TRANSECTION SUBSYSTEMS FOR ROBOTIC STAPLING AND CUTTING SYSTEMS

Systems and subsystems for cutting and stapling tissue are disclosed. More specifically, the present disclosure relates to systems, devices, and subsystems for attachments for robotic surgeries. The surgical instrument includes a transection subsystem comprising a rotatable shaft having a lumen, a firing rod extending at least partially through the lumen, a firing rack coupled to a proximal end of the firing rod, the firing rod being rotationally independent of the firing rack, and a firing gear engaged with the firing rack. Rotation of the firing gear moves the firing rack and the firing rod axially.

FIELD OF INVENTION

The present disclosure generally relates to systems, devices, and subsystems for cutting and stapling tissue. More specifically, the present disclosure relates to systems, devices, and subsystems for attachments for robotic surgeries.

BACKGROUND

Stapling is a crucial aspect of many surgical procedures, such as gastrointestinal, thoracic, and gynecological surgeries. Robotic surgical systems have gained significant recognition in recent years due to their potential to enhance surgical precision and dexterity. However, the development of a dedicated surgical stapling instrument that integrates seamlessly into the surgical workflow of a multi-purpose robot remains an unmet need for many surgeons.

SUMMARY

It is an object of the present designs to provide devices and methods to meet the above-stated needs. The designs can be for systems, devices, and subsystems for stapling attachments for robotic surgeries. The attachments can have several subsystems that can be independently actuated to provide a specific action, such as closing of an end effector of the stapler, articulation of the end effector, rolling of the end effector, and firing of the staples within the end effector.

The disclosed technology includes a transection subsystem for a surgical instrument comprising a rotatable shaft having a lumen, a firing rod extending at least partially through the lumen, and a firing rack coupled to a proximal end of the firing rod. The firing rod is rotationally independent of the firing rack. The transection subsystem further includes a firing gear engaged with the firing rack. Rotation of the firing gear can move the firing rack and the firing rod axially.

Other aspects of the present disclosure will become apparent upon reviewing the following detailed description in conjunction with the accompanying figures. Additional features or manufacturing and use steps can be included as would be appreciated and understood by a person of ordinary skill in the art.

DETAILED DESCRIPTION

Specific examples of the present invention are now described in detail with reference to the figures, where identical reference numbers indicate elements which are functionally similar or identical. The examples address many of the deficiencies associated with prior robotic attachment systems, for instance prior systems that did not provide integrated capabilities to close, articulate, roll, and fire, all with the actuation of their designated robotic outputs. The present surgical instrument includes a housing that contains the gearing and other components necessary to effect the close, articulate, roll, and fire features. In particular, the present disclosure provides a detailed discussion of the closure subsystem, articulation system, roll subsystem, and transection subsystem that are usable to close, articulate, roll, and fire an end effector of the device. Use of the term “fire” throughout this disclosure means to advance the distal portions of the transection subsystem distally. “Firing” the components shall be understood to mean cutting, stapling, or both.

Overview

Turning to the figures,FIG.1is a perspective view illustrating a surgical instrument100, according to aspects of the present disclosure. A housing102of the surgical instrument100can be attachable to a robotic arm that includes a plurality of outputs, or rotatable disks, that can actuate pucks, or other disks, on the surgical instrument100. The proximal end106of the surgical instrument100can be attached to a robotic arm and the distal end108of the surgical instrument100effects the transection and stapling of patient tissue. The proximal end106of the surgical instrument100includes a tail cover114. The surgical instrument can include one or more release buttons104that allows the device to be detached from the robotic arm.

FIG.2Ais a perspective view of the housing102as shown from the other side from what is shown inFIG.1. The housing102can include a first portion110and a second portion112. The housing102includes a series of pucks (e.g., first closure input puck202, second closure input puck204, first articulation input puck402, second articulation input puck404, roll input puck602, and transection input puck802). The pucks include features that enable them to engage with the rotating features of the robotic arm1100and a sterile adapter positioned between the surgical instrument100and the robotic arm1100, such that rotation of the pucks can actuate the gears and other components of the closure subsystem200, articulation subsystem400, roll subsystem600, and transection subsystem800described herein.

FIGS.3A and3Bshow internal components of the housing102at the proximal end106of the surgical instrument100. As shown inFIG.3A, housing102includes components of the closure subsystem200, articulation subsystem400, roll subsystem600, and transection subsystem800described herein. As will be described in greater detail herein, the pucks (e.g., first closure input puck202, second closure input puck204, first articulation input puck402, second articulation input puck404, roll input puck602, and transection input puck802) can each be attached to components that extend through the housing102and rotationally engage respective components of the closure subsystem200, articulation subsystem400, roll subsystem600, and transection subsystem800. In this way, rotation of each individual puck causes the end effector to actuate (roll, close or open, articulate, fire staples, etc.) to enable physician to complete a surgery via a robotic system.

FIG.3Bshows internal components of the surgical instrument100shown without an outer housing102, according to aspects of the present disclosure. The closure subsystem200and the articulation subsystem400each utilize two different pucks (e.g., first closure input puck202, second closure input puck204, first articulation input puck402, and second articulation input puck404) for their respective actions, whereas the roll subsystem600and transection subsystem800each utilize only one puck (e.g., roll input puck602and transection input puck802) for their respective actions. There are certain benefits to the closure subsystem200and the articulation subsystem400each utilizing two different pucks, including but not limited to providing additional force to increase the closure subsystem's200ability to compress tissue and adding input torque and reducing lash to increase responsiveness for articulation.FIG.2Bis an exploded view of the components within a proximal end106of the surgical instrument100. As shown inFIG.2B, the outer housing102can further include an intermediate housing111that can be disposed between the first portion110and the second portion112and help to provide support to the various components in the outer housing102as described further herein.

As shown inFIG.4, the surgical instrument100includes an end effector150disposed at the distal end108of the surgical instrument100. As shown, the end effector150includes an anvil152and a channel156. As will be described in greater detail herein, the anvil152can be caused to move with respect to the channel156to open and close the end effector150. Furthermore, as will be described in greater detail herein, the surgical instrument100includes a closure ring226and a closure tube212that can be actuated to cause the anvil152to open and close with respect to the channel156. The anvil152can be opened by retracting the closure ring226from the anvil152.

FIG.5Aillustrates an end effector150in a closed configuration whileFIG.5Billustrates an end effector150in an open configuration. The anvil152of the end effector150can be opened and closed by operation of a closure ring226that is coupled to the anvil152and can be slid proximally and distally by the closure tube212. As the closure ring226is slid distally the closure ring226causes the anvil152to close. As the closure ring226is slid proximally, the closure ring226causes the anvil152to open. The closure ring226can be caused to move between the opened and closed position by actuation of the closure tube212. As the closure tube212is slid proximally and distally, the closure tube212, which is engaged with the closure ring226, causes the closure ring226to also slide proximally and distally, thereby opening and closing the anvil152.

As shown inFIGS.5A and5B, the closure tube212can be actuated by movement of a closure yoke250between an open position in which the anvil152is opened and a closed position in which the anvil152is closed. The closure yoke250can slide axially in a proximal direction to open the anvil152and slide axially in a distal direction to cause the anvil152to close. In other words, when the closure yoke is in the open position, a distance X1between the closure yoke250and a distal roll bushing252(which remains stationary) will be less than when the closure yoke250is in the closed position and a distance between the closure yoke250and the distal roll bushing252is X2. As will be described in greater detail herein, the closure yoke250can be transitioned between the open and closed positions by actuation of several gears.

FIG.6Ais a cross sectional view of the end effector150showing the end effector150, the closure ring226and the closure tube212. The closure ring226can be coupled to the anvil152such that the anvil152is caused to open when the closure ring226is slid proximally and caused to close when the closure ring226is slid distally. In this way, the closure subsystem200must be actuated between the opened and closed position to transition the anvil152between the open and closed position. In other words, it is not possible to open or close the anvil152without also actuating the other components of the closure subsystem200.

FIG.6Bis a perspective view of the end effector showing the anvil152, the channel156, a cartridge installed in the channel120, and the closure ring226. The anvil152includes flanges260that can extend outwardly at a proximal end of the anvil152. As shown inFIG.6C, the anvil152further includes an anvil tab264positioned at a proximal end of the anvil152. The anvil tab264is configured to contact one or more closure ring tabs262that can extend inwardly from the closure ring226to cause the anvil152to open and close.

As shown inFIG.6C, the anvil152includes one or more anvil pins159that can extend into an opening155in the channel156. Opening155is an elongate slot in this example. It should therefore be understood that anvil pin159slides along opening155in addition to pivoting about its own axis within opening155. This action may still be regarded as “pivoting” as defined herein, even though the pivot axis translates with anvil pin159along opening155and is not in a fixed position.

