JP2023554516A - Surgical instruments and robotic surgical assemblies for robotic surgery - Google Patents

Abstract

A robotic surgical assembly (100) comprising a medical instrument (60, 160, 260) includes a frame (57), an articulation device (70) having a degree of freedom relative to said frame, and for actuating said degree of freedom. at least one tendon (90, 190) made of polymer fiber, the at least one tendon (90) having a tendon termination (92) connected to a medical device to actuate said degree of freedom. At least one tendon (90, 190) applies a tensile load to cause the articulation device (70) to actuate said degree of freedom while contacting at least a portion of the articulation device (70). At least one tendon (90) is made of a braided strand, said strand being composed of said polymer fiber.

Description

TECHNICAL FIELD This invention relates to robotic surgical assemblies.

Specifically, a robotic surgical assembly according to the invention includes at least one tendon-actuated medical instrument.

Surgical or microsurgical robotic assemblies are known in the art that include articulated robotic arms terminating in surgical instruments. For example, US Pat. No. 7,155,3116 B2 discloses a robotic assembly for performing brain microsurgery under MRI (magnetic resonance imaging) guidance, which assembly includes an MRI-based image acquisition system and two articulated an arm, each having three revolute joints with vertical axes to avoid direct gravitational loads (as shown, for example, in FIG. 7 of said U.S. Pat. No. 7,155,316 B2); Connected to respective end effectors with internal degrees of freedom of motion for grasping.

Although the solutions available in the art offer partial advantages, even small movements of surgical instruments in the surgical workplace require operating methods that involve multiple independent movements simultaneously, making kinematic precision difficult. It poses a large burden on the control and surgical workplace, and is difficult for surgeons to utilize in practice. In practice, most application areas of surgical robotic assemblies based on the master/slave paradigm are dedicated to use in minimally invasive surgery (or MIS), such as laparoscopic or endoscopic surgery. It is true. In both such applications, the kinematics of the robot assembly facilitate access of surgical instruments to the surgical site through surgical ports or openings that require coordination of multiple degrees of freedom of motion. The purpose is to optimize. In contrast, surgical and microsurgical applications in open surgery are tasks that are limited by the field of view of a surgical microscope without the limited kinematic constraints represented by surgical ports or natural apertures. It requires precise kinematic control of translational movement over space and therefore greatly benefits from the surgeon's ability to access the surgical site directly.

The basic execution of major surgical procedures such as tensioning tissues and suturing anastomoses involves orienting the tip of the surgical instrument in the direction of a large spatial cone and rotating the instrument about a longitudinal axis. It should also be noted that the tip of the needle holder requires the ability to guide the needle through the tissue (turning), for example, as a human hand is joined at the wrist and elbow.

Surgical or microsurgical robotic assemblies including remotely operated master/slave systems, such as those disclosed in U.S. Pat. No. 6,963,792A, more particularly U.S. Pat. No. 6,385,509B2 and The microsurgical devices disclosed in Published Application No. 2014-0135794A1 are generally known and are used in surgical procedures that are disorganized at the surgical site and require the coordination of multiple joints in a kinetic chain. A kinematic solution to the movement of the instrument tip is described. The effects of such loading are even more pronounced when the joint articulating the tip of the instrument is remote from the tip itself. Furthermore, the microsurgical system does not allow for proper movement and more specifically proper reorientation of the instrument tip when operating within a lesion only 10 centimeters from the skin surface.

Generally, even expert operators require extensive training to acquire specialized skills in the master command devices employed in known master/slave systems. In fact, known master devices are long Has a learning curve. Known master devices are therefore inherently unsuitable for reproducing the functionality of conventional open surgical instruments and lack the ability to perform large ranges of linear motion and angular motion in three-dimensional space. .

For example, US Pat. No. 8,521,331 B2 discloses a robotic device for laparoscopic surgery in which the master command device has a shape that allows the surgeon to wear the device on his fingers as a glove. According to another embodiment shown in FIG. 2B of said patent specification, the master command device has the shape of a control stick and is attached and deployed to a part of the surgeon's wrist so that it can be held with only one hand. It has a cylindrical stem with a pair of lateral wings that can record grasping movements. The surgeon utilizes a laparoscopic display device that is integrated with the command device.

Although the above solution is partially advantageous for laparoscopic surgery, it does not completely solve the problem and until one becomes accustomed to handling the command device instead of the familiar open surgical instruments, Long-term training of surgeons is still required.

As is well known, the practice of microsurgery requires the use of a light microscope or magnifying loupes, working within the limits of physiological tremor and with the precision with which human hand movements can reach such dimensional scales. requires a high level of dexterity and experience on the part of the surgeon.

The adoption of robotic technology can bring significant benefits, eliminating the effects of physiological tremor by allowing for a high degree of miniaturization of instruments and the standardization of the magnitude of movements in the field of operation, thereby eliminating the need for manual labor. Make it easier. For example, microsurgical procedures are performed in some processes of biological tissue reconstruction, such as performing vascular anastomoses involving small diameter vessels and nerves. Such procedures are performed to rebuild the human body, reattach limbs, and reshape tissue blood flow after the occurrence of a traumatic lesion or damage caused by surgical removal of tissue, all of which It is performed in the setting of open surgery assuming pre-existing superficial damage.

Other applications of microsurgical techniques are found in transplant surgery, neurosurgery, or vascular surgery, as well as periocular and intraocular surgery, and inner ear surgery such as cochlear implants. Similarly, the prominent surgical procedure of cardiac bypass involves the critical step of anastomosis of the coronary arteries. There is also a need for smaller instruments in other surgical techniques, such as minimally invasive surgical procedures such as laparoscopy and endoscopy, which aim to limit the invasiveness of surgical instruments to living tissue. felt. With respect to laparoscopy, the technical solutions known in the art do not allow sufficient miniaturization of the diameter of laparoscopic surgical instruments used for single-incision laparoscopic surgery or single-hole surgery. Furthermore, it is noteworthy that endoscopes typically used for MIS have instrument channels with diameters between 1 mm and 3.2 mm. Such dimensions limit the functionality of current surgical instruments available through endoscopic instrument channels, which at present typically allow only gripping motions.

Medical instruments including joint devices suitable for operation on a patient are generally known in the art. For example, WO 2010-009221A2 shows a robotic surgical instrument with a distal articulation device. The robotic surgical instrument can provide each of the three degrees of freedom of movement, pitch, yaw and grip, using only four actuation cables. Such a cable slides within a guiding channel or sheath that is present inside the body of the articulation device.

Said technical solutions limit the miniaturization of the robot articulation device because the friction between the guide channel surface and the cable sliding inside it limits the positioning accuracy that can be achieved by the articulation device. As is known in the art, as the physical dimensions of medical devices decrease, problems arise associated with the increased relevance of superficial forces, such as friction, becoming dominant over body forces. Such phenomena require the use of solutions that minimize frictional forces and at the same time reduce mechanical drift to a minimum. The loss of positioning accuracy of articulating devices is a fundamental technical obstacle to further miniaturization of articulating devices. This is because with miniaturization, the stiffness of the drive member (tendon) also decreases with the square of its diameter, making it more difficult to overcome friction for accurate positioning of the instrument tip. Furthermore, such a solution requires a tendon guidance system with channels and guide surfaces surrounding the cable providing the pitch and yaw links, and the shaft of the instrument, thus requiring known manufacturing methods such as injection molding and machining. are very difficult to miniaturize using and tend to have some mechanical weak point locations.

In order to simplify the miniaturization of surgical instruments, WO 2010-009221A2 proposes that three degrees of freedom are achieved by applying a torque to the pitch link of a cable terminated in a yaw link. shows an advantageous opportunity to reduce the number of actuating tendon terminations associated with a cable from 6 to 4 (see Figure 4A of the cited document), and a kinematic mechanism involving several gears makes it possible to select such a cable. Pulling and releasing the target is necessary to accomplish this goal. Additionally, the described drive system requires attachment of each end of the working tendon to a winch that selectively wraps the tendon to generate traction. The presence of mechanical aspects such as the winch and teeth that are susceptible to idle motion makes it difficult to drive small joints. This is because lost motion in the drive system is translated into angular play in the joint, which increases as the joint device becomes smaller. Also, the drive system is not suitable for maintaining a low preload on the actuation cable to further limit friction and wear.

Furthermore, the solutions described for tendon terminations include tortuous paths intended to capture the tendon in several sections. Such solutions require the use of cables that are sufficiently durable to withstand such capture. Otherwise, steel wire or a cable with a larger diameter is required.

A further example of an actuation cable for a surgical instrument suitable for sliding in a sheath or guide channel obtained on the side of a pulley when pulled or pushed, for example, is disclosed in U.S. Pat. No. 6,371,952 B2, U.S. Pat. It is disclosed in Specification No. 6394998B1 and International Publication No. 2010-005657A2. In particular, the latter document discloses a solution in which actuating cables follow trajectories that intersect as they orbit pulleys containing guide channels, avoiding such cables interfering with each other. Cables that interfere with each other are conditions that limit their ability to transmit motion to the articulating device, such as when one tendon is bundled or slid over another. In order to guide the tendons in a crosswise manner, a link, for example integral with the shaft of the instrument, or attached to a pitch link, necessarily with a diameter close to half the diameter of the instrument (referenced in WO 2010-005657A2) Providing an idler pulley with an idler pulley (as shown in FIG. 4 of the book) is a major obstacle to miniaturization. Moreover, the provision of grooves and walls to realize channels for actuation cables is a further obstacle to miniaturization of the shaft or cannula diameter of medical or surgical instruments.

The document US 2003-0034748A discloses a solution suitable for reducing the diameter of surgical instruments to 5.1 mm. This device foresees the use of a series of discs that act as vertebrae that provide a degree of flexibility.

However, this solution is not suitable for realizing small joints that can extend substantially the diameter of one instrument, ie with a radius of curvature similar to that diameter. Alternatively, this can be achieved by the joints described in the above-cited documents, which are based on pivot joints consisting of pure rotational axes.

A further obstacle to the miniaturization of articulated or articulated devices is the challenge of manufacturing and assembling three-dimensional micromechanical components with sufficient accuracy at reasonable processing costs. The need to generate relatively high forces at submillimeter tips in devices suggests the use of extremely stiff metals for the components, such as tool steel.

Biomedical devices are generally manufactured using manufacturing techniques derived from the microelectronics industry. For example, laser or water jet cutting is not suitable for high speed machining in three dimensions. Injection molding currently does not produce parts with sufficiently high tolerances. Electrical discharge machining (EDM), on the other hand, can produce satisfactory performance both in terms of surface finish and in terms of the geometric tolerances required for machine design. EDM generally involves a lengthy and expensive process. For example, US Pat. No. 6,768,076 B2 discloses a jig for EDM that can support parts to be cut in a single plane.

However, this jig is not suitable for repeated placement of parts and it is not possible to rotate the jig, for example when the EDM is machined so that it can act in multiple cutting planes. This results in a tedious manufacturing process requiring complex operations of recalibration each time a cut is made in a different plane. As a result, accuracy is reduced, leading to less accurate dimensional and geometric tolerances.

A need is felt for a surgical robotic assembly that can perform precise movements and conveniently control wrist joint medical instruments within a surgical workspace, such as a patient's anatomy. At the same time, there is a need to develop a reliable robot assembly that features a simple drive method without compromising its accuracy. Additionally, there is a need for a robotic assembly that is more versatile and capable of performing a wider variety of surgical procedures than known assemblies.

Thus, without limiting its functionality, it forms a master interface in a microsurgical robot assembly containing a master/slave teleoperation system that is easier and more intuitive for microsurgical surgeons to operate than known solutions. It is felt that there is a need to provide a microsurgical driver device suitable for. Similarly, there is a felt need to provide a master interface that surgeons can learn more quickly and easily. Moreover, there is a felt need to provide a command device that is more versatile than known solutions and that can be applied to different types of microsurgical procedures.

Accordingly, there is a need to provide articulating or multi-joint medical devices, or assemblies including articular devices or multi-joint devices that are structurally and functionally suitable for extreme miniaturization without compromising their reliability and safety. felt. There is also a felt need to provide a joint or multi-joint medical device or assembly comprising a joint device suitable for performing a wide variety of medical surgical treatments. Finally, there is provided an articulating or multi-articular medical device or an assembly including an articulating or multi-articulating device that is durable and capable of undergoing periodic maintenance without compromising its sterility or reliability. I feel the need.

There is a felt need to provide an articular or multi-articular medical device or an assembly including an articulating device that requires simplified manufacturing compared to known solutions.

There is a felt need to provide a method for manufacturing said medical device, which is more efficient than known solutions and which ensures the required level of precision for the assembly.

There is a felt need to provide a method for manufacturing medical devices that ensures faster processing steps without compromising manufacturing accuracy.

Furthermore, there is a need to provide a manufacturing method suitable for manufacturing parts that are intended to be extremely miniaturized without reducing the precision of manufacturing details or the ease of assembling manufactured parts.

There is therefore a felt need to provide a tendon or actuation cable based driver device for medical instruments that is suitable for extreme miniaturization without compromising accuracy or reliability in use.

Furthermore, a medical device for ensuring a predetermined preload, even if mild, on the tendon, the tendon or actuation cable for said medical device being able to independently define the preload force for each of said tendons. There is a felt need to provide a driver device based on the above.

Furthermore, drive systems based on tendons or actuating cables for medical instruments that are able to guarantee an adequate level of sterility on the medical instrument itself, in particular on the parts of the medical instrument intended to come into contact with the patient's body. There is a felt need to provide this.

Furthermore, there is a felt need to provide a tendon-based drive system without backlash.

Furthermore, there is a felt need to provide a tendon-based drive system that can reproduce the drive precision achieved by, for example, precision micrometric slitters or piezoelectric drive systems.

There is therefore a strong need to provide tendons or actuation cables for medical devices that have properties suitable for extreme miniaturization without compromising durability or reliability in use.

Furthermore, there is a felt need to provide a tendon for a medical instrument suitable for sliding over at least a portion of said instrument with improved performance with respect to friction relative to known solutions.

Furthermore, it provides a tendon for medical devices that is intended to act only under tensile loads applied to the end of the tendon, without containing solutions that could deflect the tendon's path and reduce its resistance. I feel the need to do so.

Furthermore, there is a need to provide tendons for medical instruments as well as methods for replacing tendons suitable for extending the life of the medical instrument relative to known solutions without compromising its performance in terms of sterility and reliability. I can feel it.

There is a strong need to downsize medical equipment.

A need is felt to reduce the known dimensions of medical devices.

For example, WO 2014-151952A1 shows a medical device that includes a plurality of links forming an articulating device, the medical device having a shaft that is cantilevered in the links of the medical device. It has an actuation cable that wraps around a plurality of rotatably supported pulleys. This solution is characterized by a number of parts, the arrangement of the pulleys on the shaft forcing the shaft to rotate to counteract the stresses caused by the use of the medical instrument. This solution is therefore unsuitable for miniaturization. In fact, this device cannot take dimensions less than 10 millimeters in diameter. Similar solutions are shown, for example, in the documents US 6,676,684A, US 2009-0112230A and US 2003-135204A1.

Therefore, there is a felt need to reduce the number of parts forming a medical device.

For example, WO 03-001986 A1 shows a medical device comprising a plurality of disc-shaped links forming an articulation device, each of said links having a plurality of holes for guiding an actuation cable. . This solution is therefore unsuitable for miniaturization since it is highly undesirable to implement micrometric holes in such links. At the same time, it is undesirable to provide actuation cables that slide inside such holes without being damaged.

Therefore, a need is felt to obtain accurate guidance of the actuation cable without providing micrometric holes in the links and at the same time reduce the number of parts forming the medical device.

For example, US Pat. . Although satisfactory in some respects, such a solution is also not suitable for miniaturization, since the dimensions of the protruding pin cannot be reduced without compromising the integrity of the links that make up the medical device. do not have. Accordingly, there is a felt need to provide a miniaturized medical device having multiple links actuated by actuation cables without compromising the structural integrity of the medical device and its safety in use.

The miniaturization of articulated surgical instruments requires the miniaturization of all parts, including the actuation means, for example the tendons in the case of a cable drive mechanism. Metallic multistranded cables are commonly used to actuate articulated end effectors of robotic wrist instruments, endoscopes, or catheters. However, as with any component comprising an articulated surgical instrument, miniaturization of metal cables or tendons is difficult and may result in several functional drawbacks.

Specifically, the friction between the micrometallic tendons and other small components is very high, and very high tensile forces are required. The very high tensile forces cause significant wear on the metal tendons and instrument parts, and greatly reduce instrument reliability, lifespan, and limit performance.

Furthermore, the bending radius of known metal multi-strand tendons is very limited, which impacts the possibilities for miniaturized device designs.

One of the objects of the invention described here is to overcome the limitations of the known solutions mentioned above and to provide a solution to the needs stated with reference to the state of the art.

This and other objects are achieved by an assembly according to claim 1.

Some advantageous embodiments are the subject of dependent claims.

A robotic surgical assembly comprising a medical instrument comprises a frame, an articulation device having a degree of freedom relative to the frame, and at least one tendon made of polymeric fibers designed to actuate the degree of freedom. . At least one of the tendons has a tendon end connected to a medical device to apply a tensile load to actuate the degree of freedom. Preferably, the at least one tendon activating said degree of freedom is a pair of tendons. At least one said tendon is designed to slide over at least a part of the articulation device while contacting at least a part of the articulation device to actuate said degree of freedom, preferably said The degree is a rotational joint. The degree of freedom may be a "snake" type joint and/or a vertebral joint. The articulating device may have multiple degrees of freedom. To actuate the degrees of freedom, at least one of the tendons slides in contact with at least a portion of the articulation device.

According to one embodiment, the at least part of the articulation device on which the at least one tendon slides in contact is a convexity formed by a plurality of linear generatrixes parallel to the axis of the revolute joint. It is formed by a linear weave surface. According to one embodiment, the at least part of the joint device on which the at least one tendon slides while in contact is a convexity formed by a plurality of linear generatrixes orthogonal to the axis of the revolute joint. It is formed by a linear weave surface.

According to one embodiment, said at least one tendon is constituted by strands, for example strands loosened from each other. The strands may be constituted by the polymer fibers. The strands, also called yarns, can have a round cross-section, for example a circular or oval cross-section, and/or a flat cross-section with rounded edges. The strands may have different dimensions/sizes, for example different cross-sectional dimensions such as diameters. According to one embodiment, all strands may be substantially similar.

According to one embodiment, at least one of the tendons is knitted with a pick-per-inch (PPI) generally ranging from 3 to 100. A locally relatively high PPI can increase the local stiffness of a braided tendon. Different parts of the braided tendon can have different PPIs, which can result in localized stiffness variations.

According to one embodiment, at least one tendon is knitted with a PPI ranging from 20 to 60. In other words, the tendons are knitted from polymer fibers with a PPI of 20 to 60.

Preferably, the PPI of at least one said tendon is higher in at least one tendon distal portion, said distal portion being located near the end of said tendon along the length of the tendon; The distal portion includes a distal end. According to one embodiment, the distal portion with higher PPI has a length of no more than 1/3 of the length of the tendon, preferably no more than 1/10 of the length of the tendon. More preferably, the length is 1/20 or less of the length of the tendon.

Preferably, at least one said tendon has an elastic module between 50 GPa and 100 GPa. The stiffness of the tendon can vary along the length of the tendon, which can result in localized stiffness changes.

According to one embodiment, the articulation device comprises a tendon fixation point to which the tendon ends of each tendon are connected, the frame comprises a shaft, and at least one said tendon is arranged near or at the tendon fixation point. At least one of the tendons is more flexible near or within the shaft. At least one said tendon distal portion is preferably braided with a PPI in the range of 25 to 100, more preferably with a PPI in the range of 50 to 100. According to one embodiment, the at least one tendon further includes a proximal end and a longitudinal portion between the ends. The longitudinal portion of the tendon may be braided with a PPI ranging from 3 to 30.

Preferably, at least one said tendon has a radius of curvature of 1 mm or less.

According to one embodiment, at least one said tendon has variable cross-sectional dimensions, e.g. a variable diameter, in different parts of the tendon. According to one embodiment, at least one tendon is thinner at said tendon end and at least one tendon is thicker at said longitudinal section.

According to one embodiment, at least one said tendon has a diameter between 0.05 mm and 0.3 mm.

According to one embodiment, at least one said tendon has a variable composition in different parts thereof.

According to one embodiment, at least one said tendon has a core and a jacket. The jacket can be made of braided polymer strands. According to one embodiment, the core is also made of braided polymer strands. The polymer used to construct the braid may be polyethylene (PE). The polymer used to construct the braid may be ultra high molecular weight polyethylene (UHMWPE). According to one embodiment, the core is not braided and the jacket is braided. According to one embodiment, the jacket is not braided, the core is braided, and the jacket is in the form of a coating, preferably a chemical coating, polydimethylsiloxane (PDMS) and/or polytetrafluoroethylene ( Made of PTFE). The braided jacket can have a PPI ranging from 25 to 100. According to one embodiment, the braided core has a PPI in the range of 3 to 30. According to one embodiment, the strands of the braided jacket have a cross-sectional dimension, for example a diameter, that is smaller than the cross-sectional dimension, for example a diameter, of the strands of the braided core. According to one embodiment, the strands of the braided jacket have a lower linear density than the strands of the braided core. According to one embodiment, said jacket is braided and further comprises a coating made of PDMS and/or PTFE, preferably a chemical coating, and the core may be braided.

Preferably, said convex filament surface is made integral with the links of the articulation device. The articulation device preferably does not include a sheath, groove or channel for guiding the at least one tendon. Thereby, said tendon does not form a Bowden cable since it is not received within the sheath; on the contrary, the tendon does not form a Bowden cable on one or more of the convex filamentous surfaces of the links of the articulating device. slide to activate the degree of freedom of the articulation device.

The terminal end of the tendon is preferably secured by a knot formed by the tendon itself, this knot being located at said tendon securing point of the articulating device. When the link of the articulation device has a winding surface, the tendon wraps around said winding surface and the knot is located on said winding surface, for example, the knot is placed on said winding surface. In forming the knot, heating can be applied to locally melt the material of the surface portions of the tendons in relative contact at the knot, thereby promoting adhesion of said surface portions of the tendons in relative contact at the knot. be able to.

At least one said tendon may be made of a material that is less hard than the material of the articulation device, in other words softer than the material of the articulation device.

The solution described in the present invention is a joint medical device comprising tendons made of polymer fibers, which allows a minimal bending radius along with very low friction and can allow extreme miniaturization. .

With the advantage of being highly miniaturized in size and diameter, polymeric tendons can have the disadvantages of creep, low stiffness, limited abrasion resistance, and insufficient terminal strength.

The present invention reports a list of fibers and materials suitable for low friction, small bend radius, and high stiffness polymer tendons, such as PE, UHMWPE, PBO, or Zylon®, Vectran.

In particular, the present invention presents different designs of multi-strand polymer tendons. The tendon according to the invention maximizes stiffness, reduces tangles and provides very good wear resistance without affecting low friction properties and flexibility, making it possible to reduce the size of joint medical instruments. It is ideal for

Further characteristics and advantages of the invention will become apparent from the following description of preferred embodiments, given by way of example and not by way of limitation, and with reference to the accompanying drawings, in which: FIG.

