CN104023652B - 机器人控制的一次性的马达驱动加载单元 - Google Patents

机器人控制的一次性的马达驱动加载单元 Download PDF

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CN104023652B
CN104023652B CN201280036902.XA CN201280036902A CN104023652B CN 104023652 B CN104023652 B CN 104023652B CN 201280036902 A CN201280036902 A CN 201280036902A CN 104023652 B CN104023652 B CN 104023652B
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assembly
surgical
gear
axially
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CN104023652A (zh
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K·P·穆尔
F·E·谢尔顿四世
W·B·威森伯格二世
J·R·摩根
M·H·兰西克
E·L·蒂姆珀曼
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Ethicon Endo Surgery Inc
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Abstract

本发明公开了一种与能够生成控制系统的机器人系统一起使用的独立成套的马达驱动一次性加载单元(16)。所述一次性加载单元可包括电池(526)，当所述一次性加载单元不使用时，所述电池保持在断开位置，并且当所述一次性加载单元联接到所述机器人系统时，所述电池运动到连接位置，从而允许所述电池为所述马达(562)选择性地供电。指示器可支撑在所述一次性加载单元上以指示其所述轴向驱动组件何时处于起始位置和结束位置。可提供另一个指示器以指示所述砧座组件何时处于闭合位置。

Description

机器人控制的一次性的马达驱动加载单元
相关专利申请的交叉引用
该非临时性专利申请是提交于2010年8月13日的美国专利申请序列号12/856,099的部分继续专利申请，美国专利公开文献US2010/0301096A1是提交于2008年2月14日的美国专利申请序列号12/031,628(现为美国专利No.7,793,812)的继续专利申请，所述专利申请的公开内容各自全文以引用的方式并入本文。
技术领域
本发明整体涉及内窥镜式外科器械，包括但不限于具有一次性加载单元的外科切割和缝合装置，所述装置能够将成排的钉施加到组织同时切割那些成排钉之间的组织，更具体地讲，涉及关于此类一次性加载单元的改进。
背景技术
内窥镜式外科器械通常优选于传统的开放式外科装置，因为较小的切口趋于缩短术后恢复时间并减少并发症。因此，已对适用于将远侧端部执行器通过套管针的插管精确地设置在所需的外科手术部位的一系列内窥镜式外科器械进行了显著的开发。这些远侧端部执行器以多种方式接合组织以实现诊断或治疗效果(例如，直线切割器、抓紧器、切割器、缝合器、施夹器、进入装置、药物/基因治疗递送装置和使用超声波、RF、激光等的能量装置)。
已知的外科缝合器包括端部执行器，所述端部执行器同时在组织中制造纵向切口和在切口的相对侧上施加成排的钉。端部执行器包括一对协同工作的钳口构件，如果意图将器械用于内窥镜式或腹腔镜式应用，则钳口构件能够穿过插管通道。钳口构件中的一个支撑钉仓，所述钉仓具有横向间隔开的至少两排钉。另一钳口构件限定砧座，所述砧座具有与仓中的钉排对齐的钉成形凹坑。器械通常包括多个往复式楔形件，当朝远侧驱动时，所述往复式楔形件穿过钉仓中的开口并且接合支撑钉的驱动器，以使钉朝着砧座击发。
一种类型的外科缝合装置能够用一次性加载单元(DLU)进行操作，所述一次性加载单元能够支撑其中的钉仓和刀组件。一旦手术完成，整个DLU被丢弃。被设计为容纳DLU的此类器械旨在提供用于器械的每次击发的“新的”刀片的优点。此类外科缝合装置和DLU的例子在Milliman等人的美国专利No,5,865,361中有所公开，所述专利的公开内容全文以引用的方式并入本文。
然而，此类现有的一次性加载单元需要临床医生连续地扳动柄部以击发钉并切割组织。因此，需要与一次性加载单元能够一起使用的外科缝合装置，所述一次性加载单元由包含在其中的马达驱动。
发明内容
在本发明的各种实施例的一个总的方面，提供了用于附接外科切割和缝合装置的一次性加载单元。在各种实施例中，一次性加载单元可包括载体，所述载体支撑其中的钉仓。砧座组件可活动地联接到载体以用于相对于钉仓在打开位置和闭合位置之间选择性地活动行进。轴向驱动组件可支撑在载体内，使得其在从起始位置至结束位置的远侧方向上运动穿过载体和钉仓。轴向驱动组件还可以在从结束位置至起始位置的近侧方向上回缩。马达可支撑在载体内并被构造为在远侧方向和近侧方向上驱动轴向驱动组件。电池可支撑在载体内并可联接到马达以向其提供功率。
在本发明的各种实施例的另一个总的方面，提供了用于附接外科切割和缝合装置的一次性加载单元。在各种实施例中，一次性加载单元包括载体，所述载体支撑其中的钉仓。砧座组件可活动地联接到载体以用于相对于钉仓在打开位置和闭合位置之间选择性地活动行进。外壳可联接到载体，并能够为可拆卸地且可操作地附接到外科缝合装置。轴向驱动组件可支撑在载体和外壳内，以使其在从起始位置至结束位置的远侧方向上运动穿过载体和钉仓。轴向驱动组件还可以在从结束位置至起始位置的近侧方向上回缩。马达可支撑在载体内，并能够与轴向驱动组件交接以在远侧和近侧方向上驱动轴向驱动组件。电池可支撑在载体内并可联接到马达以向其提供功率。电池可响应于由外科缝合装置的一部分向其施加的运动而在断开位置和连接位置之间选择性地运动。
在本发明的各种实施例的另一个总的方面，提供了外科切割和缝合装置。器械的各种实施例可包括可操作地支撑其中的驱动组件的柄部组件，所述驱动组件被构造为施加驱动运动和回缩运动。可活动的柄部部分可操作地支撑在柄部组件上并能够与驱动系统交接，使得可活动的柄部的操纵引起驱动系统施加驱动运动。细长主体可从柄部组件伸出，并具有联接到一次性加载单元的远端。在各种实施例中，一次性加载单元可包括载体，所述载体具有被支撑在其中的钉仓。砧座组件可活动地联接到载体以用于相对于钉仓在打开位置和闭合位置之间选择性地活动行进。轴向驱动组件可支撑在载体内，使得轴向驱动组件在从起始位置至结束位置的远侧方向上运动穿过载体和钉仓，并且还在从结束位置至起始位置的近侧方向上运动。马达可支撑在载体内，并能够与轴向驱动组件交接以在远侧和近侧方向上驱动轴向驱动组件。电池可支撑在载体内并可联接到马达以向其提供功率。电池能够与细长主体的一部分交接以在操纵可活动的柄部时从其接收驱动运动。
根据本发明的各种实施例的其他总的方面，提供了与远程可控系统一起使用的一次性加载单元。在各种实施例中，一次性加载单元包括具有与其联接的细长外壳的仓组件，所述细长外壳能够可操作地附接到细长轴组件以用于从远程可控系统的控制部分传输控制运动。一次性加载单元还包括轴向驱动组件，支撑所述轴向驱动组件以在细长轴组件向其施加旋转控制运动时从起始位置至结束位置选择性地轴向行进穿过仓组件。马达支撑在外壳内并可操作地与轴向驱动组件交接以选择性地向其施加旋转运动。在附接到控制构件时，所述功率源能够在所述外壳内从断开位置轴向运动至第一连接位置，在所述断开位置处，所述功率源与所述马达断开，在所述第一连接位置处，所述功率源向所述马达提供功率。
根据本发明的各种实施例的其他总的方面，提供了包括工具驱动部分的外科器械，所述工具驱动部分能够可操作地附接到机器人系统的一部分以用于从其接收控制运动。将细长轴联接到工具驱动部分。可轴向运动的控制构件可操作地支撑在细长轴内，并且可响应于从机器人系统向其施加的致动运动而轴向运动。外科器械还包括具有联接到细长轴的外壳的一次性加载单元。钉仓由外壳组件支撑，并且支撑轴向驱动组件以在向其施加旋转运动时从起始位置至结束位置选择性地轴向行进穿过仓组件。马达支撑在外壳内并可操作地与轴向驱动组件交接以选择性地向其施加旋转运动。在附接到控制构件时，功率源在外壳内从其中功率源与马达断开的断开位置轴向运动至其中功率源为马达提供功率的第一连接位置。
根据本发明的各种实施例的其他总的方面，提供了包括工具驱动部分的外科器械，所述工具驱动部分能够可操作地附接到机器人系统的一部分以用于从其接收控制运动。将细长轴联接到工具驱动部分。可轴向运动的控制构件可操作地支撑在细长轴内，并且可响应于从机器人系统向其施加的致动运动而轴向运动。外科器械还包括具有联接到细长轴的外壳的一次性加载单元。钉仓由外壳组件支撑，并且支撑轴向驱动组件以在向其施加旋转运动时从起始位置至结束位置选择性地轴向行进穿过仓组件。马达支撑在外壳内并可操作地与轴向驱动组件交接以选择性地向其施加旋转运动。活动的电池保持器可联接到控制构件，并且响应于由控制杆向其施加的运动在外壳内轴向运动。电池支撑在电池外壳内，并且能够与外壳中的一系列轴向间隔的接触结构轴向连通以用于控制电池对马达的功率供应。
从附图及其描述，本发明的这些和其他目的和优点将变得显而易见。
附图说明
并入本文中并且构成本说明书一部分的附图示出了本发明的实施例，并且与上面所给出本发明的各种实施例的概述和下面所给出的实施例的具体实施方式一起用于解释本发明的各种原理。
图1为联接到常规的外科切割和缝合装置的本发明的一次性加载单元实施例的透视图；
图2为图1的一次性加载单元的剖视图，其中为了清楚起见，多个部件以全视图示出；
图3为图1和2的一次性加载单元实施例的近端的剖视图，其中为了清楚起见，各种部件以全视图示出；
图4为图1-3的一次性加载单元的电路实施例的示意图；
图5为当一次性加载单元附接到外科器械的细长主体时图1-3的一次性加载单元的剖视图；
图6为示出了在一次性加载单元附接到外科器械之后一次性加载单元的各种部件的位置的电路的示意图；
图7为当驱动梁运动至砧座闭合位置时图1-6的一次性加载单元的剖视图；
图8为示出了在驱动梁运动至砧座闭合位置之后一次性加载单元的各种部件的位置的电路的示意图；
图9为当驱动梁运动至其最远端击发位置时图1-8的一次性加载单元的剖视图；
图10为示出了在驱动梁运动至其最远端击发位置之后一次性加载单元的各种部件的位置的电路的示意图；
图11为当驱动梁返回至起始位置时图1-10的一次性加载单元的剖视图；
图12为示出了当驱动梁返回至起始位置时一次性加载单元的各种部件的位置的电路的示意图；
图13为一个机器人控制器实施例的透视图；
图14为可操作地支撑本发明的多个外科工具实施例的机器人系统的一个机器人外科臂车/操纵器的透视图；
图15为图14中示出的机器人外科臂车/操纵器的侧视图；
图16为具有用于可操作地支撑机器人操纵器的定位连杆的示例性的臂车结构的透视图，该机器人操纵器可与本发明的各种外科工具实施例一起使用；
图17为本发明的外科工具实施例的透视图；
图18为用于将各种外科工具实施例附接到机器人系统的适配器和工具保持器结构的分解组件视图；
图19为图18中示出的适配器的侧视图；
图20为图18中示出的适配器的底视图；
图21为图18和19的适配器的顶视图；
图22为图17的外科工具实施例的部分底部透视图；
图23为本发明的可进行关节运动的外科端部执行器实施例的一部分的局部分解图；
图24为移除了工具安装外壳的图22的外科工具实施例的透视图；
图25为移除了工具安装外壳的图22的外科工具实施例的后部透视图；
图26为移除了工具安装外壳的图22的外科工具实施例的前透视图；
图27为图26的外科工具实施例的部分分解透视图；
图28为图22的外科工具实施例的部分横截面侧视图；
图29为图28中示出的外科工具的一部分的放大剖视图；
图30为图22中示出的外科工具实施例的工具安装部分的一部分的分解透视图；
图31为图30的工具安装部分的一部分的放大分解透视图；
图32为图22的外科工具的细长轴组件的一部分的局部剖视图；
图33为本发明的外科工具实施例的闭合螺母实施例的半部分的侧视图；
图34为本发明的另一个外科工具实施例的透视图；
图35为图34的外科工具实施例的外科端部执行器和细长轴组件的一部分的横截面侧视图，其中砧座处于打开位置并且闭合离合器组件处于中间位置；
图36为图35中示出的外科端部执行器和细长轴组件的另一个横截面侧视图，其中离合器组件接合于闭合位置；
图37为图35中示出的外科端部执行器和细长轴组件的另一个横截面侧视图，其中离合器组件接合于击发位置；
图38是本发明的工具安装部分实施例的一部分的顶视图；
图39为本发明的另一个外科工具实施例的透视图；
图40为图39的外科工具实施例的外科端部执行器和细长轴组件的一部分的横截面侧视图，其中砧座处于打开位置；
图41为图39的外科工具实施例的外科端部执行器和细长轴组件的一部分的另一个横截面侧视图，其中砧座处于闭合位置；
图42为本发明的闭合驱动螺母和部分刀杆实施例的透视图；
图43为本发明的另一个工具安装部分实施例的顶视图；
图44为本发明的另一个外科工具实施例的透视图；
图45为图44的外科工具实施例的外科端部执行器和细长轴组件的一部分的横截面侧视图，其中砧座处于打开位置；
图46为图45的外科工具实施例的外科端部执行器和细长轴组件的一部分的另一个横截面侧视图，其中砧座处于闭合位置；
图47为本发明的外科工具实施例的安装衬圈实施例的剖视图，示出了闭合驱动轴的刀杆和远端部分；
图48为图47的安装衬圈实施例的剖视图；
图49为本发明的另一个外科工具实施例的另一个工具安装部分实施例的顶视图；
图49A为本发明的另一个外科工具实施例的齿轮结构的一部分的分解透视图；
图49B为图49A中示出的齿轮结构的横截面透视图；
图50为采用了压力传感器结构的本发明的另一个外科工具实施例的外科端部执行器和细长轴组件的一部分的横截面侧视图，其中砧座处于打开位置；
图51为图50的外科工具实施例的外科端部执行器和细长轴组件的一部分的另一个横截面侧视图，其中砧座处于闭合位置；
图52为与机器人系统的工具保持器部分相关的本发明的另一个外科工具实施例的一部分的侧视图，其一些部件以横截面示出；
图53为与机器人系统的工具保持器部分相关的本发明的另一个外科工具实施例的一部分的侧视图，其一些部件以横截面示出；
图54为本发明的另一个外科工具实施例的一部分的侧视图，其一些部件以横截面示出；
图55为本发明的外科工具实施例的一部分的另一个外科端部执行器实施例的一部分的侧视图，其一些部件以横截面示出；
图56为本发明的外科工具实施例的一部分的另一个外科端部执行器实施例的一部分的侧视图，其一些部件以横截面示出；
图57为本发明的外科工具实施例的一部分的另一个外科端部执行器实施例的一部分的侧视图，其一些部件以横截面示出；
图58为图57的端部执行器的一部分的放大剖视图；
图59为图57和58的端部执行器的一部分的另一个剖视图；
图60为本发明的另一个外科工具实施例的外科端部执行器和细长轴组件的一部分的横截面侧视图，其中砧座处于打开位置；
图61为图60的外科工具实施例的外科端部执行器和细长轴组件的一部分的放大横截面侧视图；
图62为图60和61的外科端部执行器和细长轴组件的一部分的另一个横截面侧视图，其中砧座处于闭合位置；
图63为图60-62的外科工具实施例的外科端部执行器和细长轴组件的一部分的放大横截面侧视图；
图64为本发明的外科工具实施例的工具安装部分实施例的顶视图；
图65为本发明的另一个外科工具实施例的透视组件视图；
图66为可与本发明的各种外科工具实施例一起使用的一次性加载单元结构的前透视图；
图67为图66的一次性加载单元的后部透视图；
图68为图66和67的一次性加载单元的底部透视图；
图69为可与本发明的各种外科工具实施例一起使用的另一个一次性加载单元实施例的底部透视图；
图70为图66-68中示出的一次性加载单元的安装部分的分解透视图；
图71为本发明的外科工具实施例的一次性加载单元和细长轴组件实施例的一部分的透视图，其中一次性加载单元处于第一位置；
图72为图71的一次性加载单元和细长轴组件的一部分的另一个透视图，其中一次性加载单元处于第二位置；
图73为图71和72中示出的一次性加载单元和细长轴组件实施例的一部分的剖视图；
图74为图71-73中示出的一次性加载单元和细长轴组件实施例的另一个剖视图；
图75为本发明的外科工具实施例的另一个一次性加载单元实施例和细长轴组件实施例的一部分的局部分解透视图；
图76为本发明的外科工具实施例的另一个一次性加载单元实施例和细长轴组件实施例的一部分的局部分解透视图；
图77为图76的一次性加载单元实施例和细长轴组件实施例的另一个局部分解透视图；
图78为本发明的外科工具实施例的另一个工具安装部分实施例的顶视图；
图79为本发明的另一个外科工具实施例的侧视图，其一些部件以横截面示出并与机器人系统的机器人工具保持器相关；
图80为可结合本发明的各种外科工具实施例使用的外科端部执行器实施例的分解组件视图；
图81为用于驱动在本发明的各种外科端部执行器实施例中使用的切割器械的缆线驱动系统的一部分的侧视图；
图82为图81的缆线驱动系统和切割器械的顶视图；
图83为处于闭合位置的本发明的缆线驱动传动装置实施例的顶视图；
图84为处于中间位置的图83的缆线驱动传动装置实施例的另一个顶视图；
图85为处于击发位置的图83和84的缆线驱动传动装置实施例的另一个顶视图；
图86为处于图83中示出的位置的缆线驱动传动装置实施例的透视图；
图87为处于图84中示出的位置的缆线驱动传动装置实施例的透视图；
图88为处于图85中示出的位置的缆线驱动传动装置实施例的透视图；
图89为本发明的另一个外科工具实施例的透视图；
图90为用于驱动在本发明的各种外科端部执行器实施例中使用的切割器械的另一个缆线驱动系统实施例的一部分的侧视图；
图91为图90的缆线驱动系统实施例的顶视图；
图92为本发明的另一个外科工具实施例的工具安装部分实施例的顶视图；
图93为本发明的另一个外科工具实施例的顶视剖视图；
图94为本发明的外科工具实施例的外科端部执行器实施例的一部分的剖视图；
图95为图103的外科端部执行器沿着图94中的线95-95截取的横截面端视图；
图96为部分以横截面示出的图94和95的外科端部执行器的透视图；
图97为图94-96的外科端部执行器的一部分的侧视图；
图98为本发明的各种外科工具实施例的滑动件组件实施例的透视图；
图99为图98的滑动件组件实施例和图97的细长通道的一部分的剖视图；
图100-105以图解法示出了在本发明的外科工具实施例中的钉的顺序击发；
图106为本发明的外科端部执行器实施例的一部分的局部透视图；
图107为本发明的外科工具实施例的外科端部执行器实施例的一部分的局部横截面透视图；
图108为滑动件组件轴向推进穿过其中的图107的外科端部执行器实施例的另一个局部横截面透视图；
图109为本发明的另一个外科工具实施例的另一个滑动件组件实施例的透视图；
图110为滑动件组件轴向推进穿过其中的图107和108中示出的外科端部执行器实施例的一部分的局部顶视图；
图111为图110的外科端部执行器实施例的另一个局部顶视图，为了清楚起见，已省略外科钉仓的顶部表面；
图112为图107和108中示出的外科端部执行器的旋转驱动器实施例和钉推动器实施例的局部横截面侧视图；
图113为本发明的自动重新加载系统实施例的透视图，其中外科端部执行器与其提取系统以提取方式接合；
图114为图113中示出的自动重新加载系统实施例的另一个透视图；
图115为图113和114中示出的自动重新加载系统实施例的横截面正视图；
图116为图113-115中示出的自动重新加载系统实施例的另一个横截面正视图，其中其提取系统从外科端部执行器中移除用过的外科钉仓；
图117为图113-116中示出的自动重新加载系统实施例的另一个横截面正视图，示出了将新的外科钉仓加载到外科端部执行器中；
图118为本发明的另一个自动重新加载系统实施例的透视图，其一些部件以横截面示出；
图119为图118的自动重新加载系统实施例的一部分的分解透视图；
图120为图119中示出的部分自动重新加载系统实施例的另一个分解透视图；
图121为图118-120的自动重新加载系统实施例的横截面正视图；
图122为支撑其中的一次性加载单元的取向管实施例的剖视图；
图123为本发明的另一个外科工具实施例的透视图；
图124为本发明的外科工具实施例的关节运动接头实施例的局部透视图；
图125为本发明的外科工具实施例的闭合管实施例的透视图；
图126为组装在图124的关节运动接头实施例上的图125的闭合管实施例的透视图；
图127为本发明的外科工具实施例的工具安装部分实施例的一部分的顶视图；
图128为图127的工具安装部分实施例中采用的关节运动驱动组件实施例的透视图；
图129为本发明的另一个外科工具实施例的透视图；以及
图130为本发明的另一个外科工具实施例的透视图。
具体实施方式
本专利申请的申请人还拥有与本专利同一日期提交的以下专利申请，这些专利申请各自的全部内容均以引用方式并入本文：
-名称为“Surgical Instrument With Wireless Communication Between aControl Unit of a Robotic System and Remote Sensor”的美国专利申请序列号_________，代理人案卷号END5924USCIP2/060339CIP2；
-名称为“Robotically-Controlled Endoscopic Accessory Channel”的美国专利申请序列号________，代理人案卷号END5568USCIP2/100809CIP2；
-名称为“Robotically-Controlled Motorized Surgical Instrument”的美国专利申请序列号__________，代理人案卷号END6416USCIP1/080205CIP1；
-名称为“Robotically-Controlled Surgical Stapling Devices That ProduceFormed Staples Having Different Lengths”的美国专利申请序列号________，代理人案卷号END5675USCIP6/050504CIP6；
-名称为“Robotically-Controlled Motorized Cutting and FasteningInstrument”的美国专利申请序列号_______，代理人案卷号END6269USCIP1/070391CIP1；
-名称为“Robotically-Controlled Shaft Based Rotary Drive Systems ForSurgical Instruments”的美国专利申请序列号__________，代理人案卷号END6089USCIP1/070059CIP1；
-名称为“Robotically-Controlled Surgical Instrument Having RecordingCapabilities”的美国专利申请序列号________________，代理人案卷号END5773USCIP4/050698CIP4；
-名称为“Robotically-Controlled Surgical Instrument With ForceFeedback Capabilities”的美国专利申请序列号________，代理人案卷号END5773USCIP5/050698CIP5；
-名称为“Robotically-Driven Surgical Instrument With E-Beam Driver”的美国专利申请序列号_______，代理人案卷号END0908USCIP2/100810CIP2；
-名称为“Surgical Stapling Instruments With Rotatable StapleDeployment Arrangements”的美国专利申请序列号________，代理人案卷号END7002USNP/110262。
现在将描述某些示例性实施例，以从整体上理解本文所公开的装置和方法的结构、功能、制造和用途的原理。这些实施例的一个或多个实例在附图中示出。本领域的普通技术人员将会理解，本文特别描述和在附图中示出的装置和方法为非限制性的示例性实施例，并且本发明各种实施例的范围仅由权利要求书限定。就一个示例性实施例进行图解说明或描述的特征，可与其他实施例的特征进行组合。这种修改形式和变化形式旨在包括在本发明的范围之内。
本说明书通篇使用的短语“在各种实施例中”、“在一些实施例中”、“在一个实施例中”或“在实施例中”等并不一定都指相同的实施例。此外，在一个或多个其他实施例中，可按照任何合适的方式组合一个或多个实施例的具体特征、结构或特性。这种修改形式和变化形式旨在包括在本发明的范围之内。
参见附图，其中在多个视图中，类似的数字代表类似的部件，图1示出了本发明的联接到常规外科切割和缝合装置10的一次性加载单元16。切割和缝合装置10的结构和一般操作在美国专利No.5,865,361中有所描述，该专利的公开内容以引用的方式并入本文。因此，除了必需的对本发明的一次性加载单元16的操作的描述，本发明的具体实施方式将不再讨论装置10的各种部件及其操作。
继续参阅本具体实施方式，应当理解本文使用的术语“近侧”和“远侧”是以握持一次性加载单元16所附接的外科缝合装置10的柄部组件12的临床医生为参照的。因此，一次性加载单元16相对于更近侧的柄部组件12在远侧。还应当理解，为方便和清楚起见，本文可结合附图使用诸如“竖直”、“水平”、“上”、“下”、“右”和“左”的空间术语。然而，外科器械在多个取向和位置中使用，并且这些术语并非意图进行限制，也并非绝对。
如图1所示，一次性加载单元16通常可包括用于执行外科手术(例如切割组织和在切口的每一侧上施加钉)的工具组件17。工具组件17可包括仓组件18，所述仓组件包括支撑在载体216中的钉仓220。砧座组件20可以已知的方式枢转地联接到载体216上以用于在打开位置和闭合位置之间选择性地枢转行进。砧座组件20包括砧座部分204，所述砧座部分具有多个在其下表面中形成的钉变形凹部(未示出)。钉仓220容纳多个推动器或驱动器(未示出)，其中的每个推动器或驱动器都具有支撑在其上的一个或多个钉(未示出)。致动滑动件234支撑在工具组件17内，并且当致动滑动件234从工具组件17的近端驱动到远端220时，致动滑动件能够朝着砧座组件20的方向驱动钉仓220中的推动器和钉。参见图2。
一次性加载单元16还可包括具有驱动梁266的轴向驱动组件212，所述驱动梁可以由单个材料片构成，或优选地由多个堆叠片材构成。然而，驱动梁266还可由其他合适的材料构造构成。驱动梁266的远端可包括支撑刀片280和邻接表面283的竖直撑杆271，在缝合手术期间，所述邻接表面接合致动滑动件234的中间部分。刀片280通常可定位成在致动滑动件234后面略微平移通过钉仓220中的中间纵向狭槽以在缝合的身体组织排之间形成切口。固定凸缘284可以从竖直撑杆271朝远侧突出并且在其远端支撑一个或多个凸轮销286。凸轮销286的尺寸可被设计为并能够接合砧座部分204上的凸轮表面209以抵靠身体组织夹紧砧座部分204。参见图5和7。此外，片簧(未示出)可设置在砧座部分204的近端和外壳200的远端部分之间以将砧座组件20偏置至常开位置。载体216还可具有穿过其中的细长底部狭槽，竖直撑杆271的一部分通过所述细长底部狭槽延伸以得到与其附接的支撑构件287。
另外如图1所示，一次性加载单元16还可具有适于扣合到或以其他方式连接到载体216上的外壳部分200。外壳200的近端500可包括用于以可释放的方式接合外科缝合装置的细长主体14的接合块254。如美国专利No.5,865,361所述，块254与外科缝合装置的细长主体部分14的远端形成卡口式联接。
外壳200还可包括开关部分520，所述开关部分可活动地容纳其中的电池526。更具体地讲并结合图3，外壳200的开关部分520限定电池腔体522，所述电池腔体可活动地支撑电池保持器524，所述电池保持器容纳其中的电池526。如图3所示，第一电池接触器528以与电池526电接触的方式被支撑，并且第一电池接触器通过电池保持器524伸出以滑动接合电池腔体522的内壁523。相似地，第二电池接触器530以与电池526电接触的方式被安装，并且第二电池接触器也从电池保持器524伸出以沿着电池腔体522的内壁523滑动。电池保持器524中具有控制杆承窝532，当一次性加载单元16的近端联接到外科缝合装置10的细长主体14时，所述控制杆承窝能够容纳控制杆52的远端276。另外如图3所示，一系列接触器540、542、544可在壁523中定向以与电池接触器530接触。接触器540、542和544的目的将在下文中进一步详细地描述。另外如图3所示，将偏置构件或开关弹簧550定位在电池腔体522中以在近侧方向“PD”上偏置电池保持器524，使得当一次性重新加载单元16没有附接到细长主体14时，电池保持器524被偏置至如图3所示的最近侧位置。当电池接触器528和530通过弹簧550保持在“使用前”或“断开”位置时，电池接触器528和530不接触电池腔体522内的任何接触器540、542、544，从而防止电池526在未使用期间被耗尽。
