ARTICULATING ULTRASONIC SURGICAL INSTRUMENTS HAVING DISTALLY POSITIONED TRANSDUCERS

An articulating surgical instrument includes a housing, a shaft extending distally from the housing, an end effector assembly, and an articulating component interconnecting the shaft and end effector assembly. The articulating component includes a proximal disk connected to the shaft, a distal disk connected to the end effector assembly, an intermediate disk, a first flexible interconnect connecting the proximal and intermediate disks, and a second flexible interconnect connecting the intermediate and distal disks. The first flexible interconnect defines a single plane of bending to enable articulation of the end effector assembly relative to the shaft within a first plane. The second flexible interconnect defines a single plane of bending substantially perpendicular to the single plane of bending of the first flexible interconnect to enable articulation of the end effector assembly relative to the shaft within a second plane substantially perpendicular to the first plane.

FIELD

This disclosure relates to surgical instruments and systems and, more particularly, to articulating ultrasonic surgical instruments having distally positioned transducers such as for use in surgical robotic systems.

BACKGROUND

Ultrasonic surgical instruments and systems utilize ultrasonic energy, i.e., ultrasonic vibrations, to treat tissue. More specifically, a typical ultrasonic surgical instrument or system includes a transducer configured to produce mechanical vibration energy at ultrasonic frequencies that is transmitted along a waveguide to an ultrasonic end effector configured to treat, e.g., seal and/or transect, tissue.

Some ultrasonic surgical instruments and systems incorporate rotation features, thus enabling rotation of the end effector to a desired orientation within a surgical site. However, the ability to manipulate an end effector within the surgical site via rotation alone is limited.

Adding articulation capability to an ultrasonic surgical instrument increases the positions and orientations the end effector can achieve within a surgical site. However, with the addition of articulation capability comes the challenges of routing mechanical actuators, power signals, control signals, and/or mechanical vibration energy to the end effector.

SUMMARY

As used herein, the term “distal” refers to the portion that is being described which is farther from an operator (whether a human surgeon or a surgical robot), while the term “proximal” refers to the portion that is being described which is closer to the operator. Terms including “generally,” “about,” “substantially,” and the like, as utilized herein, are meant to encompass variations, e.g., manufacturing tolerances, material tolerances, use and environmental tolerances, measurement variations, design variations, and/or other variations, up to and including plus or minus 10 percent. Further, to the extent consistent, any of the aspects described herein may be used in conjunction with any or all of the other aspects described herein.

Provided in accordance with aspects of this disclosure is an articulating surgical instrument including a housing, a shaft extending distally from the housing, an end effector assembly, and an articulating component interconnecting the shaft and end effector assembly. The articulating component includes a proximal disk connected to the shaft, a distal disk connected to the end effector assembly, an intermediate disk, a first flexible interconnect connecting the proximal and intermediate disks, and a second flexible interconnect connecting the intermediate and distal disks. The first flexible interconnect defines a single plane of bending to enable articulation of the end effector assembly relative to the shaft within a first plane. The second flexible interconnect defines a single plane of bending substantially perpendicular to the single plane of bending of the first flexible interconnect to enable articulation of the end effector assembly relative to the shaft within a second plane substantially perpendicular to the first plane.

In an aspect of this disclosure, the articulating component is a monolithic, single piece of material.

In an aspect of this disclosure, each of the first and second flexible interconnects defines a beam configuration having a pair of opposed relatively narrow sides and a pair of opposed relatively broad sides. In such aspects, each of the first and second flexible interconnects may be aligned relative to a longitudinal axis defined through the shaft.

In another aspect of this disclosure, a first pair of opposed articulation cables extends from the shaft through the proximal and intermediate disks. The first pair of opposed articulation cables is anchored distally of the intermediate disk and configured to move in opposite directions to articulate the end effector assembly relative to the shaft within the first plane.

In yet another aspect of this disclosure, a second pair of opposed articulation cables extends from the shaft through the proximal, intermediate, and distal disks. The second pair of opposed articulation cables is anchored distally of the distal disk and configured to move in opposite directions to articulate the end effector assembly relative to the shaft within the second plane. In aspects, the first and second pairs of opposed articulation cables are offset about 90 degrees relative to one another.

In still another aspect of this disclosure, the end effector assembly includes a body, an ultrasonic transducer housed within the body, and an ultrasonic blade extending distally from the body and configured to treat tissue with ultrasonic energy produced by the ultrasonic transducer.

In still yet another aspect of this disclosure, the end effector assembly further includes a jaw member pivotable relative to the ultrasonic blade between an open position and a closed position for clamping tissue therebetween. In such aspects, at least one jaw actuation cable may be routed through the articulating component to the end effector assembly.

In another aspect of this disclosure, the distal disk is connected to the end effector assembly by a releasable engagement. The releasable engagement may include a first connector and a second connector. The second connector includes first and second rails defining a slot therebetween and an engagement tab positioned towards an open end of the slot. The first connector is transversely slidable between the first and second rails and into the slot. The engagement tab is configured to releasably engage the first connector within the slot upon sufficient transverse sliding of the first connector into the slot.

Another articulating surgical instrument provided in accordance with aspects of this disclosure includes a housing, a shaft assembly extending distally from the housing and including a proximal shaft and a distal articulating section, and an end effector assembly releasably coupled to the distal articulating section of the shaft assembly by a releasable engagement. The releasable engagement includes a first connector disposed on one of the end effector assembly or the distal articulating section and a second connector disposed on another of the end effector assembly or the distal articulating section. The second connector includes first and second rails defining a slot therebetween and an engagement tab positioned towards an open end of the slot. The first connector is transversely slidable between the first and second rails and into the slot. The engagement tab is configured to releasably engage the first connector within the slot upon sufficient transverse sliding of the first connector into the slot.

In an aspect of this disclosure, the first connector is disposed on the end effector assembly and the second connector is disposed on the distal articulating section.

In another aspect of this disclosure, the second connector further includes a living hinge having the engagement tab disposed at a free end of the living hinge.

