# US 11,896,335 B2 · Medical instruments for tissue cauterization > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,896,335 B2 - Document ID: US11896335B2 - Status: Granted - Kind: B2 - Application number: 17/037,380 - Filed: 2020-09-29 - Published: 2021-01-14 - Granted: 2024-02-13 - Earliest claimed: 2018-08-15 - Assignees: Auris Health, Inc. - Applicants: Auris Health, Inc. - Inventors: Travis Michael Schuh; Spencer James Witte; Alex J. Niswander - Web page: https://patentgrep.com/patent/US11896335B2 ## CPC - A61B 34/71: {Manipulators operated by drive cable mechanisms} - A61B 18/1233: {with circuits for assuring patient safety} - A61B 18/1482: {having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy} - A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)} - A61B 2017/00327: {with actuating members moving in opposite directions} - A61B 2018/00595: {Cauterization} - A61B 2018/1253: {monopolar} - A61B 2018/1422: {Hook} - A61B 2034/301: {for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes} - A61B 2034/302: {specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities} - A61B 2034/303: {specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels} - A61B 2034/715: {Cable tensioning mechanisms for removing slack} - A61B 2218/001: having means for irrigation and/or aspiration of substances to and/or from the surgical site (A61B2018/00029 and A61B2018/1472 take precedence) - A61M 25/0147: {with movable mechanical means, e.g. pull wires} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)} ## Abstract Certain aspects relate to systems and techniques for an articulating monopolar medical instrument. In one aspect, the medical instrument includes a wrist comprising a proximal clevis and a distal clevis; an end effector coupled to the distal clevis via a distal axle; at least one proximal pulley in the proximal clevis; at least one distal pulley in the distal clevis and coupled to the distal axle; a first cable configured to engage with the at least one proximal pulley and the at least one distal pulley; and a second cable configured to engage with the at least one proximal pulley without engaging the at least one distal pulley. ## Claims ### Claim 1 A medical instrument, comprising: a wrist comprising a proximal clevis and a distal clevis; an end effector coupled to the distal clevis via a distal axle; at least one proximal pulley in the proximal clevis; at least one distal pulley in the distal clevis and coupled to the distal axle; at least one first cable segment configured to engage the at least one proximal pulley and the at least one distal pulley; and at least one second cable segment configured to engage with the at least one proximal pulley without engaging the at least one distal pulley, the at least one proximal pulley being configured to rotate with respect to a pitch axis providing a first degree of freedom for articulation of the end effector, wherein the at least one first cable segment and the at least one second cable segment have a mirror symmetry across a plane that is perpendicular to and bisecting the pitch axis at a center of the proximal clevis. ### Claim 2 (depends on 1) The instrument of claim 1, wherein the at least one first cable segment is configured to engage the at least one proximal pulley and the at least one distal pulley without engaging with stationary redirect surfaces between the at least one proximal pulley and the at least one distal pulley. ### Claim 3 (depends on 1) The instrument of claim 1, wherein: the at least one first cable segment is formed of metal, and the distal clevis is formed of plastic. ### Claim 4 (depends on 1) The instrument of claim 1, wherein the at least one first cable segment has a fleet angle of about zero as the at least one first cable segment extends between the at least one proximal pulley and the at least one distal pulley. ### Claim 5 (depends on 1) The instrument of claim 1, wherein the at least one first cable segment has a fleet angle greater than about zero as the at least one first cable segment extends between the at least one proximal pulley and the at least one distal pulley. ### Claim 6 (depends on 1) The instrument of claim 1, wherein the at least one second cable segment is further configured to engage with the distal clevis at a single side of the distal clevis offset from a central axis of the wrist. ### Claim 7 (depends on 1) The instrument of claim 1, wherein the at least one first cable segment and the at least one second cable segment are asymmetric with respect to each other. ### Claim 8 (depends on 1) The instrument of claim 1, further comprising: a proximal axle coupled to the at least one proximal pulley, wherein, to actuate the wrist, the at least one proximal pulley is configured to be