Surgical instruments for robotic-assisted surgery and methods of using the same

A surgical system and device for use with a computerized surgical manipulation system, wherein the computerized surgical manipulation system includes a robotic arm and a support coupled to the robotic arm for receiving various instruments, comprising a surgical device, wherein the surgical device includes an elongated shaft; and a control housing coupled to the elongated shaft, wherein the control housing is configured to attach to a motor housing having a notch, wherein the motor housing is coupled to the support; and a trocar pivotally coupled to the support such that the trocar can pivot away from axial alignment with the support, wherein the elongated shaft extends into the pivoted trocar, wherein the trocar containing the surgical device is pivoted into axial alignment with the support such that the notch receives the elongated shaft of the surgical device, and wherein the control housing engages the motor housing.

BACKGROUND

The disclosed technology relates in general to robotic-assisted surgical technology and more specifically to end effectors and stapling devices and methods of using those devices in robotic-assisted surgical procedures.

Robotic surgery, also called robot-assisted surgery, allows doctors to perform many types of complex procedures with more precision, flexibility, and control than is possible with conventional techniques. Robotic surgery is usually associated with minimally invasive surgery, i.e., procedures performed through small incisions. It is also sometimes used in certain traditional open surgical procedures.

Example clinical robotic surgical system can include a camera arm and mechanical arms with supports for attaching surgical instruments. The doctors control the arms while seated at a computer console near the operating table. The console gives the doctors a high-definition, magnified, 3D view of the surgical site.

Minimally invasive surgical devices in the prior art are generally long (e.g., 35 mm to 60 mm) and thin (e.g., 5 mm to 15 mm diameter). Because the spatial environment in minimally invasive surgery is limited, conventional surgical devices may be too long or thin for use with certain robotic surgical systems. Further, these conventional surgical devices can present mechanical issues because of their long and thin design. B-shaped staple formation typically requires a pressure between 5-25 g/mm2, with a target pressure of 15 g/mm2. Thus, such conventional surgical stapling devices used with robotic surgical systems often form small, less rigid staples under smaller pressures because of their long and thin design. Accordingly, there is an ongoing need for a surgical device and system that is adapted for use with existing computerized surgical manipulation systems such that the surgical device maintains its mechanical function.

SUMMARY

The following provides a summary of certain example implementations of the disclosed technology. This summary is not an extensive overview and is not intended to identify key or critical aspects or elements of the disclosed technology or to delineate its scope. However, it is to be understood that the use of indefinite articles in the language used to describe and claim the disclosed technology is not intended in any way to limit the described technology. Rather the use of “a” or “an” should be interpreted to mean “at least one” or “one or more”.

One implementation of the disclosed technology provides a surgical system for use with a computerized surgical manipulation system, wherein the computerized surgical manipulation system includes a robotic arm and a support coupled to the robotic arm for receiving various instruments, comprising a surgical device, wherein the surgical device includes an elongated shaft having a proximal end and a distal end; and a control housing coupled to the proximal end of the elongated shaft, wherein the control housing is configured to attach to a motor housing having a notch formed therein, wherein the motor housing is coupled to the support; and a trocar pivotally coupled to the support such that the trocar can pivot away from axial alignment with the support, wherein the distal end of the elongated shaft extends into the pivoted trocar, wherein the trocar containing the surgical device is pivoted into axial alignment with the support such that the notch receives the elongated shaft of the surgical device, and wherein the control housing engages the motor housing.

The surgical device may further include an end effector coupled to the distal end of the elongated shaft, wherein the end effector includes a clamping mechanism having an anvil and a cartridge for containing surgical staples. The system may further comprise a closure mechanism for opening and closing the anvil on the clamping mechanism, wherein the closure mechanism is housed within the elongated shaft of the surgical device; and a firing mechanism for activating the cartridge, wherein the firing mechanism includes a laminate beam having a proximate end and a distal end, wherein a blade is coupled to the distal end of the laminate beam, and wherein the proximate end of the laminate beam is located in diversion channels within the elongated shaft of the surgical device; and a nut affixed to a rotating member, wherein the nut is coupled to the proximate end of the laminate beam wherein the firing system moves the nut from the distal end of the surgical device towards the proximal end of the surgical device, and wherein the laminate beam delaminates as it moves through the diversional channels. The trocar may include a holding feature having an inner wall and an outer wall. The holding feature of the trocar is pivotally coupled to the support through a gripping member, wherein an angled gap is formed between the gripping member and the inner wall when the trocar is axially aligned with the support, and wherein a second angled gap is formed between the gripping member and the outer wall when the trocar is pivoted away from axial alignment with the support. The elongated shaft has a diameter portion and a reduced diameter portion, wherein the reduced diameter portion engages the notch on the motor housing. The control housing has a control interface, wherein the motor housing has a motor interface, and wherein the control interface selectively attaches to the motor interface to join the control housing and the motor housing. The control interface and the motor interface each include a plurality of platters that are associated with specific mechanical features of the surgical device, wherein the platters on the control interface are configured to mate with the platters on the motor interface. The system may further comprise a bailout mechanism configured to the control housing for manually controlling mechanical operations of the surgical device.