1 is a perspective view of a surgical robot assembly according to one aspect of the present invention. FIG. 1 is a perspective view of a surgical robot assembly according to one aspect of the present invention. FIG. 1 is a perspective view of a surgical robot assembly according to one aspect of the present invention. FIG. 1 is a perspective view of a surgical robot assembly according to an aspect of the present invention associated with other elements of an operating room; FIG. 1 is a front view of a surgical robot assembly according to an aspect of the present invention associated with other elements of an operating room; FIG. 1 is a perspective view of a portion of a pair of joints or a multi-joint device according to one aspect of the present invention. FIG. FIG. 3 is a top view of a portion of a surgical robotic assembly according to an aspect of the present invention in association with other elements of an operating room and a patient. FIG. 3 is a top view of a portion of a surgical robot assembly in accordance with an aspect of the present invention in association with other elements of an operating room and a patient. 1 is a perspective view of a portion of a surgical robot assembly according to an aspect of the present invention associated with other elements of an operating room and a patient; FIG. 1 is a perspective view of a portion of a surgical robot assembly according to an aspect of the present invention in association with other elements of an operating room, a surgeon, and a patient; FIG. FIG. 1 is a perspective view showing a control device according to one embodiment of the present invention. FIG. 2 is a perspective view showing a macro positioning arm according to one aspect of the present invention. 1 is a perspective view of a portion of a robot assembly according to one aspect of the present invention. FIG. 1 is a perspective view of a portion of a robot assembly according to one aspect of the present invention. FIG. 1 is a perspective view of a portion of a robot assembly according to an aspect of the present invention associated with a microscope; FIG. 1 is a perspective view of a portion of a robotic assembly in accordance with an aspect of the present invention associated with an endoscope; FIG. 9C is an enlarged view of the detail indicated by arrows EE in FIG. 9C; FIG. 1 is a perspective view of a portion of a robot assembly according to one aspect of the present invention. FIG. FIG. 1 is a perspective view showing a medical device according to one aspect of the present invention. 1 is a perspective view of a medical device according to one aspect of the present invention, showing individual components. FIG. 1 is a perspective view of a portion of a drive system according to one aspect of the invention; FIG. 1 is a perspective view of a portion of a drive system according to one aspect of the invention; FIG. 1 is a schematic cross-sectional view of a portion of a drive system according to one aspect of the invention. FIG. 1 is a schematic cross-sectional view of a portion of a drive system according to one aspect of the invention. FIG. FIG. 1 is a perspective view showing a medical device according to one aspect of the present invention. FIG. 1 is a perspective view showing a medical device according to one aspect of the present invention. FIG. 1 is a schematic perspective view showing a medical device according to one aspect of the present invention. FIG. 1 is a schematic perspective view showing a medical device according to one aspect of the present invention. 1 is a diagram illustrating a portion of a medical instrument for robotic surgery according to one aspect of the present invention. 1 is a diagram illustrating a portion of a medical instrument for robotic surgery according to one aspect of the present invention. 1 is a schematic top view with partially transparent portions showing the tendon paths of two tendons according to one aspect of the present invention; FIG. FIG. 1 is a perspective view of a multi-joint device according to one aspect of the present invention. 1 is a perspective view of one form with separated parts of several embodiments of an articulated device according to some aspects of the present invention; FIG. FIG. 3 is a perspective view of another form with separated parts of some embodiments of an articulated device in accordance with some aspects of the present invention. FIG. 4 is a perspective view of yet another form with separate parts of some embodiments of an articulated device in accordance with some aspects of the present invention. FIG. 1 is a side view of a multi-joint device according to one aspect of the present invention. FIG. 3 is a diagram illustrating one form of several postures of some embodiments of an articulated device according to some aspects of the present invention. FIGS. 3A and 3B illustrate alternative configurations of several postures of several embodiments of articulated devices in accordance with aspects of the present invention; FIG. FIGS. 3A and 3B illustrate further configurations of several postures of several embodiments of articulated devices according to some aspects of the present invention; FIG. FIG. 3 illustrates one form of several embodiments of termination devices in accordance with some aspects of the present invention. FIG. 3 illustrates another form of some embodiments of termination devices in accordance with some aspects of the present invention. FIG. 6 illustrates yet another form of some embodiments of termination devices in accordance with some aspects of the present invention. FIG. 2 is a perspective view showing details of a tendon according to one aspect of the present invention. FIG. 2 is a perspective view showing details of a tendon according to one aspect of the present invention. FIG. 2 is a perspective view showing details of a tendon according to one aspect of the present invention. FIG. 2 is a schematic diagram of one form illustrating the course of tendons according to some aspects of the invention. FIG. 4 is a schematic diagram of another form showing the course of tendons according to some aspects of the invention. FIG. 6 is a schematic diagram of yet another form showing the course of tendons according to some embodiments of the present invention. FIG. 4 is a schematic diagram of another form showing the path of a tendon according to some aspects of the present invention. FIG. 3 is a schematic diagram of another alternative form showing the course of tendons according to some aspects of the present invention. FIG. 6 is a schematic diagram of yet another form showing the course of tendons according to some embodiments of the present invention. FIG. 1 is a schematic perspective view showing a processing jig according to one embodiment of the present invention. FIG. 3 is a schematic diagram showing a profile of a processed cutting portion according to one aspect of the present invention. 1 is a schematic perspective view showing one process of a manufacturing method according to one embodiment of the present invention. FIG. 2 is a plan view showing details of a processing jig according to one embodiment of the present invention. FIG. 2 is a perspective view showing details of a processing jig according to one embodiment of the present invention. 1 is a schematic perspective view showing one process of a manufacturing method according to one embodiment of the present invention. FIG. 1 is a front view of a tool according to one aspect of the present invention. 1 is a perspective view of a tendon with a jacket and a core, according to one embodiment. FIG. 1 is a schematic diagram of a tendon according to one embodiment. FIG. FIG. 3 is a schematic illustration of the distal end of a tendon according to one embodiment.

According to one embodiment, the term "tendon" or "actuation cable" refers to an element exhibiting generally longitudinal extension and suitable for acting under a tensile load applied at its terminal end. According to one embodiment, the term "opposing tendon" or "opposing actuating cable" refers to a further tendon that is suitable to act in an antagonistic manner to said tendon. According to one embodiment, in the accompanying drawings said tendon is generally designated by the reference number "90" and said opposing tendon is designated by the reference number 100 plus, ie, "190". Nevertheless, in figures where the distinction between said tendon and said opposite tendon is not important, said tendon and said opposite tendon are both designated by the reference numeral 90. According to one embodiment, the concept of "opposed" extends to multiple elements and/or parts of elements, to refer to the above-mentioned "tendons". According to one embodiment, the tendons included in the first pair of tendons are designated with the reference number "90, 190" and the tendons belonging to the second pair of tendons are designated with the reference number "191, 192". It will be done.

According to one embodiment, the terms "master/slave", "master", and "slave" refer to known systems of remote control.

According to one embodiment, the term "terminal" refers to a part suitable for performing an assigned task, for example forming a point of contact with at least a part of a patient. For example, in a master/slave remote control system, the termination, termination section, or termination member is at least a portion of an "end-effector."

According to one embodiment, the term "joint or articulated device" refers to a wrist, elbow, or shoulder joint of a robotic or mechatronic structure. In other words, it refers to an interconnected assembly of members and articulations suitable for supporting and/or orienting and/or positioning and/or influencing the position of said termination.

According to one embodiment, the members of the joint or articulated device are designated by the progressive designation "first member," "second member," etc. to indicate their position in the kinetic chain; ” indicates the most proximal member; in other words, “first member” indicates the most distal member from the end organ. According to one embodiment, members of the articulation device are designated with the terms "wrist member," "elbow member," or "terminal member" to indicate the function performed by said member. For example, the same member can be a "second member" and a "wrist member" at the same time.

According to one embodiment, the term "work volume," or "workspace," or "worksite," or "workspace volume" refers to the set of Cartesian poses accessible to the terminal end of a joint or articulated device. refers to According to one embodiment, the volume is approximately rectangular in shape. According to one embodiment, the working volume is substantially cylindrical.

According to one embodiment, the term "macropositioning" refers to the initial operation of positioning at least a portion of a medical device from any location to a working location within or adjacent to a surgical site. In other words, "macro positioning" refers to the act of matching the working volume to the operational field.

According to one embodiment, the term "micropositioning" refers to an act of positioning at least a portion of a medical device more finely than "macropositioning." According to one embodiment, the micro-positioning is performed in a more confined space, in real time and under the direct control of a control device (master).

According to one embodiment, the prefix "micro" before an object indicates that said object is meant to operate primarily, but not exclusively, on a sub-millimeter scale.

According to one embodiment, the term "revolute joint" refers to an articulation between two elements suitable for allowing a relative rotational moment between said two elements about an axis of joint movement. .

According to one embodiment, the term "medical instrument" refers to an instrument suitable for use during at least one course of medical surgical and/or cosmetic therapy. According to one embodiment, the term "surgical instrument" refers to a medical instrument particularly suitable for use in general in at least one course of surgical therapy. According to one embodiment, the term "microsurgical instrument" or "surgical microinstrument" refers to a medical instrument particularly suitable for use in at least one course of microsurgical therapy.

According to one embodiment, the term "frame" refers to a portion of a medical device that is primarily suitable for having a structural retention function. According to one embodiment, the "frame" may include at least one shaft that is an elongated rigid or flexible element exhibiting primarily longitudinal extension. According to one embodiment, the shaft may be hollow and/or tubular, for example.

According to one embodiment, the term "textured surface" refers to a surface achieved by the combination of a plurality of straight lines. According to one embodiment, unless specified otherwise, the term "linear surface" refers to a surface achieved by the combination of a plurality of straight lines that are substantially parallel to each other, in other words substantially parallel generators. (also called) refers to the line-woven surface.

In the following, when referring to devices or assemblies or methods for microsurgery, devices, assemblies, or assemblies suitable for application in microsurgery, i.e. operations in which optical magnifying means such as loupes or microscopes are used simultaneously; or a method, but also means a device, assembly, or method suitable for use in other surgical therapies, such as general surgery, laparoscopic surgery, or endoscopic surgery.

According to one embodiment, when referring to a "first" or "second" element (e.g., "first micro-positioning device" and "second micro-positioning device"), reference to the original text or drawings may be made. To ensure that these terms are functionally indistinguishable, they will be designated by the same reference number (e.g. "41" above) and, where clarity is sometimes required, the reference number will be designated in increments of 100. (e.g. "141" and "241" above), and thus, for example, the reference number "41" refers to the "first micro-positioning device" and the "second micro-positioning device" as well as the "third" micro-positioning device. A positioning device is shown. When a specific reference number is used, for example "141", this refers to a specific element, in this case "first micro-positioning device". Similarly, to avoid unduly burdening the text, reference numbers associated with "opposing" elements are omitted when the element is functionally indistinguishable from its counterpart.

According to a general embodiment, the surgical medical instrument 60, 160, 260, 360 comprises at least one frame 57 and at least one articulation device 70, 170, 270.

The joint devices 70, 170, 270 include:
at least one first articulation member 71 or first link 71 adapted to connect to at least a portion of said frame 57;
at least one second articulation member 72 or second link 72;
Equipped with

The first joint member 71 is connected to the second joint member 72 by a rotary joint 171.

The medical device 60, 160, 260, 360 includes at least one pair of tendons 90 adapted to move the second articulation member 72 relative to the first articulation member 71 by pulling on the tendons; 190. Said tendons serve as actuation cables suitable for traction only.

Each of said first articulation member 71 and said second articulation member 72 has a main structure having one or more convex contact surfaces 40, 80, 86, 140, 180 configured in a single piece. Including the body.

Each of the convex contact surfaces 40, 80, 86, 140, and 180 is a linear surface formed by a plurality of straight portions, and the plurality of straight portions are all parallel to each other and substantially parallel to each other. It is parallel to the first joint movement axis (PP, YY).

According to one embodiment, all said convex contact surfaces 40, 80, 86, 140, 180 at least partially define in their extension a single convex volume, in other words a single convex volume. An extension of said convex contact surface 40, 80, 86, 140, 180 of one main structure defines a convex volume with said contact surface 40, 80, 86, 140, 180. According to one embodiment, the expression "convex volume" means that, given a pair of points selected within said convex volume, the shorter linear connection between them is entirely within said convex volume. means that it is in This avoids providing grooves or channels in the pulleys for guiding the tendons and allows the dimensions of the main structure and articulation device to be miniaturized. According to one embodiment, the convex contact surfaces 40, 80, 86, 140, 180 of all the main structures define with their extension a convex hill of the main structure. .

According to one embodiment, the two tendons of said pair of tendons 90, 190 are parallel to each other and abut the same convex contact surface 40, 80, 86, 140, 180.

According to one embodiment, each tendon of said pair of tendons 90, 190 has a first tendon termination 91 associated with said frame 57 and a second tendon fixed to said second articulation member 72. a terminal end 92 and a main portion extending between the first tendon terminal end 91 and the second terminal end 92.

The main portion of each tendon of a pair of tendons 90, 190 contacts the articulation device 70, 170, 270 only on the convex contact surface 40, 80, 86, 140, 180.

According to one embodiment, the contact surfaces 40, 80, 86, 140, 180 are all parallel to each other and the joint movement axis P of the revolute joint 171 is closer to the contact surfaces 40, 80, 86, 140, 180. -P, YY is a linear surface formed by a plurality of straight line sections substantially parallel to YY.

According to one embodiment, said contact surface 40, 80, 86, 140, 180 is a sliding surface 40, 80, 140, 180 or a winding surface 86.

According to one embodiment, said sliding surfaces 40 , 80 , 140 , 180 are adapted to allow said articulation device 70 to slide said at least one tendon portion in the air or out of contact with said articulation device 70 . 70, 170, 270, or said sliding surface 40, 80, 140, 180 is a joint sliding surface 80, 180 that at least partially surrounds the joint axis of movement It is.

According to one embodiment, on the joint sliding surface 80, 180, the two or more tendons 90, 190 are at least partially in a plane orthogonal to the direction of the joint movement axis of the revolute joint 171 that is closer to the joint sliding surface 80, 180. Overlap.

According to one embodiment, at least two tendons of said at least two pairs of tendons 90, 190, 191, 192 are in contact with the same convex contact surface 40, 80, 86, 140, 180 and are parallel to each other. It is. According to one embodiment, two tendons of said pair of tendons are parallel to each other over the length of their tendon paths, and both tendons are connected to said first articulation member 71 and to said second articulation member 71. It abuts the same convex contact surfaces 40, 80, 140, 180 with member 72.

According to one embodiment, said pair of tendons connected to the same articulation member abut the same convex contact surface 40, 80, 86, 140, 180.

According to one embodiment, the main structure is a rigid body.

According to one embodiment, the medical device 60, 160, 260, 360 further includes a pair of tendons, including at least a third pair of tendons.

According to one embodiment, said convex contact surface 40, 80, 86, 140, 180 is a sliding surface 40, 80, 140, 180 on which said tendon substantially slides. Alternatively, the convex contact surface 40, 80, 86, 140, 180 is a winding surface 86 around which the tendon substantially wraps around itself without sliding.

According to one embodiment, the projection of the tendon path TT of the first tendon of said two pairs of tendons 90, 190, 191, 192 and the second tendon of said tendons (90, 190) of the same pair. The projections of the tendon paths TT intersect with each other in a plane perpendicular to the direction of the joint movement axis 171.

According to one embodiment, the medical device 60, 160, 260, 360 includes a pair of tendons 90, 190 for each articulation member 71, 72 or 77.

According to one embodiment, said contact surface 40, 80, 86, 140, 180 at least partially defines a convex hull of the articulation member 71, 72, 77 or 78.

According to one embodiment, each tendon 90, 190 defines a tendon path TT that maintains steady state relative to the articulation member 71, 72, 77 or 78 that is closer to that tendon.

According to a general embodiment, the medical device 60, 160, 260, 360 includes:
At least the joint members 71, 72, 73, 74 of the joint device 70,
a frame 57 including a shaft 65;
tendons 90, 190 suitable for moving the articulation members 71, 72, 73, 74 relative to the frame 57;
a plunger 96 movable along a degree of freedom relative to the frame 57, in contact with the tendons 90, 190 and suitable for actuating the tendons 90, 190;
a pressing element 95 movable along a linear trajectory and including an actuator;
a sterility barrier 87 disposed between said pusher element 95 and said plunger 96, said sterility barrier 87 being adapted to substantially prevent cross-bacterial contamination of two environments separated thereby; sterile barrier 87,
The plunger 96 is movable away from the sterile barrier 87 and/or the pushing element 95, and the pushing element 95 moves the plunger 96 by pushing the sterile barrier 87 into contact with the plunger 96. let

According to one embodiment, the pressing element 95 presses the plunger 96 in the inward pressing direction of the frame 57 and moves the plunger 96 along the degree of freedom of the plunger 96 relative to the frame 57 .

According to one embodiment, the pressing element 95 always exchanges a force with the plunger 96 in the pressing direction. In other words, the pressing element 95 is not suitable for exchanging tension with the plunger 96, ie, the pressing element 95 cannot pull the plunger 96.

According to one embodiment, the pressing element 95 includes a lead screw and nut type actuator.

According to one embodiment, the actuator includes a ball screw.

According to one embodiment, said pressing element 95 includes a piston.

According to one embodiment, said plunger 96 comprises a plunger first part 145 suitable for contacting said pressing element 95 and a plunger second part 146 suitable for contacting said tendons 90, 190. It has two parts.

According to one embodiment, the first part 145 of the plunger is exposed from the frame 57 so as to be pressed by the pressing element 95.

According to one embodiment, the first part 145 of the plunger extends outside the frame 57 so as to be accessible by the pressing element 95.

According to one embodiment, the first part 145 of the plunger is flush with the frame 57 so as to be accessible by the pressing element 95.

According to one embodiment, the first part 145 of the plunger includes a pressing surface 147 suitable for engaging the pressing element 95.

According to one embodiment, said pressing element 95 has a reciprocal pressing surface 148.

According to one embodiment, the pressing element 95 transmits a linear force via the reciprocal pressing surface 148 to press the plunger 96 .

According to one embodiment, said pressing element 95 comprises at least one pressing element idler pulley, not shown, suitable for pressing said pressing surface 147.

According to one embodiment, the pushing element 95 transmits a linear force via the one pushing element idle pulley to push the plunger 96.

According to one embodiment, the pressing surface 147 and the reciprocal pressing surface 148 are flat.

According to one embodiment, the pressing surface 147 and the reciprocal pressing surface 148 are curved surfaces that complement each other.

According to one embodiment, the pressing surface 147 and the reciprocal pressing surface 148 are sliding surfaces that slide relative to each other when the pressing element 95 moves along a linear trajectory.

According to one embodiment, said second portion of plunger 96 contacts said tendons 90, 190.

According to one embodiment, the medical device 60, 160, 260, 360 includes at least one tensioning element 99 suitable for preloading the tendon 90.

According to one embodiment, said tensioning element 99 is a spring.

According to one embodiment, the tensioning element 99 is suitable for applying a force between the frame 57 and the plunger 96 in the direction of moving the plunger 96 so as to preload the tendon 90. .

According to one embodiment, said tensioning element 99 is suitable for applying a force between frame 57 and plunger 96 in the direction of moving said plunger 96 away from said pressing element 95 .

According to one embodiment, the tensioning element 99 is suitable for applying a force between the frame 57 and the plunger 96 in the direction of moving the plunger 96 towards the interior of the frame 57.

According to one embodiment, the preload is substantially proportional to the compression movement of the spring 99.

According to one embodiment, the second portion 146 of the plunger pushes against at least one tendon deflectable portion 93 of the tendon 90.

According to one embodiment, the tendon deflectable portion 93 of the tendon 90 extends from a first guide pulley 197 and a second guide pulley 297.

According to one embodiment, the second part 146 of the plunger moves into a space provided between the first guide pulley 197 and the second guide pulley 297.

According to one embodiment, the plunger 96 moves between the first guide pulley 197 and the second guide pulley 297 in an amount that is linearly proportional to the movement of the plunger 96 along the degrees of freedom of the plunger 96 relative to the frame 57. The path length of the tendon 90 between the two terminals is changed.

According to one embodiment, the second part 146 of the plunger includes at least one plunger idler pulley 98 suitable for pushing the tendon deflectable part 93.

According to one embodiment, said tendon 90 has a first tendon end 91 fixed to said articulation member 71, 72, 73, 74.

According to one embodiment, said tendon 90 has a second tendon end 91 fixed to said frame 57.

According to one embodiment, the first tendon end 91 is fixed to the second part 146 of the plunger instead of the frame 57.

According to one embodiment, the frame 57 includes an upper frame part 58 and a lower frame part 59, the latter including a shaft 65.

According to one embodiment, the plunger 96 is movable along the degrees of freedom relative to the frame 57.

According to one embodiment, the plunger 96 is joined to the upper frame portion 58 with a linear joint.

According to one embodiment, the plunger 96 is joined to the lower frame portion 58 by a revolute joint (not shown).

According to one embodiment, the plunger 96 moves linearly along a degree of freedom relative to the frame 57.

According to one embodiment, the plunger 96 is maintained in proper alignment by a linear bushing (not shown) inserted into the first frame portion 58.

According to one embodiment, the plungers 96 are maintained in proper alignment with the upper frame 58 by respective shoulders 88.

According to one embodiment, the plunger 96 is a rocker that rotates about the pivot axis of the frame 57.

According to one embodiment, the sterility barrier 87 has a shape and material suitable for transmitting the pressure of the pressure element 95 to the plunger 96.

According to one embodiment, the sterility barrier 87 is a flexible continuous layer of material.

According to one embodiment, said sterile barrier 87 is between said pressing elements 95.

According to one embodiment, the sterile barrier 87 is incorporated between the pressing surface 147 and the reciprocal pressing surface 148.

According to one embodiment, the medical device 60, 160, 260, 360 includes a plurality of tendons 90, a plurality of pairs of plungers 96, and an associated pusher element 95.

According to one embodiment, the sterility barrier 87 is a flexible continuous layer of material.

According to one embodiment, said sterility barrier 87 is incorporated between each plunger 96 and the associated pressing element 95.

According to one embodiment, the sterility barrier 87 is made of a stretchable material that stretches as the plunger 96 moves relative to the frame 57, substantially controlling the movement of the plunger 96. exert an unhindering force on the target.

According to one embodiment, said sterile barrier 87 is a drape.

According to one embodiment, the sterility barrier 87 is a loose-fitting drape that stretches as the plunger 96 moves relative to the frame 57, substantially controlling the movement of the plunger 96. exert an unhindering force on the target.

Providing a pressing element 95 of a medical device 60, 160, 260, 360 according to an aspect of the invention suitable for moving a joining device across a sterile barrier allows for the production of a reliable and sterile medical device. becomes.

By providing a plunger 96 of a medical device 60, 160, 260, 360 in accordance with one aspect of the present invention, a convenient sterility barrier in the form of a drape or continuous flexible sheet material can be utilized.

By providing a plunger 96 of a medical device 60, 160, 260, 360 according to an aspect of the present invention, it is possible to increase the accuracy of commanded movements using a pushing element with a high precision linear actuator. be.

Providing a plunger 96 of a medical device 60, 160, 260, 360 according to an aspect of the invention allows a sterility barrier 87 to be external to the frame and protect tendons 90 within the frame 57. is possible.

Providing a plunger 96 of a medical device 60, 160, 260, 360 according to an aspect of the invention provides tensioning of the tendon 90, 190 for positioning any articulation member 71 of the articulation device 70. Is possible.

By providing the plunger 96 of the medical device 60, 160, 260, 360 according to one aspect of the present invention, any change in direction of operation is avoided by utilizing a continuous pressing operation of the pressing element on the plunger. Therefore, it is possible to avoid the effects of idle motion and backlash associated with changes in direction of motion.

By providing a sterility barrier 87 of a medical device 60, 160, 260, 360 according to an aspect of the invention, it is possible to provide a sterility barrier that is not attached to a pusher element and therefore is easy for surgical staff to deploy. It's easier.

According to one embodiment, said pressing element 95 includes a sensor 150.

According to one embodiment, said pressing element 95 includes a sensor 150 suitable for detecting contact between said pressing element 95 and said plunger 96 through said sterility barrier 87 .

According to one embodiment, said pressing element 95 includes a force sensor 151 suitable for measuring the pressing force exchanged between said pressing element 95 and plunger 96 via said sterile barrier 87 .

According to one embodiment, the force sensor 151 is a uniaxial load sensor that measures the component of the pressing force along the linear trajectory of the movement of the pressing element 95.

According to one embodiment, said pushing element 95 includes a pressure sensor 152 suitable for measuring the pressure exchanged between said pushing element 95 and plunger 96 via said sterility barrier 87 .

According to one embodiment, the pressure sensor 152 is a thin film pressure sensor glued to the reciprocal pressing surface 148 of the pressing element 95.

According to one embodiment, said pressing element 95 includes a non-contact proximity sensor 153 suitable for measuring the distance between said reciprocal pressing surface 148 and pressing surface 147 via said sterile barrier 87 .

Providing a pressure element 95 of a medical device 60, 160, 260, 360 according to an aspect of the invention provides a reliable and sterile medical device, as it is suitable for moving an articulating device across a sterile barrier. manufacturing becomes possible.

Providing a sensor 150 of a medical device 60, 160, 260, 360 according to an aspect of the present invention allows for sensing associated with the interaction between the articular device 70 and the human body of the patient 201 through a sterile barrier. It is possible to detect the amount of

By providing a sensor 150 of a medical device 60, 160, 260, 360 according to an aspect of the invention, it is possible to detect contact between said pushing element 95 and plunger 96 through a sterile barrier.

By providing the sensor 150 of the medical device 60, 160, 260, 360 according to an aspect of the present invention, it is possible to sense the pressing force associated with the tension of the tendon 90, 190 through the sterile barrier.

According to a general embodiment, the robotic surgical assembly 100 includes at least one medical instrument 60, 160, 260, 360 according to any one of the embodiments described above.

According to one aspect of the invention, surgical robot assembly 100 includes:
at least one micro-positioning device 41, 141, 241, 341 having multiple degrees of freedom of at least translational movement;
at least one of the medical instruments 60 having one joint device 70 or a multi-joint device 70 having multiple rotational degrees of freedom;
Equipped with

The medical instrument 60 is connected in series to the micro-positioning device 41 such that the articulated device 70 reaches a predetermined position in the working volume 7 with its terminal end 77 .

According to one embodiment, the robot assembly 100 includes a support 104 and at least one macro-positioning arm 30 connected to the support 104, with respect to the support 104, the macro-positioning arm 30 is configured to perform macro-positioning. provides multiple degrees of freedom.

According to one embodiment, the micro-positioning devices 41, 141, 241 and 341 are connected to the macro-positioning arm 30 in cascade, ie in series.

By providing a kinematic chain comprising a macro-positioning arm 30 connected in series to at least one micro-positioning device 41 , comprising a plurality of degrees of freedom of at least translational movement connected in series to a medical instrument 60 , said working volume 7 It becomes possible to separate the translational positioning movements of the terminal end 77 of the medical instrument 60 within the working volume 7 and the directional positioning movements of the terminal end 77 of the medical instrument 60 within the working volume 7 .

According to one embodiment, the micro-positioning device 41 has only translational freedom.

According to one embodiment, said micro-positioning device 41 is a Cartesian motion mechanism suitable for determining translational movements along at least two mutually orthogonal directions. According to one embodiment, said micro-positioning device 41 is a Cartesian motion mechanism suitable for determining translational movements along at least three mutually orthogonal directions.

According to one embodiment, said micro-positioning device 41 has an XYZ Cartesian movement mechanism and a further rotational degree of freedom, said rotational degree of freedom substantially coinciding with the longitudinal direction in which the medical device is deployed. The axis of rotation is the center of rotation.

According to one embodiment, the at least one medical device 60, including one articulation device 70, has multiple rotational only degrees of freedom.

According to one embodiment, the robotic surgical assembly 100 includes further micro-positioning devices 41, including at least a first micro-positioning device 141 and a second micro-positioning device 241.

According to one embodiment, said at least two micro-positioning devices 141, 241 are arranged parallel to each other. According to one embodiment, the at least two micro-positioning devices are juxtaposed to move one medical instrument on the right side and one medical instrument on the left side.

According to one embodiment, the surgical robot assembly 100 has a first medical instrument 160 connected in cascade or series to the micro-positioning device 141 and a first medical instrument 160 connected in cascade or series to the second micro-positioning device 241. At least a second medical device 260 is provided.

According to one embodiment, the first medical device 160 comprises one articulation device 170 and the second medical device comprises a second articulation device 270.

