudinal through bores 70 receive and guide distal portions of first and second articulation cables 76, 78 (FIGS. 3-5 and 14). In aspects of the disclosure, the first and second articulation cables 76 and 78 are formed from stranded metal wire or spring steel although other materials of construction are envisioned.
[0092] Each through bore 70 of the distal articulation member 54 has a generally frustoconical or flared cone shape wherein a large diameter portion of the through bore 70 is oriented proximally. Further, the body of the distal articulation member 54 is chamfered across each through bore 70 to define an angled surface 54b. Angled surfaces 54b of the distal articulation member 54 extend proximally and inwardly from an outer edge of the distal articulation member 54, and each define an angle “0” relative to the longitudinal axis of the anvil assembly 30.
[0093] The proximal portion 62 of the distal articulation member 54 also includes a pair of proximally extending teeth 72 (FIG. 13) that are spaced to define a cavity 72a therebetween.
[0094] The distal articulation member 54 also defines a longitudinally extending through slot 79 that is formed therethrough and is configured to slidably receive an I-beam 150 and a flexible drive beam 112 of drive assembly 110.
[0095] The proximal articulation member 50 (FIGS. 3-6) includes a body that can be formed integrally with or secured to the distal portion of the elongated body 14a (FIG. 3) of the stapling device 10. The proximal articulation member 50 includes a tooth 96 positioned on each side of the body thereof (only one tooth 96 shown in FIGS. 3-6). The teeth 96 of proximal articulation member 50 are configured and sized to be inter-digitated within the cavity 72a defined between the pair of teeth 72 of the distal articulation member 54.
[0096] The proximal articulation member 50 defines a bore 50a that defines a second yaw pivot axis “Y2” (FIGS. 5 and 6) that is perpendicular to the longitudinal axis “X” of the anvil assembly 30 and perpendicular to a pivot axis of the staple cartridge channel 32 relative to the anvil assembly 30. The second yaw pivot axis “Y2” is longitudinally spaced from the first yaw pivot axis “Yl”. [0097] The proximal articulation member 50 defines a longitudinally extending through slot 101 that is formed therethrough and is configured to slidably receive the flexible drive beam 112 of drive assembly 110. The longitudinally extending through slot 101 of proximal articulation member 50 is aligned with the longitudinally extending through slot 79 of distal articulation member 54.
[0098] The proximal articulation member 50 further longitudinally extends through channels 101a (see FIGS. 14 and 15) formed on opposed lateral sides of the longitudinal axis “X”. Specifically, the through channels 101a are longitudinally aligned with the longitudinal axis “X” of the anvil assembly 30 and are positioned on opposite sides of the proximal articulation member 50. The longitudinal through channels 101a receive and guide portions of first and second articulation cables 76, 78 (FIGS. 3-5 and 14).
[0099] Each through channel 101a of the proximal articulation member 50 has a generally frustoconical or flared cone shape wherein a large diameter portion of the through channel 101a is oriented distally. Further, the body of the proximal articulation member 50 is chamfered across each through channel 101a to define an angled surface 50b. Angled surfaces 50b of the proximal articulation member 50 extend distally and inwardly from an outer edge of the proximal articulation member 50, and each define an angle “0” relative to the longitudinal axis of the elongated body 14a.
[00100] The distal articulation member 54 is coupled to the proximal articulation member 50 by a yaw link or coupler 58 shown in FIGS. 5 and 6. The yaw coupler 58 includes a body 58a having a distal pair of pins or bosses 58b that couple to the distal articulation member 54, and a proximal pair of pins or bosses 58c that couple to the proximal articulation member 50. The body 58a of the yaw coupler 58 defines a through bore or slot 58d that receives and guides the flexible drive beam 112 of drive assembly 110 (FIGS. 6, 14, 15) around the yaw axes “Yl” and “Y2” The distal pair of pins or bosses 58b of the yaw coupler 58 are received within the openings or holes formed in the distal articulation member 54 and define an axis that is coincident with the first yaw pivot axis “Yl”, and the proximal pair of pins or bosses 58c of the yaw coupler 58 are received within the openings or holes formed in the proximal articulation member 50 and define an axis that is coincident with the second yaw axis “Y2”. [00101] As briefly described above, the articulation cables 76, 78 extend through the proximal articulation member 50 and are coupled to the distal articulation member 54. When the first articulation cable 76 is retracted (or pulled on) and the second articulation cable 78 is advanced (or let out), the distal articulation member 54, and the tool assembly 14 which is coupled to the distal articulation member 54, is pivoted in a first direction about the yaw pivot axes “Yl” and “Y2”, and when the second articulation cable 78 is retracted (or pulled on) and the first articulation cable 76 is advanced (or let out), the distal articulation member 54, and the tool assembly 14 which is coupled to the distal articulation member 54, is pivoted in a second direction (opposite the first direction) about the yaw pivot axes “Yl” and “Y2”.