Another implementation of the disclosed technology provides a surgical system for use with a computerized surgical manipulation system, wherein the computerized surgical manipulation system includes a robotic arm and a support coupled to the robotic arm for receiving various instruments, comprising a surgical device, wherein the surgical device includes an elongated shaft having a proximal end and a distal end; and a control housing coupled to the proximal end of the elongated shaft, wherein the control housing is configured to attach to a motor housing having a notch formed therein, wherein the motor housing is coupled to the support; and a trocar having a holding feature, wherein the holding feature has an inner wall and an outer wall, wherein the holding feature is pivotally coupled to the support such that the trocar can pivot away from axial alignment with the support, wherein the distal end of the elongated shaft extends into the pivoted trocar, wherein the trocar containing the surgical device is pivoted into axial alignment with the support such that the notch receives the elongated shaft of the surgical device, and wherein the control housing engages the motor housing.

The surgical device may further include an end effector coupled to the distal end of the elongated shaft, wherein the end effector includes a clamping mechanism having an anvil and a cartridge for containing surgical staples. The system may further comprise a closure mechanism for opening and closing the anvil on the clamping mechanism, wherein the closure mechanism is housed within the elongated shaft of the surgical device; and a firing mechanism for activating the cartridge, wherein the firing mechanism includes a laminate beam having a proximate end and a distal end, wherein a blade is coupled to the distal end of the laminate beam, and wherein the proximate end of the laminate beam is located in diversion channels within the elongated shaft of the surgical device; and a nut affixed to a rotating member, wherein the nut is coupled to the proximate end of the laminate beam, wherein the firing system moves the nut from the distal end of the surgical device towards the proximal end of the surgical device, and wherein the laminate beam delaminates as it moves through the diversional channels. The holding feature of the trocar is pivotally coupled to the support through a gripping member, wherein an angled gap is formed between the gripping member and the inner wall when the trocar is axially aligned with the support, and wherein a second angled gap is formed between the gripping member and the outer wall when the trocar is pivoted away from axial alignment with the support. The elongated shaft has a diameter portion and a reduced diameter portion, wherein the reduced diameter portion engages the notch on the motor housing. The control housing has a control interface, wherein the motor housing has a motor interface, and wherein the control interface selectively attaches to the motor interface to join the control housing and the motor housing. The control interface and the motor interface each include a plurality of platters that are associated with specific mechanical features of the surgical device, wherein the platters on the control interface are configured to mate with the platters on the motor interface. The system may further comprise a bailout mechanism configured to the control housing for manually controlling mechanical operations of the surgical device.

Still another implementation of the disclosed technology provides a surgical device adapted for use with a computerized surgical manipulation system, wherein the computerized surgical manipulation system includes a robotic arm, a support coupled to the robotic arm for receiving various instruments, and a motor housing coupled to the support, comprising an elongated shaft having a proximal end and a distal end a control housing coupled to the proximal end of the elongated shaft, wherein the control housing is configured to attach to the motor housing; an end effector coupled to the distal end of the elongated shaft, wherein the end effector includes a clamping mechanism having an anvil and a cartridge for containing surgical staples; and a trocar pivotally coupled to the support such that the trocar can pivot away from axial alignment with the support, wherein the distal end of the elongated shaft extends into the pivoted trocar, wherein the trocar is pivoted into axial alignment with the support, and wherein the control housing engages the motor housing.

The trocar includes a holding feature having an inner wall and an outer wall, wherein the holding feature of the trocar is pivotally coupled to the support through a gripping member, wherein an angled gap is formed between the gripping member and the inner wall when the trocar is axially aligned with the support, and wherein a second angled gap is formed between the gripping member and the outer wall when the trocar is pivoted away from axial alignment with the support. The control housing has a control interface with a plurality of platters, wherein the motor housing has a motor interface with a plurality of platters, and wherein the plurality of platters on the control interface selectively attaches to the plurality of platters on the motor interface to join the control housing and the motor housing.

