US 7,691,098 B2
`(10) Patent No.:
`a2) United States Patent
`Wallaceetal.
`(45) Date of Patent:
`Apr. 6, 2010
`
`
`US007691098B2
`
`(54) PLATFORMLINK WRIST MECHANISM
`
`(73)
`
`Inventors: Daniel T. Wallace, Redwood City, CA
`(US); $. Christopher Anderson,
`Northamptom, MA (US); Scott Manzo,
`Shelton, CT (US)
`Intuitive Surgical, Inc., Sunnyvale, CA
`(US)
`
`(73) Assignee:
`
`(*) Notice:
`
`Subject to any disclaimer, the term ofthis
`patent is extended or adjusted under 35
`USS.C. 154(b) by 755 days.
`
`(56)
`
`(58) Field of Classification Search ..........0...0.. 606/1.
`606/39, 51, 53, 120, 151, 190, 205, 210,
`606/237; 623/24
`o,
`See application file for complete search history.
`References Cited
`US. PATENT DOCUMENTS
`
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`2/1989 Kohli etal. ccc 414/735
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`(21) Appl. No.: 11/436,988
`(22) Filed:
`May 18, 2006
`
`(Continued)
`
`OTHER PUBLICATIONS
`
`(65)
`
`Prior Publication Data
`
`US 2007/0156119 Al
`
`Jul. 5, 2007
`
`Vortut, Jean and Cocffet, Philippe Coiffet; “Robot Technology; vol.
`3A Teleoperation and Robotics Evolution and Development”, 1986;
`Prentice-Hall, Inc; Englewood Cliffs, N.J.
`
`Related U.S. Application Data
`.
`.
`.,
`(63) Continuation of application No. 10/758,050,filed on
`Jan. 14, 2004, now Pat. No. 7,066,926, which is a
`continuation of application No. 10/186,176, filed on
`Jun. 28, 2002, now Pat. No. 6,699,235.
`.
`oo,
`(60) Provisional application No. 60/301,967,filed on Jun,
`29, 2001, provisional application No. 60/327,702,
`filed on Oct. 5, 2001.
`
`(51)
`
`Int. Cl.
`(2006.01)
`G05G 11/00
`(2006.01)
`GOSG 9/00
`(2006.01)
`B25F 9/06
`(2006.01)
`B25J 11/00
`(2006.01)
`AGIB 17/28
`(2006.01)
`AG6IB 19/00
`(2006.01)
`AGIB 17/00
`(52) U.S.C ccc. 606/15 74/490.06; 74/490.01,;
`606/914; 606/206; 606/139; 606/130; 606/142;
`606/205
`
`Primary Examiner—Henry M Johnson, III
`Assistant Examiner
`Jellrey B Lipitz
`
`(57)
`
`ABSTRACT
`
`The present invention provides a robotic surgical tool for use
`in a robotic surgical system to perform a surgical operation.
`The robotic surgical tool includes a wrist mechanism dis-
`posed near the distal end of a shaft which connects with an
`end effector. The wrist mechanism includes a distal member
`configured to support the end effector, and a plurality of rods
`extending generally along an axial direction within the shaft
`and movable generally along this axial direction to adjust the
`orientation of the distal member with respect to the shaft.
`Advancement orretraction of a first rod generally along the
`axial directiontips the base througha first angle. The addition
`ofa second angle allows the distal memberto direct the end
`effector in essentially a compoundangle. The robotic surgical
`tool mayalso include provisionsfor roll movement.
`
`14 Claims, 24 Drawing Sheets
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`Ethicon Exhibit 2002.001
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`U.S. PATI
`ENT DOCUMI
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`
`[2/
`5,699,695 A *
`4
`5,740,699 A
`5,792,135 A * 8
`6,331,181 BL* 12/2001
`6,394,998 BL*
`8/2002
`
`
`
`.......
`Canfield et al.
`74/490.06
`Ballantyneelal.
`
`Madhanietal. ....