[00102] Engagement between the teeth 72 of the distal articulation member and the tooth 96 of the proximal articulation member 50 causes the distal articulation member 54 to pivot uniformly about the yaw pivot axes “Yl” and “Y2”
[00103] Further, when fully articulated in the first direction, the angled surface 54b of the distal articulation member 54 located on a first side of tool assembly 14 abuts against, or otherwise contacts, the angled surface 50b of the proximal articulation member 50 also located on the second side of tool assembly 14, whereby the tool assembly 14 is articulated 90 degrees, in a first direction, relative to the longitudinal “X” axis. Likewise, when fully articulated in the second direction, the angled surface 54b of the distal articulation member 54 located on a second side of tool assembly 14 abuts against, or otherwise contacts, the angled surface 50b of the proximal articulation member 50 also located on the second side of tool assembly 14, whereby the tool assembly 14 is articulated 90 degrees, in a second direction, relative to the longitudinal “X” axis.
[00104] As illustrated in FIGS. 13-15, when the tool assembly 14 is articulated 90 degrees, in the second direction, the first articulation cable 76 is let out and a side of the first articulation cable 76 facing toward the central axis of tool assembly 14 is supported against the inner portion of respective through bore 70 of the distal articulation member 54 and against the inner portion of respective through channel 101a of the proximal articulation member 50. Meanwhile, the second articulation cable 78 is retracts and a side of the second articulation cable 78 facing away from the central axis of tool assembly 14 is supported against the outer portion of respective through bore 70 of the distal articulation member 54 and against the outer portion of respective through channel 101a of the proximal articulation member 50.
[00105] Similarly, when the tool assembly 14 is articulated 90 degrees, in the first direction, the first articulation cable 76 is retracted and a side of the first articulation cable 76 facing away from the central axis of tool assembly 14 is supported against the outer portion of respective through bore 70 of the distal articulation member 54 and against the outer portion of respective through channel 101a of the proximal articulation member 50. Meanwhile, the second articulation cable 78 is let out and a side of the second articulation cable 78 facing toward the central axis of tool assembly 14 is supported against the inner portion of respective through bore 70 of the distal articulation member 54 and against the inner portion of respective through channel 101a of the proximal articulation member 50.
[00106] The geometries of the through bore 70 of the distal articulation member 54 and the through channel 101a of the proximal articulation member 50 are such that when the tool assembly 14 is articulated in either the first direction or the second direction, the length of the first articulation cable 76 and the second articulation cable 78 are maintained equal or substantially the same so that a tension in each of the first articulation cable 76 and the second articulation cable 78 is maintained the same, and slack is reduced.
[00107] Further, as illustrated in FIG. 14, the through-slot 58d of the yaw coupler 58 is configured and dimensioned to maintain the laminates of the flexible drive beam 112 substantially along the center line or central longitudinal axis of the tool assembly 14, during firing of the stapling device 10, while the tool assembly 14 is articulation, such that the first articulation cable 76 and the second articulation cable 78 are maintained under tension and there is limited or no movement of the yaw coupler 58. By maintaining the flexible drive beam 112 substantially along the center line of the tool assembly 14, when the tool assembly 14 is articulated, less torque is placed on the articulation joint 16, and thus increased joint stability is achieved. Further, by maintaining the flexible drive beam 112 substantially along the center line of the tool assembly 14, also tends to mitigate advancement of the I-beam 150 during articulation of the tool assembly 14. [00108] As illustrated in FIGS. 6, 10 and 14, tool assembly 14 may include blow out plates 64 and 66 disposed on either side of the flexible drive beam 112 and extending across the articulation joint 16. Specifically, a distal end of each blow out plate 64 and 66 may be secured within distal articulation member 54 while a proximal end of each blow out plate 64 and 66 is free to translate within the proximal articulation member 50.
[00109] Turning now to FIGS. 16-27, the housing assembly 22 of tool assembly 14 includes a housing 202 having a mounting assembly 202a at a proximal end portion thereof that couples to a distal end portion of the stapling device 10. The housing 202 further includes an outer housing 202b rotatably coupled to the mounting assembly 202a and surrounding an inner housing 202c. The elongated body 14a extends distally from the housing 202.
[00110] The mounting assembly 202a of the housing 202 supports an electrical assembly 208 with electrical components (e.g., circuit board 208a, pins 208b, etc.) for electrical connection to a corresponding electrical plug (not shown) disposed in a connection portion of the stapling device 10.
[00111] The mounting assembly 202a includes a mounting button 212 that is spring biased toward an extended position and is configured to be depressed downwardly to a compressed position to selectively couple the mounting assembly 202a of the tool assembly 14 to the connection portion of the stapling device 10. For a detailed description of similar electrical and mounting assemblies, reference can be made to U.S. Patent Application Publication No. 2015/0157320, filed November 21, 2014, the entire contents of which are incorporated by reference herein.
