KR102729909B1 - Supplying electrical energy to electrosurgical instruments - Google Patents

Abstract

An end effector for a surgical instrument includes a distal clevis, first and second jaws rotatably mounted to the distal clevis at a first axle, and a proximal clevis rotatably coupled to the distal clevis at a second axle. An electrical conductor extends through the proximal clevis and terminates at the distal clevis to provide electrical energy to one or both of the first and second jaws.

Description

Supplying electrical energy to electrosurgical instruments

Minimally invasive surgical (MIS) instruments are often preferred over traditional open surgical instruments due to their reduced postoperative recovery time and minimal scarring. Laparoscopy is a type of MIS procedure in which one or more small incisions are made in the patient's abdomen and a trocar is inserted through the incisions to form a passageway providing access to the abdominal cavity. Through the trocar, various instruments and surgical tools can be introduced into the abdominal cavity. The trocar also helps facilitate insufflation to elevate the abdominal wall over the organs. Instruments and tools introduced into the abdominal cavity through the trocar can be used to engage and/or manipulate tissues in a number of ways to achieve diagnostic or therapeutic effects.

Recently, various robotic systems have been developed to assist in MIS procedures. The robotic systems can allow more intuitive hand movements by maintaining the natural eye-hand axis. The robotic systems can also allow more degrees of freedom by including a "wrist" joint that creates more natural hand-like articulations. The end effector of the instrument can be articulated (moved) using a cable-driven motion system having one or more drive cables extending through the wrist joint. A user (e.g., a surgeon) can remotely operate the end effector of the instrument by grasping and manipulating one or more controllers in space that communicate with the tool actuator coupled to the surgical instrument. The user input is processed by a computer system integrated into the robotic surgical system, and the tool actuator responds by actuating the cable-driven motion system, and more specifically, the drive cables. Moving the drive cables articulates the end effector into the desired position and configuration.

Some surgical instruments, commonly referred to as electrosurgical instruments, are electrically energized. Electrosurgical instruments have a distally mounted end effector that contains one or more electrodes. When electrically energized, the end effector electrodes can generate sufficient heat to cut, cauterize, and/or seal tissue.

Electrosurgical instruments may be configured for bipolar or monopolar operation. In bipolar operation, current is introduced into the tissue and returned therefrom by the active and return electrodes, respectively, of the end effector. In bipolar operation, the current is not required to travel a long distance through the patient before returning to the return electrode. As a result, the amount of current required is minimal, which greatly reduces the risk of accidental ablation and/or burns. Furthermore, the two electrodes are closely spaced and generally within the surgeon's field of view, which further reduces the risk of unintended ablation and burns.

In monopolar operation, current is introduced into the tissue by an active end-effector electrode (alternatively referred to as a "source electrode") and returned through a return electrode (e.g., a grounding pad) located separately on the patient's body. Monopolar electrosurgical instruments facilitate several surgical functions, such as cutting tissue, coagulating tissue to stop bleeding, or simultaneous cutting and coagulation of tissue. The surgeon can apply current whenever the conductive portion of the instrument is in electrical proximity to the patient, allowing the surgeon to operate with the monopolar electrosurgical instrument from many different angles.
(Patent Document 1) International Publication WO 2010/009223 A3
(Patent Document 2) US Patent Application Publication No. US 2009/0326530 A1

The following drawings are included to illustrate certain aspects of the present disclosure and are not to be considered as exclusive embodiments. The disclosed subject matter is capable of considerable modification, alteration, combination, and equivalents in form and function without departing from the scope of the present disclosure.
FIG. 1 is a block diagram of an exemplary robotic surgical system that may incorporate some or all of the principles of the present disclosure.
FIG. 2 is an isometric view of an exemplary surgical instrument that may incorporate some or all of the principles of the present disclosure.
Figure 3 is a diagram illustrating potential degrees of freedom about which the list of Figure 1 may be capable of joint movement (pivoting).
Figure 4 is an enlarged isometric view of the distal end of the surgical tool of Figure 1.
Figure 5 is an enlarged partial exploded view of the end effector of Figure 4.
FIG. 6 is an enlarged isometric view of another embodiment of the end effector of FIG. 4.
FIG. 7 is an enlarged isometric view of another embodiment of the end effector and list joint of FIG. 4.
FIG. 8a is an enlarged cross-sectional view of another embodiment of the end effector and list joint of FIG. 4.
FIG. 8b is a schematic diagram of an exemplary embodiment of the flex circuit of FIG. 8a.

The present disclosure relates to robotic surgical systems, and more particularly to electrosurgical instruments having an end effector having a list and electrical conductors terminating in a distal clevis of the list.

Embodiments discussed herein describe electrosurgical instruments that utilize electrical energy to perform various surgical procedures. An end effector usable with the electrosurgical instrument includes a distal clevis, first and second jaws rotatably mounted to the distal clevis at a first axle, and a proximal clevis rotatably coupled to the distal clevis at the second axle. An electrical conductor can extend through the proximal clevis and terminate at the distal clevis to supply electrical energy to at least one of the first and second jaws. Thus, the electrical conductor can be configured to supply electrical energy directly to the distal clevis and otherwise avoid supplying energy to the proximal clevis.

FIG. 1 is a block diagram of an exemplary robotic surgical system (100) that may incorporate some or all of the principles of the present disclosure. As illustrated, the system (100) may include at least one master controller (102a) and at least one arm cart (104). The arm cart (104) may be mechanically and/or electrically coupled to a robotic manipulator and, more specifically, to one or more robotic arms (106) or “tool actuators.” Each robotic arm (106) may include and otherwise provide a location for mounting one or more surgical tools or instruments (108) for performing various surgical tasks on a patient (110). Operation of the robotic arms (106) and instruments (108) may be directed by a clinician (112a) (e.g., a surgeon) from the master controller (102a).

In some embodiments, a second master controller (102b) (illustrated in dashed line) operated by a second clinician (112b) may also direct operation of the robotic arms (106) and instruments (108) in conjunction with the first clinician (112a). In such embodiments, for example, each clinician (102a, 102b) may control different robotic arms (106), or, in some cases, complete control of the robotic arms (106) may occur between the clinicians (102a, 102b). In some embodiments, additional arm carts (not shown) having additional robotic arms (not shown) may be available for the patient (110) during the procedure, and these additional robotic arms may be controlled by one or more of the master controllers (102a, 102b).