`606/1
`beeees 606/130
`Tiemey etal.
`.....
`Wallace ct al.
`........
`
`veces 606/1
`
`6.418,811 Bl*
`6,425,177 Bl
`6,516,681
`6,658,962 Bl *
`7,273,488 B2*
`2004/0111113
`
`* cited by examiner
`
`Rosheim.........
`
`.. 74/490.06
`
`
`7A/490.01
`74/490.05
` Nakamura etal.
`..
`.. 606/205
`Nakamuraetal.
`cetereeees 606/205
`
`Ethicon Exhibit 2002.002
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`U.S. Patent
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`Apr. 6, 2010
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`Sheet 1 of 24
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`US 7,691,098 B2
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`Fig. 1
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`U.S. Patent
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`Apr. 6, 2010
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`Sheet 3 of 24
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`Fig. 3A
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`Fig. 3B
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`U.S. Patent
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`Apr. 6, 2010
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`Sheet 4 of 24
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`US 7,691,098 B2
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`U.S. Patent
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`U.S. Patent
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`U.S. Patent
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`Apr. 6, 2010
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`Sheet 24 of 24
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`US 7,691,098 B2
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`1
`PLATIFORMLINK WRIST MECITANISM
`
`CROSS-REFERENCES TO RELATED
`APPLICATIONS
`
`‘This application is a continuation of U.S. patent applica-
`tion Ser. No. 10/758 ,050, filed on Jan. 14, 2004, now U.S. Pat.
`No. 7,066,926, which is a continuation of U.S. patent appli-
`cation Ser. No. 10/186,176, filed on Jun. 28, 2002, now U.S.
`Pat. No. 6,699,235, which was based on and claimed the
`benefit of U.S. Provisional Patent Application No. 60/301,
`967, filed Jun. 29, 2001, and U.S. Provisional Patent Appli-
`cation No. 60/327,702, filed Oct. 5, 2001, the entire disclo-
`sures of which are incorporated hercin by reference.
`This application is related to the following patents and
`patent applications, the full disclosures ofwhichare incorpo-
`rated herein byreference:
`PCT International Application No. PCT/US98/19508,
`entitled “Robotic Apparatus”, filed on Sep. 18, 1998, and
`published as WO99/50721;
`US. patent application Ser. No. 09/418,726,entitled “Sur-
`gical Robotic Tools, Data Architecture, and Use”, filed on
`Oct. 15, 1999;
`US. Patent Application No. 60/111,711, entitled “Image
`Shifting for a Telerobotic System”, filed on Dec. 8, 1998:
`USS. patent application Ser. No. 09/378,173, entitled “Ste-
`reo Imaging System for Use in Telerabotic System”, filed on
`Aug. 20, 1999;
`USS. patent application Ser. No. 09/398, 507, entitled “Mas-
`ter Having Redundant Degrees of Freedom”,filed on Sep. 17,
`1999;
`USS. application Ser. No. 09/399,457, entitled ““Coopera-
`tive Minimally Invasive Telesurgery System”, filed on Sep.
`17, 1999;
`U.S. patent application Ser. No. 09/373,678, entitled
`“Camera Referenced Control in a Minimally Invasive Surgi-
`cal Apparatus”, filed on Aug. 13, 1999;
`US. patent application Ser. No. 09/398,958,entitled “Sur-
`gical Tools for Use in Minimally Invasive Telesurgical Appli-
`cations”, filed on Sep. 17, 1999; and
`USS. Pat. No. 5,808,665, entitled “Endoscopic Surgical
`Instrument and Method for Use”, issued on Sep. 15, 1998.