[00112] The housing assembly 22 also supports an articulation or cable drive assembly 220 that includes articulation cables 76 and 78 and which are configured to articulate the tool assembly 14, as initially described above. The cable drive assembly 220 is supported in and/or by the inner housing 202c. The cable drive assembly 220 includes a first cable worm wheel 224, a second cable worm wheel 225, and a worm gear 226 that are rotatably supported in and/or on the inner housing 202c. [00113] The first cable worm wheel 224 of the cable drive assembly 220 includes a first gear 224a, a first capstan 224b supported on and extending from the first gear 224a, and a first fastener 224c (e.g., spring clip) that rotatably couples the first worm wheel 224 in inner housing 202c. Similarly, the second cable worm wheel 225 of the cable drive assembly 220, which mirrors the first cable worm wheel 224, includes a second gear 225a, a second capstan 225b supported on and extending from the second gear 225a, and a second fastener 225c (e.g., spring clip) that rotatably couples the second worm wheel 225 in inner housing 202c.
[00114] First fastener 224c and second fastener 225c further function to provide drag to the cable drive assembly 220 such that when the tool assembly 14 is manually rotated relative to the handle assembly 12 the respective motor of the handle assembly 12 is back driven thereby preventing any unwanted articulation of the tool assembly 14 during manual rotation thereof.
[00115] The first gear 224a of the first cable worm wheel 224 and the second gear 225a of the second cable worm wheel 225 are meshingly connected to one another via worm gear 226. The first gear 224a, the second gear 225a, and the worm gear 226 are configured such that rotation of the worm gear 226 in a first direction results in rotation of the first gear 224a in a first direction and rotation of the second gear 225a in a second direction (opposite the first direction of the first gear 224a). Similalrly, rotation of the worm gear 226 in a second direction (opposite the first direction thereof) results in rotation of the first gear 224a in a second direction (opposite the first direction thereof) and rotation of the second gear 225a in a first direction (opposite the second direction of the first gear 224a).
[00116] The first articulation cable 76 is wound around first capstan 224b of first cable worm wheel 224 and has a proximal end portion that is fixed to first capstan 224b via ferrules or the like. The second articulation cable 78 is wound around second capstan 225b of second cable worm wheel 225 and has a proximal end portion that is fixed to second capstan 225b via ferrules or the like. In this manner, as the worm gear 226 is rotated in the first direction thereof, the first articulation cable 76 may be let out as the first cable worm wheel 224 is rotated in the first direction while the second articulation cable 78 may be drawn in as the second cable worm wheel 225 is rotated in the second direction, and vice-versa. [00117] The first articulation cable 76 is wound clockwise around first capstan 224b of first cable worm wheel 224, and, as illustrated in FIG. 20, the cable drive assembly 220 includes a guide pin 229 to route the second articulation cable 78 such that the second articulation cable 78 is wound clockwise around second capstan 225b of second cable worm wheel 225. While this arrangement of worm wheels and articulation cables and cable windings is described, it is understood that any similar arrangements of worm wheels, articulation cables and windings is within the scope of the disclosure.
[00118] The worm gear 226 is oriented so as to define a longitudinal axis which is parallel with the longitudinal “X” axis. The worm gear 226 includes a spur gear 227 non-rotatably connected to a proximal end thereof. The spur gear 227 is meshingly engaged with a distal spur gear 228a of a cluster gear 228. The distal spur gear 228a of the cluster gear 228 is non-rotatably connected to a proximal spur gear 228b of the cluster gear 228. The proximal spur gear 228b of the cluster gear 228 meshingly engages with a drive spur gear 229 which is non-rotatably supported on a third or articulation drive shaft 230c of the housing assembly 22 of the tool assembly 14. Articulation drive shaft 230c of the tool assembly 14 is rotatably supported in the mounting assembly 202a of the housing assembly 22 and is configured to receive a rotary drive input from a respective motor of handle assembly 12.
[00119] The housing assembly 22 also supports a first or firing drive shaft 230a rotatably in the mounting assembly 202a. The first or firing drive shaft 230a is configured to receive a rotary drive input from a respective motor of handle assembly 12. The first or firing drive shaft 230a includes a distal end portion 231 having a threaded outer profile or surface.
[00120] The housing assembly 22 also includes a drive coupling nut 244 rotatably coupled to threaded distal end portion 231 of the first or firing drive shaft 230a, and which is slidably (and non-rotatably) disposed within the inner housing 202c.
[00121] Drive coupling nut 244 is slidably keyed within the inner housing 202c so as to be prevented from rotation as the first or firing drive shaft 230a is rotated. In this manner, as the first or firing drive shaft 230a is rotated, drive coupling nut 244 is translated along threaded distal end portion 231 of the first or firing drive shaft 230a and, in turn, through and/or along elongated shaft 14a.
[00122] Tool assembly 14 includes a distal drive member 248 that is mechanically engaged with drive coupling nut 244, such that axial movement of drive coupling nut 244 results in a corresponding amount of axial movement of the distal drive member 248. The distal end portion of distal drive member 248 supports a connection member 247 configured and dimensioned for engagement with a proximal end of the flexible drive beam 112. Drive coupling nut 244 and/or distal drive member 248 function as a force transmitting member to components of the end effector 18 of the tool assembly 14.