According to one embodiment, said second micro-positioning device 141 and said second micro-positioning device 241 are arranged such that the respective terminal end 77 of each articulation device 70 is located in a respective working volume 7 which necessarily at least partially overlaps. arranged to reach.

The provision of at least partially overlapping working volumes 7 allows surgery in situations where at least two medical instruments are utilized on a single part of the patient.

According to one embodiment, said at least two medical instruments 160, 260 are arranged parallel to each other.

According to one embodiment, said respective working volumes 7 substantially coincide.

According to one embodiment, said macro-positioning arm 30 comprises at least one support member 38 having at least one attachment mechanism 39 suitable for holding at least a part of at least one micro-positioning device 41 .

According to one embodiment, the support member 38 is suitable for simultaneously carrying/receiving at least a portion of the first micro-positioning device 141 and at least a portion of the second micro-positioning device 241.

According to one embodiment, said support member 38 comprises at least one other attachment mechanism 39 , such that said support member 38 has at least three attachment mechanisms 39 , said further attachment mechanism 39 being at least one of the further micro-positioning devices 41 . Suitable for holding parts.

According to one embodiment, the robot assembly 100 comprises at least three micro-positioning devices 41, 141, 241, 341.

According to one embodiment, the robot assembly 100 comprises at least three medical instruments 60, 160, 260, 360.

According to one embodiment, said three medical instruments 60, 160, 260, 360 are cascaded with a respective micro-positioning device 41, 141, 241, 341 of said at least three micro-positioning devices 41, 141, 241, 341. or arranged in series.

According to one embodiment, said first micro-positioning device 141, said second micro-positioning device 241 and said third micro-positioning device 341 are such that the end positions 77 of each articulation device 70 at least partially overlap. are arranged to reach each working volume.

According to one embodiment, said support member 38 includes at least three attachment mechanisms 39, each of which is suitable for holding at least a portion of a micro-positioning device 41.

According to one embodiment, the macro positioning arm 30 has three degrees of freedom.

According to one embodiment, the macro positioning arm 30 has five degrees of freedom, the five degrees of freedom being both translational and rotational.

According to one embodiment, the five degrees of freedom of the macro-positioning arm 30 include one substantially vertical translational movement, the first arm movement axis a-a, the second arm movement axis b-b , and three substantial rotational movements about the third arm movement axis cc, and at least one rotational movement about the fourth arm movement axis dd.

According to one embodiment, the axis of movement of the arm may be fixed or movable with respect to a common reference system.

According to one embodiment, the macro positioning arm 30 is a passive mechanism. In other words, according to one embodiment, said macro positioning arm 30 is manually moved by an operator.

According to one embodiment, said macro-positioning arm 30 has six degrees of freedom, at least one of which is rotational movement. Providing this property allows for the creation of active humanoid robots, as shown in the non-limiting example of FIG. 1C. According to one embodiment, the macro-positioning arm 30 is an active humanoid robot. In other words, according to one embodiment, the macro positioning arm is moved by a motorized system including a stepper motor or a servomotor.

According to an alternative embodiment, said macro-positioning arm 30 is a passive humanoid robot.

According to one embodiment, the macro-positioning arm 30 has a radius of travel of 650 mm.

According to one embodiment, the macro positioning arm 30 comprises:
one first arm member 31 connected to the support 104 and movable relative to the support 104 along a linear slide guide 36;
a second arm member 32 connected to the first arm member 31 around a first arm movement axis aa;
including.

The first arm member 31 is movable relative to said support 104 along a linear slide guide 36, thereby allowing up and down movement toward or away from the field of operation.

According to one embodiment, the macro positioning arm 30 is connected to a second arm member 32 and is movable relative to the second arm member 32 about a second arm movement axis bb. It further includes a third arm member 33.

According to one embodiment, the macro positioning arm 30 is connected to the third arm member 33 and is movable relative to the third arm member 33 about a third arm movement axis cc. It further includes a fourth arm member 34 .

According to one embodiment, said macro positioning arm 30 further comprises at least one rotating dial nut 43, said dial nut being movable about a fourth arm movement axis dd, said supporting member 38 about the fourth arm movement axis dd.

According to one embodiment, the five degrees of freedom of the macro-positioning arm 30 include one substantially vertical translational movement, the first axis of movement a-a, the second axis of movement bb; three substantial rotational movements about the third axis of movement cc and at least one rotational movement about the fourth axis of arm movement dd.

According to one embodiment, the rotary dial nut 43 includes a click stop or discontinuous movement mechanism that defines a preset displacement.

According to one embodiment, a reduction in the transmission of rotational movement occurs between the rotary dial nut 43 and the support member 38. In other words, a large angular movement of the rotary dial nut corresponds to a small angular movement of the support member 38, similar to a camera objective.

By providing the support member 38 to be movable by rotational movement about the fourth arm movement axis dd, the at least one medical device 60 associated with the macro-positioning arm 30 can be moved. The terminal end 77 is placed at a predetermined location on the patient 201 at a preferred angle between the instrument shaft and the anatomical plane, steep or shallow to facilitate suturing on different anatomical planes. It is possible to bring them close together.

According to one embodiment, said rotating dial nut 43 includes at least one knurled handle. This provides finer control.

According to one embodiment, the first arm movement axis aa, the second arm movement axis bb and the third arm movement axis cc are substantially parallel to each other.

According to one embodiment, said fourth arm movement axis dd is substantially orthogonal to said third arm movement axis cc.

According to one embodiment, a manual knob 37 operating a rack and pinion mechanism controls the movement of the first arm member 31 in the linear slide guide 36 by its rotational movement.

According to one embodiment, the macro positioning arm 30 includes the support 104, the first arm member 31, the second arm member 32, the third arm member 33, and the fourth arm member 34. at least one braking system suitable for resisting relative movement of at least two of the components.

According to one embodiment, the braking system includes at least one electromagnetic braking device.

According to one embodiment, said macro-positioning arm 30 comprises at least one release button 35 or unlocking button, which button can be switched between a brake (or lock) position and a release (or unlock) position. I can do it.

According to one embodiment, said braking system can be released by means of a release button 35.

According to one embodiment, said release button 35 can be switched between a brake position and a release position.

According to one embodiment, when the release button 35 is in its release position, the operator can move the macro-positioning arm 30 by moving at least one of the degrees of freedom of the macro-positioning arm 30. enable.

According to one embodiment, the release button 35, when in its release position, is able to release the braking system and the support 104 as well as the first arm member 31, the second arm member 32 , the third arm member 33, and the fourth arm member 34 can be simultaneously moved relative to each other.

According to one embodiment, said release button 35 is suitable for deactivating said stop system when in its release position, said first arm member 31, said second arm member 32; Simultaneous relative movement of the third arm member 33 and the fourth arm member 34 is enabled.

According to one embodiment, the release button 35 is suitable to be acted upon by pressure and is in the release position when it is pressed down and in the rest position when it is extended or not pressed down. It is in.

According to one embodiment, the robot assembly 100 includes:
the macro positioning arm 30 being passively movable by releasing the release system;
said at least one micro-positioning device 41 and said at least one articulated device 70 actively controlled by master-slave remote control from movement of said control instrument 21 when executed by a surgeon 200;
including.

According to one embodiment, said micro-positioning device 41, 141, 241 has three translational degrees of freedom.

According to one embodiment, said micro-positioning device 41, 141, 241 has four degrees of freedom, three of which are translational.

According to one embodiment, each micro-positioning device 41 includes a spherical joint 173, said spherical joint 173 being arranged in cascade or series upstream of each micro-positioning device 41.

According to one embodiment shown, for example, in FIG. 2B, each micro-positioning device 41, 141, 241 moves the medical device 60, 160 by moving the micro-positioning device 41, 141, 241 from its base, i.e., the most proximal portion. , 260 is provided with a spherical joint 173 suitable for changing the orientation of the components. According to one embodiment, the spherical joint 173 is a swivel joint that can be blocked.

According to one embodiment, the micro-positioning device 41 includes a first motorized slide 51, the first motorized slide 51 is arranged along a first slide rail 54 along a first slide direction ff. It is movable.

According to one embodiment, the micro-positioning device 41 includes a second motorized slide 52, which is arranged along a second slide rail 55 along a second slide direction gg. It is movable.

According to one embodiment, the micro-positioning device 41 includes a third motorized slide 53 movable along a third slide rail 56 along a third slide direction hh.

According to one embodiment, said first sliding direction ff is substantially linear.

According to one embodiment, said second sliding direction gg is substantially linear.

According to one embodiment, said second sliding direction gg is substantially orthogonal to said first sliding direction ff.

According to one embodiment, said third sliding direction hh is substantially linear.

According to one embodiment, said third sliding direction hh is substantially orthogonal to said first sliding direction ff and said second sliding direction gg. According to one embodiment, said third sliding direction hh is aligned with the shaft 65.

According to one embodiment, said micro-positioning device 41 is suitable for working with a stepper motor or a servo motor. According to one embodiment, said micro-positioning device 41 is suitable for working with a piezoelectric motor or an ultrasonic motor.

According to one embodiment, at least one motorized slide 51, 52, 53 of the first, second and third motorized slides has a ball screw rotating relative to the respective slide rail 54, 55, 56. It is connected to the motor via a transmission mechanism that includes and is held by a nut. According to one embodiment, the nut is solid (i.e. integral) to at least one electric slide 51, 52, 53 of the first, second and third electric slide. It is something.

Providing a transmission mechanism that includes a preloaded ball or lead screw nut type connection improves control of movement into the motorized slide and reduces backlash.

According to one embodiment, at least one electric slide 51, 52, 53 of said first, second and third electric slide is connected to a motor by a transmission mechanism comprising a toothed belt.

According to one embodiment, the motorized slides 51, 52, 53 are precision microslides with a stroke of 1 cm to 10 cm and an accuracy within the range of 0.1 microns to 25 microns.

According to one embodiment, the motor is a servo motor. According to one embodiment, the motor is a stepper motor.

According to one embodiment, the medical instrument 60 includes a motorized rotational joint 46 suitable for moving the medical instrument 60 about a longitudinal axis of rotation rr.

According to one embodiment, the micro-positioning device 41 also includes a motorized rotational joint 46 suitable for moving the medical instrument 60 about a longitudinal axis of rotation rr.

According to one embodiment, the longitudinal axis of rotation rr substantially coincides with the longitudinal axis of telescopic deployment of the medical device 60, or with the instrument axis XX, or with the longitudinal axis XX of the shaft. do. According to one embodiment, the axial angle θ is between the axial direction XX of the shaft 65 of the first medical instrument 160 and the axial direction XX of the shaft 65 of the second medical instrument 260. defined as an angle.

According to one embodiment, the medical instrument 60 includes one articulated device 70 with two rotational degrees of freedom. According to one embodiment, the medical device 60 includes one articulated device 70 with two mutually orthogonal rotational degrees of freedom to form a joined wrist.

According to one embodiment, the medical device 60 includes an articulation device 70 having at least three degrees of freedom. According to one embodiment, said articulation device 70 has three rotational degrees of freedom, two of which are centered on mutually parallel axes, and a third rotational degree of freedom is centered in said longitudinal direction. The axis of rotation is rr.

According to one embodiment, the articulation device 70 has one first rotational degree of freedom about a first rotational axis perpendicular to the instrument axis XX and one rotational degree parallel to the first rotational axis. It has three rotational degrees of freedom, a second rotational degree of freedom and a third rotational degree of freedom perpendicular to the second rotational axis, and as a result, the second and third rotational degrees of freedom are close to each other. , forming a sub-articulation of the wrist.

According to one embodiment, the medical device 60 includes an articulation device 70, which device has a further degree of freedom at its terminal end 77, said further degree of freedom allows for an opening movement of said terminal end 77. and/or a closing movement is possible. According to one embodiment, said articulation device 70 comprises in said distal part a termination device 77, said termination device 77 comprising said further degree of freedom of opening and/or closing. For example, said further degrees of freedom determine the opening and/or closing of a cutting instrument such as forceps or scissors.

According to one embodiment, the at least one medical device 60 is removably connected to the robotic assembly 100.

According to one embodiment, the medical device 60 includes at least a shaft 65 suitable for connecting the frame 57 with the articulation device 70.

According to one embodiment, the medical device 60 comprises at least one shaft 65 so as to position its articulation device 70 at a predetermined distance from the micro-positioning device 41 . According to one embodiment, the shaft 65 is suitable for moving the articulation device 70 away from the micro-positioning device 41 at a predetermined distance.

According to one embodiment, the predetermined distance is a multiple of the longitudinal extension of the articulation device 70. According to one embodiment, the predetermined distance is equal to at least five times the longitudinal extension of the articulation device 70. According to one embodiment, the predetermined distance is equal to at least 25 times the longitudinal extension of the articulation device 70. According to one embodiment, the predetermined distance is approximately equal to twenty times the longitudinal extension of the articulation device 70. According to one embodiment, said predetermined distance is measured along the longitudinal direction XX of the shaft. According to one embodiment, the predetermined distance is approximately equal to 50 times the longitudinal extension of the articulation device 70.

The provision of the shaft 65 that separates the micro-positioning device 41 and the articulation device 70 makes the micro-positioning device 41 and the articulation device 70 suitable for performing their functions when they are in the activated state. It is possible to manufacture it with the same dimensions. When the robot assembly 100 includes a plurality of medical instruments 60, 160, 260, 360, each medical instrument 60, 160, 260, spacing the respective micro-positioning device 41, 141, 241, 341 from the associated articulation device; By providing said shaft 65 in 360, each medical device end 77 is able to reach its respective working volume while retaining independent movement capabilities.

According to one embodiment, said shaft 65 is suitable for connection to said frame 57 such that said termination device 77 is at a predetermined distance from said frame 57 .

According to one embodiment, said shaft 65 is rigid.

According to one embodiment, said shaft 65 has a longitudinal extension of 30 mm to 250 mm, preferably 60 mm to 150 mm.

According to one embodiment, said shaft 65 has a longitudinal bore. According to one embodiment, the shaft 65 has a hollow tube shape.

According to one embodiment, the medical instrument 60 comprises a motor housing 61 of the medical instrument 60, which is suitable for accommodating at least one drive system of at least the articulation device 70. In this manner, actuation of the articulation device 70 occurs within the medical instrument 60.

According to one embodiment, the robot assembly 100 comprises at least one controller 20 suitable for determining the movement of at least a portion of said medical instrument 60, 160, 260 by means of a master/slave type communication system.

According to one embodiment, the assembly has a further control device 20, such that it comprises at least two input devices 20. According to one embodiment, the control device 20 is suitable for determining the operation of the articulation device 70 of the medical instrument 60. According to one embodiment, the control device 20 is suitable for determining the movement of the micro-positioning device 41. By providing said characteristics, it is possible to relate the translational movement of said control instrument 21, as registered by said detection device 22, to the translational movement of said termination device 77 within its working space 7, 17.

According to one embodiment, the control device 20 is suitable for determining the operation of the micro-positioning device 41 and the medical instrument 60.

By providing said characteristics, at least a portion of said micro-positioning device 41 and at least a portion of said medical instrument 60 are controlled by said control instrument 21 to determine rotational and translational movements of said termination device 77 within said working volume 7. can be moved.

According to an alternative embodiment, the micro-positioning device 41 has multiple passive degrees of freedom that can be braked or otherwise blocked. According to one embodiment, the plurality of degrees of freedom are arranged in series immediately upstream of the micro-positioning device 41.

According to one embodiment, said robot assembly 100 is adapted to cooperate with a vision system 103 associated with said robot assembly 100.

According to one embodiment, said vision system 103 is a microscope 103.

By providing a microscope 103 associated with the robot assembly, an existing microscope can be introduced, making the robot assembly 100 more versatile. For example, the robot assembly 100 can be used in conjunction with a microscope having a focal length of 100 mm to 500 mm, depending on the focal length of the objective lens used. Furthermore, it allows for as much as possible to eliminate the need for relatively large movements during movement of the distal end of the instrument, thereby reducing the swept volume of the robotic assembly 100 during a surgical procedure.

According to one embodiment, said microscope 103 is an optical microscope 103.

According to one embodiment, the microscope 103 is connected to the terminal end 77 of the first medical instrument 160, and/or the terminal end 77 of the second medical instrument 260, and/or the third medical instrument 260. 360 within its field of view.

According to one embodiment, said microscope 103 is suitable for framing the working volume 7.

According to one embodiment, at least one video camera 45 is connected to said support member 38.

According to one embodiment, the video camera 45 is suitable for framing the terminal end 77 of the first medical instrument 160 and the terminal end 77 of the second medical instrument 260.

According to one embodiment, said support 104 includes at least one display 111 suitable for forming a machine input interface.

According to one embodiment, said display 111 is suitable for visualizing images obtained by said video camera 45.

According to one embodiment, said video camera 45 is suitable for cooperating with said macro-positioning arm 30 to enable precise positioning of said at least one medical instrument 60. Providing this feature facilitates the process of positioning at least a portion of said at least one medical instrument 60 within the working volume 7 .

According to one embodiment, the first medical device 160, the second medical device 260, and the support member 38 are arranged to form a substantially triangular shape. This arrangement allows the robot assembly 100 to reproduce a similar triangle that exists between the surgeon's eyes and arms.

According to one embodiment, the support 104 is at least one of a mobile cart, a support structure for a microscope, a surgical bed, and a surgical table.

According to one aspect of the invention, a microsurgical robot assembly 100 for a microsurgical robot assembly 100 is suitable for at least partially forming a master interface of a master/slave pair for the microsurgical robot assembly 100. The control device 20 is
At least one spatially movable device having a shape and size suitable for being held and handled like a conventional surgical instrument, i.e. a surgical instrument suitable for operating directly on at least a portion of a patient's body 201. one control device 21;
at least one detection device 22 suitable for detecting the position of said control device 21 in at least a part of space;
including.

The control device 21 includes at least one position sensor 28 , which cooperates with the detection device 22 to detect at least the position of the control device 21 .

According to one embodiment, said detection device 22 generates an electromagnetic field to detect at least the position of said control instrument 21 by detecting the position of said at least one position sensor 28 . According to one embodiment, the detection device 22 detects at least the position of the control instrument 21 by detecting the position of the position sensor 28 by measuring at least an inertial acceleration component. According to one embodiment, the position sensor 28 includes an accelerometer.

According to one embodiment, the detection device 22 is arranged in the base structure 67 of the control device 20.

According to one embodiment, said control instrument 21 is connected to said detection device 22 by at least an electromagnetic communication system.

According to one embodiment, the control instrument 21 includes at least one forceps joint 69 operative at the distal end 68 of the control instrument 21 to cause the distal end 68 to perform a grasping or cutting motion.

According to one embodiment, at least one tip sensor 29 measures the opening angle of said forceps joint 69.

According to one embodiment, said control instrument 21 has a shape that substantially reproduces the shape of a conventional surgical instrument.

According to one embodiment, said control instrument 21 has the shape of surgical forceps.

According to one embodiment, said control instrument 21 has the shape of a scalpel.

According to one embodiment, said control device 21 has the shape of a surgical needle holder.

According to one embodiment, said control instrument 21 has the shape of surgical scissors.

According to one embodiment, said control instrument 21 has the shape of a surgical blade.

According to one embodiment, the control device 20 has at least one ergonomic support element for the operator 27. The ergonomic support element is adapted to support at least a portion of the forearm of the microsurgical surgeon 200, at least when in the operating state, so as to provide ergonomic support for the microsurgical surgeon 200. Includes at least one support surface for operator 25. Providing such characteristics allows for increased comfort for the microsurgical surgeon, which determines improved surgical efficiency.

According to one embodiment, said ergonomic support element 27 has at least a part made of soft material or foam.

According to one embodiment, said control instrument 21 is connected to said detection device 22 by at least one electromagnetic communication system. According to one embodiment, the position sensor is an electromagnetic position sensor with a micro-bobbin, and the sensor device comprises a generator of a magnetic field and an electrical circuit for reading the current induced in the micro-bobbin by the magnetic field. include. By providing this characteristic, the control instrument 21 can maintain its functionality as a conventional surgical instrument without affecting the response time of the detection device 22.

According to one embodiment, the control instrument 21 is connected to the detection device 22 by a wired connection or a cable.

According to one embodiment, the control instrument 21 is connected to the detection device 22 by a wireless connection.

According to one embodiment, the detection device 22 is suitable for measuring a spatial position, the position measurement being a measurement by induced current, or an optical measurement, or an ultrasonic measurement, or a measurement by ionizing radiation. It is.

According to one embodiment, the control device 20 includes an on/off switch implemented as a pedal or button suitable for selectively activating or deactivating input from the control device 20.

According to one embodiment, robot assembly 100 includes:
at least one control device 20 as described by one of the embodiments mentioned above;
at least one surgical microinstrument 60, 160, 260, 360 having at least one terminal end 77;
including.

According to one embodiment, the terminal end 77 is suitable for operating on at least a portion of the patient 201.

According to one embodiment, the terminal end 77 is suitable for handling a surgical needle 202, for example as shown in FIGS. 3A-3B.

According to one embodiment, said control instrument 21 has the same dimensions as a conventional surgical instrument, i.e. a surgical instrument that can be used to operate directly on at least a portion of the patient 201. Provide a similar handling experience. The surgical microinstrument 60 is suitable for reproducing similar full motion capabilities of the control instrument 21.

According to one embodiment, the robot assembly 100 is configured such that when the motion of the control instrument 21 is large and includes vibrations, the motion of the surgical microinstrument 60 is vibration-filtered and operates down to the millimeter or micron scale. It is suitable for separating the operation of the control instrument 21 and the surgical micro-instrument 60 so as to reduce the The standardized motion introduced between the master and slave interfaces allows for reduced vibration and increased accuracy of the surgical microinstrument without reducing ease of operation for the surgeon 200. It is.

According to one embodiment, when the control instrument 21 is in the actuated state, in a first three-dimensional movement of the control instrument 21 relative to the detection device, a second three-dimensional movement of the surgical microinstrument 60 is performed. The surgical microinstrument 60 is suitable for cooperating with the surgical microinstrument 60 in a corresponding manner.

According to one embodiment, the control instrument 21 is arranged such that, when in the actuated state, a first translational movement of the control instrument 21 is equal to a fraction of the amplitude of the first movement of the control instrument 21. It is adapted to cooperate with said surgical micro-instrument 60, 160, 260 so as to correspond to a second translational movement of said surgical micro-instrument 60, 160, 260. In this way, it is possible to limit the transmission of vibrations or vibrations of the control instrument 21 to the surgical microinstrument 60.

According to one embodiment, the control device 21 is arranged such that, when in the actuated state, the first translational movement of the control device 21 is substantially equal to one tenth of the amplitude of the first movement of the control device 21. is adapted to cooperate with said surgical micro-instrument 60, 160, 260 to correspond to a second translational movement of said surgical micro-instrument 60, 160, 260 of an amplitude equal to .

According to one embodiment, the control device 21 is configured such that, when in the actuated state, the first translational movement of the control device 21 is substantially equal to one-thirtieth of the amplitude of the first movement of the control device 21. is adapted to cooperate with said surgical micro-instrument 60, 160, 260 to correspond to a second translational movement of said surgical micro-instrument 60, 160, 260 of an amplitude equal to .

According to one embodiment, the control instrument 21 is configured such that, when in the actuated state, a first angular movement of the control instrument 21 corresponds to a second angular movement of the surgical microinstrument 60, 160, 260. , cooperating with the surgical microinstrument 60, 160, 260 such that the second angular movement of the microinstrument is of an amplitude substantially equal to the amplitude of the first movement of the control instrument 21. suitable for Providing such characteristics allows the use of the control instrument 21 with which the surgeon 200 is familiar.

According to one embodiment, the control instrument 21 is arranged such that, when in the actuated state, a first angular movement of the forceps joint 69 of the control instrument 21 is located at the terminal end 77 of the surgical microinstrument 60. of the surgical microinstrument 60 such that the amplitude of the second movement is substantially equal to the amplitude of the first angular movement of the forceps joint of the control instrument 21. suitable for working with.

According to one embodiment, said portion of control instrument 21 is shaped to substantially reproduce the shape of said terminal end 77 of said surgical microinstrument 60, 160, 260.

According to one embodiment, the surgical micro-instrument 60, 160, 260 comprises at least one articulation device 70, the control device 21 relative to the sensing device 22 when in the actuated state. is adapted to cooperate with said articulation device 70, 170, 270 such that a first movement of said articulation device 70, 170, 270 corresponds to a second movement of said articulation device 70, 170, 270.

According to one embodiment, robot assembly 100 also includes:
A support 104;
at least one macro positioning arm 30 with multiple degrees of freedom connected to the support 104;
at least one micro-positioning device 41, 141, 241 with multiple translational degrees of freedom;
including.

According to one embodiment, the at least one controller 20 is connected to at least a portion of the microsurgical robot assembly 100.

According to one embodiment, said at least one control device 20 is freely positionable with respect to said support 104 .

According to one embodiment, the surgical micro-instrument 60, 160, 260 comprises at least one micro-instrument sensor, the at least one micro-instrument sensor being in a position relative to the sensing device 22. It is suitable to cooperate with said detection device 22 so that the spatial position of at least a portion of the instrument 60, 160, 260 can be detected.

According to one embodiment, the micro-positioning device 41 , 141 , 241 is configured to detect a spatial position of at least a portion of the micro-positioning device 41 , 141 , 241 with respect to the detection device 22 . at least one micromanipulator sensor suitable for cooperation with 22.

According to one embodiment, the macro-positioning arm 30 cooperates with the detection device 22 to detect the spatial position of at least a portion of the macro-positioning arm 30 with respect to the detection device 22. and at least one suitable macro positioning arm sensor.

According to one embodiment, the microsurgical robot assembly 100 includes a single unit of at least one of the position sensor 28, the tip sensor 29, the macro positioning arm sensor, the micro positioner sensor, the micro instrument sensor. Suitable for cooperation with sensors suitable for detecting spatial position relative to a reference system. According to one embodiment, the microsurgical robot assembly 100 includes a single unit of at least two of the position sensor 28, the tip sensor 29, the macro positioning arm sensor, the micro positioner sensor, the micro instrument sensor. Suitable for cooperation with sensors suitable for detecting spatial position relative to a reference system. By providing this characteristic, the remote control master/slave system functions sufficiently independently of the precise position of the sensing device 22, the support 104, the macro-positioning arm 30, and the micro-positioning device 41. I can do it. In other words, the medical instrument 60 can follow the movement of the control instrument 21 relative to the same common reference coordinate system.

