Surgical instrument with articulating and rotating end effector and flexible coaxial drive

1. A surgical instrument, comprising:

a shaft having a proximal end, a distal end, and lumen extending therethrough;

an end effector coupled to the distal end of the shaft by an articulation joint such that the end effector can articulate relative to a longitudinal axis of the shaft and can rotate about a longitudinal axis of the end effector;

a first actuating cable coaxially disposed within the lumen of the shaft and extending through the articulation joint to the end effector,

a second actuating cable coaxially disposed within the first actuating cable and extending through the articulation joint to the end effector,

an articulation control shaft coaxially disposed within the lumen of the shaft and configured to translate proximally and distally to articulate the end effector relative to the longitudinal axis of the shaft;

wherein the first and second actuating cables are configured to bend and rotate through the articulation joint; and

wherein rotation of the first actuating cable relative to the second actuating cable is configured to control rotation of the end effector about a longitudinal axis thereof, and translation of the first actuating cable relative to the second actuating cable is configured to translate a blade to transect tissue grasped by the end effector.

2. The instrument of claim 1 ,

wherein the end effector includes a first jaw and a second jaw pivotally coupled to one another and movable between an open configuration and a closed configuration; and

wherein translation of the second actuating cable relative to the first actuating cable is configured to move the first and second jaws between the open and closed configurations.

3. The instrument of claim 2 , further comprising a drive arm and drive pin coupled to a distal end of the second actuating cable, the drive pin being configured to engage opposed slots formed in one of the first or second jaws such that, upon distal translation of the second actuating cable relative to the first actuating cable, the drive pin engages the opposed slots to cause the first and second jaws to move between the open configuration to the closed configuration.

4. The instrument of claim 2 , wherein translation of the first actuating cable relative to the second actuating cable is configured to only translate the blade, and translation of the second actuating cable relative to the first actuating cable is configured to only move the first and second jaws between the open and closed configurations.

5. The instrument of claim 1 ,

wherein the end effector includes a first jaw and a second jaw pivotally coupled to one another and movable between an open configuration and a closed configuration, and the blade is configured to translate proximally and distally relative to the first and second jaws.

6. The instrument of claim 5 , wherein the second actuating cable is configured to translate proximally and distally to move the first and second jaws between the open and closed configurations.

7. The instrument of claim 5 , further comprising a conductor coaxially disposed within the second actuating cable and configured to deliver energy to the end effector.

8. The instrument of claim 1 , wherein the articulation control shaft is coaxially disposed about the first actuating cable within the lumen of the shaft.

9. The instrument of claim 1 ,

wherein the articulation joint includes a distal portion rotatably coupled to the end effector and a proximal portion coupled to the shaft; and

wherein the distal portion is coupled to the proximal portion by a hinge pin that is offset from the longitudinal axis of the shaft.

10. The instrument of claim 9 , wherein the articulation control shaft is coupled to the distal portion of the articulation joint at a position oppositely offset from the longitudinal axis of the shaft.

11. The instrument of claim 9 , wherein the hinge pin is positioned along an outer circumference of the articulation joint.

12. The instrument of claim 9 , further comprising an elongate link extending between the articulation control shaft and the distal portion of the articulation joint.

13. The instrument of claim 12 , wherein the proximal portion of the articulation joint includes a slot extending proximally from a distal end thereof and sized to receive the elongate link when the end effector is articulated relative to the shaft.

14. The instrument of claim 12 , wherein the hinge pin is positioned proximal to a distal end of the elongate link when the longitudinal axis of the end effector is aligned with the longitudinal axis of the shaft.

15. The instrument of claim 1 , further comprising an interface coupled to the proximal end of the shaft and configured to control rotation and translation of the first and second actuating cables.