It should be appreciated that all combinations of the foregoing concepts and additional concepts discussed in greater detail below (provided such concepts are not mutually inconsistent) are contemplated as being part of the technology disclosed herein and may be implemented to achieve the benefits as described herein. Additional features and aspects of the disclosed system, devices, and methods will become apparent to those of ordinary skill in the art upon reading and understanding the following detailed description of the example implementations. As will be appreciated by the skilled artisan, further implementations are possible without departing from the scope and spirit of what is disclosed herein. Accordingly, the descriptions provided herein are to be regarded as illustrative and not restrictive in nature.

DETAILED DESCRIPTION

Example implementations are now described with reference to the Figures. Reference numerals are used throughout the detailed description to refer to the various elements and structures. Although the following detailed description contains many specifics for the purposes of illustration, a person of ordinary skill in the art will appreciate that many variations and alterations to the following details are within the scope of the disclosed technology. Accordingly, the following implementations are set forth without any loss of generality to, and without imposing limitations upon, the claimed subject matter.

The examples discussed herein are examples only and are provided to assist in the explanation of the apparatuses, devices, systems, and methods described herein. None of the features or components shown in the drawings or discussed below should be taken as required for any specific implementation of any of these the apparatuses, devices, systems or methods unless specifically designated as such. For ease of reading and clarity, certain components, modules, or methods may be described solely in connection with a specific Figure. Any failure to specifically describe a combination or sub-combination of components should not be understood as an indication that any combination or sub-combination is not possible. Also, for any methods described, regardless of whether the method is described in conjunction with a flow diagram, it should be understood that unless otherwise specified or required by context, any explicit or implicit ordering of steps performed in the execution of a method does not imply that those steps must be performed in the order presented but instead may be performed in a different order or in parallel.

U.S. Pat. No. 9,936,953 is relevant to the disclosed technology and is expressly incorporated by reference herein in its entirety and is made part of this patent application for all purposes. This reference discloses an end effector for use by a surgeon to staple an anatomical structure of a patient during minimally invasive procedures. The end effector comprises: (a) an anvil that includes a first end, a second end, and a face that is positionable on the first side of the anatomical structure; (b) a cartridge that is configured to house a plurality of staples and that includes a first end, a second end, and a face that is positionable on the second side of the anatomical structure; and (c) a flexible member that movably couples the first end of the anvil to the first end of the cartridge, wherein the anvil and the cartridge slidably receive the flexible member; wherein the second end of the anvil is movably coupled to the second end of the cartridge, each of the anvil and the cartridge is insertable through a trocar and the end effector is remotely operable from outside the patient with at least a portion of one of the anvil and the cartridge being movable toward the other to clamp the end effector to the anatomical structure.

Surgical instruments in accordance with the example implementations herein can be used in conjunction with a computerized surgical manipulation system, or also referred to as a robotic surgical system. In some example implementations, the computerized surgical manipulation system can include a surgeon's console, a patient cart, and a vision cart, wherein the vision cart can include a camera system and a plurality of robotic arms with supports that can each selectively receive various surgical instruments. The arms of some robotic surgical system have a series of joints to allow for a full range of movement of the arms during surgery. Example camera systems can include, for example, a dual lens optical system representing the left and right eyes. The spatial separation of these images can be projected to the surgeon's eyes in the binocular viewer to allow for true 3-D image perception at the console. Various instruments, such as the surgical instruments in accordance with the present disclosure, can be coupled to the various arms and are easily and rapidly changeable by the assistant surgeon or a trained scrub nurse at the patient side.

As described herein, surgical instruments and devices usable with computerized surgical manipulation systems can include a control housing, a drive system, and an end effector including a clamping mechanism. In one or more example implementation, the surgical instrument and device is a surgical stapling devices, wherein the clamping mechanism includes a cartridge and an anvil. During operation, via interaction with the surgical stapling devices via a surgical console, a surgeon can clamp the anvil and the cartridge on an organ or other tissue to compress the organ therebetween. Once the organ has been compressed, the surgeon can use the stapler to drive or fire staples through the organ. In one example implementation, a plurality of B-shaped staples can be formed. In another example implementation, the stapling device can be fired multiple times using multiple cartridges, or in an alternate implementation a single cartridge can be used with a single firing to complete resection of an organ. It may be advantageous to reduce the number of firings and cartridges required as the expense of a procedure can increase with the use of cartridges and with a longer procedure that can be associated with multiple stapler firings. It may also be advantageous to provide for single cartridge stapling and/or resection of an organ to reduce the time a patient is in surgery, which can improve clinical outcomes. For example, resecting a portion of the stomach in accordance with a sleeve gastrectomy procedure using a single cartridge and stapler firing may improve patient outcomes and reduce complications that can be associated with such procedures.