rotated with respect to the proximal axle such that the at least one first cable segment is advanced while the at least one second cable segment is retracted. ### Claim 9 (depends on 1) The instrument of claim 1, wherein: the at least one first cable segment comprises two first cable segments configured to engage the at least one distal pulley, and the at least one distal pulley is configured to be rotated with respect to the distal axle such that one of the two first cable segments is advanced while another of the two first cable segments is retracted. ### Claim 10 (depends on 1) The instrument of claim 1, wherein the distal clevis comprises a surface area free of stationary redirect surfaces. ### Claim 11 (depends on 10) The instrument of claim 10, wherein the distal clevis is completely devoid of any stationary redirect surfaces. ### Claim 12 (depends on 1) The instrument of claim 1, wherein: the at least one distal pulley is configured to rotate with respect to a yaw axis providing a second degree of freedom for the articulation of the end effector. ### Claim 13 (depends on 1) The instrument of claim 1, wherein the end effector comprises a monopolar hook. ### Claim 14 (depends on 13) The instrument of claim 13, wherein the monopolar hook is offset from a rotational axis that extends through the at least one distal pulley in the distal clevis. ### Claim 15 (depends on 13) The instrument of claim 13, wherein the monopolar hook comprises a first link angulated relative to a second link. ### Claim 16 (depends on 15) The instrument of claim 15, wherein: the first link comprises a proximal link and the second link comprises a distal link, and the at least one distal pulley comprises a base into which the first link is configured to be received. ### Claim 17 (depends on 16) The instrument of claim 16, wherein: the first link is configured to form an angle relative to a rotational axis of the at least one distal pulley, and the angle is configured to prevent the monopolar hook from catching on a cannula in response to removal of the instrument from the cannula. ### Claim 18 A medical instrument, comprising: a wrist comprising a proximal clevis and a distal clevis; an end effector coupled to the distal clevis via a distal axle; at least one proximal pulley in the proximal clevis; at least one distal pulley in the distal clevis and coupled to the distal axle; at least one first cable segment configured to engage the at least one proximal pulley and the at least one distal pulley; and at least one second cable segment configured to engage with the at least one proximal pulley without engaging the at least one distal pulley and engage with the distal clevis at a single side of the distal clevis offset from a central axis of the wrist, the at least one proximal pulley being configured to rotate with respect to a pitch axis providing a first degree of freedom for articulation of the end effector, wherein the at least one first cable segment and the at least one second cable segment have a mirror symmetry across a plane that is perpendicular to and bisecting the pitch axis at a center of the proximal clevis. ### Claim 19 (depends on 18) The instrument of claim 18, wherein the at least one first cable segment is configured to engage the at least one proximal pulley and the at least one distal pulley without engaging with stationary redirect surfaces between the at least one proximal pulley and the at least one distal pulley. ### Claim 20 (depends on 18) The instrument of claim 18, wherein: the at least one first cable segment and the at least one second cable segment are formed of metal, and the distal clevis is formed of plastic. ### Claim 21 (depends on 18) The instrument of claim 18, wherein the at least one first cable segment has a fleet angle of about zero as the at least one first cable segment extends between the at least one proximal pulley and the at least one distal pulley. ### Claim 22 (depends on 18) The instrument of claim 18, wherein the at least one first cable segment has a fleet angle greater than about zero as the at least one first cable segment extends between the at least one proximal pulley and the at least one distal pulley. ### Claim 23 (depends on 18) The instrument of claim 18, wherein the at least one first cable segment and the at least one second cable segment are asymmetric with respect to each other. ### Claim 24 (depends on 18) The instrument of claim 18, further comprising: a proximal axle coupled to the at least one proximal pulley, wherein, to actuate the wrist, the at least one proximal pulley is configured to be rotated with respect to the proximal axle such that the at least one first cable segment is advanced while the at least one second cable segment is retracted.