[00123] In operation, as the first or firing drive shaft 230a is rotated, due to an input drive rotation from a respective motor of the handle assembly 12, drive coupling nut 244 is caused to be translated axially along the first or firing drive shaft 230a. As drive coupling nut 244 is caused to be translated axially along the first or firing drive shaft 230a, distal drive member 248 is caused to be translated axially relative to the elongated shaft 14a. As distal drive member 248 is translated axially, and with connection member 247 connected thereto and engaged with the flexible drive beam 112, distal drive member 248 causes concomitant axial translation of the flexible drive beam 112 and I-beam 150 supported thereon, to effectuate a closure of the end effector 18 (e.g., approximation of the staple cartridge channel 32 towards anvil assembly 30) and a firing of the staple cartridge assembly 38 loaded within the staple cartridge channel 32.
[00124] The housing assembly 22 also supports a second or rotation drive shaft 230b rotatably in the mounting assembly 202a. The second or rotation drive shaft 230b is configured to receive a rotary drive input from a respective motor of handle assembly 12. The second or rotation drive shaft 230b includes a spur gear 233 keyed to a distal end thereof. The housing assembly 22 further includes a ring gear 266 meshingly engaged with spur gear 233 of the second or rotation drive shaft 230b, and which ring gear 266 is non-rotatably supported in outer housing 202b of the housing assembly 22.
[00125] As illustrated in FIGS. 16, 17, 19-24 and 27, the tool assembly 14 includes an annular wave spring 270 supported in the mounting assembly 202a of the housing 202. The wave spring 270 is interposed between the circuit board 208a and an inner housing hub 272, which inner housing hub 272 is disposed distal of the ring gear 266. The wave spring 270 (or other suitable drag component) is used to add a drag or frictional component within the tool assembly 14 to help prevent or inhibit unintentional rotation of the elongated body 14a when the motor driving articulation is operating. Specifically, the torque required to actuation articulation of the tool assembly 14 should be less than the torque required to manually rotate the tool assembly 14, and the wave spring 270 aids in providing this difference in the torque forces. Additionally, the tool assembly 14 may include a strap or the like which engages the worm gear 226, and which may additional provide friction of drag in the system with regard to articulation.
[00126] As illustrated in FIGS. 19 and 21-23, the tool assembly 14 further includes a rotation stop ring 274a which is connected to the second capstan 225b so as to rotate therewith. The stop ring 274a is configured to abut or otherwise contact, during rotation of the second capstan 225b, a corresponding stop plate 274b which is supported on the inner housing 202c. The rotation stop ring 274a and the stop plate 274b function as an articulation stop, which permit articulation of the tool assembly 14 up to about 90 degrees, whereby over stressing of the articulation cables 76, 78 may be reduced.
[00127] In operation, as the second or rotation drive shaft 230b is rotated, spur gear 233 is rotated thereby ring gear 266 and housing 202 to rotate relative to the mounting assembly 202a. Rotation of the housing 202 in turn results in rotation of the elongated shaft 14a and the end effector 18.
[00128] As briefly described above, the mounting assembly 202a of the housing 202 supports an electrical assembly 208 with electrical components (e.g., circuit board 208a, pins 208b, etc.) for electrical connection to a corresponding electrical plug (not shown) disposed in a connection portion of the stapling device 10.
[00129] As illustrated in FIGS. 19, 26 and 27, the electrical assembly 208 includes a plurality of electrical contact pins 208b supported on a circuit board 208a for electrical connection to a corresponding electrical plug of the handle assembly 12. [00130] The electrical assembly 208 further includes a strain gauge 208c electrically connected to circuit board 208a. As illustrated in FIGS. 20 and 24, the first or firing drive shaft 230a extends through strain gauge 208c. The strain gauge 208c provides a closed-loop feedback to a firing/clamping load exhibited by first or firing drive shaft 230a.
[00131] The electrical assembly 208 also includes a ribbon cable or other electrical conduit 208d having a proximal end which is in electrical connection with the circuit board 208a and a distal end supporting an electrical connector 208e. The distal end of the ribbon cable 208d extends through the elongated shaft 14a, through the articulation joint 16, and into the cavity 32a of the staple cartridge channel 32 such that the electrical connector 208e is disposed within the staple cartridge channel 32. The electrical connector 208e of the electrical assembly 208 resides in the staple cartridge channel 32 and is configured for selective electrical connection with an electrical chip (e.g., a memory chip) or the like 38a (FIG. 2) of the staple cartridge assembly 38.
[00132] With reference to FIGS. 3, 7, 8, 28 and 29, the tool assembly 14 further includes a seal member 290 supported within the elongated shaft 14a. The seal member 290 includes a central through bore 290a extending along a central axis thereof and which is configured and dimensioned for passage of the distal drive member 248 of the tool assembly 14 therethrough. The seal member 290 further includes a pair of through passages 290b (only one visible in FIG. 29) formed on diametrically opposed sides of the central through bore 290a and which are configured and dimensioned to permit the first articulation cable 76 and the second articulation cable 78 to pass therethrough. The seal member 290 is fabricate from a material capable of establishing a fluid tight, or substantially fluid tight seal within the elongated shaft 14a and amongst the distal drive member 248 and the first articulation cable 76 and the second articulation cable 78. Suitable materials for the seal material 290 include, and are not limited to rubber, silicone, nylon and polytetrafluoroethylene.
