(12) United States Patent
`Dachs, II et al.
`
`(10) Patent No.:
`(45) Date of Patent:
`
`US 8,640,788 B2
`Feb. 4, 2014
`
`USOO864O788B2
`
`(54) MOTOR INTERFACE FOR PARALLEL DRIVE
`
`SHAFTS WITHIN AN INDEPENDENTLY
`ROTATING MEMBER
`(75) Inventors: Gregory W. Dachs, II, San Francisco,
`CA (US). Todd E. Murphy, Allentown,
`PA (US); William A. Burbank, Sandy
`Hook, CT (US); William A. McDonald,
`II, Santa Clara, CA (US); Bruce
`Michael Schena, Menlo Park, CA (US)
`(73) Assignee: Intuitive Surgical Operations, Inc.,
`Sunnyvale, CA (US)
`-
`Subject to any disclaimer, the term of this
`patent is extended or adjusted under 35
`U.S.C. 154(b) by 353 days.
`
`(*) Notice:
`
`(21) Appl. No.: 12/945,461
`
`(22) Filed:
`
`Nov. 12, 2010
`
`(65)
`
`Prior Publication Data
`US 2011 FO1 18754 A1
`May 19, 2011
`Related U.S. Application Data
`(60) Provisional application No. 61/260.919, filed on Nov.
`13, 2009.
`(51) Int. Cl.
`A6B 9/00
`(52) U.S. Cl.
`USPC ............................ 173/164; 173/213; 173/216
`(58) Field of Classification Search
`USPC .......................................... 173/164, 213, 216
`See application file for complete search history.
`
`(2006.01)
`
`(56)
`
`References Cited
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`(Continued)
`
`Primary Examiner — Brian D Nash
`
`ABSTRACT
`(57)
`Mechanisms, assemblies, systems, tools, and methods incor
`porating the use of an offset drive shaft within an indepen
`dently rotating member are provided. An example mecha
`nism includes a base and a main shaft mounted to rotate
`relative to the base, a first drive shaft mounted inside the main
`shaft, and a first drive feature engaged with the first drive
`shaft. The main shaft includes a proximal end, a distal end,
`and a main shaft rotational axis defined therebetween. The
`first drive shaft is offset from the main shaft rotational axis. A
`first drive feature rotational axis is defined for the first drive
`feature and is fixed relative to the base as the main shaft
`rotates. The first drive feature rotates the first drive shaft.
`
`15 Claims, 18 Drawing Sheets
`
`Ethicon Exhibit 2012.001
`Intuitive v. Ethicon
`IPR2018-01254
`
`

`

`US 8,640,788 B2
`Page 2
`
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`2003/0105478 A1* 6/2003 Whitman et al. ............. 606, 167
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`1/2010 Manzo et al. ................... 606, 46
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`1/2010 Burbank ......................... 606/48
`OTHER PUBLICATIONS
`Vertut, Jean and Phillipe Coiffet, Robot Technology. Teleoperation
`and Robotics Evolution and Development, English translation
`Prentice-Hall, Inc., Inglewood Cliffs, NJ, USA 1986, vol. 3A, 332
`pageS.
`PCT/US 10/56610 International Search Report and Written Opinion
`of the International Searching Authority, mailed Feb. 18, 2011, 16
`pageS.
`
`
`
`* cited by examiner
`
`Ethicon Exhibit 2012.002
`Intuitive v. Ethicon
`IPR2018-01254
`
`

`

`U.S. Patent
`
`Feb. 4, 2014
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`Sheet 1 of 18
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`US 8,640,788 B2
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`Ethicon Exhibit 2012.003
`Intuitive v. Ethicon
`IPR2018-01254
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`U.S. Patent
`
`Feb. 4, 2014
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`Sheet 2 of 18
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`US 8,640,788 B2
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`Ethicon Exhibit 2012.004
`Intuitive v. Ethicon
`IPR2018-01254
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`