另外如图3所示，外壳200中还可具有其中容纳马达562和齿轮箱564的马达腔体560。齿轮箱564具有输出转轴566，所述输出转轴穿过在外壳200中形成的近侧隔板570中的孔572伸出。参见图5。将输出转轴566锁定到或以其他方式非旋转地联接到推力盘580上。如图5所示，推力盘580可旋转地支撑在推力盘腔体582内，所述推力盘腔体在形成于外壳200中的近侧隔板570和远侧隔板590之间形成。此外，如图所示，推力盘580可旋转地支撑在近侧推力轴承583和远侧推力轴承584之间。另外如图5所示，推力盘580可以在与驱动螺母610螺纹结合的驱动螺钉600的近端形成，所述驱动螺母被支撑在接合部分270中，所述接合部分在驱动梁266的远端上形成。在各种实施例中，接合部分270可包括一对接合指状物270a和270b，所述接合指状物的尺寸可被设定为并能够被容纳在驱动螺母610的狭槽内，从而将驱动螺母610非旋转地附连至驱动梁266。因此，根据驱动螺钉600的旋转方向，驱动螺钉600在驱动螺母610内的旋转将在远侧方向“DD”上或在近侧方向“PD”上驱动驱动梁266。
一次性加载单元16还可包括返回开关630，所述返回开关安装在外壳200中并且适于由刀螺母610致动。另外如图5所示，开关640安装在外壳200中并且还被定向为由刀螺母610致动，从而指示砧座组件20何时闭合。开关650安装在外壳200中并且也适于由刀螺母610致动，从而指示轴向驱动组件212已运动至完成位置。开关630、640、650的具体操作将在下文中进一步详细地描述。
图4示出了本发明的电路实施例700，所述电路实施例示出了本发明的一次性加载单元16的各种部件在处于“使用前”状态下的位置。例如，一次性加载单元16的各种部件在单元16被储存或运输时可处于这种使用前定向。如图所示，当处于这种定向时，电池接触器528和530不接触外壳200中的任何接触器540、542、544，以防止电池526在未使用期间被耗尽。
图5和6示出了当一次性加载单元16联接到外科切割和缝合器械10的细长主体14之后，一次性加载单元的各种部件的位置。具体地讲，如图5所示，控制杆52的远端276已联接到电池保持器524。当控制杆52附接于电池保持器524时，电池保持器524克服弹簧550在远侧方向“DD”上运动，使得电池接触器528、530与外壳200中的返回接触器540接触。另外，当处于上述位置时，刀螺母610将返回开关630致动到打开方向。应当理解，返回开关630为常闭开关，其由刀螺母610致动到打开位置。如图6所示，当打开返回开关630时，马达562不启动。
图7和8示出了在临床医生致动外科切割和缝合器械10的可活动柄部24(图1所示)之后一次性加载单元16的各种部件的位置。如美国专利No.5,865,361所讨论的，当可活动柄部24最初朝着固定柄部组件22运动时，引起控制杆52在远侧方向“DD”上运动。如图7所示，在砧座闭合冲程中当控制杆52最初在远侧方向上运动时，电池保持器524将电池526运动至其中电池接触器528、530接触砧座闭合接触器542的位置。此时允许功率从电池526流到马达562，所述马达旋转驱动螺钉600并且使驱动梁266向远侧运动。当驱动梁266在“DD”方向上向远侧运动时，凸轮销286接合砧座部分204的凸轮部分209并且使砧座组件20枢转至如图7所示的闭合位置。当驱动梁266向远侧运动至砧座闭合位置时，刀螺母610运动至与返回开关630解除接触，这使得返回开关重新回到其常开位置。然后刀螺母610致动砧座闭合开关640并且将其运动至打开位置。参见图8。在各种实施例中，一个或多个砧座闭合灯660可以安装在外壳200中以为临床医生提供砧座组件20已运动至闭合位置的视觉指示。
当临床医生希望击发器械10时(即致动器械10以使其切割和缝合组织)，如美国专利No.5,865,361所述，临床医生首先按下击发锁定组件80(图1)的柱塞82。然后，可以致动可活动柄部24。当按下可活动柄部24时，控制杆52将电池保持器524和电池526运动至图9和10所示的位置。如那些图所示，当将电池526运动至上述位置时，电池接触器528、530与击发接触器544接触。开关650是常闭的，直至其被刀螺母610致动。因此，当电池接触器528、530接触击发接触器544时，功率从电池526流到驱动驱动螺钉600的马达562。当旋转驱动螺钉600时，驱动梁266和刀螺母610在远侧方向“DD”上被驱动以推进致动滑动件234穿过钉仓220，从而实现钉的弹出和组织的切割。一旦驱动梁266到达击发冲程的末端(即钉仓220中的所有钉都已被击发)，刀螺母610定位为致动常闭开关650并且将其运动至打开位置(图10所示)，这使功率停止从电池526流到马达562。在各种实施例中，一个或多个远侧指示灯670可安装在外壳200上以便为临床医生提供驱动梁266已到达其最远端的击发位置的指示。
为了回缩驱动梁266，临床医生抓持柄部组件12上的回缩旋钮32(图1所示)并且在近侧方向“PD”上牵拉回缩旋钮。回缩旋钮32的操作和结构在美国专利No.5,865,361中有所讨论。一旦临床医生在近侧方向“PD”上将驱动梁266运动足够的距离以使电池运动至接触器540(图11)，功率将会通过开关630提供以使马达562反转。然后刀螺母释放开关650。然后马达562驱动驱动梁266至打开着的开关630远侧。返回开关630也处于其常闭位置，从而允许功率流到马达562并且在相反方向上旋转驱动螺钉610以在近侧方向“PD”上驱动驱动梁266。一旦刀螺母610致动刀返回开关630，刀返回开关630运动至打开位置，从而功率停止从电池526流到马达562。在各种实施例中，起始灯700可安装在外壳200中以提供驱动梁266在起始位置中的指示。
图11和12示出了在击发冲程期间当驱动梁266和刀片280的远端被意外阻塞时(即当刀片280向远侧推进通过夹持在工具组件17中的组织时)，本发明的一次性加载单元16的各种部件的位置。为了解决这种情况，可以提供如图12所示的限流器680。当其提取的电流量超出预定阈值时，限流器680关闭马达562。应当理解，在阻塞发生的时候，马达562提取的电流量将增加至超过正常击发操作中的电流量。一旦限流器680关闭马达562，临床医生可通过抓持柄部组件12上的回缩旋钮32(图1所示)并在近侧方向“PD”上牵拉回缩旋钮来回缩驱动梁266，并且马达562将以上述方式反向驱动驱动螺钉600。因此，限流器680用于当轴向驱动组件212遇到超过预定量的阻力时停止马达562，所述预定量的阻力与马达562在正常操作情况下提取的预定的最大电流量相关。该特征还节省了电池功率使得驱动梁266可以回缩。
因此，本发明的一次性加载单元16包括独立成套的马达驱动的一次性加载单元，所述自备马达驱动的一次性加载单元可与常规的外科切割和缝合器械结合使用，所述器械传统上需要临床医生手动地推进和回缩联接到其上的一次性加载单元的驱动组件和切割刀片。当刀片遇到预定量的阻力时，一次性加载单元16的各种实施例可被构造为有利于轴向驱动组件的自动回缩。
虽然已经描述了本发明的若干实施例，然而，应当理解，掌握了本发明的一些或全部优点的本领域的技术人员可能会想到这些实施例的各种修改、变型和变通形式。例如，根据各种实施例，为了执行给定的一个或多个功能，单个部件可以替换为多个部件，并且多个部件也可以替换为单个部件。因此，在不脱离随附权利要求书所限定的本发明的范围和实质的前提下，本专利申请旨在涵盖所有此类修改、变型和变通形式。
以引用方式全文或部分地并入本文的任何专利、公布或其他公开材料均仅在所并入的材料不与本发明所述的现有定义、陈述或其他公开材料相冲突的范围内并入本文。由此，在必要的程度下，本文所明确阐述的公开内容将取代以引用方式并入本文的任何相冲突的材料。如果据述以引用方式并入本文但与本文所述的现有定义、陈述或其他公开材料相冲突的任何材料或其部分，仅在所并入的材料和现有的公开材料之间不产生冲突的程度下并入本文。
旨在受到保护的本发明不应被理解为限于所公开的具体实施例。因此应将这些实施例看作是示例性的而非限制性的。在不脱离本发明实质的前提下，其他人可以对本发明进行变型和改变。因此，需要明确指出的是，本发明应涵盖权利要求书所限定的、在本发明的实质和范围之内的所有这些等同形式、变型形式和改变。
多年以来，已经开发出多种微创机器人(或“远距离外科手术”)系统以增加外科手术的灵活性，并允许外科医生以直观的方式对患者进行手术。多个此类系统在以下美国专利中有所公开，所述各个美国专利全文以引用的方式并入本文：名称为“ArticulatedSurgical Instrument For Performing Minimally Invasive Surgery With EnhancedDexterity and Sensitivity”的美国专利No.5,792,135、名称为“Robotic Arm DLUS ForPerforming Surgical Tasks”的美国专利No.6,231,565、名称为“Robotic Surgical ToolWith Ultrasound Cauterizing and Cutting Instrument”的美国专利No.6,783,524、名称为“Alignment of Master and Slave In a Minimally Invasive SurgicalApparatus”的美国专利No.6,364,888、名称为“Mechanical Actuator Interface SystemFor Robotic Surgical Tools”的美国专利No.7,524,320、名称为“Platform Link WristMechanism”的美国专利No.7,691,098、名称为“Repositioning and Reorientation ofMaster/Slave Relationship in Minimally Invasive Telesurgery”的美国专利No.7,806,891和名称为“Surgical Tool With Writed Monopolar Electrosurgical EndEffectors”的美国专利No.7,824,401。然而，过去的多个此类系统已不能生成有效切割和紧固组织所需量级的力。
图13示出了可结合图14中示出的从属机械臂车1100类型使用的主控制器1001的一个型式。主控制器1001和从属机械臂车1100以及它们各自的部件和控制系统在本文中统称为机器人系统1000。此类系统和装置的实例公开于美国专利No.7,524,320中，所述专利以引用的方式并入本文。因而，除了可能必要的理解本发明的多种实施例和形式以外，本文将不详细地描述此类装置的各个细节。众所周知，主控制器1001通常包括如下主控制器(在图13中一般表示为1003)：在外科医生通过立体显示器1002观察手术的同时，所述主控制器由外科医生抓持并在空中操控。主控制器1001通常包括手动输入装置，所述手动输入装置优选地以多个自由度运动并通常还具有用于致动工具(例如，用于闭合抓持锯、施加电势到电极等)的致动柄部。
如图14所示，在一种形式中，机械臂车1100能够致动多个外科工具，一般称为1200。使用主控制器和机械臂车结构的各种机器人外科系统和方法公开于名称为“Multi-Component Telepresence System and Method”的美国专利No.6,132,368中，该专利的全部公开内容以引用的方式并入本文。在各种形式中，机械臂车1100包括基座1002，在图示实施例中，所述基座支撑有三个外科工具1200。在各种形式中，外科工具1200均由一系列手动关节运动的连杆(一般称为装置接头1104)和机器人操纵器1106支撑。本文示出的这些结构具有在机器人连杆的大部分之上延伸的护盖。这些护盖可以是任选的，并且可在尺寸上有所限制或在一些实施例中完全消除，以使用于操纵此类装置的伺服机构遇到的惯性最小化、限制运动部件的体积以避免碰撞并且限制车1100的总重量。车1100将通常具有适于在手术室之间搬运车1100的尺寸。车1100通常能够适于穿过标准的手术室门并放置到标准的医院电梯上。在各种形式中，车1100可优选地具有重量并包括轮(或其他运输)系统，所述轮系统允许由单个维护人员将车1100设置在邻近手术台。
现在参见图15，在至少一种形式中，机器人操纵器1106可包括限制外科工具1200的运动的连杆1108。在各种实施例中，连杆1108包括由旋转接头以平行四边形结构联接在一起的刚性连接件，使得外科工具1200围绕空间1110中的某一点旋转，如在公布的美国专利No.5,817,084中更完整地描述，所述专利的全部公开内容以引用的方式并入本文。平行四边形结构将旋转限制为围绕轴1112a(有时称为俯仰轴)枢转。支撑平行四边形连杆的连接件可枢转地安装到装置接头1104(图14)上，使得外科工具1200进一步围绕轴1112b(有时称为偏航轴)旋转。俯仰轴1112a和偏航轴1112b在远程中心1114处相交，所述远程中心沿着外科工具1200的轴1208对齐。当由操纵器1106支撑时，外科工具1200可以具有另外的驱动自由度，包括外科工具1200沿着纵向工具轴线“LT-LT”的滑动运动。当外科工具1200沿着工具轴线LT-LT相对于操纵器1106滑动(箭头1112c)时，远程中心1114相对于操纵器1106的基座1116保持固定。从而，使整个操纵器总体上发生移动以重新定位远程中心1114。操纵器1106的连杆1108由一系列的马达1120驱动。这些马达响应于来自控制系统的处理器的命令而主动移动连杆1108。如将在下文中进一步详细描述，马达1120还用于操纵外科工具1200。
图16中示出了可供选择的装置接头结构。在该实施例中，外科工具1200由两个组织操纵工具之间的可供选择的操纵器结构1106'支撑。本领域的普通技术人员将会知道本发明的各种实施例可以包括多种可供选择的机器人结构，包括描述于名称为“AutomatedEndoscope System For Optimal Positioning”的美国专利No.5,878,193中的那些，该专利的全部内容以引用的方式并入本文。另外，虽然结合外科工具1200和主控制器1001之间的通信在本文中初步描述了机器人部件和机器人外科系统的处理器之间的数据通信，应当理解，类似的通信可发生在操纵器、装置接头、内窥镜或其他图像捕获装置等的电路和机器人外科系统的处理器之间，所述机器人外科系统的处理器用于部件兼容性确认、部件类型识别、部件校正(例如偏移等)通信、部件与机器人外科系统的联接确认等。
图17中示出了非常适于与机器人系统1000一起使用的示例性的非限制性外科工具1200，所述机器人系统具有可操作地联接到主控制器1001的工具驱动组件1010(图18)，所述主控制器1001可通过操作者(即，外科医生)的输入来运行。如图所示，外科工具1200包括外科端部执行器2012，所述端部执行器包括直线切割器。在至少一种形式中，外科工具1200通常包括细长轴组件2008，所述细长轴组件具有通过关节运动接头2011联接在一起的近侧闭合管2040和远侧闭合管2042。外科工具1200通过工具安装部分(一般称为1300)可操作地联接到操纵器。外科工具1200还包括将工具安装部分1300机械联接和电联接到操纵器的接口1230。接口1230的一种形式在图16-22中示出。在各种实施例中，工具安装部分1300包括工具安装板1302，所述工具安装板可操作地支撑多个(图22中示出了四个)可旋转主体部分、从动盘或从动元件1304，所述每个从动盘或从动元件均包括从从动元件1304的表面延伸的一对销1306。一个销1306比相同从动元件1304上的其他销1306更靠近每个从动元件1304的旋转轴，这有助于确保从动元件1304的正向角对齐。接口1230包括能够与安装板1302以安装方式接合的适配器部分1240，如将在下文中进一步描述。适配器部分1240可包括一系列电连接销1242(图20)，所述电连接销1242可通过工具安装部分1300中的电路板联接到存储器结构。虽然结合机械耦合元件、电耦合元件和磁力耦合元件在本文描述了接口1230，应当理解，可使用多种遥测形式，包括红外、电感耦合等。
如图18-21所示，适配器部分1240通常包括工具侧1244和保持器侧1246。在各种形式中，将多个可旋转主体1250安装到浮动板1248，所述浮动板相对于垂直于适配器1240主表面的周围适配器结构具有限定的运动范围。当沿着工具安装部分外壳1301的侧面致动杠杆1303时(参见图17)，浮动板1248的轴向运动有助于使可旋转主体1250从工具安装部分1300脱离。可采用其他机构/结构以可释放的方式将工具安装部分1300联接到适配器1240。在至少一种形式中，通过弹性径向构件将可旋转主体1250弹性地安装到浮动板1248，所述弹性径向构件围绕可旋转主体1250延伸到周边凹痕中。可旋转主体1250可通过偏转这些弹性结构相对于板1248轴向运动。当设置在第一轴向位置(朝工具侧1244)时，可旋转主体1250自由旋转而没有角度限制。然而，当可旋转主体1250朝工具侧1244轴向运动时，突出部1252(从可旋转主体1250径向延伸)横向接合浮动板上的闭锁装置以便限制可旋转主体1250围绕其轴线的角旋转。当驱动销1272将可旋转主体1250推动到受限的旋转位置直到销1234与开口1256’对齐(并滑动到其中)时，可使用该受限的旋转以有助于可旋转主体1250与机器人系统1000的对应工具保持器部分1270的驱动销1272驱动接合。可旋转主体1250的工具侧1244上的开口1256和保持器侧1246上的开口1256’能够使工具安装部分1300的从动元件1304(图22)与工具保持器1270的驱动元件1271准确对齐。有关从动元件1304的内侧和外侧销1306如上所述，开口1256,1256’位于相距其各自的旋转主体1250的旋转轴线不同的距离处，以确保与之要达到的位置不呈180度对齐。另外，每个开口1256略微径向伸长，以适当地容纳周边方向上的销1306。这使得销1306在开口1256、1256’内径向滑动并适应工具1200和工具保持器1270之间的一些轴偏差，同时使驱动元件和从动元件之间的任何角偏差和角侧隙最小化。工具侧1244上的开口1256与保持器侧1246上的开口1256’(以虚线示出)成约90度的偏移，如图21中明显地示出。
各种实施例还可包括位于适配器1240保持器侧1246上的一系列电连接器销1242，并且适配器1240的工具侧1244可包括狭槽1258(图21)以用于容纳工具安装部分1300的销阵列(未示出)。除了在外科工具1200和工具保持器1270之间传输电信号之外，可通过适配器1240的电路板将这些电连接器中的至少一些联接到适配器存储器装置1260(图20)。
可使用可拆卸的闩锁结构1239以可释放的方式将适配器1240附连到工具保持器1270。如本文所用，术语“工具驱动组件”在用于机器人系统1000的上下文中时至少涵盖适配器1240和工具保持器1270的各种实施例，并且其在图18中一般称为1010。例如，如图18所示，工具保持器1270可包括第一闩锁销结构1274，所述第一闩锁销装置的尺寸被设定为容纳在设置于适配器1240中相应的连接叉狭槽1241中。另外，工具保持器1270还可包括第二闩锁销1276，所述第二闩锁销的尺寸被设定为保持在适配器1240中相应的闩锁连接叉1243中。参见图20。在至少一种形式中，闩锁组件1245可活动地支撑在适配器1240上，并且能够在第一闩锁位置和未闩锁位置之间偏置，在第一闩锁位置中，闩锁销1276保持在各自的闩锁连接叉1243中，在未闩锁位置中，第二闩锁销1276可进入闩锁连接叉1243或从中移除。使用一个或多个弹簧(未示出)以将闩锁组件偏置到闩锁位置。适配器1240工具侧1244上的凸缘可滑动地容纳工具安装外壳1301的横向延伸的突出部。
然后转到图22-29，在至少一个实施例中，外科工具1200包括外科端部执行器2012，在该实例中，所述外科端部执行器2012此外包括至少一个部件2024，所述部件2024相对于至少一个其他部件2022在第一位置和第二位置之间响应于施加至其上的各种控制运动而选择性地运动，如将在下文中进一步详细地描述。在各种实施例中，部件2022包括能够可操作地支撑其中的外科钉仓2034的细长通道2022，并且部件2024包括可枢转地平移的夹紧构件，例如砧座2024。外科端部执行器2012的各种实施例能够使砧座2024和细长通道2022保持在确保有效缝合和切断夹持在外科端部执行器2012中的组织的间距处。如图28所示，外科端部执行器2012还包括切割器械2032和滑动件2033。例如，切割器械2032可以为刀。外科钉仓2034可操作地容纳其中支撑在可活动的钉驱动器(未示出)上的多个外科钉(未示出)。当切割器械2032朝远侧驱动穿过外科钉仓2034中居中设置的狭槽(未示出)时，其也向远侧推动滑动件2033。当滑动件2033朝远侧驱动时，其“楔形”构造接触可活动的钉驱动器并朝闭合砧座2024竖直驱动钉驱动器。当外科钉被驱动到位于砧座2024下侧的成形表面时，形成外科钉。滑动件2033可以是外科钉仓2034的一部分，使得当切割器械2032在切割操作后回缩时，滑动件2033不会回缩。砧座2024可在位于细长通道2022的近端的枢轴点2025处枢转地打开和闭合。砧座2024还可包括位于其近端的突出部2027，所述突出部与机械闭合系统(下文中进一步描述)的部件相互作用以利于砧座2024的打开。细长通道2022和砧座2024可以由导电材料(例如金属)制成，使得它们可作为与端部执行器中的一个或多个传感器连通的天线的一部分，如上所述。外科钉仓2034可以由非导电材料(例如塑料)制成，并且传感器可连接到或设置在外科钉仓2034中，也如上所述。
如图22-29所示，根据各种实施例，通过细长轴组件2008将外科端部执行器2012附接到工具安装部分1300。如图示实施例所示，轴组件2008包括关节运动接头(通常表示为2011)，所述关节运动接头使外科端部执行器2012能够选择性地围绕关节运动轴线AA-AA进行关节运动，所述关节运动轴线AA-AA基本上横向于纵向工具轴线LT-LT。参见图23。在其他实施例中，省略了关节运动接头。在各种实施例中，轴组件2008可包括闭合管组件2009，所述闭合管组件包括通过枢转连接件2044枢转地连接和可操作地支撑在脊组件(一般描述为2049)上的近侧闭合管2040和远侧闭合管2042。在图示实施例中，脊组件2049包括远侧脊部分2050，所述远侧脊部分附接到细长通道2022并且可枢转地联接到近侧脊部分2052。闭合管组件2009能够响应于施加至其上的致动运动在脊组件2049上轴向滑动。远侧闭合管2042包括开口2045，砧座2024上的突出部2027插入到所述开口中以当远侧闭合管2042在近侧方向“PD”上轴向运动时有利于砧座2024的打开。闭合管2040、2042可以由导电材料(例如金属)制成，使得其可以用作天线的一部分，如上所述。主驱动轴组件(如，驱动轴2048、2050)的部件可以由非导电材料(例如塑料)制成。
在使用中，围绕纵向工具轴线LT-LT旋转外科端部执行器2012可能是有利的。在至少一个实施例中，工具安装部分1300包括旋转的传输组件2069，所述旋转的传输组件能够接收来自机器人系统1000的工具驱动组件1010的对应的旋转输出运动，并将此旋转输出运动转化成旋转控制运动以使细长轴组件2008(和外科端部执行器2012)围绕纵向工具轴线LT-LT旋转。在各种实施例中，例如，近侧闭合管2040的近端2060通过向前的支撑支架1309和同样可活动地支撑在工具安装板1302上的闭合滑动件2100被旋转地支撑在工具安装部分1300的工具安装板1302上。在至少一种形式中，旋转的传输组件2069包括管齿轮段2062，所述管齿轮段形成于(或附接到)近侧闭合管2040的近端2060上，以通过可操作地支撑在工具安装板1302上的旋转齿轮组件2070可操作地接合。如图25所示，在至少一个实施例中，旋转齿轮组件2070包括旋转传动齿轮2072，当工具安装部分1300联接到工具驱动组件1010时，所述旋转传动齿轮联接到工具安装板1302的适配器侧1307上相应的从动盘或从动元件1304中的第一个。参见图22。旋转齿轮组件2070还包括旋转从动齿轮2074，所述旋转从动齿轮与管齿轮段2062和旋转传动齿轮2072以啮合的方式旋转地支撑在工具安装板1302上。将来自机器人系统1000的工具驱动组件1010的第一旋转输出运动施加到相应的从动元件1304，从而将引起旋转传动齿轮2072的旋转。旋转传动齿轮2072的旋转最终导致细长轴组件2008(和外科端部执行器2012)围绕纵向工具轴线LT-LT(图25中由箭头“R”表示)旋转。应当理解，在一个方向上施加来自工具驱动组件1010的旋转输出运动将引起细长轴组件2008和外科端部执行器2012围绕纵向工具轴线LT-LT在第一方向上旋转，并且在相对的方向上施加旋转输出运动将引起细长轴组件2008和外科端部执行器2012在相对于第一方向的第二方向上旋转。
在至少一个实施例中，通过在脊组件2049上沿着远侧方向“DD”使闭合管组件2009轴向运动来实现砧座2024相对于钉仓2034的闭合。如上所述，在各种实施例中，近侧闭合管2040的近端2060由闭合滑动件2100支撑，所述闭合滑动件包括闭合传动装置(一般描述为2099)的一部分。在至少一种形式中，闭合滑动件2100能够将闭合管2009支撑在工具安装板1320上，使得近侧闭合管2040能够相对于闭合滑动件2100旋转并且随闭合滑动件2100轴向行进。具体地讲，如图30所示，闭合滑动件2100具有直立的突出部2101，所述直立的突出部2101延伸到近侧闭合管2040的近端部分中的径向沟槽2063中。另外，如图27和30所示，闭合滑动件2100具有延伸穿过工具安装板1302中的狭槽1305的突出部部分2102。突出部部分2102能够保持闭合滑动件2100与工具安装板1302滑动接合。在各种实施例中，闭合滑动件2100具有直立部分2104，所述直立部分具有在其上形成的闭合齿条齿轮2106。闭合齿条齿轮2106能够与闭合齿轮组件2110驱动接合。参见图27。
在各种形式中，闭合齿轮组件2110包括闭合正齿轮2112，所述闭合正齿轮2112联接到工具安装板1302的适配器侧1307上相应的从动盘或从动元件1304中的第二个。参见图22。因此，当工具安装部分1300联接到工具驱动组件1010时，将来自机器人系统1000的工具驱动组件1010的第二旋转输出运动施加到相应的第二从动元件1304上将引起闭合正齿轮2112的旋转。闭合齿轮组件2110还包括与闭合正齿轮2112以啮合的方式而被支撑的闭合减速齿轮组2114。如图26和27所示，闭合减速齿轮组2114包括与闭合正齿轮2112以啮合的方式而被旋转地支撑的从动齿轮2116。闭合减速齿轮组2114还包括与第二闭合传动齿轮2120啮合的第一闭合传动齿轮2118，所述第二闭合传动齿轮与闭合齿条齿轮2106以啮合的方式而被旋转地支撑在工具安装板1302上。因此，将来自机器人系统1000的工具驱动组件1010的第二旋转输出运动施加到相应的第二从动元件1304将引起闭合正齿轮2112和闭合传动装置2110的旋转，并且最终轴向驱动闭合滑动件2100和闭合管组件2009。闭合管组件2009运动的轴向最终取决于第二从动元件1304旋转的方向。例如，响应于从机器人系统1000的工具驱动组件1010接收的一个旋转输出运动，将在远侧方向“DD”上驱动闭合滑动件2100并且最终在远侧方向上驱动闭合管组件1009。当朝远侧驱动远侧闭合管2042时，闭合管段2042的末端将接合砧座2024的一部分并使砧座2024枢转到闭合位置。当施加来自机器人系统1000的工具驱动组件1010的“开口”输出运动时，将沿着近侧方向“PD”驱动闭合滑动件2100和轴组件2008。当在近侧方向上驱动远侧闭合管2042时，其中的开口2045与砧座2024上的突出部2027相互作用以利于其打开。在各种实施例中，当将远侧闭合管2042运动至其起始位置时，可使用弹簧(未示出)以将砧座偏置至打开位置。在各种实施例中，闭合齿轮组件2110的各种齿轮的尺寸设定成能够产生所需的必要的闭合力，所述闭合力满意地在待由外科端部执行器2012切割和缝合的组织上闭合砧座2024。例如，闭合传动装置2110的齿轮的尺寸可设定成能够产生大约70-120磅的力。
在各种实施例中，通过刀杆2200驱动切割器械2032穿过外科端部执行器2012。参见图28和30。在至少一种形式中，刀杆2200可由(例如)不锈钢或其他类似材料制成并且具有大致矩形的横截面形状。此刀杆构造足够刚性以推动切割器械2032穿过夹持在外科端部执行器2012中的组织，同时足够柔性以使外科端部执行器2012相对于近侧闭合管2040和近侧脊部分2052围绕关节运动轴线AA-AA进行关节运动，如将在下文中进一步详细地描述。如图31和32所示，近侧脊部分2052具有延伸穿过其中的矩形通路2054，以在其被轴向推动穿过其中时为刀杆2200提供支撑。近侧脊部分2052具有近端2056，所述近端可旋转地安装到附接到工具安装板1032的脊安装托架2057上。参见图30。此结构允许近侧脊部分2052在近侧闭合管2040内旋转但不轴向运动。
