Systems and methods for instrument-based insertion architecture

Abstract

Systems, devices, and methods are disclosed in which an instrument can be translated along an insertion axis. The instruments described herein do not primarily rely on a robotic arm for instrument insertion, but rather have a novel instrument-based insertion architecture that allows portions of the instrument itself to be translated along the insertion axis. For example, an instrument can include a shaft, an end effector on a distal end of the shaft, and a handle coupled to the shaft. The architecture of the instrument allows the shaft to be translated relative to the handle along the insertion axis. The translation of the shaft does not impede other functions of the instrument, such as end effector actuation.

Description

[0001] Cross-references to related applications

[0002] This application claims the benefit of U.S. Provisional Patent Application No. 62 / 597,385, filed December 11, 2017, the entire contents of which are incorporated herein by reference. Technical Field

[0003] The systems and methods disclosed herein relate to medical devices, and more specifically to surgical tools used in various types of surgical procedures. Background Technology

[0004] This instruction manual generally relates to medical devices, and more specifically to surgical tools used in various types of surgery, including laparoscopic surgery, endoscopic surgery, endovascular surgery, and open surgery.

[0005] Robotics has a wide range of applications. Specifically, robotic arms help perform tasks that humans would normally do. For example, factories use robotic arms to manufacture cars and consumer electronics. Additionally, scientific facilities use robotic arms to automate laboratory procedures such as transporting microplates. In the medical field, doctors have begun using robotic arms to assist in performing surgical procedures.

[0006] In a surgical robotic system, a robotic arm, for example, is connected to an instrument manipulator at its end cap and can be moved to any position within a defined workspace. The instrument manipulator can be detachably coupled to surgical instruments, such as steerable catheters for endoscopic applications or any of a variety of laparoscopic and endoscopic instruments. The instrument manipulator transmits motion from the robotic arm to control the position of the surgical instrument, and can also activate controls on the instrument, such as pull wires, to steer the catheter. Additionally, the instrument manipulator can be electrically and / or optically coupled to the instrument to provide power, light, or control signals, and can receive data from the instrument, such as video streams from cameras on the instrument.

[0007] During use, surgical instruments are attached to an instrument manipulator, moving the instruments away from the patient. The robotic arm then advances the instrument manipulator and the attached instruments toward the surgical site inside the patient's body. In laparoscopic surgery, the instruments are moved through ports in the patient's body wall. The robotic arm is capable of manipulating the instruments with multiple degrees of freedom, including pitch, yaw, and insertion. Typically, the robotic arm provides all of these degrees of freedom.

[0008] Compared to insertion, robotic arms typically have a linear insertion axis to provide the degree of freedom for insertion. Difficulties can arise when the robotic arm is responsible for the linear insertion of instruments. Specifically, the mass of the robotic arm (alone or in combination with the instrument) can result in heavy oscillating mass and degrade performance at shallow insertion depths. Furthermore, reliance on the robotic arm for insertion reduces the workspace available to the surgeon or assistant during robotic surgery. Therefore, when inserting instruments linearly, it is necessary to reduce reliance on the robotic arm. Summary of the Invention

[0009] Embodiments of this application relate to systems, apparatuses, and methods for reducing reliance on robotic arms during linear instrument insertion. Specifically, the systems, apparatuses, and methods described herein relate to instruments having an instrument-based linear insertion architecture. For example, one or more instruments may be provided in which the axis of the instrument is capable of translation along the insertion axis, thereby reducing reliance on a robotic arm for linear insertion. While in some embodiments, the robotic arm may still be used in conjunction with the instrument itself for linear insertion, in other embodiments, this movement is eliminated, thereby reducing the overall profile of the robot and minimizing the wobbling mass at the end of the surgical robotic arm.