The integrity of a staple line can depend, in part, on the proper formation of the B-shaped staples, when such a staple configuration is desirable. Providing a single cartridge and single firing stapling device may improve the quality of staple formation over a device or system using multiple cartridges to complete the same procedure. For example, when using an end effector multiple times to staple and resect tissue, the previously deployed staples may be contacted by the new staples and/or cutting knife in subsequent applications. Providing a single cartridge and staple firing may help insure that the staple line, and the shape of the staples, is consistent.

A single cartridge and single firing stapling device may also provide compression benefits relative to a device and system requiring the use of multiple cartridges. It may be advantageous to provide a single firing stapling device that provide for desirable compression along the length of the tissue to be resected while also providing for a single staple line with properly formed staples. A B-shaped staple is the standard of care for gastrointestinal, vascular, pulmonary, and hepatic applications of surgical tissue fastening devices. Alignment in each of the X, Y, and Z axes of the clamping mechanism with itself (e.g., alignment of the anvil with the cartridge) on each side of the organ may improve staple delivery and formation. It will be appreciated that any suitable structure or mechanism may be incorporated into the stapling devices described herein to provide for such alignment.

Example implementations of the disclosed technology can be used, for example, in a sleeve gastrectomy procedure or resection of the stomach utilizing a computerized surgical manipulation system. It will be appreciated, however, that the devices and systems may be used in other procedures involving other anatomical structures. For example, the devices and systems may be used in a parenchymal resection, lung volume reduction surgery, or other procedures involving the lung. Further, example implementations of the disclosed technology may be useful in an anatomic resection, such as, a lobectomy, a non-anatomic parenchymal resection, or other procedures involving the liver, or in a partial nephrectomy, total nephrectomy, or other procedures involving the kidney.

FIG.1depicts the anatomy of stomach10and example resection line12for a vertical sleeve gastrectomy. Stomach10generally includes inferior end14, superior end16, anterior side18, and posterior side20. Gastroesophageal junction22opens into stomach10and is a common landmark in bariatric surgeries. Fundus24and the section of stomach10defined by greater curvature26are generally the parts of stomach10removed during a vertical sleeve gastrectomy. The remaining pouch or sleeve may be generally defined by lesser curvature28and resection line12, which presents a stomach with a significantly reduced volume. The desired location of resection line12may be about 0.5 cm to about 2 cm away from gastroesophageal junction22and about 2 cm to about 10 cm away from pylorus30. In accordance with implementations, computerized surgical manipulation systems800utilizing surgical stapling devices100described herein (shown inFIG.5) may be utilized to form high quality, consistent resection lines during a vertical sleeve gastrectomy. Implementations of the devices may be advantageous because they may be easily positionable laparoscopically using robotic-assisted surgical techniques, can accommodate different thicknesses of tissue along the resection line length, can be capable of providing uniform compressive pressure on the tissue along the resection line, and can enable a low staple firing force.

With reference toFIGS.2-3, surgical stapling device100includes elongated shaft110having distal end120and proximal end130, end effector200positioned at distal end120of elongated shaft110, and control housing300positioned at proximal end130of elongated shaft110, wherein control housing300includes prongs360and gear assembly370. In some implementations, control housing300further includes control interface310having first, second, and third rotatable platters320,330,340, wherein each rotatable platter320,330,340includes recesses350(shown inFIG.20). In one example implementation, end effector200includes clamping mechanism210having anvil220and cartridge230for holding a plurality of surgical staples. In one example implementation, elongated shaft110includes diameter portion140and reduced diameter portion150, wherein the diameter of diameter portion140is greater than the diameter of reduced diameter portion150, and wherein reduced diameter portion150of elongated shaft110is coupled to gear assembly370within control housing300.