如图28所示，将刀杆2200的远端2202附接到切割器械2032。刀杆2200的近端2204可旋转地附连到刀齿条齿轮2206上，使得刀杆2200相对于刀齿条齿轮2206自由旋转。参见图39。如图24-29所示，刀齿条齿轮2206可滑动地支撑在附接到工具安装板1302的齿条外壳2210内，使得刀齿条齿轮2206保持与刀齿轮组件2220啮合。更具体地讲并结合图27，在至少一个实施例中，刀齿轮组件2220包括刀正齿轮2222，所述刀正齿轮2222联接到工具安装板1302的适配器侧1307上相应的从动盘或从动元件1304中的第三个。参见图22。因此，将来自机器人系统1000的另一旋转输出运动通过工具驱动组件1010施加到相应的第三从动元件1304，从而将引起刀正齿轮2222的旋转。刀齿轮组件2220还包括刀减速齿轮组2224，所述刀减速齿轮组包括第一刀从动齿轮2226和第二刀传动齿轮2228。刀减速齿轮组2224可旋转地安装到工具安装板1302上，使得第一刀从动齿轮2226与刀正齿轮2222啮合。同样，第二刀传动齿轮2228与第三刀传动齿轮2230啮合，所述第三刀传动齿轮与刀齿条齿轮2206以啮合的方式而被旋转地支撑在工具安装板1302上。在各种实施例中，刀齿轮组件2220的齿轮的尺寸设定成能够产生如下力：需要所述力以驱动切割元件2032穿过夹持在外科端部执行器2012中的组织并致动其中的钉。例如，刀驱动组件2230的齿轮的尺寸可设定成能够产生大约40至100磅的力。应当理解，在一个方向上施加来自工具驱动组件1010的旋转输出运动将引起切割器械2032在远侧方向上轴向运动，并且在相对的方向上施加旋转输出运动将引起切割器械2032在近侧方向上轴向运动。
在各种实施例中，外科工具1200采用包括关节运动接头2011的关节运动系统2007，所述关节运动接头使外科端部执行器2012能够围绕关节运动轴线AA-AA进行关节运动，所述关节运动轴线AA-AA基本上横向于纵向工具轴线LT-LT。在至少一个实施例中，外科工具1200包括第一关节运动杆2250a和第二关节运动杆2250b，所述第一关节运动杆和第二关节运动杆可滑动地支撑在穿过近侧脊部分2052的相应通路2053中。参见图30和32。在至少一种形式中，通过关节运动传动装置(一般称为2249)致动第一关节运动杆2250a和第二关节运动杆2250b，所述关节运动传动装置可操作地支撑在工具安装板1032上。关节运动杆2250a、2250b中的每一个均具有从中伸出导向杆的近端2252，所述导向杆横向延伸穿过近侧脊部分2052的近端部分中的对应狭槽并且进入关节运动螺母2260中的对应弓形狭槽，所述关节运动螺母包括关节运动传动装置的一部分。图40示出了关节运动杆2250a。应当理解，关节运动杆2250b被相似地构造。如图31所示，例如，关节运动杆2250a具有导向杆2254，所述导向杆横向延伸穿过远侧脊部分2050的近端部分2056中的对应狭槽2058并且进入关节运动螺母2260中的对应弓形狭槽2262。另外，关节运动杆2250a具有通过例如销2253a可枢转地联接到远侧脊部分2050的远端2251a，并且关节运动杆2250b具有通过例如销2253b可枢转地联接到远侧脊部分2050的远端2251b。具体地讲，关节运动杆2250a在第一横向上与纵向工具轴线LT-LT横向偏移，并且关节运动杆2250b在第二横向上与纵向工具轴线LT-LT横向偏移。因此，关节运动杆2250a和2250b在相对方向上的轴向运动将使远侧脊部分2050以及附接到其上的外科端部执行器2012能够围绕关节运动轴线AA-AA进行关节运动，如将在下文中进一步详细地描述。
通过围绕纵向工具轴线LT-LT旋转关节运动螺母2260来控制外科端部执行器2012的关节运动。关节运动螺母2260可旋转地接合在远侧脊部分2050的近端部分2056，并且通过关节运动齿轮组件2270可旋转地在远侧脊部分的近端部分上驱动。更具体地讲并结合图25，在至少一个实施例中，关节运动齿轮组件2270包括关节运动正齿轮2272，所述关节运动正齿轮联接到工具安装板1302的适配器侧1307上相应的从动盘或从动元件1304中的第四个。参见图22。因此，当接口1230联接到工具保持器1270时，穿过工具驱动组件1010将来自机器人系统1000的另一旋转输入运动施加到相应的第四从动元件1304上，从而将引起关节运动正齿轮2272的旋转。关节运动传动齿轮2274旋转地支撑在工具安装板1302上并与关节运动正齿轮2272和如图所示的关节运动螺母2260的齿轮部分2264啮合。如图30和31所示，关节运动螺母2260具有在其上形成的肩部2266，所述肩部限定环形沟槽2267以容纳其中的保持杆2268。将保持杆2268附接到工具安装板1302上，并用于防止关节运动螺母2260在近侧脊部分2052上轴向运动，同时保持相对于其的旋转能力。因此，由于导向杆2254与关节运动齿轮2260中螺旋狭槽2262的相互作用，在第一方向上旋转关节运动螺母2260将导致关节运动杆2250a在远侧方向“DD”上轴向运动以及关节运动杆2250b在近侧方向“PD”上轴向运动。相似地，在与第一方向相对的第二方向上旋转关节运动螺母2260将导致关节运动杆2250a在近侧方向“PD”上轴向运动并引起关节运动杆2250b在远侧方向“DD”上轴向运动。因此，可以通过同时在远侧方向“DD”上移动关节运动杆2250a和在近侧方向“PD”上移动关节运动杆2250b而使外科端部执行器2012选择性地在第一方向“FD”上围绕关节运动轴线“AA-AA”进行关节运动。同样，外科端部执行器2012可通过同时在近侧方向“PD”上运动关节运动杆2250a和在远侧方向“DD”上运动关节运动杆2250b而使外科端部执行器2012选择性地在第二方向“SD”上围绕关节运动轴线“AA-AA”进行关节运动。参见图23。
上述工具实施例采用了交接结构，所述交接装置尤其适于将机器人控制的医疗工具安装到至少一种形式的机械臂装置上，所述机械臂结构产生至少四种不同的旋转控制运动。本领域的普通技术人员将会知道可通过机器人系统/控制器经由可编程控制系统来选择性地控制此类旋转输出运动。例如，上述工具结构可很好地适于与由美国加利福尼亚州森尼韦尔的直觉外科手术公司(Intuitive Surgical,Inc.(Sunnyvale,California,U.S.A.))制造的那些机器人系统一起使用，其中许多可以在以引用的方式并入本文的各种专利中详细描述。本发明的各种实施例的独特的和新型的方面用来利用由机器人系统提供的旋转输出运动以生成特定的控制运动，所述控制运动具有使端部执行器切割和缝合组织的足够量级。因此，本发明的各种实施例的独特结构和原则可以使本文所公开和受权利要求保护的多种不同形式的工具系统结合提供程序化的旋转或其他输出运动的其他类型和形式的机器人系统有效地使用。另外，随着继续参阅本具体实施方式将变得更加明显，利用由机器人系统产生的一种或多种控制运动还可以有效地致动需要其他形式的致动运动的本发明的各种端部执行器实施例。
图34-38示出了可结合具有工具驱动组件的机器人系统1000有效使用的另一种外科工具2300，所述工具驱动组件可操作地联接到通过操作者的输入运行的机器人系统的控制器，并且其能够向支撑在工具驱动组件上的至少一个旋转主体部分提供至少一种旋转输出运动。在各种形式中，外科工具2300包括外科端部执行器2312，所述外科端部执行器包括细长通道2322和可枢转平移的夹紧构件，例如砧2324，所述细长通道和可枢转平移的夹紧构件保持在确保有效地缝合和切断被夹持在外科端部执行器2312中的组织的间距处。如图示实施例中所示，外科端部执行器2312可包括除了前述细长通道2322和砧座2324之外的具有在其上形成的滑动件部分2333的切割器械2332、位于细长通道2322中的外科钉仓2334和具有在其上形成的螺旋形螺纹的旋转端部执行器驱动轴2336。例如，切割器械2332可以为刀。如将在下文中进一步详细地描述，旋转端部执行器驱动轴2336将使切割器械2332和滑动件部分2333轴向行进穿过外科钉仓2334以在起始位置和结束位置之间运动。切割器械2332轴向行进的方向取决于端部执行器驱动轴2336旋转的方向。砧座2324可在连接至细长通道2322的近端的枢轴点2325处可枢转地打开和闭合。砧座2324还可包括位于其近端的突出部2327，所述突出部可操作地与机械闭合系统(以下进一步描述)的部件交接以打开和闭合砧座2324。当旋转端部执行器驱动轴2336时，切割器械2332和滑动件2333将穿过外科钉仓2334从起始位置纵向行进至结束位置，从而切割夹持在外科端部执行器2312中的组织。滑动件2333穿过外科钉仓2334的运动使得其中的钉被驱动穿过被切断的组织并且抵靠闭合的砧座2324，所述砧座使钉弯曲以紧固被切断的组织。在一种形式中，细长通道2322和砧座2324可以由导电材料(例如金属)制成，使得它们可作为与端部执行器中的一个或多个传感器连通的天线的一部分，如上所述。外科钉仓2334可以由非导电材料(例如塑料)制成，并且传感器可以连接到或设置在外科钉仓2334中，如上所述。
应该指出的是，虽然本文描述的外科工具2300的实施例使用对切断的组织进行缝合的外科端部执行器2312，但是在其他实施例中，可使用用于对切断的组织进行紧固或密封的不同技术。例如，也可使用利用射频能量或粘合剂来紧固被切断的组织的端部执行器。授予Yates等人的名称为“Electrosurgical Hemostatic Device”的美国专利No.5,709,680以及授予Yates等人的名称为“Electrosurgical Hemostatic Device With RecessedAnd/Or Offset Electrodes”的美国专利No.5,688,270公开了使用射频能量来紧固被切断的组织的切割器械，该专利以引用的方式并入本文。授予Morgan等人的美国专利申请序列号11/267,811以及授予Shelton等人的美国专利申请序列号11/267,363公开了使用粘合剂来紧固被切断的组织的切割器械，该专利也以引用的方式并入本文。因此，虽然本文的描述涉及切割/缝合操作等，但是应当认识到，这仅是示例性实施例，并不旨在进行限制。也可以使用其他组织紧固技术。
在图示实施例中，外科端部执行器2312联接到细长轴组件2308，所述细长轴组件联接到工具安装部分2460并限定纵向工具轴线LT-LT。在该实施例中，细长轴组件2308不包括关节运动接头。本领域的普通技术人员将会理解其他实施例中可具有关节运动接头。在至少一个实施例中，细长轴组件2308包括中空的外管2340，所述中空的外管可旋转地支撑在工具安装部分2460的工具安装盘2462上，如将在下文中进一步详细地描述。在各种实施例中，细长轴组件2308还包括远侧脊轴2350。远侧脊轴2350具有远端部分2354，所述远端部分联接到远侧固定基座部分2360或与其一体化形成，该远侧固定基座部分不可活动地联接到通道2322。参见图35-37。
如图35中所示，远侧脊轴2350具有滑动地容纳在近侧脊轴2353中的狭槽2355内的近端部分2351，所述近侧脊轴通过至少一个支撑衬圈2357不可活动地支撑在中空外管2340内。如图35和36进一步所示，外科工具2300包括闭合管2370，所述闭合管被限制为相对于远侧固定基座部分2360仅进行轴向运动。闭合管2370具有近端2372，所述近端具有在其中形成并且与传动装置螺纹接合的内螺纹2374，所述传动装置结构(一般描述为2375)可操作地支撑在工具安装板2462上。在各种形式中，传动装置结构2375包括旋转驱动轴组件(一般称为2381)。当旋转时，旋转驱动轴组件2381将促使闭合管2370轴向运动，如将在下文中进一步详细地描述。在至少一种形式中，旋转驱动轴组件2381包括闭合离合器组件(一般称为2380)的闭合驱动螺母2382。更具体地讲，闭合驱动螺母2382具有近端部分2384，所述近端部分相对于外管2340可旋转地支撑并与闭合管2370螺纹接合。出于组装目的，近端部分2384可通过螺纹附接到保持环2386。与闭合驱动螺母2382的末端2387协作的保持环2386限定环状狭槽2388，锁定衬圈2390的肩部2392延伸到所述环状狭槽中。锁定衬圈2390不可活动地附接(例如，焊接、胶粘等)到外管2340的末端。此结构用于将闭合驱动螺母2382附连到外管2340上，同时使闭合驱动螺母2382相对于外管2340旋转。闭合驱动螺母2382还具有远端2383，所述远端具有螺纹部分2385，所述螺纹部分与闭合管2370的内螺纹2374通过螺纹接合。因此，闭合驱动螺母2382的旋转将使闭合管2370轴向运动，如图36中的箭头“D”所示。
通过由中空驱动套管2400传输的控制运动实现砧座2324的闭合和切割器械2332的致动。如图35和36所示，中空驱动套管2400可旋转地并且可滑动地容纳在远侧脊轴2350上。驱动套管2400具有可旋转地安装到近侧脊轴2353上的近端部分2401，所述近侧脊轴从工具安装部分2460伸出使得驱动套管2400可相对于近侧脊轴旋转。参见图35。另外如图35-37所示，驱动套管2400通过驱动轴2440围绕纵向工具轴线“LT-LT”旋转。驱动轴2440具有附接到其远端2442并与附接到驱动套管2400的从动齿轮2450啮合的传动齿轮2444。
驱动套管2400还具有远端部分2402，所述远端部分联接到闭合离合器组件2380的闭合离合器2410部分，所述闭合离合器组件具有近侧面2412和远侧面2414。近侧面2412具有在其上形成的一系列近侧齿状物2416，所述近侧齿状物适于与形成于闭合驱动螺母2382的近端部分2384中的相应的近侧齿状物腔体2418选择性地接合。因此，当近侧齿状物2416与闭合驱动螺母2382中的近侧齿状物腔体2418啮合时，驱动套管2400的旋转将引起闭合驱动螺母2382的旋转，并且最终引起闭合管2370轴向运动，如将在下文中进一步详细地描述。
尤其如图35和36所示，驱动离合器部分2410的远侧面2414具有形成于其上的一系列远侧齿状物2415，所述远侧齿状物适于与形成于刀驱动轴组件2420的面板部分2424中的相应的远侧齿状物腔体2426选择性地接合。在各种实施例中，刀驱动轴组件2420包括中空的刀轴段2430，所述中空的刀轴段可旋转地容纳在远侧脊轴2350的对应部分上，所述远侧脊轴的对应部分附接到固定基座2360或从固定基座2360突出。当闭合离合器部分2410的远侧齿状物2415与面板部分2424中的远侧齿状物腔体2426啮合时，驱动套管2400的旋转将引起驱动轴段2430围绕固定轴2350旋转。如图35-37所示，将刀驱动齿轮2432附接到驱动轴段2430，并与附接到端部执行器驱动轴2336的驱动刀齿轮2434啮合。因此，驱动轴段2430的旋转将引起端部执行器驱动轴2336的旋转，从而朝远侧驱动切割器械2332和滑动件2333穿过外科钉仓2334，以切割和缝合夹持在外科端部执行器2312中的组织。滑动件2333可由例如塑料制成，并且可具有倾斜的远侧表面。当滑动件2333穿过细长通道2322时，滑动件2333的前倾表面可向上推动或“驱动”外科钉仓2334中的钉穿过被夹持的组织并抵靠砧座2324。砧座2324使钉弯曲或“成形”，从而缝合切断的组织。如本文所用，术语“击发”是指引发如下动作：需要所述动作以沿远侧方向驱动切割器械和滑动件部分穿过外科钉仓，以切割夹持在外科端部执行器中的组织并驱动钉穿过切断的组织。
在使用中，围绕纵向工具轴线LT-LT旋转外科端部执行器2312可能是有利的。在至少一个实施例中，传动装置结构2375包括旋转的传输组件2465，所述旋转的传输组件能够接收来自机器人系统1000的工具驱动组件1010的对应的旋转输出运动，并将此旋转输出运动转化成旋转控制运动以使细长轴组件2308(和外科端部执行器2312)围绕纵向工具轴线LT-LT旋转。如图38所示，外管2340的近端2341可旋转地支撑在支架结构2343中，所述支架结构附接到工具安装部分2460的工具安装板2462。旋转齿轮2345形成在细长轴组件2308的外管2340的近端2341上或附接到其上，以与可操作地支撑在工具安装板2462上的旋转齿轮组件2470啮合。在至少一个实施例中，当工具安装部分2460联接到工具驱动组件1010时，旋转传动齿轮2472联接到工具安装板2462的适配器侧上相应的从动盘或从动元件1304中的第一个。参见图22和38。旋转驱动组件2470还包括旋转从动齿轮2474，所述旋转从动齿轮与旋转齿轮2345和旋转传动齿轮2472以啮合的方式而被旋转地支撑在工具安装板2462上。将来自机器人系统1000的第一旋转输出运动通过工具驱动组件1010施加到相应的从动元件1304，从而将通过可操作地联接至其而引起旋转传动齿轮2472的旋转。旋转传动齿轮2472的旋转最终导致细长轴组件2308(和端部执行器2312)围绕纵向工具轴线LT-LT旋转(主旋转运动)。
通过使闭合管组件2370在远侧方向“DD”上轴向运动来实现砧座2324相对于外科钉仓2034的闭合。通过向闭合驱动螺母2382施加旋转控制运动，实现闭合管2370在远侧方向“DD”上的轴向运动。为了向闭合驱动螺母2382施加旋转控制运动，闭合离合器2410必须首先与闭合驱动螺母2382的近端部分2384啮合。在各种实施例中，传动装置结构2375还包括可操作地支撑在工具安装板2462上的移位器驱动组件2480。更具体地讲并结合图38，可以看出，近侧脊部分2353的近端部分2359延伸穿过旋转齿轮2345并可旋转地联接到移位器齿轮齿条2481，所述移位器齿条穿过狭槽2482可滑动地附连到工具安装板2462。移位器驱动组件2480还包括移位器传动齿轮2483，当工具安装部分2460联接到工具保持器1270时，所述移位器传动齿轮联接到工具安装板2462的适配器侧上相应的从动盘或从动元件1304中的第二个。参见图22和38。移位器驱动组件2480还包括移位器从动齿轮2478，所述移位器从动齿轮与移位器传动齿轮2483和移位器齿条齿轮2482以啮合的方式而被旋转地支撑在工具安装板2462上。将来自机器人系统1000的第二旋转输出运动通过工具驱动组件1010施加到相应的从动元件1304，从而将通过可操作地联接至其而引起移位器传动齿轮2483的旋转。移位器传动齿轮2483的旋转最终引起移位器齿轮齿条2482和近侧脊部分2353以及驱动套管2400和附接至其的闭合离合器2410的轴向运动。闭合离合器2410的轴向行进方向取决于移位器传动齿轮2483通过机器人系统1000旋转的方向。因此，移位器传动齿轮2483在第一旋转方向上的旋转将引起闭合离合器2410沿近侧方向“PD”的轴向运动，从而使近侧齿状物2416与闭合驱动螺母2382中的近侧齿状物腔体2418啮合。反之，移位器传动齿轮2483在第二旋转方向(与第一旋转方向相反)上的旋转将引起闭合离合器2410沿远侧方向“DD”的轴向运动，从而使远侧齿状物2415与形成于刀驱动轴组件2420的面板部分2424中的相应的远侧齿状物腔体2426啮合。
一旦使闭合离合器2410与闭合驱动螺母2382啮合，闭合驱动螺母2382通过旋转闭合离合器2410进行旋转。通过向传动装置2375的旋转驱动传输部分2490施加旋转输出运动来控制闭合离合器2410的旋转，所述传动装置结构可操作地支撑在工具安装板2462上，如图38所示。在至少一个实施例中，旋转驱动传输部分2490包括旋转驱动组件2490’，所述旋转驱动组件包括齿轮2491，当工具安装部分2460联接到工具保持器1270时，所述齿轮联接到工具安装板2462的适配器侧上相应的从动盘或从动元件1304中的第三个。参见图22和38。旋转驱动传输部分2490还包括第一旋转从动齿轮2492，所述第一旋转从动齿轮与第二旋转从动齿轮2493和旋转传动齿轮2491以啮合的方式而被旋转地支撑在工具安装板2462上。第二旋转从动齿轮2493联接到驱动轴2440的近端部分2443。
旋转传动齿轮2491在第一旋转方向上的旋转将引起驱动轴2440在第一方向上的旋转。反之，旋转传动齿轮2491在第二旋转方向(与第一旋转方向相反)上的旋转将引起驱动轴2440在第二方向上的旋转。如上所述，驱动轴2440具有传动齿轮2444，所述传动齿轮附接到其远端2442并与附接到驱动套管2400的从动齿轮2450啮合。因此，驱动轴2440的旋转引起驱动套管2400的旋转。
现将描述操作外科工具2300的方法。一旦工具安装部分2462可操作地联接到机器人系统1000的工具保持器1270，并定向至邻近待切割和缝合的靶组织的位置，如果砧座2334尚未处于打开位置(图35)，机器人系统1000可向移位器传动齿轮2483施加第一旋转输出运动，这使闭合离合器2410轴向运动至与闭合驱动螺母2382啮合(如果尚未与其啮合)。参见图36。一旦机器人系统1000的控制器1001确定闭合离合器2410与闭合驱动螺母2382啮合(例如，通过外科端部执行器2312中与机器人控制系统连通的一个或多个传感器)，则机器人控制器1001可向旋转传动齿轮2492施加第二旋转输出运动，如上所述，这将最终引起旋转驱动螺母2382在第一方向上的旋转，从而引起闭合管2370在远侧方向“DD”上的轴向运动。当闭合管2370在远侧方向上运动时，其接触砧座2323的一部分并使砧座2324枢转至闭合位置，从而夹持介于砧座2324和外科钉仓2334之间的靶组织。一旦机器人控制器1001确定砧座2334已通过外科端部执行器2312中与之连通的相应的一个或多个传感器枢转至闭合位置，则机器人系统1000停止向旋转传动齿轮2491施加第二旋转输出运动。机器人控制器1001还可以为外科医生提供砧座2334已完全闭合的指示。然后外科医生可引发击发过程。在可供选择的实施例中，击发过程可由机器人控制器1001自动引发。然后，机器人控制器1001向移位器传动齿轮2483施加主旋转控制运动2483，这使闭合离合器2410轴向运动至与刀驱动轴组件2420的面板部分2424啮合。参见图46。一旦机器人系统1000的控制器1001确定闭合离合器2410与面板部分2424啮合(通过端部执行器2312中与机器人控制器1001连通的一个或多个传感器)，则机器人控制器1001向旋转传动齿轮2492施加第二旋转输出运动，如上所述，这最终使切割器械2332和滑动件部分2333沿远侧方向“DD”轴向运动穿过外科钉仓2334。当切割器械2332朝远侧运动穿过外科钉仓2334时，切断夹持在其中的组织。当滑动件部分2333朝远侧驱动时，其驱动外科钉仓中的钉穿过切断的组织，从而与砧座2324形成接触。一旦机器人控制器1001确定切割器械2324已到达外科钉仓2334中的结束位置(通过端部执行器2312中与机器人控制器1001连通的一个或多个传感器)，则机器人控制器1001停止向旋转传动齿轮2491施加第二旋转输出运动。然后，机器人控制器1001向旋转传动齿轮2491施加次旋转输出运动，这最终使切割器械2332和滑动件部分2333沿近侧方向“PD”轴向行进至起始位置。一旦机器人控制器1001通过外科端部执行器2312中与机器人控制器1001连通的一个或多个传感器确定切割器械2324已到达起始位置，则机器人控制器1001停止向旋转传动齿轮2491施加次旋转输出运动。然后，机器人控制器1001向移位器传动齿轮2483施加主旋转输出运动，从而使闭合离合器2410运动至与旋转驱动螺母2382接合。一旦闭合离合器2410已运动至与旋转驱动螺母2382啮合，则机器人控制器1001向旋转传动齿轮2491施加次输出运动，这最终引起旋转驱动螺母2382在第二方向上旋转，从而使闭合管2370在近侧方向“PD”上运动。如图35-37所示，闭合管2370中具有开口2345，所述开口2345接合砧座2324上的突出部2327以使砧座2324枢转至打开位置。在可供选择的实施例中，当闭合管2370回到起始位置时(图35)，可使用弹簧以将砧座2324枢转至打开位置。
图39-43示出了可结合机器人系统1000有效使用的另一个外科工具2500。在各种形式中，外科工具2500包括外科端部执行器2512，所述外科端部执行器包括细长通道2522形式的“第一部分”和可枢转地平移的夹紧构件(例如砧座2524)形式的“第二可活动部分”，所述第一部分和第二可活动部分保持在确保有效缝合和切断夹持在外科端部执行器2512中的组织的间距处。如图示实施例中所示，外科端部执行器2512可包括除了前述细长通道2522和砧座2524之外的切割器械2532形式的“第三可活动部分”、滑动件(未示出)和可活动地位于细长通道2522中的外科钉仓2534。例如，切割器械2532可以为刀。砧座2524可在连接至细长通道2522的近端的枢轴点2525处可枢转地打开和闭合。砧座2524还可包括位于其近端的突出部2527，所述突出部能够与机械闭合系统(以下进一步描述)的部件可操作地交接以打开和闭合砧座2524。当致动时，刀2532和滑动件沿着细长通道2522纵向行进，从而切割夹持在外科端部执行器2512中的组织。滑动件沿着细长通道2522的运动使得外科钉仓2534的钉被驱动穿过切断的组织并且抵靠闭合的砧座2524，所述砧座使钉弯曲以紧固被切断的组织。在一种形式中，细长通道2522和砧座2524可以由导电材料(例如金属)制成，使得它们可以作为与外科端部执行器中的一个或多个传感器连通的天线的一部分，如上所述。外科钉仓2534可以由非导电材料(例如塑料)制成，并且传感器可以连接到或设置在外科钉仓2534中，如上所述。
应该指出的是，虽然本文描述的外科工具2500的实施例使用对切断的组织进行缝合的外科端部执行器2512，但是在其他实施例中，可使用用于对切断的组织进行紧固或密封的不同技术。例如，也可使用利用射频能量或粘合剂来紧固被切断的组织的端部执行器。授予Yates等人的名称为“Electrosurgical Hemostatic Device”的美国专利No.5,709,680以及授予Yates等人的名称为“Electrosurgical Hemostatic Device With RecessedAnd/Or Offset Electrodes”的美国专利No.5,688,270公开了使用射频能量来紧固被切断的组织的切割器械，该专利以引用的方式并入本文。授予Morgan等人的美国专利申请序列号11/267,811以及授予Shelton等人的美国专利申请序列号11/267,363公开了使用粘合剂来紧固被切断的组织的切割器械，该专利也以引用的方式并入本文。因此，虽然本文的描述涉及切割/缝合操作等，但是应当认识到，这仅是示例性实施例，并不旨在进行限制。也可以使用其他组织紧固技术。
在图示实施例中，外科端部执行器2512的细长通道2522联接到细长轴组件2508，所述细长轴组件2508联接到工具安装部分2600。在至少一个实施例中，细长轴组件2508包括中空的脊管2540，所述中空的脊管不可活动地联接到工具安装部分2600的工具安装板2602。如图40和41所示，细长通道2522的近端2523包括能够附接到脊管2540的远端2541的中空的管状结构。在一个实施例中，例如，将细长通道2522的近端2523焊接或胶粘到脊管2540的远端。
如图40和41进一步所示，在至少一个非限制性实施例中，外科工具2500还包括闭合管2550形式的可轴向运动的致动构件，所述闭合管2550被限制为相对于细长通道2522和脊管1540进行轴向运动。闭合管2550具有近端2552，所述近端具有形成于其中的内螺纹2554，所述内螺纹与闭合驱动螺母2560形式的可旋转运动的部分进行螺纹接合。更具体地讲，闭合驱动螺母2560具有相对于细长通道2522和脊管2540旋转支撑的近端部分2562。出于组装目的，近端部分2562螺纹附接到保持环2570。保持环2570容纳在沟槽2529中，所述沟槽在细长通道2522的近端2523上的肩部2527和脊管1540的远端2541之间形成。此结构用于将闭合驱动螺母2560可旋转地支撑在细长通道2522内。闭合驱动螺母2560的旋转将引起闭合管2550轴向运动，如图40中的箭头“D”所示。
驱动构件延伸穿过脊管2540和闭合驱动螺母2560，在至少一个实施例中，所述驱动构件包括具有远端部分2582的刀杆2580，所述远端部分可旋转地联接到切割器械2532，使得刀杆2580可相对于切割器械2582旋转。如图40-42所示，闭合驱动螺母2560中具有狭槽2564，刀杆2580可滑动地延伸穿过所述狭槽。此结构允许刀杆2580相对于闭合驱动螺母2560轴向运动。然而，刀杆2580围绕纵向工具轴线LT-LT的旋转还将引起闭合驱动螺母2560的旋转。闭合管2550运动的轴向最终取决于刀杆2580和闭合驱动螺母2560旋转的方向。当朝远侧驱动闭合管2550时，其远端将接触砧座2524并使砧座2524枢转至闭合位置。当施加来自机器人系统1000的开放式旋转输出运动时，闭合管2550将沿近侧方向“PD”被驱动，并且凭借突出部2527与闭合管2550中的开口2555的接合而将砧座2524枢转至打开位置。