[00133] The various embodiments disclosed herein may also be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery.” Such systems employ various robotic elements to assist the clinician and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the clinician during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.
[00134] The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of clinicians may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another clinician (or group of clinicians) remotely control the instruments via the robotic surgical system. As can be appreciated, a highly skilled clinician may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.
[00135] The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the clinician to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc.) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the clinician. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s).
[00136] The master handles may include various sensors to provide feedback to the clinician relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the clinician with enhanced tactile feedback simulating actual operating conditions. The master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the clinician’s ability to mimic actual operating conditions. [00137] Referring also to FIG. 30, a medical work station is shown generally as work station 1000 and generally may include a plurality of robot arms 1002, 1003; a control device 1004; and an operating console 1005 coupled with the control device 1004. The operating console 1005 may include a display device 1006, which may be set up in particular to display three-dimensional images; and manual input devices 1007, 1008, by means of which a person (not shown), for example a clinician, may be able to telemanipulate the robot arms 1002, 1003 in a first operating mode.
[00138] Each of the robot arms 1002, 1003 may include a plurality of members, which are connected through joints, and an attaching device 1009, 1011, to which may be attached, for example, a surgical tool “ST” supporting an end effector 1100 (e.g., the tool assembly 14 described hereinabove).
[00139] The robot arms 1002, 1003 may be driven by electric drives (not shown) that are connected to the control device 1004. The control device 1004 (e.g., a computer) may be set up to activate the drives, in particular by means of a computer program, in such a way that the robot arms 1002, 1003, their attaching devices 1009, 1011 and thus the surgical tool (including the end effector 1100) execute a desired movement according to a movement defined by means of the manual input devices 1007, 1008. The control device 1004 may also be set up in such a way that it regulates the movement of the robot arms 1002, 1003 and/or of the drives.
[00140] The medical work station 1000 may be configured for use on a patient “P” lying on a patient table 1012 to be treated in a minimally invasive manner by means of the end effector 1100. The medical work station 1000 may also include more than two robot arms 1002, 1003, the additional robot arms likewise connected to the control device 1004 and telemanipulatable by means of the operating console 1005. A surgical system, such as the presently disclosed surgical system, may also be attached to the additional robot arm. The medical work station 1000 may include a database 1014 coupled with the control device 1004. In some embodiments, preoperative data from patient/living being “P” and/or anatomical atlases may be stored in the database 1014. For a more detailed description of exemplary medical work stations and/or components thereof, reference may be made to U.S. Patent Application Publication No. 2012/0116416, filed on November 3, 2011, entitled “Medical Workstation” and PCT Application Publication No. WO2016/025132, filed on July 21, 2015, entitled “Robotically Controlling Mechanical Advantage Gripping, the entire contents of each of which are incorporated by reference herein.
[00141] Persons skilled in the art will understand that the structures and methods specifically described herein and shown in the accompanying figures are non-limiting exemplary embodiments, and that the description, disclosure, and figures should be construed merely as exemplary of particular embodiments. It is to be understood, therefore, that the present disclosure is not limited to the precise embodiments described, and that various other changes and modifications may be affected by one skilled in the art without departing from the scope or spirit of the disclosure. Additionally, the elements and features shown or described in connection with certain embodiments may be combined with the elements and features of certain other embodiments without departing from the scope of the present disclosure, and that such modifications and variations are also included within the scope of the present disclosure. Accordingly, the subject matter of the present disclosure is not limited by what has been particularl shown and described.
[00142] Aspects of this disclosure may be further described by reference to the following examples:
[00143] Example 1. A tool assembly for connection to a handle assembly of a surgical device, the tool assembly comprising: an end effector including an anvil assembly and a staple cartridge channel; an elongated body having a proximal portion and a distal portion and defining a central longitudinal axis; an articulation joint coupling the end effector with the elongated body, the articulation joint including: a distal articulation member supported at a proximal end of the end effector, the distal articulation member defining a central longitudinally extending through-slot formed therein; a proximal articulation member supported at a distal end of the elongated body, the proximal articulation member defining a central longitudinally extending through-slot formed therein; and a yaw coupler pivotably coupled to the distal articulation member and the proximal articulation member, the yaw coupler defining a central longitudinally extending through-slot formed therein, the yaw coupler including: a distal pivot boss that defines a first yaw pivot axis which is orthogonal to the central longitudinal axis, the distal pivot boss pivotally connecting a distal end of the yaw coupler to the distal articulation member; and a proximal pivot boss that defines a second yaw pivot axis which is orthogonal to the central longitudinal axis and parallel to the first yaw pivot axis, the proximal pivot boss pivotally connecting a proximal end of the yaw coupler to the proximal articulation member, the second yaw pivot axis being longitudinally spaced from the first yaw pivot axis; and a drive assembly slidably supported within the elongated body and extending along the central longitudinal axis, the drive assembly including: an I-beam disposed within the end effector; and a flexible drive beam having a distal end supporting the I-beam and a proximal end extending through the through-slot of the distal articulation member, the through-slot of the yaw coupler, and through the through-slot of the proximal articulation member; a first articulation cable slidably supported within the elongated body and spaced a transverse distance from the central longitudinal axis, the first articulation cable including a distal end secured to the distal articulation member and a proximal end extending through the proximal articulation member; and a second articulation cable slidably supported within the elongated body and spaced a transverse distance from the central longitudinal axis on a side opposite the first articulation cable, the second articulation cable including a distal end secured to the distal articulation member, on a side opposite the first articulation cable, and a proximal end extending through the proximal articulation member.