The arm cart (104) and the master controllers (102a, 102b) may communicate with each other via a communication link (114), which may be any type of wired or wireless telecommunication means configured to transmit various communication signals (e.g., electrical, optical, infrared, etc.) according to any communication protocol.

The master controller (102a, 102b) typically includes one or more physical controllers that are held by the clinician (112a, 112b) and can be manipulated in space while the surgeon observes the procedure via a stereo display. The physical controllers typically include manual input devices movable in multiple degrees of freedom, often including actuable handles for operating the surgical instrument(s) (108), such as opening and closing opposing jaws, applying a potential (current) to an electrode, etc. The master controller (102a, 102b) may also include an optional feedback meter that is viewable by the clinician (112a, 112b) via the display to provide a visual indication of various surgical instrument metrics, such as the amount of force being applied to the surgical instrument (i.e., a cutting instrument or a dynamic clamping member).

Exemplary implementations of robotic surgical systems, such as system (100), are disclosed in U.S. Patent No. 7,524,320, the contents of which are incorporated herein by reference. Various details of such devices will not be described herein in detail beyond what may be necessary to understand the various embodiments and forms of various embodiments of the robotic surgical devices, systems, and methods disclosed herein.

FIG. 2 is a side view of an exemplary surgical instrument (200) that may incorporate some or all of the principles of the present disclosure. The surgical instrument (200) may be identical or similar to the surgical instrument(s) (108) of FIG. 1 and thus may be used with a robotic surgical system, such as the robotic surgical system (100) of FIG. 1. Accordingly, the surgical instrument (200) may be designed to be releasably coupled to an instrument actuator included in the robotic surgical system (100). However, in other embodiments, the surgical instrument (200) may be adapted for use in a manual or hand-operated manner without departing from the scope of the present disclosure.

As illustrated, the surgical instrument (200) includes an elongate shaft (202), an end effector (204), a wrist (206) (alternatively referred to as a “wrist joint”) that couples the end effector (204) to a distal end of the shaft (202), and a drive housing (208) coupled to a proximal end of the shaft (202). In applications where the surgical instrument is used with a robotic surgical system (e.g., the robotic surgical system (100) of FIG. 1), the drive housing (208) may include coupling features that releasably couple the surgical instrument (200) to the robotic surgical system.

The terms "proximal" and "distal" are defined herein with respect to a robotic surgical system having an interface configured to mechanically and electrically couple a surgical tool (200) (e.g., a housing (208)) to a robotic manipulator. The term "proximal" refers to a location of an element closer to the robotic manipulator, and the term "distal" refers to a location of an element closer to the end effector (204), and thus further away from the robotic manipulator. Alternatively, in manual or hand-operated applications, the terms "proximal" and "distal" are defined herein with respect to a user, such as a surgeon or clinician. The term "proximal" refers to a location of an element closer to the user, and the term "distal" refers to a location of an element closer to the end effector (204), and thus further away from the user. Additionally, the use of directional terms such as up, down, top, bottom, upward, downward, left, right, etc., are used in connection with the exemplary embodiments as depicted in the drawings, wherein the upward or upper direction is toward the top of the corresponding drawing, and the downward or lower direction is toward the bottom of the corresponding drawing.

During use of the surgical instrument (200), the end effector (204) is configured to move (pivot) about the shaft (202) in the list (206) to position the end effector (204) in desired orientations and locations relative to the surgical site. The housing (208) includes (accommodates) various mechanisms designed to control actuation (e.g., clamping, firing, rotation, articulation, energy transfer, etc.) of various features associated with the end effector (204). In at least some embodiments, the shaft (202), and thus the end effector (204) coupled thereto, is configured to rotate about a longitudinal axis (A ₁ ) of the shaft (202). In such embodiments, at least one of the mechanisms included (accommodated) within the housing (208) is configured to control rotational movement of the shaft (202) about the longitudinal axis (A ₁ ).

The surgical instrument (200) may have any of a variety of configurations capable of performing at least one surgical function. For example, the surgical instrument (200) may include, but is not limited to, forceps, a grasper, a needle driver, scissors, an electrocautery tool, a stapler, a clip applier, a hook, a spatula, a suction tool, a irrigation tool, an imaging device (e.g., an endoscope or ultrasound probe), or any combination thereof. In some embodiments, the surgical instrument (200) may be configured to apply energy to the tissue, such as radiofrequency (RF) energy.

The shaft (202) is an elongated member extending distally from the housing (208) and having at least one lumen extending therethrough along its axial length. In some embodiments, the shaft (202) may be fixed to the housing (208), but alternatively may be rotatably mounted to the housing (208) such that the shaft (202) may rotate about a longitudinal axis (A ₁ ). In yet other embodiments, the shaft (202) may be releasably coupled to the housing (208), which may allow a single housing (208) to be adaptable to a variety of shafts having different end effectors.

The end effector (204) may have a variety of sizes, shapes, and configurations. In the illustrated embodiment, the end effector (204) comprises a pair of surgical scissors including opposing jaws (210, 212) (alternatively referred to as “blades”) configured to move (articulate) between an open position and a closed position. However, as will be appreciated, the opposing jaws (210, 212) may alternatively form part of other types of end effectors, such as, but not limited to, a tissue crusher, a clip applicator, a needle actuator, a babcock including a pair of opposing gripping jaws, bipolar jaws (e.g., bipolar Maryland grippers, forceps, fenestrated grippers, etc.). One or both of the jaws (210, 212) can be configured to pivot on the list (206) to articulate the end effector (204) between an open position and a closed position.

FIG. 3 illustrates potential degrees of freedom that the list (206) may be capable of articulated (pivoted) about. The list (206) may have any of a variety of configurations. In general, the list (206) includes joints configured to allow pivotal motion of the end effector (204) about the shaft (202). The degrees of freedom of the list (206) are represented by three translational variables (i.e., surge, heave, and sway) and three rotational variables (i.e., Euler angles or roll, pitch, and yaw). The translational and rotational variables describe the positions and orientations of components of the surgical system (e.g., the end effector (204)) with respect to a given reference Cartesian frame. As illustrated in FIG. 3, "surge" refers to forward and backward translational motion, "heave" refers to up and down translational motion, and "sway" refers to left and right translational motion. With respect to rotational terms, "roll" refers to tilting about an axis, "pitch" refers to tilting forward and backward, and "yaw" refers to turning left and right.

