HANDLE MECHANISM PROVIDING UNLIMITED ROLL

Abstract

Devices having a handle that provides unlimited roll to an end-effector at the distal end of the device. For example, described herein are medical devices that have an elongate tool frame, an end-effector, and a handle that includes: a first portion, a second portion that rolls relative to the first portion, a push rod within the first portion connected to a control input, and a shuttle body within the second portion that rotates with the second portion but is axially driven by the push rod when the user actuates the control input. The device may include a proximal wrist/forearm attachment allowing one or more degrees of freedom in pitch, yaw or roll about the user's arm. The handle may articulate relative to the tool frame, and this articulation may be transmitted to the end-effector. The end-effector may be a jaw assembly.

Claims

1-53. (canceled)

54. An unlimited roll handle assembly apparatus, the apparatus comprising: a first handle portion, a second handle portion coupled to the first handle portion so that the second handle portion has one rotational degree of freedom in a first axis relative to the first handle portion but is translationally constrained relative to the first handle portion along the first axis, a push rod coupled to the first handle portion so that it has one degree of freedom along the first axis relative to the first handle portion but is rotationally constrained about the first axis relative to the first handle portion, and a shuttle body coupled to the push rod so that it has one rotational degree of freedom about the first axis relative to the push rod but is translationally constrained along the first axis relative to the push rod, further wherein the shuttle body is coupled to the second handle portion so that it has one degree of freedom along the first axis relative to the second handle portion and is rotationally constrained about the first axis relative to the second handle portion.

55. The apparatus of claim 54, further comprising an end-effector control input on the first handle portion configured to translate the push rod along the first axis.

56. The apparatus of claim 55 wherein the end-effector control input comprises a trigger, lever or button on the first handle portion configured for actuation by one or more of a user's fingers and thumb.

57. The apparatus of claim 54, wherein the second handle portion comprises a knob or dial having a grip configured to be rotated by one or more of a user's fingers and thumb.

58. The apparatus of claim 54, wherein the first handle portion comprises a palm grip configured to be held in a user's palm.

59. The apparatus of claim 54, further comprising a tool frame and an input joint between the handle assembly and the tool frame.

60. The apparatus of claim 59, wherein the input joint comprises a pitch motion path encoding a pitch motion of the handle assembly relative to the tool frame about a pitch axis of rotation and a yaw motion path, encoding a yaw motion of the handle assembly relative to the tool frame about a yaw axis of rotation, wherein the pitch axis of rotation and the yaw axis of rotation intersect in a center of rotation that is proximal to the handle assembly.

61. The apparatus of claim 60, further wherein the center of rotation coincides with a center of rotation of a user's wrist, when the use is holding the device by the handle assembly.

62. The apparatus of claim 60, wherein the pitch motion path is parallel with the yaw motion path so that the input joint is a parallel kinematic joint.

63. The apparatus of claim 59, further comprising an elongate tool shaft extending from the tool frame and having an end-effector at a distal end of the elongate tool frame.

64. The apparatus of claim 59, further comprising a cuff having a passage therethrough that is configured to hold a wrist or forearm of a user, wherein the cuff is configured to couple to the tool frame.

65. The apparatus of claim 63, wherein the rotation of the second handle portion about the first axis is transmitted to the end-effector because the tool frame is rotationally constrained relative to the second handle portion and the end-effector is rotationally constrained relative to the tool frame.

66. The apparatus of claim 63, further comprising an output joint between the tool frame and the end-effector, wherein the pitch motion path encodes pitch motion of the handle assembly relative to the tool frame for transmission to the output joint but does not encode yaw motion of the handle assembly relative to the tool frame for transmission to the output joint, and wherein the yaw motion path encodes yaw motion of the handle assembly relative to the tool frame for transmission to the output joint but does not encode pitch motion of the handle assembly relative to the tool frame for transmission to the output joint.

67. The apparatus of claim 63 wherein the end-effector is configured as a jaw assembly configured so that the actuation of the end-effector control input opens or closes the jaw assembly.

68. An unlimited roll handle assembly apparatus, the apparatus comprising: a first handle portion; a second handle portion coupled to the first handle portion so that the second handle portion has one rotational degree of freedom in a first axis relative to the first handle portion but is translationally constrained relative to the first handle portion along the first axis; a push rod coupled to the first handle portion so that it has one degree of freedom along the first axis relative to the first handle portion but is rotationally constrained about the first axis relative to the first handle portion; an end-effector control input on the first handle portion configured to translate the push rod along the first axis, wherein the end-effector control input comprises a trigger, lever or button on the first handle portion configured for actuation by one or more of a user's fingers and thumb; and a shuttle body coupled to the push rod so that it has one rotational degree of freedom about the first axis relative to the push rod but is translationally constrained along the first axis relative to the push rod, further wherein the shuttle body is coupled to the second handle portion so that it has one degree of freedom along the first axis relative to the second handle portion and is rotationally constrained about the first axis relative to the second handle portion.

69. The apparatus of claim 68, wherein the second handle portion comprises a knob or dial having a grip configured to be rotated by one or more of a user's fingers and thumb.

70. The apparatus of claim 68, wherein the first handle portion comprises a palm grip configured to be held in a user's palm.

71. The apparatus of claim 68, wherein the device further comprises a tool frame and an input joint between the handle assembly and the tool frame.

72. The apparatus of claim 71, wherein the input joint comprises a pitch motion path encoding a pitch motion of the handle assembly relative to the tool frame about a pitch axis of rotation and a yaw motion path, encoding a yaw motion of the handle assembly relative to the tool frame about a yaw axis of rotation, wherein the pitch axis of rotation and the yaw axis of rotation intersect in a center of rotation that is proximal to the handle assembly.

73. The apparatus of claim 72, further wherein the center of rotation coincides with a center of rotation of a user's wrist, when the use is holding the device by the handle assembly.

74. The apparatus of claim 72, wherein the pitch motion path is parallel with the yaw motion path so that the input joint is a parallel kinematic joint.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0037] The novel features of the invention are set forth with particularity in the claims that follow. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments, in which the principles of the invention are utilized, and the accompanying drawings of which:

[0038] FIG. 1 is a constraint map of an unlimited-roll handle (handle assembly) having four parts, illustrating the degrees of freedom and degrees of constraint between the coupled components.

[0039] FIG. 2 is a schematic of a conceptual model of an unlimited-roll handle, illustrating the attributes of each interface of four bodies forming the handle assembly.

[0040] FIG. 3A shows an example of an interface between two bodies of an exemplary unlimited-roll handle assembly (e.g., H.Body A and H.Body C) shown as a square slot and square key feature.

[0041] FIG. 3B shows an example of an interface between two bodies of an exemplary unlimited-roll handle assembly (e.g., H.Body A and H. Body C) with minimal keying surface between bodies causing a rotational constraint.

[0042] FIG. 3C is an example of an interface between two bodies of an exemplary unlimited-roll handle assembly (e.g., H.Body A and H. Body C) shown as a D-Shaft and corresponding slot feature.

[0043] FIG. 3D is an example of a thrust bearing acting as interface between two bodies of an unlimited-roll handle assembly (e.g., H.Body A and H.Body B).

[0044] FIG. 3E shows an example of a portion of an unlimited-roll handle assembly including a thrust bearing with side washers acting as interface between H.Body A and H.Body B.

[0045] FIG. 3F shows an example of a washer acting as interface between H.Body A and H.Body B in one example of an unlimited-roll handle assembly.

[0046] FIG. 3G shows a bushing acting as interface between an H.Body A and H.Body B of an unlimited-roll handle assembly.

[0047] FIG. 3H illustrates an exemplary H.Body A and H.Body B under tensile load with thrust bearing acting as interface between them as part of an unlimited-roll (e.g., roll) handle assembly.

[0048] FIGS. 3I.1 through 3I.4 respectively illustrate a thrust needle bearing, a thrust roller bearing, a roller bearing and an angular contact roller bearing, each of which may be used as part of an unlimited-roll handle assembly.

[0049] FIG. 3J illustrates an example of a tapered roller bearing that may be used as part of an unlimited-roll handle assembly.

[0050] FIG. 3K shows a radial bearing that may be used as part of an unlimited-roll handle assembly.

[0051] FIG. 3L illustrates exemplary loading conditions applied on different bodies of an unlimited-roll handle assembly.

[0052] FIG. 4A shows an example of an unlimited (infinity) handle as described herein, which is one realization of the constraint map shown in FIG. 1 as an ergonomic handle.

[0053] FIG. 4B is an exploded view of the unlimited-roll handle assembly of FIG. 4A, in which a first handle portion is configured as a palm grip (H.Body A), a second handle portion is configured as a dial (H.Body B), the push rod (H. Body C) is within the palm grip, and a shuttle (H.Body D) is within the second handle portion. An end-effector control input (e.g., handle lever) may be attached to the palm grip to actuate the end-effector.

[0054] FIG. 5 illustrates one example of a medical device (e.g., a laparoscopic device) incorporating an unlimited-roll handle assembly such as the one shown in FIGS. 4A-4B, and described herein.

[0055] FIG. 6 shows an example of a cuff that can couple with a forearm attachment portion of a tool shaft of a medical device including an unlimited-roll (roll) handle assembly. The cuff includes a passage therethrough that is configured to hold a wrist or forearm of a user, wherein the cuff is configured to couple to the forearm attachment portion of the tool frame.

[0056] FIG. 7 shows another example of a medical device having an unlimited-roll handle assembly and a jaw assembly end-effector, such as the one shown in FIG. 5.

[0057] FIG. 8 is another view of a medical device having both an unlimited-roll handle assembly and a distal end-effector configured as a jaw assembly, wherein the distal end-effector is shown in an articulated position with closed jaws, and the unlimited-roll handle assembly is similar to that shown in FIGS. 4A-4B.

[0058] FIG. 9 shows another example of a medical device having both an unlimited-roll handle assembly and a distal end-effector configured as a jaw assembly, illustrating an end-effector transmission connecting the rotation dial (H.Body B) to the end-effector.

[0059] FIG. 10 shows an example of another apparatus including an unlimited-roll handle assembly and a distal end-effector configured as a jaw assembly, wherein the apparatus is a non-articulating straight stick laparoscopic device.