[0010] In some embodiments, a medical device includes a shaft, an end effector connected to the shaft, and a handle coupled to the shaft. The handle includes a first mechanical input and a second mechanical input. The first mechanical input is configured to actuate the end effector, while the second mechanical input is configured to cause translation of the shaft relative to the handle. The actuation of the end effector is performed via a first actuation mechanism disengaged from a second actuation mechanism that causes translation of the shaft relative to the handle. The first actuation mechanism may include a first cable extending through a first set of pulleys, wherein manipulation of at least one pulley in the first set of pulleys via the first mechanical input causes a change in the length of the first cable within the handle, thereby actuating the end effector. The second actuation mechanism may include a second cable engaging a spool, wherein manipulation of the spool of the second set of pulleys via the second mechanical input causes translation of the shaft relative to the handle. The spool may be a winch, such as a zero-travel winch. The change in length of the first cable within the handle that causes actuation of the end effector is unaffected by the second actuation mechanism that translates the shaft relative to the handle. In some cases, the cable of the first actuation mechanism extends from the proximal portion of the shaft through the first set of pulleys and reaches the distal portion of the shaft. In other cases, the first actuation mechanism includes one or more cables extending through the first set of pulleys, and the second actuation mechanism includes one or more cables and an insert reel, wherein at least one or more cables of the first actuation mechanism are terminated on the insert reel.

[0011] In some embodiments, a medical system includes a base, a tool holder coupled to the base, and an instrument. A robotic arm is positionable between the base and the tool holder. The tool holder includes an attachment interface. The instrument includes a shaft, an end effector, and a handle having a reciprocating interface for attachment to the tool holder. The handle also includes a first mechanical input and a second mechanical input. The first mechanical input is configured to actuate the end effector, while the second mechanical input is configured to cause translation of the shaft relative to the handle. The actuation of the end effector is performed via a first actuation mechanism that disengages from a second actuation mechanism that causes translation of the shaft relative to the handle. In some cases, the first actuation mechanism includes a first cable extending through a first set of pulleys, wherein manipulation of at least one of the pulleys in the first set of pulleys via the first mechanical input causes a change in the length of the first cable within the handle, thereby actuating the end effector, and wherein the translation of the shaft relative to the handle is performed via a second actuation mechanism, the second actuation mechanism including a second cable engaging a spool, wherein manipulation of the spool via the second mechanical input causes the shaft to translate relative to the handle.

[0012] In some embodiments, a surgical method includes providing an instrument configured for delivery through a patient's incision or natural orifice to perform surgery at a surgical site. The instrument includes a shaft, a shank coupled to the shaft, and an end effector extending from the shaft. The shaft is translatable relative to the shank. Actuation of the end effector is performed via a first actuation mechanism disengaged from a second actuation mechanism causing the translation of the shaft relative to the shank. In some cases, the instrument includes a first actuation mechanism for actuating the end effector and a second actuation mechanism for translating the shaft relative to the shank, wherein the first actuation mechanism includes a first set of pulleys and a first cable, and the second actuation mechanism includes a reel and a second cable.

[0013] In some embodiments, a surgical method includes delivering an instrument through a patient's incision or natural orifice to perform surgery at a surgical site. The instrument includes a shaft, a shank coupled to the shaft, and an end effector extending from the shaft. The shaft is translatable relative to the shank. Actuation of the end effector is performed via a first actuation mechanism disengaged from a second actuation mechanism that causes the translation of the shaft relative to the shank. In some cases, the instrument includes a first actuation mechanism for actuating the end effector and a second actuation mechanism for translating the shaft relative to the shank, wherein the first actuation mechanism includes a first set of pulleys and a first cable, and the second actuation mechanism includes a reel and a second cable. Attached Figure Description

[0014] Figure 1A A surgical robotic system according to one embodiment is shown.

[0015] Figure 1B A surgical robotic system according to an alternative embodiment is shown.

[0016] Figure 2 A command console for a surgical robot system according to one embodiment is shown.

[0017] Figure 3 A perspective view of an instrument device manipulator for a surgical robotic system according to one embodiment is shown.

[0018] Figure 4 An embodiment is shown. Figure 3 A side view of the instrument's manipulator.

[0019] Figure 5 A fixation to, according to one embodiment, is shown. Figure 3 An exploded perspective view of an exemplary surgical tool for manipulating an instrument device.

