WO2023053135A1

WO2023053135A1 - A robotically controlled anastomosis device

Info

Publication number: WO2023053135A1
Application number: PCT/IN2022/050861
Authority: WO
Inventors: Sudhir Prem SRIVASTAVA
Original assignee: Srivastava Sudhir Prem
Priority date: 2021-09-28
Filing date: 2022-09-27
Publication date: 2023-04-06

Abstract

The present invention relates to a robotically controlled anastomosis device (133) for performing anastomosis between a graft vessel and a target vessel in order to bypass the blocked in coronary artery to restore adequate blood flow to the heart muscle. The robotically controlled anastomosis device (133) comprising a hub assembly (205) positioned at a distal end of the anastomosis device (133), wherein the hub assembly (205) is operationally connected to a robotic arm assembly (101). Further, anastomosis device (133) includes an end-effector assembly (201) positioned at a proximal end of the anastomosis device (100). A shaft (203) one end is coupled to the hub assembly (205) and the shaft (203) other end is coupled to the end-effector assembly (201) and a cable (411) positioned within the shaft (203), wherein the cable (411) one end is secured to the hub assembly (205) and the cable (411) other end is secured to the end-effector assembly (201) to facilitates in actuation of the end-effector assembly (201) to perform anastomosis.

Description

A ROBOTICALLY CONTROLLED ANASTOMOSIS DEVICE

FIELD OF THE DISCLOSURE

The present invention generally relates to a surgical device, and more particularly, the invention relates to a device for performing anastomosis in a robotic assisted surgery.

BACKGROUND OF THE DISCLOSURE

This section is intended to introduce the reader to various aspects of art that may be related to various aspects of the present disclosure, which are described below. This disclosure is believed to be helpful in providing the reader with background information to facilitate a better understanding of the various aspects of the present disclosure. Accordingly, it should be understood that these statements are to be read in this light, and not just as admissions of prior art.

Anastomosis is a surgical procedure in which two blood vessel or arteries are joined together to form/restore a continuous blood flow channel. Anastomosis may be performed for treatment of various medical condition such as coronary artery diseases (CAD). When a patient suffers from (CAD), an occlusion or stenosis in a coronary artery restricts blood flow to the heart muscle. In order to treat CAD, the area where the occlusion occurs is bypassed to reroute blood flow by grafting a vessel in the form of a harvested artery or vein, or a prosthesis. Anastomosis is performed between a graft vessel and two target vessels in order to bypass the blocked coronary artery, circumvent the occlusion and restore adequate blood flow to the heart muscle. This treatment is known as a coronary artery bypass graft procedure (CABG).

In a CABG procedure, a graft vessel such as a saphenous vein, mammary artery, radial artery or other blood vessel is harvested from the patient or another source, then placed in a bowl or other container and immersed in saline, blood or other biocompatible liquid. Before that graft vessel is connected to the target vessels, it may be prepared in some way, such as by connecting it to an anastomosis device and/or a tool for applying the anastomosis device. The graft vessel is typically connected to the anastomosis device and/or tool manually by one or more people in the operating room, using forceps, tweezers and/or other tools. Substantial skill is required to connect the slippery graft vessel to the anastomosis device and/or tool without damaging the graft vessel or otherwise rendering it unusable.

In the conventional CABG, a large incision is made in the chest and the sternum is sawed in half to allow access to the heart. In addition, a heart lung machine is used to circulate the patient's blood so that the heart can be stopped and the anastomosis can be performed. In order to minimize the trauma to the patient induced by conventional CABG, less invasive techniques have been developed in which the surgery is performed through small incisions in the patient’s chest with the aid of endoscope.

There exists an anastomosis device in the art which are used for performing the anastomosis. However, such anastomosis devices are complex to manufacture, costlier and difficult to use.

In the light of aforementioned challenges, there is a need for an improved robotically operated anastomosis device that allows ease, safety, and less cost for performing anastomosis.