[0060] FIG. 11 shows an example of another articulating medical device using an unlimited-roll handle assembly such as the one shown in FIGS. 4A-4B.

[0061] FIG. 12 is an example of an alternative unlimited-roll handle assembly in which the palm grip (H.Body A) is distal to the rotation dial (H.Body B).

[0062] FIG. 13 illustrates the use of a ratchet mechanism providing for discrete rotational positioning of the associated rotation dial of an unlimited-roll handle assembly.

[0063] FIG. 14 illustrates another embodiment of an apparatus using an unlimited-roll handle assembly.

[0064] FIG. 15 is another example of an unlimited-roll handle assembly coupled to an end-effector configured as a jaw assembly.

[0065] FIG. 16 is a front perspective view of an exemplary surgical device incorporating an unlimited-roll handle assembly and an arm (forearm) attachment.

[0066] FIG. 17 is a side perspective view of an exemplary surgical device incorporating an unlimited-roll handle assembly and an input joint encoding pitch and yaw articulation by a parallel kinematic mechanism, which provides for transmitting pitch and yaw motions to an output joint located between the tool frame and the end-effector (shown configured as a jaw assembly).

[0067] FIGS. 18A-18D show front perspective, left side perspective, back perspective and right side perspective views, respectively, of a medical device including an unlimited-roll handle assembly, an end-effector configured as a jaw assembly, a proximal forearm attachment and an input joint encoding pitch and yaw articulation, the latter of which is transmitted to a output joint articulating the end-effector. The pitch and yaw input joint has a center of rotationlocated where the pitch and yaw axes intersectthat provide for a virtual center of rotation approximately within a user's wrist when the apparatus is attached to the user.

[0068] FIG. 19A shows a side view of a portion of a medical device corresponding to that shown in FIGS. 18A-18D, coupled to a user's forearm with the unlimited-roll handle assembly held in the user's hand.

[0069] FIG. 19B shows a slightly enlarged view of the device of FIG. 19A.

[0070] FIG. 19C shows the device of FIG. 19A, in which the user is articulating the handle in pitch and yaw relative to the tool frame, illustrating that the end-effector jaws track the handle position, with the tool frame rotated relative to the orientation shown in FIGS. 19A and 19B.

[0071] FIG. 20A is a constraint map of the apparatus shown in FIGS. 18A-18D that includes an unlimited-roll handle, an input joint, an output joint and an end-effector configured as a jaw assembly.

[0072] FIG. 20B shows an alternative constraint map for another apparatus described herein.

DETAILED DESCRIPTION

[0073] Described herein are apparatuses including an unlimited-roll handle assembly. Although the unlimited-roll handle assemblies described herein may be incorporated into any apparatus (e.g., device, tool, system, machine, etc.), described herein in particular are apparatuses including unlimited-roll handles assemblies at a proximal region of an elongate tool frame (e.g., a tool shaft or including a tool shaft) having an end-effector at the distal end of the tool frame. The apparatus may include a forearm attachment at the proximal end; the forearm attachment may allow one or more degrees of freedom between the user's forearm and the tool frame while the user's hand grips the unlimited-roll handle assembly. The apparatus may be articulating; for example, the tool frame may include an input joint between the unlimited-roll handle assembly and the tool frame that may encode movement (e.g., pitch and yaw movements) between the handle and the tool frame for transmission to an output joint between the tool frame and an end-effector, so that the end-effector may be moved as the handle is moved. Although any appropriate end-effector may be used, in some variations the end-effector is a jaw assembly that includes at least a pair of jaws (end-effector portions), which move to open and close the jaws when actuated by an end-effector control input on the handle of the device.

[0074] In general, the unlimited-roll handle assemblies described herein may be configured to have four (through in some cases only three) or more parts interact together to provide unlimited rotation of a knob or dial portion of the handle assembly about a central axis relative to a palm grip portion of the handle, while still permitting the actuation of an end-effector control input to actuate the end-effector from any rotational position of the dial portion relative to the palm grip. Rotation of the knob or dial portion of the apparatus causes rotation of the end-effector, and in some cases, also causes rotation of the tool frame.

[0075] A constraint map of an unlimited-roll handle assembly is shown in FIG. 1, illustrating a conceptual model of the relative degrees of freedom (DoF) and degrees of constraint (DoC) between component portions of an unlimited-roll handle rotation mechanism. The rotation mechanism typically comprises rigid bodies that are generically referred to as: H.Body A 101, H.Body B 102, H.Body C 103, and H.Body D 104. H.Body A 101 may be referred to as the reference ground, in that the motion of all other bodies may be described with respect to H.Body A 101. For example, H.Body A 101 may be a palm grip. In general, any other of these bodies may be used as the ground reference for describing the motion of the remaining bodies.

[0076] Using H.Body A 101 as the ground reference, H.Body C 103 has a single translational degree of freedom (DoF) 105 with respect to H.Body A 101 along a first axis (e.g., Axis 1) and has rotational constraint (DoC) 105 with respect to H.Body A 101 about Axis 1. This implies that relative translation along Axis 1 is allowed between H.Body C 103 and H.Body A 101. However, relative rotation about Axis 1 is not allowed between the two, and therefore transmitted from one to the other and vice versa. H.Body B 102 has a rotational DoF 106 with respect to H.Body A 101 about Axis 1 and has translational constraint (DoC) 106 with respect to H.Body A 101 along Axis 1. H.Body D 104 has a single translational DoF 107 with respect to H.Body B 102 along Axis 1 and rotational DoF constraint 107 with respect to H.Body B 102 about Axis 1. H.Body D 104 has a rotational DoF 108 with respect to H.Body C 103 about Axis 1 and translational constraint (DoC) 108 with respect to H.Body C 103 along Axis 1.

[0077] FIG. 2 illustrates one example of an unlimited-roll handle assembly fitting the constraint map shown in FIG. 1. Even though FIG. 2 shows H.Body A 101 and H.Body B 102 to be cylindrical in shape, the schematic diagram of FIG. 2 does not depict the actual geometric features of each bodies, and these bodies can be of any general shapes as long as they satisfy the joint conditions/constraints between the various bodies as mentioned above.

[0078] The constraint map of FIG. 1 results in the following functionality of the rotation mechanism shown: using H.Body A 101 as a reference (i.e., assuming it to be stationary), this mechanism allows for the independent rotation of H.Body B 102 with respect to H.Body A 101 about Axis 1 111. While this happens, H.Body D 104 rotates along with H.Body B 102, also about Axis 1 111 and since rotation of H.Body C 103 is coupled to rotation of H.Body A 101, H.Body C 103 does not rotate. At the same time, any axial translation of the non-rotating H.Body C 103 with respect to the stationary H.Body A 101 along Axis 1 111 is transmitted to H.Body D 104, even as H.Body B 102 and H.Body D 104 rotate about Axis 1 111.

[0079] The joints within the rotation mechanism between the bodies typically comprise interfacing geometries which selective allow or prevent rotation or translation with respect to one another. For those joints which enable rotation of one body with respect to another, this joint may comprise one or more cylindrical surfaces, and these surfaces can be enabled by a bearing, bushing, or lubricious surface treatment which minimizes frictional resistances. For translating joints, these surfaces may also comprise a lubricious surface treatment. As an overall mechanism, reduced frictional resistances to both translation and rotation mean that simultaneous motion of H.Body D 104 can occur in both rotation and translation while H.Body C 103 only translates and H.Body B 102 only rotates, all with respect to H.Body A 101. Thus, another way of describing the functionality of this constraint map is that H.Body D 104 inherits the translation of H.Body C 103 and the rotation of H.Body B 102. Considering this in reverse: H.Body D 104 has two DoF with respect to H.Body A 101, translation along Axis 1 111 and rotation about Axis 1 111. Any arbitrary combination of these two motions can be separated into translation only at H.Body C 103 and rotation only at H.Body B 102.

[0080] Any of the joints described herein may be encoded for transmission to an output (e.g., output joint). The encoding may be done mechanically, electrically, or otherwise. For example, sensors may be positioned at these two bodies, e.g., a linear displacement sensor on H.Body C 103 and a rotary sensor on H.Body B 102 may give discrete/individual values for arbitrary combination of rotation and translation applied at H.Body D 104. These electrical signals could then be transmitted via wired or wireless means to a mechatronic, robotic, electronic, or computer-controlled system. Alternatively, instead of sensors, one could place actuators at these locations, e.g., a linear translational actuator between H.Body A 101 and H.Body C 103 and a rotary actuator between H.Body A 101 and H.Body B 102. Any arbitrary discrete/individual motion inputs at these two bodies get added into a combined motion at H.Body D 104 with respect to H.Body A 101. In general, the encoding of movements at any of the joints described herein may be mechanically encoded, for example, similar to that described below for an input joint 1801 encoding pitch and yaw by operating a pair of flexure transmission strips 533, 534 coupled to transmission pulleys 1813.1, 1813.2 to separately and mechanically encode pitch and yaw motions. However, other encoding techniques (electrical, optical, etc.) may alternatively or additionally be used.

[0081] In general, the degree of freedom (DoF) implies that a particular motion is allowed. Degree of constraint (DoC) implies that a particular motion is constrained, and therefore transmitted. All motions in FIG. 1 are defined with respect to Axis 1 111 (not shown), which is the axis of rotation of a handle dial (corresponding to H.Body B 102) with respect to a handle shell (corresponding to H.Body A 101). Any motion direction not explicitly mentioned could be a DoF or DoC.

[0082] In FIG. 1, H.Body C 103 is shown having a single translational DoF 105 along Axis 1 111 (not shown) with respect to H.Body A 101 and vice versa. H.Body C 103 also has a rotational constraint (DoC) 105 along Axis 1 111 with respect to H.Body A 101 and vice versa. This type of joint, between H.Bodies A and C, can be accomplished through a variety of embodiments. In one embodiment, the interfacing bodies have a keying feature between them which restricts relative rotation about Axis 1 111 and simultaneously allows for relative translation along Axis 1 111. FIG. 3A schematically describes a joint which might occur between H.Body A 101 and H.Body C 103. Referring to FIG. 3A, an outer body with a square longitudinal slot may correspond to H.Body A 101, 301 while the inner square key may correspond to H.Body C 103, 303. Considering that H.Body A 101, 301 is fixed to the reference ground, H.Body C 103, 303 will be allowed to translate about Axis 1 111, 311 while unable to rotate about Axis 1 111, 311 due to the interferences posed by square cross-sectional joint. One might consider that this joint can also have a rectangular cross-section which can provide the same single axis (Axis 1 111, 311) rotational constraint and single axis (Axis 1 111, 311) translational DoF.