As closure ring226translates distally in response to advancement of closure tube212, closure ring226translates relative to anvil152to engage anvil152. Closure ring226engages anvil152to translate anvil152distally by contacting the anvil ramp154and causing the anvil152to pivot. As anvil152continues to translate distally, the closure ring226causes the anvil152to close. Once end effector150is closed, the tissue captured between anvil152and channel156may be cut and stapled.

Once tissue positioned in the end effector150is cut and stapled, anvil152may be opened to release the tissue. End effector150may then be opened to replace staple cartridge120with a new staple cartridge. To open end effector150, the closure ring226can be translated proximally by the closure subsystem200. As closure ring226translates proximally, the one or more closure ring tabs262engage the anvil tab264to pull anvil152proximally. As anvil152translates proximally, the anvil152pivots away from channel156to an open position.

Closure Subsystem

FIGS.7A,7C,7D,7E, and7Iare detail views of a closure subsystem200, according to aspects of the present disclosure.FIGS.7A and7Dare top perspective views whileFIG.7Cis a bottom perspective view of the closure subsystem200. The closure subsystem200includes a first closure input puck202and a second closure input puck204(shown inFIG.7C). The first closure input puck202can be configured to engage with a first rotating feature of the robotic arm and the second closure input puck204can be configured to engage with a second rotating feature of the robotic arm. In this way, the robotic arm can be configured to transmit a greater amount of force to the closure subsystem200to cause the anvil152to open and close than would be possible with only a single input puck.

The first closure input puck202can be coupled to a first closure input rod203that extends into the outer housing102. The first closure input rod203can be further coupled to a first closure spur gear206. Thus, when the first closure input puck202rotates, it will also cause the first closure input rod203and the first closure spur gear206to rotate. Similarly, the second closure input puck204can be coupled to a second closure input rod205that extends into the outer housing102. The second closure input rod205can be further coupled to a second closure spur gear208. Thus, when the second closure input puck204rotates, it will also cause the second closure input rod205and the second closure spur gear208to rotate. The first closure input rod203can be held in place by a first retention clip218and the second closure input rod205can be held in place by a second retention clip220.

The first closure spur gear206and the second closure spur gear208can each be rotationally engaged with a closure cam gear210. As shown inFIGS.8A and8B, the closure cam gear210includes a closure cam track214that can be configured to receive a yoke pin216that can be coupled to the closure yoke250. As the closure cam gear210rotates, the closure cam track214causes the yoke pin216to slide proximally and distally, thereby causing the closure yoke250to slide proximally and distally. In other words, as the closure cam gear210is rotated in a first direction, the closure cam track214will guide the yoke pin216along the closure cam track214in either the proximal or distal direction. Because the yoke pin216is coupled to the closure yoke250, movement of the yoke pin216proximally or distally causes the closure yoke250to move proximally or distally. As explained previously, movement of the closure yoke250causes the anvil152to open or close.

The closure cam track214can comprise a non-linear track that can be configured to have a changing movement profile as the closure cam gear210rotates. As shown inFIGS.8A and8B, a cam track214can include a non-linear profile. In some implementations, the cam track214can be a logarithmic spiral. The cam track214is not necessarily fully logarithmic, and in some instances can be represented by higher order polynomials, as some implementations can include a portion that is non-linear, a portion that has a constant radius, and a portion that connects the non-linear and constant radius portions. These different portions can be created by splines. One novel aspect of this non-linear cam track214design is that it can be shaped such that once the yoke pin216reaches a portion of the cam track214with a constant radius, the closure cam gear210rotates but the yoke pin216does not move axially. This feature can provide benefits by accounting for, and providing tolerance for, robotic inaccuracies.

As shown inFIG.8C, the closure cam track214can comprise a first zone222and a closure zone224. The first zone222of the closure cam track214can be configured to cause the yoke pin216and, subsequently, the anvil152to compress tissue without causing a great amount of force. The closure zone224of the closure cam track214, on the other hand, can be configured to cause the anvil152to compress down on tissue with a force sufficient to keep the end effector150in place for cutting and/or stapling of the tissue. The final rotational position of the closure cam track214, and the overall configuration of the other components of the closure subsystem200, creates a closure load that meets the requirements of the particular application. In other words, once the yoke pin216reaches a final rotational position, the combination of the closure subsystem200components can cause the anvil152to move to a closed position to close down on tissue. It will be appreciated, however, that the first zone222and the closure zone224can be configured to comprise alternative percentages of the closure cam track214depending on the particular application. Furthermore, the slope of the closure cam track214at the first zone222and the closure zone224can be varied to affect the speed and force with which the anvil152opens and closes. It will be understood that the cam track214is contiguous, non-linear, and smooth, soFIGS.8C and8Ddepicting the different “zones” is not to indicate that there is a break or discontinuity in certain sections of the cam track214.FIG.8Ashows a fully open configuration, where the yoke pin216is at a position within the cam track214such that the anvil152is fully open, thereby maximizing the amount of tissue that can be placed in the jaws (e.g., anvil and channel) of the end effector150.FIG.8Bshows a fully closed configuration, where the yoke pin216is within a constant radius portion of the cam track214(in this view the yoke pin216is also at the very end of the cam track214). A fully closed configuration can indicate that the surgical instrument100is ready to proceed with firing (e.g., transection and/or stapling). Partially open configurations can exist between the examples shown inFIGS.8A and8Bwherein the system can grasp tissue.

Referring now toFIG.8D, which is a bottom view of the closure cam gear210, the view shows different regions of the cam track214that can provide different movement profiles for the yoke pin216. Referencing this view inFIG.8D, as the closure cam gear210rotates clockwise, the yoke pin216translates downward in the view (downward being distally in relation to the shaft604, seeFIGS.8A and8B). The regions of the cam track214can provide different movement profiles depending on where in the cam track214the yoke pin216is located. For example, the closure cam gear210inFIG.8Dhas indications of degrees for reference, up being labeled 0°, left being labeled 90°, down being labeled 180°, and right being labeled 270°. The cam track214can include an open dead zone270that exists between around −20° and around 0°. The open dead zone270is a region beyond an open position272that provides a level of tolerance should the closure cam gear210be rotated beyond the open position272. The open position272, or home position, can be a hard stop position where the closure ring226is positioned proximally, allowing the anvil152to be fully open (seeFIG.5B). The cam track214ofFIG.8Dincludes a high speed compression region274positioned in the next portion of the cam track214beyond the open position272. This high speed compression region274can extend from around 0° to around 90°. The high speed compression region274has a curvature that enables the yoke pin216to transition distally quickly while providing a low amount force (for example clamping force on the anvil152). This high speed compression region274can enable the surgical instrument100to grab and position the target tissue. At around 90° on the closure cam gear210ofFIG.8Dis a force transition region276. Extending beyond the force transition region276is a high force region278. The high force region278can extend from around 90° to around 300° on the closure cam gear210ofFIG.8D. This region provides a low speed, high force movement profile for the distal movement of the yoke pin216. The high force region278, for example, can be a portion of the movement profile that begins to put pressure on the tissue that is being cut and/or stapled. At around 300° on the closure cam gear210ofFIG.8Dis a closing target280. Any point beyond the closing target280can be considered as closed, as in the force and distal movement yoke pin216are considered met. Extending beyond the closing target280, and from about 300° to the end of the cam track214, is a constant force region282. Like the constant radius portion described above, the constant force region282can be a section of the cam track214where the closure cam gear210rotates but the yoke pin216does not move axially. This can help to provide tolerance for any positional error by the surgical robot1100.

The closure subsystem200can further include a manual closure spur gear230that is coupled to a manual closure handle234(as shown inFIGS.7B and7E-7I) that extends through the outer housing102. The manual closure handle234can be used, for example, by a surgical staff if the surgical robot is unable to open or close the anvil152. The manual closure spur gear230can be rotationally coupled to a manual closure cam gear232that can be keyed to the closure cam gear210. In this way, rotation of the manual closure handle234will cause the manual closure spur gear230and the manual closure cam gear232to rotate, thereby causing the closure cam gear210to rotate and open or close the anvil152. As will be appreciated, the manual closure handle234provides a surgical staff with the ability to open and close the anvil152when the surgical instrument100is disconnected from a surgical robot or to override the opening or closing of the anvil152when connected to the surgical robot.

As shown inFIGS.7E-7I, the manual closure handle234, in some examples, includes a manual closure handle grip236and a manual closure handle clip238. The manual closure handle grip236can extend beyond an outer portion of the housing102such that the physician or surgical staff can grip the manual closure grip236and rotate it to cause the anvil152to open or close. The manual closure handle clip238can be configured to extend through the manual closure handle grip236and into the housing102to attached the manual closure handle234to the housing102. The manual closure handle clip238can include one or more protruding features that can snap into place when pushed into the housing102to attached the manual closure handle234to the housing102. In other examples, the manual closure handle grip236and the manual closure handle clip238can be integrated into a single component.

