ROBOTIC SURGICAL ASSEMBLIES AND ELECTROMECHANICAL INSTRUMENTS THEREOF
20210128257 · 2021-05-06
Inventors
Cpc classification
A61B18/1445
HUMAN NECESSITIES
A61B2017/00411
HUMAN NECESSITIES
A61B18/1447
HUMAN NECESSITIES
A61B2034/302
HUMAN NECESSITIES
A61B2018/1455
HUMAN NECESSITIES
International classification
Abstract
An actuation mechanism for actuating an electromechanical end effector includes a housing, and a shaft assembly extending distally from the housing. The shaft assembly includes a shaft, a longitudinal knife bar, a first hub, and a second hub. The shaft is axially movable relative to the housing and configured to be coupled to the electromechanical end effector. Rotation of a first screw of the housing moves the first hub to effect longitudinal movement of the shaft. The longitudinal knife bar is axially movable relative to the shaft and configured to be coupled to a knife blade of the electromechanical end effector. Rotation of a second screw of the housing moves the second hub to effect axial movement of the longitudinal knife bar.
Claims
1-20. (canceled)
21. An actuation mechanism for actuating an electromechanical end effector, the actuation mechanism comprising: a housing; first and second drive members; and a shaft assembly extending distally from the housing and including: a shaft axially movable relative to the housing and configured to be coupled to an electromechanical end effector; a first hub operably coupled to the first drive member and coupled to the shaft such that the shaft is configured to move axially in response to movement of the first drive member; a longitudinal knife bar axially movable relative to the shaft and configured to be coupled to a knife blade of the electromechanical end effector; and a second hub operably coupled to the second drive member and coupled to the longitudinal knife bar such that the longitudinal knife bar is configured to move axially in response to movement of the second drive member.
22. The actuation mechanism according to claim 21, wherein the first hub includes: a first portion having the shaft secured thereto; and a second portion connected to the first portion and being threadedly connected to the first drive member such that rotation of the first drive member axially moves the first hub to effect axial movement of the shaft.
23. The actuation mechanism according to claim 21, wherein the second hub includes: a first portion having the shaft movably received therein, the first portion being connected to the longitudinal knife bar; and a second portion connected to the first portion of the second hub and operably coupled to the second drive member.
24. The actuation mechanism according to claim 23, wherein the second drive member is threadedly coupled to the second portion of the second hub such that rotation of the second drive member moves the second hub to effect axial movement of the longitudinal knife bar.
25. The actuation mechanism according to claim 21, wherein each of the first and second drive members are screws.
26. The actuation mechanism according to claim 21, wherein the first hub includes: a first portion having the shaft secured thereto; and a second portion connected to the first portion and being operably coupled to the first drive member, and wherein the second hub includes: a first portion having the shaft movably received therein, the first portion being connected to the longitudinal knife bar; and a second portion connected to the first portion of the second hub and operably coupled to the second drive member.
27. The actuation mechanism according to claim 26, wherein the shaft defines a longitudinal axis that extends through the first portion of the first hub and the first portion of the second hub.
28. The actuation mechanism according to claim 27, wherein the first portion of the first hub is laterally offset from the second portion of the first hub, and the first portion of the second hub is laterally offset from the second portion of the second hub.
29. The actuation mechanism according to claim 28, wherein the second portion of the second hub is distal of the first portion of the second hub.
30. The actuation mechanism according to claim 26, wherein the shaft includes a longitudinal slot formed therein, the first portion of the second hub having an inner surface that extends into the longitudinal slot to connect with the longitudinal knife bar such that the longitudinal knife bar moves axially with the second hub and relative to the shaft.
31. The actuation mechanism according to claim 26, wherein the second portion of the first hub and the second portion of the second hub are laterally offset from one another and from the shaft.
32. The actuation mechanism according to claim 26, wherein the shaft assembly further includes: a plate fixed within the housing; and a spring disposed between the plate and the first portion of the first hub to exert a distally-oriented bias on the first hub.
33. The actuation mechanism according to claim 21, wherein the shaft assembly further includes a plate fixed within the housing, the plate defining a first recess therethrough having a distal end of the first drive member received therein, and a second recess therethrough having a distal end of the second drive member received therein.