[0083] A functional aspect of this joint is a low friction relative sliding motion along Axis 1 111, 311 between H.Body A 101, 301 and H.Body C 103, 303. To achieve this, the surface contact between both bodies (H.Body A 101, 301 and H.Body C 103, 303) may need to be minimal so as to avoid large frictional contact between surfaces of H.Body A 101, 301 and H.Body C 103, 303. Therefore, one way of achieving the same joint between H.Body A 101, 301 and H.Body C 103, 303 with less friction contact is to minimize the contact surface area between two bodies. FIG. 3B shows one way to reduce the surface contact between H.Body A 101, 301 and H.Body C 103, 303 by interfacing the spokes of H.Body C 103, 303 with corresponding slots cut in H.Body A 101, 301.

[0084] FIGS. 3A and 3B show examples of achieving the constraint and DoF between H.Body A 101, 301 and H.Body C 103, 303 but, they can have different geometric shapes provided that the constraints and DoFs are met. For example, FIG. 3C shows one way this joint can be achieved by essentially providing a keying surface 320 via the flat end of the D-Shaft 303 (H.Body C 103, 303) that engages with a corresponding slot present in H.Body A 101, 301.

[0085] H.Body B 102, 302 and H.Body D 104, 304 have a rotational constraint about Axis 1 111, 311 and a single translational DoF 107 along Axis 1 111, 311. This is the same type of rotational constraint (DoC) 105 and translational DoF 105 that is present between H.Body A 101, 301 and H.Body C 103, 303. Therefore, each one of the ways to attain the joint between H.Body A 101, 301 and H.Body C 103, 303 are also applicable to the joint between H.Body B 102, 302 and H.Body D 104, 304; given the constraint and DoF requirements are fulfilled.

[0086] Any of the joints between H.Body A 101, 301 and H.Body C 103, 303 as well as between H.Body B 102, 302 and H.Body D 104, 304 may include or require a low friction surface contact between the bodies. This, along with rotational constraint (DoC) 105, 107 about Axis 1 111, 311 and single translational DoF 105, 107 along Axis 1 111, 311, may completely define the joint between these bodies. Similarly, a constraint, a DoF and functional requirements define the joint between H.Body A 101, 301 and H.Body B 102, 302 as well as between H.Body C 103, 303 and H.Body D 104, 304. H.Body A 101, 301 and H.Body B 102, 302 may have a single rotational DoF 106 about Axis 1 111, 311 relative to each other and translational constraint (DoC) 106 along Axis 1 111, 311. H.Body A 101, 301 and H.Body B 102, 302 may also have a functional requirement of providing low friction joint between them while they rotate relative to each other about Axis 1 111, 311. This functional requirement comes from the fact that either of the duo, H.Body A 101, 301 and H.Body B 102, 302 or H.Body C 103, 303 and H.Body D 104, 304 can be under compressive or tensile loading while fulfilling the rotational DoF 106, 108 about Axis 1 111, 311 and translational constraint (DoC) 106, 108 along Axis 1 111, 311.

[0087] For example, if H.Body A 101, 301 and H.Body B 102, 302 are placed such that their surfaces normal to Axis 1 111, 311 are under compression, they need to overcome the normal forces acting on each bodies' surfaces so as to provide the rotational DoF 106 about Axis 1 111, 311. Therefore, to provide the rotational DoF 106 about Axis 1 111, 311 and the translational constraint 106 along Axis 1 111, 311, the surfaces of H.Body A 101, 301 and H.Body B 102, 302 may need to provide low friction contact such that the bodies can rotate relative to each other about Axis 1 111, 311. FIG. 3D shows one way of obtaining the desired rotational DoF 106 and translational constraint (DoC) 106 by providing low friction surface contact. In this example, a thrust bearing 330 is used to provide the rotational DoF 106 along with maintaining low friction contact between surfaces of H.Body A 101, 301 and H.Body B 102, 302 by holding the thrust load between the two bodies. Similarly, this functionality can be achieved in many other ways that fulfill the rotational DoF 106 and translational constraint 106 requirement. For example, either an angular contact ball bearing, or a roller ball bearing, each capable of holding the required radial and thrust loads can also be used between H.Body A 101, 301 and H.Body B 102, 302. Alternatively, a bushing between two bodies can be used to provide radial support as well as capacity to bear thrust load. Other ways in which the thrust load can be supported is by having a thrust bearing 333 between H.Body A 101, 301 and H.Body B 102, 302 along with washers 334, 335 on each side of the bearing 333, for example, as is shown in FIG. 3E. A single washer 340 between H.Body A 101, 301 and H.Body B 102, 302 made of material with low friction coefficient like Teflon (PTFE), nylon, etc. can also serve the purpose for bearing the thrust load and providing the rotational DoF 106 about Axis 1 111, 311, for example, as is shown in FIG. 3F. In accordance with yet another alternative embodiment, FIG. 3G shows a bushing 345 placed between the interfacing surfaces of H.Body A 101, 301 and H.Body B 102, 302, such that it is capable to holding thrust load and thereby providing a translational constraint (DoC) 106 along Axis 1 111, 311.

[0088] The same system of two bodies with an intermediate member carrying thrust load and providing a rotational DoF 106 about Axis 1 111, 311 and providing a translational constraint (DoC) 106 along Axis 1 111, 311, shown in FIGS. 3D, 3E, and 3F also works well when there is a tensile loadas opposed to compressive loadbetween H.Body A 101, 301 and H.Body B 102, 302, for example, as illustrated in FIG. 3H with an embodiment similar to that illustrated in FIG. 3D, wherein a thrust bearing 347 is located between H.Body A 101, 301 and H.Body B 102, 302, facing normal to Axis 1 111, 311. The thrust bearing 347 between H.Body A 101, 301 and H.Body B 102, 302 can be of various types, e.g., thrust needle bearing, thrust roller bearing, roller bearing, tapered roller bearing, angular contact bearing, etc., some of which are illustrated in FIGS. 3I.1 through 3I.4. For example, FIG. 3H shows a thrust roller bearing 347 acting as joint between H.Body A 101, 301 and H.Body B 102, 302. Also, H.Body C 103, 303 and H.Body D 104, 304 may have the same type of joint as H.Body A 101, 301 and H.Body B 102, 302 and comply with all the aforementioned joint types mentioned in this section.

[0089] As illustrated in FIGS. 3I.1 through 3I.4, and FIGS. 3J and 3K, other types of bearings may be used as alternatives to, or in combination with, the above-described thrust bearings 330, 333, 347, for example, tapered roller bearings 349, radial ball bearings 394, etc.

[0090] Accordingly, H.Body A 101, 301 and H.Body B 102, 302 can be under compressive or tensile load along Axis 1 111, 311. Similarly, H.Body C 103, 303 and H.Body D 104, 304 can also be under compressive or tensile load along Axis 1 111, 311. This gives two possible combinations for the whole system presented with schematic diagram in FIG. 1 (to be under tensile load or compressive load). Either of the system of two bodies, H.Body A 101, 301 and H.Body B 102, 302, or H.Body C 103, 303 and H.Body D 104, 304 can be under tensile or compressive load. As presented in FIG. 1, with H.Body A 101, 301 serving as the reference ground, H.Body B 102, 302 can be under tension or under compression with respect to H.Body A 101, 301. However, H.Body C 103, 303 is free to move along Axis 1 111, 311 with respect to H.Body A 101, 301 and has rotational constraint about Axis 1 111, 311 with respect to H.Body A 101, 301. H.Body C 103, 303 can be under compression or tension with respect to H.Body D 104, 304, and H.Body D 104, 304 is free to translate along Axis 1 111, 311 with respect to H.Body B 102, 302 and has rotational constraint about Axis 1 111, 311 with respect to H.Body B 102, 302. FIG. 3L illustrates a configuration where H.Body B 102, 302 is under compressive load with respect to H.Body A 101, 301 and H.Body C 103, 303 is under tensile load with respect to H.Body D 104, 304. In this example, an angular contact bearing 351 is used between H.Body A 101, 301 and H.Body B 102, 302. This accounts for a joint between H.Body A 101, 301 and H.Body B 102, 302 that provides the associated translational constraint (DoC) 106 and rotational DoF 106 requirements mentioned above, along with the functional requirement of providing low friction between the surfaces in contact with one another. Similarly, a thrust bearing 330, 333, 347, 349, 394, 351 may be used between H.Body C 103, 303 and H.Body D 104, 304 may be used. This accounts for a joint between H.Body C 103, 303 and H.Body D 104, 304 that provides the associated translational constraint (DoC) 108 and rotational DoF 108 requirements mentioned above, along with the functional requirement of providing low friction surface contact.

[0091] It should be understood that even though the bodies have been illustrated as being cylindrical in shape, the constraint map (FIG. 1) doesn't imply any restriction on geometric shapes of these bodies, provided that the functionality, DoFs and constraints are satisfied.