In still another aspect of this disclosure, the end effector assembly includes a body having the first or second connector extending therefrom, an ultrasonic transducer housed within the body, and an ultrasonic blade extending distally from the body and configured to treat tissue with ultrasonic energy produced by the ultrasonic transducer.

In yet another aspect of this disclosure, the end effector assembly further includes a jaw member pivotable relative to the ultrasonic blade between an open position and a closed position for clamping tissue therebetween.

A rotating and articulating surgical instrument provided in accordance with this disclosure includes a housing, a shaft assembly extending distally from the housing and including a proximal shaft and a distal articulating section, an end effector assembly coupled to the distal articulating section and configured to articulate relative to the proximal shaft within at least one plane, and a rotation mechanism including a cable extending through the distal articulating section of the shaft assembly to the end effector assembly. The cable includes a first portion, a second portion, and a partially looped portion interconnecting the first and second portions. The partially looped portion is disposed at least partially within an annular track of a proximal head of the end effector assembly. Movement of the first and second portions of the cable in opposite directions slides the partially looped portion through the annular track to generate torque to thereby rotate the end effector assembly relative to the shaft assembly.

In an aspect of this disclosure, movement of the first and second portions of the cable in opposite directions in a first manner slides the partially looped portion through the annular track in a clockwise direction to generate torque to thereby rotate the end effector assembly relative to the shaft assembly in the clockwise direction, while movement of the first and second portions of the cable in opposite directions in a second, opposite manner slides the partially looped portion through the annular track in a counterclockwise direction to generate torque to thereby rotate the end effector assembly relative to the shaft assembly in the counterclockwise direction.

In another aspect of this disclosure, movement of the first and second portions of the cable in opposite directions slides the partially looped portion through the annular track and, as a result of friction between the partially looped portion of the cable and the annular track, torque is generated to thereby rotate the end effector assembly relative to the shaft assembly.

DETAILED DESCRIPTION

This disclosure provides articulating ultrasonic surgical instruments having distally positioned transducers. As described in detail below, the articulating ultrasonic surgical instruments of this disclosure may be configured for use with a surgical robotic system, which may include, for example, a surgical console, a control tower, and one or more movable carts having a surgical robotic arm coupled to a setup arm. The surgical console receives user inputs through one or more interface devices, which are interpreted by the control tower as movement commands for moving the surgical robotic arm. The surgical robotic arm includes a controller, which is configured to process the movement commands and to generate a torque command for activating one or more actuators of the robotic arm, which, in turn, move the robotic arm in response to the movement commands. Although described hereinbelow in connection with surgical robotic systems, the aspects and features of this disclosure may also be adapted for use with handheld articulating ultrasonic surgical instruments such as, for example, articulating endoscopic ultrasonic surgical instruments and/or articulating open ultrasonic surgical instruments.

With reference toFIG.1, a surgical robotic system10includes a control tower20, which is connected to components of the surgical robotic system10including a surgical console30and one or more robotic arms40. Each of the robotic arms40includes a surgical instrument50removably coupled thereto. Each of the robotic arms40is also coupled to a movable cart60.

The one or more surgical instruments50may be configured for use during minimally invasive surgical procedures and/or open surgical procedures. In aspects, one of the surgical instruments50may be an endoscope, such as an endoscopic camera51, configured to provide a video feed for the clinician. In further aspects, one of the surgical instruments50may be an energy based surgical instrument such as, for example, an electrosurgical forceps or ultrasonic sealing and dissection instrument configured to seal tissue by grasping tissue between opposing structures and applying electrosurgical energy or ultrasonic energy, respectively, thereto. In yet further aspects, one of the surgical instruments50may be a surgical stapler including a pair of jaws configured to clamp tissue, deploy a plurality of tissue fasteners, e.g., staples, through the clamped tissue, and/or to cut the stapled tissue. In aspects, one of the surgical instruments50is an articulating ultrasonic surgical instrument having a distally positioned transducer in accordance with this disclosure and as described in greater detail below.

Endoscopic camera51, as noted above, may be configured to capture video of the surgical site. In such aspects, the surgical console30includes a first display32, which displays a video feed of the surgical site provided by endoscopic camera51, and a second display34, which displays a user interface for controlling the surgical robotic system10. The first and second displays32and34may be touchscreen graphical user interface (GUI) displays allowing for receipt of various user inputs.

The surgical console30also includes a plurality of user interface devices, such as foot pedals36and a pair of handle controllers38aand38bwhich are used by a clinician to remotely control robotic arms40. The surgical console further includes an armrest33used to support clinician's arms while operating the handle controllers38aand38b.

The control tower20includes a display23, which may be a touchscreen GUI, and provides outputs to the various GUIs. The control tower20also acts as an interface between the surgical console30and one or more robotic arms40. In particular, the control tower20is configured to control the robotic arms40, such as to move the robotic arms40and the corresponding surgical instrument50, based on a set of programmable instructions and/or input commands from the surgical console30, in such a way that robotic arms40and the surgical instrument50execute a desired movement sequence in response to input from the foot pedals36and/or the handle controllers38aand38b.

Each of the control tower20, the surgical console30, and the robotic arm40includes a respective computer21,31,41. The computers21,31,41are interconnected to each other using any suitable communication network based on wired or wireless communication protocols. The term “network,” whether plural or singular, as used herein, denotes a data network, including, but not limited to, the Internet, Intranet, a wide area network, or a local area network, and without limitation as to the full scope of the definition of communication networks as encompassed by this disclosure. Suitable protocols include, but are not limited to, transmission control protocol/internet protocol (TCP/IP), datagram protocol/internet protocol (UDP/IP), and/or datagram congestion control protocol (DCCP). Wireless communication may be achieved via one or more wireless configurations, e.g., radio frequency, optical, Wi-Fi, Bluetooth® (an open wireless protocol for exchanging data over short distances, using short length radio waves, from fixed and mobile devices, creating personal area networks (PANs)), and/or ZigBee® (a specification for a suite of high level communication protocols using small, low-power digital radios based on the IEEE 122.15.4-2003 standard for wireless personal area networks (WPANs)).