SUMMARY

A robotically controlled anastomosis device (133) to connect a graft vessel to a target vessel comprising a hub assembly (205) positioned at a distal end of the anastomosis device (133), wherein the hub assembly (205) is operationally connected to a robotic arm assembly (101). The anastomosis device further comprises an end-effector assembly (201) positioned at a proximal end of the anastomosis device (133) and a shaft (203), wherein the shaft (203) one end is coupled to the hub assembly (205) and the shaft (203) other end is coupled to the endeffector assembly (201). A cable (411) positioned within the shaft (203), wherein the cable (411) one end is secured to the hub assembly (205) and the cable (411) other end is secured to the end-effector assembly (201) to facilitates in actuation of the end-effector assembly (201) to perform anastomosis.

The hub assembly (205) further comprises a plurality of disc (303), (305), (307) and (309) operationally connected to the end-effector assembly (201) to facilitate roll, pitch, yaw and clamping/unclamping of the end-effector assembly (201). The hub assembly (205) further comprises a plurality of disc (303), (305), (307) and (309), wherein the one disc from the plurality of disc (303), (305), (307) and (309) is operationally connected to the end-effector assembly (201) by the cable (411) to facilitate in actuation of the end-effector assembly (201) to perform anastomosis.

A robotically controlled anastomosis device (133) to connect a graft vessel to a target vessel comprising an anvil assembly (403) having a longitudinal axis and a cable (517) secured to a cartridge body (503) at one end and other end of the cable (517) is secured to a hub assembly (205), wherein the cable (517) facilitates in actuating an end-effector assembly (201) to perform anastomosis. Further, the cable (517) is crimped to the cartridge body (503) at a hole (527) and other end of the cable (517) is secured to the hub assembly (205).

The anvil assembly (403) further comprising a plurality of pockets (602) configured at its distal end a plurality of staple (513) is configured to deformed against the plurality of pocket (602). A knife (603) positioned at center of the anvil assembly (403) a knife block (605) positioned at a rear end of the knife (603), wherein the knife block (605) facilitates in advancing the knife (603) along the longitudinal axis of the anvil assembly (403). The knife block (605) includes a spring finger (613) to position the knife (603) riding on a ramp (615).

A robotically controlled anastomosis device (133) to connect a graft vessel to a target vessel comprising a cartridge assembly (401) having a cartridge cap (501) and a cartridge body (503) and a cable (517) secured to a cartridge body (503) at one end and other end of the cable (517) is secured to a hub assembly (205), wherein the cable (517) facilitates in actuating an end-effector assembly (201) to perform anastomosis. The cartridge cap (501) includes a plurality of flap tines (409) positioned at its distal end and the cartridge body (503) includes at least a heel clip (407) positioned between the distal end and the proximal end of the cartridge body (503). The cartridge body (503) further comprises two arms (507a), (507b) at its distal end and the two arms (507a), (507b) includes a cartridge (509a), (509b) containing plurality of staple drivers (511) and plurality of staples (513). Furthermore, the cartridge body (503) comprises a dual wedge (515), wherein the dual wedge (515) includes two legs (519a), (519b). Further, distal end of the two legs (519a), (519b) includes a cam (521a), (521b) configured to facilitate the drivers (511) movement in vertically downward direction to push the staples (513) against the against the plurality of pocket (602) of the anvil assembly (403).

BRIEF DESCRIPTION OF THE DRAWINGS

The summary above, as well as the following detailed description of the disclosure, is better understood when read in conjunction with the appended drawings. For the purpose of illustrating the present disclosure, exemplary constructions of the disclosure are shown in the drawings. However, the present disclosure is not limited to specific methods and instrumentalities disclosed herein. Moreover, those skilled in the art will understand that the drawings are not to scale. Wherever possible, like elements have been indicated by identical numbers.