[0092] FIGS. 4A and 4B show an example of an ergonomic handle assembly 400 (unlimited-rotation handle assembly) that utilizes the mechanism illustrated in FIG. 3L involving both compressive and tensile loading conditions. This handle 401 is an embodiment of the constraint map shown in FIG. 1. The rotation dial 402 (H.Body B 102, 402) is under translational constraint (DoC) 106 about Axis 1 111, 411 with respect to Handle Body Shell 401 (H.Body A 101, 401). The rotation dial 402 transmits this rotation about Axis 1 111, 411 to H.Body D 104, 404, which is also referred as shuttle 404. This is possible because shuttle 404 (H.Body D 104, 404) is under rotational constraint (DoC) 107 about Axis 1 111, 411 with respect to rotation dial 402 (H.Body B 102, 402) and therefore, has no relative rotation about Axis 1 111, 411. The shuttle 404 (H.Body D 104, 404) is further interfaced with H.Body C 103, 403 (referred as push rod or pull rod, i.e. push/pull rod 403) via a joint 455 which allows rotational DoF 108 along Axis 1 111, 411 and translational constraint (DoC) 108 along Axis 1 111, 411. The translation of shuttle 404 (H.Body D 104, 404) along Axis 1 111, 411 is further transmitted to the moving jaw of an end-effector via an end-effector transmission 471. The latter may alternatively be referred to (e.g., when the end-effector is configured as a jaw) as a jaw closure transmission member 471 or jaw closure actuation transmission member 471. In some variations, it may simply be referred to as a transmission cable (when it is a compliant cable, for example). This jaw closure actuation transmission member 471 can be either rigid or non-rigid body, or a combination of a rigid and non-rigid members. For example, the transmission member can be either the shaft of an apparatus (e.g., of a laparoscopic instrument) or a rod passing internally through the shaft, a cable under tension that connects to the end-effector at the distal end of the laparoscopic instrument, or a combination of a non-rigid body and a rigid body (e.g. a rod along with a cable under tension). The push/pull rod 403 (H.Body C 103, 403) and shuttle 404 (H.Body D 104, 404) are under tensile load and the rotation dial 402 (H.Body B 102, 402) is under compressive load and the latter does not translate along Axis 1 111, 411 with respect to handle shell 401 (H.Body A 101, 401).

[0093] Another variation of an ergonomic handle assembly 400 shown in FIGS. 4A and 4B can be constructed via a flexure-based design, also known as a compliant mechanism, that realizes the constraint map of FIG. 1 by employing compliant or flexure joints between the bodies H.Body A 101, H.Body B 102, H.Body C 103, and H.Body D 104 to achieve the necessary constraints.

[0094] An apparatus incorporating the unlimited-roll handle assemblies illustrated in FIGS. 4A and 4B is shown in FIGS. 5, 7, and 8 as part of a medical device (specifically a laparoscopic device). More particularly, FIGS. 5, 7, and 8 shows a laparoscopic surgical instrument having an end-effector configured as a jaw assembly; wherein in FIG. 5 the jaws are open and in FIG. 7 the jaws are shown closed.

[0095] Referring to FIGS. 5 through 8, the exemplary apparatus 500 includes a tool frame 525, the latter of which includes a tool shaft 526 and a forearm attachment portion 527 at the proximal end 528 of the tool frame 525. A wrist cuff 605having a passage therethroughthat is configured to hold a wrist 607 or forearm 608 of a user, may be coupled to the forearm attachment portion 520, 527. For example, in some embodiments, the wrist cuff 605 is operatively coupled to the forearm attachment portion 520, 527 of the tool frame 525 via a bearing therebetween that provides for the wrist cuff 605 to slide or roll so that there is a roll rotational degree of freedom between the tool frame 525 and the wrist cuff 605 about a tool axis 515 (Axis 3 515). A proximal unlimited-roll handle assembly 400for example, as shown in FIGS. 4A and 4Bmay be connected to the tool frame 525 by an input joint 529, the latter of which may be configured to encode motion between the tool frame 525 and the unlimited-roll handle assembly 400, as shown in FIGS. 5, 7 and 8. In this example, the input joint 529 includes a pair of transmission strips 533, 534 that are connected between the unlimited-roll handle assembly 400 and the forearm attachment portion 527 by corresponding associated hinged joints 530, and that may be connected in parallel to respective pivoting joints (not shown) in order to provide for separately encoding pitch and yaw rotations of the unlimited-roll handle assembly 400 relative to the tool frame 525. An output joint 583 (shown as an end-effector articulation joint) between an end-effector 565 and the tool frame 525 (e.g., tool shaft) receives transmission input (e.g., cables, not shown) from the output joint 583 to articulate the end-effector 565.

[0096] In this example, the unlimited-roll handle assembly 400 includes an ergonomic palm grip portion 101, 501 (handle shell 501) that connects to the rotation dial 102, 502, which enclose an internal push rod and shuttle (not visible), wherein these four elements are constrained per the constraint map shown in FIG. 1. The unlimited-roll handle assembly 400 also includes an end-effector control input 549 that is actuated via a handle lever 549 and acts as a mechanical extension of the internal push rod. In alternate configurations, the handle lever 549 is coupled to the push rod via a transmission mechanism that may comprise a linkage, cams, springs, etc. A transmission cable 566 connects to the shuttle and acts as a jaw closure actuation transmission member extending from the shuttle and through the tool shaft 526 to the end-effector 565. This transmission cable 566 may be enclosed by a protective and/or supporting sheath or cover or conduit, for some or entire portion of its length. The end-effector 565 itself is a jaw assembly including a first (ground) end-effector portion 569, in this example, including a fixed jaw 569 to which a pivoting second end-effector portion (moving jaw 568) is attached. The transmission cable 566 may couple to the moving jaw 568 at the end-effector closure output 577.

[0097] In FIG. 5, rotation of the dial portion 102, 502 of the unlimited-roll handle assembly 400 when the user's forearm 608 is mounted to the proximal end 528 of the tool frame 525 and the palm grip portion 101, 501 is held in the user's hand 609 so that the user can rotate the rotation dial 102, 502 between the thumb and fingers, which in turn rotates the entire tool frame 525, and therefore the end-effector 565 that is attached to the distal end 578 of the tool frame 525 via an end-effector output articulating joint 583. Thus, the handle 101, 501 may rotate about a first axis 111, 511 referred to as handle articulated roll axis 511 (Axis 1), so as to cause the tool shaft 526 to rotate about a third axis 515 referred to as the tool shaft roll axis 515 (Axis 3), which in turn causes the end-effector 565 to roll about a second axis 513, referred to as an end-effector articulated roll axis 513 (Axis 2).

[0098] The rotation dial 102, 502 (H.Body B) as shown in FIG. 5 is rotated about Axis 1 111, 511. The rotation of H.Body B 102, 502 leads to a rotation of the tool frame 525 via the transmission strips 533, 534 (as they constrain rotation DoF), which in turn causes a rotation of the tool shaft 526 (about Axis 3 515) operatively coupled to the tool frame 525, and a rotation of the end-effector 565 (about Axis 2 513) operatively coupled to the tool shaft 526. When the handle 101, 501 is articulated using the input articulating joint 529, the end-effector 565 articulates via the end-effector output articulating joint 583, wherein the end-effector articulated roll axis 513 (Axis 2) is distinct from the tool shaft roll axis 515 (Axis 3).

[0099] The above description is also relevant when describing apparatuses that either do not attach to the forearm 608 or that attach to the forearm 608 via a roll joint, so that rotation of the dial portion 102, 502 of the unlimited-roll handle assembly 400 leads to roll rotation of a forearm attachment apparatus 600 about the wrist 607 via the transmission strips 533, 534 (as they constrain the roll rotation), leading to a rotation of tool frame 525, the tool shaft 526 and eventually, the end-effector 565. FIG. 6 illustrates an example of an embodiment of a forearm attachment apparatus 600 comprising a 3-Axis gimbal assembly including a wrist cuff 605 that securely attaches to the user's wrist 607/forearm 608, leaving the user's hand 609 free to move (e.g., to grasp the handle 101, 501 and manipulate the rotation dial 102, 502 and end-effector control input 549). In this embodiment, the forearm attachment apparatus 600 allows pitch, yaw and roll degrees of freedom; the wrist cuff 605 pivotally attaches to a deviation ring 514 with a first pair of pins 610 that that provide for rotation about flexion/extension axis of rotation 516. The deviation ring 514 is in turn pivotally attached to a sled 518 with a second pair of pins 611 that provide for rotation about a deviation axis of rotation 521, wherein the sled 518 is configured to roll within a raised inner track 519 of an outer guide ring 520 about a corresponding roll axis of rotation 531. Accordingly, the forearm attachment apparatus 600 provides for pitch, yaw and roll degrees of freedom between the wrist cuff 605 and the tool frame 525 when coupled to the tool frame 525 of the apparatus 500. For example, in one set of embodiments, the outer guide ring maybe formed as part of the forearm attachment portion 527 of the apparatus 500, or it may be attached thereto. The wrist cuff 605 may be releasably coupled into the deviation ring 514 via a snap-fit coupling 540 or other some other type of coupling.

[0100] FIG. 8 shows another view of the laparoscopic instrument of FIGS. 5-7 with the end-effector 565 in an articulated position, and holding a needle that may be used to suture tissues. The end-effector fixed jaw (ground) 569 and the end-effector moving jaw 568 can be rotated about the end-effector articulated roll axis 513 (Axis 2) such that the tool shaft 526/tool frame 525 rotates about the tool shaft roll axis 515 (Axis 3) while the handle is rotated about the handle articulated roll axis 511 (Axis 1); all while simultaneously holding the needle securely by moving the end-effector moving jaw 568 towards the end-effector fixed jaw (ground) 569 via a jaw closure actuation transmission member 471 connected to H.Body D 104, 404 within the unlimited-roll handle assembly 400. The apparatus 500 shown in FIGS. 5-8 may fit a constraint map such as the one shown in FIG. 20A.

[0101] Another variation of an apparatus incorporating the unlimited-roll handle assemblies illustrated in FIGS. 4A and 4B that conforms to the constraint map illustrated in FIG. 1 is shown in FIG. 9. In this example, the rotation of a rotation dial 102, 902 (H.Body B) about Axis 1 111, 911 leads to rotation of an associated end-effector assembly 965 (shown here as a jaw assembly including a moving jaw 968 and a fixed jaw 969) about Axis 2 915. Here, the tool frame 925 including the tool shaft 926 does not rotate about their associated axis (Axis 3 915) thereof. The tool frame 925 may still be connected to a wrist cuff 605 mounted on a user's forearm 608 via a forearm attachment apparatus 600 that may provide for a pitch and/or yaw rotational DoF, as described hereinabove. The end-effector assembly 965 has a rotational DoF with respect to the distal end 927 of the associated end-effector articulation output joint 928 about Axis 2 915 (similar to that between H.Body A 101, 901 and H.Body B 102, 902 about Axis 1 111, 911) and an end-effector rotation transmission member 950 connects H.Body B 102, 902 directly to the end-effector assembly 965 via the torsionally stiff end-effector rotation transmission member 950. This may also be the jaw closure actuation transmission member 471 or may house and therefore route, a flexible jaw closure actuation transmission member 471, for example, a hollow flexible shaft (end-effector rotation transmission member 950) that is torsionally stiff that can transmit rotation from one end to another, housing a flexible (in bending) cable (jaw closure actuation transmission member 471) therewithin.