The computers21,31,41may include any suitable processor(s) operably connected to a memory, which may include one or more of volatile, non-volatile, magnetic, optical, quantum, and/or electrical media, such as read-only memory (ROM), random access memory (RAM), electrically-erasable programmable ROM (EEPROM), non-volatile RAM (NVRAM), or flash memory. The processor(s) may be any suitable processor(s) (e.g., control circuit(s)) adapted to perform operations, calculations, and/or set of instructions including, but not limited to, a hardware processor, a field programmable gate array (FPGA), a digital signal processor (DSP), a central processing unit (CPU), a microprocessor, a quantum processor, and combinations thereof. Those skilled in the art will appreciate that the processor may be substituted for by using any logic processor (e.g., control circuit) adapted to execute algorithms, calculations, and/or set of instructions.

With reference toFIG.2, each of the robotic arms40may include a plurality of links42a,42b,42c, which are interconnected at joints44a,44b,44c, respectively. The joint44ais configured to secure the robotic arm40to the movable cart60and defines a first longitudinal axis. With reference toFIG.3, the movable cart60includes a lift61and a setup arm62, which provides a base for mounting of the robotic arm40. The lift61allows for vertical movement of the setup arm62. The movable cart60also includes a display69for displaying information pertaining to the robotic arm40. The setup arm62includes a first link62a, a second link62b, and a third link62c, which provide for lateral maneuverability of the robotic arm40. The links62a,62b,62care interconnected at joints63aand63b, each of which may include an actuator (not shown) for rotating the links62band62brelative to each other and the link62c. In particular, the links62a,62b,62care movable in their corresponding lateral planes that are parallel to each other, thereby allowing for extension of the robotic arm40relative to the patient (e.g., surgical table). In aspects, the robotic arm40may be coupled to the surgical table (not shown). The setup arm62includes controls65for adjusting movement of the links62a,62b,62cas well as the lift61.

The third link62cincludes a rotatable base64having two degrees of freedom. In particular, the rotatable base64includes a first actuator64aand a second actuator64b. The first actuator64ais rotatable about a first stationary arm axis which is perpendicular to a plane defined by the third link62cand the second actuator64bis rotatable about a second stationary arm axis which is transverse to the first stationary arm axis. The first and second actuators64aand64ballow for full three-dimensional orientation of the robotic arm40.

With reference again toFIG.2, the robotic arm40also includes a holder46defining a second longitudinal axis and configured to receive an instrument drive unit (IDU)52(FIG.1). The IDU52is configured to couple to an actuation mechanism of the surgical instrument50and the camera51and is configured to move (e.g., rotate) and actuate the instrument50and/or the camera51. IDU52transfers actuation forces from its actuators to the surgical instrument50to actuate components (e.g., end effectors) of the surgical instrument50. The holder46includes a sliding mechanism46a, which is configured to move the IDU52along the second longitudinal axis defined by the holder46. The holder46also includes a joint46b, which rotates the holder46relative to the link42c.

The robotic arm40further includes a plurality of manual override buttons53disposed on the IDU52and the setup arm62, which may be used in a manual mode. For example, the clinician may press one of the buttons53to move the component associated with that button53.

The joints44aand44binclude an actuator48aand48bconfigured to drive the joints44a,44b,44crelative to each other through a series of belts45aand45bor other mechanical linkages such as drive rods, cables, levers, and/or the like. In particular, the actuator48ais configured to rotate the robotic arm40about a longitudinal axis defined by the link42a.

The actuator48bof the joint44bis coupled to the joint44cvia the belt45a, and the joint44cis in turn coupled to the joint46cvia the belt45b. Joint44cmay include a transfer case coupling the belts45aand45bsuch that the actuator48bis configured to rotate each of the links42b,42cand the holder46relative to one another. More specifically, links42b,42cand the holder46are passively coupled to the actuator48bwhich enforces rotation about a remote center point “P” that lies at an intersection of the first axis defined by the link42aand the second axis defined by the holder46. Thus, the actuator48bcontrols the angle “0” between the first and second axes allowing for orientation of the surgical instrument50. Due to the interlinking of the links42a,42b,42cand the holder46via the belts45aand45b, the angles between the links42a,42b,42cand the holder46are also adjusted in order to achieve the desired angle “0.” In aspects, some or all of the joints44a,44b,44cmay include an actuator to obviate the need for mechanical linkages.

With reference toFIG.4, each of the computers21,31,41of the surgical robotic system10may include a plurality of controllers, which may be embodied in hardware and/or software. The computer21of the control tower20includes a controller21aand safety observer21b. The controller21areceives data from the computer31of the surgical console30about the current position and/or orientation of the handle controllers38aand38band the state of the foot pedals36and/or other inputs. The controller21aprocesses these input positions to determine desired drive commands for each joint of the robotic arm40and/or the IDU52and communicates these to the computer41of the robotic arm40. The controller21aalso receives the actual joint angles and uses this information to determine force feedback commands that are transmitted back to the computer31of the surgical console30to provide haptic or other feedback through the handle controllers38aand38b. The handle controllers38aand38binclude one or more haptic feedback vibratory devices that output haptic feedback although visual, audible, and/or other feedback is also contemplated. The safety observer21bperforms validity checks on the data going into and out of the controller21aand notifies a system fault handler if errors in the data transmission are detected to place the computer21and/or the surgical robotic system10into a safe state.

The computer41includes a plurality of controllers, namely, a main cart controller41a, a setup arm controller41b, a robotic arm controller41c, and an IDU controller41d. The main cart controller41areceives and processes joint commands from the controller21aof the computer21and communicates them to the setup arm controller41b, the robotic arm controller41c, and the IDU controller41d. The main cart controller41aalso manages instrument exchanges and the overall state of the movable cart60, the robotic arm40, and the IDU52. The main cart controller41acommunicates the actual joint angles back to the controller21a.