The manual closure handle grip236can attach to the manual closure spur gear230by, for example but not limitation, receiving a protrusion of the manual closure spur gear230into a recess formed into the manual closure handle grip236(as shown inFIGS.7E and7F). The manual closure handle grip236can include engagement surfaces237that can align with corresponding engagement surfaces of the manual closure spur gear230to transfer forces from the manual closure handle grip236to the manual closure spur gear230when rotated. For example, the protrusions of the manual closure spur gear230and the recess of the manual closure handle grip236can be a hex head or other similar features.

Although not shown, in some examples, the manual closure handle grip236could include geometry that limits the travel, or provides some resistance to the travel, of the manual closure handle grip236at predetermined locations such that the manual closure handle grip236is stopped or at least slowed at positions corresponding to desired positions of the opening and closing of the anvil152. Alternatively, or in addition, the manual closure handle grip236or the manual closure handle clip238can include markings, colors, protrusions, recesses, etc. that indicate the position of the anvil152. In some examples. The manual closure handle grip236or the manual closure handle clip238can include transparent features that reveal indicators at certain positions of rotation to indicate the status. Furthermore, the manual closure handle230and/or the closure subassembly200can include torque limiting features to prevent over torquing of the closure subassembly200.

Articulation Subsystem

FIG.9is a perspective view of the surgical instrument100whileFIG.10is an exploded perspective view of the surgical instrument100. As shown, the surgical instrument100includes a cartridge120that includes staples configured to staple tissue. The surgical instrument100can further include a knife guide158, a firing rod820, and a firing rack816that can cause a knife to cut tissue, as will be described in greater detail herein. Furthermore, the surgical instrument100includes a shaft604having a shaft lumen606. The shaft604, as will be described in greater detail herein, can be disposed within the closure tube212and be coupled to a worm follower610that can cause the shaft604and end effector to rotate about the longitudinal axis474of the surgical instrument100.

The surgical instrument100includes an articulation subsystem400. As shown inFIG.10, the surgical instrument100includes a first articulation rod406A and a second articulation rod407A that can be configured to cause a distal channer retainer408and, subsequently, the end effector150to articulate in a first and second direction transverse to a longitudinal axis474of the surgical instrument100. The first articulation rod406A and the second articulation rod407A can be configured to be at least partially disposed in a rod groove478disposed on either side of the shaft604.

Views of the articulation of the distal end of the surgical instrument100are shown inFIGS.11A,11B,12A,12B, and12Cwhile detailed views of the proximal portions of an example articulation subsystem400are provided inFIGS.13A-15C. The articulation subsystem400includes a first articulation rod406A and a second articulation rod407A that each extend distally to a distal channel retainer408. The proximal end of the first articulation rod406A and the second articulation rod407A can each include a hook (first articulation rod hook405and second articulation rod hook409, shown inFIGS.10,15A,15B, and15C) or other attachment that constrains the articulation rod proximally (e.g., to a first articulation bushing426and a second articulation bushing428). In some examples, the first articulation rod406A and the second articulation rod407A can each be pinned, bolted, welded, adhered, or otherwise attached to a first rack414A and a second rack418A, respectively. The distal end of the first articulation rod406A and the second articulation rod407A can each be connected to a distal channel retainer408that can pivot back and forth (e.g., left and right) to move, or articulate, an end effector150of the surgical instrument100. The first articulation rod406A can be attached to the distal channel retainer408via a first channel retainer pin410and the second articulation rod407A can be attached to the distal channel retainer408via a second channel retainer pin411. An attachment end468of the distal channel retainer408can, for example, be attached to a channel156of the end effector150to articulate the end effector150. The attachment end468can also include a band slot484for a series of bands826to pass through, which are described in greater detail herein with respect to the transection subsystem800.

Referring now toFIGS.12A,12B, and12C, the first articulation rod406A and the second articulation rod407A can articulate the distal channel retainer408back and forth about an articulation pivot point466by pushing or pulling a respective side of the distal channel retainer408.FIG.12Aillustrates the end effector150articulated to a first position,FIG.12Billustrates the end effector150in a central position, andFIG.12Cillustrates the end effector150is a second position. To articulate the end effector150back and forth, the distal channel retainer408includes the first retainer pin410(as shown inFIG.11B), and the first articulation rod406A includes a first rod aperture412distally that engages the first retainer pin410. Similarly, the distal channel retainer408includes the second retainer pin411, and the second articulation rod407A includes a second rod aperture413distally that engages the second retainer pin411. As the first articulation rod406A translates proximally (as shown by the arrow inFIG.12C), the first articulation rod406A pulls the first retainer pin410proximally and thus articulates the distal channel retainer408about the articulation pivot point466in one direction. The second articulation rod407A can translate distally to permit the channel retainer408to articulate about the articulation pivot point466. Similarly, as the second articulation rod407A translates proximally (as shown by the arrow inFIG.12A), the second articulation rod407A pulls the second retainer pin411proximally and thus articulates the distal channel retainer408about the articulation pivot point466in the opposite direction. The first articulation rod406A can translate distally to permit the channel retainer408to articulate about the articulation pivot point466. The first articulation rod aperture412and the second articulation rod aperture413can each be oblong, as shown inFIG.11B, to account for the translation of the first and second retainer pins410,411laterally as the distal channel retainer408rotates, since the first articulation rod406A and second articulation rod407A moves only axially and is constrained to the shaft604within a rod groove478.FIG.10shows a view of the rod groove478along the length of the shaft604. Note that in other examples, the proximal and distal motions can be reversed. For example, the rotation illustrated inFIG.12Acan be accomplished by any one of distal movement of the first articulation rod406A, proximal movement of the second articulation rod407A or the coordinated movements of both articulation rods406A,407A. The same holds true for the entire articulation range of motion.

Referring now toFIGS.13A and13B, which are a detailed view and an exploded of the proximal portions of the articulation subsystem400, respectively. Additionally,FIG.14shows a cross-sectional view of the articulation subsystem400taken along line A-A ofFIG.13A. The articulation subsystem400includes features that accommodate the roll functions of the surgical instrument100. As will be described in greater detail below with respect to the roll subsystem600, the surgical instrument100includes a shaft604that can roll, i.e., rotate with respect to a longitudinal axis474of the surgical instrument100, to allow a full range of articulation for the end effector150. To elaborate, the shaft604can be directly connected to the end effector150, and therefore the combination of rolling of the shaft604(via the roll subsystem600) and articulating the end effector150(via the articulation subsystem400) enables the end effector150to articulate with more degrees of freedom than simply left to right by pivoting the distal channel retainer408. Access to the surgical site is thereby improved due to the combination of the articulation, roll, and insertion of the surgical instrument100.

The first articulation rod406A and the second articulation rod407A each extend along the rotatable shaft604, for example within the rod groove478. To account for the ability of the first articulation rod406A and the second articulation rod407A to rotate with the shaft604, the articulation subsystem400includes bushings (i.e., first articulation bushing426and second articulation bushing428) that allow the rotatable robotic outputs to move the articulation subsystem400proximally and distally (for example to move the first articulation rod406A and the second articulation rod407A) along the shaft604, while also allowing the shaft604to rotate within the articulation subsystem400. The articulation subsystem400includes a first rack414A that can be moved via a series of gearing by rotation of the first articulation input puck402, the first articulation input puck402being engageable with a corresponding rotatable robotic output. The inside of the first rack414A includes rack gearing416(as shown inFIGS.15A,15B, and15C) that facilitates axial translation of the first rack414A (e.g., distal and proximal within the outer housing102as indicated by the arrows inFIGS.15A and15C). The articulation subsystem400includes a second rack418A that can be moved via a series of gearing by rotation of the second articulation input puck404, the puck404being engageable with a corresponding rotatable robotic output. The inside of the second rack418A includes rack gearing420(as shown inFIGS.15A,15B, and15C) that enables axial translation of the second rack418A (e.g., distal and proximal within the outer housing102as indicated by the arrows inFIGS.15A and15C).

To account for the rotation of the shaft604, the articulation subsystem400includes a first articulation bushing426that is rotatable with the shaft604and is rotatably independent of the first rack414A. In other words, the rolling of the shaft604will also roll the first articulation bushing426, all while the first rack414A remains rotationally stable within the outer housing102. The first articulation bushing426can slide from a first position to a second position along a longitudinal axis474of the rotatable shaft604, thereby moving the first articulation rod406A proximally and distally. The first rack414A includes a first housing track surface462(as shown inFIG.14) that moves axially within a corresponding track in the outer housing102, thereby enabling the first rack414A to slide axially but not rotationally. The first housing track surface462and the first bushing bearing surface458can be at 90° with respect to each other. The articulation subsystem400includes a second articulation bushing428that is rotatable with the shaft604and is rotatably independent of the second rack418A. In other words, the rolling of the shaft604will also roll the second articulation bushing428, all while the second rack418A remains rotationally stable within the outer housing102. The second articulation bushing428can slide from a first position to a second position along the longitudinal axis474of the rotatable shaft604, thereby moving the second articulation rod407A proximally and distally. The second rack418A includes a second housing track surface464(as shown inFIG.14) that moves axially within a corresponding track in the outer housing102, thereby enabling the second rack418A to slide axially but not rotationally. The second housing track surface464and the second bushing bearing surface460can be at 90° with respect to each other.