[0020] Figure 6 A fixation to, according to one embodiment, is shown. Figure 3 An exploded perspective view of an exemplary surgical tool for manipulating an instrument device.

[0021] Figure 7 An enlarged perspective view is shown of an actuation mechanism for engaging and disengaging a surgical instrument from a surgical instrument holder, according to one embodiment.

[0022] Figure 8A and Figure 8B The process of engaging and disengaging a surgical instrument with a sterile adapter according to one embodiment is shown.

[0023] Figure 9A and Figure 9B The process of engaging and disengaging a surgical instrument with a sterile adapter according to an alternative embodiment is shown.

[0024] Figure 10A A perspective view of a mechanism for rolling a surgical tool rack within an instrument device manipulator according to one embodiment is shown.

[0025] Figure 10B A cross-sectional view of an instrument manipulator according to one embodiment is shown.

[0026] Figure 10C and 10DA partial exploded perspective view of the internal components and certain electronic components of an instrument device manipulator according to one embodiment is shown.

[0027] Figure 10E An enlarged perspective view of the electronic components of an instrument device manipulator according to one embodiment for causing a surgical tool rack to perform rolling indexing is shown.

[0028] Figure 11 A side view of an instrument with an instrument-based insertion architecture according to one embodiment is shown.

[0029] Figure 12 A schematic diagram of a first actuation mechanism for actuating an end effector is shown according to one embodiment.

[0030] Figure 13 An embodiment is shown. Figure 11 An enlarged side view of the first actuation mechanism of the device.

[0031] Figure 14 An embodiment is shown. Figure 11 An enlarged perspective view of the first actuation mechanism of the device.

[0032] Figure 15 An embodiment is shown. Figure 11 The view of the pulleys and cables of the instrument before the actuating pulley.

[0033] Figure 16 An embodiment is shown. Figure 11 The view of the pulleys and cables of the instrument after the actuating pulley.

[0034] Figure 17 A side view of a second actuation mechanism including a reel for axis translation, according to one embodiment, is shown.

[0035] Figure 18 A perspective view of an alternative reel using a single cable for axis translation according to one embodiment is shown.

[0036] Figure 19 A perspective view of an alternative reel, according to one embodiment, is shown, which uses more than one cable for axis translation.

[0037] Figure 20 The following is shown according to one embodiment: Figure 18 Front view of the handle of the scroll.

[0038] Figure 21 A schematic diagram is shown illustrating an alternative architecture for actuating an end effector and axial translation according to one embodiment.

[0039] Figure 22A The combination according to one implementation scheme is shown. Figure 21 An enlarged front view of an instrument with an alternative architecture for actuating end effectors and shaft insertion.

[0040] Figure 22B The combination according to one implementation scheme is shown. Figure 21 Top perspective view of an alternative architecture for actuating end effectors and shaft insertion.

[0041] Figure 23 A top perspective view of the handle and shaft of an instrument according to one embodiment is shown.

[0042] Figure 24A Utilization according to one implementation scheme is shown. Figure 12 A schematic diagram of the cross-section of the instrument axis of the insertion architecture shown.

[0043] Figure 24B Utilization according to one implementation scheme is shown. Figure 21 A schematic diagram of the cross-section of the instrument axis of the insertion architecture shown.

[0044] Figure 25 A schematic diagram is shown illustrating an architecture for driving a knife in a vascular closure device according to one embodiment.

[0045] Figure 26 A schematic diagram is shown illustrating an alternative architecture for driving a knife in a vascular closure device according to one embodiment.

[0046] Figure 27 A schematic diagram is shown illustrating yet another alternative architecture for driving a knife in a vascular closure device according to one embodiment.

[0047] Figure 28 A schematic diagram is shown illustrating an architecture for making a rigid camera an insertion device according to one embodiment.

[0048] Figure 29 A first insertion architecture that allows the camera to be partially separated from the insertion handle, according to one embodiment, is shown.