`
`BACKGROUND OF THE INVENTION
`
`
`
`e
`
`wan
`
`40
`
`45
`
`2
`with gas, and cannula sleeves are passed through small (ap-
`proximately 14 inch) incisions to provide entryports for lap-
`aroscopic surgical
`instruments. ‘he laparoscopic surgical
`instruments generally include a laparoscope (for viewing the
`surgical field) and working tools. The workingtoolsare simi-
`Jar to those used in conventional (open) surgery, except that
`the working end or end effector ofcach tool is separated from
`its handle byan extensiontube. As usedherein, the term “end
`effector” meansthe actual workingpart ofthe surgical instru-
`0 ment and can include clamps, graspers, scissors, staplers, and
`needle holders, for example. To perform surgical procedures,
`the surgeon passes these working tools or instruments
`through the cannula sleeves to an internal surgical site and
`manipulates them from outside the abdomen. The surgeon
`monitors the procedure by means ofa monitor that displays an
`imageofthe surgicalsite taken fromthe laparoscope. Similar
`endoscopic techniques are employed in, e.g., arthroscopy,
`retroperitoneoscopy, pelviscopy, nephroscopy, cystoscopy.
`cisternoscopy, sinoscopy, hysteroscopy, urethroscopy and the
`like.
`There are manydisadvantagesrelating to current MIS tech-
`nology. For example, existing MIS instruments deny the sur-
`geon the flexibility of tool placement found in open surgery.
`Most current laparoscopic tools have rigid shatts, so that it
`can be difficult to approach the worksite through the small
`incision. Additionally, the length and construction of many
`endoscopic instruments reduces the surgeon's ability to feel
`forces exerted by tissues and organsonthe end effectorofthe
`associated tool. The lack of dexterity andsensitivity of endo-
`scopic tools is a major impedimentto the expansion of mini-
`mally invasive surgery.
`Minimally invasive telesurgical robotic systems are being
`developed to increase a surgeon’s dexterity when working
`within an internal surgical site, as well as ta allow a surgeon
`to operate on a patient from a remote location. Ina telesurgery
`system, the surgeon is often provided with an image of the
`surgical sile al a computer workstation. While viewing 4
`three-dimensional image of the surgical site on a suitable
`vieweror display, the surgeon performsthe surgical proce-
`dures on the patient by manipulating master input or control
`devices ofthe workstation. The master controls the motion of
`aservomechanically operated 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 suchas,c.g., tissue
`graspers, needle drivers, or the like, that perform various
`functions for the surgeon, e.g., holding or driving a needle,
`grasping a blood vessel, or dissecting tissuc, or the like, in
`response to manipulation of the master control devices.
`Manipulation and control ofthese end effectorsis a critical
`aspect of robotic surgical systems. For these reasons, it is
`desirable to provide surgical tools which include mechanisms
`to provide three degrees of rotational movement of an end
`effector around three perpendicular axes to mimic the natural
`action of a surgcon’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 addition,
`such mechanisms
`should provide
`adequate degree of rotation to allowthe end effector to be
`manipulated in a wide variety of positions. At least some of
`these objectives will be met by the inventions described here-
`inafter.
`
`The present invention relates generally to surgical toals
`and, more particularly, to various wrist mechanismsin surgi-
`cal tools for performing robotic surgery.
`Robotic surgery has developed to improve and expand the
`use of minimally invasive surgical (MIS) techniques in the 5
`treatment of patients. Minimally invasive techniques are
`aimed. at reducing the amount of extraneous tissue that is
`damaged during diagnostic or surgical procedures, thereby
`reducing patient recovery time, discomfort, and deleterious
`side effects. The average length of a hospital stay fora stan-
`dard surgery mayalso be shortened significantly using MIS
`techniques. Thus, an increased adoption of minimally inva-
`sive techniques could save millions of hospital days and mil-
`lions ofdollars annually in hospital residency casts alone.
`Patient recovery times, patient discomfort, surgical side
`effects and time away from work may also be reduced with
`minimally invasive surgery.