The articulation subsystem400includes a first articulation drive shaft432extending from the first articulation input puck402and including a first drive gear430that can be keyed to the first articulation drive shaft432. Rotation of the first articulation input puck402by the corresponding robotic output can therefore rotate the first drive gear430. The articulation subsystem400includes a first rack gear434, which can in some instances be a hollow tube gear that slides over the first articulation drive shaft432, thereby providing a mechanical advantage to the system while also conserving space within the outer housing102. The first rack gear434can be rotatably coupled to the first articulation drive shaft432by means of a first compound gear442that has stepped teeth444, one portion of the stepped teeth444being engaged with the first drive gear430, and the other portion of the stepped teeth444being engaged with the first rack gear434. As such, rotation of the first articulation drive shaft432rotates the first drive gear430, rotation of the first drive gear430rotates the first compound gear442, and rotation of the first compound gear442rotates the first rack gear434that is surrounding the first articulation drive shaft432. Further, the first rack gear434includes first rack gear teeth446that engage with the rack gearing416of the first rack414A. Rotation of the first rack gear434therefore causes the first rack414A to translate proximally and distally to move the first articulation bushing426. With this configuration, rotation of the first input puck402in a clockwise direction (when viewed from a perspective showing the surface of the first input puck402that is configured to engage with the robotic arm1100(e.g., when viewing the outer-facing surface of first input puck402)) can cause the first rack414A to move proximally and rotation of the first puck402in a counter-clockwise direction can cause the first rack414A to move distally.

Similarly, the articulation subsystem includes a second articulation drive shaft438extending from the second articulation input puck404and including a second drive gear436. Rotation of the second articulation input puck404by the corresponding robotic output can therefore rotate the second drive gear436. The articulation subsystem400includes a second rack gear440, which can in some instances be a hollow tube gear that slides over the second articulation drive shaft438. The second rack gear440can be rotatably coupled to the second articulation drive shaft438by means of a second compound gear448that has stepped teeth450, one portion of the stepped teeth450being engaged with the second drive gear436, and the other portion of the stepped teeth450being engaged with the second rack gear440. As such, rotation of the second articulation drive shaft438rotates the second drive gear436, rotation of the second drive gear436rotates the second compound gear448, and rotation of the second compound gear448rotates the second rack gear440that is surrounding the second articulation drive shaft438. Further, the second rack gear440includes second rack gear teeth452that engage with the rack gearing420of the second rack418A. Rotation of the second rack gear440therefore causes the second rack418A to translate proximally and distally to move the second articulation bushing428. With this configuration, rotation of the second input puck404in a clockwise direction (when viewed from a perspective showing the surface of the second input puck404that is configured to engage with the robotic arm1100(e.g., when viewing the outer-facing surface of second input puck404)) can cause the second rack418A to move distally and rotation of the second input puck404in a counter-clockwise direction can cause the second rack418A to move proximally.

Referring again to the articulation bushings and racks, the first rack414A can engage with the first articulation bushing426in a manner that enables proximal or distal movement of the first articulation bushing426, while the first articulation bushing426remains able to rotate with the shaft604. The first rack414A includes a first bushing bearing surface458that abuts the first articulation bushing426. The first articulation bushing426includes a first rack groove480around the perimeter of the bushing in which the first bushing bearing surface458extends. As the first articulation bushing426rotates, the first bushing bearing surface458can track through the first rack groove480. As such, the first bushing bearing surface458can be semicircular. Similarly, the second rack418A can engage with the second articulation bushing428in a manner that enables proximal or distal movement of the second articulation bushing428, while the second articulation bushing428remains able to rotate with the shaft604. The second rack418A includes a second bushing bearing surface460that abuts the second articulation bushing428. The second articulation bushing428includes a second rack groove482around the perimeter of the bushing in which the second bushing bearing surface460extends. As the second articulation bushing428rotates, the second bushing bearing surface460can track through the second rack groove482. As such, the second bushing bearing surface460can be semicircular.

Referring now toFIGS.15A,15B, and15Cwhich show the actuation of the articulation subsystem400by movement of the first rack414A and the second rack418A.FIG.15Bshows an articulation subsystem400at a neutral, e.g., 0° state, of articulation. To move the first articulation bushing426, the first rack gear434can rotate in a first angular direction, and the first rack gear teeth446move through the first rack gearing416of the first rack414A. As shown inFIG.15A, when the first rack gear434rotates and causes the first rack414A to move proximally, the first articulation rod hook405is pulled proximally and causes the first articulation rod406A to be pulled proximally. The second articulation rod407A can be let out by the robotic arm to allow the end effector150to move in a first direction, in this example to the right (as shown inFIG.12A).

FIG.15Cshows where the first rack414A has moved distally and the second rack418A has been moved proximally. Movement of the second rack418A proximally causes the second articulation bushing428to translate proximally along the longitudinal axis474of the shaft604. In turn, the second articulation rod407A will translate proximally, thereby pivoting the distal channel retainer408such that the end effector150pivots in a second direction, in this example to the left (as shown inFIG.12C(the end effector inFIGS.12A-12Cbeing rotated 180 degrees compared toFIGS.15A-15C)). The first articulation rod406A can be let out by the robotic arm to allow the end effector150to move in the second direction. In this example, the first articulation rod406A and the second articulation rod407A only cause actuation of the end effector150when caused to move proximally, thereby pulling the distal channel retainer408to pivot from left to right. In other words, the first articulation rod406A and the second articulation rod407A only cause the end effector150actuate when pulled in this example. In other examples, the first articulation rod406A and the second articulation rod407A can be configured to work together in a push/pull relationship. For example, as one of the first articulation rod406A and the second articulation rod407A is pulled in a proximal direction, the other of the first articulation rod406A and the second articulation rod407A can be pushed in a distal direction, thereby increasing the force applied to cause the articulation. That is the first articulation input puck402and the second articulation input puck404can be used together to cause the articulation system to actuate, thereby increasing the force applied to the articulation subsystem400for articulating the end effector150.

In some examples, the articulation subsystem400described herein can achieve at least 60° of articulation in either direction, for example ±5°, ±10°, ±15°, ±20°, ±25°, ±30°, ±35°, ±40°, ±45°, ±50°, ±55°, and ±60°, or any intervening degree of articulation back and forth. It will be noted that the joint160shown inFIG.12Bthat holds the end effector150to the shaft604is exposed for visualization. The joint160can be concealed by a flexible sheath174to alleviate pinch points. The joint160described herein can include multiple articulation links that connect the closure tube212to the closure ring226. This linking system can be a boss/hole configuration that provides a pinned joint. The exterior closure system can consist of the closure tube212pushing distally forward on the two articulation links of the joint160, which in turn push on the closure ring226.

Turning now toFIGS.16A,16B,16C,16D,16E and16F, an alternative example articulation subsystem400is herein described. As shown, the articulation subsystem400can include a first inboard rack414B and a second inboard rack418B. For example, the first inboard rack414B can be positioned at least partially between the first rack gear434and the rotatable shaft604and the second inboard rack418B can be positioned at least partially between the second rack gear440and the rotatable shaft604. In this way, the articulation subsystem400will have a more compact layout and the forces applied by the first inboard rack414B and the second inboard rack418B can be distributed closer to the longitudinal axis, thereby reducing torque forces on the first inboard rack414B and the second inboard rack418B.

The first inboard rack414B and the second inboard rack418B can each be pushed or pulled together in a push/pull relationship. For example, if the first inboard rack414B and the second inboard rack418B are moved axially toward each other, the end effector150will articulate in a first direction (e.g., to the right). If the first inboard rack414B and the second inboard rack418B are moved axially away from each other, the end effector will articulate in a second direction (e.g., to the left). In this way, forces from the first articulation input puck402and the second articulation input puck404can work together to cause the end effector150to articulate in a first or a second direction.