`U.S. Patent
`
`Feb. 4, 2014
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`Sheet 3 of 18
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`US 8,640,788 B2
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`
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`24
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`frG. 3
`
`Ethicon Exhibit 2012.005
`Intuitive v. Ethicon
`IPR2018-01254
`
`

`

`U.S. Patent
`
`Feb. 4, 2014
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`US 8,640,788 B2
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`Ethicon Exhibit 2012.006
`Intuitive v. Ethicon
`IPR2018-01254
`
`

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`U.S. Patent
`
`Feb. 4, 2014
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`US 8,640,788 B2
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`Ethicon Exhibit 2012.007
`Intuitive v. Ethicon
`IPR2018-01254
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`Feb. 4
`9
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`Ethicon Exhibit 2012.008
`Intuitive v. Ethicon
`IPR2018-01254
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`Feb. 4, 2014
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`US 8,640,788 B2
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`Ethicon Exhibit 2012.010
`Intuitive v. Ethicon
`IPR2018-01254
`
`

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`U.S. Patent
`
`Feb. 4, 2014
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`US 8,640,788 B2
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`Ethicon Exhibit 2012.011
`Intuitive v. Ethicon
`IPR2018-01254
`
`

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`
`Feb. 4, 2014
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`Intuitive v. Ethicon
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`Ethicon Exhibit 2012.013
`Intuitive v. Ethicon
`IPR2018-01254
`
`

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`
`Feb. 4, 2014
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`Intuitive v. Ethicon
`IPR2018-01254
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`Intuitive v. Ethicon
`IPR2018-01254
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`Ethicon Exhibit 2012.016
`Intuitive v. Ethicon
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`
`Feb. 4, 2014
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`Ethicon Exhibit 2012.017
`Intuitive v. Ethicon
`IPR2018-01254
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`Feb. 4, 2014
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`Intuitive v. Ethicon
`IPR2018-01254
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`
`Feb. 4, 2014
`
`Sheet 17 of 18
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`US 8,640,788 B2
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`Ethicon Exhibit 2012.019
`Intuitive v. Ethicon
`IPR2018-01254
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`U.S. Patent
`
`Feb. 4, 2014
`
`Sheet 18 of 18
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`US 8,640,788 B2
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`Ethicon Exhibit 2012.020
`Intuitive v. Ethicon
`IPR2018-01254
`
`