With reference toFIGS.4-6, example surgical system50is adapted for use with computerized surgical manipulation system800. In one implementation, surgical system50includes surgical stapling device100and trocar500. In one implementation, computerized surgical manipulation system800includes robotic arm810having support820for holding motor housing400and gripping member600, wherein motor housing400has notch410, and wherein gripping member600can be a spring-loaded clip for holding trocar500. Motor housing400further includes motor interface420having slots470for receiving prongs360of control housing300and having first, second, and third rotatable platters430,440,450, wherein each rotatable platter430,440,450include projections460. A plurality of high-speed, low torque motors can be positioned within motor housing400that be used to drive the various mechanical functions of surgical stapling device100.

With reference toFIG.6, notch410extends the length L2of motor housing400and is configured to receive elongated shaft110of surgical stapling device100. In the illustrated implementation, notch410has a width of approximately 12 mm, which is shown as diameter D1. Reduced diameter portion150extends distally from control housing300, wherein reduced diameter portion150can be specifically sized to fit within notch410. In the illustrated implementation, reduced diameter150has a diameter D2, which is less than the diameter D1of notch410, and diameter portion140has a diameter D3, which is greater than the diameter D1of notch410. Reduced diameter150allows for elongated shafts larger than diameter D1of notch410to be installed in surgical system50without having to reconfigure the mechanical mechanisms (closure mechanism1000and firing mechanism1110discussed below) of surgical stapling device100. In one implementation, the length of reduced diameter portion150(shown as L1inFIG.3) is longer than length L2of notch140for allowing control housing300to attach to motor housing400.

FIGS.5,7, and8A-8Bdepict trocar500for use in surgical system50.FIG.7illustrates trocar500having distal end510, proximal end520, and trocar surface530, wherein holding feature540extends outward from trocar surface530. In the illustrated implementation, holding feature540can be located proximate to proximal end520of trocar500and define a pair of recesses550that are positioned on opposing sides of holding feature540. The geometry of recesses550allow for the desired pivoting action of trocar500. More specifically, the geometry of the recesses550allow for trocar500to slightly move or pivot relative to gripping members600, with the degree of movement confined by inner wall560and outer wall570of recess550.FIGS.5and8A-8Billustrate trocar500pivotally coupled to gripping members600. When trocar500is axially aligned with support820of robotic arm810, angled gap01is formed between gripping member600and inner wall560of recess550(shown inFIG.8A). In one example implementation, holding feature540can be biased to maintain trocar500in its axially aligned position with support820. Pivoting or tilting trocar500away from axial alignment with support820brings inner wall560in contact with gripping member600and forms second angled gap02between gripping member600and outer wall570of recess550(shown inFIG.8B). It is to be appreciated that the amount of tilt provided by trocar500can vary based on implementation, but in some example implementations, trocar500is tiltable from 0 degrees to about 10 degrees, although this disclosure is not so limited.

FIGS.9A-9Cschematically illustrate an example progression of inserting surgical stapling device100having end effector200into trocar500when slightly pivoted away from axial alignment. To insert surgical stapling device100into trocar500, trocar500can outwardly pivot to initially accept distal end120coupled with end effector200through proximal end520(shown inFIG.9A). In the illustrated implementation, surgical stapling device100is distally advanced into trocar500until reduced diameter portion150can be received into notch410of motor housing400. Trocar500containing surgical stapling device100then pivots back towards axial alignment with support820, and reduced diameter portion150secures into notch410of motor housing400(shown inFIG.9B). During a surgical procedure, trocar500can be coupled to support820or to robotic arm810of computerized surgical manipulation system800, and advancement of surgical stapling device100through trocar500can be effected by, for example, the linear translation of motor housing400relative to trocar500. Control housing300can then be lowered onto motor housing400such that control interface310and motor interface420mate (shown inFIG.9C), or motor housing400can be raised to control housing300. More specifically, recesses350on first, second, and third rotatable platters320,330,340of control interface310receive projections460on first, second, and third rotatable platters430,440,450of motor interface420. It is to be appreciated that the particular configuration of control interface310can vary based on the configuration of motor interface420. Prongs360then engage slots470to secure control housing300with motor housing400. It is to be appreciated that surgical system50and surgical stapling device100can be used with trocars that do not necessarily include a tilting feature.

FIGS.10-13depicts an example implementation of closure mechanism1000for opening and closing anvil220on end effector200. Closure mechanism1000is housed within elongated shaft110and includes drive screw1010having hollow cavity1040and follower nut1020in threaded engagement therewith. Rotation of drive screw1010causes follower nut1020to translate proximally or distally through elongated shaft110, depending on the direction of rotation of drive screw1010. In the illustrated implementation, one or more control members1030are coupled to follower nut1020and anvil220. In another example implementation, control members1030can comprise a rigid portion and a flexible portion, wherein the flexible portion can be captured within a conduit of elongated shaft110to avoid or reduce undesirable buckling. As follower nut1020is distally translated by rotation of drive screw1010, control members1030push anvil220open. As follower nut1020is proximally translated by rotation of drive screw1010, control members1030pull anvil220closed.