Embodiments of the present disclosure will now be described, by way of example only, with reference to the following diagrams wherein:

FIG. 1(a) illustrates an example implementation of a multi arm teleoperated surgical system which can be used with one or more features in accordance with an embodiment of the disclosure;

FIG. 1(b) illustrates a perspective view of an example robotic cart assembly in accordance with an embodiment of the disclosure;

FIG. 2 illustrates a perspective view of a robotically controlled anastomosis device in accordance with an embodiment of the disclosure;

FIG. 3 illustrates a back view of the distal end of the robotically controlled anastomosis device in accordance with an embodiment of the disclosure;

FIG. 4(a) illustrates a perspective view of a proximal end of the robotically controlled anastomosis device in accordance with an embodiment of the disclosure;

FIG. 4(b) illustrates another perspective view of the proximal end of the robotically controlled anastomosis device in accordance with an embodiment of the disclosure;

FIG. 5(a) illustrates a cartridge assembly of the proximal end of the robotically controlled anastomosis device in accordance with an embodiment of the disclosure;

FIG. 5(b) illustrates an exploded view of the cartridge assembly of the proximal end of the anastomosis device in accordance with an embodiment of the disclosure;

FIG. 5(c) illustrates an inside view of the cartridge assembly in accordance with an embodiment of the disclosure;

FIG. 6(a) illustrates an anvil assembly of the proximal end of the robotically controlled anastomosis device in accordance with an embodiment of the disclosure;

FIG. 6(b) illustrates a cross-sectional view of the anvil assembly of the proximal end of the robotically controlled anastomosis device in accordance with an embodiment of the disclosure;

FIG. 6(c) illustrates a cross-sectional view of an initial position of a knife assembly of the anvil assembly in accordance with an embodiment of the disclosure;

FIG. 6(d) illustrates a cross-sectional view of a cutting position of the knife assembly of the anvil assembly in accordance with an embodiment of the disclosure;

FIG. 7(a) illustrates a cross-section view of the anvil assembly and the cartridge assembly depicting initial position of clamping in accordance with an embodiment of the disclosure;

FIG. 7(b) illustrates the cross-section view of the anvil assembly and the cartridge assembly depicting clamped position in accordance with an embodiment of the disclosure;

FIG. 7(c) illustrates the cross-section view of the anvil assembly and the cartridge assembly depicting final clamped position in accordance with an embodiment of the disclosure;

FIG. 8(a) illustrates a dual wedge cam follower assembly depicting initial position of clamping in accordance with an embodiment of the disclosure; FIG. 8(b) illustrates the dual wedge cam follower assembly depicting clamped position in accordance with an embodiment of the disclosure; and

FIG. 8(c) illustrates the dual wedge cam follower assembly depicting final clamped position in accordance with an embodiment of the disclosure.

DETAILED DESCRIPTION OF THE DISCLOSURE

For the purpose of promoting an understanding of the principles of the disclosure, reference will now be made to the embodiment illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the disclosure is thereby intended, such alterations and further modifications in the illustrated system, and such further applications of the principles of the disclosure as illustrated therein being contemplated as would normally occur to one skilled in the art to which the disclosure relates.

It will be understood by those skilled in the art that the foregoing general description and the following detailed description are exemplary and explanatory of the disclosure and are not intended to be restrictive thereof. Throughout the patent specification, a convention employed is that in the appended drawings, like numerals denote like components.

Reference throughout this specification to “an embodiment”, “another embodiment”, “an implementation”, “another implementation” or similar language means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment of the present disclosure. Thus, appearances of the phrase “in an embodiment”, “in another embodiment”, “in one implementation”, “in another implementation”, and similar language throughout this specification may, but do not necessarily, all refer to the same embodiment.

The terms “comprises”, “comprising”, or any other variations thereof, are intended to cover a non-exclusive inclusion, such that a process or method that comprises a list of steps does not include only those steps but may include other steps not expressly listed or inherent to such process or method. Similarly, one or more devices or sub-systems or elements or structures proceeded by “comprises... a” does not, without more constraints, preclude the existence of other devices or other sub-systems or other elements or other structures or additional devices or additional sub-systems or additional elements or additional structures.

Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure belongs. The device, system, and examples provided herein are illustrative only and not intended to be limiting.

The terms “a” and “an” herein do not denote a limitation of quantity, but rather denote the presence of at least one of the referenced items. Further, the term sterile barrier and sterile adapter denotes the same meaning and may be used interchangeably throughout the description.

Embodiments of the disclosure will be described below in detail with reference to the accompanying drawings.

The disclosure relates to a device for manually performing anastomosis between a graft vessel and a target vessel in order to bypass the blockage in coronary artery to restore adequate blood flow to the heart muscle. The anastomosis device is intended to create an end-to-side anastomosis between a graft vessel and a target vessel. The anastomosis is created by the delivery of staples that connect the graft vessel to the target vessel and the creation of an incision to open a flow path between the graft vessel and the target vessel. The manually operated configuration of the anastomosis device incorporates a handle for actuating endeffector by a shaft coupled to the handle and the end-effector.

FIG. 1(a) illustrates an example implementation of a multi arm teleoperated surgical system which can be used with one or more features in accordance with an embodiment of the disclosure. Specifically, FIG. 1(a) illustrates the multi arm teleoperated surgical system (100) having plurality of robotic arms. In one implementation, the multi arm teleoperated surgical system may have four robotic arms (101a), (101b), (101c), (lOld) mounted on four robotic arm carts respectively around an operating table (103). The four-robotic arms (101a), (101b), (101c), (lOld) as depicted in FIG. 1(a) is for illustration purpose and the number of robotic arms may vary depending upon the specific requirement and may also depend upon the type of surgery. The four robotic arms (101a), (101b), (101c), (lOld) are arranged along the operating table (103) and may be arranged in different manner but not limited to the robotic arms (101a), (101b), (101c), (lOld) arranged along the operating table (103). The robotic arms (101a), (101b), (101c), (lOld) may be separately mounted on the four robotic arm carts or the robotic arms (101a), (101b), (101c), (lOld) mechanically and/ or operationally connected with each other or the robotic arms (101a), (101b), (101c), (lOld) connected to a central body (not shown) such that the robotic arms (101a), (101b), (101c), (10 Id) branch out of a central body (not shown). Further, the multi arm teleoperated surgical system (100) may include a console system (105), a vision cart (107), and a surgical instrument, accessories table (109).

FIG. 1(b) illustrates a perspective view of an example robotic cart assembly in accordance with an embodiment of the disclosure. The robotic cart assembly (101) may include a robotic cart (111), a base lift assembly (113), a plurality of wheel (115), a hand steering assembly (117), a column assembly (119), a set-up joint assembly (121), a telescopic joint assembly (123) and a parallelogram arm assembly (125). A surgical instrument interface assembly (127) is secured to a distal end of the parallelogram arm assembly (125). A surgical instrument actuator assembly (129) is mounted on the surgical instrument interface assembly (127) by a guide rail mechanism and capable of moving along a longitudinal axis of the surgical instrument interface assembly (127). A sterile adapter assembly (131) is releasably mounted on the surgical instrument actuator assembly (129) to separate a non-sterile part from a sterile part in a surgical theater. A locking mechanism (not shown) is provided to releasably lock and unlock the sterile adapter assembly (131) from the surgical instrument actuator assembly (129). A surgical instrument assembly (133) may be releasably lock/ unlock or engages/disengages from the sterile adapter assembly ( 131) by means of a push button (311a, 311b) (as shown in FIG. 3). The surgical instrument assembly (133) may be an anastomosis device as shown in FIG. 2.