`The most common form of minimally invasive surgery
`may be endoscopy. And, probably the most common form of
`endoscopy is laparoscopy, which is minimally invasive
`inspection and surgeryinside the abdominalcavity. In stan-
`dard laparoscopic surgery, a patient’s abdomenis insufflated
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`BRIEF SUMMARY OF THE INVENTION
`
`The present invention provides a robotic surgical tool for
`use in a robotic surgical systemto perform a surgical opera-
`
`Ethicon Exhibit 2002.027
`Intuitive v. Ethicon
`IPR2018-01254
`
`Ethicon Exhibit 2002.027
`Intuitive v. Ethicon
`IPR2018-01254
`
`

`

`US 7,691,098 B2
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`secondarticulated direction. The second angle may also be
`tion, Robotic surgical systems perform surgical operations
`anyangle in the range of0-90 degrees and oriented so that the
`with tools whichare robotically operated by a surgeon. Such
`second articulated direction is any directionthatis not parallel
`systems generally include master controllers and a robotic
`to the axial direction. The addition of a second angle would
`arm slave cart. The robotic armslave cart is positioned adja-
`allow the distal memberto direct an endeffectorin essentially
`centto the patient’s body and movesthe tools to perform the
`a compound angle or in a second articulated direction in
`surgery. ‘lhe tools have shalis which extend into an internal
`relation to the shaft ofthe surgical tool. In most embodiments,
`surgical site within the patient body via minimally invasive
`the second angle is greater than approximately 30 degrees. In
`access openings. The robotic armslave cart is connected with
`some embodiments, the second angleis greater than approxi-
`master controllers which are grasped by the surgeon and
`mately 60 degrees and in other embodiments the second angle
`manipulated in space while the surgeon views the procedure
`is greater than approximately 70 degrees. If the first angle
`on a stereo display. The master controllers are manual input
`represents the pitch ofthe wrist mechanism,the second angle
`devices which preferably move with six degrees of freedom,
`and which often further have an actuatable handle for actuat-
`mayrepresent the yawof the wrist mechanism andvice versa.
`The plurality ofrods may comprise two, three, four or more
`ing the tools (for cxample, for closing grasping saws, apply-
`rods. In preferred embodiments, three or four rodsare used to
`ing anelectrical potential to an electrode,or the like). Robotic
`provide both pitch and yawangulation. When four rods are
`surgery systems and methods are further described in co-
`used,the first and secondrodsare pasitioned adjacent to each
`pending U.S. patent application Ser. No. 08/975,617, filed
`other and the remaining two rods are located in positions
`Nov. 21, 1997, the full disclosure of which is incorporated
`diametrically opposite to the first and second rods. The four
`herein by reference.
`rods are generally arranged symmetrically around a central
`As described, robotic surgical tools comprise an elongated.
`axis of the shaft or the axial direction. Whenthefirst rod is
`shaft having a surgical end effector disposed near the distal
`advanced, the diametrically opposite rod is simultaneously
`end of the shaft. As used herein, the terms “surgical instru-
`retracted. Likewise, when the first rod is retracted, the dia-
`ment’, “instrument”, “surgical tool’, or “tool” refer to a
`metrically opposite rod is simultancously advanced. This is
`memberhaving a working end which carrics one or more end
`similarly the case with the second rod andits diametrically
`effectors to be introduced into a surgical site in a cavity ofa 2
`opposite rod. Thus, the rods actuate in pairs. Such actuation
`patient, and is actuatable fromoutside the cavity to manipu-
`will be further described in a later section.
`late the end effector(s) for effecting a desired treatment or
`To maintain desired positioning ofthe rods, some embodi-
`medical function of a target tissue in the surgical site. The
`ments include a guide tube having a plurality of guideslots.
`instrumentor tool typically includes a shaft carrying the end
`Eachguide slot is shaped for receiving and guiding one ofthe
`effector(s) at a distal end, and is preferably servomechani-
`plurality of rods substantially along the axial direction. In
`cally actuated bya telesurgical system for performing func-
`
`tions such as holding or driving a needle, grasping a blood some embodiments, the rods are shaped so asto havearect-
`vessel, and dissecting tissue. In addition,as used herein,“end
`angular cross-section. In these instances, the corresponding
`effector”refers to the actual working part that is manipulable
`guide slots also rectangular in shape to receive and maintain
`for effecting a predetermined treatmentofa target tissue. For
`properorientation of the rods.