在使用中，围绕纵向工具轴线LT-LT旋转外科端部执行器2512可能是有利的。在至少一个实施例中，工具安装部分2600能够接收来自机器人系统1000的相应的第一旋转输出运动，并将此旋转输出运动转化成旋转控制运动以使细长轴组件2508围绕纵向工具轴线LT-LT旋转。如图38所示，中空的脊管2540的近端2542可旋转地支撑在支架装置2603中，所述支架结构2603附接到工具安装部分2600的工具安装板2602上。外科工具2500的各种实施例还包括可操作地支撑在工具安装板2602上的传动装置结构，一般描述为2605。在各种形式中，传动装置结构2605包括旋转齿轮2544，所述旋转齿轮形成于或附接到脊管2540的近端2542，以与可操作地支撑在工具安装板2602上的旋转驱动组件2610啮合。在至少一个实施例中，当工具安装部分2600联接到工具保持器1270时，旋转传动齿轮2612联接到工具安装板2602的适配器侧上相应的旋转主体、从动盘或从动元件1304中的第一个。参见图22和43。旋转驱动组件2610还包括旋转从动齿轮2614，所述旋转从动齿轮与旋转齿轮2544和旋转传动齿轮2612以啮合的方式而被旋转地支撑在工具安装板2602上。将来自机器人系统1000的第一旋转输出运动通过工具驱动组件1010施加到相应的从动旋转主体1304，从而将通过可操作地联接至其而引起旋转传动齿轮2612的旋转。旋转传动齿轮2612的旋转最终使细长轴组件2508(和端部执行器2512)围绕纵向工具轴线LT-LT旋转。
通过使外部闭合管2550在远侧方向“DD”上轴向运动来实现砧座2524相对于外科钉仓2534的闭合。通过向闭合驱动螺母2382施加旋转控制运动，实现闭合管2550在远侧方向“DD”上的轴向运动。在各种实施例中，通过向刀杆2580施加旋转输出运动来转动闭合驱动螺母2560。通过向旋转闭合系统2620施加旋转输出运动来控制刀杆2580的旋转，所述旋转闭合系统2620可操作地支撑在工具安装板2602上，如图43所示。在至少一个实施例中，旋转闭合系统2620包括闭合传动齿轮2622，当工具安装部分2600联接到工具保持器1270时，所述闭合传动齿轮联接到工具安装板2462的适配器侧上相应的从动可旋转主体部分、盘或元件1304中的第二个。参见图22和43。在至少一个实施例中，闭合传动齿轮2622与闭合齿轮系(一般描述为2623)驱动啮合。闭合齿轮驱动系2623包括可旋转地支撑在工具安装板2602上的第一从动闭合齿轮2624。通过驱动轴2628将第一闭合从动齿轮2624附接到第二闭合从动齿轮2626。第二闭合从动齿轮2626与可旋转地支撑在工具安装板2602上的第三闭合从动齿轮2630啮合。闭合传动齿轮2622在第二旋转方向上的旋转将引起第三闭合从动齿轮2630在第二方向上的旋转。反之，闭合传动齿轮2483在次旋转方向(与第二旋转方向相反)上的旋转将引起第三闭合从动齿轮2630在次旋转方向上的旋转。
如图43所示，将驱动轴组件2640联接到刀杆2580的近端。在各种实施例中，驱动轴组件2640包括具有正方形横截面形状的近侧部分2642。近侧部分2642能够与第三从动齿轮2630中相应的成形孔滑动地接合。当第三从动齿轮2630旋转时，此结构引起驱动轴组件2640(和刀杆2580)的旋转。驱动轴组件2640通过刀驱动组件2650在远侧和近侧方向上被轴向推进。一种形式的刀驱动组件2650包括旋转传动齿轮2652，当工具安装部分2600联接到工具保持器1270时，所述旋转传动齿轮联接到工具安装板2462的适配器侧上相应的从动可旋转主体部分、盘或元件1304中的第三个。参见图22和43。旋转从动齿轮2652与齿轮系(一般描述为2653)驱动啮合。在至少一种形式中，齿轮系2653还包括可旋转地支撑在工具安装板2602上的第一旋转从动齿轮组件2654。第一旋转从动齿轮组件2654与第三旋转从动齿轮组件2656啮合，所述第三旋转从动齿轮组件可旋转地支撑在工具安装板2602上并且与第四旋转从动齿轮组件2658啮合，所述第四旋转从动齿轮组件与驱动轴组件2640的螺纹部分2644啮合。旋转传动齿轮2652在第三旋转方向上旋转将引起驱动轴组件2640和刀杆2580在远侧方向“DD”上轴向行进。反之，旋转传动齿轮2652在三级旋转方向(与第三旋转方向相反)上旋转将引起驱动轴组件2640和刀杆2580在近侧方向上运动。
现将描述操作外科工具2500的方法。一旦工具安装部分2600可操作地联接到机器人系统1000的工具保持器1270，则机器人系统1000可将外科端部执行器2512定位在邻近待切割和缝合的靶组织的位置。如果砧座2524尚未处于打开位置(图49)，机器人系统1000可向闭合驱动齿轮2622施加第二旋转输出运动，这引起刀杆2580在第二方向上的旋转。刀杆2580在第二方向上的旋转引起闭合驱动螺母2560在第二方向上的旋转。当闭合驱动螺母2560在第二方向上旋转时，闭合管2550在近侧方向“PD”上运动。当闭合管2550在近侧方向“PD”上运动时，砧座2524上的突出部2527与闭合管2550中的开口2555交接并使砧座2524枢转至打开位置。除此之外或在可供选择的实施例中，当闭合管2550回到起始位置时(图40)，可使用弹簧(未示出)以将砧座2354枢转至打开位置。然后，可通过机器人系统1000操纵打开的外科端部执行器2512以将靶组织定位在打开的砧座2524和外科钉仓2534之间。然后，外科医生可通过致动机器人控制系统1000以向闭合传动齿轮2622施加第二旋转输出运动来引发闭合过程，如上所述，这最终引起闭合驱动螺母2382在第二方向上的旋转，从而引起闭合管2250在远侧方向“DD”上的轴向行进。当闭合管2550在远侧方向上运动时，其接触砧座2524的一部分并使砧座2524枢转至闭合位置，从而夹持砧座2524和钉仓2534之间的靶组织。一旦机器人控制器1001确定砧座2524已通过端部执行器2512中与之连通的相应的一个或多个传感器枢转至闭合位置，则机器人控制器1001停止向闭合传动齿轮2622施加第二旋转输出运动。机器人控制器1001还可以为外科医生提供砧座2524已完全闭合的指示。然后外科医生可引发击发过程。在可供选择的实施例中，击发过程可由机器人控制器1001自动引发。
在机器人控制器1001确定砧座2524处于闭合位置之后，然后机器人控制器1001向旋转传动齿轮2652施加第三旋转输出运动，这引起驱动轴组件2640和刀杆2580在远侧方向“DD”上的轴向运动。当切割器械2532朝远侧运动穿过外科钉仓2534时，切断夹持在其中的组织。当滑动件部分(未示出)朝远侧驱动时，其驱动外科钉仓2534中的钉穿过切断的组织，从而与砧座2524形成接触。一旦机器人控制器1001通过外科端部执行器2512中与机器人控制器1001连通的一个或多个传感器确定切割器械2532已到达外科钉仓2534内的结束位置，则机器人控制器1001停止向旋转传动齿轮2652施加第二旋转输出运动。然后，机器人控制器1001向旋转传动齿轮2652施加次旋转控制运动，这最终使切割器械2532和滑动件部分在近侧方向“PD”上轴向行进至起始位置。一旦机器人控制器1001通过端部执行器2512中与机器人控制器1001连通的一个或多个传感器确定切割器械2524已到达起始位置，则机器人控制器1001停止向旋转传动齿轮2652施加次旋转输出运动。然后，机器人控制器1001可向闭合传动齿轮2622施加次旋转输出运动，这引起刀杆2580在次方向上的旋转。刀杆2580在次方向上的旋转引起闭合驱动螺母2560在次方向上的旋转。当闭合驱动螺母2560在次方向上旋转时，闭合管2550在近侧方向“PD”上运动至打开位置。
图44-49B示出了可结合机器人系统1000有效使用的另一个外科工具2700。在各种形式中，外科工具2700包括外科端部执行器2712，所述外科端部执行器包括细长通道2722形式的“第一部分”和包括可枢转地平移的夹紧构件(例如砧座2724)形式的“第二可活动部分”，所述第一部分和第二可活动部分保持在确保有效缝合和切断夹持在外科端部执行器2712中的组织的间距处。如图示实施例中所示，外科端部执行器2712可包括除了前述通道2722和砧座2724之外的切割器械2732形式的“第三可活动部分”、滑动件(未示出)和可活动地位于细长通道2722中的外科钉仓2734。例如，切割器械2732可以为刀。砧座2724可在连接至细长通道2722的近端的枢轴点2725处可枢转地打开和闭合。砧座2724还可包括位于其近端的突出部2727，所述突出部与机械闭合系统(以下进一步描述)的部件交接以打开和闭合砧座2724。当致动时，刀2732和滑动件沿着细长通道2722纵向行进，从而切割夹持在外科端部执行器2712中的组织。滑动件沿着细长通道2722的运动使得外科钉仓2734的钉被驱动穿过切断的组织并且抵靠闭合的砧座2724，所述砧座使钉弯曲以紧固被切断的组织。在一种形式中，细长通道2722和砧座2724可以由导电材料(例如金属)制成，使得它们可以作为与外科端部执行器中的一个或多个传感器连通的天线的一部分，如上所述。外科钉仓2734可以由非导电材料(例如塑料)制成，并且传感器可以连接到或设置在外科钉仓2734中，如上所述。
应该指出的是，虽然本文描述的外科工具2500的实施例使用对切断的组织进行缝合的外科端部执行器2712，但是在其他实施例中，可使用用于对切断的组织进行紧固或密封的不同技术。例如，也可使用利用射频能量或粘合剂来紧固被切断的组织的端部执行器。授予Yates等人的名称为“Electrosurgical Hemostatic Device”的美国专利No.5,709,680以及授予Yates等人的名称为“Electrosurgical Hemostatic Device With RecessedAnd/Or Offset Electrodes”的美国专利No.5,688,270公开了使用射频能量来紧固被切断的组织的切割器械，该专利以引用的方式并入本文。授予Morgan等人的美国专利申请序列号11/267,811以及授予Shelton等人的美国专利申请序列号11/267,363公开了使用粘合剂来紧固被切断的组织的切割器械，该专利也以引用的方式并入本文。因此，虽然本文的描述涉及切割/缝合操作等，但是应当认识到，这仅是示例性实施例，并不旨在进行限制。也可以使用其他组织紧固技术。
在图示实施例中，外科端部执行器2712的细长通道2722联接到细长轴组件2708，所述细长轴组件2708联接到工具安装部分2900。虽然未示出，细长轴组件2708可包括关节运动接头以允许外科端部执行器2712围绕基本上横向于工具轴线LT-LT的轴线选择性地进行关节运动。在至少一个实施例中，细长轴组件2708包括中空的脊管2740，所述中空的脊管不可活动地联接到工具安装部分2900的工具安装板2902。如图45和46所示，细长通道2722的近端2723包括通过安装衬圈2790附接到脊管2740的中空的管状结构。图47中示出了安装衬圈2790的剖视图。在各种实施例中，安装衬圈2790具有能够附接至脊管2740的远端的近侧凸缘末端2791。在至少一个实施例中，例如，将安装衬圈2790的近侧凸缘末端2791焊接或胶粘到脊管2740的远端。如图45和46进一步所示，安装衬圈2790还具有安装毂部分2792，所述安装毂部分的尺寸设定成能够容纳其上的细长通道2722的近端2723。细长通道2722的近端2723通过例如焊接、粘结等不可活动地附接到安装毂部分2792。
如图45和46进一步所示，外科工具2700还包括闭合管2750形式的可轴向运动的致动构件，所述闭合管被限制为相对于细长通道2722进行轴向运动。闭合管2750具有近端2752，所述近端具有形成于其中的内螺纹2754，所述内螺纹与闭合驱动螺母2760形式的可旋转运动的部分进行螺纹接合。更具体地讲，闭合驱动螺母2760具有相对于细长通道2722和脊管2740旋转支撑的近端部分2762。出于组装目的，近端部分2762螺纹附接到保持环2770。保持环2770容纳在沟槽2729中，所述沟槽在通道2722的近端2723上的肩部2727和安装衬圈2790的安装毂2729之间形成。此结构用于将闭合驱动螺母2760旋转地支撑在通道2722内。闭合驱动螺母2760的旋转将引起闭合管2750轴向运动，如图45中的箭头“D”所示。
驱动构件延伸穿过脊管2740、安装衬圈2790和闭合驱动螺母2760，在至少一个实施例中，所述驱动构件包括具有联接到切割器械2732的远端部分2782的刀杆2780。如图45和46所示，安装衬圈2790具有穿过其中的通路2793以允许刀杆2780滑动地穿过其中。相似地，闭合驱动螺母2760中具有狭槽2764，刀杆2780可滑动地延伸穿过所述狭槽。此结构允许刀杆2780相对于闭合驱动螺母2760轴向运动。
通过旋转从动闭合轴2800来控制砧座2724的致动。如图45和46所示，闭合驱动轴2800的远端部分2802延伸穿过安装衬圈2790中的通路2794，并且闭合齿轮2804附接至其上。闭合齿轮2804能够与闭合驱动螺母2760的内表面2761驱动接合。因此，闭合轴2800的旋转也将引起闭合驱动螺母2760的旋转。闭合管2750运动的轴向最终取决于闭合轴2800和闭合驱动螺母2760旋转的方向。例如，响应于从机器人系统1000接收的一个旋转闭合运动，闭合管2750将在远侧方向“DD”上被驱动。当闭合管2750朝远侧驱动时，开口2745将接合砧座2724上的突出部2727并使砧座2724枢转至闭合位置。当施加来自机器人系统1000的开放式旋转运动时，闭合管2750将在近侧方向“PD”上被驱动并且将砧座2724枢转至打开位置。在各种实施例中，可使用弹簧(未示出)以将砧座2724偏置至打开位置(图45)。
在使用中，围绕纵向工具轴线LT-LT旋转外科端部执行器2712可能是有利的。在至少一个实施例中，工具安装部分2900能够接收来自机器人系统1000的相应的第一旋转输出运动以使细长轴组件2708围绕工具轴线LT-LT旋转。如图49所示，中空的脊管2740的近端2742可旋转地支撑在支架装置2903和轴承组件2904中，所述支架结构和轴承组件附接到工具安装部分2900的工具安装板2902。旋转齿轮2744形成于或附接到脊管2740的近端2742，以与可操作地支撑在工具安装板2902上的旋转驱动组件2910啮合。在至少一个实施例中，当工具安装部分2600联接到工具保持器1270时，旋转传动齿轮2912联接到工具安装板2602的适配器侧上相应的从动盘或从动元件1304中的第一个。参见图22和49。旋转驱动组件2910还包括旋转从动齿轮2914，所述旋转从动齿轮与旋转齿轮2744和旋转传动齿轮2912以啮合的方式而被旋转地支撑在工具安装板2902上。将来自机器人系统1000的第一旋转控制运动通过工具保持器1270和适配器1240施加到相应的从动元件1304，从而将通过可操作地联接至其而引起旋转传动齿轮2912的旋转。旋转传动齿轮2912的旋转最终导致细长轴组件2708(和端部执行器2712)围绕纵向工具轴线LT-LT旋转(主旋转运动)。
通过使闭合管组件2750在远侧方向“DD”上轴向运动来实现砧座2724相对于外科钉仓2734的闭合。通过将旋转控制运动施加到闭合驱动螺母2760来实现闭合管2750在远侧方向“DD”上的轴向运动。在各种实施例中，通过施加旋转输出运动到闭合驱动轴2800来旋转闭合驱动螺母2760。如图49所示，闭合驱动轴2800的近端部分2806上具有与闭合驱动组件2920啮合的从动齿轮2808。在各种实施例中，闭合驱动系统2920包括闭合传动齿轮2922，当工具安装部分2900联接到工具保持器1270时，所述闭合传动齿轮联接到工具安装板2462的适配器侧上相应的从动旋转主体或从动元件1304中的第二个。参见图22和49。闭合传动齿轮2922以与闭合齿轮系(一般描述为2923)以啮合的方式而被支撑。在至少一种形式中，闭合齿轮系2923包括可旋转地支撑在工具安装板2902上的第一从动闭合齿轮2924。通过驱动轴2928将第一闭合从动齿轮2924附接到第二闭合从动齿轮2926。第二闭合从动齿轮2926与行星齿轮组件2930啮合。在各种实施例中，行星齿轮组件2930包括可旋转地支撑在轴承组件2904中的从动行星闭合齿轮2932，所述轴承组件安装在工具安装板2902上。如图49和49B所示，闭合驱动轴2800的近端部分2806可旋转地支撑在脊管2740的近端部分2742中，使得从动齿轮2808与行星齿轮2932上形成的中心齿轮齿2934啮合。另外如图49A所示，两个另外的支撑齿轮2936附接到脊管2740的近端部分2742或相对于所述脊管的近端部分旋转地支撑以向其提供轴承支撑。此具有行星齿轮组件2930的结构用于通过旋转驱动组件2910适应脊轴2740的旋转，同时允许闭合从动齿轮2808与闭合驱动系统2920保持啮合。另外，闭合传动齿轮2922在第一方向上的旋转将最终引起闭合驱动轴2800和闭合驱动螺母2760的旋转，这将最终导致砧座2724闭合，如上所述。反之，闭合传动齿轮2922在第二相反方向上的旋转将最终引起闭合驱动螺母2760在相反方向上的旋转，这将使砧座2724打开。
如图49所示，刀杆2780的近端2784具有与之附接并与刀驱动组件2940驱动接合的螺纹轴部分2786。在各种实施例中，螺纹轴部分2786通过附接到工具安装板2902的轴承2906旋转地支撑。此结构允许螺纹轴部分2786相对于工具安装板2902旋转和轴向运动。刀杆2780通过刀驱动组件2940在远侧和近侧方向上轴向推进。一种形式的刀驱动组件2940包括旋转传动齿轮2942，当工具安装部分2900联接到工具保持器1270时，所述旋转传动齿轮联接到工具安装板2902的适配器侧上相应的旋转主体、从动盘或从动元件1304中的第三个。参见图22和49。旋转传动齿轮2942与刀齿轮系(一般描述为2943)啮合。在各种实施例中，刀齿轮系2943包括可旋转地支撑在工具安装板2902上的第一旋转从动齿轮组件2944。第一旋转从动齿轮组件2944与第三旋转从动齿轮组件2946啮合，所述第三旋转从动齿轮组件可旋转地支撑在工具安装板2902上并且与第四旋转从动齿轮组件2948啮合，所述第四旋转从动齿轮组件与刀杆2780的螺纹部分2786啮合。旋转传动齿轮2942在一个方向上的旋转将引起刀杆2780在远侧方向“DD”上轴向行进。反之，旋转传动齿轮2942在相反方向上的旋转将引起刀杆2780在近侧方向上运动。否则，可使用工具2700，如上所述。
图50和51示出了基本上与上文详细描述的工具2700相同的外科工具实施例2700’。然而，工具2700’包括压力传感器2950，所述压力传感器能够向机器人控制器1001提供关于砧座2724受到的夹紧压力的量的反馈。在各种实施例中，例如，压力传感器可包括弹簧偏置的接触开关。对于连续信号而言，可使用其上具有应变计的悬臂梁或内部有应变计的圆顶按钮盖。另一种产品形式可包括仅以已知的所需负载接触的断路开关。此结构可包括基座上的圆顶，其中该圆顶为一个电极并且基座为另一个电极。此结构允许机器人控制器1001通过调节施加到砧座2724的闭合压力的量来调节施加到外科端部执行器2712内组织的夹紧压力的量。本领域的普通技术人员将会理解，此压力传感器结构可与本文所述的若干外科工具实施例以及它们的等价结构一起有效地使用。
图52示出了可结合机器人系统1000有效使用的另一个外科工具3000的一部分。外科工具3003采用一个或多个机载马达以为外科端部执行器切割器械的各种部件提供功率。在至少一个非限制性的实施例中，例如，外科工具3000包括直线切割器(未示出)形式的外科端部执行器，其具有上述类型和构造的砧座(未示出)和外科钉仓结构(未示出)。外科工具3000还包括上述类型的细长轴(未示出)和砧座闭合结构(未示出)。因而，除了必须理解外科工具3000的各种实施例的独特和新颖属性之外，此部分的具体实施方式将不重复对那些部件的描述。
在所示的实施例中，端部执行器包括联接到刀杆3003的切割器械3002。如图52所示，外科工具3000包括工具安装部分3010，所述工具安装部分包括能够与适配器部分1240’以安装方式交接的工具安装板3012，所述适配器部分以上述各种方式联接到机器人系统1000。工具安装部分3010能够可操作地支撑其上的传动装置结构3013。在至少一个实施例中，适配器部分1240’在适配器1240没有采用功率旋转主体和盘构件的情况下可能与上文中详细描述的适配器部分1240相同。在其他实施例中，适配器部分1240’可能与适配器部分1240相同。被视为在本发明的各种形式的实质和范围内的其他修改形式可以采用一种或多种来自工具保持器部分1270(如在上文中所述)的机械运动(即，旋转运动)以功率/致动传动装置结构3013，同时还使用一个或多个在工具安装部分3010内的马达以为外科端部执行器的一个或多个其他部件提供功率。另外，虽然所示实施例的端部执行器包括直线切割器，但是本领域的普通技术人员将会知道，在不脱离本发明的各种形式的实质和范围的情况下可结合其他类型的外科端部执行器有效地使用所示实施例的独特和新颖属性。
在各种实施例中，工具安装板3012能够至少容纳第一击发马达3011以为刀杆3003提供击发和回缩运动，所述刀杆联接到切割器械3002或与切割器械可操作地交接。工具安装板3012具有一系列电连接销3014，所述电连接销能够与适配器1240’中的狭槽1258(图21)交接。此结构允许机器人系统1000的控制器1001为外科工具3000的电子控制电路3020提供控制信号。虽然结合机械耦合元件、电耦合元件和磁力耦合元件在本文中描述了接口，应当理解，可使用多种遥测形式，包括红外、电感耦合等。
控制电路3020在图52中以图解示意图的形式示出。在一种形式或实施例中，控制电路3020包括电池3022形式的功率源，所述电池联接到通断螺线管功率源开关3024。控制电路3020还包括联接到双极开关3028的通断击发螺线管3026以用于控制马达3011的旋转方向。因而，当机器人系统1000的控制器1001提供适当的控制信号时，开关3024将允许电池3022为双极开关3028提供功率。机器人系统1000的控制器1001还将为双极开关3028提供适当的信号，从而为马达3011提供功率。当期望击发外科端部执行器(即，朝远侧驱动切割器械3002穿过夹持在外科端部执行器中的组织)时，双极开关3028将处于第一位置。当期望将切割器械3002回缩至起始位置时，双极开关3028将通过控制器1001运动至第二位置。
外科工具3000的各种实施例还采用尺寸设定成与击发齿轮系3031结合的齿轮箱3030，在至少一个非限制性实施例中，所述击发齿轮系包括击发传动齿轮3032，所述击发传动齿轮与击发从动齿轮3034啮合以生成所需量的驱动力，从而驱动切割器械3002穿过组织并以本文所述的各种方式驱动和形成钉。在图52中示出的实施例中，从动齿轮3034联接到与螺母结构3038螺纹接合的螺杆轴3036，限制所述螺母装置进行轴向运动(由箭头“D”表示)。将螺母结构3038附接到击发杆3003。因而，通过在第一方向上旋转螺杆轴3036在远侧方向“DD”上驱动切割器械3002，并通过在相反的第二方向上旋转螺杆轴可以在近侧方向“PD”上回缩切割器械3002。
图53示出了另一个基本上与上述工具3000相同的外科工具3000’的一部分，不同的是从动齿轮3034附接到驱动轴3040。将驱动轴3040附接到与第三从动齿轮3044啮合的第二传动齿轮3042，所述第三从动齿轮与联接到击发杆3003的螺钉3046啮合。
图54示出了可结合机器人系统1000有效使用的另一个外科工具3200。在该实施例中，外科工具3200包括非限制性形式的外科端部执行器3212，所述外科端部执行器包括相对于至少一个其他端部执行器部件部分在第一位置和第二位置之间选择性运动的部件部分。如将在下文中进一步详细地描述，外科工具3200采用机载马达以为传动装置结构3305的各种部件提供功率。外科端部执行器3212包括可操作地支撑外科钉仓3234的细长通道3222。细长通道3222具有可滑动地延伸到中空的细长轴组件3208中的近端3223，所述中空的细长轴组件联接到工具安装部分3300。另外，外科端部执行器3212包括通过一对耳轴3225可枢转地联接到细长通道3222的砧座3224，所述耳轴容纳在细长通道3222中相应的开口3229内。轴组件3208的远端部分3209包括开口3245，当细长通道3222相对于轴组件3208的远端部分3209在近侧方向“PD”上轴向运动时，砧座3224上的突出部3227插入到所述开口中以打开砧座3224。在各种实施例中，可以使用弹簧(未示出)以将砧座3224偏置至打开位置。
如上所述，外科工具3200包括工具安装部分3300，所述工具安装部分包括能够操作地支撑传动装置结构3305并与适配器部分1240’安装交接的工具安装板3302，所述适配器部分以上述各种方式联接到机器人系统1000。在至少一个实施例中，适配器部分1240’在没有适配器1240采用的功率盘构件的情况下可能与上文中详细描述的适配器部分1240相同。在其他实施例中，适配器部分1240’可能与适配器部分1240相同。然而，在此实施例中，因为外科端部执行器3212的各种部件全部由工具安装部分3300中的马达提供功率，外科工具3200将不采用或需要来自工具保持器部分1270的任何机械(即，非电的)致动运动以为外科端部执行器3200部件提供功率。被视为在本发明的各种形式的实质和范围内的其他修改形式可以采用一种或多种来自工具保持器部分1270(如在上文中所述)的机械运动以功率/致动一个或多个外科端部执行器部件，同时还使用一个或多个在工具安装部分内的马达以为外科端部执行器的一个或多个其他部件提供功率。
在各种实施例中，工具安装板3302能够支撑第一击发马达3310以用于为传动装置结构3305提供击发和回缩运动，从而驱动联接到上述类型的切割器械3332的刀杆3335。如图54所示，工具安装板3212具有一系列电连接销3014，所述电连接销能够与适配器1240’中的狭槽1258(图21)交接。此结构允许机器人系统1000的控制器1001为外科工具3200的电子控制电路3320、3340提供控制信号。虽然结合机械耦合元件、电耦合元件和磁力耦合元件在本文中描述了接口，应当理解，可使用多种遥测形式，包括红外、电感耦合等。
在一种形式或实施例中，第一控制电路3320包括第一电池3322形式的第一功率源，所述第一电池联接到第一通断螺线管功率源开关3324。第一击发控制电路3320还包括第一通断击发螺线管3326，所述第一通断击发螺线管联接到第一双极开关3328以控制第一击发马达3310的旋转方向。因而，当机器人控制器1001提供适当的控制信号时，第一开关3324将允许第一电池3322为第一双极开关3328提供功率。机器人控制器1001还将为第一双极开关3328提供适当的信号，从而为第一击发马达3310提供功率。当期望击发外科端部执行器(即，朝远侧驱动切割器械3232穿过夹持在外科端部执行器3212中的组织)时，第一开关3328将通过机器人控制器1001设置在第一位置。当期望将切割器械3232回缩至起始位置时，机器人控制器1001将发送适当的控制信号以使第一开关3328运动至第二位置。
外科工具3200的各种实施例还采用尺寸设定成与附接其上的击发传动齿轮3332结合的第一齿轮箱3330，所述击发传动齿轮可操作地与击发齿轮系3333交接。在至少一个非限制性实施例中，击发齿轮系333包括击发从动齿轮3334，所述击发从动齿轮与传动齿轮3332啮合以生成所需量的驱动力，从而驱动切割器械3232穿过组织并以本文中所述的各种方式驱动和形成钉。在图54示出的实施例中，从动齿轮3334联接到驱动轴3335，所述驱动轴具有与之联接的第二从动齿轮3336。第二从动齿轮3336以与第三从动齿轮3337啮合的方式被支撑，所述第三从动齿轮与第四从动齿轮3338啮合。第四从动齿轮3338与刀杆3235的螺纹近侧部分3339啮合，限制所述刀杆进行轴向运动。因而，通过在第一方向上旋转驱动轴3335，在远侧方向“DD”上驱动切割器械3232并在相反的第二方向上旋转驱动轴3335，切割器械3232可在近侧方向“PD”上回缩。
如上所述，通过相对于细长轴组件3208使细长通道3222轴向运动来控制砧座3224的打开和闭合。细长通道3222的轴向运动由闭合控制系统3339控制。在各种实施例中，闭合控制系统3339包括闭合轴3340，所述闭合轴具有与螺纹闭合杆3342通过螺纹接合的中空的螺纹端部3341。螺纹端部3341可旋转地支撑在脊轴3343中，所述脊轴可操作地与工具安装部分3300交接并延伸穿过轴组件3208的一部分，如图所示。闭合系统3339还包括闭合控制电路3350，所述闭合控制电路包括第二电池3352形式的第二功率源，所述第二电池联接到第二通断螺线管功率源开关3354。闭合控制电路3350还包括第二通断击发螺线管3356，所述第二通断击发螺线管联接到第二双极开关3358以控制第二闭合马达3360的旋转。因而，当机器人控制器1001提供适当的控制信号时，第二开关3354将允许第二电池3352为第二双极开关3354提供功率。机器人控制器1001还将为第二双极开关3358提供适当的信号，从而为第二马达3360提供功率。当期望闭合砧座3224时，第二开关3348将处于第一位置。当期望打开砧座3224时，第二开关3348将运动至第二位置。