The pivot motion may include pitch motion about a first axis of the list (206) (e.g., the X-axis), yaw motion about a second axis of the list (206) (e.g., the Y-axis), and combinations thereof to allow 360° rotational motion of the end effector (204) about the list (206). In other applications, the pivot motion may be limited to movement within a single plane, such as only pitch motion about the first axis of the list (206) or only yaw motion about the second axis of the list (206).

Referring again to FIG. 2 , the surgical instrument (200) may also include a plurality of drive cables (obscured in FIG. 2 ) forming part of a cable-driven motion system configured to facilitate movement and articulation of the end effector (204) relative to the shaft (202). Moving (actuating) at least some of the drive cables moves the end effector (204) between an unarticulated position and an articulated position. The end effector (204) is shown in FIG. 2 in an unarticulated position where the longitudinal axis (A ₂ ) of the end effector (204) is substantially aligned with the longitudinal axis (A ₁ ) of the shaft (202), such that the end effector (204) is at substantially zero angle relative to the shaft (202). Due to factors such as manufacturing tolerances and precision of the measuring device, the end effector (204) may not be at an exact zero angle with respect to the shaft (202) in the non-articulated position, but can nevertheless be considered "substantially aligned" therewith. In the articulated position, the longitudinal axes (A ₁ , A ₂ ) will be angularly offset from one another such that the end effector (204) is at a non-zero angle with respect to the shaft (202).

Still referring to FIG. 2, the surgical instrument (200) may be supplied with power (current) via a power cable (214) coupled to the housing (208). In other embodiments, the power cable (214) may be omitted and power may be supplied to the surgical instrument (200) via an internal power source, such as one or more batteries or fuel cells. However, for purposes of this description, it will be assumed that power is provided to the surgical instrument (200) via the power cable (214). In either case, the surgical instrument (200) may alternatively be characterized and otherwise referred to herein as an “electrosurgical instrument” capable of providing electrical energy to the end effector (204).

A power cable (214) may be placed in communication with a generator (216) that supplies energy, such as electrical energy (e.g., radiofrequency energy), ultrasonic energy, microwave energy, thermal energy, or any combination thereof, to the surgical tool (200) and, more specifically, to the end effector (204). Thus, the generator (216) may include a radiofrequency (RF) source, an ultrasonic source, a direct current source, and/or any other suitable type of electrical energy source, which may be activated independently or simultaneously.

In applications where the surgical instrument (200) is configured for bipolar operation, the power cable (214) will include a supply conductor and a return conductor. Current can be supplied from a generator (216) through the supply conductor to an active (or source) electrode positioned at the end effector (204), and current can flow through the return conductor back to the generator (216) through the return conductor positioned at the end effector (204). In the case of a bipolar gripper having opposing jaws, for example, the jaws may have their proximal ends isolated from each other and their inner surfaces (i.e., the areas of the jaws that grip tissue) serve as electrodes that apply current in a controlled path through the tissue. In applications where the surgical instrument (200) is configured for unipolar operation, the generator (216) transmits current through a supply conductor to an active electrode positioned at the end effector (204), and the current is returned (dissipated) through a return electrode (e.g., a grounding pad) separately coupled to the patient's body.

FIG. 4 is an enlarged isometric view of the distal end of the surgical instrument (200) of FIG. 2. More specifically, FIG. 4 depicts an enlarged view of the end effector (204) and the list (206), with the end effector (204) in an unarticulated position. The list (206) operably couples the end effector (204) to the shaft (202). However, in some embodiments, a shaft adapter may be directly coupled to the list (206) and otherwise interposed between the shaft (202) and the list (206). Thus, in at least one embodiment, the shaft (202) depicted in FIG. 4 may be replaced with a shaft adapter. In such embodiments, without departing from the scope of the present disclosure, the shaft adapter may be directly coupled to the list (206) at its distal end and directly coupled to the shaft (202) at its proximal end. As used herein, the term "operably coupled" refers to either a direct or indirect coupling engagement. Thus, the list (206) may be operably coupled to the shaft (202) via a direct coupling engagement, in which the list (206) is directly coupled to the distal end of the shaft (202), or an indirect coupling engagement, in which a shaft adapter is interposed between the list (206) and the distal end of the shaft (202).

To operatively couple the end effector (204) to the shaft (202), the list (206) includes a distal clevis (402a) and a proximal clevis (402b). The end effector (204) (i.e., jaws (210, 212)) is rotatably mounted to the distal clevis (402a) at the first axle (404a), the distal clevis (402a) is rotatably mounted to the proximal clevis (402b) at the second axle (404b), and the proximal clevis (402b) is coupled to the distal end (406) of the shaft (202) (or alternatively, a shaft adapter).

The list (206) provides a first pivot axis (P ₁ ) extending through the first axle (404a) and a second pivot axis (P ₂ ) extending through the second axle (404b). The first pivot axis (P ₁ ) is substantially perpendicular (orthogonal) to the longitudinal axis (A ₂ ) of the end effector (204), and the second pivot axis (P ₂ ) is substantially perpendicular (orthogonal) to both the longitudinal axis (A ₂ ) and the first pivot axis (P ₁ ). Motion about the first pivot axis (P ₁ ) provides a “yaw” joint motion of the end effector (204), and motion about the second pivot axis (P ₂ ) provides a “pitch” joint motion of the end effector (204). In the illustrated embodiment, the jaws (210, 212) are mounted on a first pivot axis (P ₁ ) such that the jaws (210, 212) pivot relative to one another to open and close the end effector (204), or alternatively pivot simultaneously to articulate the orientation of the end effector (204).

A plurality of drive cables, illustrated as drive cables (408a, 408b, 408c, 408d), extend longitudinally within a lumen (410) defined by the shaft (202) (and/or shaft adapter) and pass through the list (206) to be operatively coupled to the end effector (204). While four drive cables (408a-408d) are illustrated in FIG. 4 , more than four or less than four drive cables (408a-408d) may be included without departing from the scope of the present disclosure.