`

`1.
`MOTOR INTERFACE FOR PARALLEL DRIVE
`SHAFTS WITHIN AN INDEPENDENTLY
`ROTATING MEMBER
`
`CROSS-REFERENCES TO RELATED
`APPLICATIONS
`
`This application claims the benefit under 35 U.S.C. S 119
`(e) of U.S. Patent Application No. 61/260,919 (filed Nov. 13,
`2009; entitled “Motor Interface For Parallel Drive Shafts
`Within An Independent Rotating Member), which is incor
`porated herein by reference. This application is also related to
`U.S. patent application Ser. No. 12/945,730 (concurrently
`filed; entitled “Wrist Articulation By Linked Pull Rods”),
`U.S. patent application Ser. No. 12/945,740 (concurrently
`filed; entitled “Double Universal Joint'), U.S. patent appli
`cation Ser. No. 12/945,748 (concurrently filed; entitled “Sur
`gical Tool Containing Two Degree of Freedom Wrist'), and
`U.S. patent application Ser. No. 12/945,541 (concurrently
`filed; entitled “End Effector With Redundant Closing Mecha
`nisms), all of which are incorporated herein by reference.
`
`10
`
`15
`
`BACKGROUND
`
`Minimally invasive Surgical techniques are aimed at reduc
`ing the amount of extraneous tissue that is damaged during
`diagnostic or Surgical procedures, thereby reducing patient
`recovery time, discomfort, and deleterious side effects. As a
`consequence, the average length of a hospital stay for stan
`dard Surgery may be shortened significantly using minimally
`invasive Surgical techniques. Also, patient recovery times,
`patient discomfort, surgical side effects, and time away from
`work may also be reduced with minimally invasive Surgery.
`A common form of minimally invasive Surgery is endos
`copy, and a common form of endoscopy is laparoscopy,
`which is minimally invasive inspection and Surgery inside the
`abdominal cavity. In standard laparoscopic Surgery, a
`patient’s abdomen is insufflated with gas, and cannula sleeves
`are passed through Small (approximately one-half inch or
`less) incisions to provide entry ports for laparoscopic instru
`mentS.
`Laparoscopic Surgical instruments generally include an
`endoscope (e.g., laparoscope) for viewing the Surgical field
`and tools for working at the Surgical site. The working tools
`are typically similar to those used in conventional (open)
`Surgery, except that the working end or end effector of each
`tool is separated from its handle by an extension tube (also
`known as, e.g., an instrument shaft or a main shaft). The end
`effector can include, for example, a clamp, grasper, Scissor,
`Stapler, cautery tool, linear cutter, or needle holder.
`To perform Surgical procedures, the Surgeon passes work
`ing tools through cannula sleeves to an internal Surgical site
`and manipulates them from outside the abdomen. The Sur
`geon views the procedure from a monitor that displays an
`image of the Surgical site taken from the endoscope. Similar
`endoscopic techniques are employed in, for example, arthros
`copy, retroperitoneoscopy, pelviscopy, nephroscopy, cystos
`copy, cisternoscopy, sinoscopy, hysteroscopy, urethroscopy,
`and the like.
`Minimally invasive telesurgical robotic systems are being
`developed to increase a Surgeon’s dexterity when working on
`an internal Surgical site, as well as to allow a Surgeon to
`operate on apatient from a remote location (outside the sterile
`field). In a telesurgery system, the Surgeon is often provided
`with an image of the Surgical site at a control console. While
`viewing a three dimensional image of the Surgical site on a
`Suitable viewer or display, the Surgeon performs the Surgical
`
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`2
`procedures on the patient by manipulating master input or
`control devices of the control console. Each of the master
`input devices controls the motion of a servo-mechanically