As illustrated in FIG. 2, the anastomosis device (133) comprises a proximal end (201), a distal end (205) and a shaft (203) connecting the proximal end (201) to the distal end (205). The proximal end (201) may interchangeably be referred as an end-effector or end-effector assembly (201) throughout the description. The end-effector (201) is the actual part of the anastomosis device (100) which touches the graft vessel and the target vessel to perform anastomosis. The distal end (205) may be an actuation mechanism which facilitates the proximal end (201) in performing the anastomosis. The connecting shaft (203) may include a cable (not shown) to facilitate in performing the anastomosis by transmitting the actuation from distal end (205) to the proximal end (201). The connecting shaft may be made of a rigid material. The details of the distal end (201) and the proximal end (205) are disclosed in the forthcoming description.

FIG. 3 illustrates a back view of the distal end of the robotically controlled anastomosis device (133). The distal end (205) of the robotically controlled anastomosis device (133) may also be referred as hub assembly (205) which consists of an actuation mechanism. The hub assembly (205) may include a housing (301), plurality of disc (303), (305), (307) and (309). The plurality of disc (303), (305), (307) and (309) are configured to rotate in both directions (clockwise and counter-clockwise) to provide various movements of the end-effector (201) such as roll, pitch, yaw and clamping/unclamping of a cartridge assembly to fire the staples from the cartridge assembly. Each disc (303), (305), (307) and (309) includes a plurality of pins spaced apart from each other and protruding from the respective disc (303), (305), (307) and (309). In one implementation, the surgical instrument disc (303) may include a pin (303a, 303b), the surgical instrument disc (305) may include a pin (305a, 305b), the surgical instrument disc (307) may include a pin (307a, 307b) and the surgical instrument disc (309) may include a pin (309a, 309b) respectively. Further, the hub assembly (205) may include a plurality of push button (311a, 311b) to disengage the robotically controlled anastomosis device (133) from the sterile adapter assembly (131).

As illustrated in FIG. 4(a) and FIG. 4(b), the proximal end of the robotically controlled anastomosis device comprises a cartridge assembly (401) and an anvil assembly (403). The proximal end may also be referred as end-effector/ end-effector assembly (201). The cartridge assembly (401) comprises plurality of staples and its driver’s assembly (405), a heel clip (407) and a plurality of flap tines (409). An actuation cable (411) one end is secured to the cartridge assembly (401) by means of various securing mechanism but not limited to crimping. The other end of the actuation cable (411) is operationally secured to the hub assembly (205).

The end-effector (201) assembly is coupled to the hub assembly (205) by means of a shaft (203). The shaft (203) is capable to rotating along its longitudinal axis so that the surgeon can achieve the desired position of the end-effector assembly (201) at the time of positioning the anastomosis device to perform anastomosis (133). The rotation of shaft is facilitated by one or more disc from the plurality of (303), (305), (307) and (309) as illustrated in FIG. 3. Further, the pitch movement (413) of the end-effector assembly (201) is facilitated by a clevis (415), a pitch cable (417) and any one of the discs from the plurality of disc (303), (305), (307) and (309) and yaw movement (419) of the end-effector assembly (201) is facilitated by a clevis (415), a yaw cable (421) and any one of the discs from the plurality of disc (303), (305), (307) and (309).

According to one implementation, the method used for performing the anastomosis is to first prepare the graft vessel and mount it on the cartridge assembly (401). The graft vessel is prepared by creating a hood and the graft vessel is positioned between the arms (507a, 507b) (as shown in FIG. 5(b)) of the cartridge assembly (401) with an apex of the hood fitted onto the heel clip (407). The flaps of the hood are pressed onto the flap tines (409). The next step is to create a small incision in the target vessel. The anastomosis device is positioned and the anvil assembly (403) is inserted into the target vessel. The positioning of the end-effector assembly (201) after insertion into the target vessel is facilitated by a robotic arm (101) to which the distal end (205) is mounted. After insertion of the anvil assembly (403) into the target vessel, the anastomosis device (133) is actuated a surgeon through the console system (105) (as show in FIG. 1(a)). First, the end-effector assembly (201) is clamped and this action clamps the anvil assembly (403) (inside the target vessel) to the cartridge assembly (401) (with the graft vessel mounted on it). Once the anvil assembly (403) is fully clamped with the cartridge assembly (401), the anastomosis device (133) immediately proceeds with the deployment/forming of the staples facilitated by driver’s and staple assembly (405) and the creation of the incision which opens the required flow path between the graft vessel and the target vessel. When the actuation is complete, the cartridge assembly (401) has moved to a position to permit automatic unclamping when the actuation force is relaxed by releasing the surgeon from the console system (105). Once the anvil assembly (403) and the cartridge assembly (401) are unclamped, the anvil assembly (403) can be withdrawn from the target vessel a suture is placed to stitch and close hole created by the anvil assembly (403).