工具安装部分3300的各种实施例还采用联接到闭合传动齿轮3364的第二齿轮箱3362。闭合传动齿轮3364与闭合齿轮系3363啮合。在各种非限制性形式中，闭合齿轮系3363包括附接到闭合驱动轴3366的闭合从动齿轮3365。与附接到闭合轴3340的闭合轴齿轮3360啮合的闭合传动齿轮3367也附接到闭合驱动轴3366。图54示出了处于打开位置的端部执行器3212。如上所述，当螺纹闭合杆3342处于图54中示出的位置时，弹簧(未示出)将砧座3224偏置至打开位置。当期望闭合砧座3224时，机器人控制器1001将启动第二马达3360以旋转闭合轴3340，从而在近侧方向‘PD’上牵拉螺纹闭合杆3342和通道3222。当砧座3224与轴3208的远端部分3209接触时，砧座3224枢转至闭合位置。
现将描述操作外科工具3200的方法。一旦工具安装部分3302可操作地联接到机器人系统1000的工具保持器1270，机器人系统1000可将端部执行器3212定位在邻近待切割和缝合的靶组织的位置。如果砧座3224尚未处于打开位置，则机器人控制器1001可启动第二闭合马达3360以在远侧方向上将通道3222驱动至图54中示出的位置。一旦机器人控制器1001通过在端部执行器和/或工具安装部分3300中的一个或多个传感器确定外科端部执行器3212已处于打开位置，则机器人控制器1001可为外科医生提供信号，从而通知外科医生随后可闭合砧座3224。一旦靶组织定位在打开的砧座3224和外科钉仓3234之间，则外科医生可通过启动机器人控制器1001以向第二闭合马达3360施加闭合控制信号来开始闭合过程。第二闭合马达3360向闭合轴3340施加旋转运动，以在近侧方向“PD”上牵拉通道3222直到砧座3224枢转至闭合位置。一旦机器人控制器1001通过在外科端部执行器3212和/或与机器人控制系统连通的工具安装部分3300中的一个或多个传感器确定砧座3224已运动至闭合位置，则马达3360可被停止。然后，可通过外科医生启动控制器1001上的触发器、按钮等手动开始击发过程，或控制器1001可自动地开始击发过程。
为了开始击发过程，机器人控制器1001启动击发马达3310以在远侧方向“DD”上驱动击发杆3235和切割器械3232。一旦机器人控制器1001通过在外科端部执行器3212和/或马达驱动部分3300中的传感器确定切割器械3232已运动至外科钉仓3234中的结束位置，则机器人控制器1001可为外科医生提供指示信号。然后，外科医生可手动启动第一马达3310以回缩切割器械3232至起始位置，或机器人控制器1001可自动地启动第一马达3310以回缩切割元件3232。
图54中示出的实施例不包括关节运动接头。图55和56示出了分别具有端部执行器3212’、3212”的外科工具3200’和3200”，所述端部执行器3212’、3212”可与具有本文所公开的各种类型的关节运动接头的细长轴实施例一起使用。例如，如图55所示，螺纹闭合轴3342通过柔性缆线或其他柔性构件3345联接到细长通道3222的近端3223。关节运动接头(未示出)在细长轴组件3208中的位置将与柔性构件3345一致，从而使柔性构件3345适应此关节运动。另外，在上述的实施例中，柔性构件3345可旋转地附连到细长通道3222的近端部分3223以使柔性构件33345相对于其旋转，从而防止柔性构件3229相对于通道3222“卷绕”。虽然未示出，可通过刀杆以上述方式中的一者来驱动切割元件，该刀杆也可适应细长组件的关节运动。图56示出了基本上与上述外科端部执行器3212基本上相同的外科端部执行器3212”，不同的是螺纹闭合杆3342附接到闭合螺母3347，限制所述闭合螺母3347仅在细长轴组件3208内进行轴向运动。将柔性构件3345附接到闭合螺母3347。此结构还防止螺纹闭合杆3342卷绕柔性构件3345。可采用柔性刀杆3235’以利于外科端部执行器3212”的关节运动。
上述外科工具3200、3200’和3200”也可采用本文所述的切割器械实施例中的任何一个。如上所述，通过牵拉细长通道至与细长轴组件的远端接触来闭合这些工具的每个端部执行器的砧座。因此，一旦靶组织位于钉仓3234和砧座3224之间，机器人控制器1001可开始向内牵拉通道3222至轴组件3208中。然而，在各种实施例中，为了防止端部执行器3212、3212’、3212”在该闭合过程中使靶组织随着端部执行器运动，控制器1001可同时使工具保持器运动并最终使工具运动以补偿细长通道3222的运动，从而使靶组织实际上被夹持在砧座和细长通道之间而不被移动。
图57-59示出了除了下文描述的差异之外基本上与上述外科工具3200”相同的另一个外科工具实施例3201。在该实施例中，螺纹闭合杆3342’具有可变节距的沟槽。更具体地讲，如图58所示，闭合杆3342’具有远侧沟槽部分3380和近侧沟槽部分3382。远侧沟槽部分3380和近侧沟槽部分3382能够与支撑在中空的螺纹端部3341’中的凸耳3390相接合。如图58所示，远侧沟槽部分3380具有比沟槽部分3382更细小的节距。因此，此可变节距结构通过凸耳3390和近侧沟槽部分3382之间的接合而允许细长通道3222以第一速度或速率被牵拉到轴3208中。当凸耳3390接合远侧沟槽部分时，通道3222将以第二速度或速率被牵拉到轴3208中。因为近侧沟槽部分3382比远侧沟槽部分3380更粗糙，第一速度将大于第二速度。此结构用于加速端部执行器的初始闭合以用于操纵组织，然后在将组织准确地定位在其中之后，生成适当夹持组织以对组织进行切割和缝合的闭合力的大小。因此，砧座3234最初以较小的力快速闭合，然后随着砧座更慢闭合而施加更大的闭合力。
在将组织完全夹持在所需位置以进行切割和缝合之前，可利用外科端部执行器打开和闭合运动以允许使用者使用端部执行器抓持和操纵组织。例如，使用者可在该过程中多次打开和闭合外科端部执行器以将端部执行器定位在使组织被保持在所需位置的适当的位置。因此，在至少一些实施例中，为了生成用于击发的高负载，细牙螺纹可能需要多达5至10次完全旋转以生成必要的负载。在一些情况下，例如，该动作可能花费长达2至5秒。如果在定位/组织操纵过程中每次也花费等长的时间打开和闭合端部执行器，则定位端部执行器可能花费过长的时间。如果出现这种情况，使用者可能放弃使用端部执行器以使用常规的抓紧器装置。使用抓紧器等可不利地增加与完成外科手术相关的成本。
上述实施例采用一个或多个电池以为用于驱动端部执行器部件的马达提供功率。通过机器人系统1000控制马达的启动。在可供选择的实施例中，功率源可包括由机器人系统1000为马达提供的交流电“AC”。即，交功率可由通过工具保持器和适配器为机器人系统1000提供功率的系统供给。在其他实施例中，功率线或绳可附接到工具安装部分3300以提供所需的来自单独的交流电源或直流电源的功率。
在使用中，控制器1001施加初始旋转运动至闭合轴3340(图54)以向内轴向牵拉细长通道3222至细长轴组件3208中，并以第一速率使砧座从第一位置运动至中间位置，所述中间位置对应于其中远侧沟槽部分3380过渡到近侧沟槽部分3382的点。进一步将旋转运动施加到闭合轴3340将使砧座相对于外科钉仓从中间位置运动至闭合位置。当处于闭合位置时，待切割和缝合的组织被适当地夹持在砧座和外科钉仓之间。
图60-64示出本发明的另一个外科工具实施例3400。该实施例包括从工具安装部分3500延伸的细长轴组件3408。细长轴组件3408包括可旋转的近侧闭合管段3410，所述可旋转的近侧闭合管段可旋转地连接在近侧脊构件3420上，该近侧脊构件刚性地联接到工具安装部分3500的工具安装板3502。近侧脊构件3420具有远端3422，所述远端联接到外科端部执行器3412的细长通道部分3522。例如，在至少一个实施例中，细长通道部分3522具有远端部分3523，所述远端部分“以钩的形式接合”脊构件3420的远端3422。细长通道3522能够支撑其中的外科钉仓3534。该实施例可使用本文所公开的各种切割器械实施例中的一个来切断夹持在外科端部执行器3412中的组织，并将钉仓3534中的钉击发至切断的组织中。
外科端部执行器3412具有通过一对耳轴3525可枢转地联接到细长通道3522的砧座3524，所述耳轴3525容纳在细长通道3522中相应的开口3529内。砧座3524通过远侧闭合管段3430在打开位置(图60)和闭合位置(图61-63)之间运动。远侧闭合管段3430的远端部分3432包括开口3445，当远侧闭合管段3430相对于其进行轴向运动时，砧座3524上的突出部3527插入到所述开口中以打开和闭合砧座3524。在各种实施例中，将开口3445成形以使得当闭合管段3430在近侧方向上运动时，闭合管段3430使砧座3524枢转至打开位置。除此之外或作为另外一种选择，可使用弹簧(未示出)以将砧座3524偏置至打开位置。
如图60-63所示，远侧闭合管段3430包括凸耳3442，所述凸耳3442从其远端3440延伸至与可旋转的近侧闭合管段3410的远端3412中形成的可变节距沟槽/螺纹3414进行螺纹接合。可变节距沟槽/螺纹3414具有远侧部分3416和近侧部分3418。远侧沟槽/螺纹部分3416的节距小于近侧沟槽/螺纹部分3418的节距。另外如图60-63所示，通过轴向保持器销3450限制远侧闭合管段3430相对于脊构件3420进行轴向运动，所述轴向保持器销容纳在脊构件3420的远端中的轴向狭槽3424中。
如上所述，通过旋转近侧闭合管段3410打开和闭合砧座2524。可变节距螺纹结构通过凸耳3442和近侧沟槽/螺纹部分3418之间的接合而允许以第一速度或速率在远侧方向“DD”上驱动远侧闭合管段3430。当凸耳3442接合远侧沟槽/螺纹部分3416时，将以第二速度或速率在远侧方向上驱动远侧闭合管段3430。因为近侧沟槽/螺纹部分3418比远侧沟槽/螺纹部分3416更粗糙，第一速度将大于第二速度。
在至少一个实施例中，工具安装部分3500能够接收来自机器人控制器1001的相应的第一旋转运动，并将该第一旋转运动转化成主旋转运动，以使可旋转的近侧闭合管段3410围绕纵向工具轴线LT-LT旋转。如图64所示，近侧闭合管段3410的近端3460可旋转地支撑在附接到工具安装部分3500的工具安装板3502的支架结构3504中。旋转齿轮3462形成于或附接到闭合管段3410的近端3460，以与可操作地支撑在工具安装板3502上的旋转驱动组件3470啮合。在至少一个实施例中，当工具安装部分3500联接到工具保持器1270时，旋转传动齿轮3472联接到工具安装板3502的适配器侧上相应的从动盘或从动元件1304中的第一个。参见图22和64。旋转驱动组件3470还包括旋转从动齿轮3474，所述旋转从动齿轮与旋转齿轮3462和旋转传动齿轮3472以啮合的方式而被旋转地支撑在工具安装板3502上。将来自机器人控制器1001的第一旋转控制运动通过工具保持器1270和适配器1240施加到相应的从动元件1304，从而将通过可操作地联接至其而引起旋转传动齿轮3472的旋转。旋转传动齿轮3472的旋转最终引起闭合管段3410的旋转，从而打开和闭合砧座3524，如上所述。
如上所述，外科端部执行器3412采用上述类型和构造的切割器械。图64示出了用于轴向推进刀杆3492的刀驱动组件3480的一种形式，所述刀杆3492附接到此类切割器械。一种形式的刀驱动组件3480包括旋转传动齿轮3482，当工具驱动部分3500联接到工具保持器1270时，所述旋转传动齿轮联接到工具安装板3502的适配器侧上相应的从动盘或从动元件1304中的第三个。参见图22和64。刀驱动组件3480还包括可旋转地支撑在工具安装板5200上的第一旋转从动齿轮组件3484。第一旋转从动齿轮组件3484与第三旋转从动齿轮组件3486啮合，所述第三旋转从动齿轮组件可旋转地支撑在工具安装板3502上并与第四旋转从动齿轮组件3488啮合，所述第四旋转从动齿轮组件与联接到刀杆3492的驱动轴组件3490的螺纹部分3494啮合。旋转传动齿轮3482在第二旋转方向上旋转将引起驱动轴组件3490和刀杆3492在远侧方向“DD”上轴向行进。反之，旋转传动齿轮3482在次旋转方向(与第二旋转方向相反)上旋转将引起驱动轴组件3490和刀杆3492在近侧方向上运动。
图65-74示出了可结合机器人系统1000使用的本发明的另一个外科工具3600实施例。如图65所示，工具3600包括一次性加载单元3612形式的端部执行器。可结合工具3600使用的一次性加载单元的各种形式在例如名称为“End Effector Arrangements For aSurgical Cutting and Stapling Instrument”的美国专利申请公布No.US 2009/0206131A1中公开，该专利的公开内容全文以引用的方式并入本文。
在至少一种形式中，一次性加载单元3612包括砧座组件3620，所述砧座组件3620被支撑以相对于可操作地支撑其中的钉仓3640的载体3630而枢转行进。安装组件3650可枢转地联接到仓载体3630，以使载体3630围绕关节运动轴线AA-AA相对于纵向工具轴线LT-LT枢转。参见图70，安装组件3650包括上部安装部分3652和下部安装部分3654。每个安装部分包括在其每个侧面上的螺纹镗孔3656，所述螺纹镗孔的尺寸设定成能够容纳螺栓(未示出)以固定载体3630的近端。一对中心定位的枢转构件3658通过一对联接构件3660在上部安装部分和下部安装部分之间延伸，所述联接构件与外壳部分3662的远端接合。每个联接构件3660均包括互锁近侧部分3664，所述互锁近侧部分能够容纳于在外壳部分3662的近端中形成的沟槽3666中，从而使安装组件3650和外壳部分3662保持在相对于其的纵向固定位置。
在各种形式中，一次性加载单元3614的外壳部分3662包括包含在外部外壳3674内的上半部外壳3670和下半部外壳3672。上半部外壳3670的近端包括用于以可释放的方式接合细长轴3700和插入尖端3678的接合块3676。接合块3676与细长轴3700的远端形成卡口式联接，这将在下文中进一步详细地描述。外壳半部3670、3672限定用于可滑动地容纳轴向驱动组件3680的通道3674。第二关节运动连接件3690的尺寸设定成可滑动地定位于在外壳半部3670、3672之间形成的狭槽3679中。将一对防爆板3691设置在邻近与轴向驱动组件3680的远端相邻的外壳部分3662的远端，以防止在载体3630的关节运动过程中驱动组件3680向外凸出。
在各种实施例中，第二关节运动连接件3690包括至少一个细长金属板。优选地，堆叠两个或更多个金属板以形成连接件3690。关节运动连接件3690的近端包括钩部分3692，所述钩部分能够接合延伸穿过细长轴3700的第一关节运动连接件3710。第二关节运动连接件3690的远端包括套环3694，所述套环的尺寸设定成能够接合安装组件3650上形成的突出。突出与枢轴销3658横向错开，使得第二关节运动连接件3690的线性运动促使安装组件3650围绕枢轴销3658枢转，从而使载体3630进行关节运动。
在各种形式中，轴向驱动组件3680包括细长驱动梁3682，所述细长驱动梁3682包括远侧工作头3684和近侧接合部分3685。驱动梁3682可由单个材料片或优选地多个堆叠的片材制成。接合部分3685包括一对接合指状物，所述接合指状物的尺寸设定成并能够以安装方式接合驱动构件3686中形成的一对相应的保持狭槽。驱动构件3686包括近侧通道口3687，当一次性加载单元3614的近端与外科工具3600的细长轴3700接合时，所述近侧通道口3687能够容纳控制杆2720的远端3722(参见图74)。
参见图65和72-74，为了使用外科工具3600，首先将一次性加载单元3612固定到细长轴3700的远端。应当理解，外科工具3600可包括关节运动或非关节运动的一次性加载单元。为了将一次性加载单元3612固定到细长轴3700，将控制杆3720的远端3722插入到一次性加载单元3612的插入尖端3678中，并且插入尖端3678在图72中箭头“A”示出的方向上纵向滑动到细长轴3700的远端，使得第二关节运动连接件3690的钩部分3692在细长轴3700中的通道3702内滑动。每个接合块3676将在细长轴3700各自的通道(未示出)中对齐。当钩部分3692接合通道3702的近侧壁3704时，一次性加载单元3612在图71和74中箭头“B”示出的方向上旋转以使第二关节运动连接件3690的钩部分3692运动至与第一关节运动连接件3710的指状物3712接合。接合块3676还在细长轴3700中的环形通道3703内形成“卡口式”联接。在加载单元3612的旋转过程中，接合块3676接合挡板3730的凸轮表面3732(图72)，以首先在图72中箭头“C”示出的方向上运动板3730以便将接合构件3734锁定在控制杆3720的凹槽3721中，从而防止控制杆3720在一次性加载单元3612的附接过程中纵向运动。在最终程度的旋转过程中，接合块3676从凸轮表面3732脱离以允许挡板3730在图71和74中箭头“D”示出的方向上从接合构件3734的后面运动，从而再次允许控制杆3720纵向运动。虽然上述附接方法反映了相对于细长轴3700操纵一次性加载单元3612，但是本领域的普通技术人员将会知道，一次性加载单元3612可支撑在固定位置，并且机器人系统1000可相对于一次性加载单元3612操纵细长轴部分3700，从而实现上述联接过程。
图75示出了可附接在具有细长轴3700’的卡口式结构中的另一个一次性加载单元3612’，所述细长轴3700’除了下文所述差异之外基本上与轴3700相同。如图75所示，细长轴3700’具有延伸其至少一部分的狭槽3705，并且所述狭槽3705能够容纳其中的接合块3676。在各种实施例中，一次性加载单元3612’包括从其延伸的臂3677，在一次性加载单元3612’旋转之前，所述臂可与从外壳部分3662延伸的接合块3676对齐或至少基本上对齐。在至少一个实施例中，例如，当一次性加载单元3612’插入到细长轴3700’中时，臂3677和接合块3676可插入到细长轴3700’中的狭槽3705中。当一次性加载单元3612’旋转时，可将臂3677充分地限制在狭槽3705内，使得狭槽3705可将臂保持在适当的位置，然而接合块3676可被定位为使得其不被限制在狭槽3705内并可相对于臂3677旋转。当旋转时，关节运动连接件3690的钩部分3692与延伸穿过细长轴3700’的第一关节运动连接件3710接合。
可使用将一次性加载单元联接到细长轴的末端的其他方法。例如，如图76和77所示，一次性加载单元3612”可包括能够与细长轴3700”的连接器部分3740接合的连接器部分3613。在至少一个实施例中，连接器部分3613可以包括可以与连接器部分3740的至少一个突出和/或沟槽配合的至少一个突出和/或沟槽。在至少一个此类实施例中，连接器部分可包括协作的燕尾部分。在各种实施例中，连接器部分能够彼此互锁，并且防止或至少抑制一次性加载单元3612”沿着轴线3741进行远侧和/或近侧运动。在至少一个实施例中，轴向驱动组件3680’的远端可包括小孔3681，所述小孔能够容纳从控制杆3720’延伸的突出3721。在各种实施例中，此结构可允许一次性加载单元3612”在不与轴线3741共线或平行的方向上组装到细长轴3700。虽然未示出，轴向驱动组件3680’和控制杆3720可包括任何其他合适的突出和小孔结构以可操作地彼此连接。另外在该实施例中，第一关节运动连接件3710可操作地与第二关节运动连接件3690接合。
如图65和78所示，外科工具3600包括工具安装部分3750。工具安装部分3750包括能够附接至工具驱动组件1010的工具安装板3751。工具安装部分可操作地支撑其上的传动装置结构3752。在使用中，围绕由细长轴3700限定的纵向工具轴线旋转一次性加载单元3612可能是有利的。在至少一个实施例中，传动装置结构3752包括旋转的传输组件3753，所述旋转的传输组件能够接收来自机器人系统1000的工具驱动组件1010的对应的旋转输出运动，并将此旋转输出运动转化成旋转控制运动以使细长轴3700(和一次性加载单元3612)围绕纵向工具轴线LT-LT旋转。如图78所示，细长轴3700的近端3701可旋转地支撑在支架结构3754中，所述支架装置3754附接到工具安装部分3750的工具安装板3751。旋转齿轮3755形成于或附接到细长轴3700的近端3701，以与可操作地支撑在工具安装板3751上的旋转齿轮组件3756啮合。在至少一个实施例中，当工具安装部分3750联接到工具驱动组件1010时，旋转传动齿轮3757驱动地联接到工具安装板3751的适配器侧上相应的从动盘或从动元件1304中的第一个。旋转的传输组件3753还包括旋转从动齿轮3758，所述旋转从动齿轮以与旋转齿轮3755和旋转传动齿轮3757以啮合的方式而被旋转地支撑在工具安装板3751上。将来自机器人系统1000的第一旋转输出运动通过工具驱动组件1010施加到相应的从动元件1304，从而将通过可操作地联接至其而引起旋转传动齿轮3757的旋转。旋转传动齿轮3757的旋转最终致使细长轴3700(和一次性加载单元3612)围绕纵向工具轴线LT-LT旋转(主旋转运动)。
如图78所示，将驱动轴组件3760联接到控制杆2720的近端。在各种实施例中，控制杆2720通过刀/闭合驱动传动装置3762在远侧和近侧方向上轴向行进。一种形式的刀/闭合驱动组件3762包括旋转传动齿轮3763，当工具安装部分3750联接到工具保持器1270时，所述旋转传动齿轮联接到工具安装板3751的适配器侧上相应的从动可旋转主体部分、盘或元件1304中的第二个。旋转从动齿轮3763与齿轮系(一般描述为3764)驱动啮合。在至少一种形式中，齿轮系3764还包括可旋转地支撑在工具安装板3751上的第一旋转从动齿轮组件3765。第一旋转从动齿轮组件3765与第二旋转从动齿轮组件3766啮合，所述第二旋转从动齿轮组件可旋转地支撑在工具安装板3751上并且与第三旋转从动齿轮组件3767啮合，所述第三旋转从动齿轮组件与驱动轴组件3760的螺纹部分3768啮合。旋转传动齿轮3763在第二旋转方向上旋转将引起驱动轴组件3760和控制杆2720在远侧方向“DD”上轴向行进。反之，旋转传动齿轮3763在次旋转方向(与第二旋转方向相反)上旋转将引起驱动轴组件3760和控制杆2720在近侧方向上运动。当控制杆2720在远侧方向上运动时，其朝远侧驱动其驱动梁3682和工作头3684穿过外科钉仓3640。当工作头3684朝远侧驱动时，其可操作地接合砧座3620以将砧座枢转至闭合位置。
可通过施加轴向关节运动控制运动至第一关节运动连接件3710和第二关节运动连接件3690来使仓载体3630围绕关节运动轴线AA-AA选择性地进行关节运动。在各种实施例中，传动装置结构3752还包括可操作地支撑在工具安装板3751上的关节运动驱动器3770。更具体地讲并结合图78可看出，能够可操作地与第一关节运动连接件3710接合的关节运动驱动轴3771的近端部分3772延伸穿过旋转齿轮3755并可旋转地联接到移位器齿条齿轮3774，所述移位器齿条齿轮穿过狭缝3775可滑动地附连到工具安装板3751。关节运动驱动器3770还包括移位器传动齿轮3776，当工具安装部分3750联接到工具保持器1270时，所述移位器传动齿轮联接到工具安装板3751的适配器侧上相应的从动盘或从动元件1304中的第三个。关节运动驱动组件3770还包括移位器从动齿轮3778，所述移位器从动齿轮与移位器传动齿轮3776和移位器齿条齿轮3774以啮合的方式而被旋转地支撑在工具安装板3751上。将来自机器人系统1000的第三旋转输出运动通过工具驱动组件1010施加到相应的从动元件1304，从而将通过可操作地联接至其而引起移位器传动齿轮3776的旋转。移位器传动齿轮3776的旋转最终引起移位器齿轮齿条3774和关节运动驱动轴3771的轴向运动。关节运动驱动轴3771的轴向行进的方向取决于移位器传动齿轮3776通过机器人系统1000旋转的方向。因此，移位器传动齿轮3776在第一旋转方向上的旋转将引起关节运动驱动轴3771在近侧方向“PD”上的轴向运动并引起仓载体3630围绕关节运动轴线AA-AA在第一方向上枢转。反之，移位器传动齿轮3776在第二旋转方向(与第一旋转方向相反)上的旋转将引起关节运动驱动轴3771在远侧方向“DD”上的轴向运动，从而引起仓载体3630围绕关节运动轴线AA-AA在相反方向上枢转。
图79示出了可结合机器人系统1000使用的本发明的另一个外科工具3800实施例。如图79所示，外科工具3800包括直线切割器3814形式的外科端部执行器3812，所述直线切割器采用各种缆线驱动的部件。各种形式的缆线驱动的直线切割器在例如名称为“Surgical Stapler With Universal Articulation and Tissue Pre-Clamp”的美国专利No.7,726,537和名称为“Cable Driven Surgical Stapling and Cutting InstrumentWith Improved Cable Attachment Arrangements”的美国专利公开No.US 2008/0308603A1中公开，所述专利的公开内容全文均以引用的方式并入本文。此类直线切割器3814可以被称为“一次性加载单元”，因为其被设计为在单次使用后被丢弃。然而，本发明的各种实施例的各种独特和新颖的结构也可结合可重复使用的缆线驱动的端部执行器使用。
如图79所示，在至少一种形式中，直线切割器3814包括可操作地支撑其中的外科钉仓3834的细长通道3822。砧座3824被可枢转地支撑以相对于外科钉仓3834运动。砧座3824具有能够与预夹紧衬圈3840相互作用的凸轮表面3825，所述预夹紧衬圈被支撑以相对于凸轮表面进行轴向运动。将端部执行器3814与附接到工具安装部分3900的细长轴组件3808联接。在各种实施例中，可采用闭合缆线3850以将预夹紧衬圈3840朝远侧移动到凸轮表面3825及其上方，以相对于外科钉仓3834闭合砧座3824并压缩其间的组织。优选地，闭合缆线3850在点3841处或靠近点3841附接到预夹紧衬圈3840，并馈通砧座3824(或在砧座3824的近侧部分的下方)中的通道并朝近侧馈通轴3808。闭合缆线3850在近侧方向“PD”上的致动迫使预夹紧衬圈3840朝远侧抵靠凸轮表面3825以相对于钉仓组件3834闭合砧座3824。可采用返回机构，例如，弹簧、缆线系统等以将预夹紧衬圈3840返回至重新打开砧座3824的预夹紧方向。
细长轴组件3808的形状可以是圆柱形的，并且限定通道3811，所述通道的尺寸可被设计为能够容纳管适配器3870。参见图80。在各种实施例中，管适配器3870可与细长轴3808的内部通道以摩擦配合接合的方式而被滑动容纳。管适配器3870的外表面还可包括至少一个机械接口，例如，切口或凹口3871，所述切口或凹口被取向为与设置在内部通道3811的内周边上的相应的机械接口，例如径向向内延伸的突起或棘爪(未示出)配合，以将管适配器3870锁定到细长轴3808。在各种实施例中，管适配器3870的远端可包括一对相对的凸缘3872a和3872b，它们限定了用于在其中枢转地容纳枢轴块3873的腔体。每个凸缘3872a和3872b可包括小孔3874a和3874b，所述小孔被取向为容纳延伸穿过枢轴块3873中的小孔的枢轴销3875，以允许枢轴块3873围绕与纵向工具轴线“LT-LT”垂直的轴线而枢转运动。通道3822可由两个向上延伸的凸缘3823a、3823b形成，所述向上延伸的凸缘中具有尺寸设定成能够容纳枢轴销3827的小孔。继而，枢轴销3875穿过枢轴块3873中的小孔安装，以允许外科端部执行器3814在给定的外科手术过程中当需要时围绕“Y”轴旋转。枢轴块3873沿着“Z”轴围绕销3875的旋转使外科端部执行器3814围绕“Z”轴旋转。参见图80。在不脱离本发明的实质和范围的情况下，可有效采用将细长通道3822紧固到枢轴块3873上的其他方法。
在制备或组装过程中外科钉仓3834可被组装并安装在细长通道3822内，并作为外科端部执行器3812的一部分出售，或在需要时外科钉仓3834可被设计为选择性地安装在细长通道3822内并单独出售，例如作为单次使用的置换件、可替换的或一次性的钉仓组件。例如，外科端部执行器3812可枢转地、操作地或一体地附接到一次性外科缝合器的细长轴组件3808的远端3809上是在本公开范围内的。众所周知，使用的或用过的一次性加载单元3814可从细长轴组件3808中移除并用未使用的一次性单元替换。一旦将未耗费的或未使用的钉仓3834安装在细长通道3822中，则直线切割器3814还可优选地包括致动器、优选地动态夹紧构件3860、滑动件3862以及钉推动器(未示出)和钉(未示出)。参见图80。