[0102] Another example of an apparatus 1000 incorporating the above-described unlimited-roll handle assembly 400 of FIGS. 4A and 4B is shown in FIG. 10. This apparatus 1000 is configured as a straight stick device with a non-articulating end-effector 1065. Other straight stick apparatusesfor example, as described in U.S. Pat. No. 4,712,545, U.S. Pat. No. 5,626,608, and U.S. Pat. No. 5,735,874may benefit from incorporation of the unlimited-roll handle apparatuses, for example, the unlimited-roll handle assembly 400 illustrated in FIGS. 4A and 4B. FIG. 10 shows an example of a surgical instrument comprising an unlimited-roll handle assembly 400 (including palm grip portion 101, 1001 and a dial portion 102, 1002), a tool shaft 1026 and the non-articulating end-effector 1065, wherein, for example, there is a rotation joint 1067 between the moving jaw 1068 and fixed jaw 1069 of the non-articulating end-effector 1065, the latter configured as a jaw assembly. The non-articulating end-effector 1065 connects to the rotation dial 102, 1002 (H.Body D) via a jaw closure actuation transmission member (not visible in FIG. 10). This apparatus 1000 provides the functionality of closing and opening the non-articulating end-effector 1065 by moving the moving jaw 1068 relative to the fixed jaw 1069. The apparatus 1000 may also provide the rotation of the non-articulating end-effector 1065 about the handle axis 1011 (Axis 1 111, 1011), wherein the shaft axis 1015 (Axis 3) remains parallel to the handle axis 1011 (Axis 1 1011) under rotation of the H.Body B 102, 1002, tool shaft 1026 and the non-articulating end-effector 1065 attached hereto.

[0103] Referring to FIG. 11, in accordance with another set of embodiments that incorporate the unlimited-roll handle assemblies illustrated in FIGS. 4A and 4B, articulation at the input joint 529 is encoded via either a serial kinematic input articulation joint or a parallel kinematic input articulation joint. For example, FIG. 11 shows an articulating laparoscopic device 1100. Such devices include a handle 101, 1101, tool shaft 1126 and an articulating end-effector 1165. Similar to the above-described non-articulating laparoscopic device 1000, the articulating laparoscopic device 1100 also incorporates an end-effector rotation joint 1167 (open/close functionality) operative between a moving jaw 1168 and a fixed jaw 1169, but in addition to this open/close end-effector rotation joint 1167, also contains an output articulation joint 1143 for end-effector articulation, and a corresponding associated input articulation joint 1142. The input articulation joint 1142 may be implemented as either a serial kinematic (S-K) input joint or parallel kinematic (P-K) input joint. Some articulating instruments that consist of serial kinematic (S-K) input joint (such as the one shown in FIG. 11) can be found, for example, in U.S. Pat. No. 8,465,475; U.S. Pat. No. 5,713,505, U.S. Pat. No. 5,908,436, U.S. application Ser. No. 11/787,607 and U.S. Pat. No. 8,029,531. Examples of articulating instruments incorporating a parallel kinematic (P-K input joint may be found, for example, in U.S. Patent Application Publication No. 2013/0012958. In such devices, although the end-effector may be a jaw assembly and may be shown in an open jaw condition, an associated articulating instrument can also perform rotation with the end-effector rotation joint in a closed jaw condition or with the output articulation joint in an articulated condition.

[0104] FIGS. 12 and 13 illustrate other apparatus variations the incorporate the unlimited-roll handle assembly illustrated in FIG. 4 that following the constraint map illustrated in FIG. 1. These handle variations may be used with any of the other apparatus components described herein (including with other device architectures and/or constraint maps). For example, in FIG. 12, the rotation dial 102, 1202 is proximal to the palm grip portion 101, 1201. The apparatus may include a shaft 1226 and an end-effector 1265, and may include the same axes as described above (first Axis 111, 1211, second Axis 1213 and third Axis 1215). In the constraint map of FIG. 1, joint characteristics (DoFs and DoCs) between H.Body A 101, 1202 and H.Body C are the same as the ones between H.Body B 102, 1201 and H.Body D. Also, joint characteristics (DoFs and DoCs) between H.Body A 101, 1202 and H.Body B 102, 1201 are the same as the ones between H.Body C and H.Body D. Therefore, any of the four bodies can be referred as ground reference. FIG. 13 shows a differently-located reference ground, located in the handle assembly. In FIG. 13, when mapped to the constraint map of FIG. 1, H.Body B 102, 1302 is chosen as reference ground and interfaces firmly with user's hand 609, whereas, H.Body A 101, 1301 is rotated with respect to H.Body B 102, 1302. Here, H.Body C 103, 1303 rotates with respect to H.Body D 104, 1304 and H.Body C 103, 1303. Another way of explaining this embodiment (shown in FIG. 13) is that the handle's rear end of the above-described embodiments is now placed at the proximal end and vice versa.

[0105] Any of the apparatuses described herein may include a rotation lock/ratcheting mechanism, as illustrated in FIG. 13. The handle assembly shown by the constraint map of FIG. 1 consists of a joint between H.Body A 101, 1301 and H.Body B 102, 1302 which provides rotational DoF about Axis 1 111. This rotation can be made more tactile by application of ratcheting feature between H.Body A 101, 1301 and H.Body B 102, 1302. Ratcheting between H.Body A 101, 1301 and H.Body B can provide a sense of discrete rotation degrees while rotating about Axis 1. FIG. 13 illustrates a similar variation. In this example, a thrust bearing 1317 is located between the palm grip 101, 1301 and the rotation dial 102, 1302, as is a ratchet mechanism 1319. The shuttle 104, 1304 and push rod 103, 1303 otherwise operate per the constraint diagram of FIG. 1.

[0106] The unlimited-roll handle assemblies described herein may also be used with an apparatus configured to provide a pecking motion at an end-effector operatively coupled thereto. For example, referring to FIG. 14, other embodiments of an unlimited-roll handle assembly 400 of FIG. 4 (fitting the constraint map of FIG. 1) may provide for the opening and closing of an end-effector jaw triggered directly by radially pressing the rotation dial 102, 1402 (H.Body B). For example, the embodiment illustrated in FIG. 14 comprises a handle shell 101, 1401 (H.Body A), held in a hand 609 of the user, and may include a rotation dial 102, 1402 (H.Body B) that can rotate relative to handle shell 101, 1401 (H.Body A) about Axis 1 111, 1411. The rotation dial 104, 1404 (H.Body B), when radially pressed, pushes a shuttle 104, 1404 (H.Body D) along Axis 1 111, 1411 in accordance with the translational DoF of the shuttle 104, 1404 (H.Body D) with respect to the rotation dial 104, 1404 (H.Body B) along Axis 1 111, 1411. This closes a combined shaft and end-effector 1432 that is rigidly connected to the rotation dial 102, 1402 (H.Body B), as shown in FIG. 14. The flexible nature of the body representing combined shaft and end-effector 1432 directs the movement of shuttle 104, 1404 (H.Body D)as a sleeve 1404over the combined shaft and end-effector 1432. This sleeve 1404/shuttle 104, 1404 (H.Body D), controls the opening and closing of the associated end-effector 1432, the latter of which acts as a double action jaw that can have various applications in open surgery, for example, in eye surgery or in minimal invasive surgery. The push/pull rod (H.Body C, which can't be seen in FIG. 14) may be keyed to the interior of the handle shell 101, 1401 (H.Body A) and attached via a spring, so that after the push/pull rod (H.Body C) is moved relative to handle shell 101, 1401 (H.Body A), it retracts back to its original position with the help of the spring. Accordingly, this provides for the motion of the push/pull rod (H.Body C) and shuttle 104, 1404 (H.Body D) along Axis 1 111, 1411 when the shuttle 104, 1404 (H.Body D) is pushed along Axis 1 by radially pressing the rotation dial 104, 1404 (H.Body B), and provides for retracting both the shuttle 104, 1404 (H.Body D) and the push/pull rod (H.Body C) to their original position thereafter. Accordingly, for this embodiment, the combined end-effector 1432 can be rotated about its normal axis (Axis 1 111, 1411), and the associated end-effector 1432 can be used to grab or clamp external bodies by pecking the shuttle 104, 1404 (H.Body D), which closes of the end-effector 1432, and can then be used to release the external body by releasing the shuttle 104, 1404 (H.Body D), which opens the end-effector 1432.

[0107] Referring to FIG. 15, in accordance with another embodiment, an apparatus 1500 utilizing a pull-pull configuration for jaw closure transmission incorporates an unlimited-roll handle assembly 400 such as was shown in FIG. 4A, including a shuttle 104, 404 (H.Body D) keyed to H.Body B 102, 402. An associated jaw closure (open/close) actuation transmission member 1530 is first pulled to close an end-effector moving jaw 1567 with respect to a corresponding end-effector fixed jaw 1568, and is then subsequently pulled to open the end-effector moving jaw 1567 with respect to the end-effector fixed jaw 1568. The jaw closure (open/close) actuationtransmission member 1530 is attached to H.Body D 104, 404, where H.Body D can translate with respect to H.Body B 102, 402 as a result of the translational DoF 107 along Axis 1 111, 411, but which has a translational constraint (DoC) 108 with respect to H.Body C 103, 403. Once H.Body D 104, 404 moves along Axis 1 111, 411 to pull the jaw closure (open/close) actuation transmission member 1530 to close the jaws 1567, 1568 (i.e. bringing the end-effector moving jaw 1567 and end-effector fixed jaw 1568 together), a second jaw closure (open/close) actuation transmission member 1532 is pulled to open the end-effector moving jaw 1567. To open the jaws 1567, 1568 the second jaw closure actuation transmission member 1532 may be pulled. In one embodiment, the second jaw closure actuation transmission member 1532 can be pulled using a pull spring 1513, grounded at a reference frame called Spring Reference Ground 1512. Depending on how the roll transmission member is routed throughout the whole assembly, Spring Reference Ground 1512 can occur at different locations in the assembly, as follows: (1) If roll transmission is by means of an input articulating joint 529, a tool frame/tool shaft 1526, an output articulating joint 583, then the spring reference ground 1512 can occur at the H.Body B 102, 402, or the tool frame/tool shaft 1526, or the end-effector fixed jaw 1568; (2) If roll transmission is by means of an independent roll transmission member routed across the input articulating joint 529, through tool frame/tool shaft 1526, and the output articulating joint 583 (given an extra roll DoF between output joint distal end and end-effector base), then the spring reference ground 1512 can occur at H.Body B 102, 402 or at the end-effector fixed jaw 1568.