34. The actuation mechanism according to claim 21, wherein the housing further includes: a first input drive coupler non-rotatably coupled to a proximal end of the first drive member and configured to be drivingly coupled to an instrument drive unit; and a second input drive coupler non-rotatably coupled to a proximal end of the second drive member and configured to be drivingly coupled to the instrument drive unit.
35. An electromechanical surgical instrument for use with a robotic system, the electromechanical surgical instrument comprising: an end effector including: a pair of opposing jaw members configured to grasp tissue disposed therebetween; and a knife blade movably disposable between the pair of opposing jaw members to sever the tissue disposed therebetween; and an actuation mechanism including: a housing; first and second drive members disposed in the housing; and a shaft assembly extending distally from the housing and including: a shaft axially movable relative to the housing and configured to be coupled to the end effector; a first hub operably coupled to the first drive member and coupled to the shaft such that the shaft is configured to move axially in response to movement of the first drive member to effect at least one of an opening or a closing of the pair of opposing jaw members; a longitudinal knife bar axially movable relative to the shaft and configured to be coupled to the knife blade; and a second hub operably coupled to the second drive member and coupled to the longitudinal knife bar such that the longitudinal knife bar is configured to move axially in response to movement of the second drive member to effect axial movement of the knife blade.
36. The electromechanical surgical instrument according to claim 35, wherein the first hub includes: a first portion having the shaft secured thereto; and a second portion connected to the first portion and being threadedly connected to the first drive member such that rotation of the first drive member moves the first hub to effect longitudinal movement of the shaft.
37. The electromechanical surgical instrument according to claim 35, wherein the second hub includes: a first portion having the shaft movably received therein, the first portion being connected to the longitudinal knife bar; and a second portion connected to the first portion of the second hub and operably coupled to the second drive member.
38. The electromechanical surgical instrument according to claim 37, wherein the second drive member is threadedly coupled to the second portion of the second hub such that rotation of the second drive member moves the second hub to effect axial movement of the longitudinal knife bar.
39. The electromechanical surgical instrument according to claim 35, wherein each of the first and second drive members are screws.
40. The electromechanical surgical instrument according to claim 35, wherein the first hub includes: a first portion having the shaft secured thereto; and a second portion connected to the first portion and being operably coupled to the first drive member, and wherein the second hub includes: a first portion having the shaft movably received therein, the first portion being connected to the longitudinal knife bar; and a second portion connected to the first portion of the second hub and operably coupled to the second drive member.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] Embodiments of the present disclosure are described herein with reference to the accompanying drawings, wherein:
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DETAILED DESCRIPTION
[0027] Embodiments of the presently disclosed robotic surgical system including an actuation mechanism for actuating an electromechanical end effector and methods thereof are described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein the term “distal” refers to that portion of the robotic surgical system, actuation mechanism, electromechanical end effector, or components thereof, that is further from the user, while the term “proximal” refers to that portion of the robotic surgical system, actuation mechanism, electromechanical end effector, or components thereof, that is closer to the user.
[0028] Referring initially to
[0029] With continued reference to
[0030] Robotic surgical system 1 is configured for use on a patient “P” lying on a surgical table “ST” to be treated in a minimally invasive manner by means of a surgical instrument, e.g., electrosurgical and/or electromechanical instrument 10. Robotic surgical system 1 may also include more than two robotic arms 2, 3, the additional robotic arms likewise being connected to control device 4 and being telemanipulatable by means of operating console 5. A surgical instrument, for example, electrosurgical and/or electromechanical instrument 10 (including electrosurgical and/or electromechanical end effector 200 (
[0031] Control device 4 may control a plurality of motors (Motor 1 . . . n) with each motor configured to drive a relative rotation of drive members of an actuation mechanism 100 (
[0032] For a detailed discussion of the construction and operation of a robotic surgical system, reference may be made to U.S. Pat. No. 8,828,023, the entire contents of which are incorporated herein by reference.