`instance, some end effectors have a single working member
`In a second aspect of the present invention, the robotic
`suchasa scalpel, a blade,or an electrode. Other end elTectors
`surgical tool includes a tool base disposednear the proximal
`end of the shaft. The tool base includes mechanisms for
`have a pairor plurality of working members such as forceps,
`graspers, scissors, or clip appliers, for example.
`actuating the wrist mechanism and often mechanisms for
`Ina first aspectofthe present invention,the robotic surgical
`actuating the end effector. Mechanismsfor actuating the wrist
`tool includes a wrist mechanism disposed near the distal end
`mechanism includes mechanismsfor advancingorretracting
`of the shaft which connects with the end effector. The wrist
`the first rod. In some embodiments, such mechanisms com-
`mechanismincludes a distal member, configured to support
`prisesa first rotational actuation memberto whichthefirst rod
`is attached so that rotation ofthe first rotational actuation
`the end effector, and a plurality of rods extending generally
`along anaxial direction within the shaft and movable gener-
`memberadvancesorretracts the first rod. Typically, another
`rod is attachedto the first rotational actuation memberin a
`ally along this axial direction to adjust the orientationof the
`distal member with respectto the axial direction or shaft. The
`position diametrically opposite to thefirst rod so that rotation
`distal member mayhave any form suitable for supporting an
`of the first rotational actuation member simultancously
`end effector. In most embodiments, the distal memberhas the
`advancesthefirst rod and retracts the diametrically opposite
`form of a clevis. In anycase, the distal member hasa base to
`rod. In some embodiments, the tool base further comprises a
`second rotational actuation member to which the second rod
`whichthe rods are rotatably connected.
`is attached so that rotation of the secondrotational actuation
`Advancementorretraction ofa first rod generally along the
`axial direction tips the base througha first angle so that the
`member advances or retracts the second rod substantially
`distal member faces a first articulated direction. The first
`along the axial direction. Again, another rod is often attached
`angle may be anyangle in the range of 0-90 degrees and
`to the second rotational actuation memberin a position dia-
`oriented so that the first articulated direction is any direction
`metrically opposite to the second rodsothat rotation of the
`that is not parallel to the axial direction. This would allowthe
`secondrotational actuation membersimultaneously advances
`distal member to direct an end effector in any direction in
`the second. rod and retracts the diametrically opposite rod.
`relation to the shaft ofthe surgical tool. In most embodiments,
`Thus, by rotating the first and second rotational actuation
`the first angle is greater than approximately 30 degrees. In
`members, the distal memberis tipped through two angles, or
`some embodiments, the first angle is greater than approxi-
`acompoundangle, so that the distal member faces anydesired
`direction. This allows refined control of the end effector
`mately 60 degrees and in other embodimentsthe first angle is
`greater than approximately 70 degrees. Thisfirst angle may
`throughout three dimensions.
`represent the pitch or the yawof the wrist mechanism.
`The robotic surgical tool of the present invention mayalso
`In some embodiments, advancementor retraction ofa sec-
`include provisions for roll movement. Roll movement is
`ond rod generally along the axial direction tips the base
`achieved byrotating the shaft aroundits central axis. Since
`through a second angle so that the distal member faces a
`the shaft is connected to a guide tube through which the
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`Ethicon Exhibit 2002.028
`Intuitive v. Ethicon
`IPR2018-01254
`
`Ethicon Exhibit 2002.028
`Intuitive v. Ethicon
`IPR2018-01254
`
`

`

`US 7,691,098 B2
`
`5
`plurality of rodspass, rotation of the shaft rotates guide tube
`whichin turn rotates the rods around the central axis which is
`parallel to the axial direction.‘lo actuate such rall, the above
`described tool base comprisesa roll pulley whichrotates the
`shaft. Since the rods extend throughthe roll pulley and attach
`to the rotational actuation members, such rotation is possible
`by flexing of the rods. Duc to the length, thickness and fiex-
`ibility ofthe rods, 360 degreerotationis possible. Thus, pitch,
`yaw and roll movement canbe individually actuated by the
`tool base, particularly by manipulation ofthe rotational actua-
`tion members androll pulley.