The setup arm controller41bcontrols each of joints63aand63band the rotatable base64of the setup arm62and calculates desired motor movement commands (e.g., motor torque) for the pitch axis. The setup arm controller41balso controls the brakes. The robotic arm controller41ccontrols each joint44aand44bof the robotic arm40and calculates desired motor torques required for gravity compensation, friction compensation, and closed loop position control of the robotic arm40. The robotic arm controller41ccalculates a movement command based on the calculated torque. The calculated motor commands are then communicated to one or more of the actuators48aand48bin the robotic arm40. The actual joint positions are transmitted by the actuators48aand48bback to the robotic arm controller41c.

The IDU controller41dreceives desired joint angles for the surgical instrument50, such as wrist and jaw angles, and computes desired currents for the motors in the IDU52. The IDU controller41dcalculates actual angles based on the motor positions and transmits the actual angles back to the main cart controller41a.

With respect to control of the robotic arm40, initially, a pose of the handle controller controlling the robotic arm40, e.g., the handle controller38a, is transformed into a desired pose of the robotic arm40through a hand eye transform function executed by the controller21a. The hand eye function is embodied in software executable by the controller21aor any other suitable controller of the surgical robotic system10. The pose of the handle controller38amay be embodied as a coordinate position and role-pitch-yaw (“RPY”) orientation relative to a coordinate reference frame, which is fixed to the surgical console30. The desired pose of the instrument50is relative to a fixed frame on the robotic arm40. The pose of the handle controller38ais then scaled by a scaling function executed by the controller21a. In aspects, the coordinate position is scaled down and the orientation is scaled up by the scaling function. In addition, the controller21aalso executes a clutching function, which disengages the handle controller38afrom the robotic arm40. In particular, the controller21astops transmitting movement commands from the handle controller38ato the robotic arm40if certain movement limits or other thresholds are exceeded and in essence acts like a virtual clutch mechanism, e.g., limiting mechanical input from effecting mechanical output.

The desired pose of the robotic arm40is based on the pose of the handle controller38aand is then passed by an inverse kinematics function executed by the controller21a. The inverse kinematics function calculates angles for the joints44a,44b,44cof the robotic arm40that achieve the scaled and adjusted pose input by the handle controller38a. The calculated angles are then passed to the robotic arm controller41c, which includes a joint axis controller having a proportional-derivative (PD) controller, the friction estimator module, the gravity compensator module, and a two-sided saturation block, which is configured to limit the commanded torque of the motors of the joints44a,44b,44c.

Turning toFIGS.5-7, a surgical instrument110provided in accordance with this disclosure generally includes a housing120, a shaft assembly130extending distally from housing120, an end effector assembly500extending distally from shaft assembly130, and an actuation assembly190(FIG.7) disposed within housing120and operably associated with end effector assembly500. Instrument110is detailed herein as an articulating ultrasonic surgical instrument configured for use with a surgical robotic system, e.g., surgical robotic system10(FIG.1). However, the aspects and features of instrument110provided in accordance with this disclosure, as detailed below, are equally applicable for use with other suitable surgical instruments and/or in other suitable surgical systems, e.g., motorized, other power-driven systems, and/or manually actuated surgical systems (including handheld instruments).

Housing120of instrument110includes a body122and a proximal face plate124that cooperate to enclose actuation assembly190therein. Proximal face plate124includes through holes defined therein through which input couplers191-194of actuation assembly190extend. A pair of latch levers126(only one of which is illustrated inFIG.5) extend outwardly from opposing sides of housing120to enable releasable engagement of housing120with a robotic arm of a surgical robotic system, e.g., robotic arm40of surgical robotic system10(FIG.1). A window128defined through body122of housing120permits thumbwheel440to extend therethrough to enable manual manipulation of thumbwheel440from the exterior of housing120to permit manual opening and closing of end effector assembly500.

Shaft assembly130of instrument110includes a proximal shaft134and an articulating section136disposed between and interconnecting proximal section134with end effector assembly500. Articulating section136includes one or more articulating components such as, for example, one or more links, pivots, joints, flexible bodies, etc. A plurality of articulation cables138(FIG.9) or other suitable actuators extend through articulating section136. More specifically, articulation cables138(FIG.9) may be operably coupled to end effector assembly500at the distal ends thereof and extend proximally through articulating section136of shaft assembly130and proximal shaft134of shaft assembly130, and into housing120, wherein articulation cables138(FIG.9) operably couple with an articulation sub-assembly200of actuation assembly190to enable selective articulation of end effector assembly500relative to proximal shaft134and housing120, e.g., about at least two axes of articulation (yaw and pitch articulation, for example).

With particular reference toFIGS.6A and6B, end effector assembly500includes a body510retaining an ultrasonic transducer532therein, an ultrasonic blade540operably coupled to ultrasonic transducer532via an ultrasonic horn534and extending distally from body510, and a jaw member550operably coupled to body510to enable pivoting of jaw member550relative to ultrasonic blade540from a spaced-apart position to an approximated position to clamp tissue between ultrasonic blade540and jaw member550. Jaw member550includes a rigid structural frame552that is operably coupled to body510, and a compliant jaw liner554that is captured by rigid structural frame552and positioned to oppose ultrasonic blade540to enable clamping of tissue therebetween.

Referring again toFIGS.5-7, actuation assembly190is disposed within housing120and includes an articulation sub-assembly200and a jaw drive sub-assembly400. Articulation sub-assembly200is operably coupled between first and second input couplers191,192, respectively, of actuation assembly190and articulation cables138(FIG.9) such that, upon receipt of appropriate inputs into first and/or second input couplers191,192, articulation sub-assembly200manipulates articulation cables138(FIG.9) to articulate end effector assembly500in a desired direction, e.g., to pitch and/or yaw end effector assembly500.