The drive cables (408a-408d) form part of the cable-driven motion system briefly described above and may be referred to and otherwise characterized as a cable, a band, a line, a cord, a wire, a rope, a string, a twisted string, an elongated member, or the like. The drive cables (408a-408d) may be manufactured from a variety of materials including, but not limited to, metals (e.g., tungsten, stainless steel, etc.) or polymers. Exemplary drive cables are described in U.S. Patent Publication No. 2015/0209965, entitled “Compact Robotic Wrist,” and U.S. Patent Publication No. 2015/0025549, entitled “Hyperdexterous Surgical System,” the contents of which are hereby incorporated by reference. The lumen (410) may be a single lumen as illustrated, or alternatively may include multiple independent lumens each accommodating one or more of the drive cables (408a-408d).

The drive cables (408a-408d) extend proximally from the end effector (204) to a drive housing (208) (FIG. 2) where they are operably coupled to various actuation mechanisms or devices housed (contained) therein to facilitate longitudinal movement (translation) of the drive cables (408a-408d) within the lumen (410). Selective actuation of any or all of the drive cables (408a-408d) causes the end effector (204) (e.g., one or both of the jaws (210, 212)) to articulate (pivot) about the shaft (202). More specifically, the selective actuation causes the corresponding drive cables (408a-408d) to translate longitudinally within the lumen (410), thereby causing pivotal movement of the end effector (204). For example, one or more of the drive cables (408a-408d) may be longitudinally translated to cause the end effector (204) to articulate (e.g., cause both jaws (210, 212) to move obliquely in the same direction), cause the end effector (204) to open (e.g., cause one or both of the jaws (210, 212) to move away from the other), or cause the end effector (204) to close (e.g., cause one or both of the jaws (210, 212) to move toward the other).

Moving the drive cables (408a-408d) can be accomplished in a variety of ways, such as by triggering an associated actuator or mechanism operably coupled to or housed within the drive housing (208) ( FIG. 2 ). Moving a given drive cable (408a-408d) comprises applying a proximal tension (i.e., a pulling force) to the given drive cable (408a-408d), which causes the given drive cable (408a-408d) to translate and thereby move (articulate) the end effector (204) relative to the shaft (202).

The list (206) includes a first plurality of pulleys (412a) and a second plurality of pulleys (412b), each configured to interact with and redirect drive cables (408a-408d) for engagement with an end effector (204). The first plurality of pulleys (412a) are mounted on a proximal clevis (402b) at a second axle (404b), and the second plurality of pulleys (412b) are also mounted on a proximal clevis (402b), but at a third axle (404c) positioned proximal to the second axle (404b). The first and second plurality of pulleys (412a, 412b) cooperatively turn the drive cables (408a to 408d) through an “S” shaped path before the drive cables (408a to 408d) are operatively coupled to the end effector (204).

In at least one embodiment, a pair of drive cables (408a-408d) are operably coupled to each jaw (210, 212) and configured to “oppositely” actuate the corresponding jaw (210, 212). In the illustrated embodiment, for example, the first and second drive cables (408a, 408b) are coupled to a connector (not shown) in the first jaw (210), and the third and fourth drive cables (408c, 408d) are coupled to a connector (not shown) in the second jaw (212). As a result, operation of the first drive cable (408a) pivots the first jaw (210) about the first pivot axis (P ₁ ) toward the open position, and operation of the second drive cable (408b) pivots the first jaw (210) in the opposite direction and toward the closed position about the first pivot axis (P ₁ ). Similarly, operation of the third drive cable (408c) pivots the second jaw (212) about the first pivot axis (P ₁ ) toward the open position, and operation of the fourth drive cable (408d) pivots the second jaw (212) in the opposite direction and toward the closed position about the first pivot axis (P ₁ ).

Accordingly, the drive cables (408a-408d) may be characterized or otherwise referred to as "opposing" cables that act cooperatively (and, furthermore, antagonistically) to cause relative or simultaneous movement of the first and second jaws (210, 212). When the first drive cable (408a) is actuated (moved), the second drive cable (408b) naturally follows as if coupled to the first drive cable (408a), and when the third drive cable (408c) is actuated, the fourth drive cable (408d) naturally follows as if coupled to the third drive cable (408c), and vice versa.

The end effector (204) further includes a first jaw holder (414a) and a second jaw holder (414b) laterally offset from the first jaw holder (414a). The first jaw holder (414a) is mounted to the first axle (404a) and configured to receive and seat the first jaw (210), such that movement (rotation) of the first jaw holder (414a) about the first pivot axis (P ₁ ) correspondingly moves (rotates) the first jaw (210). The first jaw holder (414a) may also provide and otherwise define a first pulley (416a) configured to receive and seat one or more drive cables, such as first and second drive cables (408a, 408b), to achieve such movement (rotation). A second jaw holder (414b) is similarly mounted to the first axle (404a) and configured to receive and seat the second jaw (212), such that movement (rotation) of the second jaw holder (414b) about the first pivot axis (P ₁ ) correspondingly moves (rotates) the second jaw (212). The second jaw holder (414b) may also provide and otherwise define a second pulley (416b) configured to receive and seat one or more drive cables, such as third and fourth drive cables (408c, 408d), to achieve such movement (rotation).

As used herein, the term "jaw holder" is intended to apply to various types of end effectors having opposing jaws or blades that are movable relative to one another. In the illustrated embodiment, the jaws (210, 212) comprise opposing scissors blades of a surgical scissors end effector. Accordingly, the jaw holders (414a, 414b) could alternatively be referred to as "blade holders." However, in other embodiments, without departing from the scope of the present disclosure, the jaws (210, 212) could alternatively comprise opposing jaws used in a gripper end effector, or the like, and the term "jaw holder" would similarly apply. Furthermore, the term "holder" in "jaw holder" could be replaced with "mount," "actuating member," or "actuating member."