`actuated/articulated Surgical instrument. During the Surgical
`procedure, the telesurgical system can provide mechanical
`actuation and control of a variety of Surgical instruments or
`tools having end effectors that perform various functions for
`the Surgeon, for example, holding or driving a needle, grasp
`ing a blood vessel, dissecting tissue, or the like, in response to
`manipulation of the master input devices.
`Manipulation and control of these end effectors is a par
`ticularly beneficial aspect of robotic surgical systems. For this
`reason, it is desirable to provide Surgical tools that include
`mechanisms that provide three degrees of rotational move
`ment of an end effector to mimic the natural action of a
`Surgeon’s wrist. Such mechanisms should be appropriately
`sized for use in a minimally invasive procedure and relatively
`simple in design to reduce possible points of failure. In addi
`tion, Such mechanisms should provide an adequate range of
`motion to allow the end effector to be manipulated in a wide
`variety of positions.
`Non robotic linear clamping, cutting and Stapling devices
`have been employed in many different Surgical procedures.
`For example, such a device can be used to resect a cancerous
`or anomalous tissue from a gastro-intestinal tract. Unfortu
`nately, many known Surgical devices, including known linear
`clamping, cutting and stapling devices, often have opposing
`jaws that may be difficult to maneuver within a patient. For
`known devices having opposing jaws that are maneuverable
`within a patient. Such devices may not generate Sufficient
`clamping force for some surgical applications (e.g., tissue
`clamping, tissue Stapling, tissue cutting, etc.), which may
`reduce the effectiveness of the surgical device.
`Thus, there is believed to be a need for an improvement in
`the maneuverability of surgical end effectors, particularly
`with regard to minimally invasive Surgery. In addition, there is
`believed to be a need for surgical end effectors with high
`actuation force, for example, high clamping force.
`
`BRIEF SUMMARY
`
`Mechanisms, assemblies, systems, tools, and methods are
`provided, many of which incorporate the use of an offset drive
`shaft within an independently rotating member. Such mecha
`nisms, assemblies, systems, tools, and methods may be par
`ticularly beneficial for use in Surgery, for example, in mini
`mally invasive Surgery, in minimally invasive robotic Surgery,
`as well as other types of surgery. The combination of an offset
`drive shaft mounted for rotation within an independently
`rotatable instrument shaft allows significant actuation power
`to be transferred to an end effector while leaving a central
`region of the instrument shaft available for routing of other
`components, for example, control cables, control wires, cath
`eters, or other such components. Drive shaft actuation can be
`used to articulate and/or orient an end effector, for example,
`So as to provide a relatively high desired clamping force. Such
`as for cutting or stapling, optionally with a limited response
`rate. Cable actuation may be used for relatively lower force
`articulation and/or orientation of the end effector when a
`higher response rate is desired, such as when telesurgically
`grasping and manipulating tissues. Exemplary hybrid cable/
`shaft actuated Systems may selectably actuate a single grasp
`ing/treatment jaw joint using either a high force shaft drive or
`a high response cable drive. While the various embodiments
`disclosed herein are primarily described with regard to sur
`gical applications, related mechanisms, assemblies, systems,
`
`Ethicon Exhibit 2012.021
`Intuitive v. Ethicon
`IPR2018-01254
`
`