Jaw drive sub-assembly400operably couples fourth input coupler194of actuation assembly190with jaw member550such that, upon receipt of appropriate input, e.g., in a first rotational direction, into fourth coupler194, jaw drive sub-assembly400pivots jaw member550towards the approximated position to clamp tissue between and apply a jaw force within an appropriate jaw force range to tissue clamped between compliant jaw liner554of jaw member550and ultrasonic blade540, and such that, upon receipt of appropriate input, e.g., in a second, opposite rotational direction, into fourth input coupler194, jaw drive sub-assembly400pivots jaw member550towards the spaced-apart position to release clamped tissue. Alternatively, jaw drive sub-assembly400may be configured to receive separate inputs for opening and closing jaw member550. In either configuration, jaw drive sub-assembly400may be tuned to provide a jaw clamping force, or jaw clamping force within a jaw clamping force range, to tissue clamped between jaw member550and ultrasonic blade540, such as described in U.S. Patent Application Pub. No. 2022/0117622, the entire contents of which are hereby incorporated herein by reference. Alternatively, the jaw drive sub-assembly400may include a force limiting feature, e.g., a spring, whereby the clamping force applied to tissue clamped between jaw member550and ultrasonic blade540is limited to a particular jaw clamping force or a jaw clamping force within a jaw clamping force range, such as described in U.S. Pat. No. 10,368,898, the entire contents of which are hereby incorporated herein by reference.

Actuation assembly190is configured to operably interface with a surgical robotic system, e.g., system10(FIG.1), when instrument110is mounted on a robotic arm thereof, to enable robotic operation of actuation assembly190to provide the above detailed functionality. That is, surgical robotic system10(FIG.1) selectively provides inputs, e.g., rotational inputs to input couplers191-194of actuation assembly190to articulate end effector assembly550, clamp tissue between jaw member550and ultrasonic blade540, release tissue (e.g., sealed and/or transected tissue) from between jaw member550and ultrasonic blade540, and, in aspects, rotate end effector assembly500. However, as noted above, it is also contemplated that actuation assembly190be configured to interface with any other suitable surgical systems, e.g., a manual surgical handle, a powered surgical handle, etc.

Turing toFIGS.8-15B, a distal portion of surgical instrument110(FIGS.5-6B) is shown and described in greater detail. As noted above, surgical instrument110(FIGS.5-6B) includes a shaft assembly130having a proximal shaft134and an articulating section136disposed between and interconnecting proximal shaft134with end effector assembly500.

Referring toFIGS.8and9, articulating section136of shaft assembly130of surgical instrument110(FIGS.5-6B) includes an articulating component600formed monolithically from a single piece of material (e.g., a biocompatible polymer or other suitable material), although other configurations are also contemplated. Articulating component600includes a proximal disk610, a distal disk620, one or more intermediate disks630disposed between the proximal and distal disks610,620, respectively, and a flexible interconnect640,650interconnecting each pair of adjacent disks610,620,630.

Proximal disk610is engaged to a distal end of proximal shaft134to thereby secure a proximal end of articulating component600to the distal end of proximal shaft134. Proximal disk610defines a plurality of apertures612defined longitudinally therethrough. Apertures612are radially-spaced about the periphery of disk610. In aspects, four apertures612are provided offset approximately 90 degrees relative to one another, although any other suitable number and/or positioning of apertures612is also contemplated. Each aperture612is configured to receive one of the articulation cables138of articulation sub-assembly200of actuation assembly190(seeFIG.7) therethrough.

Distal disk620is configured to engage and, in aspects, releasably engage, a proximal end of end effector assembly500to thereby secure a distal end of articulating component600to the proximal end of end effector assembly500. Distal disk620defines a plurality of apertures622defined longitudinally therethrough. Apertures622are radially-spaced about the periphery of disk620. In aspects, two apertures622are provided offset approximately 180 degrees relative to one another, although any other suitable number and/or positioning of apertures622is also contemplated. Each aperture622is configured to receive an articulation cable138of articulation sub-assembly200of actuation assembly190(seeFIG.7) therethrough with the articulation cable138anchored on a distal side of the aperture622, e.g., via a ball, knot, ferrule, or other suitable anchor configured to inhibit passage of the distal end of the articulation able138proximally through the corresponding aperture622.

Distal disk620further includes a distal connector660configured to enable releasable engagement of end effector assembly500with articulating component600, as detailed below, although other suitable configurations including integrated configurations are also contemplated.

The one or more intermediate disks630are disposed between the proximal and distal disks610,620, respectively. Although detailed below with respect to one intermediate disk630(in the singular, for purposes of clarity), it is understood that multiple intermediate disks630may be provided. Intermediate disk630defines a plurality of apertures632longitudinally therethrough. Apertures632are radially-spaced about the periphery of disk630and are aligned with corresponding apertures612of disk610, e.g., four apertures632are provided offset approximately 90 degrees relative to one another. Further, two of apertures632are aligned with corresponding apertures622of disk620. In this manner, the articulation cables138, e.g., four articulation cables138, extending through apertures612of proximal disk610also extend through apertures632of intermediate disk630. Two diametrically-opposed articulation cables138of the four articulation cables138are anchored on distal sides of the corresponding apertures632of intermediate disk630, e.g., via a ball, knot, ferrule, or other suitable anchor configured to inhibit passage of the distal end of the articulation cable138proximally through the corresponding aperture632. The other two diametrically-opposed articulation cables138of the four articulation cables138extend distally from intermediate disk630and through corresponding apertures622of distal disk620wherein, as noted above, these articulation cables138are anchored on the distal side of distal disk620.

With additional reference toFIGS.10A and10B, flexible interconnects640,650interconnect proximal and intermediate disks610,630and intermediate and distal disks630,620, respectively. Each flexible interconnect640,650defines a single plane of flexibility. More specifically, flexible interconnects640,650may define beam configurations having a pair of opposed relatively narrow sides and a pair of opposed relatively broad sides. In this manner, each flexible interconnect640,650is configured to flex in directions defined within a single plane extending substantially parallel to the relatively narrow sides and substantially perpendicular to the relatively broad sides. However, other suitable configurations of flexible interconnects640,650each having a single plane of flexibility are also contemplated. Flexible interconnects640,650may define narrowed thickness portions and/or openings defined therethrough to facilitate bending with the respective planes of flexibility thereof. Each flexible interconnect640,650may be configured to flex to a bend angle of at least 60 degrees; in aspects, at least 75 degrees; and in still other aspects, at least 90 degrees. In aspects, flexible interconnects640,650intersect a longitudinal axis defined through proximal shaft134and, in some aspects, may be centered on the longitudinal axis defined through proximal shaft134.