According to one embodiment, the at least one surgical microinstrument 60, 160, 260 is removably connected to the robotic assembly 100.

According to one embodiment, microsurgical robot assembly 100 also includes:
a further control device 21, including a first control device 121 and a second control device 221;
further surgical microinstruments 60, 160, 260, including first surgical microinstrument 160 and second surgical microinstrument 260;
including.

According to one embodiment, when the first control instrument 121 is in the actuated state, a first movement of the first control instrument 121 relative to the sensing device 22 is caused by the first surgical micro-instrument 160 is adapted to cooperate with said first surgical microinstrument 160 to accommodate a second movement of said first surgical microinstrument 160.

According to one embodiment, said second control instrument 221 is configured such that when in the actuated state, a first movement of said second control instrument 221 relative to said sensing device 22 causes a second movement of said surgical microinstrument 260. The surgical microinstrument 260 is adapted to cooperate with the second surgical microinstrument 260 to accommodate movement of the surgical microinstrument 260.

According to one embodiment, said first control instrument 121 is suitable for forming a master interface of said robot assembly 100 for one first hand of the surgeon 200.

According to one embodiment, the second control instrument 221 is suitable for forming a master interface of the robotic assembly 100 for a second hand of the surgeon 200, which is different from the first hand. There is.

According to one embodiment, said first control instrument 121 and second control instrument 221 are substantially mirror images in shape and position so as to form a master interface of said robotic assembly 100 for the surgeon's hands. It is reversed. In this way, the interface has improved ergonomics and is more familiar to the surgeon.

According to one embodiment, the control device 20 includes at least two control instruments 21, 121, 221.

According to one embodiment, the microsurgical robot assembly 100 comprises a further detection device 22, such as having at least two detection devices.

According to one embodiment, the control device 20 has at least two detection devices 22 .

According to one embodiment, the microsurgical robot assembly 100 comprises at least one further control device 20, such as having a first control device 120 and a second control device 220.

According to one embodiment, said first control device 120 is suitable for forming a master interface of said robot assembly 100 for a first hand of a surgeon 200.

According to one embodiment, said second control device 220 is suitable for forming a master interface of said robot assembly 100 for a second hand of the surgeon 200, which is different from said first hand.

According to one embodiment, the first control device 120 and the second control device 220 have substantially mirrored configurations so as to form a master interface of the robot assembly 100 for the surgeon's hands. has. In this way, the interface has improved ergonomics and is more familiar to the surgeon.

According to one aspect of the invention, the medical device 60, 160, 260, 360 includes at least one frame 57 and one articulation device 70.

The articulation device 70 comprises at least one first articulation member 71 or first link 71 and at least a second articulation member 72 or second link 72 suitable for connection to at least a portion of the frame 57. Equipped with

The first link 71 is connected to the second link 72 via a rotary joint 171.

The medical device 60 is also suitable for having at least one tendon 90, 190 and moving at least the second link 72 relative to the first link 71 by pulling the tendon. There is.

At least one of the first link 71 and the second link 72 has at least a sliding surface 40 , 80 , 140 , 180 ; , 190 is adapted to allow at least a portion of it to slide thereon.

The sliding surfaces 40, 80, 140, 180 are line-woven surfaces 40, 80, 140, 180. Specifically, it is a linear surface formed by a plurality of straight line parts that are all parallel to each other and substantially parallel to the joint movement axes PP and YY.

According to one embodiment, said sliding surfaces 40, 80, 140, 180 are arranged substantially in the articulation axis PP of the revolute joint 171 connecting said first link 71 to said second link 72. The linear surfaces 40, 80, 140, 180 are parallel and are formed by a plurality of linear portions that are all parallel to each other.

According to one embodiment, the sliding surfaces 40, 80, 140, 180 are arranged substantially in the articulation axis YY of the revolute joint 171 connecting the first link 71 to the second link 72. These are linear surfaces 40, 80, 140, and 180 formed by a plurality of straight line portions that are orthogonal and all parallel to each other. In this case, the rotary joint is a rotary joint that connects the second link 72 and the third link 73 and/or a rotary joint that connects the second link 72 and the end member 77. There may be. The second link 72 is preferably a wrist member 78 that defines two orthogonal axes PP and YY.

According to one embodiment, the sliding surfaces 40, 80, 140, 180 are linear surfaces 40, 80, 140, 180. Specifically, a plurality of straight line portions that are all parallel to each other and substantially parallel to the joint movement axes PP, YY of the rotary joint 171 closest to the sliding surfaces 40, 80, 140, 180. This is a linear surface formed by According to one embodiment, the nearest revolute joint 171 is determined by measuring along the direction of the tendon path TT.

According to one embodiment, the articulation axis may be fixed or movable relative to the base reference system.

According to one embodiment, said at least one second link 72 is a wrist member 78, said wrist member 78 comprising a plurality of straight lines parallel to each other and substantially parallel to the first articulation axis. It has at least one sliding surface 40, 80, 140, 180 formed by a section.

According to one embodiment, said wrist member 78 is at least one suitable for forming at least a part of a second revolute joint 171 having a second axis of joint movement that is not parallel to said first axis of joint movement. Includes one joint 172.

According to one embodiment, the first joint movement axis and the second joint movement axis are substantially orthogonal to each other.

According to one embodiment, said first joint movement axis is a pitch axis PP.

According to one embodiment, said second joint movement joint axis is the yaw axis YY.

According to one embodiment, the medical device 60, 160, 260 has at least one termination member 77.

According to one embodiment, said end member 77 is suitable for contacting a portion of the patient 201 when in the actuated state.

According to one embodiment, said termination member 77 is suitable for handling a surgical needle 202.

According to one embodiment, the termination member 77 includes a cutting surface or blade and can function as a scalpel.

According to one embodiment, said end member 77 has at least one winding surface 86 formed by a plurality of straight sections all parallel to each other and substantially parallel to the axis of articulation. According to one embodiment, said winding surface 86 is suitable for allowing at least a portion of said tendons 90, 190 to wind around it.

According to one embodiment, said second articulation member 72 is a termination member 77.

According to one embodiment, said articulation device 70 , 170 , 270 comprises a third articulation member 73 suitable to be connected at least to said second articulation member 72 by a revolute joint 171 .

According to one embodiment, said third articulation member 73 is a terminal member 77.

According to one embodiment, said end member 77 is connected to said wrist member 78 by a revolute joint 171.

According to one embodiment, said at least one articulation member 72 is an elbow member 75, said elbow member 75 comprising a plurality of straight sections all parallel to each other and substantially parallel to a single joint movement axis. It has a plurality of sliding surfaces 40, 80, 140, 180 formed by.

According to one embodiment, said elbow member 75 includes at least one articulation 172 suitable for forming at least a part of a revolute joint 171.

According to one embodiment, said articulation device 70 comprises a third articulation member 73 suitable to be connected to at least said second articulation member 72 by a revolute joint 171, said second articulation member 72 The third joint member 73 is an elbow member 78.

According to one embodiment, the elbow member 75 is connected to the first articulation member 71 by a revolute joint 171 and the elbow member 78 is connected to the elbow joint member 75 via a revolute joint 171.

According to one embodiment, said articulation device 70 comprises a fourth articulation member 74 suitable for connection to at least said third articulation member 73 via a revolute joint 171 .

According to one embodiment, said fourth articulation member 74 is a terminal member 77.

According to one embodiment, the end member 77 has at least one winding surface 86 formed by a plurality of straight sections that are all parallel to each other and substantially parallel to the axis of articulation; 86 is suitable for allowing at least a portion of said tendon 90, 190 to be wrapped thereon.

According to one embodiment, the articulation device 70 has the first member 71 , which is connected to the wrist member 78 via a rotational joint 171 . and is connected to the termination member 77.

According to one embodiment, the articulation device 70 comprises a first member 71 connected to the elbow member 75 by a rotational joint 171 and connected to the wrist member 75 by a rotational joint 171. 78 and is itself connected to said end member 77 by a revolute joint 171 . Those skilled in the art will appreciate that the use of articulation members similar to 71, 72, 73 includes zero to more elbow articulation members 75, preferably orthogonal pairs of wrist articulation members 78, and at least one terminal articulation member. It will be apparent that articulation device 70 can be constructed to include 77 series of members.

According to one embodiment, the winding surface 86 is a woven surface.

According to one embodiment, the winding surface is substantially unsuitable for the tendons 90, 190 to slide past. This is because the tendons 90, 190 terminate near the winding surface 86 in an articulation member having the winding surface 86.

According to one embodiment, the medical device 60 has at least one pair of tendons, including one tendon 90 and one opposed tendon 190, wherein the tendon 90 and the opposed tendon 190 are connected to the second joint. Their second terminal end 92 or second tendon terminal end 92 is connected to the respective tendon fixation point 82 or tendon of said second articulation member 72 so as to move the member 72 in opposite directions about its articulation axis. Suitable for connection to termination 82.

According to one embodiment, the medical device 60 has at least one pair of tendons, including one tendon 90 and one opposed tendon 190, wherein the tendon 90 and the opposed tendon 190 define the termination member 77. connecting at their second terminal end 92 or second tendon terminal end 92 to the tendon fixation point 82 or tendon terminal mechanism 82 of said terminal member 77 for movement in opposite directions about its articulation axis; Are suitable.

By providing such a feature, the tendons 90 and the opposing tendons 190 can act competitively. For example, both the tendon 90 and the opposing tendon 190 cause the end member to move about the yaw axis YY. Therefore, there can be no passive or free joint movement; instead there is only actively guided and controlled movement.

According to one embodiment, the tendon 90 and the opposing tendon 190 are connected by their second terminal ends 92 to the first articulation member 71, the second articulation member 72, the third articulation member 73, and the fourth articulation member 73. It is suitable for connecting to a respective tendon fixation point 82 or tendon termination mechanism 82 of at least one of the articulation members 74 .

According to one embodiment, said tendons 90 and opposing tendons 190 are arranged by their second terminal ends 92 to at least one respective tendon anchorage point 82 or Suitable for connection to tendon termination mechanism 82.

According to one embodiment, said medical instrument 60 comprises at least one shaft 65 suitable for guiding said at least one tendon 90, 190. The shaft 65 is a shaft according to any of the embodiments described above.

According to one embodiment, said shaft 65 has a substantially circular cross-section and a diameter of less than 4 millimeters. This allows for extreme miniaturization of medical instruments.

According to one embodiment, the shaft 65 includes a longitudinal hole for passing the at least one tendon 90, 190 therein.

According to one embodiment, the shaft 65 is integral with the frame 57.

According to one embodiment, the articulation device 70 has a longitudinal extension of less than 10 millimeters.

According to one embodiment, the articulation device 70 has a volume of less than 10 cubic millimeters.

According to one embodiment, the termination member 77 includes at least one first portion 177 of the termination member and at least a second portion 277 of the termination member. According to one embodiment, said first portion 177 of the end member and said second portion 277 of the end member are movable relative to each other about an articulation axis to determine a grasping or cutting motion. . According to one embodiment, the joint movement axis is the yaw axis YY.

According to one embodiment, the medical device 60 including at least one pair of tendons includes a tendon 90 and an opposing tendon 190, and includes a first portion 177 of the termination member and a second portion 277 of the terminal member. For movement in opposite directions, one of the tendons 90 and the opposing tendon 190 connects by its second terminal end 92 at a respective tendon anchorage point 82 or tendon termination mechanism 82 on the first termination member 177. The tendon 90 and the other of the opposing tendons 190 are connected by their second terminal ends 92 at respective tendon fixation points 82 or tendon termination features 82 on the second termination member 277. suitable for

According to one embodiment, each of said end member first part 177 and said end member second part 277 has at least one winding surface 86.

According to one embodiment, the medical instrument 60 includes at least one pair of tendons, including one tendon 90 and one opposed tendon 190, wherein the tendon 90 and the opposed tendon 190 determine a grasping or cutting operation. The respective tendon anchorage points 82 or tendon termination mechanisms of the termination members 77 are connected by their second terminal ends 92 to move the third articulation member 73 relative to the fourth articulation member 74 . Suitable for connecting with 82.

According to one embodiment, the tendons 90 and the opposing tendons 190 wrap their distal portions around at least a portion of the at least one winding surface 86 of the termination member 77 .

According to one embodiment, the sliding surfaces 40, 80, 140, 180 are such that the articulation device determines that at least a portion of the tendon is deflected away and travels without contacting the articulation device 70. 70, 170, 270 are sliding sides 40, 140 suitable for extending away from the central volume.

According to one embodiment, said sliding side surface 40, 140 abuts the surface of the member on which it is formed, has at least a continuous surface 64 and shares a local tangent plane. According to one embodiment, said sliding side surface 40, 140 forms at least one sharp edge 63 with the member on which it is formed.

According to one embodiment, said sliding side surface 40, 140 joins the surface of the member from which it is formed on one side with a continuous surface 64 and on the other side the surface of the member from which it is formed. A sharp edge 63 is formed.

According to one embodiment, said sliding surfaces 40, 80, 140, 180 are joint sliding surfaces 80, 180 that at least partially surround the joint movement axis. According to one embodiment, the sliding surfaces 40, 80, 140, 180 are articulated sliding surfaces 80, 180 that at least partially surround at least one of the pitch axis PP and the yaw axis YY. and the joint sliding surfaces 80, 180 are arranged along the pitch axis to allow at least one intersection between the tendon path TT of the tendon 90 and the tendon path TT of the opposing tendon 190. It is oriented in the opposite direction with respect to at least one of PP and the yaw axis YY. In other words, the joint sliding surfaces 80, 180 are not suitable for pointing towards the joint movement axis of the nearest rotary joint 171 when in the actuated state.

According to one embodiment, said joint sliding surface is convex, such that said pitch axis PP or yaw axis YY partially surrounding at least one of the

According to one embodiment, the term "nearest joint" refers to the revolute joint 141 that is closest to the sliding surface 40, 80, 140, 180 along the tendon path TT.

According to one embodiment, on the joint sliding surfaces 80, 180, the tendon path TT of the tendon 90 and the tendon path TT of the opposing tendon 190 do not intersect, but the nearest rotary joint 171 at least partially overlap in a projection plane orthogonal to the direction of the joint movement axis.

According to one embodiment, on the joint sliding surfaces 80, 180, the tendon path TT of the tendon 90 and the tendon path TT of the opposing tendon 190 are the joint movement axis of the nearest rotary joint 171. are different from each other and parallel to each other in a projection plane parallel to .

According to one embodiment, the tendon path TT of the tendon 90 overlaps at least the tendon path TT of the opposing tendon 190 in a projection plane orthogonal to the direction of the joint movement axis of the nearest joint. According to one embodiment, the tendon path TT of the tendon 90 is substantially parallel to the tendon path TT of the opposing tendon 190 in a projection plane parallel to the joint movement axis of the nearest revolute joint. .

According to one embodiment, the tendon paths TT of each tendon 90 are substantially parallel to each other in a projection plane parallel to the joint movement axis of the nearest revolute joint 171.

According to one embodiment, the tendon path TT is substantially constant on the articular member it contacts. In other words, even when the tendon 90 is sliding, the overall tendon path TT is substantially always in the same position relative to the articular member of the medical instrument 60 that it contacts.

Such a feature is such that the sliding surfaces 40, 80, 140, 180 of the winding surface 86 have a cooperative geometric relationship with the tendon termination feature 82, and the tendon termination feature 82 has a cooperating geometric relationship with the tendon termination feature 82. This is uniquely achieved by being arranged to fit into a portion of a medical device.

According to one embodiment, said tendon path TT remains substantially steady on the articulation member contacting both tendon 90 and opposing tendon 190 determining opposing articulation motions.

According to one embodiment, the tendon path TT of each tendon 90 is substantially constant in its section with respect to the frame 57, except for the deflectable portion 93. Said deflectable portion 93 is in fact suitable for being deflected by a pusher assembly 94, like a guitar string.

According to one embodiment, said at least one tendon 90, 190, when in the actuated state, has an entire continuous straight aerial section 9 not in contact with the sliding surface 40, 80 or the winding surface 86. and a curved section in contact with the sliding surfaces 40, 80 of the joint members 71, 72, 73, 74, 75, 77, 78, or the winding surface 86.

According to one embodiment, said at least one tendon 90 , 190 wraps around itself at least partially over said articulation sliding surface 40 , 140 of said first articulation member 71 . Draw a path around the joint member 71 of.

According to one embodiment, the at least one tendon 90 , 190 is arranged at the distal end so as to wrap itself at least partially over the articulation sliding surface 80 , 180 of the second articulation member 72 . Draw a path around the second articulation member 72 of.

According to one embodiment, the medical device 60 includes a plurality of tendons.

According to one embodiment, the projection of the tendon path TT of the tendon 90 and the tendon path TT of the opposing tendon 190 in a plane orthogonal to the joint movement axis of the nearest revolute joint 171 is: They overlap at least at intersection point 16.

According to one embodiment, the aerial segment 9 of the tendon path TT of the tendon 90 is substantially parallel to at least one aerial segment 9 of the opposing tendon 190.

According to one embodiment, the tendon paths TT of each tendon 90 are substantially parallel to each other in a projection plane parallel to the direction of the joint movement axis of the nearest revolute joint 171.

According to one embodiment, each said tendon termination feature 82 connects said tendon 90 to said at least one sliding surface that follows a tendon path TT substantially parallel to the tendon path TT of any other tendon. each tendon 90 , 190 is arranged to support it so that it slides over 40 , 80 and keeps its tendon path TT substantially orthogonal to the axis of joint movement of the nearest revolute joint 171 be done.

According to one embodiment, each tendon termination mechanism 82 is arranged to support each tendon 90, 190 such that its tendon path TT is constant with respect to its proximate articulation member.

According to one embodiment, the tendon termination mechanism 82 is configured to maintain the tendon path TT of each tendon 90 in substantially constant contact with the winding surface 86 when in the actuated state. will be placed in

According to one embodiment, the tendon termination mechanism 82 is arranged such that the tendon path TT of each tendon 90, 190 does not come into contact with the tendon path TT of other tendons 90, 190 when in the actuated state. be done.

According to one embodiment, the tendon termination mechanism 82 slides on at least one sliding surface 40, 80 and slides on the same sliding surface 40, 80 when each tendon 90 is in the actuated state. When moving, it is arranged to trace a curved section of the tendon path TT that is substantially parallel to the curved section of the tendon path TT drawn by the other tendons 90,190.

According to one embodiment, the medical instrument 60 is a surgical instrument suitable for application in at least one of microsurgery, minimally invasive surgery, and laparoscopic surgery.

According to one embodiment, the medical device 60 is suitable for use in biopsies. According to one embodiment, the medical instrument 60 is suitable for use in endoscopic surgery.

According to one embodiment, said tendons 90, 190 have a substantially circular cross section. According to one embodiment, the diameter of the tendons 90, 190 is variable in different parts of the tendons 90, 190. According to one embodiment, the mechanical properties of the tendons 90, 190 are variable in different parts of the tendons 90, 190. According to one embodiment, the tendons 90, 190 are obtained by joining tendon parts having different properties. According to one embodiment, the composition of the tendons 90, 190 is variable in different parts of the tendons 90, 190.

According to one embodiment, said tendon path T--T in at least a portion of the tendon comprises a sliding surface 40, 80, 140 on which the tendon slides in any operating state, i.e. at any angle of rotation of the revolute joint 171. , 180 are substantially locally orthogonal to the generatrix. These characteristics contribute to avoiding that the tendon path TT of each of the tendons is ever deflected. In other words, it does not bend in a direction parallel to the joint movement axis of the closest rotary joint 171.

According to one embodiment, said tendon path TT is substantially locally orthogonal to the generatrix of the sliding surface 40, 80, 140, 180 on which it slides.

According to one embodiment, said articulation device 70 is primarily made of metallic material.

According to one embodiment, said articulation member is suitable for being polished in order to further reduce the friction caused by the sliding of said at least one tendon when said tendon slides on said member.

According to one aspect of the invention, tendon drive system 50 for medical device 60 , 160 , 260 includes at least one pusher assembly 94 .

Said medical device 60, 160, 260 comprises a frame 57 and at least one tendon 90, 190 adapted only to act under an applied tensile load at its terminal end, the tendon direction TT being defined. or the tendon path TT substantially coincides with the direction of longitudinal development of said tendon 90, said tendon 90 being at its first end 91, or proximal tendon end 91, or first tendon end. It is fixed to the frame 57 at 91.

The pusher assembly 94 deflects the deflectable portion 93 of the tendon 90 along a pushing direction across the tendon path TT to deflect the tendon path TT and induce an increased tensile load on the tendon 90. suitable for applying force to at least a portion of the

When the pusher assembly presses in the pushing direction across the tendon path TT, it tends to stretch the tendon path locally and only locally. Such local path distraction results in larger local tendon loops that are directly related to the amount of advancement of the pusher assembly. The creation of such a larger localized tendon loop results in a proportional retraction of the distal end 92 of the tendon secured to the tendon termination feature 82 on the glenoid member at the opposite end of the tendon, resulting in resulting in movement of the joint members.

According to one embodiment, the pusher assembly 94 functions as a one-sided restraint for the tendon 90.

According to one embodiment, the pusher assembly 94 lengthens or shortens the tendon path TT in at least one section of the tendon path TT that is substantially straight.

According to one embodiment, the pusher assembly 94 is suitable for retrieving a predetermined length of the tendon 90. According to one embodiment, the pusher assembly 94 is suitable for releasing a predetermined length of the tendon 90.

According to one embodiment, the pusher assembly 94 is configured to push the tendon at the tendon deflectable portion 93 of the tendon 90 such that the deflection of the tendon path TT is reduced and the tension of the tendon 90 is reduced. Suitable for retreating laterally on path TT. In this way, controlled movement of at least a portion of the articulation device 70 of the medical instrument 60 is enabled.

The terms "retreat" and "recover" mean that when pressing in the pressing direction, the pusher assembly transverse to the tendon path TT locally and only locally shortens the tendon path. means. Such local shortening creates an increasingly smaller local loop that is directly related to the amount of pullback of the pusher assembly, on the opposite side of the tendon that is secured to the articular member on which it acts at the distal end 92. Allowing movement of the distal end allows movement of the articulation member.

According to one embodiment, the tendon 90 and the opposing tendon 190 are connected to the articulating device 70 of the medical device 60 when the tendon 90 and the opposing tendon 90 are tensioned by respective tensioning elements 99, 199. has a length such that it is held in a reference position.

According to one embodiment, said frame 57 includes at least one shaft 65 in which a longitudinal axial direction XX is defined, said direction being an axis of longitudinal deployment of said shaft 65. coincident or parallel to its axis.

According to one embodiment, said tendon 90 comprises at least one longitudinal tendon section 19 in which the tendon path TT is substantially parallel to the longitudinal direction XX of the shaft; 65, determining the movement of at least said longitudinal tendon portion 19 at least along the axial direction XX.

According to one embodiment, the pressing direction is parallel to the longitudinal direction XX of the shaft.

According to one embodiment, the pressing direction is perpendicular to the longitudinal direction XX of the shaft.

According to one embodiment, said tendons 90 are pretensioned. In this manner, when the pusher assembly 90 ceases its pushing action against the deflectable portion 93, the tendon 90 remains substantially under tension. The provision of pre-tensioned tendons allows for easy calibration of the tendon drive system 50 and allows arbitrary determination of which posture of the articulation device positions the zero-push motion posture.

According to one embodiment, the pusher assembly 94 always applies minimal positive tension to the tendons 90. In this manner, the tendon 90 remains under tension substantially all the time when the pusher assembly contacts the tendon deflectable portion 93. Providing pre-tensioned tendons allows for efficient control of tendon path within medical device 60 under any operating conditions.

According to one embodiment, said tendon 90 includes a second or distal tendon termination 92 suitable for pulling a movable element, which movable element is connected to said second distal tendon termination 92. can do.

According to one embodiment, along the tendon path TT the first tendon termination 91 is encountered, then the at least tendon deflectable portion 93 and then the second tendon termination 92.

According to one embodiment, the movable element is at least a portion of the medical device 60, 160, 260 and is movable relative to the frame 57.

According to one embodiment, when the tendon deflectable portion 93 is deflected by the pusher assembly 94, the tendon 90 determines movement of at least a portion of the articulation device 70 relative to the frame 57.

According to one embodiment, the pusher assembly 94 is movable relative to the frame 57 and pushes the plunger 96 such that the plunger 96 pushes against at least one tendon deflectable portion 93 of the tendon 90. at least one pressing element 95 suitable for

According to one embodiment, at least one body is arranged between said pressing element 95 and said plunger 96. According to one embodiment, said pressing element 95 is in contact with said plunger. In other words, said at least one pressing element 95 is suitable for pressing said plunger 96 directly or indirectly.

According to one embodiment, the pressing element 95 is arranged in a contact position in which the pressing element 95 is suitable to perform a pressing movement on the plunger 96 and when the pressing element 95 is away from the plunger 96 and It is movable relative to said plunger 96 in a non-contact position where it does not exert any pressing action on 96. According to one embodiment, in the contact position the pressing element 95 is not necessarily in contact with the plunger 96. In other words, according to one embodiment, the pressing element 95 performs a pressing operation via at least one intermediate body arranged between the pressing element 95 and the plunger 96 .

According to one embodiment, the pusher assembly 94 also includes at least one sterility barrier 87 suitable to substantially prevent cross-microbial contamination of the two separating environments.

According to one embodiment, the sterility barrier 87 is arranged between the pressing element 95 and the plunger 96.

According to one embodiment, the sterility barrier is of a shape and material suitable for transmitting the pressure of the pressure element 95 to the plunger 96.