`

`US 8,640,788 B2
`
`15
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`30
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`40
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`3
`tools, and methods may find use in a wide variety of applica
`tions, both inside and outside a human body, as well as in
`non-Surgical applications.
`In a first aspect, a mechanism including an offset drive
`shaft mounted within a rotating main shaft is provided. The
`mechanism includes a base, a main shaft mounted to rotate
`relative to the base, a first drive shaft mounted inside the main
`shaft, and a first drive feature engaged with the first drive
`shaft. The main shaft includes a proximal end, a distal end,
`and a main shaft rotational axis defined therebetween. The
`10
`first drive shaft is offset from the main shaft rotational axis. A
`first drive feature rotational axis is defined for the first drive
`feature and is fixed relative to the base as the main shaft
`rotates. The first drive feature rotates the first drive shaft.
`Various approaches may used to rotate the first drive shaft
`via the first drive feature. For example, the main shaft rota
`tional axis and the first drive feature rotational axis can be
`coincident. Engagement between the first drive feature and
`the first drive shaft can permit an axial movement of the first
`drive shaft relative to the base. The first drive feature can be
`engaged with the first drive shaft through an opening in the
`main shaft. The first drive shaft can include a second drive
`feature that protrudes through the main shaft opening and
`engages the first drive feature. The second drive feature can
`include external gear teeth. The first drive feature can include
`an internal ring gear.
`In many embodiments, the mechanism includes a third
`drive feature for rotating the main shaft. For example, a third
`drive feature having a third drive feature rotational axis can
`engage the main shaft. The third drive feature rotational axis
`can be fixed relative to the base as the third drive feature
`rotates the main shaft.
`In many embodiments, a second drive shaft is mounted
`inside the main shaft and offset from the main shaft rotational
`axis. A fourth drive feature having a fourth drive feature
`35
`rotational axis can be engaged with the second drive shaft. A
`fourth drive feature rotational axis can be fixed relative to the
`base as the main shaft rotates. The fourth drive feature can
`rotate the second drive shaft. The fourth drive feature can be
`engaged with the second drive shaft through an opening in the
`main shaft.
`In many embodiments, the support of the first drive shaft is
`integrated into the main shaft. For example, the main shaft can
`include a recess configured to interface with a bearing Sup
`porting the first drive shaft, and the mechanism can further
`include the bearing supporting the first drive shaft. The
`mechanism can further include a retaining ring to retain the
`bearing Supporting the first drive shaft.
`In many embodiments, an end effector is coupled with the
`distal end of the main shaft. The end effector can be coupled
`with the first drive shaft and/or with the second drive shaft.
`The end effector can be rotated by a rotation of the main shaft.
`A rotation of the first drive shaft and/or of the second drive
`shaft can actuate the end effector.
`In many embodiments, the mechanism further comprises a
`control cable drive feature and a control cable engaged with
`the control cable drive feature. The control cable can be
`routed within the main shaft between the main shaft proximal
`and distal ends. The mechanism can further comprise an end
`effector coupled with the control cable. A motion of the
`control cable can actuate the end effector.
`In another aspect, a robotic assembly including an offset
`drive shaft mounted within a rotating main shaft is provided.
`The robotic assembly includes a base; a main shaft mounted
`to rotate relative to the base; a drive shaft mounted inside the
`main shaft; an actuation assembly coupled with the main
`shaft and the drive shaft; and an end effector coupled with the
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`main shaft. The main shaft includes a proximal end, a distal
`end, and a main shaft rotational axis defined therebetween.
`The drive shaft is offset from the main shaft rotational axis.
`The actuation assembly is operable to independently rotate
`the main shaft relative to the base, and rotate the drive shaft
`relative to the main shaft. The end effector includes a shaft
`driven mechanism coupled with the drive shaft.
`In many embodiments, the robotic assembly further com
`prises a second drive shaft mounted inside the main shaft and
`offset from the main shaft rotational axis. The actuation
`assembly can be further operable to independently rotate the
`second drive shaft relative to the main shaft. The end effector
`can further comprise a second shaft driven actuation mecha
`nism operatively coupled with the second drive shaft.
`In many embodiments, the robotic assembly further com
`prises a control cable coupled with the end effector. The
`control cable can be routed within the main shaft between the
`main shaft proximal and distal ends. A motion of the control
`cable can actuate the end effector.
`In another aspect, a robotic system including an offset drive
`shaft mounted within a rotating main shaft is provided. The
`robotic system includes a base; a main shaft mounted to rotate
`relative to the base; a first drive shaft mounted inside the main
`shaft; a second drive shaft mounted inside the main shaft; an
`actuation assembly coupled with the main shaft, the first drive
`shaft, and the second drive shaft; a controller, and an end
`effector coupled with the main shaft so that the end effector is
`rotated by a rotation of the main shaft. The main shaft
`includes a proximal end, a distal end, and a main shaft rota
`tional axis defined therebetween. The first drive shaft and the
`second drive shaft are offset from the main shaft rotational
`axis. The controller includes an input and an output. The input
`is coupled with an input device to receive at least one input
`signal from the input device. The output is coupled with the
`actuation assembly to output at least one control signal to the
`actuation assembly. The controller includes a processor and a
`tangible medium containing instructions that when executed
`cause the processor to generate the at least one control signal
`in response to the at least one input signal so that the input
`device can be used by a user to independently rotate the main
`shaft relative to the base, rotate the first drive shaft relative to
`the main shaft, and rotate the second drive shaft relative to the
`main shaft. The end effector includes a first shaft driven
`mechanism coupled with the first drive shaft and a second
`shaft driven actuation mechanism coupled with the second
`drive shaft.
`In many embodiments, the actuation assembly comprises
`additional components. For example, the actuation assembly
`can include a first motor coupled with the first drive shaft and
`the controller. The actuation assembly can include a second
`motor coupled with the second drive shaft and the controller.
`The actuation assembly can include a main shaft motor
`coupled with the main shaft and the controller. The actuation
`assembly can include a first encoder coupled with the first
`motor and the controller. The first encoder can output a first
`motor position signal to the controller in response to a posi
`tion of the first motor. The actuation assembly can include a
`second encoder coupled with the second motor and the con
`troller. The second encoder can output a second motor posi
`tion signal to the controller in response to a position of the
`second motor. The actuation assembly can include a main
`shaft encoder coupled with the main shaft motor and the
`controller. The main shaft encoder can output a main shaft
`position signal to the controller in response to a position of the
`main shaft motor.
`In many embodiments, the robotic system further com
`prises a control cable coupled with the end effector. The
`
`Ethicon Exhibit 2012.022
`Intuitive v. Ethicon
`IPR2018-01254
`
`