[0049] Figure 30 and Figure 31 A second insertion architecture that allows the camera to be partially separated from the insertion handle, according to one embodiment, is shown.

[0050] Figure 32 A diagram is shown illustrating an alternative architecture for axis translation according to another embodiment.

[0051] Figure 33 A side sectional view of an instrument with multiple seals to prevent air leakage from the patient is shown.

[0052] Figure 34 A front sectional view of an instrument with multiple seals is shown.

[0053] The accompanying drawings illustrate embodiments of the invention for illustrative purposes only. Those skilled in the art will readily recognize from the following discussion that alternative embodiments of the structures and methods shown herein can be employed without departing from the principles of the invention as described herein. Detailed Implementation

[0054] I. Surgical Robotic Systems

[0055] Figure 1A An embodiment of a surgical robot system 100 is illustrated. The surgical robot system 100 includes a base 101 coupled to one or more robotic arms, such as robotic arm 102. The base 101 is communicatively coupled to the references herein. Figure 2 A command console is described further. The base 101 can be positioned to allow the robotic arm 102 to enter and perform surgery on a patient, while a user, such as a physician, can control the surgical robot system 100 based on the comfort of the command console. In some embodiments, the base 101 can be coupled to a surgical table or bed for patient support. For example, in some embodiments, the base 101 coupled to the robotic arm 102 can be coupled to the bed (e.g., via one or more rails extending along the bed) Figure 1B (As shown). Although for clarity in Figure 1A Not shown, but in some embodiments, base 101 may include subsystems such as control electronics, pneumatic devices, power supplies, light sources, etc. Robotic arm 102 includes multiple arm segments 110 coupled at joint 111, providing multiple degrees of freedom for the robotic arm 102, for example, seven degrees of freedom corresponding to seven arm segments. Base 101 may include power supply 112, pneumatic pressure device 113, and control and sensor electronics 114—including components such as a central processing unit, data bus, control circuitry, and memory—and associated actuators such as motors to move the robotic arm 102. The electronics 114 in base 101 may also process and transmit control signals communicated from a command console.

[0056] In some embodiments, the base 101 includes wheels 115 for transporting the surgical robot system 100. The mobility of the surgical robot system 100 helps adapt to spatial constraints in the operating room and facilitates the proper positioning and movement of surgical equipment. Furthermore, mobility allows the robotic arm 102 to be configured so that it does not obstruct the patient, physician, anesthesiologist, or any other equipment. During procedures, the user can control the robotic arm 102 using control devices such as a command console.

[0057] In some embodiments, the robotic arm 102 includes an assembly joint that uses a combination of brakes and a counterbalancing device to maintain the position of the robotic arm 102. The counterbalancing device may include a gas spring or a coil spring. The brake (e.g., a fail-safe brake) may include mechanical and / or electronic components. Furthermore, the robotic arm 102 may be a gravity-assisted passive support type robotic arm.

[0058] Each robotic arm 102 can be coupled to an instrument device manipulator (IDM) 117 via a mechanism conversion interface (MCI) 116. The IDM 117 can serve as a tool holder. In some embodiments, the IDM 117 can be removed and replaced with a different type of IDM; for example, a first-type IDM for manipulating endoscopes can be replaced with a second-type IDM for manipulating laparoscopes. The MCI 116 includes connectors for transmitting pneumatic pressure, electrical power, electrical signals, and optical signals from the robotic arm 102 to the IDM 117. The MCI 116 can be a positioning screw or a substrate connector. The IDM 117 uses techniques including direct drive, harmonic drive, gear drive, belt and pulley, magnetic drive, etc., to manipulate surgical tools such as instruments 118. The MCI 116 can be interchanged based on the type of IDM 117 and can be customized for a particular type of surgery. The robotic arm 102 may include a joint-level torque sensing and a wrist at the distal end.