[0108] In some variations, the unlimited-roll handle assembly is generally configured to include a forearm attachment apparatus 600. The unlimited-roll handle apparatus 1600 may provide the ability for simultaneously transmitting roll and closure action to H.Body D 104 with respect to H.Body A 101. Such a variation that includes a forearm attachment apparatus 600 that provides for addition degrees of freedom (DoF) was described above in FIGS. 5-8, and another example is shown in FIG. 16. In this example, a (one) jointreferred to as a forearm attachment apparatus 1611exists between a wrist attachment/wrist cuff 1609 and a tool frame 1625. The forearm attachment apparatus 1611 (similar to 600 shown in FIG. 6) may be used to couple the wrist attachment/wrist cuff 1609 to the tool frame 1625, allowing either zero, or one or more degrees of freedom DoF between the user's forearm and the unlimited-roll handle apparatus 1600, depending upon the nature of the forearm attachment apparatus 1611. The forearm attachment apparatus 600 may be used with either articulating devices or non-articulating devices. For example, one embodiment can include a roll DoF by providing a roll rotation joint 1611 between the wrist attachment/wrist cuff 1609 and the tool frame 1625. This joint may use a sled 518for example, as illustrated in FIG. 6which can provide for a roll rotational DoF about the roll axis 111, 531 or the arm axis 612. Another embodiment can provide for a pitch DoF by providing a rotation joint to allow rotation about the flexion/extension axis of rotation 516. Another embodiment can provide for a yaw DoF by providing a rotation joint to allow rotation about the deviation axis of rotation 521. Another embodiment can provide for both pitch and yaw DoF by providing one or more rotation joints that allow rotation about the flexion/extension axis of rotation 516 and rotation about the deviation axis of rotation 521, respectively, for example, by incorporating an intermediate body referred to as a deviation ring 514, for example, as illustrated in FIG. 6. Another embodiment can provide for roll (about the arm axis 612), pitch (about the flexion/extension axis of rotation 516) and yaw (about the deviation axis of rotation 521) degrees of freedom (DoFs). Also as shown in FIG. 16, a joint also exists between the tool frame 1625 and the tool shaft 1626, called a shaft-frame joint 1615, which may have a zero DoF (i.e. a rigid connection between the tool shaft 1626 and the tool frame 1625), which, for the embodiments disclosed herein, is the default configuration. The device 1601 illustrated in FIG. 16 includes a handle palm grip 101, 1601 (H.Body A), a rotation dial 102, 1602 (H.Body B), an end-effector input 1612 (e.g. a handle lever 549), a shaft-frame joint 1615, an end-effector 1665 at a distal end 1627 of the tool shaft 1626, for which are defined an associated handle axis 1611 (Axis 1 1611), an associated tool shaft axis 1615 (Axis 3 1615) and an associated end-effector axis 1613 (Axis 2 1613).

[0109] Some variations of a non-articulating instrument 1600 that is forearm mounted and that incorporates the unlimited-roll handle assembly 400 of FIGS. 4A and 4B may include a separate tool frame 1625 and a separate tool shaft 1626. In one such configuration, the tool frame 1625 and wrist attachment/wrist cuff 1609 may be rigidly attached (i.e. 0 DoF). In this case, if the tool shaft 1626 is rigidly connected to the rotation dial 102, 1602 (H.Body B), then the device 1601 may be configured so that there is at least one roll rotation DoF between the tool shaft 1626 and the tool frame 1625. Furthermore, a shaft-frame joint 1615 can have a roll DoF, a Pitch DoF, and/or a Yaw DoF.

[0110] Any of the apparatuses incorporating an unlimited-roll handle apparatus described herein may also include a virtual center (VC) 1721 at the associated input articulation joint, for example, as shown in FIG. 17. This device 1700 can have either a serial or parallel kinematic input joint, with the associated joint axes intersecting at the virtual center (VC) 1721. This device 1700 is similar to that shown in FIGS. 5,7, and 8, but explicitly shows the virtual center (VC) 1721. The device 1700 also includes an end-effector assembly 1765 that is also configured as a jaw assembly.

Example: Medical Device

[0111] FIGS. 18A-18D illustrate one example of a medical device 1800 configured as a laparoscopic apparatus 1800 including an unlimited-roll handle assembly 400 (similar to that illustrated in FIGS. 4A and 4B), an elongate tool frame 525, a forearm attachment apparatus 600 (similar to that illustrated in FIG. 6) having multiple degrees of freedom between the user's arm and the tool frame 525, an end-effector assembly 1765 configured as a jaw assembly and an input joint 1801 that encodes pitch and yaw rotation of the unlimited-roll handle assembly 400 for transmission to an output joint 583, e.g. an end-effector output articulating joint 583, so that the end-effector assembly 1765 may articulate in the same direction as does the unlimited-roll handle assembly 400, for example, as illustrated in FIGS. 19A-19C. A schematic constraint diagram for the medical device 1800 shown in FIGS. 18A-18D is shown in FIG. 20A. An alternative constraint diagram for an medical device 1800 as described herein is shown in FIG. 20B.

[0112] Referring again to FIGS. 18A-18D, the overall medical device 1800 comprises a pulley block 1805, a tool frame 525 including a tool shaft 526 (the tool shaft 526 may be considered a portion of the tool frame 525), all rigidly inter-connected to one another. The pulley block 1805 serves as the outer ring 1805 of a forearm attachment joint 1807 that interfaces with the distal forearm 608 of a user via a wrist cuff 1803, as described above.

[0113] In this example, the wrist cuff 1803 and the outer ring 1805 are all part of the forearm attachment joint 1807 (corresponding to the forearm attachment apparatus 600 of FIG. 6). The forearm attachment joint 1807 comprises the outer ring 1805, a sled 518, a deviation ring 514, and the wrist cuff 1803 (all connected in series), as illustrated in FIG. 6 and described hereinabove, and provide three rotational degrees of freedom (DoF) between the wrist cuff 1803 and the outer ring 1805, i.e. roll, pitch, and yaw. Roll is the rotation direction about the axis of the outer ring 1805, which is the same as the axis of the tool shaft 526. Pitch and yaw are orthogonal rotations with respect to the roll rotation about the pitch axis 1833 and yaw axis 1831, respectively, as illustrated in FIG. 18C. When the medical device 1800 is mounted on the forearm 608 (i.e., the wrist cuff 1803 is attached to the forearm 608/wrist 607 of a user), the forearm attachment joint 1807 provides the above three rotational degrees of freedom DoF between the tool frame 525 and user's/surgeon's forearm 608.

[0114] The tool frame 525 extends from the outer ring 1805/pulley block 1805, and is shaped around the unlimited-roll handle assembly 400 so as to accommodate a user's hand 609 (over its entire range of articulation) while supporting the unlimited-roll handle assembly 400. The tool frame 525 rigidly connects to the tool shaft 526, which further extends in a distal direction (i.e., away from the forearm attachment joint 1807 and the user). A two-DoF articulating joint (also referred to as the output joint 583/end-effector articulating joint 583) is located at the end (also referred to as the output of the medical device 1800) of the tool shaft 526. These two degrees of freedom DoF are pitch rotation and yaw rotation, which are controlled/actuated by articulating the input joint 1801 (discussed below) between the unlimited-roll handle assembly 400 and the pulley block 1805. Additionally, the end-effector assembly 1765 is equipped with a pair of jaws 1756 that can be opened and closed in response to a handle lever 549 of the unlimited-roll handle assembly 400.

[0115] The input joint 1801 is located between the unlimited-roll handle assembly 400 and the pulley block 1805 at the proximal end 528 of the medical device 1800, and provides for two rotational degrees of freedom (DoF) (pitch rotation and yaw rotation) therebetween. The input joint 1801 is a parallel kinematic mechanism comprising two flexure transmission strips 533, 534 and two transmission pulleys 1813.1, 1813.2 (a pitch pulley 1813.1 and a yaw pulley 1813.2). The axes of the pulleys 1813.1, 1813.2, when extrapolated, intersect at a virtual center (VC) 1821 in space. For this reason, the parallel kinematic input joint 1801 of the medical device 1800 is also referred to as a Virtual Center mechanism 1801 or a Virtual Center input joint 1801. When the medical device 1800 is mounted on a user's forearm 608 via the forearm attachment joint 1807 and the user's hand 609 holds the handle 101, 501 of the unlimited-roll handle assembly 400, the overall geometry of the medical device 1800 is such that the virtual center (VC) 1821 produced by the parallel kinematic input joint 1801 coincides with the center of rotation the user's wrist joint 607. This ensures a natural, comfortable, unrestricted articulation of the surgeon's wrist 607 while using the medical device 1800.

[0116] Given the above configuration of the medical device 1800, the yaw and pitch rotations of the user's wrist 607 with respect to his/her forearm 608 are translated to the corresponding rotations of the unlimited-roll handle assembly 400 with respect to the pulley block 1805/tool frame 525. The parallel kinematic design of the virtual center/mechanism 1801 is such that the two rotation components (pitch and yaw) of the handle 101, 501 with respect to the pulley block 1805 are mechanically separated/filtered into a pitch-only rotation at the pitch pulley 1813.1 and a yaw-only rotation at the yaw pulley 1813.2. The pitch pulley 1813.1 and yaw pulley 1813.2 are respectively pivoted (and mounted) with respect to the pulley block 1805 about the corresponding associated pitch rotation axis 1833 and yaw rotation axis 1831, respectively. The pitch and yaw rotations of the unlimited-roll handle assembly 400 (and therefore, of the surgeon's wrist 607) thus captured at the pitch 1813.1 and yaw 1813.2 transmission pulleys are then transmitted as corresponding rotations of the end-effector articulating joint 583 via cables that originate at the transmission pulleys 1813.1, 1813.2 and run through the pulley block 1805, tool frame 525, and tool shaft 526 all the way to the end-effector assembly 1765.