`

`US 8,640,788 B2
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`control cable can be routed within the main shaft between the
`main shaft proximal and distal ends. A motion of the control
`cable can actuate the end effector.
`In another aspect, a robotic tool including an offset drive
`shaft mounted within a rotating main shaft is provided. The
`robotic tool is configured for mounting on a manipulator
`having a tool interface with first, second, and third drive
`features. The robotic tool includes a proximal tool chassis
`releasably mountable to the tool interface; a distal end effec
`tor having a distal degree of freedom and a shaft driven
`actuation mechanism; a main shaft having a proximal end
`adjacent the chassis, a distal end adjacent the end effector, a
`bore extending therebetween, and a lateral opening distally of
`the proximal end; and a hybrid cable/shaft drive system
`operatively coupling the drive features of the tool interface to
`the end effector when the chassis is mounted to the tool
`interface. Actuation of the first drive feature rotates the main
`shaft and the end effector relative to the chassis about a main
`shaft rotational axis. Cables extending from the chassis dis
`tally within the bore of the main shaft couple the distal degree
`of freedom of the end effector to the second drive feature. The
`first drive shaft couples the shaft driven actuation mechanism
`of the end effector to the third drive feature through the lateral
`opening in the main shaft. The first drive shaft is offset from
`the main shaft rotational axis.
`In another aspect, a method fortransmitting torque through
`an offset drive shaft routed within a rotatable main shaft is
`provided. The method includes Supporting a main shaft to
`rotate relative to a base so that the main shaft rotates about a
`main shaft rotational axis, Supporting a drive shaft to rotate
`relative to the main shaft so that the drive shaft rotates about
`a drive shaft rotational axis that is offset from the main shaft
`rotational axis, engaging the drive shaft with a drive feature
`having a drive feature rotational axis that is fixed relative to
`the base as the main shaft rotates, rotating the main shaft
`relative to the base, and rotating the drive feature relative to
`the main shaft so as to rotate the drive shaft relative to the
`main shaft. In many embodiments, the main shaft rotates
`relative to the base and the drive shaft rotates relative to the
`main shaft simultaneously.
`In another aspect, a minimally invasive Surgical method is
`provided. The method includes introducing an end effector to
`an internal Surgical site within a patient through a minimally
`invasive aperture or natural orifice by manipulating a base,
`rotating the end effector relative to the base, and performing
`a surgical task with the end effector by rotating a first drive
`shaft relative to the instrument shaft so that the first drive shaft
`actuates the end effector. In the method, the end effector is
`Supported relative to the base by an elongated instrument
`shaft, the end effector is rotated relative to the base by rotating
`the instrument shaft relative to the base about an instrument
`shaft rotational axis, and the first drive shaft rotates relative to
`the instrument shaft about a first drive shaft rotational axis
`that is offset from the instrument shaft rotational axis. In
`many embodiments, the method further comprises actuating
`the end effector by rotating a second drive shaft relative to the
`instrument shaft, the second drive shaft rotating about a sec
`ond drive shaft rotational axis that is offset from the instru
`ment shaft rotational axis.
`For a fuller understanding of the nature and advantages of
`the present invention, reference should be made to the ensu
`ing detailed description and accompanying drawings. Other
`aspects, objects and advantages of the invention will be appar
`ent from the drawings and detailed description that follows.
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`BRIEF DESCRIPTION OF THE DRAWINGS
`
`FIG. 1 is a plan view of a minimally invasive robotic
`Surgery system being used to perform a Surgery, in accor
`dance with many embodiments.
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`FIG. 2 is a perspective view of a Surgeon’s control console
`for a robotic Surgery system, in accordance with many
`embodiments.