[0059] The tool or instrument 118 may include laparoscopic instruments, endoscopic instruments, and / or endoscopic instruments capable of performing surgery at a surgical site on a patient. In some embodiments, the instrument 118 includes a laparoscopic instrument capable of being inserted into a patient's incision. The laparoscopic instrument may include a rigid shaft, a semi-rigid shaft, or a flexible shaft. When designed for laparoscopic surgery, the distal end of the shaft may be connected to an end effector, which may include, for example, a wrist, a gripper, scissors, or other surgical tools. In some embodiments, the instrument 118 includes an endoscopic surgical tool that is inserted into a patient's anatomy to capture images of the anatomy (e.g., body tissue). In some embodiments, the endoscopic instrument includes a tubular and flexible shaft. An endoscope includes one or more imaging devices (e.g., a camera or sensor) for capturing images. The imaging device may include one or more optical components, such as optical fibers, fiber arrays, or lenses. The optical components move with the tip of the instrument 118 such that movement of the tip of the instrument 118 results in a change in the image captured by the imaging device. In some embodiments, the device 118 includes an endovascular instrument, such as a bronchoscope or urethroscope, that can be inserted through a patient's natural orifice. The endovascular instrument may include a tubular and flexible shaft. When designed for endovascular surgery, the distal end of the shaft may be connected to an end effector, which may include, for example, a wrist, a gripper, scissors, or other surgical tools.

[0060] In some embodiments, the robotic arm 102 of the surgical robotic system 100 uses elongated moving members to manipulate the instrument 118. The elongated moving members may include drawstrings (also called push-pull wires), cables, fibers, or flexible shafts. For example, the robotic arm 102 may actuate multiple drawstrings coupled to the instrument 118 to deflect the tip of the instrument 118. The drawstrings may include both metallic and non-metallic materials, such as stainless steel, Kevlar, tungsten, carbon fiber, etc. In some embodiments, the instrument 118 may exhibit nonlinear behavior in response to forces applied by the elongated moving members. This nonlinear behavior may be based on the stiffness and compressibility of the instrument 118, and the variability in relaxation or stiffness between the different elongated moving members.

[0061] Surgical robot system 100 includes a controller 120, such as a computer processor. Controller 120 includes a calibration module 125, an image registration module 130, and a calibration storage device 135. Calibration module 125 can characterize nonlinear behavior using a model with piecewise linear response along with parameters such as slope, hysteresis, and blind zone values. Surgical robot system 100 can more accurately control endoscope 118 by determining accurate values ​​for these parameters. In some embodiments, some or all of the functions of controller 120 are performed external to surgical robot system 100, for example, on another computer system or server communicatively coupled to surgical robot system 100.

[0062] Figure 1B A surgical robotic system according to an alternative embodiment is shown. Similar to... Figure 1A Implementation plan of surgical robot system in China Figure 1B The surgical robotic system includes one or more robotic arms 102 having an IDM 117 and surgical tools or instruments 118 attached thereto. In this embodiment, the one or more robotic arms 102 are attached to one or more adjustable rails 150, which are coupled to a patient platform 160 in the form of a bed. In this embodiment, three robotic arms 102 are attached to the adjustable rails 150 on a first side of the patient platform 160, while two robotic arms 102 are attached to the adjustable rails 150 on a second side of the patient platform 160, thereby providing a system with two arms.

[0063] II. Command Console

[0064] Figure 2A command console 200 for a surgical robot system 100 according to one embodiment is shown. The command console 200 includes a console base 201, a display module 202 (e.g., a monitor), and control modules such as a keyboard 203 and a joystick 204. In some embodiments, one or more of the functions of the command modules 200 may be integrated into the base 101 of the surgical robot system 100 or communicatively coupled to another system of the surgical robot system 100. A user 205, such as a physician, uses the command console 200 to remotely control the surgical robot system 100 from an ergonomic position.

[0065] The console base 201 may include a central processing unit, a memory unit, a data bus, and associated data communication ports, which are responsible for interpreting and processing signals such as camera images and tracking signals such as those from… Figure 1A The sensor data of the illustrated device 118. In some embodiments, both console base 201 and base 101 perform signal processing to achieve load balancing. Console base 201 can also process commands and instructions provided by user 205 through control modules 203 and 204. In addition... Figure 2 In addition to the keyboard 203 and joystick 204 shown, the control module may also include other devices such as a computer mouse, tracking pad, trackball, control pad, video game controller, and sensors (e.g., motion sensors or cameras) that capture hand and finger gestures.