[0033] With specific reference to
[0034] With reference to
[0035] Housing 102 of actuation mechanism 100 has a generally cylindrical configuration and is constructed of two housing portions or halves 102a, 102b that are connected to one another. Housing 102 has a proximal end 104a and a distal end 104b defining a longitudinal axis “X” therebetween. In embodiments, housing 102 may be any shape suitable for receipt in a distal end 2a of robotic arm 2. Housing halves 102a, 102b together define a cavity 105 that houses various components of actuation mechanism 100. Proximal end 104a of housing 102 supports a first input drive coupler 108 configured to be detachably, non-rotatably coupled to one respective drive member (not shown) of instrument drive unit 20, and supports a second input drive coupler 110 configured to be detachably, non-rotatably coupled to another respective drive member (not shown) of instrument drive unit 20.
[0036] Housing 102 of actuation mechanism 100 further includes a first drive member or first screw 112 and a second drive member or second screw 114, each being disposed within cavity 105 of housing 102 and extending in parallel alignment with longitudinal axis “X” of housing 102. In some embodiments, housing 102 may include more than two drive members. A proximal end 112a of first screw 112 is non-rotatably coupled to first input drive coupler 108, and a proximal end 114a of second screw 114 is non-rotatably coupled to second input drive coupler 110. Upon actuation of motors (not shown) of instrument drive unit 20, the drive members (not shown) of instrument drive unit 20 rotate, resulting in concomitant rotation of first and second screws 112, 114 of actuation mechanism 100 via the first and second input drive couplers 108, 110 of housing 102. The rotation of first screw 112 of housing of actuation mechanism 100 ultimately results in the actuation of jaw members 202a, 202b of electromechanical end effector 200, and the rotation of second screw 114 of actuation mechanism 100 ultimately results in the actuation of knife blade 218 of electromechanical instrument 200, as described in greater detail below.
[0037] As mentioned above, actuation mechanism 100 of electrosurgical and/or electromechanical instrument 10 includes shaft assembly 120, which extends distally from within housing 102. Shaft assembly 120 operatively intercouples instrument drive unit 20 with knife blade 218 of electromechanical end effector 200 and jaw members 202a, 202b of electromechanical end effector 200 of electrosurgical and/or electromechanical instrument 10. Shaft assembly 120 generally includes an outer tube or shaft 122, a rod 130 extending through shaft 122, and a longitudinal knife bar 123 (
[0038] Rod 130 of shaft assembly 120 acts as a guide along which shaft 122 translates. Rod 130 extends from proximal end 104a of housing 102, through the length of shaft 122, and terminates at jaw members 202a, 202b of electromechanical end effector 200. Rod 130 has a proximally disposed annular member 132 fixed with proximal end 104a of housing 102, such that rod 130 is prevented from longitudinal movement relative to housing 102. As such, shaft 122 can translate longitudinally along and relative to rod 130 to open or close jaw members 202a, 202b of electromechanical end effector 200.
[0039] Longitudinal knife bar 123 of shaft assembly 120 has a proximal portion disposed within housing 102 and a distal portion connected to or integrally formed with knife blade 218. Knife bar 123 is axially movable relative to and within shaft 122 to move knife blade 218 between a proximal position and a distal position. In the proximal position, knife blade 218 is disposed proximal to jaw members 202a, 202b, and in the distal position, knife blade 218 is disposed between jaw members 202a, 202b to sever tissue clamped between jaw members 202a, 202b.
[0040] Shaft assembly 120 further includes a proximal plate 126a and a distal plate 126b each being fixed within respective proximal and distal ends 104a, 104a of housing 102. Proximal plate 126a defines a pair of channels 128a, 128b therethrough having proximal ends 112a, 114a of first and second screws 112, 114 disposed therein, respectively. Housing 102 includes a pair of bearings 134a, 134b disposed within proximal plate 126a and about first and second screws 112, 114 to assist in rotation of first and second screws 112, 114. Distal plate 126b, which is spaced distally from proximal plate 126a, defines first and second recesses 136a, 136b therein having distal ends 112b, 114b of first and second screws 112, 114 received therein, respectively. Proximal and distal plates 126a, 126b cooperatively maintain the spatial orientation of first and second screws 112, 114 while allowing first and second screws 112, 114 to rotate therein. Distal plate 126b further defines a third recess or channel 136c therethrough, which is disposed between first and second recesses 136a, 136b. Third recess 136c of distal plate 126b has shaft 122 extending therethrough.