The surgical tool (200) may also include an electrical conductor (418) that supplies electrical energy to the end effector (204), thereby transforming the surgical tool (200) into an “electrosurgical instrument.” Similar to the drive cables (408a-408d), the electrical conductor (418) may extend longitudinally within the lumen (410). In some embodiments, the electrical conductor (418) and the power cable (214) ( FIG. 2 ) may comprise the same structure. However, in other embodiments, the electrical conductor (418) may be electrically coupled to the power cable (214), such as in the drive housing (208) ( FIG. 2 ). In yet other embodiments, the electrical conductor (418) may extend into the drive housing (208) where it is electrically coupled to an internal power source, such as a battery or fuel cell.

In some embodiments, the electrical conductor (418) may comprise a wire. However, in other embodiments, the electrical conductor (418) may comprise a rigid or semi-rigid shaft, rod, or strip (ribbon) made of a conductive material. In some embodiments, the electrical conductor (418) may be partially covered with an insulative covering (420) made of a non-conductive material. The insulative covering (420) may comprise, for example, a plastic applied to the electrical conductor (418) via heat shrinkage, but may alternatively be any other non-conductive material.

In operation, without departing from the scope of the present disclosure, the end effector (204) may be configured for unipolar or bipolar operation. Electrical energy is transmitted to the end effector (204), which acts as an active (or source) electrode, by means of an electrical conductor (418). In at least one embodiment, the electrical energy conducted through the electrical conductor (418) may comprise radiofrequency ("RF") energy having a frequency of about 100 kHz to 1 MHz. The RF energy causes ultrasonic agitation or friction, and indeed resistive heating, thereby increasing the temperature of the target tissue. Thus, the electrical energy supplied to the end effector (204) is converted to heat and transferred to adjacent tissue to cut, cauterize, and/or coagulate the tissue (depending on the localized heating of the tissue), which may be particularly useful for sealing blood vessels or diffuse hemorrhages.

A conventional electrosurgical instrument having an articulated wrist will typically include an electrical conductor terminating at a proximal clevis, with a structural interconnection between the distal clevis and the proximal clevis providing the electrical energy required to energize the end effector for actuation. Terminating the electrical conductor at the proximal clevis allows the wrist to articulate without being impeded by the electrical conductor. However, in accordance with embodiments of the present disclosure, the electrical conductor (418) may extend through the proximal clevis (402b) and otherwise bypass it to terminate at the distal clevis (402a). As a result, the electrical conductor (418) may conduct electrical energy to the distal clevis (402a), which may then be transmitted via conduction to one or both of the jaws (210, 212).

As illustrated, a seal (422) (illustrated in dashed lines) may be arranged at the interface between the proximal clevis (402b) and the shaft (102) (or alternatively, the shaft adapter). The seal (422) may be configured to substantially isolate the interior of the shaft (102) from the end effector (204) by preventing the movement of contaminants and fluids therethrough in either direction. As illustrated in dashed lines, the electrical conductor (418) may extend through the seal (422) and the proximal clevis (402b) before terminating at the proximal end of the distal clevis (402a).

In at least one embodiment, the electrical conductor (418) may be provided with or otherwise defined by an arcuate section (424) that allows the electrical conductor (418) to pass through the proximal clevis (402b) without contacting (engaging) any or all of the proximal clevis (402b), the second axle (404b), or the second plurality of pulleys (412b). In other embodiments, the arcuate section (424) may be omitted, and the electrical conductor (418) may nonetheless be arranged to pass through the proximal clevis (402b) without engaging any of these structural components.

As illustrated, the electrical conductor (418) may terminate in a conductor adapter (426). The conductor adapter (426) may be fabricated from a conductive material, such as a conductive metal, and configured to transmit (conduct) electrical energy from the electrical conductor (418) to the distal clevis (402a). In the illustrated embodiment, the conductor adapter (426) is assembled on the second axle (404b) and interposed between the first plurality of pulleys (412a) and the proximal end of the distal clevis (402a). The first plurality of pulleys (412a) may be fabricated from a conductive material and may be suitably insulated from conducting electrical energy to the proximal clevis (402b). However, in other embodiments, the first plurality of pulleys (412a) may be manufactured from any electrically insulating or non-conductive material to insulate the distal end of the proximal pulley (402b) from the electrical energy supplied to the conductor adapter (426) and the distal clevis (402a). Suitable non-conductive materials include, but are not limited to, ceramics (e.g., zirconia, alumina, aluminum nitride, silicates, silicon nitride, etc.), high temperature and high strength plastics, thermoplastic or thermosetting polymers (e.g., polyether ether ketones, ULTEM™, VESPEL®, polyphenylsulfone, polysulfone, RADEL®, polyamide-imides, polyimides, epoxies, etc.), composites (e.g., fiberglass), hard rubbers (e.g., ebonite), metals having an insulative coating, or any combination thereof.

The conductor adapter (426) can be in contact with and otherwise electrically engaged (communicated with) the distal clevis (402a) to transmit (conduct) electrical energy supplied by the electrical conductor (418) to at least one of the jaws (210, 212) to energize one or both of the jaws (210, 212) for actuation. In some embodiments, for example, the electrical energy is conducted to the jaws (210, 212) via one or both of the first axle (404a) and the jaw holders (414a, 414b), which can be fabricated from a conductive material. However, in other embodiments, the jaw holders (414a, 414b) may be fabricated from a non-conductive material, and electrical energy may alternatively be conducted to one or both of the jaws (210, 212) via the first axle (404a).

FIG. 5 is an enlarged partial exploded view of an end effector (204) according to one or more embodiments. More specifically, FIG. 5 depicts the end effector (204) including jaws (210, 212) and corresponding jaw holders (414a, 414b) mounted on a distal clevis (402a) from a first axle (404a). FIG. 5 also depicts a portion of a first plurality of pulleys (412a) disassembled or otherwise removed from a second axle (404b) and an electrical conductor (418).

In the illustrated embodiment, the insulating sheath (420) (illustrated in dashed lines) extends to and terminates adjacent to the conductor adapter (426). In such an embodiment, the insulating sheath (420) may prove advantageous in preventing discharge or electrical communication between the electrical conductor (418) and the proximal clevis (402b) (FIG. 4), the second axle (404b) (FIG. 4), or the second plurality of pulleys (412b) (FIG. 4). However, in other embodiments, the insulating sheath (420) may terminate proximal to the proximal clevis (402b), and yet be arranged and/or designed to avoid inadvertently conducting electrical energy to the proximal clevis (402b), the second axle (404b), and the second plurality of pulleys (412b).