`Althoughactuation of the wrist mechanism is achieved by
`manipulation ofthe rods, itis the connection ofthe rodsto the
`base which allows tipping and manipulation of the distal
`member to face a desired direction. Such connection is
`achieved with the use of a plurality of linkages, each linkage
`connecting one ofthe plurality ofrods with the base. In some
`embodiments,
`the linkages comprise orthogonal
`linkage
`assemblies. Each orthogonallinkage assembly rotatably con-
`nects one ofthe plurality of rods with the base to allow the 2
`base to be rotatedin at least two directions with respect to the
`axial direction. In some embodiments, each orthogonallink-
`age assembly comprises an orthogonal linkage havinga first
`link portion which is rotatably connectable with the onc ofthe
`plurality of rods and a secondlink portion whichis rotatably
`connectable with the base and whereinthe first link portion
`and the second link portion lie in orthogonal planes. In other
`embodiments, each orthogonallinkage assembly comprises a
`linkage fastener having a link base portion whichis rotatably
`connectable with one ofthe pluralityofrods and a cylindrical
`fastening end portion which is rotatably connectable with the
`base. The different orthogonal linkage assemblies allow the
`base to be rotated to different degrees of angularity relative to
`the axial direction.
`Such rotation is assisted by flexibility of the rods. Gener-
`ally, eachrod is flexible in at least one direction. For example,
`wheneach rodhas a rectangular cross-section, having a wide
`side and a narrowside, the rod maybe flexible along the wide
`side yet rigid along the narrow side. When the rods are
`arrangedso that the wide sides are parallel to the perimeter of
`the shaft, flexibility along the wide sides allows each rod to
`bend slightly inward, toward the center of the shaft or the
`longitudinal axis. This allows greater rotation of the distal
`memberand flexibility in design parameters.
`Ina third aspectofthe present invention, methods of actu-
`ating the robotic surgical tool are provided. In some embodi-
`ments, methods include providing a robotic surgical tool
`comprising a wrist mechanism, whichincludes a distal mem-
`ber coupleable witha surgical end effector and having a base
`and a plurality of rods rotatably connected to the base and 5
`extending along an axial direction, and actuating the wrist by
`manipulating a first rod ofthe plurality ofrods to tip the base
`througha first angle so that the distal member faces a first
`articulated direction. Manipulating typically comprises
`advancing or retracting the first rod. As previously men-
`tioned, advancingor retracting may comprise rotating a first
`rotational actuation memberto whichthefirst rod is attached.
`Likewise, actuating the wrist mayfurther comprises manipu-
`lating a second rod of the plurality of rods to tip the base
`through a second angle so that the distal member faces a
`secondarticulated direction. Again, advancing orretracting
`may comprise rotating a second rotational actuation member
`to which the secondrod is attached.
`Insome embodiments, methods further comprise actuating
`the wrist byrotating the plurality of rods around a longitudi-
`nal axis parallel to the axial direction to rotate the base. In
`some embodiments, rotating the plurality of rods comprises
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`rotating a roll pulley through which the plurality of rods
`extend. And,lastly, methods mayfurther comprise coupling
`the end effector to the base and actuating the end effector.
`Other objects and advantagesofthe present invention will
`become apparent from the detailed description to follow,
`together with the accompanying drawings.
`
`
`
`BRILT DESCRIPTION OF TIE DRAWINGS
`
`FIG.1 is a perspective overall view of an embodiment of
`the surgical tool of the present invention.
`FIGS. 2A-2B illustrate exemplarysurgical end effectors.
`FIG,3 illustrates an embodiment of a wrist mechanism.
`FIGS. 3A-3B illustrate possible arrangements of guide
`slots within the guide tube.