`FIG. 3 is a perspective view of a robotic surgery system
`electronics cart, in accordance with many embodiments.
`FIG. 4 diagrammatically illustrates a robotic Surgery sys
`tem, in accordance with many embodiments.
`FIG.5A is a front view of a patient side cart (surgical robot)
`of a robotic Surgery system, in accordance with many
`embodiments.
`FIG. 5B is a front view of a robotic surgery tool.
`FIG. 6 diagrammatically illustrates a robotic assembly
`having two offset drive shafts within a rotatable main shaft, in
`accordance with many embodiments.
`FIG. 7 diagrammatically illustrates the integration of com
`ponents of the robotic assembly of FIG. 6 with a controller, in
`accordance with many embodiments.
`FIG. 8 diagrammatically illustrates a robotic tool and an
`associated robotic system, in accordance with many embodi
`mentS.
`FIG. 9 is a perspective view of a robotic tool that is releas
`ably mountable to a robotic tool manipulator, in accordance
`with many embodiments.
`FIG. 10 is a perspective view of the proximal end of a
`robotic tool of FIG. 9, showing an actuation assembly, in
`accordance with many embodiments.
`FIG. 11 is a perspective view of a cross section of the
`actuation assembly of FIG. 10, illustrating components used
`to actuate a first offset internal drive shaft, in accordance with
`many embodiments.
`FIG. 12 is a perspective view illustrating components of the
`actuation assembly of FIG. 10 that are used to actuate a
`second offset internal drive shaft, in accordance with many
`embodiments.
`FIG. 13 is a perspective view of a cross section of the
`actuation assembly of FIG. 10, illustrating various compo
`nents and the routing of end effector control cables, in accor
`dance with many embodiments.
`FIG. 14 is a cross-sectional view of the actuation assembly
`of FIG. 10, illustrating various components and the routing of
`end effector control cables, in accordance with many embodi
`mentS.
`FIG. 15A is a perspective view of a main shaft coupling
`fitting used to couple a rotatable main shaft with a proximal
`tool chassis, showing openings through which internally
`mounted offset drive shafts are driven and external gear teeth
`that are used to rotate the main shaft, inaccordance with many
`embodiments.
`FIG. 15B is a perspective view of an internal subassembly
`that includes two internal offset drive shafts and associated
`Support fittings, in accordance with many embodiments.
`FIG.15C is a perspective view showing the combination of
`the components of FIGS. 15A and 15B, in accordance with
`many embodiments.
`FIG. 15D is an end view showing the combination of the
`components of FIGS. 15A and 15B, in accordance with many
`embodiments.
`FIG. 16 is a perspective view of an actuation assembly
`having a reduced part count configuration, inaccordance with
`many embodiments.
`FIG. 17 is a perspective cross-sectional view of the actua
`tion assembly of FIG. 16.
`FIGS. 18A and 18B are proximal and distal end views,
`respectively, of the actuation assembly of FIG. 16.
`FIG. 19 is a plan view illustration of the integration of the
`actuation assembly of FIG.16 within a proximal tool chassis,
`in accordance with many embodiments.
`
`Ethicon Exhibit 2012.023
`Intuitive v. Ethicon
`IPR2018-01254
`
`

`

`US 8,640,788 B2
`
`7
`FIG. 20 is a simplified diagrammatic illustration of a sur
`gical assembly, in accordance with many embodiments.
`FIG. 21 is a flow diagram of a method for transmitting
`torque through an offset drive shaft routed within a rotatable
`main shaft, in accordance with many embodiments.
`FIG. 22 is a flow diagram of a minimally invasive Surgical
`method, in accordance with many embodiments.
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`The Surgeon’s Console 16 is usually located in the same
`room as the patient so that the Surgeon may directly monitor
`the procedure, be physically presentifnecessary, and speak to
`an Assistant directly rather than over the telephone or other
`communication medium. However, the Surgeon can be
`located in a different room, a completely different building, or
`other remote location from the Patient allowing for remote
`Surgical procedures (i.e., operating from outside the sterile
`field).
`FIG.3 is a perspective view of the Electronics Cart 24. The
`Electronics Cart 24 can be coupled with the endoscope 28 and
`can include a processor to process captured images for Sub
`seque