在各种实施例中，动态夹紧构件3860与滑动件3862相关联，例如，安装和靠在滑动件上、或与其相连或一体结合和/或靠在其后面。据设想，动态夹紧构件3860可具有与其连接的或一体成型的凸轮楔形件或凸轮表面，或由凸轮楔形件或凸轮表面的远侧前表面推动。在各种实施例中，动态夹紧构件3860可包括具有横向小孔3864(销3865可安装或安装在其中)的上部3863、中央支撑件或向上的延伸部分3866和基本上为T形的底部凸缘3867，所述各部分配合以在滑动件3862的纵向远侧运动过程中沿着理想的切割路径滑动地保持动态夹紧构件3860。前切刃3868(这里为刀片3869)的尺寸设定成靠在钉仓组件3834的狭槽3835中，并且一旦缝合就使组织分离。如本文所用，术语“刀组件”可以包括上述动态夹紧构件3860、刀3869和滑动件3862或其他刀/梁/滑动件驱动结构和切割器械结构。另外，本发明的各种实施例可采用刀组件/切割器械结构，所述刀组件/切割器械结构可完全支撑在钉仓3834中或局部支撑在钉仓3834和细长通道3822中或全部支撑在细长通道3822中。
在各种实施例中，可通过缆线驱动组件3870在近侧方向和远侧方向上驱动动态夹紧构件3860。在一个非限制性形式中，缆线驱动组件包括一对推进缆线3880、3882和击发缆线3884。图81和82示出了图表形式的缆线3880、3882、3884。如那些图所示，第一推进缆线3880可操作地支撑在第一远侧缆线过渡支撑体3885和第一近侧缆线过渡支撑体3886上，所述第一远侧缆线过渡支撑体可包括附接到细长通道3822的远端的例如皮带轮、杆、绞盘等，所述第一近侧缆线过渡支撑体可包括由细长通道3822可操作地支撑的例如皮带轮、杆、绞盘等。第一推进缆线3880的远端3881附连到动态夹紧组件3860。第二推进缆线3882可操作地支撑在第二远侧缆线过渡支撑体3887和第二近侧缆线过渡支撑体3888上，所述第二远侧缆线过渡支撑体可包括安装到细长通道3822的远端的例如皮带轮、杆、绞盘等，所述第二近侧缆线过渡支撑体可包括安装到细长通道3822的近端的例如皮带轮、杆、绞盘等。第二推进缆线3882的近端3883可附接到动态夹紧组件3860。另外，在这些实施例中，采用环状击发缆线3884并将其连接在支撑体3889上，所述支撑体可包括安装在细长轴3808中的皮带轮、杆、绞盘等。在一个实施例中，回缩缆线3884可在套环中形成并联接到连接器3889’，所述连接器固定地附接到第一推进缆线3880和第二推进缆线3882。
本发明的各种非限制性实施例包括可操作地支撑在工具安装部分3900的工具安装板3902上的缆线驱动传动装置3920。工具安装部分3900具有一系列电连接销3904，所述电连接销能够与适配器1240’中的狭槽1258(图21)交接。此结构允许机器人系统1000为工具3800的控制电路3910提供控制信号。虽然结合机械耦合元件、电耦合元件和磁力耦合元件在本文中描述了接口，应当理解，可使用多种遥测形式，包括红外、电感耦合等。
控制电路3910在图79中以示意图的形式示出。在一种形式或实施例中，控制电路3910包括电池3912形式的功率源，所述电池联接到通断螺线管功率源开关3914。然而，在其他实施例中，功率源可包括交流电源。控制电路3910还包括通断螺线管3916，所述螺线管联接到双极开关3918以控制马达旋转方向。因此，当机器人系统1000提供适当的控制信号时，开关3914将允许电池3912为双极开关3918提供功率。机器人系统1000还为双极开关3918提供适当的信号以为移位器马达3922提供功率。
转到图83-88，缆线驱动传动装置3920的至少一个实施例包括可操作地安装到驱动轴3932的驱动皮带轮3930，所述驱动轴与上述类型和构造的从动元件1304附接，所述从动元件被设计为与适配器1240的相应的驱动元件1250交接。参见图18和84。因此，当工具安装部分3900可操作地联接到工具保持器1270时，机器人系统1000可在所需方向上施加旋转运动到驱动皮带轮3930。第一驱动构件或皮带3934驱动接合驱动皮带轮3930，并且可旋转地支撑在移位器轭3940上的第二驱动轴3936。移位器轭3940可操作地联接到移位器马达3922，使得移位器马达3922的轴3923在第一方向上的旋转将在第一方向“FD”上偏移移位器轭，并且移位器马达轴3923在第二方向上的旋转将在第二方向“SD”上偏移移位器轭3940。本发明的其他实施例可采用移位器螺线管结构，以在所述的第一方向和第二方向上偏移移位器轭。
如图83-86所示，闭合传动齿轮3950安装到第二驱动轴3936，并能够与闭合驱动组件(一般称为3951)选择性地啮合。同样，击发传动齿轮3960也安装到第二驱动轴3936，并能够与击发驱动组件(一般称为3961)选择性地啮合。第二驱动轴3936的旋转引起闭合传动齿轮3950和击发传动齿轮3960旋转。在一个非限制性实施例中，闭合驱动组件3951包括闭合从动齿轮3952，所述闭合从动齿轮联接到可旋转地支撑在第三驱动轴3956上的第一闭合皮带轮3954。闭合缆线3850驱动地容纳在第一闭合皮带轮3954上，使得闭合从动齿轮3952的旋转将驱动闭合缆线3850。同样，击发驱动组件3961包括击发从动齿轮3962，所述击发从动齿轮联接到可旋转地支撑在第三驱动轴3956上的第一击发皮带轮3964。第一驱动皮带轮3954和第二驱动皮带轮3964在第三驱动轴3956上独立地旋转。击发缆线3884驱动地容纳在第一击发皮带轮3964上，使得击发从动齿轮3962的旋转将驱动击发缆线3884。
另外在各种实施例中，缆线驱动传动装置3920还包括制动组件3970。例如，在至少一个实施例中，制动组件3970包括闭合制动器3972，所述闭合制动器包括附接到传动装置外壳3971的一部分的弹簧臂3973。闭合制动器3972具有齿轮凸耳3974，所述齿轮凸耳的尺寸设定成能够接合闭合从动齿轮3952的齿状物，如将在下文中进一步详细地描述。制动组件3970还包括击发制动器3976，所述击发制动器包括附接到传动装置外壳3971的另一部分的弹簧臂3977。击发制动器3976具有齿轮凸耳3978，所述齿轮凸耳的尺寸设定成能够接合击发从动齿轮3962的齿状物。
外科工具3800的至少一个实施例可按如下使用。工具安装部分3900可操作地联接到机器人系统1000的接口1240。操作机器人系统的控制器或控制单元，以将待切割和缝合的组织定位在打开的砧座3824和钉仓3834之间。当位于初始位置时，制动组件3970已锁定了闭合从动齿轮3952和击发从动齿轮3962，使得它们不能旋转。即，如图84所示，齿轮凸耳3974与闭合从动齿轮3952锁定接合，并且齿轮凸耳3978与击发从动齿轮3962锁定接合。一旦外科端部执行器3814已被适当地定位，机器人系统1000的控制器1001将为移位器马达3922(或移位器螺线管)提供控制信号，从而在第一方向上移动移位器轭3940。当移位器轭3940在第一方向上运动时，当闭合传动齿轮3950运动至与闭合从动齿轮3952啮合时，闭合传动齿轮使齿轮凸耳3974运动至与闭合从动齿轮3952脱离。如图83所示，当处于该位置时，齿轮凸耳3978保持与击发从动齿轮3962锁定接合，从而防止击发系统的致动。然后，机器人控制器1001穿过从动元件1304和工具保持器1240的对应部件之间的接口而为驱动皮带轮3930提供第一旋转致动运动。当驱动皮带轮3930在第一方向上旋转时，闭合缆线3850被旋转以将预夹紧衬圈3840驱动至与砧座3824的凸轮表面3825闭合接合，以便使其运动至闭合位置，从而夹紧砧座3824和钉仓3834之间的靶组织。参见图79。一旦砧座3824已运动至闭合位置，机器人控制器1001停止施加第一旋转运动至驱动皮带轮3930。然后，机器人控制器1001可通过发送另一控制信号至移位器马达3922(或移位器螺线管)来使移位器轭在第二方向“SD”上运动而开始击发过程，如图94所示。当移位器轭3940在第二方向上运动时，当击发传动齿轮3960运动至与击发从动齿轮3962啮合时，击发传动齿轮使齿轮凸耳3978与击发从动齿轮3962脱离。如图85所示，当处于该位置时，齿轮凸耳3974保持与闭合从动齿轮3952锁定接合，从而防止闭合系统的致动。然后，穿过从动元件1304和工具保持器1240的对应部件之间的接口来启动机器人控制器1001，以为驱动皮带轮3930提供第一旋转致动运动。当驱动皮带轮3930在第一方向上旋转时，击发缆线3884被旋转以在远侧方向“DD”上驱动动态夹紧构件3860，从而击发钉并切割夹持在端部执行器3814中的组织。一旦机器人系统1000通过传感器或通过监测施加到驱动皮带轮3930的旋转输入的量来确定动态夹紧构件3860已到达其最远侧位置，则控制器1001可向驱动皮带轮3930施加第二旋转运动以在相反方向上旋转闭合缆线3850，从而在近侧方向“PD”上回缩动态夹紧构件3860。一旦动态夹紧构件回缩至起始位置，停止向驱动皮带轮3930施加第二旋转运动。然后，移位器马达3922(或移位器螺线管)通电，以将移位器轭3940移动到闭合位置(图83)。一旦闭合传动齿轮3950与闭合从动齿轮3952啮合，则机器人控制器1001可再次向驱动皮带轮3930施加第二旋转运动。驱动皮带轮3930在第二方向上的旋转使闭合缆线3850将预夹紧衬圈3840回缩至与砧座3824的凸轮表面3825脱离，以允许砧座3824运动至打开位置(通过弹簧或其他装置)，从而从外科端部执行器3814释放被缝合的组织。
图89示出了采用如图90-92中示出的齿轮从动击发杆4092的外科工具4000。该实施例包括从工具安装部分4100延伸的细长轴组件4008。工具安装部分4100包括可操作地支撑其上的传动装置结构4103的工具安装板4102。细长轴组件4008包括可旋转的近侧闭合管4010，所述可旋转的近侧闭合管可旋转地连接在近侧脊构件4020上，所述近侧脊构件刚性联接到工具安装板4102。近侧脊构件4020具有联接到外科端部执行器4012的细长通道部分4022的远端。外科端部执行器4012可基本上类似于上述外科端部执行器3412。另外，可通过与近侧闭合管4010可操作地交接的远侧闭合管4030打开和闭合外科端部执行器4012的砧座4024。远侧闭合管4030与上述远侧闭合管3430相同。相似地，近侧闭合管4010与上述近侧闭合管段3410相同。
通过以上述方式相对于远侧闭合管3410旋转近侧闭合管4010来打开和闭合砧座4024。在至少一个实施例中，传动装置包括闭合传动装置结构(一般称为4011)。如将在下文中进一步描述，闭合传动装置4011能够接收来自机器人系统1000的相应的第一旋转运动，并将此第一旋转运动转化成主旋转运动，以使可旋转的近侧闭合管4010围绕纵向工具轴线LT-LT旋转。如图92所示，近侧闭合管4010的近端4060可旋转地支撑在支架结构4104中，所述支架装置4104附接到工具安装部分4100的工具安装板4102。旋转齿轮4062形成于或附接到闭合管段4010的近端4060，以与可操作地支撑在工具安装板4102上的旋转驱动组件4070啮合。在至少一个实施例中，当工具安装部分4100联接到工具保持器1270时，旋转传动齿轮4072联接到工具安装板4102的适配器侧上相应的从动盘或从动元件1304中的第一个。参见图22和92。旋转驱动组件4070还包括旋转从动齿轮4074，所述旋转从动齿轮与旋转齿轮4062和旋转传动齿轮4072以啮合的方式而被旋转地支撑在工具安装板4102上。将来自机器人系统1000的第一旋转控制运动通过工具保持器1270和适配器1240施加到相应的从动元件1304，从而将通过可操作地联接至其而引起旋转传动齿轮4072的旋转。旋转传动齿轮4072的旋转最终引起闭合管段4010的旋转，从而打开和闭合砧座4024，如上所述。
如上所述，端部执行器4012采用如图90和91中示出的切割元件3860。在至少一个非限制性实施例中，传动装置结构4103还包括刀驱动传动装置结构，所述刀驱动传动装置结构包括刀驱动组件4080。图92示出了用于轴向推进刀杆4092的刀驱动组件4080的一种形式，所述刀杆4092使用上述缆线相对于外科工具3800附接到此切割元件。具体地讲，刀杆4092替代外科工具3800的实施例中采用的击发缆线3884。一种形式的刀驱动组件4080包括旋转传动齿轮4082，当工具安装部分4100联接到工具保持器1270时，所述旋转传动齿轮联接到工具安装板4102的适配器侧上相应的从动盘或从动元件1304中的第二个。参见图22和92。刀驱动组件4080还包括可旋转地支撑在工具安装板4102上的第一旋转从动齿轮组件4084。第一旋转从动齿轮组件4084与第三旋转从动齿轮组件4086啮合，所述第三旋转从动齿轮组件可旋转地支撑在工具安装板4102上并与第四旋转从动齿轮组件4088啮合，所述第四旋转从动齿轮组件与联接到刀杆4092的驱动轴组件4090的螺纹部分4094啮合。旋转传动齿轮4082在第二旋转方向上旋转将引起驱动轴组件4090和刀杆4092在远侧方向“DD”上轴向行进。反之，旋转传动齿轮4082在次旋转方向(与第二旋转方向相反)上旋转将引起驱动轴组件4090和刀杆4092在近侧方向上运动。击发杆4092在近侧方向“PD”上的运动将在远侧方向“DD”上驱动切割元件3860。反之，击发杆4092在远侧方向“DD”上的运动将引起切割元件3860在近侧方向“PD”上运动。
图93-99示出了可结合机器人系统1000有效使用的另一个外科工具5000。在各种形式中，外科工具5000包括外科缝合器械形式的外科端部执行器5012，所述外科缝合器械包括细长通道5020和可枢转平移的夹紧构件(例如砧座5070)，所述细长通道和可枢转平移的夹紧构件保持在确保有效缝合和切断夹持在外科端部执行器5012中的组织的间距处。如图95所示，细长通道5020的横截面可以是大致U形的，并且由例如钛、203不锈钢、304不锈钢、416不锈钢、17-4不锈钢、17-7不锈钢、6061或7075铝、铬钢、陶瓷等制成。大致U形的金属通道盘5022可支撑在细长通道5020的底部，如图所示。
各种实施例包括滑动件组件5030形式的致动构件，所述滑动件组件5030可操作地支撑在外科端部执行器5012中，并响应于施加至其上的控制运动在起始位置和结束位置之间轴向运动。在一些形式中，金属通道盘5022具有居中设置的狭槽5024以可活动地容纳滑动件组件5030的基座部分5032。基座部分5032包括支脚部分5034，所述支脚部分的尺寸设定成可滑动地容纳在细长通道5020中的狭槽5021中。参见图95。如图94、95、98和99所示，滑动件组件5030的基座部分5032包括能够通过螺纹容纳在螺纹驱动轴5130上的轴向延伸的螺纹镗孔5036，如将在下文中进一步详细地描述。另外，滑动件组件5030包括支撑组织切割刀片或组织切割器械5040的直立支撑部分5038。直立支撑部分5038终止于顶部5042，所述顶部具有从其中突起的横向延伸的一对保持翅片5044。如图95所示，翅片5044被定位成容纳在砧座5070中相应的狭槽5072内。当滑动件组件5030朝远侧驱动穿过夹持在外科端部执行器5014中的组织时，翅片5044和支脚5034用于将砧座5070保持在所需的间隔开的闭合位置处。另外如图97和99所示，滑动件组件5030还包括往复或顺序致动的驱动组件5050，以朝闭合砧座5070驱动钉推动器。
更具体地讲并结合图95和96，细长通道5020能够可操作地支撑其中的外科钉仓5080。在至少一种形式中，外科钉仓5080包括主体部分5082，所述主体部分可由例如维克特拉(Vectra)、尼龙(6/6或6/12)制成并包括居中设置的狭槽5084，以容纳滑动件组件5030的直立支撑部分5038。参见图95。这些材料还可用10％-40％的玻璃、碳或矿物质填充。外科钉仓5080还包括多个腔体5086以用于可活动地支撑其中成行的或成排的钉支撑推动器5088。腔体5086可排列在间隔开的纵向延伸的行或排5090、5092、5094、5096中。例如，排5090在本文中可被称为第一外侧排。排5092在本文中可被称为第一内侧排。排5094可被称为第二内侧排以及排5096可被称为第二外侧排。第一内侧排5090和第一外侧排5092位于纵向狭槽5084的第一横向侧上，第二内侧排5094和第二外侧排5096位于纵向狭槽5084的第二横向侧上。第一内侧排5092中的第一钉推动器5088相对于第一外侧排5090中的第一钉推动器5088交错排列。相似地，第二外侧排5096中的第二钉推动器5088相对于第二内侧排5094中的第二推动器5088交错排列。每个推动器5088可操作地支撑其上的外科钉5098。
在各种实施例中，顺序致动或往复致动的驱动组件5050包括附接到公共轴5056的一对外侧驱动器5052和一对内侧驱动器5054，所述公共轴5056可旋转地安装在滑动件组件5030的基座5032中。外侧驱动器5052被取向为与设置在通道盘5022中的相应的多个外侧激活腔体5026顺序或往复地接合。同样，内侧驱动器5054被取向为与设置在通道盘5022中的相应的多个内侧激活腔体5028顺序或往复地接合。内侧激活腔体5028相对于邻近的外侧激活腔体5026交错排列。参见图96。另外如图96和98所示，在至少一个实施例中，滑动件组件5030还包括位于镗孔5036的每个侧面上的远侧楔形件段5060和中间楔形件段5062，以当滑动件组件5030在远侧方向“DD”上朝远侧驱动时与推动器5088接合。如上所述，滑动件组件5030通过螺纹容纳在驱动轴5130的螺纹部分5132上，所述驱动轴可旋转地支撑在端部执行器5012中。例如，在各种实施例中，驱动轴5130具有支撑在远侧轴承5136中的远端5134，所述远侧轴承安装在外科端部执行器5012中。参见图95和96。
在各种实施例中，外科端部执行器5012通过细长轴组件5108联接到工具安装部分5200。在至少一个实施例中，工具安装部分5200可操作地支撑传动装置结构(一般称为5204)，所述传动装置结构能够接收来自机器人系统的旋转输出运动。细长轴组件5108包括可在脊构件5120上旋转和轴向运动的外部闭合管5110，所述脊构件刚性联接到工具安装部分5200的工具安装板5201。脊构件5120还具有联接到外科端部执行器5012的细长通道部分5020的远端5122。
在使用中，围绕由细长轴组件5008限定的纵向工具轴线LT-LT来旋转外科端部执行器5012可能是有利的。在各种实施例中，外部闭合管5110具有近端5112，所述近端通过向前的支撑支架5203可旋转地支撑在工具驱动部分5200的工具安装板5201上。外部闭合管5110的近端5112能够可操作地与传动装置结构5204的旋转传动部分5206交接。在各种实施例中，外部闭合管5110的近端5112也支撑在闭合滑动件5140上，所述闭合滑动件也可活动地支撑在工具安装板5201上。闭合管齿轮段5114形成在外部闭合管5110的近端5112上，以与旋转传动装置结构5206的旋转驱动组件5150啮合。如图93所示，在至少一个实施例中，旋转驱动组件5150包括旋转传动齿轮5152，当工具驱动部分5200联接到工具保持器1270时，所述旋转传动齿轮联接到工具安装板5201的适配器侧1307上相应的从动盘或从动元件1304中的第一个。旋转驱动组件5150还包括旋转从动齿轮5154，所述旋转从动齿轮以与闭合管齿轮段5114和旋转传动齿轮5152啮合的方式而被旋转地支撑在工具安装板5201上。将来自机器人系统1000的第一旋转控制运动通过工具保持器1270和适配器1240施加到相应的从动元件1304以引起旋转传动齿轮5152的旋转。旋转传动齿轮5152的旋转最终引起细长轴组件5108(和端部执行器5012)围绕纵向工具轴线LT-LT(图93中由箭头“R”表示)旋转。
通过使外部闭合管5110在远侧方向“DD”上轴向运动来实现砧座5070相对于外科钉仓5080的闭合。外部闭合管5110的此类轴向运动可以通过传动装置结构5204的闭合传动部分5144实现。如上所述，在各种实施例中，外部闭合管5110的近端5112由闭合滑动件5140支撑，所述闭合滑动件使近端5112相对于其进行旋转，但是随着闭合滑动件5140轴向行进。具体地讲，如图93所示，闭合滑动件5140具有直立的突出部5141，所述直立的突出部延伸到外部闭合管5110的近端部分5112中的径向沟槽5115中。另外，如上所述，闭合滑动件5140可滑动地安装到工具安装板5201。在各种实施例中，闭合滑动件5140具有直立部分5142，所述直立部分具有在其上形成的闭合齿条齿轮5143。闭合齿条齿轮5143能够与闭合传动装置结构5144驱动接合。
在各种形式中，在各种形式中，闭合传动装置结构5144包括闭合正齿轮5145，所述闭合正齿轮联接到工具安装板5201的适配器侧1307上相应的从动盘或从动元件1304中的第二个。因此，当接口1230联接到工具安装部分5200时，将来自机器人系统1000的第二旋转控制运动通过工具保持器1270和适配器1240施加到相应的第二从动元件1304上将引起闭合正齿轮5145的旋转。闭合传动装置结构5144还包括以与闭合正齿轮5145和闭合齿条齿轮5143啮合的方式而被支撑的从动闭合齿轮组5146。因此，将来自机器人系统1000的第二旋转控制运动通过工具保持器1270和适配器1240施加到相应的第二从动元件1304将引起闭合正齿轮5145的旋转，并最终轴向驱动闭合滑动件5140和外部闭合管5110。闭合管5110运动的轴向最终取决于第二从动元件1304旋转的方向。例如，响应于接收自机器人系统1000的一个旋转闭合运动，闭合滑动件5140将在远侧方向“DD”上被驱动，并且外部闭合管5110最终也将在远侧方向上被驱动。外部闭合管5110具有远端5116中的开口5117，所述远端能够以上述方式与砧座5070上的突出部5071接合。当朝远侧驱动外部闭合管5110时，闭合管5110的近端5116将接触砧座5070并将其枢转闭合。当施加来自机器人系统1000的“开口”旋转运动时，将在近侧方向“PD”上驱动闭合滑动件5140和外部闭合管5110，并且以上述方式将砧座5070枢转至打开位置。
在至少一个实施例中，驱动轴5130具有近端5137，所述近端具有与之附接的近侧轴齿轮5138。近侧轴齿轮5138以与附接到旋转驱动杆5160的远侧传动齿轮5162啮合的方式而被支撑，使用脊构件5120可旋转地支撑所述旋转驱动杆。通过旋转刀传动装置结构5207来控制旋转驱动杆5160和最终旋转驱动轴5130的旋转，所述旋转刀传动装置结构包括支撑在工具安装板5210上的传动装置结构5204的一部分。在各种实施例中，旋转刀传动装置结构5207包括可操作地支撑在工具安装板5201上的旋转刀驱动系统5170。在各种实施例中，刀驱动系统5170包括旋转传动齿轮5172，当工具驱动部分5200联接到工具保持器1270时，所述旋转传动齿轮联接到工具安装板5201的适配器侧上相应的从动盘或从动元件1304中的第三个。刀驱动系统5170还包括第一旋转从动齿轮5174，所述第一旋转从动齿轮以与第二旋转从动齿轮5176和旋转传动齿轮5172啮合的方式而被旋转地支撑在工具安装板5201上。将第二旋转从动齿轮5176联接到旋转驱动杆5160的近端部分5164。
旋转传动齿轮5172在第一旋转方向上的旋转将引起旋转驱动杆5160和旋转驱动轴5130在第一方向上的旋转。反之，旋转传动齿轮5172在第二旋转方向(与第一旋转方向相反)上的旋转将引起旋转驱动杆5160和旋转驱动轴5130在第二方向上的旋转。2400因此，驱动轴2440的旋转引起驱动套管2400的旋转。
现将描述操作外科工具5000的一种方法。工具驱动器5200可操作地联接到机器人系统1000的接口1240。操作机器人系统1000的控制器1001以将待切割和缝合的组织定位在打开的砧座5070和外科钉仓5080之间。一旦通过机器人系统1000定位外科端部执行器5012而使得靶组织位于砧座5070和外科钉仓5080之间，则可启动机器人系统1000的控制器1001以向与闭合正齿轮5145联接的第二从动元件1304施加第二旋转输出运动，以在远侧方向上轴向驱动闭合滑动件5140和外部闭合管5110，从而以上述方式枢转闭合砧座5070。一旦机器人控制器1001通过例如外科端部执行器5012和/或工具驱动部分5200中的传感器确定砧座5070已闭合，则机器人控制器1001系统可为外科医生提供表明砧座闭合的指示。此类指示可以是例如光和/或可听见的声音、控制构件上的触觉反馈等形式。然后外科医生可引发击发过程。然而，在可供选择的实施例中，机器人控制器1001可自动开始击发过程。
为了开始击发过程，机器人控制器将第三旋转输出运动施加到与旋转传动齿轮5172联接的第三从动盘或从动元件1304。旋转传动齿轮5172的旋转使旋转驱动杆5160和旋转驱动轴5130以上述方式旋转。可以结合图94、96和97最好地理解外科钉5098的击发和成形。当滑动件组件5030在远侧方向“DD”上驱动穿过外科钉仓5080时，远侧楔形件段5060首先接触钉推动器5088并开始使其朝闭合砧座5070运动。当滑动件组件5030继续朝远侧移动时，外侧驱动器5052将落入通道盘5022中的相应的激活腔体5026中。然后，每个外侧驱动器5052的相对端将接触相应的外侧推动器5088，所述外侧推动器将远侧楔形件段5060和中间楔形件段5062向上移动。滑动件组件5030的进一步远侧运动使外侧驱动器5052旋转并朝砧座5070驱动相应的推动器5088，从而当推动器驱动至砧座5070中时使支撑在其上的钉5098成形。应当理解，当滑动件组件5030朝远侧运动时，刀片5040切断夹持在砧座和钉仓之间的组织。因为内侧驱动器5054和外侧驱动器5052附接到相同的轴5056并且内侧驱动器5054与外侧驱动器5052在轴5056上径向错开，当外侧驱动器5052朝砧座5070驱动其相应的推动器5088时，内侧驱动器5054落入其下一个相应的激活腔体5028中，从而使它们以相同的方式朝闭合砧座5070可旋转地或往复地驱动相应的内侧推动器5088。因此，当滑动件组件5030朝远侧被驱动时，在居中设置的狭槽5084的每一侧上的横向对应的外侧钉5098同时一起成形，并且在狭槽5084的每一侧上的横向对应的内侧钉5098同时一起成形。一旦机器人控制器1001通过传感器或通过监测施加到驱动轴5130和/或旋转驱动杆5160的旋转输出量来确定滑动件组件5030已到达其最远侧位置，则控制器1001可将第三旋转输出运动施加到驱动轴5130以在相反方向上旋转驱动轴5130，从而将滑动件组件5030回缩至其起始位置。一旦滑动件组件5030回缩至起始位置(如通过端部执行器5012和/或工具驱动部分5200中的传感器发送信号)，则停止向驱动轴5130施加第二旋转运动。然后，外科医生可手动启动砧座打开过程或可通过机器人控制器1001自动开始。为了打开砧座5070，将第二旋转输出运动施加到闭合正齿轮5145，以在近侧方向上轴向驱动闭合滑动件5140和外部闭合管5110。当闭合管5110朝近侧运动时，在闭合管5110远端5116中的开口5117接触砧座5070上的突出部5071，以将砧座5070枢转至打开位置。当闭合管5116返回至起始位置时，也可使用弹簧将砧座5070偏置至打开位置。此外，外科端部执行器5012和/或工具安装部分5200中的传感器可为机器人控制器1001提供表明砧座5070现已打开的信号。然后，外科端部执行器5012可从外科手术部位撤回。
图100-105以图解法出了外科工具组件5000’中钉的顺序击发，所述外科工具组件基本上类似于上述外科工具组件5000。在该实施例中，内侧驱动器5052’和外侧驱动器5054’具有凸轮形状，其具有如图100-106中示出的凸轮表面5053和致动器突起5055。驱动器5052’、5054’连接在由滑动件组件5030’可旋转地支撑的相同的轴5056’上。在该实施例中，滑动件组件5030’具有用于接合推动器5088的远侧楔形件段5060’。图100示出了当滑动件组件5030’在远侧方向“DD”上被驱动时两个内侧或外侧驱动器5052’、5054’的初始位置。如图所示，推动器5088a向上推进楔形件段5060’并接触驱动器5052’、5054’。滑动件组件5030’在远侧方向上的进一步行进促使驱动器5052’、5054’在“P”方向(图101)上枢转，直到致动器部分5055接触激活腔体5026、5028的端壁5029a，如图102所示。滑动件组件5030’在远侧方向“DD”上的继续推进促使驱动器5052’、5054’在“D”方向上旋转，如图103所示。当驱动器5052’、5054’旋转时，推动器5088a向上推动凸轮表面5053至图104中示出的最终竖直位置。当推杆5088a到达图104和105中示出的最终竖直位置时，将支撑在其上的钉(未示出)驱动至砧座的钉成形表面以形成钉。