With reference toFIG.14, firing mechanism1100of surgical stapling device100comprises nut1110threadedly coupled to rotating member1120, wherein rotating member1120is coaxial with nut1110. In the illustrated implementation, rotating member1120is positioned within hollow cavity1040of drive screw1010such that drive screw1010and rotating member1120are axially aligned and co-radial, while being able to rotate independently. During a surgical procedure, nut1110can initially start at a distal position, and during firing of surgical stapling device100, nut1110can be proximally translated through rotation of rotating member1120.

With reference toFIGS.15-16, firing mechanism1100may further comprise beam1200and blade1300.FIG.15depicts example beam1200in a flat, laid-out configuration, wherein beam1200includes bands1210, distal end1220, proximal end1230, and aperture1240, wherein proximal end1230defines aperture1240that receives nut1110. In one implementation, beam1200can be stamped from ½ to ¾ hard 300 series stainless steel, for example, and then folded to form the desired operational shape.FIG.16depicts example beam1200in an example elongated folded, laminate configuration, wherein bands1210are mirrored, and wherein blade1300having cutting edge1310is coupled to distal end1220of beam1200. Blade1300can be coupled to distal end1220via any suitable attachment technique, such as a seam weld, spot welds, or combinations thereof.

FIGS.17-18depict firing mechanism1100configured within surgical stapling device100, according to one example implementation. Elongated shaft110of surgical stapling device100can define band splitting portion1400that includes band splitter1430and two diversion channels1410that each laterally divert from central channel1420. The laminate portion of beam1200is located in central channel1420such that blade1300is positioned at the distal end of end effector200. Band splitting portion1400is positioned proximally to the proximal end of rotating member1120such that nut1110engages aperture1240, allowing bands1210of beam1200to be delaminated and diverted into diversion channels1410as nut1110travels along rotating member1120.

FIGS.19A-19Bdepict de-lamination of beam1200at three different operational positions1700,1800,1900during operation of surgical stapling device100. As surgical stapling device100is activated, nut1110is urged proximally along rotating member1120causing beam1200and blade1300to correspondingly move in a proximal direction. As blade1300is urged proximally, cutting edge1310can transect tissue and surgical staples from cartridge230can be inserted into the tissue. At first operational position1700, nut1110and blade1300are both in their distal-most positions. At second operational position1800, nut1110has proximally advanced, causing a portion of beam1200to pass through band splitting portion1400and divert into diversion channels1410. At third operational position1900, nut1110and blade1300are both in their proximal-most positions, and bands1210of beam1200have been almost fully separated or de-laminated by band splitter1430. It will be appreciated that beam1200can include a single band, instead of having mirrored bands1210. In such an implementation, the single band can be routed to one side of nut1110through one of diversion channels1410.

With reference toFIGS.19A-19B, the direction of rotation of rotating member1120can be reversed in a bailout situation (shown inFIGS.25A-25B) to distally translate nut1110. As nut1110translates distally along rotating member1120, beam1200will travel through band splitting portion1400in the reverse direction (from third operational position1900to first operational position1700) and be returned to its laminated configuration.

FIGS.20-21depict example gear assembly370housed within control housing300. As shown inFIG.20, each of first, second, and third rotatable platters320,330,340affects rotation of a specific mechanical feature of surgical stapling device100. In the illustrated implementation, first rotatable platter320corresponds to activating firing mechanism1100, second rotatable platter330corresponds to rotating elongated shaft110, and third rotatable platter340corresponds to rotating drive screw1010to open or close anvil220. As shown inFIG.21, gear assembly370is arranged within control housing300to correspond to first, second, and third rotatable platters320,330,340. In the illustrated implementation, closing gear372is arranged to correspond with third rotatable platter340, firing gear374is arranged to correspond with first rotatable platter320(through planetary gear900), and rotating gear376is arranged to correspond with second rotatable platter330. In the illustrated implementation, closing gear372, firing gear374, and rotating ear376are axially aligned. Gear assembly370allows for the rotation of elongated shaft110and end effector200(through rotating gear376), the activation of closure mechanism1000(through closing gear372), and the activation of firing mechanism1100(through firing gear374) to be co-radial.