As illustrated in FIG. 5(a), FIG. 5(b) and FIG. 5(c), the cartridge assembly (401) includes a cartridge cap (501) made up of any biocompatible materials. The cartridge assembly (401) further includes a cartridge body (503). The proximal end (505) of the cartridge body (503) includes two arms (507a), (507b) and each arm (507a), (507b) includes a bay /cartridge (509a), (509b) containing plurality of staple drivers (511) and plurality of staples (513). As illustrated in FIG. 4(c), the cartridge body (503) contains the plurality of staple drivers (511), plurality of staples (513) and a dual wedge (515). The cartridge assembly (401) has been designed to execute the required sequence of operation with the actuation of a cable (517). This is a significant simplification over other anastomosis devices which have four or more cables that are required. The plurality of staples (513) is used to connect the graft vessel to the target vessel. These staples (513) are arranged in bays/cartridges (509a), (509b) which are molded into both arms (507a), (507b) of the cartridge body (503). The staples (513) are formed against pockets (602) in the anvil assembly (403) as shown in FIG. 6(a) and FIG. 6(b). The staples (513) are advanced by individual drivers (511) one for each staple (513). The plurality of drivers (511) is sequentially actuated from right to left (as shown by the referral numeral 529) via a dual wedge (515). The dual wedge (515) has two legs (519a), (519b), one leg for each arm (509a), (509b) of the cartridges body (503). The one end of the dual wedge (515) includes a cam (521a), (521b) for moving the plurality of drivers (511) in downwardly to push the respective plurality staples (513) against the pocket (602) to perform the anastomosis.

The two legs (519a), (519b) of the dual wedge (515) includes a cam follower (523a), (523b) which facilitates in advancing the dual wedge (515) to facilitate the anastomosis. Further, the dual wedge (515) includes a cable hole (527) through which the one end of the actuation cable (517) is secured. The dual wedge (515) also includes an actuation tab (525) pointing in downwards direction which facilitate in advancing a knife block (605) (as shown in FIG. 6(b)) and which is explained in the description below.

As illustrated in FIG. 6(a), FIG. 6(b), FIG. 6(c) and FIG. 6(d), the anvil assembly (403) includes a knife (603) and a knife block (605) for creating the incision in the target vessel that establishes the required flow path. The knife (603) is positioned within the anvil assembly (403) for creating the incision in the target vessel. The initial position of the knife (603) (as shown in FIG. 6(b)) is retracted for easy insertion of the anvil (601) into the target vessel. The surgeon actuates the anastomosis device through the console system (105) (as show in FIG. 1(a)) and a cable (602) facilitate in advancing the knife (603) and as the staples (513) (as shown in FIG. 5(c)) are formed, the knife (603) advances on a ramped surface (607) (as shown in FIG. 6(d)) to cutting the target vessel. Just prior to the end of stroke, the knife (603) moves down a ramp back (609) to the retracted position (as shown in FIG. 7(c)) within the anvil for ease of removal. The other end which is opposite to the cutting end of the knife (603) has circular/oval profile (611). The circular/oval profile (611) of the knife (603) is positioned on a knife block (605). The knife block (605) has a spring finger (613) to keep the knife (603) riding on the ramp (615). Now, referring to FIG. 5(c), the knife block (605) is advanced when the actuation tab (525) on the dual wedge (515) engages it and pushes it in forward direction. Specifically, the dual wedge (515) actuation tab (525) is behind the knife block (605) initially. As the dual wedge (515) advances forward, the first staple (513) is formed. Then the actuation tab (513) of the dual wedge (515) engages the knife (603) so that the cut is initiated after the first staple (513) is formed. Similarly, as the dual wedge (515) continues forward, the knife (603) continues to cut the tissue just proximal of the next forming staple. Finally, the knife (603) is retracted on the ramp (609) as the last staple is formed. The result is a cut that begins just distal of the first formed staple and stops just proximal of the last formed staple.