Continuing with reference toFIGS.8-10B, flexible interconnects640,650are offset approximately 90 degrees relative to one another such that the planes of flexibility defined by flexible interconnects640,650are substantially perpendicular to one another. Further, the two diametrically-opposed articulation cables138anchored on the distal side of intermediate disk630extend between proximal disk610and intermediate disk630along a plane that is substantially parallel or coplanar with the plane of flexibility defined by flexible interconnect640, while the two diametrically-opposed articulation cables138anchored on the distal side of distal disk620extend between intermediate disk630and distal disk620along a plane that is substantially parallel or coplanar with the plane of flexibility defined by flexible interconnect650. In this manner, actuation of the two diametrically-opposed articulation cables138anchored on the distal sides of intermediate disk630in opposite manners (e.g., tensioning one of the cables138and de-tensioning the opposed cable138) flexes flexible interconnect640to bend within the plane of flexibility thereof (with the direction of bending depending upon which of the cable138is tensioned and which cable138is de-tensioned), while actuation of the two diametrically-opposed articulation cables138anchored on the distal sides of distal disk620in opposite manners (e.g., tensioning one of the cables138and de-tensioning the opposed cable138) flexes flexible interconnect650to bend within the plane of flexibility thereof (with the direction of bending depending upon which of the cable138is tensioned and which cable138is de-tensioned). In aspects, flexible interconnects640,650are oriented relative to one another and proximal shaft134such that flexion of flexible interconnects640,650within the planes of flexibility thereof provides pitch and yaw articulation, respectively, of end effector assembly500relative to proximal shaft134.

With additional reference toFIG.7, articulation sub-assembly200is operably coupled between first and second input couplers191,192, respectively, of actuation assembly190and the articulation cables138(FIG.9) and configured such that: in response to a rotational input into first coupler191in a first direction, articulation sub-assembly200actuates the two diametrically-opposed articulation cables138anchored on the distal sides of intermediate disk630in opposite directions with equal magnitude to articulate end effector assembly500in an upward pitch direction; in response to a rotational input into first coupler191in a second, opposite direction, articulation sub-assembly200actuates the two diametrically-opposed articulation cables138anchored on the distal sides of intermediate disk630in opposite directions with equal magnitude (oppositely from above) to articulate end effector assembly500in an downward pitch direction; in response to a rotational input into second coupler192in a first direction, articulation sub-assembly200actuates the two diametrically-opposed articulation cables138anchored on the distal sides of distal disk620in opposite directions with equal magnitude to articulate end effector assembly500in an right yaw direction; and in response to a rotational input into second coupler192in a second direction, articulation sub-assembly200actuates the two diametrically-opposed articulation cables138anchored on the distal sides of distal disk620in opposite directions with equal magnitude (oppositely from above) to articulate end effector assembly500in an left yaw direction. Accordingly, any suitable combination of pitch and/or yaw articulation (or other suitable articulation) can be achieved.

In aspects, articulating component600includes one or more lumens such as, for example, a central lumen670(FIG.10A) extending through each of the disks610,620,630and flexible interconnects640,650. Central lumen670(FIG.10A) enables the passage of jaw open and close cables580,590, respectively, from proximal shaft134through articulating component600to end effector assembly500to enable pivoting of jaw member550towards and away from ultrasonic blade540, respectively, as detailed below. Electrical wires for delivering electrical signals to drive ultrasonic transducer532of end effector assembly500may likewise extend through one of the lumens, e.g., central lumen670(FIG.10A); alternatively, electrical communication may be established in any other suitable manner such as, for example, via wires, electrically-conductive structures of surgical instrument110(FIGS.5-7), and/or combinations thereof.

Referring toFIGS.8and11-13, end effector assembly500, as noted above, may be utilized with surgical instrument110(FIGS.5-7) or any other suitable surgical instrument and generally includes body510retaining ultrasonic transducer532therein, an ultrasonic horn534coupled to and extending distally from ultrasonic transducer534, an ultrasonic blade540coupled to and extending distally from ultrasonic horn534and body510, and jaw member550operably coupled to body510to enable pivoting of jaw member550relative to ultrasonic blade540between the spaced-apart position and the approximated position. End effector assembly500, in addition or as an alternative to the description herein, may include any of the aspects and features of the end effector assembly detailed in U.S. Provisional Patent Application No. 63/325,195, filed on Mar. 30, 2022, the entire contents of which are hereby incorporated herein by reference.

Body510of end effector assembly500encloses and secures ultrasonic transducer532therein. Body510includes a proximal connector512configured to releasably engage distal connector660of articulating component600to releasably engage end effector assembly500with articulating component600, although other suitable configurations including integrated configurations are also contemplated. Body510further includes first and second cable guide channels516a,516bconfigured to guide jaw open and close cables580,590from jaw member550proximally along body510to articulating component600, wherein jaw open and close cables580,590may extend through, about, along or otherwise proximally relative to articulating component600and, ultimately, through proximal shaft134to connect to jaw drive sub-assembly400of actuation assembly190(seeFIG.7). Body510may also include proximal apertures (not shown) for electrical wires and/or other suitable electrically-conductive pass-through connectors to enable passage of electrical signals through body510and to ultrasonic transducer532to drive ultrasonic transducer532. Body510, in aspects, may be configured to engage ultrasonic horn534and sealingly enclose ultrasonic transducer532therein similarly as detailed in Patent Application Publication Nos. US 2019/0231385, US 2021/0369295, and/or WO 2021/006984, the entire contents of each of which is hereby incorporated herein by reference.