`FIGS. 3C-3D illustrate connection of rods to the distal
`membervia orthogonallinkages.
`FIG. 4 illustrates movement of the wrist mechanism
`through a compoundangle.
`FIG, 5 illustrates tipping ina variety ofdirections including
`a combinationsofpitch and yaw.
`FIGS.6A-6Fillustrate three different embodiments of the
`wrist mechanism ofthe present invention.
`FIG. 7 illustrates assemblageofthefirst main embodiment
`of the wrist mechanism.
`FIGS. 8-9 illustrate joining of a rod with an orthogonal
`linkage and thenjoiningofthe linkage witha foot onthedistal
`clevis.
`FIG, 10 illustrates joining of additional rods to the distal
`clevis.
`FIG.11Aillustrates the firstmain embodimentofthe wrist
`mechanism wherein four rods are attached. FIG. 11B is a
`cross-sectional view of FIG. 117A.
`
`FIG,12 illustrates assemblage ofthe second main embodi-
`ment ofthe wrist mechanism.
`FIG, 13 illustrates joining of a rod with a linkage fastener
`and forlater joining with a distal clevis half.
`FIG. 14 illustrates joming rods with corresponding, aper-
`tures on the first and second clevis halves with the use of
`linkage fasteners.
`FIGS. 15-16 showmating ofthe clevis halves and joining
`witha clevistip.
`FIG, 17A illustrates the second main embodimentof the
`wrist mechanism wherein four rodsare attached. FIG. 17Bis
`a cross-sectional view of FIG. 17A.
`FIG. 18 isa perspective view of an embodiment of the wrist
`mechanism showing rods inserted through a guide tube.
`FIG. 19 illustrates tipping of the distal clevis in response ta
`advancementand/or retraction of one or more rods.
`FIG.20 illustrates assemblage ofthe third main embodi-
`ment of the wrist mechanism.
`FIGS. 21-22 illustrate joining of a rod with an linkage
`fastener and then joining linkage fastener with a foot onthe
`distal clevis.
`FIG, 23Aillustrates the third main embodimentofthe wrist
`mechanism wherein four rods are attached. FIG. 23B is a
`cross-sectional view of FIG. 23A.
`FIG, 24 illustrates Gppingolthe distal clevis in response ta
`advancementand/or retraction of one or more rods.
`FIG,25 illustrates joining of a rod with a wire to create a
`wire/rod assembly.
`FIG,26 illustrates inserting the wire/rod assemblythrough
`a roll pulley within the tool base.
`FIG. 27 illustrates additional features of the tool base,
`including rotational actuation members.
`
`Ethicon Exhibit 2002.029
`Intuitive v. Ethicon
`IPR2018-01254
`
`Ethicon Exhibit 2002.029
`Intuitive v. Ethicon
`IPR2018-01254
`
`

`

`US 7,691,098 B2
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`TIG. 28 is a side viewillustrating insertion of the wire
`througha crosshole in a pivot pin whichis mounted ina sector
`gear.
`FIG.29 is a side view illustrating crimping of a crimp onto
`the wire to maintain positioning of the rod against the pivot
`pin.
`FIG.30 is a top perspective viewofthe tool base, including
`mechanisms to manipulate the rods to actuate the wrist
`mechanism.
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`DETAILED DESCRIPTION OF THE INVENTION
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`TIG.1 illustrates a surgical tool 50 ofthe present invention
`whichis used in robotic surgery systems. The surgical tool 50
`includesa rigid shaft 52 having a proximal end54,a distal end
`56 anda longitudinal axis therebetween. The proximal end 54
`is coupled to a tool base 62. The tool base 62 includes an
`interface 64 which mechanically and electrically couples the
`tool 50 to a manipulator on the robotic arm cart. A distal
`member,in this embodimenta distal clevis 58, is coupled to 2
`shaft 52 by a wrist joint or wrist mechanism 10, the wrist
`mechanism 10 providing the distal clevis