According to one embodiment, said pressing element 95 is movable relative to said frame 57 along a substantially linear trajectory.

According to one embodiment, said pressing element 95 is a piston.

According to one embodiment, when the pusher assembly determines the deflection of the tendon path TT, the at least two tendon guiding elements 97 direct the deflection of the tendon path TT between the two guiding elements 97. The drive system 50 comprises at least two tendon guiding elements 97 or guide pulleys arranged along the tendon path TT, cooperating to confine the tendon path section TT.

According to one embodiment, said plunger 96 comprises at least one plunger idler pulley 98 suitable for pressing said tendon deflectable portion 93, said plunger idler pulley 98 being free to rotate about its axis. , and is thus suitable for reducing sliding friction in said tendon deflectable portion 93 at least when pressed by said plunger 96 .

According to one embodiment, the plunger idler pulley 98 is a ball bearing.

According to one embodiment, said second tendon termination 92 is a boss, loop or knot.

According to one embodiment, said tendons 90 are suitable for being pretensioned.

According to one embodiment, the tendon drive system 50 includes at least one pretensioning element 99 suitable for maintaining the tendon 90 pretensioned.

According to one embodiment, the pretensioning element 99 is a spring suitable for applying a force between the frame 57 and the plunger 96, the preload being substantially proportional to the compression movement of the spring 99. Add to the tendons 90 above.

According to one embodiment, the pusher assembly 94 includes an electric motor suitable for moving the pushing element 95.

According to one embodiment, the pusher assembly 94 includes a lead screw and nut type actuator. According to one embodiment, the actuator includes a ball screw.

According to one embodiment, said tendon 90 is at least partially made of a softer material than the material of the surface on which it slides. In other words, said tendon 90 is at least partially made of a material with a lower hardness than the surface on which it slides.

According to one embodiment, said tendons 90 are at least partially made of a polymeric material. Providing tendons that are at least partially made of polymeric material allows for reduced wear on the surfaces that slide against, for example, metal tendons.

According to a variant of one embodiment, said first tendon end 91 is fixed to said plunger 96 rather than to said frame 57 .

According to one embodiment, said tendon drive system 50 has at least one further tendon 190 or It includes opposing tendons 190, said tendons 190 extending along a tendon direction TT or a tendon path TT.

According to one embodiment, the tendon drive system 50 is configured to oppose the pusher assembly 94 and deflect the tendon path TT to induce an increase in the tensile load on the opposed tendon 190 and the tendon 90. at least one further pusher assembly 94 or opposing pusher assembly 194 suitable for pushing at least a portion of the tendon deflectable portion 93 of said opposing tendon 190 along the tendon lateral pushing direction TT. . In other words, the tendon 90 and the opposing tendon are adapted to act in opposition to each other like antagonistic muscles in the human body that work together to determine the adduction and abduction movements of a joint.

According to one embodiment, the opposed pusher assembly 194 pushes the tendon deflectable portion 93 of the opposed tendon 190 along a pushing direction transverse to the tendon path T--T, and - deflect T, inducing a tensile load in the opposing tendon 190 from its proximal portion 18 and in the tendon 90 from its distal portion 19;

According to one embodiment, the tendon 90 and the tendon 190 are distally structurally connected by a joint between the tendon and the opposing tendon. According to one embodiment, both the tendon and the counter tendon are distally structurally connected to a common joint element such that the transmission of force by the tendon to the counter tendon is ensured.

According to one embodiment, the opposing tendons 190 have a second or distal end 92 , and the second or distal end 92 is the second tendon end of the opposing tendon 190 . Suitable for pulling a movable element connectable to 92.

According to one embodiment, the opposing tendons 190 pull the second tendon end 92 of the tendon 90 and a common single movable element associated with the second tendon end 92 of the opposing tendon 190. has a second or distal end 92 suitable for. According to one embodiment, said tendon 90 and said opposed tendon 190 are arranged in said common single movable position when said tendon 90 and said opposed tendon 190 are pretensioned by their respective pretensioning elements. It has a length such that the element is in the reference position.

According to one embodiment, said tendon 90 and said opposing tendon 190 are two parts of a single tendon 90.

According to one embodiment, the second tendon end 92 of the tendon 90 and the second end 92 of the opposing tendon 190 coincide, and the second end 92 of the tendon 90 and the opposing tendon 190 coincide. and said second tendon end 92 of said second tendon end 92 .

According to one embodiment, the opposed tendon 190 includes at least a longitudinal portion 19, and the tendon path TT is such that the opposed tendon 190 is aligned with respect to the shaft 65 at least along the longitudinal direction XX of the shaft. substantially parallel to the longitudinal direction XX of the shaft so as to move at least said longitudinal portion 19 of the shaft.

According to one embodiment, the tendon drive system 50 includes at least one pair of tendons 90, 190 for each degree of freedom, the tendon pair including a tendon 90 and an opposing tendon 190.

According to one embodiment, said tendon 90 and said opposed tendon 190 are such that the force transmitted by said tendon 90 and said opposed tendon 190 to a common movable element is greater than the force transmitted by said tendon 90 and said opposed tendon 190. It is suitable to be pulled at the same time as it is the sum.

According to one embodiment, said tendon 90 and said opposing tendon 190 are adapted to be pulled simultaneously with substantially the same amount of force.

According to one embodiment, said tendon 90 and said opposing tendon 190 are adapted to be pulled with one force higher than the other.

According to one embodiment, said tendon 90 and said opposing tendon 190 are adapted to be pulled simultaneously to retrieve substantially the same tendon length from their proximal portions.

According to one embodiment, said tendon 90 is adapted to be pulled to retrieve a length of a first tendon from its proximal section, while at the same time said opposing tendon 190 is released by its proximal section. and is adapted to release a second tendon length substantially equal to said first tendon length from an opposing tendon.

According to one embodiment, the tendon drive system 50 includes:
It includes opposed pretensioning elements 199 suitable for maintaining said opposed tendons 190 pretensioned.

According to one embodiment, said opposed pretensioning element 199 is a spring 99.

According to one embodiment, the pretensioning element 99 and the opposing pretensioning element 199 are arranged on the pretensioned tendon such that the pusher assembly 94 and the opposing pusher assembly 194 can act simultaneously. 90 and said opposing tendons 190 are adapted to cooperate to maintain them simultaneously.

By providing the pretensioning element 99 and the counter pretensioning element 199, the tendon 90 and the counter tendon 190 are provided with a suitable pretensioner for balancing the weight of the common movable element attached to them. The tensioning values allow them to be kept in their pre-tensioned state. In this way, gravity has no effect on the drive system.

According to one embodiment, said tendon 90 and said opposing tendon 190 extend their second end 92 of said second articulation member 72 and said end member 77 so as to move it in opposite directions. Suitable for connection to one respective tendon fixation point 82 or tendon termination mechanism 82 . Due to said characteristics and the cooperation of said pretensioning element 99 and said counter-pretensioning element 199, all movements can be actively guided and controlled, eliminating any passive or free joint movements such as by return springs. can be avoided.

According to one embodiment, the tendon drive system 50 includes a plurality of tendons 90 and a plurality of opposing tendons 190.

According to one embodiment, the tendon drive system 50 includes a plurality of pusher assemblies 94 and a plurality of opposing pusher assemblies 194.

According to one embodiment, the plurality of tendons 90 and the plurality of opposing tendons 190 are such that the tendon path TT of each tendon 90, 190 runs separately with respect to the path of all other tendons 90, 190. As shown in FIG.

According to one embodiment, the plurality of tendons 90 and the plurality of tendons 190 are arranged on the drum 59 substantially radially or ray-like. According to one embodiment, the plurality of tendons 90 and the plurality of counter tendons 190 are configured as one drum 59, such as a cylinder of a radial engine, and the path of the tendons 90 and the counter tendons 190 is do not intersect each other on 59.

According to one embodiment, each tendon 90 of said plurality of tendons 90 is adapted to be engaged by its respective pusher assembly 94 independently of other tendons 90.

According to one embodiment, said tendons 90 of said plurality of tendons 90 are adapted to be engaged by a respective pusher assembly 94 independently of an associated counter tendon 190.

According to one embodiment, a drive system assembly for a medical device 60, 160, 260 includes:
at least one tendon drive system 50 according to an embodiment of any of the embodiments described above;
at least one medical device 60, 160, 260 comprising at least one articulation device 70, 170, 270 having at least one rotational joint;
Equipped with

According to one embodiment, said tendon 90 , 190 is fixed or restrained at its second end 92 to at least a part of said articulation device 70 , 170 , 270 that is movable relative to said frame 57 . The tendons 90 , 190 are thereby suitable for pulling at least a portion of the articulating device 70 , 170 , 270 to move that portion relative to the frame 57 .

According to one embodiment, said opposing tendon 190 pulls at least a portion of said articulating device 70 , 170 , 270 against said opposing tendon 57 by a movement opposite to that determined by said tendon 90 . Both said tendon 90 and said opposing tendon 190 are connected at their respective second ends 92 to the same joint of said articulating device 70, 170, 270 which is movable relative to said frame 57. It is fixed to the part.

According to one embodiment, the drive system assembly includes a pair of tendons 90, 190, which pair of tendons includes a tendon 90 and an opposing tendon 190 for all degrees of freedom of movement of the articulating device 70, 170, 270. include.

According to one embodiment, when the tendon 90 and the opposing tendon 190 are pulled simultaneously and with substantially the same amount of force, at least one of the articulation devices 70, 170, 270 of the medical device 60, 160, 260 Partial movement is blocked.

According to one embodiment, when the tendon 90 and the opposing tendon 190 are simultaneously pulled with different magnitudes of force, one force being greater than the other, the joint of the medical device 60, 160, 260 A controlled movement of at least a portion of the device 70, 170, 270 occurs.

According to one embodiment, the medical instrument 60, 160, 260 is at least one of a surgical instrument, a microsurgical instrument, a laparoscopic instrument, an endoscopic instrument, and a biopsy instrument. It is.

According to one aspect of the invention, a tendon 90 , 190 for a medical device 60 that includes at least one articulation device 70 and one frame 57 is adapted to move at least a portion of the articulation device 70 relative to the frame 57 . suitable for

The articulation device 70 has at least one degree of freedom of movement relative to the frame 57.

Said tendons 90 are only suitable for operation under tensile loads.

The tendon 90 is made of a material with lower hardness than the material of the joint device 70.

Providing this characteristic allows the manufacture of a medical device 60 having an articulation device 70 that is more resistant to wear caused by the sliding of tendons 90 over at least a portion of said articulation device 70. Become. Furthermore, this property avoids any wear and tear of the material of the surfaces of the articulating device 70 on which the tendons slide. In other words, by providing this characteristic it is possible to avoid damage to the articulation device 70 due to the influence of the tendons 90 sliding over it when in the actuated state.

According to one embodiment, the tendon 90 slides over at least a portion of the articulation device 70 when in the actuated state.

According to one embodiment, said articulating device 70 comprises at least two articulating links 71, 72, 73, 74, 75, 77, 78, 177, 277, said at least one tendon 90, 190 Slides on both of the two articulated links. Said at least two articulating links may define degrees of freedom, for example a rotational joint driven by said at least one tendon 90, 190. Alternatively, said at least two articulating links may define further degrees of freedom, for example a revolute joint not driven by said at least one tendon 90, 190, but driven by a further tendon, for example.

Sliding of said at least one tendon preferably occurs on a convex linear surface 40 , 80 , 140 , 180 of articulating device 70 .

According to one embodiment, said at least two articulating links are in contact with each other. The at least two articulating links may define a snake-type articulating device. The at least two articulation links may define a wrist articulation device.

According to one embodiment, said tendons 90 are made of a structure that is not suitable for transmitting pressure.

According to one embodiment, the tendons 90 are made of a softer material than the material of the articulation device 70.

According to one embodiment, said tendons 90 are manufactured from a polymeric material. By providing a tendon made at least partially of a polymeric material, the wear of the surfaces on which it slides can be reduced, e.g. with respect to tendons made of metal, as established during the design stage. It helps maintain geometrical tolerances, thereby extending the life of the tendon 90, 190, as well as the life of the medical device 60, 160, 260.

According to one embodiment, said tendons 90, 190 are made of polyethylene. According to one embodiment, the tendons 90, 190 are made of high molecular weight polyethylene or ultra high molecular weight polyethylene. According to one embodiment, said tendons 90, 190 are made of Kevlar. According to one embodiment, said tendons 90, 190 are made of Vectran. According to one embodiment, the tendons 90, 190 are made of Zylon or PBO. According to one embodiment, said tendons 90, 190 are made of a combination of said materials.

According to one embodiment, said tendons 90, 190 are made of polymer fibers.

According to one embodiment, said articulation device 70 is made of metallic material.

According to one embodiment, the articulation device 70 is made of at least one of INOX or stainless steel, ultra-high speed steel, hardened steel, forged steel, titanium.

According to one embodiment, said articulation device 70 is made of a ceramic electrically conductive material.

According to one embodiment, said tendons 90 include at least one tendon termination 91 suitable for being glued to said frame 57.

According to one embodiment, said tendons 90 are unraveled into strands around their first tendon end 91 to maximize the bonded surface.

According to one embodiment, the tendon 90 includes at least a second tendon termination 92 suitable for connecting to at least a portion of the articulation device 70.

According to one embodiment, said second tendon termination 92 is a ridge. According to one embodiment, said second tendon termination is a loop. According to one embodiment, as shown for example in FIG. 28, said second tendon termination 92 is a knot.

According to one embodiment, the second tendon end 92 is adhered to at least a portion of the articulation device 70.

According to one embodiment, the first tendon termination 91 is terminated by wrapping the tendon around a portion of the medical device 60 multiple times. According to one embodiment, the second terminal end 92 is terminated by wrapping the tendon around a portion of the medical device 60 multiple times. According to one embodiment, said tendon is wrapped with a radius of curvature substantially equal to its diameter.

According to one embodiment, the tendons 90, 190 have a diameter of 0.05 mm to 0.3 mm.

According to one embodiment, the tendons 90, 190 have a modulus of elasticity between 50 GPa and 100 GPa.

According to one embodiment, the tendons 90, 190 are manufactured to have a radius of curvature of approximately 1 millimeter or less.

According to one embodiment, said tendon 90 is only suitable for operation under a tensile load applied at the end, and said tendon is pinched, guided laterally in a channel, or comprises a sheath. avoid.

According to one embodiment, said tendons 90, 190 are suitable for being pre-stretched in a loading cycle comprising at least two loads of substance equal to at least half the tensile breaking strength of said tendons 90, 190.

According to one embodiment, said tendon 90 has a lateral dimension, ie a dimension substantially perpendicular to said tendon path TT which is variable in different tendon sections.

According to one embodiment, said tendons 90, 190 have a substantially circular cross section.

According to one embodiment, the diameter of the tendon 90 is variable in different parts of the tendon 90.

According to one embodiment, the tendon 90 is thinner at the second tendon end 92. According to one embodiment, said tendon 90 is thinner at said distal portion 92' thereof. According to one embodiment, said tendons 90 are thicker in said longitudinal portion 19. In this way, the tendons 90, 190 are suited to be more flexible near or at the tendon fixation point 82 and stiffer at or near the inside of said shaft 65.

According to one embodiment, the mechanical properties of the tendon 90 are variable in different parts of the tendon 90.

According to one embodiment, said tendons 90, 190 are obtained by joining or juxtaposing tendon parts having different properties.

According to one embodiment, the composition of the tendons 90, 190 is variable in different parts of the tendons 90, 190.

According to one embodiment, the tendons 90, 190 have a diameter of 0.1 mm to 0.3 mm.

According to one embodiment, said tendon 90 is adapted to cooperate with an opposing tendon 190 to move at least a portion of said articulation device 70, 170, 270.

According to one embodiment, when said tendon 90 and said opposing tendon 190 are suitable to be pulled simultaneously with one force being greater than the other, said articulating device 70, 170, 270 or said medical device A controlled movement of at least a portion of 60, 160, 260 occurs.

According to one embodiment, movement of at least a portion of the articulation device 70 of the medical device 60 is prevented when the tendon 90 and the opposing tendon 190 are pulled simultaneously with the same force.

According to one embodiment, tendon pairs 90, 190, each pair of tendons including a tendon 90 and an opposing tendon 190, predict for every degree of freedom of movement of the articulating device 70.

According to one embodiment, the tendons 90, 190, 191, 192 of the medical instruments 60, 160, 260, 360 of the robotic surgical assembly 100 are made of braided strands, preferably braided polymer strands. The strands, also called "yarns", can have different sizes. Each strand or yarn can be composed of polymeric fibers forming the strand or yarn. Preferably the fiber polymer is UHMWPE. According to one embodiment, the polymer of the fiber is polyethylene (PE). The tendons and strands are made of fibers of PE, UHMWPE, Kevlar, Vectran, Zylon, or PBO, or combinations thereof. The fibers constituting the strands may each have an elastic modulus of up to 150 Gpa. Fibers are gathered to form the strands, which are further knitted to form the tendons 90, 190, 191, 192. Tendons can have a modulus of elasticity of 130 Gpa or less, or generally between 50 and 100 Gpa. Braiding of polymer strands can be achieved using a braiding device (e.g. H.A. McKenna et al. (2004), "Handbook of fiber rope technology", Woodhead Publishing, ISBN 978-1-85573-606-1). )). Braiding devices include, for example, braiding machines that include a mandrel for braiding tendons and a plurality of bobbins for each strand/yarn.

According to one embodiment, the tendons 90, 190, 191, 192 include a jacket 90' and a core 90'', where the jacket 90' is braided and the core 90'' may be braided. According to one embodiment, core 90'' is not braided.

If both the jacket 90' and the core 90'' are braided, for example as shown in FIG. braided. Thereby, the jacket 90' and the core 90'' are not braided with each other, but are braided independently of each other. This allows local relative movement between the jacket 90' and the core 90''. Preferably, if the core 90'' is formed by braided strands, the number of strands forming the jacket 90' is greater than the number of strands forming the core 90''.

According to one embodiment, the jacket 90' of the tendon 90, 190, 191, 192 is placed over a portion of the articulation device 70, 170, 270, preferably one of the links 71, 72 of the articulation device 70, 170, 270. Since it is designed to slide on one or more convex woven surfaces 40, 80, 140, 180, jacket 90' is primarily designed to obtain the desired sliding friction. According to one embodiment, the core 90'' is designed to withstand primarily tensile loads. Preferably, the braided jacket 90' also contributes to withstanding tensile loads, thereby cooperating with the braided or unbraided core 90''. The braid pitch may be different for the jacket 90' and core 90''. According to one embodiment, the braid pitch of the jacket is greater than the braid pitch of the core. According to one embodiment, the braid pitch of the jacket is smaller than the braid pitch of the core.

The jacket is preferably coated with polydimethylsiloxane (PDMS) and/or polytetrafluoroethylene (PTFE) and/or other suitable materials such as resins to improve wear resistance without impact sliding friction. . The PDMS and/or PTFE coating 90''' can also reduce the roughness of the braided tendons, for example. This roughness is caused by the presence of the strands that are knitted together, and this roughness increases the tendon's wear resistance during sliding.

According to one embodiment, the at least one tendon 90, 190, 191, 192 is at least part of the link 71, 72, 73, 74, 75, 77, 78, 177, 277 of the articulating device 70, 170, 270. and traces a tortuous path with its distal portion 92', which contacts and slides on one or more convex woven surfaces of said link. move. On the other hand, the main longitudinal portions 19 of the tendons 90, 190, 191, 192 received within the instrument shaft 65 have a substantially straight path. Preferably, at least one tendon 90, 190, 191, 192 slides and wraps around one or more convex contact surfaces 40, 80, 86, 140, 180 of the link to trace said tortuous path. The distal portion 92' of is braided with a higher pick-per-inch (PPI) than the longitudinal portion 19 of the same tendon 90, 190, 191, 192.

As is known, "PPI" refers to the number of picks per inch of a braid (for example, A.Biking et al., (2012), "VariAbles and Methods for ASTHETHETIC BRAID DESIGN", JOURNAL OF. TEXTILE AND Apparel (JTATM), Technology and Management, Vol. 7 Issue 4). Pick number (PPI) is typically expressed as the number of picks per unit length (inch) of the braid in a line parallel to the braid axis and represents the number of times the strands cross each inch of length of the braided tendon. This parameter PPI may also be related to the "pitch" of the braid, and the "cycle length" of the braid (e.g., H. A. McKenna et al. (2004) "Handbook of fiber rope technology"). , Woodhead Publishing, ISBN 978-1-85573-606-1). This parameter PPI may also be related to the "braid angle".

The higher the PPI, the smoother the braid, but analysis conducted by the inventors shows that if the number of pics is too high, tendon stiffness generally decreases.

Having a higher PPI allows for flattening, ie, greater resistance to lateral compression. According to a preferred embodiment, each tendon distal portion 92' describes the tortuous path and has a high PPI in the range of 25 to 100. According to one embodiment, the main longitudinal portion 19 of each tendon describes a substantially straight path and has a PPI ranging from 3 to 25. In order to be able to successfully trace a tortuous path and slide in contact with the articulating device 70, each tendon distal portion 92' that traces a tortuous path preferably has a main portion of the tendon. Compared to the straight longitudinal portion 19, it has a greater resistance to flattening, ie to lateral compression.

The distal portion 92' of the tendon 90, 190, 191, 192 can have a length of 3 to 5 mm. The distal portion 92' of the tendon 90, 190, 191, 192 ranges from 5% to 10% (1/20 to 1/10) of the total length of the tendon (i.e., from the proximal end 91 to the distal end 92). can have a length of According to one embodiment, the length of the tendon is approximately 20 cm. The distal portion 92' of the tendon 90, 190, 191, 192 can have a length of about 1/3 of the length of the tendon.

The linear density of the strands forming said tendons 90, 190, 191, 192 may range from 10 to 55 dTex (i.e. the ratio of "deciTex": grams/10 kilometers), preferably from 10 to 25 dTex. . Procedures for measuring linear density are described, for example, in H. A. McKenna et al. (2004), "Handbook of fiber rope technology", Woodhead Publishing, ISBN 978-1-85573-606-1.

Tendons 90, 190, 191, 192 may not be provided with any braided jacket and may include a braided core 90'' formed by 6 to 12 braided line strands with a PPI ranging from 10 to 60; For example, it may include a polyethylene braided core.

The stiffness of the tendons 90, 190, 191, 192 may vary along their longitudinal extent. The local PPI, and/or the local linear density, and/or the number of jacket braided strands, and/or the number of core braided strands may influence the local stiffness of the tendon. Thereby, desired local mechanical properties can be achieved by adjusting the local PPI, and/or the local linear density, and/or the number of jacket braided strands, and/or the number of core braided strands. Tendons 90, 190, 191, 192 having the following properties can be obtained. For example, the local PPI should not be too high, as this will compromise the tensile stiffness of the braided tendons, and the local PPI should not be too low, as this will reduce the resistance to flattening (compression) and abrasion resistance. do not have. Flattening can change the properties of the tendon, especially the sliding friction. This is because the cross-section of the circular tendons 90, 190, 191, 192 becomes oblong and/or oval, thereby increasing the contact area with the articulating device 70. According to the inventors, a good compromise is to flatten the tendon to the extent that its lateral dimension does not exceed twice the outer diameter of the circular tendon. In this way, the jacket can be appropriately braided to mechanically suppress the tendency of the core to flatten.

For example, as shown in FIGS. 15E and 15F, the main longitudinal portion 19 of each tendon 90, 190, 191, 192 includes a tendon distal portion 92' (in black) near and at the terminal end 92 of the tendon. (shown) may have a reduced PPI (shown in light gray). The tendon distal portion 92' near and at the terminal end 92 of the tendon is designed to follow a tortuous path and slide in contact with one or more convex woven surfaces of the articulating device, At least one of the three or more convex linear surfaces is preferably made integral with the links 71 , 72 , 73 , 74 , 75 , 77 , 78 , 177 , 277 of the articulating device 70 .

As shown for example in FIG. It may have a reduced PPI compared to distal portion 92'.

The outer diameter (diameter) of the braided tendons 90, 190, 191, 192 may be less than 0.5 mm, preferably less than 0.4 mm, and more preferably 0.3 mm or less.

The distal ends 92 of the tendons 90, 190, 191, 192 are designed to transfer loads to the links to actuate the degrees of freedom of the articulating device 70. Preferably, the distal end 92 forms a knot formed by the tendon itself, and the distal end is preferably heated (ie, heat treated) to strengthen the knot. The knot may be a stopper knot. Heating may locally melt the tendon segments that form the knot. Thus, at the distal ends 92, ie, knots, of the polymeric tendons 90, 190, there may be portions that melt together due to such heat treatment.

According to one embodiment, the distal end 92 is heated when the knot is achieved. According to one embodiment, the distal end 92 is heated before or during the knot is formed and the tendon segment further distal to the knot is cut. Heating can be done by conventional methods such as laser heating, torch heating, oven heating, etc.

Preferably, if the tendon includes a jacket and/or a coating, the heating determines a local melting of the jacket 90' and/or jacket coating 90''', thereby causing the jacket 90' of different tendon segments to melt at the knot. and/or the coating 90''' melts together. Thereby, the relative slippage of the plurality of tendon segments forming the knot is reduced, thus enhancing the tensile resistance of the knot and the ultimate tensile strength of the tendon 90, 190, 191, 192 as a whole. .

The knot at the distal end 92 may optionally be connected to the links to which the distal end 92 is connected, e.g., the second link 72, the third link 73, the end members 177, 277, the wrist, as described in this disclosure. For the member 78, it can function as an actuation force transmission element.

Knots can be a weakness in the ultimate tensile strength of tendons 90. The type of knot can be selected to balance minimizing vulnerability of the tendons 90, 190 while being as small as possible. Heating the knot at the distal end 92 causes localized melting of the tendon segments that form the knot itself, increasing the strength of the knot. After tying a knot at the distal end 92 of tendon 90, there may still be tendon segments distal to the knot. In such a case, heating the knot and the tendon segment distal to the knot will melt the tendon material, causing the segment distal to the knot and the knot to melt together and prevent adhesion at the knot. Further improvements can be achieved by shortening or eliminating segments distal to the knot.