FIGS.22-23depict gear assembly370having springs380on gear shafts390, according to one example implementation As previously described, recesses350on first, second, and third rotatable platters320,330,340must align and accept projections460on first, second, and third rotatable platters430,440,450to join control housing300with motor housing400. To aid in alignment of recesses350and projections460, springs380bias first, second, and third rotatable platters320,330,340(an operational position) and allow for slight linear translation into control housing300(an initialization position). In some example implementations, the linear translation is approximately 0.060 inches.

With further reference toFIGS.22-23, once first, second, and third rotatable platters320,330,340of control housing300are translated into the initialization position, control software of computerized surgical manipulation system800can rotate first, second, and third rotatable platters320,330,340of motor housing400to align projections460with recesses350. The amount of rotation depends on the number of projections460and recesses350. For example, if there are four corresponding projections460and recesses350, first, second, and third rotatable platters320,330,340of motor housing400can be rotated clockwise and counterclockwise along a 90° arc to allow projections460and recesses350to engage. By comparison, if there are two corresponding projections460and recesses350, first, second, and third rotatable platters320,330,340of motor housing400can be rotated clockwise and counterclockwise along a 180° arc to allow projections460and recesses350to engage. In some example implementations, initialization of first, second, and third rotatable platters320,330,340of control housing300is automatically executed upon detection of control housing300being in close proximity to motor housing400, such as via a Hall Effect sensor or other suitable proximity sensor. Furthermore, during operation of surgical stapling device100, various encoders associated with the motors in motor housing400can provide feedback for use by computerized surgical manipulation system800to demand the operational status of surgical stapling device100. Due to the relatively small amount of linear translation of first, second, and third rotatable platters320,330,340, closing gear372and rotating gear376remain in a meshed arrangement, even when first, second, and third rotatable platters320,330,340are in the initialization position. In some implementations, however, to achieve the desired gear reduction and torque with regard to firing mechanism1100, planetary gearhead900can be used to drive firing gear374. In accordance with such implementations, planetary gearhead900provides a gear reduction of approximately 104:1.

FIG.24depicts example sun gear1500driven by motor housing400, which is used to drive planetary gearhead900. When moving first rotatable platter320associated with firing gear374to its initialization position, it may be desirable to avoid re-engaging sun gear1500with planetary gearhead900. As such, spring380can be positioned on shaft390external to planetary gearhead900, and first rotatable platter320can ride along shaft390. Spring380can bias first rotatable platter320into the operational position but allows first rotatable platter320to linearly translate along shaft390for initialization.

FIG.25A-25Bdepicts an example implementation of bailout mechanism1600included in control housing300, wherein bailout mechanism1600allows for manual control of various mechanical operations of surgical stapling device100. Bailout mechanism1600comprises first knob1610for manually controlling firing gear374(firing mechanism1100) and second knob1620for manually controlling closing gear372(closure mechanism1000). In the illustrated implementation, second knob1620is a thumbwheel. It is to be appreciated that an additional knob can be provided for manually controlling rotating gear376(rotation of elongated shaft110and end effector200). In the illustrated implementation, first knob1610is fixedly coupled to firing gear374. During a bailout situation, a user can press first knob1610downward to force firing gear374from engaged position1630(shown inFIG.25A) to disengaged position1640(shown inFIG.25B). As shown inFIGS.25A-25B, firing gear374can be biased towards engaged position1630and can be disengaged from planetary gearhead900by spring1650or other suitable biasing element. Once firing gear374is pushed into disengaged position1640, pawl1660can be used to maintain firing gear374in disengaged position1640. Further, in some implementations, a ratchet system can engage when firing gear374is in disengaged position1640to only permit rotation of firing gear374and first knob1610in a first direction (i.e., to only allow for movement of firing mechanism1100in reverse). As depicted inFIG.25B, second knob1620can be used to selectively rotate closing gear372to manually open or close anvil220of end effector200.

All literature and similar material cited in this application, including, but not limited to, patents, patent applications, articles, books, treatises, and web pages, regardless of the format of such literature and similar materials, are expressly incorporated by reference in their entirety. Should one or more of the incorporated references and similar materials differs from or contradicts this application, including but not limited to defined terms, term usage, described techniques, or the like, this application controls.