[0041] With reference to
[0042] First portion 140a of first hub 140 has an annular cavity 142 defined therein. A spring 144 is received within annular cavity 142 and coupled with proximal plate 126a to exert a distally-oriented bias on first hub 140. First portion 140a of first hub 140 has an inner surface 146 disposed within annular cavity 142. Inner surface 146 of first hub 140 defines a first cylindrical passageway 148a through first portion 140a of first hub 140. Shaft 122 of shaft assembly 120 is frictionally secured within first passageway 148a of first portion 140a of first hub 140 to prevent relative longitudinal movement between first hub 140 and shaft 122. In some embodiments, shaft 122 is fastened to first portion 140a of first hub 140 via an alternative fastening engagement, such as, for example, an adhesive or a fastener.
[0043] Second portion 140b of first hub 140 is laterally offset from first portion 140a of first hub 140. Second portion 140b has an inner surface 150 defining a second cylindrical passageway 148b through second portion 140b. First screw 112 extends through second passageway 148b and is threadedly engaged to inner surface 150 of second portion 140b. Since shaft 122 is frictionally retained (or fixedly secured) within first portion 140a of first hub 140, rotation of first screw 112 within second portion 140b of first hub 140 moves first hub 140 along first screw 112 in a proximal or distal direction to effect a corresponding proximal or distal longitudinal movement of shaft 122 relative to housing 102.
[0044] In use, the first drive member (not shown) of instrument drive unit 20 drives rotation of first screw 112 of actuation mechanism 100 via first input drive coupler 108. Rotation of first screw 112 drives either proximal or distal longitudinal movement of first hub 140 along first screw 112. Proximal or distal longitudinal movement of first hub 140 relative to and along first screw 112 drives the concomitant proximal or distal longitudinal movement of shaft 122 of shaft assembly 120, via the engagement of shaft 122 within first passageway 148a of first portion 140a of first hub 140. As such, rotation of first screw 112 axially moves shaft 122 relative to housing 102. Axial movement of shaft 122 relative to housing 102 actuates jaw members 202a, 202b of electromechanical instrument 200.
[0045] With reference to
[0046] First portion 160a of second hub 160 is movably disposed within third recess 136c of distal plate 126b. First portion 160a of second hub 160 has an inner surface 162 that defines a first cylindrical passageway 164a through first portion 160a. Shaft 122 of shaft assembly 120 is movably disposed within first passageway 164a of first portion 160a of second hub 160 to allow relative longitudinal movement between second hub 160 and shaft 122. A projection (not shown) of inner surface 162 of first portion 160a of second hub 160 extends into first passageway 164a of first portion 160a of second hub 160 and through a longitudinal slot 127 (
[0047] Second portion 160b of second hub 160 is laterally offset from first portion 160a of second hub 160, and is distal of first portion 160a of second hub 160, thus giving second hub 160 a generally L-shaped configuration. In some embodiments, second hub 160 may assume a variety of shapes, such as, for example, linear, T-shaped, arcuate, or the like. Second portion 160b of second hub 160 has an inner surface 166 defining a second cylindrical passageway 164b therethrough. Second screw 114 extends through second passageway 164b of second hub 160 and is threadedly engaged to inner surface 166 of second portion 160b of second hub 160. As such, rotation of second screw 114 within second portion 160b of second hub 160 moves second hub 160 along second screw 114 in a proximal or distal direction to effect a corresponding proximal or distal movement of knife bar 123 within and relative to shaft 122.