As illustrated, the distal clevis (402a) may include a bushing (502) that is seated within and otherwise receivable within an opening (504) defined within a proximal end of the distal clevis (402a). In some embodiments, the bushing (502) may be fabricated from any of the non-conductive materials noted herein, but may alternatively be fabricated from a conductive material such that electrical energy may be transmitted to at least one of the jaws (210, 212) through at least a portion of the bushing (502). The bushing (502) may be configured to receive the second axle (404b) such that the second axle (404b) may rotate relative to the bushing (502) during articulation of the end effector (204).

The first plurality of pulleys (412a) and the conductor adapter (426) may be mounted to the bushing (502) and may be capable of rotating relative to the bushing (502) during articulation of the end effector (204). Thus, the conductor adapter (426) may be capable of slidingly engaging and otherwise riding upon the bushing (502) during operation. As a result, and in contrast to previous electrosurgical instruments, the conductor adapter (426) does not terminate at a solder point or crimp, but instead “floats” over the bushing (502) while providing electrical energy to the distal clevis (402a). In the illustrated embodiment, the bushing (502) is configured to receive and seat the first plurality of pulleys (412a) and the conductor adapters (426) and is provided with a variety of diameters, but alternatively, without departing from the scope of the present disclosure, may include a constant diameter.

The conductor adapter (426) may comprise or otherwise configure a distal end of the electrical conductor (418) and may take any shape or design that facilitates electrical communication between the electrical conductor (418) and the distal clevis (402a). In the illustrated embodiment, for example, the conductor adapter (426) comprises a stamped fisheye connector that defines or provides a continuous annular ring. The conductor adapter (426) may extend around the bushing (502) to enable the electrical conductor (418) to transmit electrical energy to the distal clevis (402a). However, in other embodiments, the conductor adapter (426) may alternatively comprise a discontinuous annular ring. In yet other embodiments, without departing from the scope of the present disclosure, the conductor adapter (426) may alternatively terminate in a bent portion arranged to engage continuously with the bushing (502).

FIG. 6 is an enlarged isometric view of another embodiment of an end effector (204) according to one or more embodiments. Similar to FIG. 5, FIG. 6 depicts the end effector (204) including jaws (210, 212) and corresponding jaw holders (414a, 414b) mounted on a distal clevis (402a) from a first axle (404a). Additionally, a first plurality of pulleys (412a) are mounted on the second axle (404b) for relative rotation. Additionally, an electrical conductor (418) extends proximal to the distal clevis (402a) and terminates at or near the proximal end thereof, and an insulating sheath (420) (illustrated in dashed lines) may extend along a portion or all of the length of the electrical conductor (418).

However, unlike the embodiment of FIG. 5, the electrical conductor (418) terminates in a conductor adapter (602) that is not dissimilar to the conductor adapter (426) of FIGS. 4 and 5. More specifically, the conductor adapter (602) may include an arcuate member or “saddle” arranged to engage a corresponding arcuate surface (604) of the distal clevis (402a). In the illustrated embodiment, the arcuate surface (604) is limited to the proximal end of the distal clevis (402a), but may alternatively be provided at any other location without departing from the scope of the present disclosure. The conductor adapter (602) may be fabricated from a conductive material, such as a conductive metal (e.g., spring steel, beryllium copper, etc.), and configured to transfer (conduct) electrical energy from the electrical conductor (418) to the distal clevis (402a). In an exemplary operation, the distal clevis (402a) can articulate about a second pivot axis (P ₂ ) of the second axle (404b), and the conductor adapter (602) can maintain engagement with the arcuate surface (604) during such movement.

FIG. 7 is an enlarged isometric view of another embodiment of an end effector (204) and a wrist joint (206), according to one or more additional embodiments. In the illustrated embodiment, the end effector (204), including jaws (210, 212) and corresponding jaw holders (414a, 414b), is mounted to a distal clevis (402a) on a first axle (404a), with the proximal clevis (402b) being depicted in phantom (dashed) lines. Additionally, the first and second plurality of pulleys (412a, 412b) are mounted to the second and third axles (404b, 404c), respectively, as generally described above.

In the illustrated embodiment, the electrical conductor (418) extends through the seal (422) and terminates in a distal clevis (402a) having a conductor adapter (702). The conductor adapter (702) effectively couples the electrical conductor (418) to the distal clevis (402a) such that electrical energy transmitted (transmitted) through the electrical conductor (418) is correspondingly transmitted (transmitted) to the distal clevis (402a) during operation. The conductor adapter (702) may include any connector type, such as, but not limited to, a crimp, solder, weld, or any combination thereof. In some embodiments, the electrical conductor (418) may include an insulating covering (not shown) covering part or all of the electrical conductor (418) to prevent the electrical conductor (418) from inadvertently conducting electrical energy to the proximal clevis (402b), the second axle (404b), or the second plurality of pulleys (412b).

In some embodiments, at least a portion of the electrical conductor (418) may include or otherwise define a conductive spring member (704). The conductive spring member (704) may include a flexible or resilient section of the electrical conductor (418) that allows the end effector (204) to articulate about the second pivot axis (P ₂ ) of the second axle (404b) without losing electrical conductivity to the distal clevis (402a) through the electrical conductor (418). In some embodiments, the conductive spring member (704) may include a tightly wound coil of a conductive material, such as Nitinol wire. In other embodiments, the conductive spring member (704) may include a flexible, but flat, ribbon made of a conductive material. During operation, the conductive spring member (704) can be configured to flex or bend to allow the distal clevis (402a) to articulate while still supplying electrical energy to it.

FIG. 8a is an enlarged cross-sectional view of another embodiment of an end effector (204) and a wrist joint (206), according to one or more embodiments. In the illustrated embodiment, the end effector (204), including jaws (210, 212) and corresponding jaw holders (414a, 414b), is mounted to a distal clevis (402a) on a first axle (404a). Additionally, first and second plurality of pulleys (412a, 412b) are mounted to second and third axles (404b, 404c), respectively, which are mounted to the proximal clevis (402b).