As illustrated in FIG. 7(a), FIG. 7(b) and FIG. 7(c), in order to activate the anastomosis device with a cable (602) (as shown in FIG. 6(a)), the design takes advantage of the fact that clamping of anvil assembly (403) and the cartridge assembly (401) always precedes the dual wedge (515) (as shown in FIG. 5(c)) advancing. The single deployment cable (602) is attached to the one end of the dual wedge (515). The cable (602) is routed from the dual wedge (515) around a first guide pin (701) and down to a second guide pin (703) on the anvil (705) and then routed out from the rear end (707). In order to ensure that the dual wedge (515) does not advance when the cable (602) is pulled until the anvil (705) and cartridge assembly (709) are clamped as shown in FIG. 7(b), legs with cam posts (523a), (523b) (as shown in FIG. 5(c)) are provided on both sides of the dual wedge (515). The rear end (707) of the anvil (705) is a circular profile (711) through which a pitch cable (411) (as shown in FIG. 4(a)) is routed to provide pitch movement of the end-effector assembly (201).

Referring to FIG. 8(a), FIG. 8(b) and FIG. 8(c), initially, when the anvil (705) and cartridge assembly (709) (as shown in FIG. 7(a)) are unclamped (due to a leaf spring (801) that forces them open), a dual wedge cam follower (803) are in a track (805) that only permits rotation of the dual wedge cam follower (803) as required for clamping. Once fully clamped, the dual wedge cam follower (803) aligns with a new section of horizontal track (807) that allows the dual wedge cam follower (803) to advance along the horizontal track (807). Once the dual wedge cam follower (803) gets to the final distal position, the cam path opens up again allowing the dual wedge cam follower (803) (and cartridge) to rotate back to the unclamped position (809).

The foregoing descriptions of exemplary embodiments of the present disclosure have been presented for purposes of illustration and description. They are not intended to be exhaustive or to limit the disclosure to the precise forms disclosed, and obviously many modifications and variations are possible in light of the above teaching. The exemplary embodiment was chosen and described in order to best explain the principles of the disclosure and its practical application, to thereby enable others skilled in the art to best utilize the disclosure and various embodiments with various modifications as are suited to the particular use contemplated. It is understood that various omissions, substitutions of equivalents are contemplated as circumstance may suggest or render expedient but is intended to cover the application or implementation without departing from the spirit or scope of the claims of the present disclosure.

Benefits, other advantages, and solutions to problems have been described above with regard to specific embodiments. However, the benefits, advantages, solutions to problems, and any component(s) that may cause any benefit, advantage, or solution to occur or become more pronounced are not to be construed as a critical, required, or essential feature or component of any or all the claims.

While specific language has been used to describe the disclosure, any limitations arising on account of the same are not intended. As would be apparent to a person in the art, various working modifications may be made to the device in order to implement the inventive concept as taught herein.