[0117] In addition to the yaw and pitch rotational degrees of freedom (DoFs) provided by the input joint 1801, the input joint also provides/allows for an axial translational degree of freedom (DoF) along the roll axis 111, 1835, which provides/allows for a range of user hand 609 sizes to be accommodated by the medical device 1800, and ensures free and unrestricted hand 609/wrist 607 articulation.

[0118] Furthermore, the flexure transmission strips 533, 534 are stiff in twisting about the roll axis 111, 1835, which ensures that the input joint 1801 constrains (and therefore transmits) roll rotation from the distal end of the unlimited-roll handle assembly 400 (i.e., the dial) via the flexure transmission strips 533, 534 to the pulley block 1805. Note that pulley block 1805 serves as the outer ring 1805 of the forearm attachment joint 1807, which provides a well-defined low-resistance rotation about roll axis 111, 1835 with respect to the wrist cuff 1803. This implies that when the user holds the handle 101, 501 in his/her palm, he/she can articulate the handle 101, 501 in any desired yaw and pitch directions, resulting in corresponding articulation of the end-effector assembly 1765. Then he/she can twirl the dial portion 102, 502 of the unlimited-roll handle assembly 400i.e. the rotation dial 102, 502with his/her thumb and fingers (typically index finger) while keeping the articulation of the unlimited-roll handle assembly 400 fixed. The twirling of the rotation dial 102, 502 (i.e., roll rotation) is transmitted to the pulley block 1805/outer ring 1805 via the parallel kinematic input joint 1801 (i.e. via the flexure transmission strips 533, 534 of the Virtual Center mechanism 1801). The pulley block 1805 then rotates about the roll axis 111, 1835 with respect to the wrist cuff 1803, which is attached to the forearm 608 of the user. As a result the entire tool frame 525 rotates about the roll axis 111, 1835 with respect to the forearm 608 of the user. Since the tool shaft 526 is rigidly connected to the tool frame 525, the tool shaft 526 also rotates about the roll axis 111, 1835. The roll rotation of the tool shaft 526 is transmitted to the end-effector assembly 1765 as well via the output joint 583 (i.e. via the end-effector articulating joint 583). Because the articulation of the end-effector assembly 1765 (at the output joint 583) is controlled by the corresponding articulation of the handle 101, 501 (at the input joint 1801), if the latter is held fixed, the former is also held fixed, while roll rotation is transmitted all the way from the twirling motion of the surgeon's fingers to the end-effector assembly 1765. This particular mode of operating the medical device 1800 is referred to as articulated roll.

[0119] In addition to producing end-effector roll via twirling of the surgeon's thumb and fingers (resulting in rotation of the rotation dial 102, 502 with respect to the handle 101, 501), another way to produce this roll is when the surgeon rotates (about the roll axis 111, 1835) the entire unlimited-roll handle assembly 400 by pronating and supinating his/her hand 609 and forearm 608. This roll motion is also transmitted to the tool frame 525 via the flexure transmissions strips 533, 534 of the Virtual Center mechanism 1801 and the pulley block 1805, and subsequently transmitted to the end-effector assembly 1765 via the tool shaft 526. However, the amount of roll motion achieved in this manner is limited by the range of pronation/supination allowed by the user's (i.e. surgeon's) hand 609/forearm 608.

[0120] On the other hand, by having two distinct components in the unlimited-roll handle assembly 400the handle 101, 501 and the rotation dial 102, 502this limitation is overcome. The handle 101, 501, which remains fixed in the user's hand 609, is indeed limited in its roll angle by the pronation/supination limit of the user's hand 609/forearm 608. However, the user canvia his/her fingersendlessly, or infinitely, roll-rotate the rotation dial 102, 502 with respect to the handle 101, 501. This infinite-roll rotation is then transmitted to the end-effector assembly 1765, as described above. This infinite-roll capability provides significant and unique functionality to the surgeon in complex surgical procedure, such as when sewing, knot-tying, etc.

[0121] As noted already, the unlimited-roll handle assembly 400 comprises a rotation dial 102, 502 and a handle 101, 501, which are connected by a rotation joint therebetween which has a single rotational DoF about the roll axis 111, 1835. Additionally, the unlimited-roll handle assembly 400 also houses an end-effector actuation mechanism that is actuated by the handle lever 549, wherein as the handle lever 549 is depressed (by the user's fingers, typically middle, ring, and pinky fingers) with respect to the handle 101, 501, the end-effector actuation mechanism translates this action into a pulling action of a transmission cable 566 of an end-effector transmission 471. This pulling action is transmitted via the rotating interface/joint between the handle 101, 501 and the rotation dial 102, 502 to the end-effector assembly 1765 via the transmission cable 566 within a flexible conduit between the rotation dial 102, 502 and tool frame 525, then through the tool shaft 526, and finally to the end-effector jaws 1756 of the end-effector assembly 1765 via the end-effector articulating joint 583. A jaw closure mechanism in the end-effector assembly 1765 closes the end-effector jaws 1756 responsive to the pulling action of the transmission cable 566, as would be needed to operate shears, graspers, a needle-holder, etc.

[0122] The virtual center (VC) 1721 provided by the input joint 1801 coincides with the center of rotation of the wrist joint 607 of the user operating the medical device 1800. Furthermore, the three rotational axes of the corresponding three rotational degrees of freedom (DoFs) (yaw axis 1831, pitch axis 1833, and roll axis 1835) provided by the forearm attachment joint 1807 may all intersect at one point, referred to as the center of rotation of the forearm attachment joint 1807. This center of rotation of the forearm attachment joint 1807 may coincide with the center of rotation of the input joint 1801 (i.e. the virtual center (VC) of rotation 1721 of the unlimited-roll handle assembly 400 with respect to the pulley block 1805).

[0123] Accordingly, the center of rotation of the forearm attachment joint 1807 may also coincide with the center of rotation of the user's wrist joint 607 when the medical device 1800 is mounted on a user's forearm 608.

[0124] In particular, when the user's wrist 607 in not articulated (i.e., is in a nominal position) the forearm axis should coincide with the axis of the outer ring 1805, which should coincide with the axis of the tool shaft 526, which should coincide with the axis of the end-effector assembly 1765. This is when the handle 101, 501 is not articulated with respect to the pulley block 1805 (i.e. is nominal) and therefore the end-effector assembly 1765 is not articulated with respect to the tool shaft 526.

[0125] To facilitate the ease of performing an infinity roll of the medical device 1800, the overall weight of the medical device 1800 may be distributed such that its center of gravity lies close to the roll axis 111, 1835 of the medical device 1800, which ensures that as the user rolls the medical device 1800 (as described above) he/she is not working with or against gravity. With the weight of the medical device 1800 supported at the user's forearm 608 and a trocar on the patient's body, locating the center of gravity of the medical device 1800 on the roll axis 111, 1835 makes driving the roll rotation relatively effortless because gravity no longer has an effect on the roll rotation.

[0126] In addition to all the functionality mentioned above, the overall design and construction of the medical device 1800 also helps filter out hand tremors and prevent them from reaching the end-effector assembly 1765. In the medical device 1800, the handle 101, 501and therefore surgeon's hand 609are isolated from the pulley block 1805/tool frame 525/tool shaft 526 by means of the flexure transmission strips 533, 534, that because of their material and/or construction, prevent any hand tremors from reaching the tool shaft 526 and end-effector assembly 1765. The tool frame 525 is mounted on the forearm 608 via the forearm attachment joint 1807. Therefore the tool shaft 526, which is connected to the tool frame 525, is controlled by the forearm 608 of the surgeon. Not only does this help drive power motions (translating the tip of the shaft in three directions), but the forearm 608 has many fewer tremors compared to the hand 609, so that the shaft will experience fewer tremors as well.

[0127] Thus the flexure transmission strips 533, 534 may help separate out the yaw and pitch rotation components of the rotation of the handle 101, 501 with respect to the pulley block 1805 (equivalently, the yaw and pitch rotations of the hand 609 with respect to the forearm 608), and separately transmit these components of rotation to the corresponding pitch 1813.1 and yaw 1813.2 transmission pulleys, the latter of which are mounted on the pulley block 1805. The flexure transmission strips 533, 534 also help transmit the roll rotation from the unlimited-roll handle assembly 400 to the pulley block 1805, tool frame 525, tool shaft 526, all the way to the end-effector assembly 1765, and also help filter out or block hand tremors from reaching the pulley block 1805, and therefore from reaching the tool frame 525, and therefore from reaching the tool shaft 526, and finally, therefore from reaching the end-effector assembly 1765.

[0128] The use of an unlimited-roll handle assembly 400 enables surgeons to have better control of the surgical instrument during surgery as a result of being able to transfer natural, ergonomic, and intuitive motion from the surgeon's hand 609/wrist 607/forearm 608 to the end-effector assembly 1765. The Virtual Center mechanism 1801 allows the pitch and yaw rotations of the surgeon's wrist 607 to be mapped and transferred intuitively and fluidly to corresponding rotations of the end-effector articulating joint 583. Without benefit of the unlimited-roll handle assembly 400 to perform a roll of the end-effector assembly 1765, the surgeon would otherwise be limited to pronation and supination of his/her forearm 608, which is inherently biomechanically limited. To perform an articulated roll in which the axis of the roll remains offset from the axis of the forearm 608, pronation and supination are combined with flexion and extension of the wrist 607. Due to the limitations in the human body, this rotation in limited in both total roll angle as well as the offset angle from the surgeon's wrist axis. Pronation, supination, flexion, and extension of the wrist 607 all have various maximum articulation angles. Therefore, in order to perform an articulated roll where the axis of the roll remains constant, the angle of the roll will be limited to the by the maximum angle that the hand 609 can make with the wrist 607 in the worst possible orientation.

