# US 11,304,768 B2 · Wrist articulation by linked tension members > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,304,768 B2 - Document ID: US11304768B2 - Status: Granted - Kind: B2 - Application number: 17/069,606 - Filed: 2020-10-13 - Published: 2021-01-28 - Granted: 2022-04-19 - Earliest claimed: 2009-11-13 - Assignees: Intuitive Surgical Operations, Inc. - Applicants: Intuitive Surgical Operations, Inc. - Inventors: William A. Burbank - Web page: https://patentgrep.com/patent/US11304768B2 ## CPC - A61B 34/30: Surgical robots - A61B 34/35: for telesurgery - A61B 34/37: Leader-follower robots (A61B34/35 takes precedence) - A61B 34/71: {Manipulators operated by drive cable mechanisms} - A61B 34/76: {Manipulators having means for providing feel, e.g. force or tactile feedback} - A61B 2017/2927: {the angular position of the head being adjustable with respect to the shaft} - A61B 2034/302: {specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities} - A61B 2034/305: {Details of wrist mechanisms at distal ends of robotic arms} - A61B 2034/715: {Cable tensioning mechanisms for removing slack} - Y10T 29/49826: Assembling or joining - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - Y10T: TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION ## Abstract Surgical tools include an end effector mounted to an instrument shaft for articulation relative to the instrument shaft. A surgical tool includes an instrument shaft, an intermediate member pivotally coupled to the instrument shaft, an end effector and four tension members. The end effector includes an end effector base that is pivotally coupled to the intermediate member. The end effector base includes four attachment features. Each of the four tension members interfaces with an associated one of the four attachment features. The four tension members extend distally within a lumen of the instrument shaft and are arranged in diagonally opposed pairs. ## Claims ### Claim 1 A minimally invasive surgical tool comprising: an instrument shaft elongated along a longitudinal axis; an intermediate member pivotally coupled to the instrument shaft for rotation of the intermediate member relative to the instrument shaft; an end effector comprising an end effector base, wherein the end effector base is pivotally coupled to the intermediate member for rotation of the end effector base relative to the intermediate member, wherein the end effector base comprises four attachment features; and four tension members, wherein each of the four tension members interfaces with an associated one of the four attachment features, wherein the four tension members extend distally within a lumen of the instrument shaft and are arranged in a first diagonally opposed pair of the four tension members and a second diagonally opposed pair of the four tension members. ### Claim 2 (depends on 1) The minimally invasive surgical tool of claim 1, further comprising an end effector articulation mechanism drivingly coupled with each of the four tension members, wherein the end effector articulation mechanism is operable to articulate the four tension members to selectively orient the end effector base relative to the instrument shaft about each of a first axis and a second axis that is transverse to the first axis. ### Claim 3 (depends on 2) The minimally invasive surgical tool of claim 2, wherein the end effector articulation mechanism comprises: a first capstan, wherein the first diagonally opposed pair of the four tension members is drivingly coupled with the first capstan; and a second capstan, wherein the second diagonally opposed pair of the four tension members is drivingly coupled with the second capstan. ### Claim 4 (depends on 2) The minimally invasive surgical tool of claim 2, wherein the end effector articulation mechanism is back-drivable so as to accommodate reorientation of the end effector base relative to the instrument shaft induced by forces applied to the end effector via contact with tissue. ### Claim 5 (depends on 2) The minimally invasive surgical tool of claim 2, wherein the first axis and the second axis are non-intersecting. ### Claim 6 (depends on 5) The minimally invasive surgical tool of claim 5, wherein the first axis and the second axis are separated by 2 mm or less. ### Claim 7 (depends on 2) The minimally invasive surgical tool of claim 2, wherein the second axis is perpendicular to the first axis. ### Claim 8 (depends on 2) The minimally invasive surgical tool of claim 2, wherein: the intermediate member has an exterior width along one of the first axis and the second axis; the intermediate member has an exterior length along the other of the first axis and the second axis; and the exterior width is less than the exterior length so that the intermediate member has an elongate shape. ### Claim 9 (depends on 1) The minimally invasive surgical tool of claim 1, wherein each of the tension members is under tension for all orientations of the end effector base relative to the instrument shaft. ### Claim 10 (depends on 1) The minimally invasive surgical tool of claim 1, wherein the four tension members and the four attachment features are configured so that each of the four tension members slides on the associated one of the four attachment features during reorientation of the end effector base relative to the instrument shaft. ### Claim 11 (depends on 1) The minimally invasive surgical tool of claim 1, wherein: each of the four attachment features has a curved portion; and each of the four tension members comprises an attachment lug configured to rotate around and along the curved portion of the associated one of the four attachment features. ### Claim 12 (depends on 1) The minimally invasive surgical tool of claim 1, wherein: each of the four tension members has a curved portion; and each of the four attachment features comprises an attachment lug configured to rotate around and along the curved portion of the associated one of the four tension members. ### Claim 13 (depends on 1) The minimally invasive surgical tool of claim 1, wherein: the end effector comprises a cable articulated member; and the minimally invasive surgical tool further comprises a pair of control cables drivingly coupled with the cable articulated member. ### Claim 14 (depends on 13) The minimally invasive surgical tool of claim 13, wherein: the pair of control cables extend distally from within the lumen of the instrument shaft to the end effector; and the pair of control cables extend through the intermediate member. ### Claim 15 (depends on 13) The minimally invasive surgical tool of claim 13, wherein the cable articulated member is configured for grasping tissue. ### Claim 16 (depends on 1) The minimally invasive surgical tool of claim 1, wherein: the end effector comprises a first shaft actuated member and a first rotatable input shaft drivingly coupled with the first shaft actuated member; the minimally invasive surgical tool further comprises a first rotatable drive shaft that is drivingly coupled with the first rotatable input shaft; and the first rotatable drive shaft extends distally from within the lumen of the instrument shaft to the first rotatable input shaft offset to a first side of the intermediate member. ### Claim 17 (depends on 16) The minimally invasive surgical tool of claim 16, further comprising a first coupling member coupling the first rotatable drive shaft with the first rotatable input shaft so that a rate of rotation of the first rotatable drive shaft and the first rotatable input shaft are equal when the first rotatable drive shaft is transverse to the first rotatable input shaft. ### Claim 18 (depends on 16) The minimally invasive surgical tool of claim 16, wherein the first shaft actuated member is configured to staple tissue. ### Claim 19 (depends on 16) The minimally invasive surgical tool of claim 16, wherein: the end effector comprises a second shaft actuated member and a second rotatable input shaft drivingly coupled with the second shaft actuated member; the minimally invasive surgical tool further comprises a second rotatable drive shaft that is drivingly coupled with the second rotatable input shaft; and the second rotatable drive shaft extends distally from within the lumen of the instrument shaft to the second rotatable input shaft offset to a second side of the intermediate member. ### Claim 20 (depends on 19) The minimally invasive surgical tool of claim 19, further comprising a second coupling member coupling the second rotatable drive shaft with the second rotatable input shaft so that a rate of rotation of the second rotatable drive shaft and the second rotatable input shaft are equal when the second rotatable drive shaft is transverse to the second rotatable input shaft. ### Claim 21 (depends on 19) The minimally invasive surgical tool of claim 19, wherein the second shaft actuated member is configured to clamp tissue. ### Claim 22 (depends on 8) The minimally invasive surgical tool of claim 8, wherein the exterior width is less than one-fourth the exterior length.