In the illustrated embodiment, the electrical conductor (418) extends through the seal (422), is coupled to a flex circuit (802) that extends through the proximal clevis (402b) and terminates at the distal clevis (402a). The flex circuit (802) effectively couples the electrical conductor (418) to the distal clevis (402a) such that electrical energy transmitted (transmitted) through the electrical conductor (418) is correspondingly transmitted (transmitted) to the distal clevis (402a) during operation. The flex circuit (802) may comprise, for example, a polyimide flexible circuit, but alternatively, without departing from the scope of the present disclosure, may be manufactured from polyether ether ketone (PEEK).

FIG. 8B is a schematic diagram of an exemplary embodiment of a flex circuit (802) of FIG. 8A, according to one or more embodiments of the present disclosure. As illustrated, the flex circuit (802) includes a substantially flat film having a printed circuit (804) embedded therein. The printed circuit (804) extends from and is communicatively coupled to an electrical conductor (418) for transmitting electrical energy to a distal clevis (402a) ( FIG. 8A ).

The flex circuit (802) can include a first opening (806a) configured to receive a second axle (404b) and a second opening (806b) configured to receive a third axle (404c). In the first opening (806a), the flex circuit (802) can include an annular conductive pad (808) that places the printed circuit (804) in communication with the distal clevis (402a) ( FIG. 8a ). The conductive pad (808) can be made of silver, gold, or other conductive metal forming an annular ring. Trapping the flex circuit (804) between the bushing (502) ( FIG. 5) and the first plurality of pulleys (412a) ( FIG. 8a) provides an electrically conductive path. Thus, the conductive pad (808) transfers energy to the distal clevis (402a), which can transfer electrical energy to one or both of the jaws (210, 212).

Embodiments disclosed herein include:

A. An end effector comprising a distal clevis, first and second jaws rotatably mounted to the distal clevis at the first axle, a proximal clevis rotatably coupled to the distal clevis at the second axle, and an electrical conductor extending through the proximal clevis and terminating in the distal clevis to supply electrical energy to at least one of the first and second jaws.

B. A surgical tool comprising: a drive housing, an elongated shaft extending from the drive housing, an end effector arranged at a distal end of the elongated shaft and including first and second jaws, a distal clevis interposed between the end effector and the elongated shaft, the distal clevis rotatably mounting the first and second jaws at a first axle, and a wrist including a proximal clevis operably coupled to the elongated shaft and coupled to the distal clevis at the second axle, and an electrical conductor extending from the drive housing through the proximal clevis, the electrical conductor terminating at the distal clevis and supplying electrical energy to at least one of the first and second jaws.

C. A method of operating a surgical instrument, comprising the steps of positioning the surgical instrument adjacent a patient for surgery, wherein the surgical instrument comprises a drive housing, an elongated shaft extending from the drive housing, an end effector arranged at a distal end of the elongated shaft and including first and second jaws, a distal clevis interposed between the end effector and the elongated shaft, the end effector rotatably mounting the first and second jaws on a first axle, and a wrist comprising a proximal clevis operably coupled to the elongated shaft and coupled to the distal clevis on the second axle, and an electrical conductor extending from the drive housing through the proximal clevis and terminating in the distal clevis. A method of operating a surgical instrument further comprising the step of supplying electrical energy to the distal clevis through the electrical conductor and thereby energizing at least one of the first and second jaws.

Each of embodiments A, B, and C may have one or more of the following additional elements in any combination: Element 1: The electrical conductor is selected from the group consisting of a wire, shaft, rod, or strip made of a conductive material. Element 2: Further comprising an insulating coating partially covering the electrical conductor. Element 3: The electrical conductor passes through the proximal clevis without contacting the proximal clevis. Element 4: Further comprising a conductor adapter arranged at a distal end of the electrical conductor to place the electrical conductor in electrical communication with the distal clevis. Element 5: The conductor adapter is assembled on the second axle. Element 6: The second axle extends through a bushing seated within an opening defined in the proximal end of the distal clevis, and the conductor adapter is mounted to the bushing. Element 7: The bushing is made of a nonconductive material selected from the group consisting of ceramics, plastics, thermoplastic or thermosetting polymers, composite materials, hard rubbers, metals having an insulating coating, and any combination thereof. Element 8: The conductor adapter comprises a continuous annular ring. Element 9: The conductor adapter comprises an arcuate member arranged to engage a corresponding arcuate surface of the distal clevis. Element 10: A portion of the electrical conductor defines a conductive spring member.

Element 11: The end effector is configured for unipolar or bipolar operation. Element 12: Further comprising a seal arranged at a proximal end of the proximal clevis, wherein the electrical conductor extends through the seal. Element 13: A shaft adapter is interposed between the list and the elongated shaft. Element 14: Further comprising a conductor adapter arranged at a distal end of the electrical conductor for placing the electrical conductor in electrical communication with the distal clevis. Element 15: The conductor adapter is assembled on the second axle. Element 16: The conductor adapter includes an arcuate member arranged to engage a corresponding arcuate surface of the distal clevis.

Element 17: A conductor adapter is arranged at a distal end of the electrical conductor, and the method further comprises the steps of placing the electrical conductor in electrical communication with the distal clevis by the conductor adapter, and articulating the list while maintaining the electrical communication with the distal clevis by the conductor adapter.

By way of non-limiting examples, exemplary combinations applicable to A, B, and C include: element 1 and element 2; element 4 and element 5; element 5 and element 6; element 6 and element 7; element 4 and element 8; element 4 and element 9; element 4 and element 10; element 14 and element 15; and element 14 and element 16.

Accordingly, the disclosed systems and methods are well adapted to achieve the purposes and advantages mentioned, as well as those inherent therein. The specific embodiments disclosed above are illustrative only, as the teachings of the present disclosure may be modified and practiced in different, but equivalent, ways that will be apparent to those skilled in the art having the benefit of the teachings herein. Furthermore, no limitations are intended to the details of construction or design set forth herein, other than as set forth in the claims below. Accordingly, it is apparent that the specific exemplary embodiments disclosed above may be altered, combined, or modified, and that all such modifications are considered to be within the scope of the present disclosure. The systems and methods illustratively disclosed herein may suitably be practiced in the absence of any element not specifically disclosed herein and/or any optional element disclosed herein. Although a configuration or method is described in terms of "comprising," "containing," or "having" various components or steps, the configuration or method may also "consist essentially of" or "consist of" the various components and steps. All numbers and ranges disclosed above may vary by any amount. Whenever a numerical range having a lower and upper limit is disclosed, any number falling within that range and any included range are specifically disclosed. In particular, all value ranges disclosed herein (in the form of, "about a to about b," or equivalently, "about a to b," or equivalently, "about a-b") should be understood to describe all numbers and ranges included within the broader value range. Furthermore, terms in the claims shall have their ordinary and customary meanings unless otherwise expressly and clearly defined by the patent owner. Furthermore, the indefinite articles "a" or "an" as used in the claims are defined herein to mean one or more than one of the elements they introduce. In the event of any conflict in the use of a word or term in this specification and in one or more patents or other documents that may be incorporated herein by reference, the definition that is consistent with this specification shall govern.