[00144] Example 2. The tool assembly according to example 1, wherein: the distal articulation member includes: a first angled surface on a first side of the central longitudinal axis, wherein the first angled surface of the distal articulation member defines a first angle relative to the central longitudinal axis, and wherein the distal end of the first articulation cable is secured to the first angled surface of the distal articulation member; and a second angled surface on a second side of the central longitudinal axis, opposite the first angled surface of the distal articulation member, wherein the second angled surface of the distal articulation member defines a second angle relative to the central longitudinal axis, and wherein the distal end of the second articulation cable is secured to the second angled surface of the distal articulation member; and the proximal articulation member includes: a first angled surface on a first side of the central longitudinal axis, wherein the first angled surface of the proximal articulation member defines a first angle relative to the central longitudinal axis, and wherein the proximal end of the first articulation cable slidably extends through the first angled surface of the proximal articulation member; and a second angled surface on a second side of the central longitudinal axis, opposite the first angled surface of the proximal articulation member, wherein the second angled surface of the proximal articulation member defines a second angle relative to the central longitudinal axis, and wherein the proximal end of the second articulation cable slidably extends through the second angled surface of the proximal articulation member, wherein the first angled surface of the distal articulation member is in apposition to the first angle surface of the proximal articulation member; and wherein the second angled surface of the distal articulation member is in apposition to the second angle surface of the proximal articulation member.
[00145] Example 3. The tool assembly according to example 2, wherein: the first angled surface of the distal articulation member is angled 45 degrees relative to the central longitudinal axis; the second angled surface of the distal articulation member is angled 45 degrees relative to the central longitudinal axis; the first angled surface of the proximal articulation member is angled 45 degrees relative to the central longitudinal axis; and the second angled surface of the proximal articulation member is angled 45 degrees relative to the central longitudinal axis.
[00146] Example 4. The tool assembly according to example 3, wherein: the first angled surface of the distal articulation member defines a flared cone shaped through bore, wherein the distal end of the first articulation cable is received within the flared cone shaped through bore of the first angled surface of the distal articulation member; the second angled surface of the distal articulation member defines a flared cone shaped through bore, wherein the distal end of the second articulation cable is received within the flared cone shaped through bore of the second angled surface of the distal articulation member; the first angled surface of the proximal articulation member defines a flared cone shaped through passage, wherein the proximal end of the first articulation cable extends through the flared cone shaped through passage of the first angled surface of the proximal articulation member, wherein an enlarged portion of the flared cone shaped through bore of the first angled surface of the distal articulation member is in apposition to an enlarged portion of the flared cone shaped through passage of the first angled surface of the proximal articulation member; and the second angled surface of the proximal articulation member defines a flared cone shaped through passage, wherein the proximal end of the second articulation cable extends through the flared cone shaped through passage of the second angled surface of the proximal articulation member, wherein an enlarged portion of the flared cone shaped through bore of the second angled surface of the distal articulation member is in apposition to an enlarged portion of the flared cone shaped through passage of the second angled surface of the proximal articulation member.
[00147] Example 5. The tool assembly according to example 4, further comprising: a cable drive assembly supported at a proximal end of the elongated body, the cable drive assembly including: a first cable worm wheel rotatably supported in a housing of the tool assembly, the first cable worm wheel including: a first gear; and a first capstan supported on and extending from the first gear, wherein the proximal end of the first articulation cable is wrapped at least partially around the first capstan; a second cable worm wheel rotatably supported in the housing of the tool assembly, the second cable worm wheel including: a second gear; and a second capstan supported on and extending from the second gear, wherein the proximal end of the second articulation cable is wrapped at least partially around the second capstan; and a worm gear rotatably supported in the housing of the tool assembly, the worm gear meshingly engaged with the first gear of the first cable worm wheel and with the second gear of the second worm wheel.
[00148] Example 6. The tool assembly according to example 5, wherein the first gear of the first cable worm wheel, the second gear of the second cable worm wheel, and the worm gear are configured such that rotation of the worm gear in a first direction results in rotation of the first gear of the first cable worm wheel in a first direction and rotation of the second gear of the second cable worm wheel in a second direction, wherein the first direction is opposite the second direction.
[00149] Example 7. The tool assembly according to example 6, wherein the proximal end of the first articulation cable is wound around the first capstan of the first cable worm wheel and wherein the proximal end of the second articulation cable is wound around the second capstan of the second cable worm wheel.