[0048] In use, the second drive member (not shown) of instrument drive unit 20 (
[0049] With reference to
[0050] The upper and lower jaw members 202a, 202b are electrically coupled to a cable (not shown), and to a generator (not shown), via respective suitable electrical wiring extending through shaft 122 of actuation mechanism 100 to provide an electrical pathway to the pair of electrically conductive, tissue-engaging sealing plates 204a, 204b disposed on the upper and lower jaw members 202a, 202b, respectively. The sealing plate 204a of upper jaw member 202a opposes the sealing plate 204b of lower jaw member 202b. In some embodiments, the sealing plates 204a, 204b are electrically coupled to opposite terminals, e.g., positive or active (+) and negative or return (−) terminals associated with the generator. Thus, bipolar energy may be provided through the sealing plates 204a, 204b to tissue. Alternatively, the sealing plates 204a, 204b may be configured to deliver monopolar energy to tissue. In a monopolar configuration, one or both sealing plates 204a, 204b deliver electromechanical energy from an active terminal, e.g., (+), while a return pad (not shown) is placed generally on a patient and provides a return path to the opposite terminal, e.g., (−), of the generator. Each jaw member 202a, 202b includes a jaw insert (not shown) and an insulator 206a, 206b that serves to electrically insulate the sealing plates 204a, 204b from the jaw insert of the jaw members 202a, 202b, respectively.
[0051] In the closed configuration, a separation or gap distance is maintained between the sealing plates 204a, 204b by an array of stop members 208 (
[0052] A pivot pin 210 extends through a proximal portion 212a, 212b of each of the jaw members 202a, 202b to pivotally support the jaw members 202a, 202b. Pivot pin 210 permits jaw members 202a, 202b to pivot thereabout to move electromechanical end effector 200 between the open and closed configurations (
[0053] Proximal portion 212a, 212b of each of the jaw members 202a, 202b also includes a lateral cam slot 214a, 214b extending therethrough. Lateral cam slot 214a of upper jaw member 202a extends in oblique relation to a longitudinal axis defined by upper jaw member 202a. Lateral cam slot 214b of lower jaw member 202b extends in parallel relation to a longitudinal axis defined by lower jaw member 202b. In this way, lateral cam slot 214a of upper jaw member 202a is angled relative to lateral cam slot 214b of lower jaw member 202b when the jaw members 202a, 202b are disposed in the closed configuration. A cam pin 216 extends through lateral cam slots 214a, 214b of jaw members 202a, 202b and is longitudinally movable through lateral cam slots 214a, 214b. Cam pin 216 is mechanically coupled (e.g., via welding, friction-fit, laser welding, etc.) to a distal end of rod 130 of shaft assembly 120. As mentioned above, rod 130 is prevented from longitudinal movement relative to housing 102 of actuation mechanism 100 due to the fixed engagement of annular member 132 of rod 130 with housing 102 of actuation mechanism 100. Therefore, cam pin 216, via its mechanical coupling to rod 130, is also prevented from longitudinal movement relative to housing 102 of actuation mechanism 100.
[0054] In operation, to open jaw members 202a, 202b to the expanded configuration shown in
[0055] To close jaw members 202a, 202b to the approximated configuration shown in
[0056] Upon approximating jaw members 202a, 202b, electromechanical energy may be delivered, by an electromechanical generator (not shown), to the tissue through the electrically conductive seal plates 204a, 204b to effect a tissue seal. Once a tissue seal is established, the sealed tissue or portion thereof may be severed by knife blade 218. To sever the sealed tissue, longitudinal knife bar 123 (
[0057] In some embodiments, various components of actuation mechanism 100 may be calibrated prior to usage. For example, to calibrate knife bar 123 of actuation mechanism 100, knife bar 123 is moved proximally until a hard stop is detected. Knife bar 123 is then moved distally a nominal distance (e.g., approximately 0.005 inches) to a home position. Knife bar 123 is then moved between the home position and a proximal-most position. Torque and/or current will be monitored continuously during proximal and distal movement of knife bar 123 to detect a fault state wherein the torque required to move knife bar 123 is beyond a threshold amount (e.g., a spike or excessive load in value of a torque cell).
[0058] To calibrate shaft of actuation mechanism, first hub 140 is moved distally until a hard stop is detected. First hub 140 is then moved proximally a nominal distance (e.g., approximately 0.005 inches) to a home position. First hub 140 is then moved between the home position and a distal-most position. Torque and/or current will be monitored continuously during proximal and distal movement of first hub 140 to detect a fault state wherein the torque required to move first hub 140, and thus shaft 122, is beyond a threshold amount (e.g., a spike or excessive load in value of a torque cell).
[0059] After the above-noted calibration sequence has been conducted, actuation mechanism 100 is ready for use.
[0060] It will be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be construed as limiting, but merely as exemplifications of various embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended thereto.