As used herein, the phrase "at least one of" following a series of items, with the terms "and" or "or" separating any of those items, refers to the list as a whole, rather than to each individual member of the list (i.e., each item). The phrase "at least one of" allows for the meaning of including at least one of any of the items, and/or at least one of any combination of the items, and/or at least one of each of the items. By way of example, the phrase "at least one of A, B, and C" or "at least one of A, B, or C" refers to just A, just B, or just C; any combination of A, B, and C; and/or at least one of each of A, B, and C, respectively.

Claims (20)

As an end effector,
distal clevis;
A first jaw and a second jaw rotatably mounted on the distal clevis at the first axle;
a proximal clevis rotatably connected to said distal clevis on the second axle; and
An electrical conductor extending through said proximal clevis, electrically bypassing said proximal clevis, and terminating at said distal clevis, wherein said electrical conductor supplies electrical energy via conduction to at least one of said first jaw and said second jaw;
An end effector wherein said electrical conductor provides a rigid arched section that prevents said electrical conductor from contacting said proximal clevis and a third axle mounted on said proximal clevis proximal to said second axle. An end effector in the first aspect, wherein the electrical conductor is selected from the group consisting of a wire, a shaft, a rod, and a strip made of a conductive material. An end effector in the second aspect, further comprising an insulative covering that partially covers the electrical conductor. An end effector, in the first aspect, further comprising a conductor adapter arranged at a distal end of the electrical conductor for placing the electrical conductor in electrical communication with the distal clevis. In the fourth paragraph, the conductor adapter is an end effector assembled on the second axle. An end effector in accordance with claim 5, wherein the second axle extends through a bushing seated within an opening defined within a proximal end of the distal clevis, and the conductor adapter is slidably engageable with the bushing. An end effector in claim 6, wherein the bushing is made of a non-conductive material selected from the group consisting of ceramics, plastics, thermoplastic or thermosetting polymers, composite materials, hard rubber, metals having an insulative coating, and any combination thereof. In claim 4, the end effector comprises a conductor adapter comprising a continuous annular ring. An end effector in claim 4, wherein the conductor adapter comprises an arched member arranged to engage a corresponding arched surface of the distal clevis. An end effector in claim 4, wherein a portion of the electrical conductor defines a conductive spring member. As a surgical instrument,
drive housing;
An elongate shaft extending from the drive housing;
An end effector arranged at a distal end of the above elongated shaft and including a first jaw and a second jaw;
A wrist interposed between said end effector and said elongated shaft, said distal clevis rotatably mounting said first jaw and said second jaw on a first axle, and a proximal clevis operably coupled to said elongated shaft and coupled to said distal clevis on a second axle; and
An electrical conductor extending from said drive housing, extending through said proximal clevis, electrically bypassing said proximal clevis, and terminating at said distal clevis to provide electrical energy via conduction to at least one of said first jaw and said second jaw;
A surgical instrument wherein said electrical conductor provides a rigid arched section that prevents said electrical conductor from contacting said proximal clevis and a third axle mounted on said proximal clevis proximal to said second axle. A surgical tool in claim 11, wherein the end effector is configured for monopolar or bipolar operation. In claim 11, the surgical tool further comprises a seal arranged at an interface between the proximal end of the proximal clevis and the shaft, wherein the electrical conductor extends through the seal. A surgical tool in claim 11, wherein a shaft adapter is interposed between the list and the elongated shaft. A surgical tool, further comprising a conductor adapter arranged at a distal end of the electrical conductor for maintaining the electrical conductor in electrical communication with the distal clevis in accordance with claim 11. A surgical tool, wherein in claim 15, the conductor adapter is assembled on the second axle. A surgical instrument in claim 15, wherein the conductor adapter comprises an arched member arranged to engage a corresponding arched surface of the distal clevis. As a method of operating a surgical instrument,
A step of positioning the surgical tool adjacent to the patient for surgery, wherein the surgical tool is:
drive housing,
An elongated shaft extending from the above drive housing,
An end effector arranged at the distal end of the above-mentioned elongated shaft and including a first jaw and a second jaw,
A list comprising a distal clevis interposed between said end effector and said elongated shaft, said first jaw and said second jaw rotatably mounted on a first axle, and a proximal clevis operably coupled to said elongated shaft and coupled to said distal clevis on a second axle, and
positioning the surgical instrument, said surgical instrument comprising an electrical conductor extending from said drive housing and extending through said proximal clevis and electrically bypassing said proximal clevis and terminating at said distal clevis; and
A step of supplying electrical energy to the distal clevis through the electrical conductor, thereby supplying energy through conduction to at least one of the first jaw and the second jaw,
A method of operating a surgical instrument, wherein said electrical conductor provides a rigid arched section that prevents said electrical conductor from contacting said proximal clevis and a third axle mounted on said proximal clevis proximal to said second axle. In the 18th paragraph, the conductor adapter is arranged at the distal end of the electric conductor, and the method comprises:
The step of placing said electrical conductor in electrical communication with said distal clevis by means of said conductor adapter; and
A method of operating a surgical instrument, further comprising the step of articulating said list while maintaining electrical communication with said distal clevis by said conductor adapter. In the 11th paragraph, a bushing seated within an opening defined within the proximal end of the distal clevis, wherein the second axle extends through the bushing; and
A surgical tool further comprising a conductor adapter arranged at a distal end of said electrical conductor and slidably engageable with said bushing, said conductor adapter placing said electrical conductor in electrical communication with said distal clevis.

Images