Similar to the first rack414A and the second rack418, the first inboard rack414B and the second inboard rack418B can be configured to cause the first articulation rod406A and the second articulation rod407A to move proximally and distally via a first articulation bushing426and a second articulation bushing428. Because the first inboard rack414B and the second inboard rack418B are positioned at least partially around the rotatable shaft604adjacent the first articulation bushing426and the second articulation bushing428, the first inboard rack414B and the second inboard rack418B can push on the first articulation bushing426and the second articulation bushing428, respectively, without the need for a portion of the racks to extend outwardly and engage with the bushings. As shown inFIGS.16C and16D, similar to the first rack414and the first articulation bushing426, the first inboard rack414B includes a first bushing bearing surface458that engages with a first rack groove480. Similarly, the second inboard rack418B includes a second bushing bearing surface460that engages with the second rack groove482. In this way, the first inboard rack414B and the second inboard rack418B can be configured to move the first articulation bushing426and the second articulation bushing428proximally and distally but remain rotationally independent of the first articulation bushing426and a second articulation bushing428.

As shown inFIG.16E, the first articulation bushing426and the second articulation bushing428can each include one or more bushing extensions427that protrude from the first articulation bushing426and the second articulation bushing428in a direction along the longitudinal axis. In this way, the bushing extensions427can help to prevent the first articulation bushing426and the second articulation bushing428from binding when being pushed or pulled proximally or distally.

As shown inFIG.16F, the first inboard rack414B and the second inboard rack418B can each have a housing track surface415that moves axially within a corresponding track176B in the first portion112of the housing102and a track176A of the intermediate housing111, thereby enabling the first inboard rack414B to slide axially but not rotationally. In other words, the housing track surfaces415of the first inboard rack414B and the second inboard rack418B are configured to slide along the tracks176A,17B of the first portion112of the housing102and the intermediate housing111disposed in the housing102. In this way, any rotational force applied to the first inboard rack414B and the second inboard rack418B by the roll subsystem600will not cause the first inboard rack414B and the second inboard rack418B to rotate within the housing102.

Turning now toFIGS.17A,17B,17C,17D,17E,17F, and17G, yet another alternate example of the articulation subsystem400will be shown and described. As shown, the articulation subsystem400can include a single inboard rack414C that extends around the rotatable shaft604. The first tube drive teeth446can engage with the single inboard rack414C on a first side and the second tube drive teeth452can engage with the single inboard rack414C on a second side. That is, the first tube drive teeth446and the second tube drive teeth452can engage the singe inboard rack414C together. The single inboard rack414C can be engaged with a single articulation bushing429that is coupled to a single articulation rod403. That is, compared to the previous examples shown and described herein, the example articulation subsystem400shown inFIGS.17A-17Gcan include a single articulation rod403that can be both pulled and pushed by a single articulation bushing429and a single inboard rack414C.

As shown inFIG.17C, the single inboard rack414C is separated from the single articulation bushing429by one or more bearings425. The a first bearing425is constrained distally by a flange431and a second bearing425is constrained proximally by a locking ring433. Constrained as such, movement of the single inboard rack414C causes the single articulation bushing420to move axially. By including the bearings425, the single inboard rack414C can be rotationally independent of the single articulation bushing429but still be configured to cause the single articulation bushing429(and, consequently, the single articulation rod403) to translate proximally and distally. Furthermore, because the first tube drive teeth446and the second tube drive teeth452engage the single inboard rack414C together, it will be appreciated that forces from the first articulation input puck402and the second articulation input puck404can work together to cause the end effector150to translate in a first and in a second direction.

Turning now toFIGS.17F and17G, the articulation subsystem400can include a knife guide469that can be positioned between the attachment end468and the proximal end of the shaft604. The knife guide469can include a band slot471similar to the band slot484of the attachment end468that can help to guide the bands826that translate proximally and distally. The knife guide469can help to prevent the bands826from buckling, twisting, or otherwise becoming bound when translating proximally or distally, thereby helping to ensure the knife166can also more proximally and distally.

As shown inFIGS.17F and17G, the articulation subsystem400can include an articulation rod post484that can receive the single articulation rod403, The articulation rod post484can couple the single articulation rod403to the attachment end468to cause the end effector150to articulate left and right when the single articulation rod403is moved proximally and distally.

Roll Subsystem

The surgical instrument100includes a roll subsystem600. Detailed views of the proximal portions of an example roll subsystem600are provided inFIGS.18A,18B,18C,18D, and18E. Referring specifically toFIGS.18A and18B, the roll subsystem600includes a series of gears that allow the shaft604to rotate distally along a longitudinal axis474of the surgical instrument100. The shaft604can be directly connected to the end effector150, and therefore rolling of the shaft604enables the end effector150to roll a single articulation plane to any orthogonal position. The shaft604includes a shaft lumen606extending therethrough, and distal portions of a transection subsystem800extend through the shaft lumen606. The transection subsystem800is described in greater detail below.

The roll subsystem600includes a roll input puck602that is engageable with a corresponding rotatable robotic output. The roll input puck602can be rotationally engaged with a worm gear608extending therefrom, such that rotation of the roll input puck602turns the worm gear608either clockwise or counter-clockwise. Since the roll input puck602is positioned perpendicular to the length of the surgical instrument100, and therefore perpendicular to the shaft604, the roll subsystem600includes a worm follower610that is engaged with the worm gear608. The worm follower610can be coupled to the shaft604, allowing rotation of the shaft604. To keep the worm follower610positioned at the correct location relative to the worm gear608, the roll subsystem600includes a stabilization plate612that surrounds the shaft604distal to the worm follower610. The stabilization plate612can be positioned within a corresponding slot within the outer housing102to prevent the stabilization plate612from sliding axially along the shaft604, while also providing the shaft604lateral alignment within the housing102. The roll subsystem600can also include a roll bearing614and a roll bearing plate616, the roll bearing614being positioned between the stabilization plate612and the roll bearing plate616.

In some examples, the roll subsystem600includes a roll stop bushing618engaged with the rotatable shaft604. The roll stop bushing618can be coupled to the worm follower610and/or shaft604and provide feedback on positioning of the rotatable shaft604. For example, the roll stop bushing618includes a stop620positioned thereon that can contact a housing tab626positioned on the outer housing102. The roll subsystem600can roll the shaft604to a first position where the roll stop bushing618contacts the housing tab626at a first side, and then roll the shaft604to a second position where the roll stop bushing618contacts the housing tab626at a second, opposite side. The robotic output that actuates the roll subsystem600can use the hard stops at the housing tab626to determine a baseline, or 0°, rotation for the shaft604. This example can provide the shaft604greater than 300° of rotation, for example greater than 305°, greater than 310°, greater than 315°, greater than 320°, greater than 325°, greater than 330°, greater than 335°, greater than 340°, greater than 345°, greater than 350°, greater than 355° of rotation, or more.

In some examples, the roll subsystem600does not include a housing tab626and allows the roll subsystem600to continue to roll indefinitely. In this configuration, the control device1110, described in greater detail herein, can be programmed to determine a home position and can be configured to track and accurately determine the position of the roll subsystem600and/or the end effector150at any given point of rotation.

In some examples, the roll subsystem600can also include a follower bushing622(as shown inFIGS.18C,18D, and18E) having a follower bushing stop624extending therefrom. In this example, the follower bushing622can be positioned between the shaft604and the roll stop bushing618. The shaft604and follower bushing622can be directly coupled to each other, and the roll stop bushing618and the follower bushing622can rotate relative to each other. The roll subsystem600can roll the shaft604to a first position where the roll stop bushing618contacts the housing tab626, and the follower bushing622contacts the roll stop bushing618at a first side (seeFIG.18C). The roll subsystem600can then rotate the shaft604until the follower bushing622contacts the roll stop bushing618at the other side (seeFIG.18D), and then continue rotating by pushing the roll stop bushing618circumferentially until the roll stop bushing618contacts the housing tab626and the follower bushing622contacts the roll stop bushing618at a second, opposite side (seeFIG.18E). This example using the follower bushing622can provide a greater degree of rotation, for example greater than 360° of rotation, or in some instances about 320° of rotation in either direction (e.g., 640° in total). Referring briefly toFIG.10, which shows distal portions of the roll subsystem600, the view shows how the rod groove478of the shaft604can extend along the length of the shaft604. The first articulation rod406A can extend through the rod groove478of the shaft604, and rotation of the shaft604by the roll subsystem600can therefore rotate the articulation rod406A.

