# US 11,439,470 B2 · Robotically-controlled surgical instrument with selectively articulatable end effector

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- Number: US 11,439,470 B2
- Document ID: US11439470B2
- Status: Granted
- Kind: B2
- Application number: 16/150,688
- Filed: 2018-10-03
- Published: 2019-04-04
- Granted: 2022-09-13
- Earliest claimed: 2011-05-27
- Assignees: Cilag GmbH International
- Applicants: Ethicon LLC
- Inventors: James T. Spivey; Mark S. Ortiz; Frederick E. Shelton, IV
- Web page: https://patentgrep.com/patent/US11439470B2

## CPC

- A61B 34/30: Surgical robots
- A61B 1/00042: {for mechanical operation}
- A61B 17/068: Surgical staplers {, e.g. containing multiple staples or clamps}({staplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105;} for performing anastomosis A61B17/115; {staplers in general B25C5/00})
- A61B 17/07207: {the staples being applied sequentially}
- A61B 17/320016: {Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes (A61B10/0233, A61B17/29, A61B17/3207 take precedence)}
- A61B 34/71: {Manipulators operated by drive cable mechanisms}
- A61B 1/0052: {Constructional details of control elements, e.g. handles}
- A61B 1/0058: {using shape-memory elements}
- A61B 17/072: for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B 17/115: Staplers for performing anastomosis, e.g. in a single operation
- A61B 17/32053: {Punch like cutting instruments, e.g. using a cylindrical or oval knife (A61B17/326 takes precedence; trepans A61B17/1695)}
- A61B 50/30: Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments (for wound clamps A61B17/10; for ligaturing clips A61B17/122; packages or dispensers for surgical gloves or finger-stalls A61B42/40)
- A61B 50/36: for collecting or disposing of used articles
- A61B 90/37: {Surgical systems with images on a monitor during operation}
- A61B 2017/00057: {Light}
- A61B 2017/00199: {with a console, e.g. a control panel with a display}
- A61B 2017/0023: {disposable}
- A61B 2017/003: {Steerable}
- A61B 2017/00309: {Cut-outs or slits}
- A61B 2017/00314: {Separate linked members}
- A61B 2017/00323: {Cables or rods}
- A61B 2017/00327: {with actuating members moving in opposite directions}
- A61B 2017/00367: {Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like}
- A61B 2017/0042: {with special provisions for gripping}
- A61B 2017/00473: {Distal part, e.g. tip or head (A61B2017/00464 takes precedence)}
- A61B 2017/00477: {Coupling (A61B2017/0046 takes precedence)}
- A61B 2017/00685: {Archimedes screw}
- A61B 2017/00734: {battery operated}
- A61B 2017/0688: {Packages or dispensers for surgical staplers}
- A61B 2017/07235: {containing different staples, e.g. staples of different shapes, sizes or materials}
- A61B 2017/07242: {achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes}
- A61B 2017/07264: {characterised by its staple forming cavities, e.g. geometry or material}
- A61B 2017/07271: {characterised by its cartridge}
- A61B 2017/07278: {characterised by its sled or its staple holder}
- A61B 2017/2905: {flexible}
- A61B 2017/291: {the position of the handle being adjustable with respect to the shaft}
- A61B 2017/2919: {details of linkages or pivot points}
- A61B 2017/2923: {Toothed members, e.g. rack and pinion}
- A61B 2017/2927: {the angular position of the head being adjustable with respect to the shaft}
- A61B 2017/2933: {camming or guiding means}
- A61B 2017/2937: {with flexible part}
- A61B 2017/2946: {Locking means}
- A61B 2017/2947: {Pivots}
- A61B 2017/320052: {Guides for cutting instruments}
- A61B 2034/306: {Wrists with multiple vertebrae}
- A61B 2090/0811: {for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument}
- A61B 2090/372: {Details of monitor hardware}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Devices and systems are provided for controlling movement of a working end of a surgical device by means of a robotic system. In one embodiment, systems and devices are provided for moving an end effector on a distal end of a surgical fastening device. Movement can include rotational movement of the end effector about an axis of the shaft, articulation of the end effector relative to the shaft, and actuation of an end effector, e.g., closing, firing, and/or cutting.