Continuing with reference toFIGS.8and11-13, ultrasonic transducer532may include a stack of piezoelectric elements secured, under pre-compression between proximal and distal end masses or a proximal end mass and ultrasonic horn534with electrodes (not shown) electrically coupled between piezoelectric elements of the stack of piezoelectric elements to enable energization thereof to produce ultrasonic energy. However, other suitable ultrasonic transducer configurations, including plural transducers and/or non-linear transducers are also contemplated. Electrical lead wires or other suitable electrical communication paths (not shown) are configured to connect the electrodes of ultrasonic transducer532with an ultrasonic generator (not shown) to enable an electrical drive signal generated by the ultrasonic generator to be imparted to the stack of piezoelectric elements of ultrasonic transducer532to energize the stack of piezoelectric elements to produce ultrasonic energy for transmission to ultrasonic blade540via ultrasonic horn534to treat tissue, e.g., seal, transect, dissect, score, perform an otomy, or otherwise treat tissue.

Ultrasonic horn534is engaged to the stack of piezoelectric elements of ultrasonic transducer532and extends distally therefrom. Ultrasonic blade540extends distally from ultrasonic horn534and distally from body510. Ultrasonic blade540may define a curved configuration wherein the directions of movement of jaw member550between the spaced-apart and approximated positions are perpendicular to the direction of curvature of ultrasonic blade540. However, it is also contemplated that ultrasonic blade540define a straight configuration or that ultrasonic blade540additionally or alternatively curve towards or away from jaw member550; that is, where the directions of movement of jaw member550between the spaced-apart and approximated positions are coplanar or parallel to the direction of curvature of ultrasonic blade540. Multiple curvatures of ultrasonic blade540(in the same or different directions) and/or combinations of curved and linear portions of ultrasonic blade540are also contemplated. Likewise, some portions or surfaces of ultrasonic blade540may be curved while others are not curved. Ultrasonic blade540may additionally or alternatively taper in width (a dimension perpendicular to the directions of movement of jaw member550in a proximal-to-distal direction and/or in height (a dimension parallel or coplanar with the directions of movement of jaw member550) in a proximal-to-distal direction. Other configurations are also contemplated.

Jaw member550of end effector assembly500, as noted above, includes rigid structural frame552and compliant jaw liner554. Rigid structural frame552includes a bifurcated proximal portion555(e.g., to receive ultrasonic blade540therebetween) and an elongated distal portion556extending distally from bifurcated proximal portion555. Bifurcated proximal portion555includes first and second spaced-apart jaw flags557a,557b. Pivot bosses559(only one of which is shown) are aligned with one another (thereby defining a pivot axis), extend outwardly from flags557a,557b, and are configured for receipt within opposing apertures529(only one of which is shown) of body510to thereby pivotably couple jaw member550with body510. One of the jaw flags, e.g., jaw flag557a, further defines a pulley560aincluding an annular channel560bdefined about an outer periphery thereof. A notch562is defined within pulley560ain communication with annular channel560b.

Jaw open and close cables580,590, respectively, may be formed via a single cable having a looped distal end disposed between jaw open cable580and jaw close cable590. More specifically, as shown inFIG.13, the looped distal end of the single cable defining jaw open and close cables580,590, respectively, may be disposed about pulley560a, at least partially seated within annular channel560bof jaw member550. A keying collar564fixed, e.g., as a crimp or in any other suitable manner, about the looped distal end of the single cable defining jaw open and close cables580,590, respectively, is fixed (permanently or removably) within notch562, e.g., via welding, adhesion, or mechanical engagement, to thereby define an anchor point where the looped distal end of the single cable defining jaw open and close cables580,590, respectively, is fixed relative to pulley560a. Thus, when jaw open cable580is pulled proximally (and jaw close cable590is de-tensioned), jaw member550is urged to pivot away from ultrasonic blade540towards the open position. On the other hand, when jaw close cable590is pulled proximally (and jaw open cable580is de-tensioned), jaw member550is urged to pivot towards ultrasonic blade540towards the closed position.

With additional reference toFIG.7, jaw open and close cables580,590, respectively, extend proximally through first and second cable guide channels516a,516b, respectively, through and/or about articulating component600(FIG.9), and through proximal shaft134to connect with jaw drive sub-assembly400of actuation assembly190. More specifically, jaw open and close cables580,590, respectively, may be coupled to jaw drive sub-assembly400in an equal and opposite manner such that a rotational input in a first direction to an input coupler194associated with actuation assembly190(FIG.7) actuates jaw drive sub-assembly400to pull jaw open cable580proximally while de-tensioning jaw close cable590(allowing jaw close cable590to move distally), thereby pivoting jaw member550away from ultrasonic blade540towards the open position, and such that a rotational input in a second, opposite direction to input coupler194actuates jaw drive sub-assembly400to pull jaw close cable590proximally while de-tensioning jaw open cable580(allowing jaw open cable580to move distally), thereby pivoting jaw member550towards ultrasonic blade540towards the closed position, e.g., to grasp tissue between jaw member550and ultrasonic blade540.

Turning toFIGS.10A,11, and14-15B, as noted above, in aspects, body510of end effector assembly500includes a proximal connector512configured to releasably engage distal connector660of distal disk620of articulating component600to releasably engage end effector assembly500with articulating component600and, thus, the remainder of surgical instrument110(FIGS.5-8). Further, it is understood that the features of connector660and proximal connector512detailed below may be reversed.

Connector660includes a pair of spaced-apart rails662,664defining a slot666therebetween. Connector660may further include a spring tab668defined at the free end of a resilient living hinge669disposed towards the open end of slot666of connector660.