FIGS.19A and19Bshow alternative components of a roll subsystem600to the one shown inFIGS.18A-18E, according to aspects of the present disclosure.FIG.19Ais a perspective view of the components of the roll subsystem600. In the embodiment shown, the stabilization plate612shown inFIG.26has been replaced with a thicker thrust block712. The thrust block712is positioned near the proximal end of the shaft604so as to counteract axial forces on the shaft604caused by distal movement of the closure tube212(seeFIG.1). Providing a more robust thrust block712, including a thickness711greater than 1.0 cm, or greater than 1.5 cm, can provide better loading scenarios (to stop deflection) and can better share the load with the housing102. The thrust block712includes supports713that engage with a buttress178, such as the buttress178shown inFIG.19I. As shown inFIG.19I, the buttress178sits within the housing102and distributes loads applied to the buttress178from the thrust block712(as well as other components) to the housing102.FIG.19Ashows additional components that can be included in the alternative design, including a roll bearing714, which can be substantially similar to the roll bearing614in18A, and a roll bearing plate716, which can be substantially similar to the roll bearing plate616inFIG.18A(inFIG.19A, the bearing plate716is thicker than the roll bearing plate616to further add to the robustness and load sharing at this component).FIG.19Aalso shows a roll stop bushing718, which can be substantially similar to roll stop bushing618.FIG.19Bis a top, cross-sectional view of the components of the roll subsystem600. The roll subsystem600includes a first locking ring752and a second locking ring754. The locking rings752,754can be positioned such that they secure the worm follower610and the roll stop bushing718together. The stop730of the roll stop bushing718is also shown; the stop720can be substantially similar to the stop620described above.

Referring toFIG.19Cfor reference, as shown, the inside of the worm follower610may not be entirely round and, similarly, the outside surface of the shaft604may not be entirely round. Instead, the worm follower610and the shaft604can have corresponding anti-backlash features. It is desirable to reduce backlash in the gearing of a surgical instrument100to improve accuracy and to ensure proper calibration. For instance, a robot can home and/or calibrate roll by rolling the shaft604from one mechanical calibration position to another mechanical calibration position (seeFIGS.18C-18Efor a discussion of rotational constraints for the roll subsystem600). Therefore, backlash reduction can help to ensure accurate calibration. The implementations shown inFIGS.19C-19Fprovide examples of such anti-backlash features.

FIG.19Cis a detailed view of the worm follower610. Here, the inside area of the worm follower610(i.e., the portion engaged with the shaft604) includes one or more gear flats756. A gear flat756can be used to ensure that the worm follower610constrains the shaft604so that they rotate together. The one or more gear flats756are positioned to abut and/or contact one or more corresponding shaft flats758on the exterior surface of shaft604. In the example shown, the worm follower610comprises a first gear flat756A and a second gear flat756B, and the rotatable shaft604comprises (i) a first shaft flat758A positioned to correspond to the first gear flat756A and (ii) a second shaft flat758A positioned to correspond to the second gear flat756B. Having more than one flat can further limit backlash between the two components. In certain implementation, the first gear flat756A can coincide with the portion of the shaft604that houses the rod groove478(see, e.g.,FIG.10).

The one or more gear flats756may be milled, broached, or formed into the worm follower610and, as such, tight corners between the flat and curved section may not be possible or may not be desired, for instance because abrupt corners could be a location for stress fractures. Accordingly, the transitions between the one or more gear flats756and the curved section to provide gaps between the worm follower610and the shaft604at certain positions. Two such gaps are shown inFIG.19Cand are labeled as first gap761A and second gap761B. A first end of the first gear flat756A is rounded and inwardly turned so as to come to a singular point760. A first end of the second gear flat756B is rounded and inwardly turned so as to come to the singular point760. A portion of the worm follower610between the first gear flat756A and the singular point760is separated from the rotatable shaft604by the aforementioned first gap761A. A portion of the worm follower610between the second gear flat756B and the singular point760is separated from the rotatable shaft604by the second gap761B. The singular point760contacts the rotatable shaft604to provide the circumferential control of the shaft604within the worm follower610.

FIGS.19D-19Fshow additional or alternative anti-backlash features for the worm follower610and shaft604. InFIG.19D, the worm follower610includes a key762that engages with a keyway734in the shaft604. Alternatively, the shaft604could include the key and the worm follower610the keyway. In some examples, the key/keyway could be combined with one of the other anti-backlash features, such as first shaft flat758A and first gear flat756A, as shown. InFIG.19E, the example shown also includes a key762and a keyway734, but the keyway734extends entirely through the wall of the shaft604. InFIG.19F, the worm follower610has different wall thickness, as measured to the inside surface of the worm follower610that contacts the shaft604. The worm follower610has a first portion with a first wall thickness767A and a second portion with a second wall thickness767B, the first wall thickness767A being thicker than the second wall thickness767B. This change in the interior wall geometry thereby forms a gear step766. Similarly, the rotatable shaft604has a first portion with a first wall thickness769A and a second portion with a second wall thickness769B, the first wall thickness769A being thicker than the second wall thickness769B. This change in the interior wall geometry of the shaft604thereby forms a shaft step768. The gear step766is sized and positioned to engage with the shaft step768to reduce backlash as the worm gear608actuates the worm follower610. It is also contemplated that the worm follower610and shaft604are inseparably connected, such as with a weld or adhesive, though manufacturing a connected embodiment may take additional steps in manufacturing.

FIGS.19G and19Hshow example anti-backlash features for a worm gear608, according to aspects of the present disclosure. The disclosure above discussed reducing backlash at the connection between the shaft604and worm follower610, but another point of potential backlash in the roll subsystem600is where the roll input puck602and its respective input shaft605engages with the worm gear608.FIG.19Gshows the placement of the input puck602, input shaft605, and worm gear608, whereas the topFIG.19Hcross sectional view shows the example anti-backlash features. The input shaft605extends at least partially through the worm gear608. The input shaft605includes a flat section772positioned to correspond to a worm drive flat770of the worm gear608. This flat-on-flat feature is similar to the gear flats756and shaft flats758discussed with respect toFIG.19Cand helps to reduce backlash in the system.

The surgical instrument100includes a transection subsystem800. This subsystem can be referred to as a transection subsystem since actuation of the system results in a cutting of tissue via cutting mechanisms of the end effector150, mechanisms of which are described in more detail below. The transection subsystem800includes a series of gears proximally that allow the system to fire a firing rack816distally. Because the surgical instrument100includes a roll feature, e.g., via the roll subsystem600, the proximal portion of the transection subsystem800(e.g., with the gearing and firing rack816, seeFIG.20) is not rotatable, but the distal end (e.g., firing rod820, bands826, etc., seeFIG.21) can rotate along with the roll of the shaft604.

Referring specifically now toFIG.20, the transection subsystem800includes a transection input puck802that is engageable with a corresponding rotatable robotic output. The transection input puck802can be rotationally engaged with a transection drive shaft804extending therefrom, such that rotation of the transection input puck802turns the transection drive shaft804. Rotation of the transection drive shaft804causes, either directly or indirectly via gearing, distal or proximal translation of the firing rack816, which results in firing of the staples126and/or knife166in the end effector.

Since the distal translation of the firing rack816is used to translate a distal knife166, a higher degree of force is desired for the distal translation. The force needed to push the knife166forward can be great, as it can include the accumulation of forces required to cut tissue, drive staples, and interact with any friction. As such, the present disclosure provides a series of gearing to increase the transection, or cutting, force by providing a mechanical advantage past the transection input puck802. The transection subsystem800includes a transection spur gear806that is coupled to the transection drive shaft804such that rotation of the transection drive shaft804also turns the transection spur gear806. The transection subsystem800includes a transection ramp gear808that is rotatably engaged with the transection spur gear806, meaning that rotation of the transection spur gear806in a first direction causes a corresponding rotation of the transection ramp gear808in the opposite direction. The transection ramp gear808can have a larger diameter than the transection spur gear806. A ramp gear shaft810can be coupled to and extend from the transection ramp gear808, such that the ramp gear shaft810rotates with the rotation of the transection ramp gear808. A transection ramp spur gear811can be coupled to the ramp gear shaft810such that the transection ramp spur gear811can be caused to rotate when the ramp gear shaft810rotates.

The transection subsystem800includes a speed gear812that is rotatably engaged with the transection ramp spur gear811, meaning that rotation of the ramp gear shaft810in a first direction causes a corresponding rotation of the speed gear812in the opposite direction. The speed gear812can have a larger diameter than the ramp gear shaft810and the transection ramp gear808. The transection spur gear806, the transection ramp gear808, the transection ramp spur gear811, and speed gear812can each be spur gears.

The transection subsystem800includes a firing gear814that is rotationally dependent on the gearing, for example rotation of the firing gear814is ultimately dependent on rotation of the transection input puck802. In the examples with a speed gear812, the firing gear814can be rotatable with rotation of the speed gear812. The firing gear814is engaged with teeth818of the firing rack816, such that rotation of the firing gear814causes a distal translation of the firing rack816. As will be appreciated, the differences in gear sizes of the transection subsystem800can increase the linear velocity of the firing rack816.