## Claims

### Claim 1

A surgical instrument for use with a robotic surgical system, wherein said surgical instrument comprises:
a mounting portion operably interfacing with the robotic surgical system;
an elongate shaft extending from said mounting portion, wherein said elongate shaft defines a longitudinal shaft axis;
a drive system comprising a push-to-fire knife, wherein said push-to-fire knife is operably responsive to said robotic surgical system, wherein said drive system advances said push-to-fire knife in response to a firing motion transmitted from said robotic surgical system;
a first articulation joint extending from said elongate shaft, wherein said first articulation joint comprises a first articulation axis transverse to said longitudinal shaft axis;
a second articulation joint extending from said first articulation joint, wherein said second articulation joint comprises a second articulation axis positioned distal to said first articulation axis, and wherein said second articulation axis is transverse to said first articulation axis and said longitudinal shaft axis;
an end effector extending from said second articulation joint;
a first pair of articulation cables operably engaged with said first articulation joint and actuatable in response to an output motion from the robotic surgical system, wherein said end effector is rotated about said first articulation axis when said first pair of articulation cables are actuated; and
a second pair of articulation cables extending through said first articulation joint and said second articulation joint, wherein said second pair of articulation cables are operably engaged with said end effector and actuatable in response to an output motion from the robotic surgical system, and wherein said end effector is rotated about said first articulation axis and said second articulation axis when said first pair of articulation cables and one of said second pair of articulation cables are actuated simultaneously.

### Claim 2 (depends on 1)

The surgical instrument of claim 1, wherein said end effector is not rotated about said second articulation axis when said first pair of articulation cables are actuated.

### Claim 3 (depends on 1)

The surgical instrument of claim 1, wherein said end effector comprises:
a first jaw;
a second jaw movable relative to said first jaw between an open position and a closed position; and
a staple cartridge comprising a plurality of staples removably stored therein.

### Claim 4 (depends on 1)

The surgical instrument of claim 1, wherein said first articulation axis and said second articulation axis are approximately 90 degrees apart.

### Claim 5

A surgical instrument for use with a robotic surgical system, wherein said surgical instrument comprises:
a mounting portion operably interfacing with the robotic surgical system;
an elongate shaft extending from said mounting portion, wherein said elongate shaft defines a longitudinal shaft axis;
a drive system comprising a push-to-fire knife, wherein said push-to-fire knife is operably responsive to said robotic surgical system, wherein said drive system advances said push-to-fire knife in response to a firing motion transmitted from said robotic surgical system;
a first articulation joint extending from said elongate shaft, wherein said first articulation joint comprises a first articulation axis transverse to said longitudinal shaft axis;
a second articulation joint extending from said first articulation joint, wherein said second articulation joint comprises a second articulation axis positioned distal to said first articulation axis, and wherein said second articulation axis is transverse to said first articulation axis and said longitudinal shaft axis;
an end effector extending from said second articulation joint;
a first articulation actuator operably engaged with said first articulation joint and actuatable in response to an output motion from the robotic surgical system, wherein said end effector is rotated about said first articulation axis when said first articulation actuator is actuated; and
a second articulation actuator extending through said first articulation joint and said second articulation joint, wherein said second articulation actuator is operably engaged with said end effector and actuatable in response to an output motion from the robotic surgical system, and wherein said end effector is rotated about said first articulation axis and said second articulation axis when said first articulation actuator and said second articulation actuator are actuated at the same time.

### Claim 6 (depends on 5)

The surgical instrument of claim 5, wherein said end effector is not rotated about said second articulation axis when said first articulation actuator is actuated.

### Claim 7 (depends on 5)

The surgical instrument of claim 5, wherein said end effector comprises:
a first jaw;
a second jaw movable relative to said first jaw between an unclamped position and a clamped position; and
a staple cartridge comprising a plurality of staples removably stored therein.

### Claim 8 (depends on 5)

The surgical instrument of claim 5, wherein said first articulation axis and said longitudinal shaft axis are approximately 90 degrees apart.

### Claim 9 (depends on 8)

The surgical instrument of claim 8, wherein said first articulation axis and said second articulation axis are approximately 90 degrees apart.