[00150] Example 8. The tool assembly according to example 7, wherein the worm gear is oriented so as to define a longitudinal axis which is parallel with the central longitudinal axis of the elongated body, and wherein the first cable worm wheel and the second cable worm wheel are each oriented so as to define a respective longitudinal axis which is oriented orthogonal to the central longitudinal axis of the elongated body.
[00151] Example 9. A tool assembly for connection to a handle assembly of a surgical device, the tool assembly comprising: an end effector including an anvil assembly and a staple cartridge channel; an elongated body having a proximal portion and a distal portion and defining a central longitudinal axis; an articulation joint coupling the end effector with the elongated body, the articulation joint including: a distal articulation member supported at a proximal end of the end effector; a proximal articulation member supported at a distal end of the elongated body; and a yaw coupler pivotably coupled to the distal articulation member and the proximal articulation member; a drive assembly including: a drive assembly slidably supported within the elongated body and extending along the central longitudinal axis, the drive assembly including: an I-beam disposed within the end effector; and a flexible drive beam having a distal end supporting the I-beam and a proximal end extending through the distal articulation member, the through the yaw coupler, and through the proximal articulation member; a first articulation cable slidably supported within the elongated body and spaced a transverse distance from the central longitudinal axis, the first articulation cable including a distal end secured to the distal articulation member and a proximal end extending through the proximal articulation member; and a second articulation cable slidably supported within the elongated body and spaced a transverse distance from the central longitudinal axis on a side opposite the first articulation cable, the second articulation cable including a distal end secured to the distal articulation member, on a side opposite the first articulation cable, and a proximal end extending through the proximal articulation member; and a cable drive assembly supported at a proximal end of the elongated body, the cable drive assembly including: a first cable worm wheel rotatably supported in a housing of the tool assembly, the first cable worm wheel including: a first gear; and a first capstan supported on and extending from the first gear, wherein the proximal end of the first articulation cable is wrapped at least partially around the first capstan; a second cable worm wheel rotatably supported in the housing of the tool assembly, the second cable worm wheel including: a second gear; and a second capstan supported on and extending from the second gear, wherein the proximal end of the second articulation cable is wrapped at least partially around the second capstan; and a worm gear rotatably supported in the housing of the tool assembly, the worm gear meshingly engaged with the first gear of the first cable worm wheel and with the second gear of the second worm wheel.
[00152] Example 10. The tool assembly according to example 9, wherein the first gear of the first cable worm wheel, the second gear of the second cable worm wheel, and the worm gear are configured such that rotation of the worm gear in a first direction results in rotation of the first gear of the first cable worm wheel in a first direction and rotation of the second gear of the second cable worm wheel in a second direction, wherein the first direction is opposite the second direction.
[00153] Example 11. The tool assembly according to example 10, wherein the proximal end of the first articulation cable is wound around the first capstan of the first cable worm wheel and wherein the proximal end of the second articulation cable is wound around the second capstan of the second cable worm wheel.
[00154] Example 12. The tool assembly according to example 11, wherein the worm gear is oriented so as to define a longitudinal axis which is parallel with the central longitudinal axis of the elongated body, and wherein the first cable worm wheel and the second cable worm wheel are each oriented so as to define a respective longitudinal axis which is oriented orthogonal to the central longitudinal axis of the elongated body.
[00155] Example 13. The tool assembly according to example 9, wherein: the distal articulation member defines a central longitudinally extending through-slot formed therein; the proximal articulation member defines a central longitudinally extending through-slot formed therein; and the yaw coupler defines a central longitudinally extending through-slot formed therein.
[00156] Example 14. The tool assembly according to example 13, wherein the yaw coupler includes: a distal pivot boss defining a first yaw pivot axis which is orthogonal to the central longitudinal axis, wherein the distal pivot boss pivotally connects a distal end of the yaw coupler to the distal articulation member; and a proximal pivot boss defining a second yaw pivot axis which is orthogonal to the central longitudinal axis and parallel to the first yaw pivot axis, wherein the proximal pivot boss pivotally connects a proximal end of the yaw coupler to the proximal articulation member, the second yaw pivot axis being longitudinally spaced from the first yaw pivot axis. [00157] Example 15. The tool assembly according to example 14, wherein: the distal articulation member includes: a first angled surface on a first side of the central longitudinal axis, wherein the first angled surface of the distal articulation member defines a first angle relative to the central longitudinal axis, and wherein the distal end of the first articulation cable is secured to the first angled surface of the distal articulation member; and a second angled surface on a second side of the central longitudinal axis, opposite the first angled surface of the distal articulation member, wherein the second angled surface of the distal articulation member defines a second angle relative to the central longitudinal axis, and wherein the distal end of the second articulation cable is secured to the second angled surface of the distal articulation member; and the proximal articulation member includes: a first angled surface on a first side of the central longitudinal axis, wherein the first angled surface of the proximal articulation member defines a first angle relative to the central longitudinal axis, and wherein the proximal end of the first articulation cable slidably extends through the first angled surface of the proximal articulation member; and a second angled surface on a second side of the central longitudinal axis, opposite the first angled surface of the proximal articulation member, wherein the second angled surface of the proximal articulation member defines a second angle relative to the central longitudinal axis, and wherein the proximal end of the second articulation cable slidably extends through the second angled surface of the proximal articulation member.