Proximal connector512includes a proximally-extending neck513aand a head513bdisposed at the free end of neck513a. Head513bdefines a width (or diameter) greater than a width (or diameter) of neck513a. More specifically, head513bis configured to slide transversely between rails662,664and into slot666of connector660but is sufficiently dimensioned to inhibit longitudinal passage between rails662,664and out of slot666. Neck513a, on the other hand, is configured to extend longitudinally between and distally from rails662,664when head513bis engaged within slot666. With head513bfully received within slot666, spring tab668is configured to engage head513bto thereby secure head513bwithin slot666transversely between the closed end of slot666and spring tab668, thereby securely engaging end effector assembly500with articulating component600. In aspects, end effector assembly500is permitted to rotate relative to articulating component600despite this secure engagement; in other aspects, end effector assembly500is rotationally fixed. Spring tab668may be manually displaced, against the bias thereof, to disengage spring tab668from head513band enable transverse withdrawal of proximal connector512from slot666of connector660, thereby disengaging end effector assembly500from articulating component600.

Proximal connector512and connector660may define cooperating electrical contacts (not explicitly shown) that are configured to electrically couple with one another upon engagement of end effector assembly500with articulating component600to thereby connect ultrasonic transducer532of end effector assembly500to electrical wires and/or structures extending through the remainder of surgical instrument110(FIGS.5-7) and ultimately connected to the ultrasonic generator, thus enabling driving of ultrasonic transducer532when end effector assembly500is engaged with articulating component600. Alternatively, manual electrical connections may be established.

Jaw open and close cables580,590, respectively, may additionally or alternatively be releasably engagable with jaw member550to facilitate releasable operable engagement of end effector assembly500with articulating component600. More specifically, jaw open and close cables580,590, respectively, may be releasably seated within annular channel560bof pulley560aof jaw member550via releasable engagement of keying collar564within notch562. Other suitable releasable engagements are also contemplated such as, for example, intermediate connectors along jaw open and close cables580,590, respectively, to enable releasable engagement between proximal and distal portions of jaw open and close cables580,590, respectively.

With reference toFIGS.16-18, a rotation mechanism configured for use with surgical instrument110(FIGS.5-7) or any other suitable surgical instrument is shown generally identified by reference numeral800. Rotation mechanism800includes a cable810having a clockwise rotation cable portion812, a counterclockwise rotation cable portion814, and a partially looped cable portion816. Clockwise and counterclockwise rotation cable portions812,814, respectively, of cable810extend proximally through and/or about articulating component600and through proximal shaft134to connect with actuation assembly190. More specifically, Clockwise and counterclockwise rotation cable portions812,814, respectively, of cable810may be coupled to a rotation drive assembly (not explicitly shown) in an equal and opposite manner such that a suitable rotational input, e.g., in a first direction, to an input coupler193associated with actuation assembly190(FIG.7) pulls clockwise rotation cable portion812proximally while de-tensioning and allowing counterclockwise rotation cable portion814to move distally and such that a suitable rotational input, e.g., in a second, opposite direction, to input coupler193de-tensions clockwise rotation cable portion812allowing clockwise rotation cable portion812to move distally and pulls counterclockwise rotation cable portion814proximally. Alternatively, actuation assembly190(FIG.7) may be configured to receive separate inputs for proximally pulling clockwise and counterclockwise rotation cable portions812,814, respectively.

Rotation mechanism800further includes proximal connector512of end effector assembly500which, as noted above, includes a head513bcoupled to articulating component600(FIGS.8-9) or other suitable portion of surgical instrument110(FIG.7), e.g., via removable or integral engagement. More specifically, in aspects, whether removable or integral, head513bis rotatably coupled to articulating component600(FIGS.8-9) or other suitable portion of surgical instrument110(FIG.7). Head513bdefines a disk-shaped configuration (facilitating the above-noted rotatable engagement) and includes an annular track820defined about the annular perimeter of the disk-shaped head513b. Partially looped cable portion816extends circumferentially greater than 180 degrees but less than 360 degrees and is seated within annular track820of head513bof proximal connector512. As a result of this configuration, when clockwise rotation cable portion812is pulled proximally (and counterclockwise rotation cable portion814moves distally), cable810slides through annular track820in a clockwise direction. As cable810slides through annular track820, friction between cable810and annular track820generates a clockwise torque at proximal connector512, thereby urging end effector assembly500to rotate in a clockwise direction about and relative to articulating component600and proximal shaft134. On the other hand, when counterclockwise rotation cable portion814is pulled proximally (and clockwise rotation cable portion812moves distally), cable810slides through annular track820in a counterclockwise direction. As cable810slides through annular track820, friction between cable810and annular track820generates a counterclockwise torque at proximal connector512, thereby urging end effector assembly500to rotate in a counterclockwise direction about and relative to articulating component600and proximal shaft134. Suitable structures such as, for example, roughened surfaces, protrusions, indents, teeth, and the like may be provided on cable810and/or annular track820to increase friction and, thus, increase torque generation and/or to otherwise facilitate rotation or rotational control of end effector assembly500about and relative to articulating component600and proximal shaft134.

Thus, as detailed above, rotation mechanism800enables selective rotation of end effector assembly500relative to articulating component600and proximal shaft134, e.g., in response to a corresponding input to input coupler193of actuation assembly190(FIG.7). This rotation may be provided in addition to the multi-plane, e.g., pitch and yaw, articulation provided by articulating component600, as detailed above; may be in addition to single-plane (e.g., pitch or yaw) articulation provided by articulating component600; or may be utilized with (or without) any other suitable articulation mechanism.

Although this disclosure is detailed with respect to an ultrasonic surgical instrument including a distally positioned transducer, this disclosure is equally applicable to other suitable surgical instruments. For example and without limitation, the transducer, ultrasonic horn, and ultrasonic blade may be replaced with energy-generating electrodes and an opposing jaw member configured for positioning opposite the movable jaw member. In such configurations, the proximal body of the end effector assembly may house power, energy-generating, and/or control electronics to operate an energy-based component associated with the fixed jaw member and/or the movable jaw member, e.g., either or both including an RF electrode for monopolar or bipolar tissue treatment, a thermal cutting element configured to thermally treat tissue, a microwave probe, combinations of various different energy modalities, etc.

It will be understood that various modifications may be made to the aspects and features disclosed herein. Therefore, the above description should not be construed as limiting, but merely as exemplifications of various configurations. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.