As described above, the firing rack816can be rotationally stable within the outer housing102, but because the more distal end of the transection subsystem800must rotate with the roll features of the roll subsystem600, the distal portion of the transection subsystem800can rotate independent of the firing rack816. The transection subsystem800includes a firing rod820rotatably coupled to the distal end of the firing rack816, such that the firing rod820can rotate independent of the firing rack816. The rotatable connector between the firing rod820and the firing rack816includes a T-shaped tab822on the proximal end of the firing rod820that engages with a slot824on the firing rack816. The tab/slot connection allows free rotation of the firing rod820but also constrains the firing rod820to the firing rack816axially. An example of this connection between the firing rod820and the firing rack816is shown inFIGS.20and21. It will be understood that the T-shaped tab could alternatively be on the firing rack816and the slot could be on the firing rod820.

Referring toFIGS.22A,22B,22C, and23, which provide detailed views of certain distal components of the transection subsystem800, the distal end of the firing rod820can be coupled to a series of bands826that extend distally toward the end effector150. These bands provide a degree of flexibility to the firing mechanism, while also providing axial stiffness to push the knife166through tissue. The surgical instrument100includes a cover832that protects the bands826.FIG.22Cfurther shows the bands826distally. The surgical instrument100includes knife guide158(or knife guide469) that allows the end effector150to articulate as described herein. The bands826can pass through the knife guide158, and the knife guide158provides lateral support to guide the laminates through any articulation angle. The bands826can also pass through the band slot484of the attachment end468of the distal channel retainer408.

Referring toFIGS.22A,22B, and22C, the transection subsystem800can have a final firing length that can correspond to a length of a staple cartridge120within the end effector150. For example, if a staple cartridge120provides 35 mm of cutting/stapling, then the transection subsystem800can be configured to translate the firing rack816amaximum of 35 mm, as shown inFIG.22C. It will be understood that certain degrees of tolerance can be built in depending on how long the staple cartridge120is to deliver 35 mm of staples.

The end effector150can include an anvil152. The channel156can accept a staple cartridge120within a cartridge slot162therein. The staple cartridge120can include a plurality of staples126. A sled122can be driven distally (as shown inFIG.22C) through the cartridge120to drive the staples126into the anvil152. The sled122can be pushed distally via the knife166at the end of the bands826. The knife166can, therefore, act both as a firing member to push the sled122distally and as a transection member to cut tissue. The knife166can be retained at a closed non-fired position by a leaf spring168(as shown inFIG.23). The leaf spring168can bias knife166into a lockout position if no sled122is present and, as the knife166travels distally forward, the leaf spring168will stop the knife166from moving forward. The anvil152can include an anvil ramp154proximally. The closure subsystem200can close the anvil152by moving the closure ring226distally and over the anvil ramp154, thereby hinging the anvil152closed.

FIG.20also shows two hard stop features of the firing rack816. More distally is a distal hard stop819, and more proximally is a proximal hard stop821. These hard stops819,821exist where the teeth818of the firing rack816end, thereby providing a mechanical backup to stop the firing rack816from either over firing (i.e., the proximal hard stop821prevents the firing rack816from over-extending) or from over retracting (i.e., the distal hard stop819prevents the firing rack816from over-retracting).

In some examples, the end effector150can have a safety mechanism in place to prevent attempts to fire a spent cartridge, or prevent firing the knife166when there is no sled122present. For example, the knife166can be biased toward the channel156, and the knife166requires a sled122to be present for the knife166to travel distally. As shown inFIG.23, if no sled122is present (indicating that the cartridge120is spent or there is no cartridge120), the knife166will bend toward the channel156, and then a lockout feature170on the knife166can contact a lockout wall124on the channel156to stop distal movement of the knife166.

To help prevent the end effector150from moving while the transection subsystem800fires the knife166, the surgical instrument100can be configured to cause the first articulation input puck and the second articulation input puck404to rotate and apply opposing forces on each other. In this way, the articulation subsystem400can effectively be locked to prevent distal movement of the knife166and knife bands826from causing the articulation system400to move while the transection subsystem800is firing. This can be accomplished by a control device1110(described further herein) causing the first articulation input puck and the second articulation input puck404to rotate in directions to cause opposing forces on each other. For example, if the articulation subsystem400includes two racks414,418, the method1200can include turning the first articulation input puck402and the second articulation input puck404in opposite directions. On the other hand, if the articulation subsystem400includes a single rack414C, the method1200can include turning the first articulation input puck402and the second articulation input puck404in the same direction. In this way, the articulation subsystem400can be preventing from causing the end effector150from moving side to side.

As shown inFIGS.24A,24B, and24C, the transection subsystem800includes a key receiver830A that can be rotationally coupled to the gearing of the transection subsystem800to manually retract the firing rack816and thus knife166. The key receiver830A can be rotationally coupled to the transection ramp gear808or the speed gear812, whereas rotationally coupling the key receiver830A to the transection ramp gear808provides a higher degree of gearing ratio such that rotation of the key receiver830A moves the firing rack816proximally more quickly. This mechanical, manual retract can help in the scenario where the distal knife166has become stuck or otherwise unable to retract, and the robot is unable to turn the transection input puck802sufficiently to retract the knife166.

In some examples, the outer housing102of the surgical instrument100can have a compartment834that is closed by a cover832(shown inFIG.2B) that provides access to the manual knife return key836A. The top of the key receiver830can have a pattern (unidirectional ramps shown inFIG.24E) that matches a unidirectional pattern on the manual knife return key836A so that the firing rack816can only be retracted using this manual override, and not advanced. In some examples, the firing rack816can extend proximally from the outer housing102and can be covered by a tail cover114. For example, the key receiver830A can include ramps that allow unidirectional application or torque from the manual knife return key836A. The tail cover114can be made from a transparent material so that surgical staff can view the position of the firing rack816.

As shown inFIG.24D, the manual knife return key836A can include one or more locking tabs839configured to attach the manual knife return key836A to the key receiver830A. For example, as shown inFIG.24E, the key receiver830A can include a ledge833about which the locking tab839can extend to prevent the manual knife return key836from detaching from the key receiver830A when attached. The locking tabs839can be positioned such that the manual knife return key836A can move upwardly away from the key receiver830A if the manual knife return key836A is turned in the wrong direction but still be prevented from detaching from the key receiver830A.

Several different examples of manual knife return configurations will now be described in relationFIGS.25A-25Q.FIGS.25A and25Bare cross-sectional views of alternate manual knife return key836B and a key receiver830B. The manual knife return key836B in this example comprises exterior threads840that align with threads of the second portion112of the housing102. The manual knife return key836B can be threaded into the second portion112of the housing102and aligned with the key receiver830B to manually retract the knife166. The example shown inFIGS.25A and25Bcan include a gasket842that can bias the manual knife return key836B outwardly such that the threads840of the manual knife return key836B will engage the second portion112of the housing102to cause the manual knife return key836B to remove from the housing102if the manual knife return key836B is turned in the wrong direction. As will be appreciated, the threads840can help to retain the manual knife return key836B in the housing102so that it won't be dropped or otherwise dislodged.

FIGS.25C,25D, and25Eillustrate a tether844that can be used with a manual knife return key836to help secure the manual knife return key836to the surgical device100. The tether844can be attached around the manual knife return key836but allow for the manual knife return key836to turn freely. The tether844can be attached at the opposite end to the second portion112of the housing102. In this way, the manual knife return key836can be prevented from being dropped or dislodged. As will be appreciated, dropping the manual knife return key836can lead to the manual knife return key836becoming unsterile and requiring either a replacement manual knife return key836or cleaning of the manual knife return key836.

FIGS.25F and25Gillustrate alternate examples of the manual knife return key836C and the key receiver830C. The manual knife return key836C can include an internal cam850and the key receiver830C can include a spline852that can correspond to the internal cam850. In this example, the manual knife return key836C can be threaded onto the key receiver830C only in one direction to help prevent causing the knife166to extend distally (i.e., you only want the knife166to be retracted proximally when using the manual knife return key836).

FIGS.25H-25Jillustrate a similar manual knife return key836D to the manual knife return key836C and a similar key receiver830D to the key receiver830C. The manual knife return key836D, however, can include a rounded internal cam860and the key receiver830D can include a rounded spline862. The rounded internal cam860can similarly engage the rounded spline862only in one direction to help ensure the manual knife return key836D is rotated only in the direction of retracting the knife166.

FIG.25Killustrates yet another manual knife return key836E and key receiver830E. The manual knife return key836E can include internal threads870and the key receiver830E can include external threads872that correspond to the internal threads870. As before, the internal threads870are threaded in the direction of causing the knife166to retract. Thus, if a user were to turn the manual knife return key836E in the wrong direction (i.e., cause the knife166to move distally), the internal threads870and the external threads872will cause the manual knife return key836E to disengage from the key receiver830E.