图107-112示出了例如可结合上文详细描述的工具安装部分1300和轴2008使用的外科端部执行器5312。在各种形式中，外科端部执行器5312包括细长通道5322，所述细长通道如上所述能够支撑其中的外科钉仓5330。外科钉仓5330包括主体部分5332，所述主体部分包括用于容纳滑动件组件5380的竖直支撑部分5386的居中设置的狭槽5334。参见图107-109。外科钉仓体部分5332还包括多个腔体5336以用于可活动地支撑其中的钉支撑推动器5350。腔体5336可排列在间隔开的纵向延伸的排5340、5342、5344、5346中。排5340、5342位于纵向狭槽5334的一个横向侧上，并且排5344、5346位于纵向狭槽5334的另一个横向侧上。在至少一个实施例中，推动器5350能够支撑其上的两个外科钉5352。具体地讲，位于细长狭槽5334的一侧上的每个推动器5350支撑处于交错取向的排5340中的一个钉5352和排5342中的一个钉5352。同样，位于细长狭槽5334的另一侧上的每个推动器5350支撑处于交错取向的排5344中的一个外科钉5352和排5346中的另一个外科钉5352。因此，每个推动器5350支撑两个外科钉5352。
如图107、108进一步所示，外科钉仓5330包括多个旋转驱动器5360。更具体地讲，在细长狭槽5334的一侧上的旋转驱动器5360排列在单行5370中并且与行5340、5342中的推动器5350相对应。另外，在细长狭槽5334的另一侧上的旋转驱动器5360排列在单行5372中并且与行5344、5346中的推动器5350相对应。如图107所示，每个旋转驱动器5360可旋转地支撑在钉仓体5332内。更具体地讲，每个旋转驱动器5360可旋转地容纳在相应的驱动器轴5362上。每个驱动器5360具有在其上形成的弓形斜坡部分5364，所述弓形斜坡部分能够接合在每个推动器5350上形成的弓形下表面5354上。参见图112。另外，每个驱动器5360具有底部支撑部分5366，所述底部支撑部分从驱动器延伸以滑动地支撑通道5322上的推动器5360。每个驱动器5360具有能够与滑动件组件5380接合的向下延伸的致动杆5368。
如图109所示，在至少一个实施例中，滑动件组件5380包括基座部分5382，所述基座部分具有支脚部分5384，所述支脚部分的尺寸设定成可滑动地容纳在通道5322中的狭缝5333中。参见图107。滑动件组件5380包括支撑组织切割刀片或组织切割器械5388的直立支撑部分5386。直立支撑部分5386终止于顶部5390，所述顶部具有从其中突起的横向延伸的一对保持翅片5392。将翅片5392定位成容纳于砧座(未示出)中相应的狭槽(未示出)内。正如上述实施例，当滑动件组件5380朝远侧被驱动穿过夹持在外科端部执行器5312中的组织时，翅片5392和支脚部分5384用于将砧座(未示出)保持在所需的间隔开的闭合位置。直立支撑部分5386能够附接到刀杆2200(图28)。滑动件组件5380还具有水平延伸的致动器板5394，将所述水平延伸的致动器板成形为用于与推动器5360上的每个致动杆5368致动接合。
现将结合图107和108描述外科端部执行器5312的操作。当在远侧方向“DD”上驱动滑动件组件5380穿过钉仓5330时，致动器板5394顺序接触推动器5360上的致动杆5368。当滑动件组件5380继续朝远侧运动时，致动器板5394顺序接触细长狭槽5334的每一侧上的驱动器5360的致动器杆5368。此动作使驱动器5360从第一未致动位置旋转至致动部分，在该致动部分中，推动器5350朝闭合砧座被驱动。当推动器5350朝砧座被驱动时，其上的外科钉5352被驱动至与砧座的下侧形成接触。一旦机器人系统1000通过传感器或其他装置确定滑动件组件5080已到达其最远侧位置时，则机器人系统1000的控制系统可将刀杆和滑动件组件5380回缩至起始位置。然后，机器人控制系统可启动用于将砧座返回至打开位置以释放被缝合的组织的过程。
图113-117示出了本发明的自动重新加载系统实施例的一种形式，一般称为5500。在一种形式中，自动重新加载系统5500能够用“新的”外科端部执行器部件替换机器人外科系统的可操纵的外科工具部分中“用过的”外科端部执行器部件。如本文所用，术语“外科端部执行器部件”可包括例如外科钉仓、一次性加载单元、或使用时被用过并且必须用新的部件替换的其他端部执行器部件。此外，术语“用过的”是指端部执行器部件已被启动并且在当前状态下不再可用于所需目的。例如，在外科钉仓或一次性加载单元的上下文中，术语“用过的”是指之前支撑在其中的至少一些未成形的钉已从其“击发”。如本文所用，术语“新的”外科端部执行器部件是指在预期用途条件下的端部执行器部件。在外科钉仓或一次性加载单元的上下文中，例如，术语“新的”是指其中具有未成形的钉并且准备好使用的此类部件。
在各种实施例中，自动重新加载系统5500包括基座部分5502，所述基座部分可在战略上位于机器人系统1109的机械臂车1100(图14)的工作区域1000内。如本文所用，术语“可操纵的外科工具部分”总体上是指本文所公开的各种类型的外科工具和可操作地附接到例如机械臂车1100或类似装置的其他形式的外科机器人致动的工具，所述机械臂车1100或类似装置能够自动地操纵和致动外科工具。本文所用的术语“工作区域”是指机器人系统的可操纵的外科工具部分的运动的范围。图14总体上示出了可包括机械臂车1100的工作区域的区域。本领域的普通技术人员将会知道在此示出的工作区域的形状和尺寸仅为示例性的。工作区域的最后尺寸、形状和位置将最终取决于可操纵的外科工具部分的构造、行进限制的范围和位置。因此，本文所用的术语“工作区域”旨在涵盖多种不同尺寸和形状的工作区域，并且不应限制于图14中示出的样品工作区域的具体尺寸和形状。
如图113所示，基座部分5502包括新的部件支撑部分或结构5510，所述新的部件支撑部分或装置能够在“加载取向”上可操作地支撑至少一个新的外科端部执行器部件。如本文所用，术语“加载取向”是指以此方式支撑新的端部执行器部件，以允许可操纵的外科工具部分的相应的部件支撑部分在除了必须的致动机器人系统之外没有人为干预的情况下，与新的端部执行器部件(或使新的端部执行器部件与可操纵的外科工具部分的相应的部件支撑部分加载接合)加载接合(即，可操作地位于或可操作地附接到新的端部执行器部件)。继续参阅本具体实施方式将进一步理解，在至少一个实施例中，准备护士将在外科手术之前用完成外科手术所需的适当长度和颜色的仓(一些外科钉仓可支撑某些尺寸的钉，其尺寸可由仓体的颜色指示)来加载新的部件支撑部分。然而，在外科手术过程中，不需要直接的人机互动来重新加载机器人直线切割器。在一种形式中，外科端部执行器部件包括钉仓2034，所述钉仓能够可操作地设置于上述各种其他端部执行器结构的任何部件支撑部分(细长通道)中。出于解释的目的，将新的(未使用的)仓指定为“2034a”并且将用过的仓指定为“2034b”。该图示出了被设计为与包括通道2022和砧座2024的外科端部执行器2012一起使用的仓2034a、2034b，所述通道和砧座的构造和操作在上文中已详细地描述。仓2034a、2034b与上述仓2034相同。在各种实施例中，仓2034a、2034b能够扣合保持(即，加载接合)在外科端部执行器2012的通道2022中。然而，继续参阅本具体实施方式，本领域的普通技术人员将会知道在不脱离本发明的实质和范围的情况下，可结合其他仓结构的自动移除和安装而有效地利用自动的仓重新加载系统5500的独特且新颖的特性。
在示出的实施例中，术语“加载取向”是指将新的外科钉仓2034a的远侧末端部分2035a插入到新的仓支撑部分5510的相应的支撑腔体5512中，使得新的外科钉仓2034a的近端部分2037a处于方便的取向，以使臂车1100操纵外科端部执行器2012至如下位置：在该位置，新的仓2034a可自动地加载到外科端部执行器2012的通道2022中。在各种实施例中，基座5502包括至少一个传感器5504，所述传感器与机器人控制器1001的控制系统1003连通，以为控制系统1003提供基座5502的位置和/或每个分段的或新的仓2034a的重新加载长度和颜色。
另外如图所示，基座5502还包括能够收集用过的仓2034b的收集容器5520，所述用过的仓已从可操作地附接到机器人系统1000的外科端部执行器2012中移除或脱离。另外，在一种形式中，自动重新加载系统5500包括提取系统5530，在除了必须的致动机器人系统之外无需特定的人为干预的情况下，所述提取系统用于将用过的端部执行器部件从端部执行器或可操纵的外科工具部分的相应的支撑部分中自动地移除。在各种实施例中，提取系统5530包括提取钩构件5532。在一种形式中，例如，提取钩构件5532刚性地支撑在基座部分5502上。在一个实施例中，提取钩构件具有在其上形成的至少一个钩5534，当其支撑在外科端部执行器2012的细长通道2022中时，所述钩能够与用过的仓2034b的远端2035以钩的形式接合。在各种形式中，提取钩构件5532便利地位于收集容器5520的一部分中，使得当用过的端部执行器部件(仓2034b)与提取钩构件5532以提取方式接合时，用过的端部执行器部件(仓2034b)从相应的部件支撑部分(细长通道2022)移除并落入收集容器5020中。因此，为了使用该实施例，可操纵的外科工具部分对附接至其的端部执行器进行操纵，以使其中用过的仓2034b的远端2035与钩5534以钩的形式接合，然后以此方式移动端部执行器，以将用过的仓2034b从细长通道2022中分离。
在其他结构中，提取钩构件5532包括旋转的轮构造，所述旋转的轮构造具有从其突起的一对沿直径相对的钩5334。参见图113和116。提取钩构件5532可旋转地支撑在收集容器5520中，并联接到由机器人系统的控制器1001所控制的提取马达5540。该形式的自动重新加载系统5500可按如下使用。图115示出了可操作地附接到可操纵的外科工具部分1200的外科端部执行器2012的引入。如图所示，机器人系统1000的臂车1100将外科端部执行器2012置于所示的位置，其中提取构件5532的钩端部5534与外科端部执行器2012中用过的仓2034b的远端2035以钩的形式接合。外科端部执行器2012的砧座2024处于打开位置。用过的仓2034b的远端2035与钩端部5532接合后，提取马达5540被致动以旋转提取轮5532，从而使用过的仓2034b从通道2022中脱离。为了有助于用过的仓2034b从通道2022中脱离(或如果提取构件5530是固定的)，机器人系统1000可在向上的方向上(图116中的箭头“U”)移动外科端部执行器2012。随着用过的仓2034b从通道2022中分离，用过的仓2034b落入收集容器5520中。一旦用过的仓2034b从外科端部执行器2012中移除，则机器人系统1000将外科端部执行器2012运动至图117中示出的位置。
在各种实施例中，传感器结构5533邻近提取构件5532定位，所述提取构件与机器人系统1000的控制器1001连通。传感器结构5533可包括传感器，当远侧末端部分2035b与提取构件5532接合时，所述传感器能够感测外科端部执行器2012的存在，更具体地讲感测用过的外科钉仓2034b的顶端2035b的存在。在一些实施例中，传感器结构5533可包括例如光幕结构。然而，可采用其他形式的接近传感器。在此结构中，当具有用过的外科钉仓2034b的外科端部执行器2012与提取构件5532以提取方式接合时，传感器感测外科钉仓2034b的远侧末端2035b(如光幕被损坏)。当提取构件5532旋转并且松散地弹出外科钉仓2034b并落入收集容器5520中时，光幕又一次未被损坏。因为在此过程中未移动外科端部执行器2012，所以机器人控制器1001确定用过的外科钉仓2034b已从中移除。也可成功地采用其他传感器结构以为机器人控制器1001提供用过的外科钉仓2034b已从外科端部执行器2012中移除的指示。
如图117所示，外科端部执行器2012被定位成抓持通道2022和砧座2024之间新的外科钉仓2034a。更具体地讲，如图114和117所示，每个腔体5512具有与之相关的相应的直立的压垫5514。定位外科端部执行器2012使得压垫5514位于新的仓2034a和砧座2024之间。一旦处于该位置，机器人系统1000将砧座2024闭合到压垫5514上，所述压垫用于推动新的仓2034a至与外科端部执行器2012的通道2022扣合。一旦新的仓2034a已在细长通道2022中扣合到位，则机器人系统1000从自动的仓重新加载系统5500中撤出外科端部执行器2012，以与进行另一个外科手术结合使用。
图118-122示出了另一个自动重新加载系统5600，其可用于从可操纵的外科工具结构3600(图65-78)中移除用过的一次性加载单元3612并重新加载新的一次性加载单元3612，所述可操纵的外科工具结构可操作地附接到臂车1100或机器人系统1000的其他部分。如图118和119所示，一种形式的自动重新加载系统5600包括外壳5610，所述外壳具有支撑在其上的旋转转盘顶板5620形式的可活动的支撑组件，所述旋转转盘顶板与外壳5610配合形成中空的封闭区5612。自动重新加载系统5600能够可操作地支撑在机器人系统的可操纵的外科工具部分的工作区域中，如上所述。在各种实施例中，旋转转盘板5620具有用于支撑其中的多个取向管5660的多个孔5622。如图119和120所示，旋转转盘板5620附连到芯轴5624上。芯轴5624居中设置在封闭区5612内并具有附接至其的芯轴齿轮5626。芯轴齿轮5626与联接到转盘驱动马达5630的转盘传动齿轮5628啮合，所述转盘驱动马达与机器人系统1000的机器人控制器1001可操作地连通。
自动重新加载系统5600的各种实施例还可包括转盘锁定组件，一般称为5640。在各种形式中，转盘锁定组件5640包括附连到芯轴5624上的凸轮盘5642。芯轴齿轮5626可附接到凸轮盘5642的下侧，并且凸轮盘5642可键锁到芯轴5624。在可供选择的结构中，芯轴齿轮5626和凸轮盘5642可独立地非旋转地附连到芯轴5624。如图119和120所示，多个凹口5644围绕凸轮盘5642的周边间隔开。锁定臂5648可枢转地安装到外壳5610中，并通过锁定弹簧5649被偏置到与凸轮盘5642的周边接合。如图118所示，凸轮盘5642的外周边是圆形的以利于相对于锁定臂5648旋转凸轮盘5642。每个凹口5644的边缘也是圆形的，使得当凸轮盘5642旋转时，通过凸轮盘5642的周边使锁定臂5648与凹口5644脱离。
各种形式的自动重新加载系统5600能够支撑便携式/可替换的托盘组件5650，所述托盘组件能够在单个取向管5660中支撑多个一次性加载单元3612。更具体地讲并结合图119和120，可替换的托盘组件5650包括具有从其底侧突起的居中设置的定位芯轴5654的托盘5652。定位芯轴5654的尺寸设定成能够容纳在芯轴5624的中空端部5625中。托盘5652中具有能够支撑其中的取向管5660的多个孔5656。每个取向管5660在期望方向上通过取向管5660上的定位翅片5666被定位在可替换的托盘组件5650中的对应孔5656中，所述取向管被设计为容纳在托盘组件5650中相应的定位狭槽5658中。在至少一个实施例中，定位翅片5666具有大致V形的横截面形状，所述横截面形状的尺寸设定成适合在V形定位狭槽5658中。此结构用于在所需的起始位置处定位取向管5660，同时当向其施加旋转运动时，使其在孔5656中旋转。即，当向取向管5660施加旋转运动时，V形定位翅片5666将从其相应的定位狭槽中弹出，从而使管5660相对于托盘5652旋转，如将在下文中进一步详细地描述。另外如图118-120所示，可替换的托盘5652可设有一个或多个柄部部分5653以当加载有取向管5660时有利于托盘组件5652的传输。
如图122所示，每个取向管5660包括具有凸缘式开口端5664的主体部分5662。主体部分5662限定腔体5668，所述腔体的尺寸设定成能够在其中容纳一次性加载单元3612的一部分。为了对一次性加载单元3612在取向管5660中进行正确取向，腔体5668具有在其中形成的平坦的定位表面5670。如图122所示，平坦的定位表面5670能够有利于在所需的或预定的非旋转方向上将一次性加载单元插入到腔体5668中。另外，腔体5668的端部5669可包括泡沫或缓冲材料5672，所述泡沫或缓冲材料被设计为缓冲腔体5668内的一次性加载单元3612的远端。另外，定位表面的长度可与一次性加载单元3612的轴向驱动组件3680的滑动支撑构件3689配合，以进一步将一次性加载单元3612定位在取向管5660中的所需位置。
取向管5660可由尼龙、聚碳酸酯、聚乙烯、液晶聚合物、6061或7075铝、钛、300或400系列不锈钢、涂布的或涂漆钢、电镀钢等制成，并且当加载到可替换的托盘5662并且定位芯轴5654插入到芯轴5624的中空端部5625中时，取向管5660延伸穿过转盘顶板5620中相应的孔5662。每个可替换的托盘5662配备有与机器人系统1000的控制器1001的控制系统1003连通的位置传感器5663。传感器5663用于确定重新加载系统的位置，以及容纳在托盘中的每个重新加载件的数量、长度、颜色和击发状态。另外，与机器人控制器1001连通的一个或多个光学传感器5665可用于感测加载到位于托盘5662中的一次性加载单元的类型/尺寸/长度。
自动重新加载系统5600的各种实施例还包括用于将旋转运动施加到取向管5660的驱动组件5680，从而将一次性加载单元3612保持附接到外科工具3600(总体上为“可操纵的外科工具部分”)的轴3700，所述外科工具可操作地联接到机器人系统。驱动组件5680包括附接到锁定臂5648的支撑轭5682。因此，支撑轭5682随着锁定臂5648枢转。支撑轭5682可旋转地支撑管惰轮5684和管驱动轮5686，所述管驱动轮由附接至其的管马达5688驱动。管马达5688与控制系统1003连通并受其控制。管惰轮5684和管驱动轮5686由例如天然橡胶、三都平(sanoprene)、热塑性聚氨酯树脂(isoplast)等制成，使得其外表面生成足够量的摩擦力，以在管马达5688致动时使与之接触的取向管5660旋转。惰轮5684和管驱动轮5686相对于彼此取向，以在两者间形成支架区域5687以用于容纳其中驱动接合的取向管5060。
在使用中，加载到自动重新加载系统5600中的一个或多个取向管5660是空的，同时其他取向管5660可操作地支撑其中相应的新的一次性加载单元3612。如将在下文中进一步详细地描述，使用空的取向管5660容纳其中用过的一次性加载单元3612。
在系统5600定位在机器人系统的可操纵的外科工具部分的工作区域内之后，可按如下使用自动重新加载系统5600。如果可操纵的外科工具部分具有可操作地与之联接的用过的一次性加载单元3612，则支撑在可替换的托盘5662上的取向管5660中的一个是空的，以容纳其中用过的一次性加载单元3612。然而，如果可操纵的外科工具部分不具有可操作地与之联接的一次性加载单元3612，则每个取向管5660可设有适当取向的新的一次性加载单元3612。
如上所述，一次性加载单元3612采用旋转的“卡口式”连接结构，以将一次性加载单元3612可操作地联接到可操纵的外科工具部分的对应部分。即，为了将一次性加载单元3612附接到可操纵的外科工具部分(3700-参见图71、72)的对应部分，当那些部件已运动至彼此加载接合时，必须将旋转安装运动施加到一次性加载单元3612和/或可操纵的外科工具部分的对应部分。此类安装运动在本文统称为“加载运动”。同样，为了将用过的一次性加载单元3612从可操纵的外科工具的相应部分中分离，必须施加旋转分离运动到用过的一次性加载单元3612和/或可操纵的外科工具部分的相应部分，同时移动用过的一次性加载单元和可操纵的外科工具的相应部分使之彼此远离。此类分离运动统称为“提取运动”。
为了开始加载过程，启动机器人系统1000以操纵可操纵的外科工具部分和/或自动重新加载系统5600以使可操纵的外科工具部分与新的一次性加载单元3612加载接合，所述新的一次性加载单元支撑在与驱动组件5680驱动接合的取向管5660中。一旦机器人控制系统1000的机器人控制器1001(图13)将可操纵的外科工具部分定位成与新的一次性加载单元3612加载接合，机器人控制器1001启动驱动组件5680以施加旋转加载运动到其中支撑有新的一次性加载单元3612的取向管5660，和/或施加另一个旋转加载运动到可操纵的外科工具部分的相应部分。在施加此类旋转加载运动时，机器人控制器1001还使可操纵的外科工具部分的相应部分朝新的一次性加载单元3612移动至与之加载接合。一旦一次性加载单元3612与可操纵的工具部分的相应部分加载接合，加载运动中止并且可使可操纵的外科工具部分移动远离自动重新加载系统5600，所述自动重新加载系统附带有与之可操作地联接的新的一次性加载单元3612。
为了将用过的一次性加载单元3612从相应的可操纵的外科工具部分中分离，机器人系统的机器人控制器1001操纵可操纵的外科工具部分，以将用过的一次性加载单元3612的远端插入到空的取向管5660中，所述取向管与驱动组件5680保持驱动接合。然后，机器人控制器1001启动驱动组件5680，以施加旋转提取运动到其中支撑有用过的一次性加载单元3612的取向管5660和/或施加旋转提取运动到可操纵的外科工具部分的相应部分。机器人控制器1001还使可操纵的外科工具部分从用过的旋转的一次性加载单元3612中撤离。然后，停止旋转提取运动。
用过的一次性加载单元3612从可操纵的外科工具部分中移除之后，机器人控制器1001可启动转盘驱动马达5630，以导引转盘顶板5620使另一个取向管5660与驱动组件5680驱动接合，所述另一个取向管支撑其中的新的一次性加载单元3612。然后，可重复加载过程，以将其中新的一次性加载单元3612附接到可操纵的外科工具部分的相应部分。机器人控制器1001可记录已从特定的可替换托盘5652中使用的一次性加载单元的数量。一旦控制器1001确定从此托盘中使用了所有新的一次性加载单元3612，则控制器1001可为外科医生提供如下信号(可视的和/或可听的)，所述信号表明支撑所有用过的一次性加载单元3612的托盘5652必须被容纳新的一次性加载单元3612的新的托盘5652所替换。
图123-128示出了非常适于与具有工具驱动组件1010(图18)的机器人系统1000一起使用的本发明的外科工具6000的另一个非限制性实施例，所述工具驱动组件可操作地联接到通过操作者(即，外科医生)的输入而运行的主控制器1001。如图123所示，外科工具6000包括外科端部执行器6012，所述端部执行器包括直线切割器。在至少一种形式中，外科工具6000通常包括细长轴组件6008，所述细长轴组件具有通过关节运动接头6100联接在一起的近侧闭合管6040和远侧闭合管6042。外科工具6000通过工具安装部分(一般称为6200)可操作地联接到操纵器。外科工具6000还包括接口6030，所述接口可以上述详细描述的各种方式将工具安装部分6200机械联接和电联接到操纵器。
在至少一个实施例中，外科工具6000包括外科端部执行器6012，所述外科端部执行器此外包括至少一个部件6024，所述部件相对于至少一个其他部件6022在第一位置和第二位置之间响应于施加到部件6024的各种控制运动而选择性地运动，如将在下文中进一步详细地描述，从而进行外科手术。在各种实施例中，部件6022包括能够可操作地支撑其中的外科钉仓6034的细长通道6022，并且部件6024包括可枢转地平移的夹紧构件，例如砧座6024。外科端部执行器6012的各种实施例能够使砧座6024和细长通道6022保持在确保有效缝合和切断夹持在外科端部执行器6012中的组织的间距处。除非另外说明，端部执行器6012类似于上述外科端部执行器2012并包括切割器械(未示出)和滑动件(未示出)。砧座6024可包括位于其近端的突出部6027，所述突出部与机械闭合系统(下文中进一步描述)的部件相互作用以利于砧座6024的打开。细长通道6022和砧座6024可以由导电材料(例如金属)制成，使得它们可作为与端部执行器中的一个或多个传感器连通的天线的一部分，如上所述。外科钉仓6034可以由非导电材料(例如塑料)制成，并且传感器可连接到或设置在外科钉仓6034中，也如上所述。
如图123所示，根据各种实施例，通过细长轴组件6008将外科端部执行器6012附接到工具安装部分6200。如图示实施例中所示，细长轴组件6008包括关节运动接头(一般称为6100)，所述关节运动接头使外科端部执行器6012围绕基本上横向于纵向工具轴线LT-LT的第一工具关节运动轴线AA1-AA1和基本上横向于纵向工具轴线LT-LT以及第一关节运动轴线AA1-AA1的第二工具关节运动轴线AA2-AA2选择性地进行关节运动。参见图124。在各种实施例中，细长轴组件6008包括闭合管组件6009，所述闭合管组件包括通过枢转连接件6044和6046枢转地连接的近侧闭合管6040和远侧闭合管6042。闭合管组件6009可活动地支撑在脊组件上(一般称为6102)。
如图125所示，近侧闭合管6040通过上部枢转连接件6044U和下部枢转连接件6044L可枢转地连接到中间闭合管接头6043，使得中间闭合管接头6043围绕第一闭合轴线CA1-CA1和第二闭合轴线CA2-CA2相对于近侧闭合管6040枢转。在各种实施例中，第一闭合轴线CA1-CA1基本上平行于第二闭合轴线CA2-CA2，并且两根闭合轴线CA1-CA1,CA2-CA2基本上横向于纵向工具轴线LT-LT。如图126进一步所示，中间闭合管接头6043通过左侧枢转连接件6046L和右侧枢转连接件6046R可枢转地连接到远侧闭合管6042，使得中间闭合管接头6043围绕第三闭合轴线CA3-CA3和第四闭合轴线CA4-CA4相对于远侧闭合管6042枢转。在各种实施例中，第三闭合轴线CA3-CA3基本上平行于第四闭合轴线CA4-CA4，并且两根闭合轴线CA3-CA3,CA4-CA4基本上横向于第一闭合轴线CA1-CA1和第二闭合轴线CA2-CA2以及纵向工具轴线LT-LT。
闭合管组件6009能够响应于施加至其上的致动运动在脊组件6102上轴向滑动。远侧闭合管6042包括开口6045，所述开口与砧座6024上的突出部6027交接以当远侧闭合管6042在近侧方向“PD”上轴向运动时有利于砧座6024的打开。闭合管6040、6042可以由导电材料(例如金属)制成，使得其可以用作天线的一部分，如上所述。脊组件6102的部件可以由非导电材料(例如塑料)制成。
如上所述，外科工具6000包括工具安装部分6200，所述工具安装部分能够以上文详细描述的方式可操作地附接到机器人系统1000的工具安装组件1010。如图127所示，工具安装部分6200包括可操作地支撑其上的传动装置结构6204的工具安装板6202。在各种实施例中，传动装置结构6204包括关节运动传动装置6142，所述关节运动传动装置结构包括关节运动系统6140的一部分，以围绕第一工具关节运动轴线TA1-TA1和第二工具关节运动轴线TA2-TA2使外科端部执行器6012进行关节运动。第一工具关节运动轴线TA1-TA1基本上横向于第二工具关节运动轴线TA2-TA2，第一工具关节运动轴线和第二工具关节运动轴线均基本上横向于纵向工具轴线LT-LT。参见图124。
为了有利于使外科端部执行器6012围绕第一工具关节运动轴线TA1-TA1和第二工具关节运动轴线TA2-TA2选择性地进行关节运动，脊组件6102包括近侧脊部分6110，所述近侧脊部分通过枢轴销6122可枢转地联接到远侧脊部分6120以围绕TA1-TA1选择性地枢转行进。相似地，远侧脊部分6120通过枢轴销6124可枢转地附接到外科端部执行器6012的细长通道6022，以使外科端部执行器6012围绕第二工具轴线TA2-TA2相对于远侧脊部分6120选择性地枢转。
在各种实施例中，关节运动系统6140还包括可操作地与外科端部执行器6012交接的多个关节运动元件，以及可操作地支撑在工具安装构件6200中的关节运动控制结构6160，如将在下文中进一步详细地描述。在至少一个实施例中，关节运动元件包括第一对第一关节运动缆线6144和6146。第一关节运动缆线位于纵向工具轴线的第一或右侧上。因此，第一关节运动缆线在本文中称为右上部缆线6144和右下部缆线6146。右上部缆线6144和右下部缆线6146沿着近侧脊部分6110的右侧分别延伸穿过相应的通路6147、6148。参见图128。关节运动系统6140还包括第二对第二关节运动缆线6150、6152。第二关节运动缆线位于纵向工具轴线的第二或左侧上。因此，第二关节运动缆线在本文中称为左上部关节运动缆线6150和左下部关节运动缆线6152。左上部关节运动缆线6150和左下部关节运动缆线6152在近侧脊部分6110中分别延伸穿过通路6153、6154。
如图124所示，右上部缆线6144围绕上部枢转接头6123延伸并且在左侧枢转接头6125处附接到细长通道6022的左上侧。右下部缆线6146围绕下部枢转接头6126延伸并且在左侧枢转接头6125处附接到细长通道6022的左下侧。左上部缆线6150围绕上部枢转接头6123延伸并且在右侧枢转接头6127处附接到细长通道6022的右上侧。左下部缆线6152围绕下部枢转接头6126延伸并且在右侧枢转接头6127处附接到细长通道6022的右下侧。因此，为了围绕第一工具关节运动轴线TA1-TA1使外科端部执行器6012向左(箭头“L”)枢转，必须在近侧方向“PD”上牵拉右上部缆线6144和右下部缆线6146。为了围绕第一工具关节运动轴线TA1-TA1使外科端部执行器6012向右(箭头“R”)进行关节运动，必须在近侧方向“PD”上牵拉左上部缆线6150和左下部缆线6152。为了在向上的方向(箭头“U”)上围绕第二工具关节运动轴线TA2-TA2使外科端部执行器6012进行关节运动，必须在近侧方向“PD”上牵拉右上部缆线6144和左上部缆线6150。为了在向下的方向(箭头“DW”)上围绕第二工具关节运动轴线TA2-TA2使外科端部执行器6012进行关节运动，必须在近侧方向“PD”上牵拉右下部缆线6146和左下部缆线6152。