If the link of the indirect device 70 is provided with a winding surface 86 on which the tendon distal portion 92' can be wound/unwound without sliding, the tendon 90 is wrapped around said winding surface and the knot is tied. can be located on the winding surface 86, for example as shown in FIG. 28, the knot is on the winding surface 86.

Preferably, the braided tendon jacket 90' has a variable PPI, with the distal portion 92' of the tendon 92 having a PPI in the range of 50 to 100, while the longitudinal portion 19 of the same tendon has a PPI of about 10 to 20. Has a PPI lower in the range. According to our analysis, this allows for a reduction in overall tendon elongation to achieve the desired overall axial stiffness and acceptable axial inelastic elongation.

Braided tendons can typically be subjected to inelastic testing when subjected to a tensile load. Therefore, with the aim of simplifying the control, i.e. numerical control, of the robotic surgical assembly 100 by making the inelastic deformation of the tendons in surgical conditions predictable, the tendons 90, 190, 191, 192 are preferably , preloaded with pre-stretch cycles. The pre-extension load may be approximately half the ultimate tensile strength of the tendons 90, 190, 191, 192.

The relatively high PPI of the jacket allows it to compress the core where the tendon 90, 190, 191, 192 bends (ie, the distal portion 92' of the tendon 90, 190, 191, 192). This allows the tendons 90, 190, 191, 192 to have a substantially circular cross-section, avoiding an oblong cross-section in the actuated state. The term "circular cross-section" as used herein is clearly a simplification. This is because tendons are composed of braided yarns and therefore have irregular contours in a given cross section. Additionally, the term "circular" as used herein refers to this unique contour shape. Preferably, the term "diameter" as used herein also refers to the cross-sectional profile of a braided tendon that is not perfectly circular, as the cross-section of the braid may locally deviate from an ideal circle. .

Preferably, the core 90'' of the tendon may be formed by a single strand of higher linear density or multiple strands of lower linear density. Although the jacket 90' has a lower linear density compared to the tendon core 90'', it can be composed of a greater number of strands, and said strands of the tendon jacket 90' have a higher PPI. Can be braided. The relatively high PPI of the jacket 90' allows the tendons 90, 190, 191, 192 to compress the core 90'' where they bend (i.e., their distal portions 92'), while at the same time compressing the core 90'' The core 90'' can be sufficiently covered without exposing the core 90''. Therefore, forcing the core 90'' to slide over the medical device 60, 160, 260, 360 can be avoided. According to one embodiment, each of the strands making up the braided jacket 90' has a linear density in the range of 10 to 25 dTex.

Below, a method of connecting the polymer tendons 90 to the links 72, 73, 74, 75, 77, 78, 177, 277 of the joint device 70 and operating the links (degrees of freedom of the joint device 70) will be described. The tendons can be formed by braided polymer fibers and/or braided polymer strands formed by polymer fibers.

The method includes the steps of providing at least one tendon 90, 190 made of polymeric fibers designed to actuate said degree of freedom and connecting the distal end 92 of the tendon to the articulation device 70 of the medical device. and applying a tensile load to actuate the degree of freedom.

The step of connecting may include connecting the distal end 92 of the polymeric tendon 90, 190 to the anchor point 82 (ie, termination feature 82) of the link of the articulation device 70 to which the tendon is connected.

The connecting step includes tying a knot at the distal end 92 of the tendon. At this stage, there may be an extra segment distal to the knot due to the knot tying process.

The step of connecting also includes heating the knot. This heating step may be performed after tying the knot.

The heating determines the local melting of the knot-forming tendon segments, thereby reducing the local relative slippage of the knot-forming tendon segments. Heating determines the local melting of the tendon segments forming the knot and strengthens the knot.

Heating may be performed while removing the tendon segment distal to the knot. The tendon segments distal to the knot may also be heat treated (heated) to melt the segments distal to the knot and melt together with the knot. In this way, the knot is further strengthened and at the same time the redundant distal segment is removed.

Heating can be done by laser heating, torch heating, oven heating, or any combination of the above.

If the tendon 90 has a jacket 90', the heating determines a local melting of the jacket 90', melting the jackets 90' of different tendon segments together at the knot.

If the tendon 90 has a coating 90''', the heating determines a local melting of the coating 90''', melting the coatings 90''' of different tendon segments together at the knot.

In the following, a driving method for the robot assembly 100 will be described.

A method for driving a surgical robot assembly includes the following steps: providing a robot assembly 100 according to any one of the embodiments described above;
utilizing at least one vision system associated with robotic assembly 100 to visualize at least a portion of patient 201;
positioning the macro-positioning arm 30 such that the working volume 7 reached by at least a portion of the end portion 77 is within the field of view of at least one vision system 103 associated with the robot assembly 100;
driving at least one micro-positioning device 41, 141, 241, 341;
driving at least one articulation device 70, 170, 270 of the medical device 60, 160, 260, 360;
including.

According to one possible mode of operation, the method of driving the surgical robot assembly includes the following steps, listed in preferred but not exclusive order: The macro-positioning arm 30 can be moved. releasing the macro positioning arm 30 as shown in FIG.
positioning the macro-positioning arm 30 such that the working volume 7 reached by the at least one endpoint 77 is within the field of view of the at least one vision system 103 associated with the robot assembly 100;
a step of locking the macro positioning arm 30;
driving the at least one micro-positioning device 41, 141, 241 by the at least one control device 20;
driving the at least one articulation device 70, 170, 270 of the medical device 60, 160, 260 by the control device 20;
It further includes at least one of the following.

A method of controlling a microsurgical controller for a microsurgical robot assembly is described below.

A method of controlling a microsurgical controller for a microsurgical robot assembly comprises the following steps, listed in preferred but non-limiting order: providing one microsurgical control device 20;
a step of operating the control device 21;
moving at least a portion of the control device 21 relative to the detection device 22;
including.

According to one possible mode of operation, a method includes the following further steps: providing a microsurgical robot assembly 100 according to an embodiment of the previously described embodiments;
moving the surgical microinstrument 60, 160, 260 by the control instrument 21;
moving the micro-positioning device 41, 141, 241 by the control device 21;
displaying at least a portion of a patient 201 using a microscope 103 associated with the robot assembly 100;
activating a remote control state or mode, the remote control state or mode causing movement of the control instrument 21 in a first direction with respect to a coordinate system associated with at least one of the detection device 22 and the microscope 103; , activating the remote control state or mode corresponding to movement of the surgical microinstrument 60, 160, 260 in the same direction relative to the coordinate system;
Contains at least one of the following.

According to one embodiment, said part of the patient 201 is included in said working volume 7.

According to one possible mode of operation, a method comprises the following further steps:
providing a further control device 20 to include a first control device 120 and a second control device 220;
operating the first control device 120 with a first hand;
operating the second control device 220 with a second hand;
including.

According to one possible mode of operation, a method comprises the following further steps:
providing a further control device 21 to include a first control device 121 and a second control device 221;
operating the first control device 121 with one hand;
operating the second control device 221 with the other hand;
including.

According to one embodiment, said articulation members 71, 72, 73, 74 are obtained by wire electrical discharge machining.

According to one embodiment, said articulation members 71, 72, 73, 74 are obtained by microinjection molding.

According to one embodiment, said articulation members 71, 72, 73, 74 are obtained by three-dimensional printing.

A method of manufacturing the medical device 60, 160, 260 will be described below.

According to one possible mode of operation, a method for manufacturing a medical device 60, 160, 260 comprises a process for manufacturing a medical device 60, 160, 260 according to one of the embodiments described above, comprising at least This is achieved by one additional manufacturing technique.

According to one possible mode of operation, the method of manufacturing the medical device 60, 160, 260 includes a microinjection molding medical device manufacturing process. In other words, the method of manufacturing the medical device 60, 160, 260 includes a process of manufacturing the medical device by micro-molding.

A method of driving tendons 90, 190 for medical instruments 60, 160, 260 is described below.

The method for driving tendons 90 for medical instruments 60, 160, 260 includes the following steps, listed in preferred but non-limiting order of execution:
A') providing a tendon drive system 50 according to any one of the embodiments described above;
B') pressing at least a portion of said tendon 90, 190 to deflect its tendon path TT;
C') generating a tensile load on the tendons 90, 190;
including.

According to one possible mode of operation, a method includes the further step of providing a drive system assembly according to any one of the previously described embodiments.

According to one possible mode of operation, a method comprises the following further steps:
D') pre-tensioning the tendon 90 before step B;
E') driving the pusher assembly 94 before step B and after step D;
F') after step C, moving at least a portion of the articulation device 70, 170, 270 of the medical device 60, 160, 260;
G') driving the opposed pusher assembly 194 after step F');
H') moving at least a portion of the articulation device 70, 170, 170 of the medical device 60, 160, 260 of step F') in the opposite direction after step G');
Contains at least one of the following.

According to one possible mode of operation, one method is to
I') simultaneously driving the pusher assembly 94 and the opposing pusher assembly 194;
J') pulling the tendon 90 and the opposing tendon 190 with different magnitudes of force, one force being greater than the other;
K') moving at least a portion of the articulation device 70, 170, 270 of the medical device 60, 160, 260 by controlled movement;
including the further process of

According to one possible mode of operation, one method is to
L') instead of step J'), pulling the tendon 90 and the tendon 190 with substantially the same amount of force;
M') instead of step K'), blocking movement of at least a portion of the articulation device 70, 170, 270 of the medical device 60, 160, 260;
including the further process of

According to one possible mode of operation, a method may include, instead of steps I'), J'), K'), the following steps:
N') simultaneously driving the pusher assembly 94 and the opposing pusher assembly 194;
O') simultaneously pulling said tendon (90) to retrieve the length of the first tendon from its proximal portion and, by its proximal portion, retrieving the length of the opposing tendon substantially equal to the length of the first tendon; releasing said opposing tendons (190) to release a second length;
P') moving at least a portion of the articulation device 70, 170, 270 of the medical device (60, 160, 260) by a controlled movement in relation to the length of the tendon and the length of the opposing tendon; process and
including.

According to one possible mode of operation, one method is to
driving the opposed tendon 190 by the opposed pusher assembly 194;
moving at least a portion of the medical device 60, 160, 260 by the pusher assembly 94;
including the further process of

A method for replacing tendons 90, 190 on a medical device is described below.

According to one possible mode of operation, the method of replacing tendons 90, 190 involves the following steps:
providing a further tendon 90, 190 according to any of the previously described embodiments;
a step (A'') of removing the tendons 90, 190 from the medical device 60;
attaching the further tendon 90, 190 to the medical device 60 (B'');
including.

According to one possible mode of operation, the tendon 90 is first attached to said second tendon end 92 and then to said first tendon end 91.

According to one mode of operation, the method includes the following further steps:
prior to step (A''), locking said plunger (96) in a suitable position to remove any pretension in the associated tendon 90 (C'');
including.

According to one embodiment, the plunger (96) is locked by the use of a pin inserted into the plunger locking hole 48.

According to one possible mode of operation, a method comprises the following further steps:
A step (D'') of cleaning the medical instrument 60 between the step (A'') and the step (B'');
including.

According to one possible mode of operation, said step (D'') comprises a further sub-step of immersing said medical device 60 in an organic solvent bath.

According to one possible mode of operation, said step (A'') includes a further sub-step of dissolving the remaining part of the tendon 90.

According to one possible mode of operation, said step (A'') comprises a further sub-step of introducing said medical device 60 into an autoclave or other sterilization system.

According to one possible mode of operation, said step (A'') comprises a further sub-step of introducing said medical device 60 into an oven at a temperature of 25° C. to 150° C.

According to one possible mode of operation, said step (A'') includes a sub-step of immersing said medical device 60 in a chemical-organic solvent bath.

According to one possible mode of operation, said step (B'') comprises the following sub-steps listed in preferred but not exclusive order:
a sub-step of locking the articulation device 70 in a reference position and/or locking the plunger 96 in its locking position;
connecting the second terminal end 92 to the articulating device 70;
passing the further tendon 90, 190 into the shaft 65;
a sub-step of connecting the first tendon end 91 to the frame 57;
including.

According to one possible mode of operation, a method comprises the following further steps:
after step (B'') a step (E'') of calibrating said medical device 60, 160, 260 identifying a new zero position of the plunger;
including.

A method of manufacturing articulation devices 70, 170, 270 is described below.

According to one aspect of the invention, one method of manufacturing articulation device 70, 170, 270 includes the following steps, in the following preferred order:
A process (A''') of providing a processing jig 112 in the EDM processing machine and arranging a plurality of workpieces 117 on the processing jig 112;
cutting a desired shape on the workpiece 117 with mutually parallel cutting lines (B''');
Contains at least

By providing a single cutting operation on the workpiece with mutually parallel cutting lines, it is possible to machine parallel surfaces on the workpiece with very high parallelism accuracy.

According to one possible mode of operation, the processing method described above allows the processing of line-woven surfaces characterized by parallel generatics in the workpiece 117.

According to one possible mode of operation, the processing method described above makes it possible to cut workpieces of very small dimensions, for example millimeter or submillimeter dimensions.

According to one embodiment, the processing method is suitable for manufacturing at least one articulation device 70 comprising a plurality of articulation members 71, 72, 73, 74, 75, 76, 77, 78.

According to one possible mode of operation, the machining method is suitable for machining parallel cuts in the workpiece 117 so as to form an articulation member comprising surfaces parallel to each other.

According to one possible mode of operation, the machining method comprises parallel cuts in the workpiece 117, such that the articulation members have surfaces parallel to each other, thereby forming articulation members suitable for complementary assembly. suitable for processing.

According to one possible mode of operation, the EDM processing machine is suitable for performing wire EDM and has a cutting wire 115.

According to one embodiment, the cutting wire 115, or EDM wire 115, or electrical discharge machining wire 115 has a diameter of 30 microns to 100 microns, preferably 50 microns.

By providing the aforementioned machining method, only thermal energy can be transferred to the workpiece 117 to be machined, and mechanical energy can be transferred to the workpiece 117 to be machined, for example to perform the cutting with a milling machine. As in the case, mechanical energy inducing bending can be avoided.

According to one embodiment, the processing method is suitable for manufacturing at least one joint device for applications in the medico-surgical field.

According to one embodiment, the processing method is suitable for use in the manufacture of at least one articulation device suitable for applications in precision mechanics, for example in the manufacture of watches. According to one embodiment, the processing method is suitable for producing at least one articulation device suitable for use in the jewelry and/or fashion jewelry field. According to one embodiment, the processing method is suitable for the production of at least one articulation device suitable for application in the assembly of electromechanical products.

According to one possible mode of operation, the process (A''') comprises the following sub-processes:
a substep of attaching a plurality of workpieces to the processing jig 112 in their respective member sheets 116;
including.

According to one possible mode of operation, the following sub-steps are first carried out during said step (A'''), namely: The sub-step (A1''') of providing the processing jig 112 on the EDM processing machine carried out,
Next, a sub-process (A2''') of placing a plurality of workpieces 117 on the processing jig 112 is performed.

According to one possible mode of operation, a method includes the following further steps between the sub-steps (A1''') and the sub-steps (A2'''): a step of performing calibration (C'');'),
including.

According to one possible mode of operation, a method includes the following further steps between step (A''') and step (B'''):
a process of performing calibration (C''');
including.

According to one possible mode of operation, a method includes the following further steps after step (B'''): rotating the processing jig 112 (D''');
a step of repeating the step (B''');
including.

According to one possible mode of operation, the step of rotating the machining jig 112 includes rotating the machining jig 112 using a rotary table to avoid removing the machining jig 112 from the cutting machine. Then, a further process of performing the following steps, namely:
a process of rotating the processing jig 112;
performing a second calibration or cutting calibration only on the reference rod 118;
and a step of repeating the step (B''').

According to one possible mode of operation, said step of calibrating (C''') comprises the following sub-steps:
A step of turning on the EDM processing machine,
providing a reference bar 118 having an axis parallel to the member sheet 116 of the workpiece 117;
contacting the cutting wire 115 with a first portion 122 or a portion facing the side of the wire approach 122 of the reference bar 118;
Measuring or registering the position of the wire;
and/or measuring or registering the position of said cutting wire 115 when said cutting wire 115 is in contact with a first part of a first workpiece to be machined or with a part facing the side of the wire approach; performing the previous process on each workpiece 117;
and/or contacting the cutting wire 115 with a second rod portion 123 of the reference rod 118 or with a portion facing the side of the wire release 123 opposite to the first rod portion 122;
Measuring or registering the position of the cutting wire 115;
calculating the position of the axis of the reference rod 118 as the midpoint between the position of the wire when contacting the first rod part and the position of the wire when contacting the second rod part; step and
and/or measuring or registering the position of the cutting wire 115 when in contact with a second portion of the first workpiece or a portion facing the side of the wire release;
the first workpiece as an intermediate point between the position of the wire when in contact with the first part of the workpiece and the position of the wire when in contact with the second part of the workpiece; a step of calculating the position of
and/or performing the previous process on each workpiece 117;
and/or repeating the procedure for all cut planes XY, YZ, XZ;
including.

According to one embodiment, the processing fixture 112 of the articulating device 70, 170, 270 is suitable for being mounted on an EDM processing machine.

According to one embodiment, the processing jig 112 is suitable for making at least two cuts in different cutting planes of the workpiece 117 using a single cutting profile 110 for each cutting plane.

According to one implementation, the processing fixture 112 includes a first pair of fixation surfaces 113, 114, which are opposed, substantially parallel to each other, and parallel to the first It is adjusted to be substantially orthogonal to the cutting plane XY.

According to one embodiment, the processing jig 112 includes a second pair of fixed surfaces 134, 135 that are opposite, substantially parallel to each other, and that It is adjusted to be substantially orthogonal to the plane YZ.

According to one embodiment, said first pair of fixation surfaces 113, 114 and said second pair of fixation surfaces 134, 135 are adjusted.

According to one embodiment, each pair of placement surfaces includes at least one base fixation surface 113, 135 and at least one fixture fixation surface 114, 134.

According to one embodiment, the plurality of member sheets 116 are substantially perpendicular to the first cutting plane XY or the second substantially perpendicular to the cutting plane YZ. Also, the plurality of member sheets 116 cross at most one of the workpieces 117 at a time when the workpieces are attached to the respective member sheets 116.

According to one embodiment, the member sheets 116 are substantially parallel to each other.

According to one embodiment, the processing jig 112 includes a pair of placement surfaces that are opposed, substantially parallel to each other, and substantially orthogonal to the third cutting plane XZ.

According to one embodiment, the third pair of arrangement surfaces include at least a guide hole 125, and the EDM processing The EDM wire 115 of the machine is inserted into at least one said guide hole 125.

According to one embodiment, the processing jig 112 also includes:
comprising a plurality of member sheets 116, each of the plurality of member sheets 116 being adapted to receive at least one workpiece 117, said workpiece 117 realizing at least a portion of said articulation device 70, 170, 270; suitable for.

According to one embodiment, the processing fixture 112 also has at least one reference bar 118 suitable for allowing cutting calibration.

According to one embodiment, said processing fixture 112 includes at least one fixing element or fastening element, said at least one fixing element or fastening element said at least one workpiece in its respective member sheet 116. Suitable for firmly connecting to 117.

According to one embodiment, said at least one fastening element is a conductive adhesive.

According to one embodiment, said at least one fastening element is a grub screw.

According to one embodiment, the grub screw is suitable for being installed in a screw hole provided in the at least one fastening surface.

According to one embodiment, the fastening grub screw is suitable for entering into the screw hole of the fastening surface.

According to one embodiment, the processing jig 112 includes four member sheets 116 and a reference bar 118.

According to one embodiment, each member sheet 116 is spaced substantially the same distance from its respective fastening surface.

According to one embodiment, the fastening surfaces are arranged in stages so as to form a stepped profile. In other words, the fastening surfaces are arranged in stages so as to form a step-shaped profile with respect to at least one cutting plane XY, YZ, XZ.

According to one embodiment, the processing jig 112 has a surface facing any cut plane XY, YZ, XZ of less than 10,000 square millimeters.

According to one embodiment, the processing jig 112 has a surface facing any cut plane XY, YZ, XZ of less than 5000 square millimeters.

Known microsurgical procedures are performed by a surgeon 200 or a microsurgical surgeon 200 using manual instruments such as forceps, scissors, and needle holders used to manipulate highly fragile tissues and ducts that are 1 mm or less in diameter. done manually. The most commonly performed microsurgical procedure step is anastomosis, where two small severed blood vessels are sutured together to reestablish blood flow. This procedure is performed by holding two adjacent vascular stubs with specific clamps and using a small caliber needle to perform the sutures. Accordingly, the microsurgical surgeon 200 must maintain a high level of concentration and sensitivity in order to suppress the natural tremor of the hand and delicately manipulate the fragile tissue with which the instrument interacts. It is clear that robotics can significantly improve the performance of complex microsurgical procedures.

According to one embodiment, the robot assembly 100 performs extremely precise motions that reduce the actual hand motions of the surgeon 200 and eliminate tremor while replicating the kinematics of a human wrist on a small scale. It has the ability to assist the surgeon 200 in performing microsurgical procedures by using the articulating and robotic devices.

According to one embodiment, the surgical robot assembly 100 includes a support 104, an articulated macro-positioning arm 30, and a pair of micro-positioning devices 41, 141, 241. A medical device 60, 160, 260 with a motor box 61 and a sterile articulation device 70, 170, 270 is attached to each micro-positioning device 41, 141, 241.

Two control devices 20 suitable for robotic control of two medical instruments 60 , 160 , 260 and micro-positioning devices 41 , 141 , 241 are connected to support 104 by communication cables 109 . All electronic control circuit boards and power supplies for the robot assembly 100 are integrated into the support 104, except for a control panel 108 for switching on and off and for the operator to manage user messages from the robot assembly 100. placed on the surface. A dedicated external video microscope input allows integration of any conventional external microscope 103 for microsurgical applications. A digital microscope 103 is integrated into the system to visualize the substantially overlapping working volumes 7 of the two sterile joint devices 70, 170, 270.

According to one embodiment, the possible configurations of the surgical robot assembly 100 are specifically dedicated to performing microsurgery on the end of a limb or on a free flap. A surgical table 102 on which a limb to be operated on or a free flap is placed is installed, connected to micro-positioning devices 41, 141, and 241, and remotely controlled in real time by a microsurgical surgeon 200 using each control device 20. This includes the use of a pair of articulation devices 70, 170, 270. The microscope 103 is not part of the surgical robot assembly 100, but is an independent element important for visualization of the working volume 7 during the performance of the surgery.

According to one embodiment, possible configurations of the surgical robot assembly 100 that are particularly suitable for breast reconstruction procedures, but also suitable for performing microsurgery on all other body regions include: a support 104 for supporting a patient 100 and for transporting a movable operating table 102 carrying a lying patient 201 to an adjacent operating room; and a surgical robot assembly extending from the support 104. one passive articulated macro-positioning arm 30 that allows 100 active components to reach the anatomical site involved in the procedure. A pair of precision micro-positioning devices 41, 141, 241, or micro-positioning devices 41, 141, 241, are located at the ends of the surgical robot assembly 100, each having four degrees of freedom; Attached to the positioning devices are respective medical instruments 60, 160, 260, which are used by the surgeon 200 to perform microsurgical procedures by manipulating tissue and small suture needles. All procedures are performed under visual guidance provided by an external conventional surgical microscope 103.

According to one embodiment, the support 104 has both structural and transport functions for the surgical robot assembly 100 and, with the macro-positioning arm 30 connected thereto, allows the support 104 to have both a structural and transport function for the surgical robot assembly 100 and to locate the anatomical site to be operated on. It becomes possible to simultaneously position a pair of micro-positioning devices 41, 141, 241 and medical instruments 60, 160, 260 that are close to each other. The micro-positioning devices 41 , 141 , 241 and the medical instruments 60 , 160 , 260 are actively moved and controlled by the control device 20 in real time.

According to one embodiment, each control device 20 includes a support clamp or bracket that can be independently positioned, for example by connecting to the operating table 102. The control device 20 is connected to the surgical robot assembly 100 by a power cable 107, which is also suitable for transmitting control data.

According to one embodiment, a retractable handle 106 and a footrest 105 are located on the rear side to facilitate transport of the surgical robot assembly 100. The cart 104 has a control panel 108 on the rear side for the user to manage parameters of the surgical robotic assembly 100 and to display messages or warnings for the machine itself. The on/off type switch (power button) and emergency stop button are located on the same side. A power cable 107 supplies current to the entire system, and the image data acquired by the digital microscope is transferred to the surgical instrument via a communication cable 109 so that the information obtained from the vision can be integrated into the control device. transmitted to robot assembly 100. According to one embodiment, the surgical robotic assembly 100 includes a footrest 105 located at the bottom of the rear side of the cart to support the robotic assembly 100 during positioning within the operating room. Suitable for use in conjunction with or as an alternative to the retractable handle 106 for transportation.

The footrest 105 allows the feet of the worker responsible for moving the robot assembly 100 to rest on it, so that the robot assembly 100 is pushed from the base, eliminating the risk of falling during movement. I can do it.