[00158] Example 16. The tool assembly according to example 15, wherein: the first angled surface of the distal articulation member is in apposition to the first angle surface of the proximal articulation member; and the second angled surface of the distal articulation member is in apposition to the second angle surface of the proximal articulation member.
[00159] Example 17. The tool assembly according to example 16, wherein: the first angled surface of the distal articulation member is angled 45 degrees relative to the central longitudinal axis; the second angled surface of the distal articulation member is angled 45 degrees relative to the central longitudinal axis; the first angled surface of the proximal articulation member is angled 45 degrees relative to the central longitudinal axis; and the second angled surface of the proximal articulation member is angled 45 degrees relative to the central longitudinal axis. [00160] Example 18. The tool assembly according to example 17, wherein: the first angled surface of the distal articulation member defines a flared cone shaped through bore, wherein the distal end of the first articulation cable is received within the flared cone shaped through bore of the first angled surface of the distal articulation member; the second angled surface of the distal articulation member defines a flared cone shaped through bore, wherein the distal end of the second articulation cable is received within the flared cone shaped through bore of the second angled surface of the distal articulation member; the first angled surface of the proximal articulation member defines a flared cone shaped through passage, wherein the proximal end of the first articulation cable extends through the flared cone shaped through passage of the first angled surface of the proximal articulation member, wherein an enlarged portion of the flared cone shaped through bore of the first angled surface of the distal articulation member is in apposition to an enlarged portion of the flared cone shaped through passage of the first angled surface of the proximal articulation member; and the second angled surface of the proximal articulation member defines a flared cone shaped through passage, wherein the proximal end of the second articulation cable extends through the flared cone shaped through passage of the second angled surface of the proximal articulation member, wherein an enlarged portion of the flared cone shaped through bore of the second angled surface of the distal articulation member is in apposition to an enlarged portion of the flared cone shaped through passage of the second angled surface of the proximal articulation member.
[00161] Example 19. A surgical device comprising: a handle assembly including a motor and a battery for powering the motor; and a tool assembly selectively connectable to the handle assembly and configured to receive rotary forces from the motor and electrical power from the battery, the tool assembly including: an end effector including an anvil assembly and a staple cartridge channel; an elongated body having a proximal portion and a distal portion and defining a central longitudinal axis; an articulation joint coupling the end effector with the elongated body, the articulation joint including: a distal articulation member supported at a proximal end of the end effector; a proximal articulation member supported at a distal end of the elongated body; and a yaw coupler pivotably coupled to the distal articulation member and the proximal articulation member; a drive assembly slidably supported within the elongated body and extending along the central longitudinal axis, the drive assembly including: an I-beam disposed within the end effector; and a flexible drive beam having a distal end supporting the I- beam and a proximal end extending through the distal articulation member, the through the yaw coupler, and through the proximal articulation member; a first articulation cable slidably supported within the elongated body and spaced a transverse distance from the central longitudinal axis, the first articulation cable including a distal end secured to the distal articulation member and a proximal end extending through the proximal articulation member; and a second articulation cable slidably supported within the elongated body and spaced a transverse distance from the central longitudinal axis on a side opposite the first articulation cable, the second articulation cable including a distal end secured to the distal articulation member, on a side opposite the first articulation cable, and a proximal end extending through the proximal articulation member; and a cable drive assembly supported at a proximal end of the elongated body, the cable drive assembly including: a first cable worm wheel rotatably supported in a housing of the tool assembly, the first cable worm wheel including: a first gear; and a first capstan supported on and extending from the first gear, wherein the proximal end of the first articulation cable is wrapped at least partially around the first capstan; a second cable worm wheel rotatably supported in the housing of the tool assembly, the second cable worm wheel including: a second gear; and a second capstan supported on and extending from the second gear, wherein the proximal end of the second articulation cable is wrapped at least partially around the second capstan; and a worm gear rotatably supported in the housing of the tool assembly, the worm gear meshingly engaged with the first gear of the first cable worm wheel and with the second gear of the second worm wheel; and a staple cartridge selectively connectable within the staple cartridge channel of the end effector.
[00162] Example 20. The surgical device of example 19, wherein: the distal articulation member of the articulation joint of the tool assembly defines a central longitudinally extending through-slot formed therein; the proximal articulation member of the articulation joint of the tool assembly defines a central longitudinally extending through-slot formed therein; and the yaw coupler of the articulation joint of the tool assembly defines a central longitudinally extending through-slot formed therein, wherein the yaw coupler includes: a distal pivot boss that defines a first yaw pivot axis which is orthogonal to the central longitudinal axis, the distal pivot boss pivotally connecting a distal end of the yaw coupler to the distal articulation member; and a proximal pivot boss that defines a second yaw pivot axis which is orthogonal to the central longitudinal axis and parallel to the first yaw pivot axis, the proximal pivot boss pivotally connecting a proximal end of the yaw coupler to the proximal articulation member, the second yaw pivot axis being longitudinally spaced from the first yaw pivot axis.