FIG.25Lillustrates the manual knife return key836B with the key receiver830, but also includes a spring880A that can permit the key receiver830B to disengage from the manual knife return key836B when the manual knife return key836is turned in the wrong direction. In this way, the key receiver830B must be turned by the manual knife return key836B in the correct direction to cause the knife166to retract. As shown inFIG.25L, the manual knife return key836B can be configured to contact the second portion112of the housing102to prevent a user from inserting the manual knife return key836B into the key receiver830B with sufficient force to overcome the ramps to cause the knife166to move distally. In other words, by including a spring880A, a user can only turn the key receiver830B in the correct direction (to cause the knife166to retract).

FIG.25Millustrates another example of a key receiver830F. The key receiver830F can be similar to the key receiver830B and spring880A combination shown inFIG.25Lexcept the key receiver830F includes an integrated spring880B. The integrated spring880B can perform the same function as the spring880A described in relation toFIG.25L. That is the integrated spring880B permits the key receiver830F to disengage from the manual knife return key836B when turned in the wrong direction.

FIG.25Nillustrates another example manual knife return key836G having an internal cam890design and the key receiver830G can include a protrusion892that can extend into the internal cam890. The manual knife return key836G and key receiver830G can be used similar to the manual knife return keys836C and836D previously described in that the manual knife return key836G can only turn the key receiver830G in one direction (i.e., the direction of retracting the knife166).

FIGS.250,25P, and25Qillustrate yet another example of a key receiver830H and a manual knife return key836H. The key receive830H in this example can include supported walls894and cantilevered walls896. The cantilevered walls896can be configured to bend out of the path of a key knobs898of the manual knife return key836H when turned in the wrong direction (as shown inFIG.25Q) but engage with the key knobs898when the manual knife return key836H is turned in the correct direction (as shown inFIG.25P). That is, the cantilevered walls896enable the key receiver830H to only turn in the direction of the knife166retraction. If the user tried to turn the manual knife return key836H in the wrong direction (i.e., causing the knife166to move distally), the cantilevered walls896will disengage from the manual knife return key836H and the user cannot cause the knife166to move distally.

Any of the closure subsystems200, articulation subsystems400, roll subsystems600, or transection subsystems800described herein can be, respectively, substituted by or combined with any of the closure subsystems200, articulation subsystems400, roll subsystems600, or transection subsystems800described in U.S. Provisional Application No. 63/514,972 (Docket No. END9567USPSP1) or those described in U.S. Provisional Application No. 63/634,201 (END9567USPSP2), both of which are incorporated herein by reference in their entireties. Any of the end effectors150described herein can be substituted by or combined with any of the end effectors150described in U.S. Provisional Application No. 63/514,972 (Docket No. END9567USPSP1) or those described in U.S. Provisional Application No. 63/634,201 (END9567USPSP2), both of which are incorporated herein by reference in their entireties.

CLAUSES

Examples of the present disclosure can be implemented by any of the following numbered clauses:

Clause 1: A transection subsystem (800) for a surgical instrument (100) comprising: a rotatable shaft (604) having a lumen (606); a firing rod (820) extending at least partially through the lumen (606); a firing rack (816) coupled to a proximal end of the firing rod (820), the firing rod (820) being rotationally independent of the firing rack (816); and a firing gear (814) engaged with the firing rack (816), wherein rotation of the firing gear (814) moves the firing rack (816) and the firing rod (820) axially.

Clause 2: The transection subsystem (800) according to Clause 2 further comprising a transection input puck (802) engageable with a first transection robotic output, wherein rotation of the firing gear (814) is dependent on rotation of the transection input puck (802).

Clause 3: The transection subsystem (800) according to Clause 2 further comprising: a transection drive shaft (804) coupled to the transection input puck (802); a transection spur gear (806) coupled to the transection drive shaft (804); a transection ramp gear (808) engaged with the transection spur gear (806); a ramp gear shaft (810) coupled to the transection ramp gear (808) and a ramp spur gear (811); and a speed gear (812) engaged with the ramp spur gear (811).

Clause 4: The transection subsystem (800) according to Clause 3, wherein the speed gear (812) is coupled to the firing gear (814).

Clause 5: The transection subsystem (800) according to claim4, wherein a diameter of the speed gear (812) is greater than a diameter of the firing gear (814).

Clause 6: The transection subsystem (800) according to any one of Clauses 1 to 6, wherein: the firing rack (816) defines a slot (824); the firing rod (820) comprises a T-shaped tab (822); and the T-shaped tab (822) is engaged with the slot (824) to enable rotation of the firing rod (820) with respect to the firing rack (816) while maintaining a longitudinal connection.

Clause 7: The transection subsystem of any one of Clauses 1 to 6 further comprising: a key receiver (830) in mechanical communication with the firing gear (814); and a key (836) configured to engage with the key receiver (830), wherein rotating the key (836) when engaged with the key receiver (830) causes the key receiver (830) and the firing gear (814) to rotate, thereby moving the firing rod (820) axially.

Clause 8: The transection subsystem of Clause 7, the key receiver (830) comprising one or more unidirectional ramps (831); and the key (836) comprising one or more corresponding unidirectional ramps configured to engage with the unidirectional ramps in a first direction and to slide along the unidirectional ramps in a second direction.

Clause 9: The transection subsystem of Clause 8, further comprising a spring (880) configured to permit the key receiver830to move away from the key (836) when the key (836) is rotated in the second direction.

Clause 10: The transection subsystem of any one of Clauses 7-9, the key (836) comprising one or more locking tabs (839) configured to attach the key (836) to the key receiver (830).

Clause 11: The transection subsystem of Clause 7, the key comprising threads (840) configured to engage with a housing (102) of the surgical instrument (100).

Clause 12: The transection subsystem of Clause 11, wherein, when the key (836) is turned in a first direction, the threads (840) cause the key (836) to move toward the key receiver (830) and, when the key (836) is turned in a second direction, the threads (840) cause the key (836) to move away from the key receiver (830).

Clause 13: The transection subsystem of any of Clauses 7-12 further comprising a tether (844) attached to the key (836) and a housing102of the medical device (100).

Clause 14: The transection subsystem of Clause 7, wherein the key (836) comprises a cam surface (850) and the key receiver (830) comprises a spline (852) configured to engage with the cam surface.

Clause 15: The transection subsystem of Clause 7, wherein the key (836) comprises a cam surface (850) and the key receiver (830) comprises a protrusion (892) configured to engage with the cam surface.

Clause 16: A transection subsystem (800) for a surgical instrument (100) comprising: a firing rod (820); a firing rack (816) coupled to a proximal end of the firing rod (820), the firing rod (820) being rotationally independent of the firing rack (816); a firing gear (814) engaged with the firing rack (816); a key receiver (830) in mechanical communication with the firing gear (814); and a key (836) configured to engage with the key receiver (830), wherein rotating the key (836) when engaged with the key receiver (830) causes the key receiver (830) and the firing gear (814) to rotate, thereby moving the firing rod (820) axially.

Clause 17: The transection subsystem of claim16, the key receiver (830) comprising one or more unidirectional ramps (831); and the key (836) comprising one or more corresponding unidirectional ramps configured to engage with the unidirectional ramps in a first direction and to slide along the unidirectional ramps in a second direction.

Clause 18: The transection subsystem of claim16, the key (836) comprising one or more locking tabs (839) configured to attach the key (836) to the key receiver (830).

Clause 19: The transection subsystem of claim16, the key comprising threads (840) configured to engage with a housing (102) of the surgical instrument (100).

Clause 20: The transection subsystem of claim19, wherein, when the key (836) is turned in a first direction, the threads (840) cause the key (836) to move toward the key receiver (830) and, when the key (836) is turned in a second direction, the threads (840) cause the key (836) to move away from the key receiver (830).

The invention is not necessarily limited to the examples described, which can be varied in construction and detail. The terms “distal” and “proximal” are used throughout the preceding description and are meant to refer to a positions and directions relative to a treating physician. As such, “distal” or distally” refer to a position distant to or a direction away from the physician. Similarly, “proximal” or “proximally” refer to a position near or a direction towards the physician. Furthermore, the singular forms “a,” “an,” and “the” include plural referents unless the context clearly dictates otherwise. Furthermore, the use of “couple”, “coupled”, or similar phrases should not be construed as being limited to a certain number of components or a particular order of components unless the context clearly dictates otherwise.

In describing example embodiments, terminology has been resorted to for the sake of clarity. As a result, not all possible combinations have been listed, and such variants are often apparent to those of skill in the art and are intended to be within the scope of the claims which follow. It is intended that each term contemplates its broadest meaning as understood by those skilled in the art and includes all technical equivalents that operate in a similar manner to accomplish a similar purpose without departing from the scope and spirit of the invention. It is also to be understood that the mention of one or more steps of a method does not preclude the presence of additional method steps or intervening method steps between those steps expressly identified. Similarly, some steps of a method can be performed in a different order than those described herein without departing from the scope of the disclosed technology.