Claims

1. A robotically controlled anastomosis device (133) to connect a graft vessel to a target vessel, the anastomosis device (133) comprising: a hub assembly (205) positioned at a distal end of the anastomosis device (133), wherein the hub assembly (205) is operationally connected to a robotic arm assembly (101); an end-effector assembly (201) positioned at a proximal end of the anastomosis device (133); a shaft (203), wherein the shaft (203) one end is coupled to the hub assembly (205) and the shaft (203) other end is coupled to the end-effector assembly (201); and a cable (411) positioned within the shaft (203), wherein the cable (411) one end is secured to the hub assembly (205) and the cable (411) other end is secured to the endeffector assembly (201) to facilitates in actuation of the end-effector assembly (201) to perform anastomosis.

2. The anastomosis device (133) as claimed in claim 1, the hub assembly (205) further comprises a plurality of disc (303), (305), (307) and (309) operationally connected to the end-effector assembly (201) to facilitate roll, pitch, yaw and clamping/unclamping of the end-effector assembly (201).

3. The anastomosis device (133) as claimed in claim 1, the hub assembly (205) further comprises a plurality of disc (303), (305), (307) and (309), wherein the one disc from the plurality of disc (303), (305), (307) and (309) is operationally connected to the end-effector assembly (201) by the cable (411) to facilitate in actuation of the end-effector assembly (201) to perform anastomosis.

4. A robotically controlled anastomosis device (133) to connect a graft vessel to a target vessel, the anastomosis device (133) comprising: an anvil assembly (403) having a longitudinal axis; and a cable (517) secured to a cartridge body (503) at one end and other end of the cable (517) is secured to a hub assembly (205), wherein the cable (517) facilitates in actuating an end-effector assembly (201) to perform anastomosis.

5. The anastomosis device (133) as claimed in claim 4, wherein the cable (517) is crimped to the cartridge body (503) at a hole (527) and other end of the cable (517) is secured to the hub assembly (205).

. The anastomosis device (133) as claimed in claim 4, the anvil assembly (403) further comprising a plurality of pockets (602) configured at its distal end. . The anvil assembly (403) as claimed in claim 4, wherein a plurality of staple (513) is configured to deformed against the plurality of pocket (602). . The anastomosis device (133) as claimed in claim 4, the anvil assembly (403) further comprises a knife (603) positioned at center of the anvil assembly (403).

9. The anastomosis device (133) as claimed in claim 4, the anvil assembly (403) further comprising a knife block (605) positioned at a rear end of the knife (603), wherein the knife block (605) facilitates in advancing the knife (603) along the longitudinal axis of the anvil assembly (403).

10. The anvil assembly (403) as claimed in claim 9, wherein the knife block (605) includes a spring finger (613) to position the knife (603) riding on a ramp (615). 1. A robotically controlled anastomosis device (133) to connect a graft vessel to a target vessel, the anastomosis device (133) comprising: a cartridge assembly (401) having a cartridge cap (501) and a cartridge body (503); and a cable (517) secured to a cartridge body (503) at one end and other end of the cable (517) is secured to a hub assembly (205), wherein the cable (517) facilitates in actuating an end-effector assembly (201) to perform anastomosis.

12. The anastomosis device (133) as claimed in claim 11, wherein the cartridge cap (501) includes a plurality of flap tines (409) positioned at its distal end.

13. The anastomosis device (133) as claimed in claim 11, wherein the cartridge body (503) includes at least a heel clip (407) positioned between the distal end and the proximal end of the cartridge body (503).

14. The anastomosis device (133) as claimed in claim 11, the cartridge body (503) further comprises two arms (507a), (507b) at its distal end and the two arms (507a), (507b) includes a cartridge (509a), (509b) containing plurality of staple drivers (511) and plurality of staples (513).

15. The anastomosis device (133) as claimed in claim 11, the cartridge body (503) further comprises a dual wedge (515), wherein the dual wedge (515) includes two legs (519a), (519b).

16. The dual wedge (515) as claimed in claim 15, wherein a distal end of the two legs (519a), (519b) includes a cam (521a), (521b) configured to facilitate the drivers (511) movement in vertically downward direction to push the staples (513) against the against the plurality of pocket (602) of the anvil assembly (403).

Dated this 28^th Day of September 2021