According to one embodiment, the controller 20 has the ability to control the micro-positioning device and the robotic motion of the medical instrument 60, 160, 260. The control device 20 comprises a control instrument 21 that detects the spatial position in real time by means of magnetic tracking sensors. The magnetic tracking sensor is made with a magnetic field generator and a wired marker housing a micro-bobbin, such as, but not limited to, a magnetic tracking sensor manufactured by NDI-Northern Digital Inc., 103 Randall Drive Waterloo, Ontario, Canada N2V1C5. "Planar field generator" and "NDI AURORA V3 tracking system" including "Mini 6DOF" sensor. The control instrument 21 integrates all the markers necessary for the detection of the six spatial coordinates of the control instrument 21 relative to the base structure 67 and has an additional gripping freedom provided at its tip 68 . The opening angle of the tip 68 is measured by a tip sensor, said tip sensor 29 being a position sensor or a proximity sensor. A connecting tendon 23 connects the control device 21 to a base structure 67, which base structure is in particular equipped with a magnetic field generator suitable for power supply and data transmission between the control device 21 and said base structure 67. A power and communications tendon 24, which houses the magnetic field generator but is not required when equipped with the sensing device 22, connects the magnetic field generator to an external power source on the robot assembly cart 104 and provides control instrument position and orientation, as well as control Data related to the opening angle of the forceps of the instrument 21 is transmitted. Further markers for the detection of the six spatial coordinates of the cart relative to the base structure 67 are present on the support 104 and are connected to the base structure 67 by power and communication tendons 24 . A status signal light 26 is integrated within the base structure 67 to communicate control device activity to the user. A soft, dedicated ergonomic operator support 27 is constructed to allow ergonomic use of the control device 20. The control instrument 21 reproduces the shape of conventional micro-instruments such as forceps and needle holders to make handling more intuitive and familiar to the surgeon.

According to one embodiment, the macro-positioning arm 30 allows the anatomical region involved in the surgical procedure to be determined by the active parts of the robotic assembly 100, such as the micro-positioning devices 41, 141, 241 and the medical instruments 60, 160, 260. can be reached by The macro positioning arm 30 consists of four members 31, 32, 33, 34 connected in series to each other by passive rotational joints having vertical and parallel arm movement axes a-a, bb, cc, respectively. Become. Inside each revolute joint, an electromagnetic brake allows the position of each single member to be spatially locked. For ease of gripping and actuation, a dedicated brake release button 35 located on the bottom side of the fourth arm member 34 allows all joint brakes to be released simultaneously. Therefore, each arm member can be spatially rearranged in space as required by the user. The new position can then be settled by undepressing the release button 35.

According to one embodiment, the first member 31 of the macro positioning arm 30 is connected to the cart 104 by a rack and pinion mechanism, by which when the manual knob 37 is rotated, the first member 31 is preferably The movement of the macro-positioning arm 30 within a dedicated linear slide guide 36 along a vertical linear displacement axis can be manually controlled.

According to one embodiment, the fourth member 34 of the macro-positioning arm 30 has a revolute joint at its tip, which revolute joint allows the fourth arm movement perpendicular to the third arm movement axis c--c. It is manually actuated by a dedicated rotating dial nut 43 that rotates about axis dd.

According to one embodiment, macro positioning arm 30 is connected to support member 38 via a revolute joint. The rotary joint is manually actuated by movement of the rotary dial nut 43. A pair of micro-positioning devices 41, 141, 241 are connected to the two tips of the support member 38, and the support member is further attached with a video camera 45 in the middle thereof, and the video camera is used for microsurgery. An enlarged image of the working volume 7 in which the work is carried out can be displayed. The medical device 60, 160, 260 is rigidly attached to the distal portion of the micro-positioning device 41, 141, 241.

According to one embodiment, the micro-positioning devices 41, 141, 241 are connected orthogonally to each other and along each of the three linear displacement axes ff, gg, hh and along the motorized rotary joint 46. It includes three electric slides 51, 52, 53 that can each move independently.

According to one embodiment, the motorized slides 51, 52, 53 are motorized microslides. The medical instrument 60, 160, 260 is rigidly attached to the micro-positioning device 41, 141, 241 which rotates about its longitudinal axis of rotation rr by means of a motorized rotational joint 46.

According to one embodiment, the medical instrument 60 has a motor housing 61 which includes at least one tendon drive system 50 for driving the articulation device 70 of the medical instrument 60 and its A termination device 77 is housed therein. According to one embodiment, a transmission mechanism integrated within a mechanical transmission box 62 connected to a motor housing 61 provides motion via a shaft 65 to the medical instrument 60, to the articulation device 70 and to the termination device 77. introduce.

According to one embodiment, the medical device 60 is configured with a motor housing 61 that includes an actuator for driving the medical device 60 and associated electronic control and motor driver boards. The mechanical transmission box 62 includes a dedicated mechanism for transmitting the motor movement along the axial direction XX via the shaft 65 to the articulation and termination device 77 and is connected to the motor housing 61. .

According to one embodiment, the motor housing 61 includes six pressing elements 95 associated with three degrees of freedom of the medical instrument 60. In particular, said pushing element is moved by at least one pusher assembly 94, which comprises a microphone with a linear transmission system lead screw and an electric motor. An actuation piston 95 emerges from the wall of the motor housing 61 facing the transmission box 62 and actuates a transmission mechanism integrated in the mechanical transmission box 62.

According to one embodiment, the motor housing 61 and the mechanical transmission box 62 are separated by a sterile barrier 87 and are integrally connected to each other by a connection mechanism, e.g. a bayonet connection, as shown in FIG. be able to.

According to one embodiment, the shaft 65 is hollow, made of metal, extends itself along the longitudinal direction XX and inserts itself into the mechanical transmission box 62. An articulation device 70, 170, 270 with a termination device 77 at the tip is inserted at the other shaft end or tip.

According to one embodiment, six pressing elements 95 implemented as working pistons connected to the motor move the motor housing 61 into the mechanical transmission box by coupling with a respective plunger 96 of the mechanical transmission box 62. 62.

According to one embodiment, said pressing element 95 and said plunger 96 are separated by a sterility barrier 87.

According to one embodiment, the plunger 96 can be moved linearly along the piston movement axis and by a linear bushing, not shown, inserted into the first frame part 58 or the upper frame 58, and respectively It is maintained in proper alignment by the shoulder surface 88 of.

According to one embodiment, the actuation of the articulation device 70 is assigned to six tendons 90 or actuation cables 90, which are independent and mechanically connected from a tendon fixing surface 84 in the mechanical transmission box 62. It travels to the articulation device 70 of the medical instrument 60 via the expression transmission box 62, the tendon passage hole, and the hollow shaft 65.

According to one embodiment, in the inner travel section of the mechanical transmission box 62, each tendon 90 is attached to said lower frame 59 so as to change its path direction until it is aligned with the instrument axis XX. It wraps around each of the four guide pulleys 97. Such guide pulleys 97 may be fixed pulleys or idle pulleys; in a preferred configuration, the first guide pulley 197 located closest to the first tendon end 91 is a fixed guide pulley 197. Except for the idle pulley.

According to one embodiment, a further plunger idler pulley 98 is mounted on each plunger 96 and moves together with that plunger along a linear piston pulley movement axis. Each actuation tendon 90 also partially wraps around a respective plunger idler pulley 98 secured to a respective plunger 96 . The plunger idle pulley 98 is arranged between the first guide pulley 197 and the second guide pulley 297.

According to one embodiment, the movement of the plunger 96 caused by the actuating piston 95 and therefore the movement of the plunger idler pulley 98 is caused by pressing the tendon 90 to cause the movement of the first guide pulley 197 and the second guide pulley 297 is changed. The length change is transmitted by the transmission mechanism to the distal joint of the medical device 60, 160, 260, causing its actuation.

According to one embodiment, a spring 99 suitable for acting by compression is inserted between the plunger idler pulley 98 and the upper frame 58 around the plunger 96.

According to one embodiment, the spring 99 generates a force directed along the axis of plunger movement and provides a variable preload on each plunger 96, which preload always causes the tendon 90 to be slightly It is sufficient to keep it under tension and avoid derailing from said guide element 97, 98, 197, 297 during changes in its traction load.

According to one embodiment, the tendon guiding element 89 maintains each tendon 90 in position and prevents its derailment even in the event of an abnormality such as loss of tension in the tendon 90.

According to one embodiment, the articulation device 70 has six low friction, low minimum radius of curvature, and high Use molecular tendons. Each actuation cable or tendon 90 is glued by low viscosity acrylic adhesive to the tendon fastening surface 84 of the lower frame 59 and includes four continuous guiding elements 97 integral with the lower frame 59 until reaching the center of the transmission box 62; 197, 297 and enters the articulation device 70, 170, 270 through the central hole in the shaft 65 of the medical instrument 60, 160, 260 distributed in the instrument direction XX. .

As shown in FIG. 13, the first guide pulley 197 of each actuation cable 90 is a fixed pulley 197 around which the tendon 90 is wrapped. The continuous guiding element is an idler pulley around which the tendon 90 is partially wrapped. A space is provided between the first guide pulley 197 and the second guide pulley 297 to allow linear movement of the plunger 96 actuated by the actuating piston 95.

According to one embodiment, at least one tendon 90 is wrapped around at least four guide pulleys 197, 297, 397, 497 thereby defining a third guide element 397 and a fourth guide element 497. Between the third guide element 397 and the fourth guide element 497, a tendon guide element 89 maintains the tendon 90 in the correct position and prevents the tendon 90 from derailing even in the event of an abnormality such as loss of tension. To avoid.

According to one embodiment, the articulation members forming the articulation devices 70, 170, 270 and their termination devices 77 add a grasping degree of freedom of movement at the tip and allow movement of the human wrist with a total of three degrees of freedom of movement. Reproduce.

According to one embodiment, the first articulation member 71 and the second articulation member 72 are connected to each other by a revolute joint 171 about a first axis of rotation PP, and then the first articulation member 72 of the end member The portion 177 and the second portion 277 of the end member are both connected to the second joint member 72 and are arranged around a second joint movement axis YY orthogonal to the first joint movement axis PP. It rotates freely and is provided with a termination device 77 at its tip.

According to one embodiment, the first member 71 locks onto or is coaxially joined to the shaft 65 of the medical device 60 and is rigidly attached thereto by a fixing pin 76 .

According to one embodiment, the six actuation cables 90 are symmetrical in two plane groups of three with respect to the axial section defined by the instrument axis XX and the first joint axis PP. and pass through the respective disposed medical device shafts.

According to one embodiment, the tendons and opposing tendons 90, 190 associated with the second articulation member 72 that provide clockwise and counterclockwise rotation about the first articulation axis PP are: are arranged opposite to each other with respect to said cross section and slide past two opposite sliding sides 40 of a first member 71, both then transverse said cross section in front of said first articulation axis PP. Then, it is wrapped around at least one joint sliding surface 80 of the second member 72 and finally attached to the second member 72.

According to one embodiment, the tendon associated with the first part 177 of the termination member and the counter tendon 90, as well as the two tendons 90 associated with the second part of the termination member 277, are both in said axial section. traveling on the same side, both sliding on the same sliding side 40, 140 of the first member 71, then both traversing said cross-section before the first joint movement axis PP, and then Both wrap around at least one identical sliding surface 80 of the second member 72, continue their path, and finally end by wrapping in opposite directions around the winding surface 86 of the end member 77. When only the first portion 177 of the termination member or only the second portion 277 of the termination member is actuated, the The associated tendon 90 slides along the sliding surface 80 of the second member 72 .

According to one embodiment, movement of the articulation device 70 is achieved by a polymer actuation cable 90 or a polymer tendon 90. These tendons 90 pass through the mechanical transmission box 62 and run along the entire hollow shaft 65 to reach the articulation device 70 and the termination device 77.

According to one embodiment, the transmission of motion to the joints of articulating device 70 is a function of the passage of tendons 90 within the articulating device.

By taking advantage of the low friction, very small radius of curvature of the tendons 90, the tendons slide over the articulation members that make up the articulation device and wrap around different articulation axes PP, YY.

According to one embodiment, the members constituting the articulation device 70 are actually rotatably connected to each other by the axial support function of the revolute joint 171. Each member has a joint sliding surface 80 or a joint winding surface 86 for the tendon 90 along its body centered on the joint movement axis PP, YY.

According to one embodiment, a further elbow joint member 75 is arranged in front of a wrist joint member 78 suitable for reproducing the movements of the human wrist, and is arranged in front of a wrist joint member 78, which is arranged in two different parallel joint movement axes PP, This can be included by providing an elbow joint member 75 characterized by having a P--P. According to one embodiment, a first member 71 is coupled to said elbow member 75, said elbow member 75 having two separate mutually parallel articulation axes PP, PP, respectively are the proximal side and the distal side, ie, the first joint and the second joint. The elbow member 75 has two sliding side surfaces disposed laterally opposite each other with respect to a second cross section defined as a plane including a first axis PP and a second joint movement axis YY. 40, 140.

According to one embodiment, there are eight actuation cables 90, 190. Said eight actuation cables or tendons run on the sliding side surface 40, 140 of the first member and are arranged in groups of four by four with respect to said first cross-section, and are aligned with a first joint movement axis P. -P, they run on the first joint sliding surface 80 of the elbow member 75 by traversing the cross section.

According to one embodiment, two actuation cables 90, 190 dedicated to the movement of the revolute joint 171 of the elbow member terminate in said elbow member 75. The remaining six cables 90, 190 continue along the sliding sides 40, 140 of the elbow revolute joint 171 and traverse the second cross section in front of said second joint axis. The next progression of the tendons around the second member 72, third member 73, and fourth member 74 into the end member first portion 177 and the end member second portion 277 is in the wrist configuration. Similar to those mentioned above in the description.

According to one embodiment, all the parts forming the articulation device 70 and the termination device 77 are manufactured by wire EDM performed on two orthogonal working planes XY, YZ.

According to one embodiment, the manufacture of the first member 71 begins with a cylindrical piece 117 to be machined, said first member having two circular surfaces allowing concentric insertion into the shaft 65. present.

According to one embodiment, said circular surface has a lower mating feature, such as a through hole, which allows a rigid attachment of said first member of shaft 65 by a fixing pin 76. The first member 71 has two mechanisms supporting the rotary joint 171 at its distal portion, each of which includes a cylindrical seat centered on the first joint movement axis PP, and a lateral Characterized by the shoulder surface.

According to one embodiment, all holes machined by wire EDM, such as pinhole 79, have an extra machined groove 49 caused by the passage of cutting wire 115.

According to one embodiment, said first cross section is defined comprising an instrument axis XX and a first articulation axis PP, and the first member 71 has two opposing tendon sliding surfaces 40 , 140, the two opposing tendon sliding surfaces 40, 140 being symmetrically opposed, ie mirror symmetrical with respect to said cross section, each having a rounded shape.

According to one embodiment, machined by wire EDM, each sliding surface 80 , 180 , 40 , 140 is formed by a sweeping movement of parallel linear generating bars moving directly along the cutting profile 110 .

According to one embodiment, the actuation cables 90 are slid in two groups of three along each of the two mutually opposing sliding sides 40, 140 of the first member 71; It traverses said section in front of the axis of rotation and then continues running onto the second member 72 .

According to one embodiment, said second member 72 has proximally an articulating sliding surface 80 disposed about said first articulating axis PP having a cylindrical portion.

According to one embodiment, said articulation sliding surface 80 is formed by parallel straight generating lines following a wire EDM cutting profile.

According to one embodiment, the articulation of the first member 71 about the first articulation axis PP is characterized by a pin retention mechanism 76 and a lateral shoulder surface. Two tendon termination features 82 are provided on the sides of the second member 72 to enable fixation of the second tendon termination 92 of the second member by knots or gluing. Distally, the two support mechanisms of the third and fourth revolute joints feature pinholes 79 and lateral shoulder surfaces about the second joint translation axis YY, respectively.

According to one embodiment, the second joint movement axis YY is orthogonal to the first joint movement axis PP. Since the pinhole 79 is processed by wire EDM, it has a processing groove 49 created by the cutting wire 115.

According to one embodiment, the third member 73 features a pinhole 79 placed around the second articulation axis YY. The third member 73 is fitted to the second member 72 by the seat of the articulating pin and the associated lateral shoulder surface. The winding surface 86 of the actuation cable 90, 190 allows the actuation cable 90, 190 to be wrapped around the winding surface 86 concentric with the second joint movement axis YY.

A tendon termination mechanism 82 and a tendon fixing point 82 are provided on the side surface of the third member 73. Tendon termination feature 82 allows passage of tendon 90, and tendon anchorage point 82 retains second tendon termination 92, 192 of third member 73 defined by the knot.

According to one embodiment, end member first portion 177 and end member second portion 277 are joined to second member 72 and share the same second articulation axis YY.

According to one embodiment, the first portion 177 of the termination member mirrors the shape of the second portion 277 of the termination member.

According to one embodiment, if the termination device 77 present on the third member 73 is a surgical or microsurgical medical instrument 60, for example similar to a scalpel blade, the third member 73 can be individually fitted to the members 72 of.

According to one embodiment, the terminal member 77 is itself a surgical or microsurgical medical instrument 60, similar to a scalpel blade or an optical fiber tendon carrier for laser light treatment. 77 can be individually joined to the second member 72. In this case, the articulation device 70 has only two degrees of freedom of movement, in particular pitch and yaw, and has lost the degree of freedom of grip.

According to one embodiment, the first portion 177 of the termination member and the second portion 277 of the termination member include a cutting microdevice, a termination microdevice providing a straight grip, a microdevice providing an angled grip, a needle A number of different termination devices 77 may be mated, such as holders and other conventional microsurgical instruments such as those illustrated in FIGS. 25-27. The termination devices reproduce the geometry, size, and functionality of conventional microsurgical instrument tips to facilitate their recognition and use by the microsurgical surgeon 200.

According to one embodiment, fixation pin 76 is inserted into a pin hole 79 in a member of articulation device 70. Fixation pin 76 is preferably made of hard metal and is conditioned and polished to reduce sliding friction.

According to one embodiment, the fixing pin 76 has a tightening margin when fitting into the pin hole 79 arranged corresponding to the joint movement axes PP and YY of the rotary joint 171.

According to one embodiment, the fixing pin 76 has a tolerance or clearance within the pinhole 79 associated with the winding surface 86.

According to one embodiment, the connection between the first member 71 and the second member 72 by means of a fixed pin 76 provides a connection between the first member 71 and the second member 72 at a second A rotary joint suitable for rotation around the joint movement axis PP is formed.

According to one embodiment, the single fixed pin connection between the second articulation member 72 and the end member first portion 177 and the end member second portion 277 is substantially between +90° and - A revolute joint between said three members 72, 177 and member 277 is formed with an associated working angle comprised within a range of 90°. The joint defines two degrees of freedom characterized by yaw and grip of the medical instrument 60.

According to one embodiment, polymeric tendons 90, 190 can be terminated in several ways. These methods provide a rigid fixation of the polymeric tendons 90, 190 so that they can be tensioned, and such tension can also be transmitted to the joint members or parts to which they are connected. Drive movement.

According to one embodiment, the tendon 90 passes through the tendon termination mechanism 82 and is locked by a knot formed in the tendon 90 itself located at said tendon fixation point 82.

According to one embodiment, a second method of securing the tendon 90, used for example for actuation of the second member 72, includes passing a loop of the tendon 90 around the tendon securing point 82 and , so that the tendon 90 acts as a single tendon 90 on both sides and the load it carries is halved.

According to one embodiment, a third method of securing the tendon 90 involves inserting the tendon portion into the tendon securing point 82 intended for this use and also, for example, attaching the first end 91 to the machine of the tendon drive system 50. An adhesive is used that is specific to the polymer from which the tendons 90 are made, such as that used to adhere to the lower frame 59 of the transmission box 62.

According to one embodiment, the articulation device 70 has three degrees of freedom of movement, in particular one pitch degree of freedom between the first member 71 and the second member 72, a second degree of freedom between the second member 72 and the third It features one yaw degree of freedom between the member 73 and one grasping or grasping degree of freedom between the end member first portion 177 and the end member second portion 277.

According to one embodiment, the second articulation member 72, the end member first portion 177, and the end member second portion 277 are aligned with the first articulation axis PP and the second articulation axis, respectively. It can move independently around the joint movement axis YY. Movement of the medical instrument 60 is effected by an actuation cable 90 running through members joined together by a revolute joint.

According to one embodiment, the pair of tendons 90, 190 are suitable to act as a pair of agonistic and antagonistic tendons associated with the first portion 177 of the termination member. Includes tendons 90 and opposing tendons 190. Further, the pair of tendons 90, 190 includes a tendon 90 and an opposing tendon 190 suitable to act as a pair of agonist and antagonist tendons associated with the second portion 277 of the termination member. Further, the pair of tendons 90, 190 includes a tendon 90 and an opposing tendon 190 suitable to function as a pair of agonist and antagonist tendons associated with the second articulation member 72.

According to one embodiment, a pair of tendons 90, 190, including a tendon 90 and an opposing tendon 190 suitable for actuating a pair of agonist and antagonist tendons, impart rotational movement to the second portion 277 of the termination member. The second joint movement axis Y--Y travels through the sliding side surface 40 of the first joint member 71, traverses the cross section, and causes the joint sliding movement of the second joint member 72. It runs over surface 80 and then splits, each wrapping in opposite directions around the winding surface 86 of the second portion 277 of the termination member and terminating in a knot. When one of the two tendons 90 , 190 is tensioned or released, it slides on the sliding surface 40 of the first joint member 71 and the second joint member 72 . It passes through the sliding surface 80 and either wraps around itself as on a fixed pulley or unwinds on the winding surface 86 of the fourth articulation member.

According to one embodiment, a further tendon pair 90, 190 consisting of a tendon 90 and an opposing tendon 190 actuates the first part 177 of the termination member in the same way as actuates the second part 277 of the termination member. let

According to one embodiment, a further pair of tendons 90, 190 comprising a tendon 90 and an opposing tendon 190 suitable to act as a pair of agonist and antagonist tendons connects the second joint member 72 to the first joint. The first member 71 is moved around the movement axis PP and runs over the sliding side surface 40, 140 of the first member 71 on one side with respect to the cross section of the medical device 60, and runs across the cross section and on the sliding side surface 40, 140 of the first member 71 in the opposite direction. They wrap themselves in opposite directions around the joint sliding surfaces 80 of the two joint members 72 and terminate at tendon fixation points 82 . Specifically, each actuating tendon 90, 190 of the second articulation member 72 is formed in a loop shape, passes around its respective tendon fixation point 82, and returns by folding back, similar to the travel path of the opposing tendon. It passes through the winding surface 86, the joint sliding surface 80, and the sliding side surface 40 along the path.

According to one embodiment, moving the second articulation member 72 about the first articulation axis PP in one rotational direction places both ends of the tendons 90, 190 under tension. Furthermore, unlike the two tendon pairs 90, 190 which actuate the end member first part 177 and the end member second part 277, respectively, in the case of the tendons 90 of the second articulation member 72, the tendons 90 During movement, rather than sliding past the sliding surface of the second articulating member 72, it wraps around or unwinds around said articulating sliding surface 80, as if it were a pulley.

According to one embodiment, six independent tendons 90 are used for actuation of the three degrees of freedom of movement of the articulation device 70, while eight cables are connected to the sliding side 40 of the first articulation member. and the sliding side surface 80 of the second articulation member 72. This is because the loop end portions of the actuation cables 90, 190 of the second member 72 are under tension during movement in one direction about the first joint movement axis PP.

According to one embodiment, the sliding surfaces 80, 180 between the actuation cable 90 and the members of the articulation device 70 are formed with a minimum surface area to reduce friction. The tendons 90, 190 are maintained as far as possible with their tendon paths TT parallel to the instrument axis XX, terminating at a second tendon termination 92, to avoid lateral forces. do.

According to one embodiment, the intersection of the tendons 90 and the crossing of said cross-section between the articulation sliding surface 40 and the first axis of rotation PP means that the tendon 90 crosses the articulation sliding surface during its movement. 80 and ensure a constant length and angle of the tendons 90, 190.

A method for fabricating three-dimensionally assembleable mechanical microcomponents by EDM is described below. In particular, the method allows for the manufacture of articulating devices 70 with characteristic outer diameters of less than 4 mm for applications in microsurgery. Furthermore, the main features of the particular machining tool 112, which are fundamental elements for the establishment of an economically sustainable manufacturing process and which are able to guarantee the required precision, are explained below.

According to one embodiment, the need to manufacture microcomponents with many mechanical details and high levels of precision requires the use of hard metals as the structural material and wire EDM as the processing process for the parts. do. As is known, EDM is a subtractive manufacturing process, in which material is removed by a conductive piece. The conductive strip itself and the electrode are separated by a dielectric liquid, such as water or oil, and a voltage difference is maintained between the conductive strip and the electrode, causing a series of electrical discharges until the desired shape of the material is obtained. A current is generated. In particular, during wire EDM processing, a workpiece 117 is held stationary and immersed in a dielectric liquid bath, for example made of copper or brass, with a diameter varying between 0.5 mm and 0.02 mm. A metal cutting wire 115 continues to run between the two bobbins. The cutting wire 115 is maintained in a horizontal plane by upper and lower guides driven by a computer numerical control system to perform a two-dimensional cutting profile. Although the movement of the guide is very precise, with an overall machining resolution close to 1 micron (μm), planar cutting substantially limits the production of three-dimensional parts. Although some advanced processing machines have upper guides that are independently movable in a horizontal plane, the ability to produce complex 3D parts has not been substantially improved.

The main advantages of wire EDM are:
Possibility to process hard metals,
no direct contact between the tool and the part 117 to be machined;
Being able to process delicate details without distortion,
being able to obtain a good surface finish;
being able to manufacture complex geometries or those that are difficult to manufacture with conventional cutting tools, while maintaining very low tolerances;
including.

For each cut surface, the manual process of fixing each single metal workpiece 117 to the processing machine, and then the calibration of the processing machine itself, is a very slow process during the manufacture of the part and is performed individually. It is also the process that introduces the greatest geometric errors that prevent a perfect fit between manufactured microcomponents.

According to one embodiment, a machining fixture 112 is provided that is specifically intended for this use, in order to substantially reduce manufacturing time and to ensure the precision necessary for a correct fit of the manufactured microcomponents. . The method provides mechanical support that allows simultaneous fixation and processing of all workpieces 117, and the articulation device 70 in one or more different planes by a single cutting profile 110 and a single calibration step. simplifying the assembly of at least a portion of the

According to one possible mode of operation, the front face of the processing fixture 112 has a member hole 116 suitable for holding the workpiece 117 with very tight tolerances, ie at least H6h5.

According to one possible mode of operation, the front side of the machining fixture 112 has a "stepped" profile that allows short through holes to be passed through the stepped sides.