As previously stated and as used herein, the singular forms “a,” “an,” and “the,” refer to both the singular as well as plural, unless the context clearly indicates otherwise. The term “comprising” as used herein is synonymous with “including,” “containing,” or “characterized by,” and is inclusive or open-ended and does not exclude additional, unrecited elements or method steps. Although many methods and materials similar or equivalent to those described herein can be used, particular suitable methods and materials are described herein. Unless context indicates otherwise, the recitations of numerical ranges by endpoints include all numbers subsumed within that range. Furthermore, references to “one implementation” are not intended to be interpreted as excluding the existence of additional implementations that also incorporate the recited features. Moreover, unless explicitly stated to the contrary, implementations “comprising” or “having” an element or a plurality of elements having a particular property may include additional elements whether or not they have that property.

The terms “substantially” and “about”, if or when used throughout this specification describe and account for small fluctuations, such as due to variations in processing. For example, these terms can refer to less than or equal to ±5%, such as less than or equal to ±2%, such as less than or equal to ±1%, such as less than or equal to ±0.5%, such as less than or equal to ±0.2%, such as less than or equal to ±0.1%, such as less than or equal to ±0.05%, and/or 0%.

Underlined and/or italicized headings and subheadings are used for convenience only, do not limit the disclosed subject matter, and are not referred to in connection with the interpretation of the description of the disclosed subject matter. All structural and functional equivalents to the elements of the various implementations described throughout this disclosure that are known or later come to be known to those of ordinary skill in the art are expressly incorporated herein by reference and intended to be encompassed by the disclosed subject matter. Moreover, nothing disclosed herein is intended to be dedicated to the public regardless of whether such disclosure is explicitly recited in the above description.

There may be many alternate ways to implement the disclosed technology. Various functions and elements described herein may be partitioned differently from those shown without departing from the scope of the disclosed technology. Generic principles defined herein may be applied to other implementations. Different numbers of a given module or unit may be employed, a different type or types of a given module or unit may be employed, a given module or unit may be added, or a given module or unit may be omitted.

Regarding this disclosure, the term “a plurality of” refers to two or more than two. Unless otherwise clearly defined, orientation or positional relations indicated by terms such as “upper” and “lower” are based on the orientation or positional relations as shown in the figures, only for facilitating description of the disclosed technology and simplifying the description, rather than indicating or implying that the referred devices or elements must be in a particular orientation or constructed or operated in the particular orientation, and therefore they should not be construed as limiting the disclosed technology. The terms “connected”, “mounted”, “fixed”, etc. should be understood in a broad sense. For example, “connected” may be a fixed connection, a detachable connection, or an integral connection; a direct connection, or an indirect connection through an intermediate medium. For an ordinary skilled in the art, the specific meaning of the above terms in the disclosed technology may be understood according to specific circumstances.

Specific details are given in the above description to provide a thorough understanding of the disclosed technology. However, it is understood that the disclosed implementations and implementations can be practiced without these specific details. For example, circuits can be shown in block diagrams in order not to obscure the disclosed implementations in unnecessary detail. In other instances, well-known circuits, processes, algorithms, structures, and techniques can be shown without unnecessary detail in order to avoid obscuring the disclosed implementations.

Furthermore, the disclosed technology can be implemented by hardware, software, scripting languages, firmware, middleware, microcode, hardware description languages, and/or any combination thereof. When implemented in software, firmware, middleware, scripting language, and/or microcode, the program code or code segments to perform the necessary tasks can be stored in a machine readable medium such as a storage medium. A code segment or machine-executable instruction can represent a procedure, a function, a subprogram, a program, a routine, a subroutine, a module, a software package, a script, a class, or any combination of instructions, data structures, and/or program statements. A code segment can be coupled to another code segment or a hardware circuit by passing and/or receiving information, data, arguments, parameters, and/or memory contents. Information, arguments, parameters, data, etc. can be passed, forwarded, or transmitted via any suitable means including memory sharing, message passing, ticket passing, network transmission, etc.

It should be appreciated that all combinations of the foregoing concepts and additional concepts discussed in greater detail herein (provided such concepts are not mutually inconsistent) are contemplated as being part of the disclosed technology. In particular, all combinations of claimed subject matter appearing at the end of this disclosure are contemplated as being part of the technology disclosed herein. While the disclosed technology has been illustrated by the description of example implementations, and while the example implementations have been described in certain detail, there is no intention to restrict or in any way limit the scope of the appended claims to such detail. Additional advantages and modifications will readily appear to those skilled in the art. Therefore, the disclosed technology in its broader aspects is not limited to any of the specific details, representative devices and methods, and/or illustrative examples shown and described. Accordingly, departures may be made from such details without departing from the spirit or scope of the general inventive concept.