16. The instrument of claim 15 , wherein the interface is configured for use with a surgical robot.

17. The instrument of claim 1 , further comprising a conductor coaxially disposed within the second actuating cable through the articulation joint and configured to deliver energy to the end effector, the conductor being configured to translate within the second actuating cable relative to the first and second actuating cables, the conductor being configured to rotate with the end effector to maintain a constant relative alignment between the end effector and the conductor.

18. The instrument of claim 1 , further comprising a guide disposed at a proximal end of the end effector and in engagement with a distal end of the first actuating cable, the guide being configured to indicate an alignment of the first actuating cable, the guide having a cylindrical body and at least one radially extending through slot, and the blade being received within the through slot such that the guide is configured to maintain alignment of the blade.

19. A surgical instrument, comprising:

an elongate cylindrical housing having a proximal end, a distal end, and a lumen extending the through along a longitudinal axis;

an end effector coupled to the distal end of the housing by a hinge mechanism including a hinge pin that is offset from the longitudinal axis of the housing;

first and second coaxial members extending through the lumen and the hinge mechanism to the end effector, the second coaxial member being coaxially disposed within the first coaxial member,

wherein the surgical instrument has a first configuration in which the elongate cylindrical housing and the end effector are substantially coaxially aligned, and a second configuration in which the end effector is pivoted relative to the elongate cylindrical housing such that the end effector is angularly offset from the longitudinal axis;

wherein the first and second coaxial members are configured to bend and rotate within the hinge mechanism when the surgical instrument is in the second configuration; and

wherein rotation of the first coaxial member is configured to rotate the end effector relative to the elongate cylindrical housing, translation of the first coaxial member is configured to cause translation of a knife along the end effector, and translation of the second coaxial member is configured to cause capture of tissue by the end effector.

20. The surgical instrument of claim 19 , wherein the hinge mechanism includes a push-pull mechanism.

21. The surgical instrument of claim 20 , wherein the push-pull mechanism includes a distal end and a proximal end and is coaxially disposed between the housing and the first coaxial member.

22. The surgical instrument of claim 21 ,

wherein the hinge pin pivotally connects a first side of the end effector to the housing, and the hinge mechanism further includes a second hinge pin pivotally connecting a second side of the end effector to the push-pull mechanism; and

wherein the hinge pin is proximal to the second hinge pin when the instrument is in the first configuration.

23. The surgical instrument of claim 22 , wherein the hinge mechanism includes an elongate link disposed between the second hinge pin and the distal end of the push-pull mechanism.

24. The surgical instrument of claim 20 , wherein the push-pull mechanism is configured to actuate the surgical instrument from the first configuration to the second configuration with substantially linear movement of the push-pull mechanism.

25. The surgical instrument of claim 19 , wherein the end effector includes a grasper; and

wherein the second coaxial member is configured to actuate the grasper to capture the tissue.

26. The surgical instrument of claim 25 , wherein the first and second coaxial members are configured to slide along the longitudinal axis within the elongate cylindrical housing and the hinge mechanism while the surgical instrument is in the second configuration to actuate the grasper and the knife.

27. The surgical instrument of claim 25 , further comprising a substantially cylindrical guide disposed around the second coaxial member and connected to a grasper actuation link, the guide having a slot extending therethrough for receiving a distal end of the knife such that the knife can slide within the slot.

28. A surgical method, comprising:

articulating an end effector relative to a shaft about an articulation joint by translating a single articulation control shaft coaxially disposed within the shaft;

rotating the end effector about a longitudinal axis thereof by rotating a first actuating cable coaxially disposed within the articulation control shaft and extending through the articulation joint to the end effector;

translating a blade along the end effector by translating the first actuating cable; and

causing the end effector to capture tissue by translating a second actuating cable coaxially disposed within the first actuating cable and extending through the articulation joint to the end effector.

29. The method of claim 28 , wherein translating the second actuating cable causes movement of first and second jaws of the end effector to capture the tissue.

30. The method of claim 29 , further comprising delivering energy to tissue grasped by the first and second jaws through a conductor coaxially disposed within the second actuating cable.