According to one possible mode of operation, the grub screw M2 secures the workpiece 117 to the processing fixture 112 and ensures good electrical conductivity between the workpiece 117 and said processing fixture 112, which is the basis of a successful EDM process. guarantee sex.

According to one possible mode of operation, the grub screws are invisible under the plane in which they are screwed, ie headless. This is to avoid restricting the fixing of the jig along those planes in the vise of the EDM processing machine.

According to one possible mode of operation, as an alternative to a grub screw and a screw hole associated with a grub screw, the workpiece 117 is fixed to a machining fixture 112 and a good electrical conductivity is ensured in said machining fixture 112. Therefore, the use of conductive adhesive is necessary.

According to one possible mode of operation, on the processing fixture 112 the workpieces 117 are arranged such that they do not overlap in the working plane, for example the XY, YZ plane. By doing so, providing a single continuous cutting profile 110 of the wire allows cutting different independent details or profiles for each plane in each workpiece 117.

According to one possible mode of operation, the gaps or non-overlapping sections between two adjacent workpieces are minimized to keep the dimensions of the processing fixture 112 as compact as possible. In this way, it is possible to minimize the distance between the upper guide and the lower guide, improving machining accuracy.

According to one possible mode of operation, the metal reference rod 118 is inserted into the processing fixture 112 and used to calibrate the EDM machine once the processing fixture 112 and workpiece 117 are installed on the machine. .

According to one possible mode of operation, a first calibration is provided for a given machining fixture 112 with all workpieces 117 placed thereon and the EDM machine used for machining, and is performed only once. be done. The first calibration may identify and correct any errors related to the geometrical errors of the EDM machine and the processing fixture 112, such as the relative position between the reference rod 118 and the workpiece 117.

According to one possible mode of operation, once the position of the workpiece 117 is defined in various cutting planes with respect to the reference bar 118, the cutting profile 110 is adjusted to take into account any differences between the reference position and the actual position. is generated.

According to one possible mode of operation, said first calibration is repeated only if the EDM machine is changed or a new processing fixture 112 is used.

According to one possible mode of operation, a second calibration procedure is anticipated each time the processing fixture 112 with the workpiece 117 placed thereon is fixed in the vise of the EDM machine before cutting, or the cutting calibration is performed only on calibration rod 118. The cut calibration process eliminates geometric offsets and errors associated with manual fixturing of the fixture and identifies the origin of the machine reference system relative to the axis of the reference bar.

According to one possible mode of operation, in order to precisely fix the processing fixture 112 in the vise of the EDM processing machine, said processing fixture 112 has at least one pair of fastening or fixing surfaces 113 facing and parallel to each other. , 114 and a flat rear X-Z surface, the pair of fastening or fixing surfaces 113, 114 are adjusted to be gripped by the jaws of a vice, and the flat rear X-Z surface is adjusted so that it is perpendicular to the fixed surfaces 113, 114 and on the same plane as the reference plane of the processing machine, which is orthogonal to the clamp of the vice.

According to one possible mode of operation, by not using a rotary table in the EDM machine, the processing fixture 112 needs to have a pair of fixed surfaces 113, 114. The pair of fixing surfaces 113 and 114 are flat and parallel, and are adjusted to face each other with respect to each cut surface provided in the manufacture of the microcomponent.

According to one possible mode of operation, other cutting planes can be generated by suitably modifying the machining fixture 112.

According to one possible mode of operation, it is necessary to provide an opening 125 in the machining fixture for machining in a third orthogonal plane. Providing the opening 125 allows the cutting wire 115 to be inserted inside the processing jig, thus making it possible to avoid cutting a part of the processing jig 112, for example. However, several independent cutting profiles must be utilized without the need for further calibration. Nevertheless, at the end of every cutting profile 110 in said plane, the cutting wire 115 must be cut and reinserted into the next opening 125.

According to one possible mode of operation, the manufacturing process utilized for manufacturing the parts of the articulation device 70 includes four workpieces 117 consisting of metal cylinders made of tool steel that are inserted into the workpiece holes on the front side of the machining fixture 112. 116 and then securing them with M2 size grub screws.

According to one possible mode of operation, all three-dimensional microcomponents forming the micromedical articulation device 70 are made of wires from a metal workpiece 117, in particular a steel cylinder with an outer diameter of 3 mm and a length of 12 mm. Processed by EDM in two planes XY and YZ.

According to one possible operating mode, the processing fixture 112 with the workpiece 117 placed thereon is fixed in the vise of the EDM processing machine by using the fixing surfaces 113, 114 as reference planes for fixing, and then Calibration in the XY plane is performed using the axis of a reference rod 118 firmly attached to the processing jig 112 as a reference. A first cutting profile 110 is performed in the XY plane, machining all workpieces 117 fixed on a machining jig 112.

According to one possible mode of operation, the machining fixture 112 is then removed from the machine, rotated 90° to machine along said second plane YZ of the machining fixture 112, and re-rotated. It will be installed.

According to one possible mode of operation, a second calibration for the second machining plane YZ is performed and then cutting of the second cutting profile 210 is performed.

According to one possible mode of operation, by providing the EDM machine with a rotatable or orientable table, the cutting calibration process is carried out only once and can be adjusted as needed between one cutting profile and the next. It is possible to rotate the working plane.

According to one possible mode of operation, at the end of the second cutting profile 210, the manufactured part can be completely removed from the workpiece and collected in the machine bath of the EDM machine.

In accordance with one aspect of the present invention, a robotic assembly is provided that enables positioning and motion control of at least one joint medical instrument within a working volume in a reliable, accurate, and easily controllable manner. be.

According to one aspect of the present invention, by providing a robotic assembly, positioning and simultaneous movement of joined medical instruments by at least two of the medical instruments each having one articulation device operable within a workspace is provided. can be controlled in a reliable, accurate and easily controllable manner such that all body parts of the patient can be reached at the distal end of the medical device.

By providing a robotic assembly according to an aspect of the invention that includes an image capture system but does not have an integrated microscope, it is possible to limit the cost and physical volume of said assembly, and it is possible to limit the cost and physical volume of said assembly, making it possible to This creates a compact platform that can be adapted for installation, allowing for retrofit operation.

A low burden microsurgical robotic assembly is achieved by providing a robotic assembly according to an aspect of the present invention that has as few moving parts as possible that require a large range of movement during movement of the distal end of a medical instrument. It is possible to provide improved comfort for microsurgical surgeons. For example, it can be operated remotely while in close proximity to the operating table, thus allowing direct viewing and access to the surgical site. It also improves the overall working condition of the surgical team by avoiding collisions with moving parts of the robot, for example when accessing the surgical site, as well as improving the flow of people or air around the robot transport or robot assembly. can be simplified. Similarly, it becomes possible to use two or more robotic assemblies simultaneously for one patient.

By providing a control device according to one aspect of the invention, the remote control master interface can be simplified and made more intuitive and comfortable without limiting its functionality. At the same time, the required training time is reduced for surgeons who are not necessarily experts in microsurgical procedures in order to achieve sufficient proficiency with the control device.

By providing a microsurgical robot assembly according to an aspect of the present invention with control instruments suitable for replicating the geometry of conventional surgical or microsurgical instruments, it is possible for the surgeon to It is possible to provide a familiar master interface for remote operation.

At the same time, according to one aspect of the invention, by providing at least one sensor coupled to an electromagnetic three-dimensional tracking device, the control instrument is suitable for reproducing the functionality of a conventional surgical or microsurgical instrument. It also allows complete freedom of movement in three-dimensional space and also makes it possible to easily relocate the control device between, for example, an operating table and a microscope. Furthermore, a good performance of the robot system is guaranteed also in terms of response time.

At the same time, according to one aspect of the invention, the robot assembly and the sensing device are provided with a compact control device and at least one sensor suitable for associating the device with a common reference system, thereby making the control device flexible in a convenient manner. For example, the control device can be placed next to the operating table, on a support near the microscope, or in a position that is considered ergonomic for the surgeon looking into the microscope.

By providing a control instrument according to one aspect of the invention, which reproduces the shape of a conventional microsurgical instrument having at least one joint at its tip, such as a forceps forceps, with at least one aperture sensor, It is possible to control the opening, closing, and grasping movements of mated medical devices in a precise and familiar manner.

Providing a medical device comprising a tendon-driven articulation device according to an aspect of the invention reduces the complexity of its machining, for example by eliminating the provision of channels or sheaths, and reduces the complexity of its machining during use or assembly. This enables the ultimate miniaturization of medical instruments without reducing their reliability.

Providing an articulation device according to one aspect of the invention comprising an actuation cable or tendon made of a non-metallic material, such as a polymeric material, reduces the radius of curvature of said tendon and the coefficient of friction of said tendon, resulting in Further miniaturization of the articulating device is possible.

By providing an articulation device according to one aspect of the invention, having a woven surface with all parallel generatrix lines for sliding of said tendon, and a tendon termination feature arranged in a unique geometrical relationship with said surface. , it is possible to work without tendon guiding channels or sheaths, still ensuring parallelism of the tendons and thus allowing an extreme miniaturization of the articulating device.

By providing a manufacturing method according to an aspect of the present invention and a processing jig suitable for ensuring simultaneous positioning of multiple workpieces in such a way that the cutting lines are kept parallel to each other, It is possible to obtain a single cutting path with the EDM cutting wire for each cutting plane in the piece. In this way, it is possible to produce parallel surfaces on the part with high tolerances, even when very detailed and small geometries are machined.

By providing a manufacturing method according to one aspect of the invention, it is possible to produce micromechanical components that ensure high precision and surfaces that are suitable for medical and/or surgical applications.

By providing a manufacturing method according to an aspect of the present invention, it is possible to manufacture medical devices more quickly and, as a result, more cost-effectively than known solutions.

By providing a processing jig and a manufacturing method according to one aspect of the present invention, it is possible to obtain a fast and efficient process even when repeatedly positioning a workpiece in a processing machine.

By providing an improved machining jig for EDM according to an aspect of the present invention that accelerates the cutting process of multiple cutting planes, the number and duration of steps for machine calibration purposes can be reduced. It is possible.

By providing a manufacturing method for electrolytic corrosion according to an aspect of the present invention, which allows the fabrication of micromechanical components containing cavities and ridges, even leaving a groove between two prongs 81 of the material, the hole It is suitable for forming a pin holding mechanism without the need for machining, and it is possible to significantly reduce machining time.

By providing a tendon drive system according to an aspect of the invention, it is possible to ensure the movement of said tendon only by means of a pusher assembly suitable for pressing on said tendon and creating a tensile load on at least a part of said tendon. be. In this way, the drive system avoids pulling the tendon, for example by clinging to a portion of the tendon or by wrapping a portion of the tendon around a winch.

By providing a tendon drive system according to an aspect of the present invention, the number and complexity of parts of the drive device are reduced, and backlash of parts when those parts are not placed can be avoided. makes the system suitable for extreme miniaturization without compromising its reliability or its accuracy.

By providing a tendon according to one aspect of the present invention, it is possible to reduce the outer diameter of the tendon without degrading its performance in terms of durability or reliability, and as a result, the outer diameter can be reduced. become.

By providing a tendon according to an aspect of the invention, it is possible to ensure an improved performance with respect to sliding friction of the tendon in at least a part of the medical device compared to known solutions.

By providing a tendon and a tendon replacement method according to one aspect of the invention, it is possible to extend the working life of the instrument relative to known solutions.

By providing a tendon according to one aspect of the invention made of a non-metallic material, such as a polymeric material, it is possible to reduce the radius of curvature of the tendon and the coefficient of friction of the tendon, resulting in It is possible to improve the miniaturization of medical instruments equipped with tendons.

By providing a tendon according to one aspect of the invention, it is possible to operate without providing a tendon guide tube or sheath within the medical device, ensuring parallelism between multiple tendons and thus Extreme miniaturization of instruments is possible.

As mentioned above, articulation device 70 can be obtained by providing tendon 90 that includes second tendon termination 92 . The articulation device member does not require tendon guides or channels to facilitate the path of the tendons 90 so that they do not interfere with each other. In practice, the geometrical position of the tendon ends 92 is selected such that the tendons 90 run substantially parallel to each other and parallel to the sliding surfaces 40,80.

By providing sliding surfaces, such as sliding surfaces 40 and articulating sliding surfaces 80 as described above, the tendon is able to slide through the articulating device with low friction.

The coordination of the sliding surfaces 40, 80 with the geometrical positions of the first tendon end 91 and the second tendon end 92 reduces the frictional force between the tendon and the sliding surface as well as the first It is possible to ensure that the fastening reaction forces at the tendon end 91 and the second tendon end 92 are substantially parallel to each other and along the same axis.

By coordinating the sliding surfaces 40, 80 with the geometrical positions of the first tendon end 91 and the second tendon end 92, it is possible to realize an extreme miniaturization of the medical instrument 60. be. For example, in this way it is possible to work without providing pulleys and/or other tendon guides that are not suitable for miniaturization beyond a certain threshold. For example, according to one embodiment, the medical device shaft 65 may have an outer diameter of 3 millimeters.

By providing tendons 90 that maintain a radius of curvature below 1 mm, for example, the formation of loops is avoided when at least a portion of said articulating device 70 moves relative to the movement axes PP, YY. , it is possible to design a tendon path TT that wraps at least partially around the members 71, 72, 73, 74, 75, 77, 78, 177, 277 of the articulating device 70.

By providing said tendon drive system 50 and tendons 90, 190 having said first tendon termination 91 and said second tendon termination 92 raised and/or knotted and/or glued as described above. , it is possible to install and easily replace the tendons 90, 190 with high precision, extending the working life of the medical device 60. Furthermore, by providing tendons made of polymeric material, the members of the articulating device 70 are not damaged during active conditions.

Providing a tendon drive system 50 having at least a pusher assembly 94 mounted on the tendon deflectable portion 93 of the tendons 90 and adapted to push the tendons without compressing said tendons or It is possible to actuate said tendons without having to wrap them around the capstan.

In this way, it is possible to avoid damaging them when in working condition, and thus it is possible to extend the life of the tendons and the medical device 60 and reduce maintenance costs.

As mentioned above, by providing the tendon drive system 50, it is possible to minimize backlash within the tendon drive system 50 and always provide a predetermined preload.

By providing a substantially linear pusher assembly, micrometric actuation systems such as slides and piezoelectric actuators can be integrated to control tensile loading of the tendons as well as to release and pull precise lengths of tendons. It is possible to move at least a portion of the medical instrument by a desired amount, for example around an axis of movement.

Providing a tendon drive system suitable for cooperating with an articulating device across a sterile barrier allows for the production of reliable and sterile medical devices.

As mentioned above, by providing a manufacturing method based on EDM, it is possible to manufacture the entire joint device with only one placement step on the processing machine, and without reducing the reliability or accuracy of the manufacturing process. Time and cost can be reduced.

By providing the manufacturing method according to one aspect of the present invention, a tendon that slides over a joint member of a joint device having a woven surface having parallel generatrix lines is stationary relative to the joint member. It is possible to manufacture it in such a way that it is possible to maintain the path. Thereby, the friction between the tendon and the sliding surface of the joint member can be minimized, and the joint device can be easily miniaturized.

As previously mentioned, by providing a manufacturing method based on EDM, it is possible to obtain parts with sub-millimeter dimensions, as it is suitable for transmitting only thermal stimuli to the workpiece, and the extreme limits of the medical device 60 can be achieved. Enables downsizing. Also, by making cuts on multiple workpieces in a single pass, acceptable cutting accuracy is maintained.

By providing an EDM tool and method according to an aspect of the present invention suitable for cutting parts in multiple workpieces that are assembled together after machining in a single wire pass, prongs, pivot holes, etc. It is possible to obtain a fit with millimeter precision, which is particularly suitable for forming rotary joint mechanisms, such as profiles of joint members. Thus, the pieces can be securely attached by snap-fitting or by controlled backlash between like parts.

Surgeon familiarity and ergonomics may be improved by providing a robotic assembly 100 that includes at least one control instrument that replicates a conventional surgical instrument and control device that includes ergonomic support elements for the operator. This can result in improved surgical outcomes and patient comfort.

Avoiding structural mechanical vibrations at the end of the instrument by providing a robot assembly according to one aspect of the invention, comprising a macro-positioning arm with a mechanical structure of the arm member and a high stiffness joint. , thus making the surgeon's work easier.

Although several combinations of the embodiments described above are illustrated in the accompanying drawings, a person skilled in the art will be able to construct combinations not shown in the drawings without departing from the scope of the appended claims. would be able to do so.

In order to meet specific and undefined needs, those skilled in the art may make certain modifications, adaptations, and substitutions of functionally equivalent elements without departing from the scope of the following claims.

7 Working Volume or Common Working Space Volume 9 Aerial Segment of Tendons 16 Point of Intersection 18 Proximal Tendon Portion 19 Distal Tendon Portion 20 Control Device 21 Control Instrument 22 Sensing Device 23 Connection Cable 24 Communication and Power Cable 25 Operator Support Surface 26 Condition Signal light 27 Operator support element 28 Piston sensor 29 Tip sensor 30 Macro positioning arm 31 First arm member 32 Second arm member 33 Third arm member 34 Fourth arm member 35 Release button or brake release button 36 Straight line Slide guide 37 Manual knob 38 Support member 39 Mounting mechanism 40 Sliding surface 41 Micro positioning device 43 Rotating dial nut 45 Video camera 46 Electric rotary joint 47 Base 48 Plunger locking hole 49 Machining groove 50 Tendon drive system 51 First electric slide , or first electric micro slide 52 second electric slide, or second electric micro slide 53 third electric slide, or third electric micro slide 54 first slide rail 55 second slide rail 56 3 slide rails 57 frame 58 first frame part or upper frame 59 second frame part, drum or lower frame 60 medical instrument, micro instrument or surgical micro instrument 61 motor housing 62 mechanical transmission box 63 sharp edge of sliding side 64 continuous surface of sliding side 65 shaft or hollow shaft 67 control device base structure 68 tip of control device 69 forceps joint of control device 70 joint or multi-joint device 71 first member, First joint member or first link 72 Second member, second joint member or second link 73 Third member, third joint member or third link 74 Fourth member , fourth joint member, or fourth link 75 Elbow member or elbow link 76 Fixed pin 77 Termination device, termination member, or termination portion 78 Wrist member or wrist type joint member 79 Pinhole 80 Sliding surface or joint sliding Moving surface 81 Prong 82 Tendon termination mechanism or tendon fixation point 83 Surface 84 Tendon fastening surface 86 Winding surface or weave winding surface 87 Sterile barrier 88 Shoulder surface 89 Tendon guiding element 90 Tendon, actuation cable, or tendon end 1 pair of tendons 90' jacket 90'' core 90''
90''' coating 91 first end, first tendon end, proximal tendon end, or first tendon end 92 second end, second tendon end, distal tendon end, or second tendon end termination 92' tendon distal portion 93 tendon deflectable or deflectable portion 94 pusher assembly or means 95 pushing element, piston, actuating piston or linear actuating piston 96 plunger or sliding shaft 97 guiding element, tendon guiding element, or Guide pulley 98 Plunger idler pulley 99 Tensioning element, pretensioning element, or spring 100 Robotic surgical assembly, robotic surgical assembly, surgical robotic assembly, microsurgical robotic assembly, or microsurgical robotic assembly 102 Operating table 103 Vision system, microscope, or surgical microscope 104 Support or cart 105 Foot rest 106 Retractable handle 107 Power cable 108 Control panel 109 Communication cable 110 Cutting profile or cutting line 111 Display 112 Processing fixture 113 Fixation a first fixing surface of the first pair of surfaces 114 a second fixing surface of the first pair of fixing surfaces 115 a cutting wire, an EDM wire, or an electrical discharge machining wire 116 a part hole or a part sheet 117 a workpiece or workpiece to be machined Piece 118 Reference rod 120 First control device 122 First rod section 123 Second rod section 125 Guide hole or opening 134 First fixing surface of second pair of fixing surfaces 135 Second fixing surface Pair of second fixation surfaces 141 First micro-positioning device 145 First part of the plunger 146 Second part of the plunger 147 Pressure surface 148 Mutual pressure surface 150 Sensor 151 Force sensor 152 Pressure sensor 153 Proximity sensor 160 First medical device 170 first articulation device 171 revolute joint 172 articulation 173 spherical joint 177 first portion of end member 190 opposing tendons or opposing tendons of a first pair of tendons 191 tendons of a second pair of tendons 192 opposing tendons of the second pair of tendons 194 opposing pusher assemblies or opposing pusher assemblies 197 first guiding elements or first guiding pulleys 199 opposing tensioning elements, opposing pretensioning elements or opposing springs 210 second cutting profile 220 second control device 221 second control device 241 second micro-positioning device 260 second medical device 270 second articulation device 277 second portion of end member 297 second tendon guiding element, or Second tendon guide pulley 397 Third tendon guide element or third tendon guide pulley 497 Fourth tendon guide element or fourth tendon guide pulley 200 Surgeon or microsurgical surgeon 201 Patient 202 Surgical needle 341 Third micro-positioning device 360 Third medical instrument TT Tendon direction or tendon path XX Longitudinal axis direction or instrument axis PP Pitch axis or first joint movement axis Y-Y Yaw axis , or second joint movement axis a-a first arm movement axis bb second arm movement axis cc third arm movement axis dd fourth arm movement axis ee macro positioning arm Longitudinal axis of the base of ff First sliding direction gg Second sliding direction hh Third sliding direction rr Longitudinal axis of rotation XY First cutting plane YZ 2nd cutting plane X-Z 3rd cutting plane θ Axis angle

Claims (22)

A robotic surgical assembly (100) comprising a medical instrument (60, 160, 260), comprising:
a frame (57);
a joint device (70) having a degree of freedom relative to the frame;
at least one tendon (90, 190) made of polymer fibers for actuating said degrees of freedom;
Equipped with
at least one said tendon (90) has a tendon termination (92) connected to said medical device to apply a tensile load for actuating said degree of freedom;
To actuate the degrees of freedom, at least one of the tendons (90, 190) slides over at least a portion of the articulation device (70) while contacting at least a portion of the articulation device (70). death,
at least one said tendon (90) is made of braided strands, said strands being comprised of said polymer fibers;
Robotic surgical assembly (100). The robotic surgical assembly (100) of claim 1, wherein the degree of freedom is a revolute joint. The at least part of the articulation device (70) on which the at least one tendon (90, 190) slides is formed by a plurality of linear generatrixes parallel to the axis of the revolute joint. formed by convex linear weave surfaces (40, 80, 140, 180),
A robotic surgical assembly (100) according to claim 2. The at least part of the articulation device (70) on which the at least one tendon (90, 190) slides is defined by a plurality of linear generatrixes parallel or orthogonal to the axis of the revolute joint. It is formed by the formed convex linear surface (40, 80, 140, 180),
A robotic surgical assembly (100) according to claim 2. The articulation device (70) comprises at least two articulation links, and at least one of the tendons (90, 190) slides on both of the at least two articulation links.
A robotic surgical assembly (100) according to any one of claims 1 to 4. at least two of the articulated links are in contact with each other;
A robotic surgical assembly (100) according to claim 5. at least one said tendon (90, 190) has a PPI ranging from 20 to 60;
A robotic surgical assembly (100) according to any one of claims 1 to 6. the PPI of at least one said tendon (90, 190) is higher in its distal portion (92'), said distal portion (92') being located near said tendon end (92);
A robotic surgical assembly (100) according to any one of claims 1 to 7. Said distal portion (92') having a higher PPI has a length of no more than 1/3 of the length of said tendon, preferably no more than 1/10 of the length of said tendon. , more preferably has a length of 1/20 or less of the length of the tendon,
A robotic surgical assembly (100) according to claim 8. said tendon termination (92) is a knot;
A robotic surgical assembly (100) according to any one of claims 1 to 9. the knot is formed by locally heating to melt the segments of the tendon (90, 190);
A robotic surgical assembly (100) according to claim 10. the articulation link of the articulation device (70) includes a winding surface (86), the knot is placed on the winding surface (86);
Preferably, the winding surface (86) is a woven surface formed by linear generatrix lines that are all parallel to each other.
Robotic surgical assembly (100) according to claim 10 or 11. The articulation device (70) comprises a tendon fixation point (82) to which the tendon termination (92) is connected;
The frame (57) includes a shaft (65),
At least one said tendon (90, 190) is more flexible near or at said tendon fixation point (82) and near or within said shaft (65). harder in,
A robotic surgical assembly (100) according to any one of claims 1 to 12. At least one said tendon (90, 190) has a distal portion (92') located near said tendon termination (92), said distal portion (92') having a diameter in the range of 25 to 100. braided with PPI, preferably in the range of 50 to 100;
A robotic surgical assembly (100) according to any one of claims 1 to 13. at least one said tendon (90, 190) has a longitudinal portion (19) braided with PPI ranging from 3 to 25;
A robotic surgical assembly (100) according to any preceding claim. at least one said tendon (90, 190) is thinner at said tendon end (92) and/or said tendon distal portion (92');
A robotic surgical assembly (100) according to any one of claims 1 to 15. At least one said tendon (90, 190) has a core (90'') and a jacket (90'), said jacket (90') and/or said core (90'') being made of braided polymer strands. is made,
A robotic surgical assembly (100) according to any preceding claim. The jacket (90') is braided with a PPI ranging from 25 to 100;
A robotic surgical assembly (100) according to claim 17. The core (90'') is braided with a PPI ranging from 3 to 30;
Robotic surgical assembly (100) according to claim 17 or 18. The strands of the braided jacket (90') have a cross-sectional dimension, e.g. a diameter, that is smaller than the cross-sectional dimension, e.g. a diameter, of the strands of the braided core (90'').
A robotic surgical assembly (100) according to any one of claims 17 to 19. the linear density of the strands of the braided jacket (90') is lower than the linear density of the strands of the braided core (90'');
A robotic surgical assembly (100) according to any one of claims 17 to 20. the jacket (90') is or includes a coating;
Preferably, said coating is made of PDMS and/or PTFE.
A robotic surgical assembly (100) according to any one of claims 17 to 19.

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