[0129] However, with the addition of the unlimited-roll handle assembly 400, the surgical instruments described herein are able to intuitively, fluidly, and ergonomically provide for the end-effector assembly 1765 to directly inherit or achieve the yaw, pitch, and roll of the input of the medical device 1800. In addition to pronation and supination of the surgeon's wrist 607, roll is also transferred to the end-effector assembly 1765 with the rolling of the rotation dial 102, 502. When the handle 101, 501 is in an articulated position where the axis of the end-effector assembly 1765 is no longer concentric with the axis of the forearm 608, the surgeon is able to ergonomically perform an articulated roll by keeping the wrist 607 fixed and rolling the rotation dial 102, 502 with his/her thumb/fingers. This enables an articulated roll in every orientation of the wrist 607 with the roll angle being only limited to that specific orientation of the wrist 607. The roll of the end-effector assembly 1765 is no longer limited in rotation by the surgeon's limitation in pronation, supination, flexion, and extension. By controlling the roll of the instrument through the rotation dial 102, 502 by their thumb/fingers, the surgeon is able to perform an infinite amount of roll while still being able to use the actuate the handle lever 549 of the end-effector actuation mechanism to control the open/close actuation of the end-effector assembly 1765 in any articulation or roll orientation.

[0130] Furthermore, the unlimited-roll handle assemblies described herein enable simultaneous and predictable control of all the minimal access tool's advanced features with an ergonomic interface. This handle features power motions, finesse motions and intuitive control of articulation. These three actions are individually aligned to optimal regions of the user's hand 609. Power motions such as gripping the handle and lever to close the jaw are confined to the palm and rear fingers. Finesse motions such as rotating the rotation dial 102, 502 are aligned to the thumb and first fingers (e.g., index finger). The separation of power and finesse actions to these regions of the hand 609 minimizes user fatigue. This also reduces the cognitive load for the user, reducing their mental fatigue. Similar to using a computer joystick, articulation is controlled by gently directing the handle to the desired angle.

[0131] Yet further, the unlimited-roll handle apparatuses described herein enable the simultaneous actions of open/close, roll rotation and articulation (or any combination). Like one's own hand 609, motions are fluid and natural. Performing a running stitch by rotating the rotation dial 102, 502 in continuous direction without unwinding, unlocking or other intermediate step is a novelty compared with other suturing instruments. This is made possible by balancing the instrument and simplifying the mechanics of instrument rotation. When the rotation dial 102, 502 on the unlimited-roll handle assembly 400 is rotated, the entire instrument rotates or orbits in the same direction around the user's wrist 607. During this process, the virtual center also rotates but remains focused at the center of the user's wrist 607. Consequently, performance is consistent and predictable, even during complex moves like an articulated axial rotation.

[0132] As perceived by the user, the unlimited-roll-handle-based apparatuses described herein enable a finesse roll of the associated unlimited-roll handle assembly while engaging the end-effector closure mechanism. Initially, the rotation mechanism within the unlimited-roll handle assembly as previously described comprises optimized bearings between the various bodies within the mechanism. It is by way of the bearings between various bodies of the rotation mechanism that the surgeon does not notice any difference in the resistance to rotate when the jaw closure lever is engaged or disengaged. Infinite rotation of the unlimited-roll handle assembly is enabled by a swivel joint and several keying features within the rotation mechanism which prevent the jaw closure cable from twisting upon itself during rotation.

[0133] During use, these unlimited-roll handle-based assemblies may allow the surgeon to perform an articulation of the end-effector assembly 1765 of the overall surgical device 1800 by articulating their own wrist 607 while comfortably holding the base of the handle 101, 501 and handle lever 549. Articulation of the unlimited-roll handle apparatus leverages the handle 101, 501, at the distal end of the rotation dial 102, 502, to rotate the flexure transmission strips 533, 534 along with their associated transmission pulleys 1813.1, 1813.2, the latter of which are centered about the surgeon's wrist 607 in accordance with what is also referred to as the Virtual Center mechanism 1801. Rotation of the two transmission pulleys 1813.1, 1813.2 drives associated articulation cables within the frame to provide for controlling the corresponding articulation of the end-effector assembly 1765. Once an articulated position is established, the surgeon may choose to close the jaw by actuating the handle lever 549 on the handle 101, 501. The process of suturing with a needle requires that the surgeon roll-rotate the end-effector assembly 1765 about its articulated axis. thereby driving the needle about its curvature axis through various tissue planes. These unlimited-roll handle-based assemblies may (in conjunction with the other features described herein) provide the surgeon with easy access to the rotation dial 102, 502 that provides for rotating both the associated flexure transmission strips 533, 534 and the associated transmission pulleys 1813.1, 1813.2 about the surgeon's wrist 607, as enabled by an associated three-axis wrist gimbal (i.e. the forearm attachment joint 1807). The three-axis wrist gimbal constrains and centers the medical device 1800 about the surgeon's wrist 607 so that rotation of the rotation dial 102, 502 and Virtual Center mechanism 1801 drives a predictable concentric rotation of the pulley block 1805, tool frame 525, tool shaft 526 and end-effector assembly 1765 about the surgeon's wrist 607.

[0134] These devices provide for finesse rotation control with relatively low resistances to rotation both within the unlimited-roll handle assembly (addressed via bearings) and at the wrist gimbal (addressed via minimized contact surfaces and low friction plastic materials), with overall balance of the device (addressed by establishing a center of gravity on the axis of rotation and redistribution of weight throughout the device), and with the use of flexure transmission strips 533, 534 which offer little compliance in torsion/twisting about roll axis 111, 1835.

[0135] When a feature or element is herein referred to as being on another feature or element, it can be directly on the other feature or element or intervening features and/or elements may also be present. In contrast, when a feature or element is referred to as being directly on another feature or element, there are no intervening features or elements present. It will also be understood that, when a feature or element is referred to as being connected, attached or coupled to another feature or element, it can be directly connected, attached or coupled to the other feature or element or intervening features or elements may be present. In contrast, when a feature or element is referred to as being directly connected, directly attached or directly coupled to another feature or element, there are no intervening features or elements present. Although described or shown with respect to one embodiment, the features and elements so described or shown can apply to other embodiments. It will also be appreciated by those of skill in the art that references to a structure or feature that is disposed adjacent another feature may have portions that overlap or underlie the adjacent feature.

[0136] Terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. For example, as used herein, the singular forms a, an and the are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms comprises and/or comprising, when used in this specification, specify the presence of stated features, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups thereof. As used herein, the term and/or includes any and all combinations of one or more of the associated listed items and may be abbreviated as /.

[0137] Spatially relative terms, such as under, below, lower, over, upper and the like, may be used herein for ease of description to describe one element or feature's relationship to another element(s) or feature(s) as illustrated in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if a device in the figures is inverted, elements described as under or beneath other elements or features would then be oriented over the other elements or features. Thus, the exemplary term under can encompass both an orientation of over and under. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. Similarly, the terms upwardly, downwardly, vertical, horizontal and the like are used herein for the purpose of explanation only unless specifically indicated otherwise.

[0138] Although the terms first and second may be used herein to describe various features/elements (including steps), these features/elements should not be limited by these terms, unless the context indicates otherwise. These terms may be used to distinguish one feature/element from another feature/element. Thus, a first feature/element discussed below could be termed a second feature/element, and similarly, a second feature/element discussed below could be termed a first feature/element without departing from the teachings of the present invention.

[0139] Throughout this specification and the claims which follow, unless the context requires otherwise, the word comprise, and variations such as comprises and comprising means various components can be co-jointly employed in the methods and articles (e.g., compositions and apparatuses including device and methods). For example, the term comprising will be understood to imply the inclusion of any stated elements or steps but not the exclusion of any other elements or steps.

[0140] In general, any of the apparatuses and methods described herein should be understood to be inclusive, but all or a sub-set of the components and/or steps may alternatively be exclusive, and may be expressed as consisting of or alternatively consisting essentially of the various components, steps, sub-components or sub-steps.

[0141] As used herein in the specification and claims, including as used in the examples and unless otherwise expressly specified, all numbers may be read as if prefaced by the word about or approximately, even if the term does not expressly appear. The phrase about or approximately may be used when describing magnitude and/or position to indicate that the value and/or position described is within a reasonable expected range of values and/or positions. For example, a numeric value may have a value that is +/0.1% of the stated value (or range of values), +/1% of the stated value (or range of values), +/2% of the stated value (or range of values), +/5% of the stated value (or range of values), +/10% of the stated value (or range of values), etc. Any numerical values given herein should also be understood to include about or approximately that value, unless the context indicates otherwise. For example, if the value 10 is disclosed, then about 10 is also disclosed. Any numerical range recited herein is intended to include all sub-ranges subsumed therein. It is also understood that when a value is disclosed that less than or equal to the value, greater than or equal to the value and possible ranges between values are also disclosed, as appropriately understood by the skilled artisan. For example, if the value X is disclosed the less than or equal to X as well as greater than or equal to X (e.g., where X is a numerical value) is also disclosed. It is also understood that the throughout the application, data is provided in a number of different formats, and that this data, represents endpoints and starting points, and ranges for any combination of the data points. For example, if a particular data point 10 and a particular data point 15 are disclosed, it is understood that greater than, greater than or equal to, less than, less than or equal to, and equal to 10 and 15 are considered disclosed as well as between 10 and 15. It is also understood that each unit between two particular units are also disclosed. For example, if 10 and 15 are disclosed, then 11, 12, 13, and 14 are also disclosed.

[0142] Although various illustrative embodiments are described above, any of a number of changes may be made to various embodiments without departing from the scope of the invention as described by the claims. For example, the order in which various described method steps are performed may often be changed in alternative embodiments, and in other alternative embodiments one or more method steps may be skipped altogether. Optional features of various device and system embodiments may be included in some embodiments and not in others. Therefore, the foregoing description is provided primarily for exemplary purposes and should not be interpreted to limit the scope of the invention as it is set forth in the claims.

[0143] The examples and illustrations included herein show, by way of illustration and not of limitation, specific embodiments in which the subject matter may be practiced. As mentioned, other embodiments may be utilized and derived there from, such that structural and logical substitutions and changes may be made without departing from the scope of this disclosure. Such embodiments of the inventive subject matter may be referred to herein individually or collectively by the term invention merely for convenience and without intending to voluntarily limit the scope of this application to any single invention or inventive concept, if more than one is, in fact, disclosed. Thus, although specific embodiments have been illustrated and described herein, any arrangement calculated to achieve the same purpose may be substituted for the specific embodiments shown. This disclosure is intended to cover any and all adaptations or variations of various embodiments. Combinations of the above embodiments, and other embodiments not specifically described herein, will be apparent to those of skill in the art upon reviewing the above description.