关节运动缆线6144、6146、6150、6152的近端联接到包括球形接头组件的关节运动控制结构6160，所述球形接头组件是关节运动传动装置结构6142的一部分。更具体地讲并结合图128，球形接头组件6160包括在近侧脊6110的近侧部分形成的球形构件6162。关节运动控制环6164可活动地支撑在球形构件6162上。如图128进一步所示，关节运动缆线6144、6146、6150、6152的近端通过相应的球形接头结构6166联接到关节运动控制环6164。关节运动控制环6164由关节运动驱动组件6170控制。尤其如图128所示，将第一关节运动缆线6144、6146的近端在位于平面6159上的相应间隔开的第一点6149、6151处附接到关节运动控制环6164。同样，将第二关节运动缆线6150、6152的近端在也沿着平面6159设置的相应间隔开的第二点6153、6155处附接到关节运动控制环6164。继续参阅本具体实施方式，本领域的普通技术人员将会知道，当关节运动控制环6164由关节运动驱动组件6170操纵时，关节运动控制环6164上的此类缆线附接构造有利于所需范围内的关节运动动作。
在各种形式中，关节运动驱动组件6170包括水平关节运动组件(一般称为6171)。在至少一种形式中，水平关节运动组件6171包括附接到水平齿轮结构6180的水平推动缆线6172。关节运动驱动组件6170还包括竖直关节运动组件(一般称为6173)。在至少一种形式中，竖直关节运动组件6173包括附接到竖直齿轮结构6190的竖直推动缆线6174。如图127和128所示，水平推动缆线6172延伸穿过附接到近侧脊部分6110的支撑板6167。水平推动缆线6174的远端通过相应的球形/枢转接头6168附接到关节运动控制环6164。竖直推动缆线6174延伸穿过支撑板6167，并且其远端通过相应的球形/枢转接头6169附接到关节运动控制环6164。
水平齿轮结构6180包括枢转地安装到水平轴6181上的水平从动齿轮6182，所述水平轴附接到近侧脊部分6110的近侧部分。水平推动缆线6172的近端可枢转地附接到水平从动齿轮6182，使得当水平从动齿轮6172围绕水平枢转轴线HA旋转时，水平推动缆线6172施加第一枢转运动到关节运动控制环6164。同样，竖直齿轮结构6190包括竖直从动齿轮6192，所述竖直从动齿轮可枢转地支撑在与近侧脊部分6110的近侧部分附接的竖直轴6191上，以便围绕竖直枢转轴线VA枢转行进。竖直推动缆线6174的近端可枢转地附接到竖直从动齿轮6192，使得当竖直从动齿轮6192围绕竖直枢转轴线VA旋转时，竖直推动缆线6174施加第二枢转运动到关节运动控制环6164。
水平从动齿轮6182和竖直从动齿轮6192通过可操作地与关节运动移位器组件6320交接的关节运动齿轮系6300驱动。在至少一种形式中，关节运动移位器组件包括关节运动传动齿轮6322，所述关节运动传动齿轮联接到工具安装板6202的适配器侧1307上相应的从动盘或从动元件1304中的一个。参见图22。因此，当接口1230联接到工具保持器1270时，将来自机器人系统1000的旋转输入运动通过工具驱动组件1010施加到相应的从动元件1304上，从而将引起关节运动传动齿轮6322的旋转。将关节运动从动齿轮6324附接到可旋转地支撑在工具安装板6202上的花键式移位器轴6330。关节运动从动齿轮6324与关节运动传动齿轮6322啮合，如图所示。因此，关节运动传动齿轮6322的旋转将引起轴6330的旋转。在各种形式中，移位器从动齿轮组件6340可活动地支撑在移位器轴6330的花键部分6332上。
在各种实施例中，移位器从动齿轮组件6340包括附接到移位器板6344的从动移位器齿轮6342。移位器板6344与移位器螺线管组件6350可操作地交接。移位器螺线管组件6350通过导体6352联接至相应的销6352。参见图127。将销6352取向为与适配器1240的工具侧1244上的狭槽1258(图21)电连通。此结构用于将移位器螺线管组件6350电联接到机器人控制器1001。因此，移位器螺线管6350的致动将如图127和128中的箭头“S”所示使移位器轴6330的花键部分6332上的移位器从动齿轮组件6340发生偏移。关节运动齿轮系6300的各种实施例还包括水平齿轮组件6360，所述水平齿轮组件包括安装在可旋转地附接到工具安装板6202的轴6361上的第一水平传动齿轮6362。第一水平传动齿轮6362以与第二水平传动齿轮6364啮合的方式而支撑。如图128所示，水平从动齿轮6182与第二水平从动齿轮6364的远侧面部分6365啮合。
关节运动齿轮系6300的各种实施例还包括竖直齿轮组件6370，所述竖直齿轮组件包括安装在可旋转地支撑在工具安装板6202上的轴6371上的第一竖直传动齿轮6372。第一竖直传动齿轮6372以与第二竖直传动齿轮6374啮合的方式而被支撑，第二水平传动齿轮6364与所述第二竖直传动齿轮被同心地支撑。第二竖直传动齿轮6374可旋转地支撑在近侧脊部分6110上以绕其行进。第二水平传动齿轮6364可旋转地支撑在所述第二竖直传动齿轮6374的一部分上以独立地在其上旋转行进。如图128所示，竖直从动齿轮6192与第二竖直从动齿轮6374的远侧面部分6375啮合。
在各种形式中，第一水平传动齿轮6362具有第一直径并且第一竖直传动齿轮6372具有第二直径。如图127和128所示，轴6361与轴6371不在公共轴线上。即，第一水平从动齿轮6362和第一竖直从动齿轮6372不围绕公共轴线旋转。因此，当移位器齿轮6342设置在中心“锁定”位置使得移位器齿轮6342与第一水平从动齿轮6362和第一竖直传动齿轮6372啮合时，关节运动系统6140的部件被锁定就位。因此，可活动的移位器齿轮6342和第一水平和竖直传动齿轮6362、6372的结构以及关节运动移位器组件6320可统称为关节运动锁定系统(一般称为6380)。
在使用中，机器人系统1000的机器人控制器1001可按如下控制关节运动系统6140。为了围绕第一工具关节运动轴线TA1-TA1使端部执行器6012向左进行关节运动，机器人控制器1001启动移位器螺线管组件6350，以使移位器齿轮6342与第一水平传动齿轮6362啮合。然后，控制器1001施加第一旋转输出运动到关节运动传动齿轮6322，以在第一方向上驱动移位器齿轮，从而最终在另一个第一方向上驱动水平从动齿轮6182。驱动水平从动齿轮6182以枢转球形部分6162上的关节运动环6164，从而在近侧方向“PD”上牵拉右上部缆线6144和右下部缆线6146。为了围绕第一工具关节运动轴线TA1-TA1使端部执行器6012向右进行关节运动，机器人控制器1001启动移位器螺线管组件6350，以使移位器齿轮6342与第一水平传动齿轮6362啮合。然后，控制器1001在相反方向上施加第一旋转输出运动到关节运动传动齿轮6322，以在第二方向上驱动移位器齿轮6342，从而最终在另一个第二方向上驱动水平从动齿轮6182。此动作使关节运动控制环6164以此方式运动以在近侧方向“PD”上牵拉左上部缆线6150和左下部缆线6152。在各种实施例中，当致动水平齿轮组件6360时，在竖直齿轮组件6370的齿轮之间产生的齿轮比和摩擦力用于防止竖直从动齿轮6192的旋转。
为了围绕第二工具关节运动轴线TA2-TA2在向上的方向上使端部执行器6012进行关节运动，机器人控制器1001启动移位器螺线管组件6350，以使移位器齿轮6342与第一竖直传动齿轮6372啮合。然后，控制器1001施加第一旋转输出运动到关节运动传动齿轮6322，以在第一方向上驱动移位器齿轮6342，从而最终在另一个第一方向上驱动竖直从动齿轮6192。驱动竖直从动齿轮6192以枢转近侧脊部分6110的球形部分6162上的关节运动环6164，从而在近侧方向“PD”上牵拉右上部缆线6144和左上部缆线6150。为了围绕第二工具关节运动轴线TA2-TA2在向下的方向上使端部执行器6012进行关节运动，机器人控制器1001启动移位器螺线管组件6350，以使移位器齿轮6342与第一竖直驱动齿轮6372啮合。然后，控制器1001在相反方向上施加第一旋转输出运动到关节运动传动齿轮6322，以在第二方向上驱动移位器齿轮6342，从而最终在另一个第二方向上驱动竖直从动齿轮6192。从而此动作使关节运动控制环6164在近侧方向“PD”上牵拉右下部缆线6146和左下部缆线6152。在各种实施例中，当致动竖直齿轮组件6370时，在水平齿轮组件6360的齿轮之间产生的齿轮齿数比和摩擦力用于防止水平从动齿轮6182的旋转。
在各种实施例中，多个传感器可以与机器人控制器1001连通，以确定端部执行器6012的关节运动位置。例如，此类传感器可与关节运动接头6100交接或位于工具安装部分6200中。例如，可以使用传感器以检测近侧脊部分6110的球形部分6162上的关节运动控制环6164的位置。来自传感器至控制器1001的此类反馈允许控制器1001调节关节运动传动齿轮6322的旋转量和旋转输出的方向。另外，如上所述，当移位器传动齿轮6342居中设置成与第一水平传动齿轮6362和第一竖直传动齿轮6372啮合时，端部执行器6012被锁定在关节运动位置。因此，获得所需的关节运动量之后，控制器1001可启动移位器螺线管组件6350，以使移位器齿轮6342与第一水平传动齿轮6362和第一竖直传动齿轮6372啮合。在可供选择的实施例中，可将移位器螺线管组件6350弹簧启动至中心锁定位置。
在使用中，围绕纵向工具轴线LT-LT旋转外科端部执行器6012可能是有利的。在至少一个实施例中，工具安装部分上的传动装置结构6204包括旋转的传输组件6400，所述旋转的传输组件能够接收来自机器人系统1000的工具驱动组件1010的相应的旋转输出运动，并将此旋转输出运动转化成旋转控制运动，以使细长轴组件6008(和外科端部执行器6012)围绕纵向工具轴线LT-LT旋转。在各种实施例中，例如，近侧闭合管6040的近端部分6041通过向前的支撑支架6205以及也可活动地支撑在工具安装板6202上的闭合滑动件6510而旋转地支撑在工具安装部分6200的工具安装板6202上。在至少一种形式中，旋转的传输组件6400包括管齿轮段6402，所述管齿轮段形成于(或附接到)近侧闭合管6040的近端6041上，以通过可操作地支撑在工具安装板6202上的旋转齿轮组件6410可操作地接合。如图127所示，在至少一个实施例中，旋转齿轮组件6410包括旋转传动齿轮6412，当工具安装部分6200联接到工具驱动组件1010时，所述旋转传动齿轮联接到工具安装板6202的适配器侧1307上相应的从动盘或从动元件1304中的第二个。参见图22。旋转齿轮组件6410还包括第一旋转从动齿轮6414，所述第一旋转从动齿轮与旋转传动齿轮6412以啮合的方式而被旋转地支撑在工具安装板6202上。第一旋转从动齿轮6414附接到可旋转地支撑在工具安装板6202上的驱动轴6416。第二旋转从动齿轮6418附接到驱动轴6416，并与在近侧闭合管6040上的管齿轮段6402啮合。将来自机器人系统1000的工具驱动组件1010的第二旋转输出运动施加到相应的从动元件1304，从而将引起旋转传动齿轮6412的旋转。旋转传动齿轮6412的旋转最终导致细长轴组件6008(和外科端部执行器6012)围绕纵向工具轴线LT-LT旋转。应当理解，在一个方向上施加来自工具驱动组件1010的旋转输出运动将引起细长轴组件6008和外科端部执行器6012围绕纵向工具轴线LT-LT在第一方向上旋转，并且在相对的方向上施加旋转输出运动将引起细长轴组件6008和外科端部执行器6012在相对于第一方向的第二方向上旋转。
在至少一个实施例中，通过在脊组件2049上沿着远侧方向“DD”使细长轴组件2008的闭合部分轴向运动来实现砧座2024相对于钉仓2034的闭合。如上所述，在各种实施例中，近侧闭合管6040的近端部分6041由闭合滑动件6510支撑，所述闭合滑动件包括闭合传动装置(一般描述为6512)的一部分。如图127所示，近侧闭合管部分6040的近端部分6041具有在其上形成的衬圈6048。闭合滑动件6510通过与衬圈6048中的环形沟槽6049接合的轭6514与衬圈6048联接。此结构用于使衬圈6048在保持与闭合传动装置6512联接的同时围绕纵向工具轴线LT-LT旋转。在各种实施例中，闭合滑动件6510具有直立部分6516，所述直立部分具有在其上形成的闭合齿条齿轮6518。闭合齿条齿轮6518能够与闭合齿轮组件6520驱动接合。参见图127。
在各种形式中，闭合齿轮组件6520包括闭合正齿轮6522，所述闭合正齿轮6522联接到工具安装板6202的适配器侧1307上相应的从动盘或从动元件1304中的第二个。参见图22。因此，当工具安装部分6202联接到工具驱动组件1010时，将来自机器人系统1000的工具驱动组件1010的第三旋转输出运动施加到相应的第二从动元件1304上将引起闭合正齿轮6522的旋转。闭合齿轮组件6520还包括以与闭合正齿轮6522和闭合齿条齿轮2106啮合的方式而被支撑的闭合减速齿轮组6524。因此，将来自机器人系统1000的工具驱动组件1010的第三旋转输出运动施加到相应的第二从动元件1304将引起闭合正齿轮6522和闭合传动装置6512的旋转，并且最终在近侧脊部分6110上轴向驱动闭合滑动件6510和近侧闭合管6040。近侧闭合管6040运动的轴向最终取决于第三从动元件1304旋转的方向。例如，响应于从机器人系统1000的工具驱动组件1010接收的一个旋转输出运动，将在远侧方向“DD”上驱动闭合滑动件6510并且最终在远侧方向“DD”上驱动近侧闭合管6040。当朝远侧驱动近侧闭合管6040时，通过其与近侧闭合管6040的连接，还朝远侧驱动远侧闭合管6042。当朝远侧驱动远侧闭合管6042时，闭合管6042的端部将接合砧座6024的一部分并使砧座6024枢转到闭合位置。当施加来自机器人系统1000的工具驱动组件1010的“开口”输出运动时，将在近侧脊部分6110上沿着近侧方向“PD”驱动闭合滑动件6510和近侧闭合管6040。当在近侧方向“PD”上驱动近侧闭合管6040时，还将在近侧方向“PD”上驱动远侧闭合管6042。当在近侧方向“PD”上驱动远侧闭合管6042时，其中的开口6045与砧座6024上的突出部6027相互作用以利于其打开。在各种实施例中，当远侧闭合管6042运动至其起始位置时，可使用弹簧(未示出)以将砧座6024偏置至打开位置。在各种实施例中，闭合齿轮组件6520的各种齿轮的尺寸设定成能够产生所需的必要的闭合力，所述闭合力满意地在待由外科端部执行器6012切割和缝合的组织上闭合砧座6024。例如，闭合传动装置6520的齿轮的尺寸设定成能够产生大约70-120磅的闭合力。
在各种实施例中，通过刀杆6530驱动切割器械穿过外科端部执行器6012。参见图127。在至少一种形式中，刀杆6530由接头结构(未示出)制成和/或由如下材料制成：所述材料在保持足够的刚性的同时可适应外科端部执行器6102围绕第一工具关节运动轴线和第二工具关节运动轴线而进行的关节运动，以推动切割器械穿过夹持在外科端部执行器6012中的组织。刀杆6530延伸穿过近侧脊部分6110中的中空通路6532。
在各种实施例中，刀杆6530的近端6534可旋转地附连到刀齿条齿轮6540上，使得刀杆6530相对于刀齿条齿轮6540自由旋转。刀杆6530的远端以上述各种方式附接到切割器械。如图127所示，刀齿条齿轮6540可滑动地支撑在附接到工具安装板6202的齿条外壳6542内，使得刀齿条齿轮6540保持与传动装置结构6204的刀驱动传动装置部分6550啮合。在各种实施例中，刀驱动传动装置结构部分6550包括刀齿轮组件6560。更具体地讲并结合图127，在至少一个实施例中，刀齿轮组件6560包括刀正齿轮6562，所述刀正齿轮联接到工具安装板6202的适配器侧1307上相应的从动盘或从动元件1304中的第四个。参见图22。因此，将来自机器人系统1000的另一旋转输出运动通过工具驱动组件1010施加到相应的第四从动元件1304将引起刀正齿轮6562的旋转。刀齿轮组件6560还包括刀减速齿轮组6564，所述刀减速齿轮组包括第一刀从动齿轮6566和第二刀传动齿轮6568。刀减速齿轮组6564可旋转地安装到工具安装板6202上，使得第一刀从动齿轮6566与刀正齿轮6562啮合。同样，第二刀传动齿轮6568与第三刀传动齿轮组件6570啮合。如图127所示，第二刀从动齿轮6568与第三刀驱动齿轮组件6570的第四刀从动齿轮6572啮合。第四刀从动齿轮6572与第五刀从动齿轮组件6574啮合，所述第五刀从动齿轮组件与刀齿条齿轮6540啮合。在各种实施例中，刀齿轮组件6560的齿轮的尺寸设定成能够产生驱动切割器械穿过夹持在外科端部执行器6012中的组织并致动其中的钉所需的力。例如，刀齿轮组件6560的齿轮的尺寸可设定成能够产生大约40-100磅的驱动力。应当理解，在一个方向上施加来自工具驱动组件1010的旋转输出运动将引起切割器械在远侧方向上轴向运动，并且在相对的方向上施加旋转输出运动将引起切割器械在近侧方向上轴向运动。
通过上述说明可以理解，外科工具6000代表对现有机器人工具结构的大幅改进。外科工具6000采用的独特的和新颖的传动装置结构使该工具可操作地联接到仅具有四个旋转输出主体的机器人系统的工具保持器部分1010，另外从其获得旋转输出运动以：(i)围绕基本上彼此横向的以及横向于纵向工具轴线的两条不同的关节运动轴线使端部执行器进行关节运动；(ii)围绕纵向工具轴线旋转端部执行器6012；(iii)相对于外科钉仓6034不同程度地闭合砧座6024以使端部执行器6012能够用于操纵组织然后将其夹紧到适当位置以用于切割和缝合；以及(iv)击发切割器械以切割夹持在端部执行器6012中的组织。上述本发明的各种实施例的独特的和新颖的移位器结构使得两种不同的关节运动动作从机器人系统的单个旋转主体部分获得功率。
以上已经结合切割型外科器械对本发明的各种实施例进行了描述。然而，应该指出的是，在其他实施例中，本文公开的本发明的外科器械不必为切割型外科器械，而是可被用于包括遥感器转发器的任何类型的外科器械中。例如，其可为非切割内窥镜式器械、抓紧器、缝合器、施加器、进入装置、药物/基因治疗递送装置、利用超声波、射频、激光等的能量装置。此外，本发明例如可为腹腔镜式器械。本发明也可在传统的内窥镜式和开放式外科器械以及机器人辅助的手术中得到应用。
图129示出了结合具有超声功率的端部执行器7012的外科工具7000使用本发明的某些实施例的各个方面。端部执行器7012通过细长轴组件7008可操作地附接到工具安装部分7100。工具安装部分7100可基本上类似于上述各种工具安装部分。在一个实施例中，端部执行器7012包括超声功率的钳口部分7014，所述超声功率的钳口部分由交流电或直流电以已知方式提供功率。此类超声动力的装置在例如名称为“Robotic Surgical Tool WithUltrasound Cauterizing and Cutting Instrument”的美国专利No.6,783,524中公开，该专利的全部公开内容以引用的方式并入本文。在图示实施例中，示出了单独的功率线7020。然而，应当理解，可通过工具安装部分7100从机器人控制器1001对其提供功率。外科端部执行器7012还包括可用于将组织夹持到超声钳口部分7014上的可活动钳口7016。可以本文所述的各种方式中的任意一种通过机器人控制器1001选择性地致动可活动的钳口部分7016穿过工具安装部分7100。
图130示出了结合具有包括直线型缝合装置的端部执行器8012的外科工具8000使用本发明的某些实施例的各种方面。端部执行器8012通过上述类型和构造的细长轴组件3700可操作地附接到工具安装部分8100。然而，端部执行器8012可通过本文所述的各种其他细长轴组件附接到工具安装部分8100。在一个实施例中，工具安装部分8100可基本上类似于工具安装部分3750。然而，还可使用本文详细描述的各种其他工具安装部分和它们各自的传动装置结构。此类线性缝合压头部分也在例如名称为“Surgical Stapling DeviceWith Staple Driver That Supports Multiple Wire Diameter Staples”的美国专利No.7,673,781中公开，该专利的全部公开内容以引用的方式并入本文。
在授予Shelton,IV等人的美国专利公开No.2011/0062212A1中公开的各种传感器实施例可以与本文所公开的许多外科工具实施例一起使用，该专利的公开内容全文以引用的方式并入本文。如上所述，主控制器1001通常包括主控制器(一般表示为1003)，在外科医生通过立体显示器1002观察手术的同时，所述主控制器由外科医生抓持并在空中操控。参见图13。主控制器1001是手动输入装置，其优选地以多个自由度运动，并且通常还具有用于致动外科工具的致动柄部。本文所公开的一些外科工具实施例在其工具驱动部分中采用一个或多个马达，以为工具端部执行器提供各种控制运动。此类实施例也可从机器人系统部件中所采用的马达结构中获得另外的控制运动。本文中所公开的其他实施例从机器人系统内的马达结构中获得全部的控制运动。
在不脱离本发明的实质和范围的情况下，此类马达功率结构可采用各种传感器结构，所述传感器结构在上述引用的美国专利申请中公布以为外科医生提供多种形式的反馈。例如，采用手动致动击发触发器的那些主控制器结构1003可使用马达运转传感器以为外科医生提供与施加到切割构件或由其承受的力的大小相关的反馈。马达运转传感器可能够与击发触发器部分连通，以检测击发触发器部分何时致动而由端部执行器开始切割/缝合操作。马达运转传感器可以为比例传感器，例如变阻器或可变电阻器。当击发触发器被拉近时，传感器检测此运动，并发送电信号，所述电信号指示提供给相应马达的电压(或功率)。当传感器为可变电阻器等时，马达的转速可与击发触发器的运动量大致成比例。即，如果操作者仅少量牵拉或者闭合击发触发器，则马达的转速相对较低。当完全拉近击发触发器(或者处于完全闭合位置)时，马达的转速为其最大值。换句话讲，外科医生越用力牵拉击发触发器，则施加到马达上的电压就越大，从而转速就越大。其他结构可为外科医生提供反馈计1005并为外科医生提供力的大小的视觉指示，所述反馈计可通过显示器1002观察，并且所述力的大小为施加到切割器械或动态夹紧构件的力的大小。其他传感器结构可用于为主控制器1001提供指示，以指示钉仓是否已加载到端部执行器中、砧座是否在击发之前已运动至闭合位置等。
在可供选择的实施例中，可结合控制器1001使用马达控制的接口，所述控制器根据外科端部执行器承受的负载(如，夹紧力、切割力等)来限制最大的触发器牵拉力。例如，越难驱动切割器械穿过夹持在端部执行器中的组织，则越难牵拉/致动击发触发器。在其他实施例中，将控制器1001上的触发器布置成使得触发器牵拉位置与端部执行器位置/状态相当。例如，仅当完全击发端部执行器时完全按下触发器。
可将本文所公开的装置设计为单次使用后即进行处理，或者可将它们设计为可多次使用。然而，在任一种情况下，所述装置均可进行修复，以在至少一次使用后再次使用。重新修复可包括如下步骤的任意组合：拆卸该装置、然后清洗或置换某些部分以及随后组装。特别是，所述装置可以拆卸，而且可以任意组合选择性地置换或移除该装置任意数目的特定零件或部分。清洗和/或置换特定部分后，该装置可以在修复设施处重新组装以便随后使用，或者在即将进行外科手术前由外科手术队重新组装。本领域的技术人员将会知道，装置的修复可利用多种用于拆卸、清洗/置换和重新组装的技术。这些技术的使用以及所得的修复装置均在本发明的范围内。
尽管本文已经结合某些公开的实施例描述了本发明，但是可对那些实施例进行多种修改和变型。例如，可采用不同类型的端部执行器。另外，凡是公开了用于某些部件的材料的情形均可使用其他材料。上述描述和以下权利要求旨在涵盖所有这类修改形式和变型。
以引用方式全文或部分地并入本文的任何专利、公布或其他公开材料均仅在所并入的材料不与本发明所述的现有定义、陈述或其他公开材料相冲突的范围内并入本文。由此，在必要的程度下，本文所明确阐述的公开内容将取代以引用方式并入本文的任何相冲突的材料。如果据述以引用方式并入本文但与本文所述的现有定义、陈述或其他公开材料相冲突的任何材料或其部分，仅在所并入的材料和现有的公开材料之间不产生冲突的程度下并入本文。

Claims (8)

1.一种外科器械，包括：
工具驱动部分(3500)，所述工具驱动部分能够可操作地附接到机器人系统(1000)的一部分以从所述机器人系统的一部分接收控制运动；
细长轴(3408)，所述细长轴联接到所述工具驱动部分(3500)；
可轴向运动的控制构件(52)，所述可轴向运动的控制构件可操作地支撑在所述细长轴(3408)内，并且能够响应于从所述机器人系统(1000)施加至所述控制构件的致动运动而轴向运动；以及
一次性加载单元(16)，所述一次性加载单元包括：
外壳(200)，所述外壳联接到所述细长轴(3408)；
包括钉仓(18)的仓组件，所述钉仓由外壳(200)支撑；
轴向驱动组件(212)，所述轴向驱动组件被支撑，以用于在向所述轴向驱动组件施加旋转运动时，所述轴向驱动组件从起始位置选择性地轴向行进穿过所述仓组件至结束位置；
马达(562)，所述马达支撑在所述外壳(200)中并且与所述轴向驱动组件(212)可操作地交接，以向所述轴向驱动组件选择性地施加所述旋转运动；以及
功率源(526)，在附接到控制构件(52)时，所述功率源(526)能够在所述外壳(200)内从断开位置轴向运动至第一连接位置，在所述断开位置处，所述功率源(526)与所述马达(562)断开，在所述第一连接位置处，所述功率源(526)向所述马达(562)提供功率。
2.根据权利要求1所述的外科器械，其中所述仓组件还包括砧座组件(20)，在从所述轴向驱动组件(212)向所述砧座组件施加闭合运动时，所述砧座组件能够在打开位置和闭合位置之间选择性地运动。
3.根据权利要求1所述的外科器械，其中所述一次性加载单元(16)还包括：
第一接触结构(540)，所述第一接触结构(540)在所述外壳(200)中与所述马达(562)连通，并且当所述功率源(526)位于所述第一连接位置时，所述第一接触结构(540)能够与所述功率源(526)接触；以及
第二接触结构(542)，所述第二接触结构(542)在所述外壳(200)中与所述马达(562)连通，并且当所述功率源(526)位于第二连接位置时，所述第二接触结构(542)能够与所述功率源(526)接触。
4.根据权利要求3所述的外科器械，其中当所述功率源(526)位于所述第一连接位置时，所述功率源(526)能够在向所述可轴向运动的控制构件(52)施加致动运动时轴向运动至所述第二连接位置。
5.根据权利要求2所述的外科器械，其中所述一次性加载单元还包括：
第一接触结构(540)，所述第一接触结构(540)在所述外壳(200)中与所述马达(562)连通，并且当所述功率源(526)位于所述第一连接位置时，所述第一接触结构(540)能够与所述功率源(526)接触；以及
第二接触结构(542)，所述第二接触结构(542)在所述外壳(200)中与所述马达(562)连通，并且当所述功率源(526)位于第二连接位置时，所述第二接触结构(542)能够与所述功率源(526)接触，使得所述马达(562)向所述轴向驱动组件(212)提供功率，从而向所述砧座组件(20)施加所述闭合运动。
6.根据权利要求5所述的外科器械，还包括第三接触结构(544)，所述第三接触结构(544)在所述外壳(200)中与所述马达(562)连通，并且当所述功率源(526)位于第三连接位置时，所述第三接触结构(544)能够与所述功率源(526)接触。
7.根据权利要求6所述的外科器械，其中当所述功率源(526)位于所述第三连接位置时，所述马达(562)将所述轴向驱动组件(212)朝近侧驱动至所述仓组件中的所述结束位置。
8.根据权利要求1所述的外科器械，还包括：
可运动的电池保持器(524)，所述可运动的电池保持器(524)能够联接到所述控制构件(52)，并且能够响应于由所述控制构件(52)向所述可运动的电池保持器(524)施加的运动而在所述外壳内轴向运动，其中，所述控制构件包括控制杆；
其中，所述功率源包括电池，所述电池支撑在电池保持器(524)内，并且能够与所述外壳(200)中的一系列轴向间隔的接触结构(540、542、544)选择性地轴向连通，以用于控制从所述电池对所述马达(562)的功率供应。
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