[0066] User 205 can use command console 200 to control surgical tools, such as instrument 118, in speed mode or position control mode. In speed mode, user 205 uses a control module to directly control the pitch and yaw movements of the distal end of instrument 118 based on direct manual control. For example, movement on joystick 204 can be mapped to yaw and pitch movements in the distal end of instrument 118. Joystick 204 can provide tactile feedback to user 205. For example, joystick 204 vibrates to indicate that instrument 118 cannot be translated or rotated further in a certain direction. Command console 200 can also provide visual feedback (e.g., pop-up messages) and / or auditory feedback (e.g., beeps) to indicate that instrument 118 has reached maximum translation or rotation.

[0067] In position control mode, command console 200 uses a three-dimensional (3D) map of the patient and a pre-defined computer model of the patient to control surgical tools, such as instruments 118. Command console 200 provides control signals to the robotic arm 102 of surgical robot system 100 to manipulate instruments 118 to a target position. Because it relies on a 3D map, position control mode requires accurate mapping of the patient's anatomy.

[0068] In some implementations, user 205 can manually manipulate the robotic arm 102 of the surgical robot system 100 without using command console 200. During assembly in the operating room, user 205 can move the robotic arm 102, instruments 118, and other surgical equipment to access the patient. The surgical robot system 100 can rely on force feedback and inertial control from user 205 to determine the appropriate configuration of the robotic arm 102 and equipment.

[0069] Display module 202 may include an electronic monitor, a virtual reality viewing device such as goggles or glasses, and / or other devices for display. In some embodiments, display module 202 is integrated with a control module, for example, as a tablet device with a touchscreen. Furthermore, user 205 can use the integrated display module 202 and control module to view data and input commands into the surgical robot system 100.

[0070] Display module 202 can use stereoscopic devices such as sun visors or goggles to display 3D images. The 3D images provide an "internal view" (i.e., an endoscopic view), which is a computer-generated 3D model showing the patient's anatomy. The "internal view" provides a virtual environment inside the patient and the expected position of instrument 118 within the patient's body. User 205 compares the "internal view" model with actual images captured by a camera to help mentally orient and confirm that instrument 118 is in the correct—or approximately correct—position within the patient's body. The "internal view" provides information about the anatomical structures surrounding the distal end of instrument 118, such as the shape of the patient's small intestine or colon. Display module 202 can simultaneously display the 3D model and computed tomography (CT) scan of the anatomy surrounding the distal end of instrument 118. Furthermore, display module 202 can overlay a predetermined optimal navigation path for instrument 118 onto the 3D model and CT scan.

[0071] In some implementations, a model of the instrument 118 is displayed along with a 3D model to help indicate the state of the surgical procedure. For example, a CT scan identifies lesions in anatomical structures that may require a biopsy. During the procedure, the display module 202 may display a reference image captured by the instrument 118 corresponding to its current position. The display module 202 may automatically display different views of the model of the instrument 118 based on user settings and the specific surgical procedure. For example, the display module 202 may display a top fluorescein view of the instrument 118 during a navigation step as it approaches the patient's operating area.

[0072] III. Machine and Device Operator

[0073] Figure 3 A perspective view of an instrument device manipulator (IDM) 300 for a surgical robotic system according to one embodiment is shown, and Figure 4 This is a side view of an IDM 300 according to one embodiment. The IDM 300 is configured to attach surgical tools or instruments to a robotic surgical arm in a manner that allows surgical tools to rotate or “roll” continuously about the axis of the surgical tool. The IDM 300 includes a base 302 and a surgical tool holder assembly 304 coupled to the base. The surgical tool holder assembly 304 serves as a tool holder for holding instruments 118. The surgical tool holder assembly 304 also includes an outer housing 306, a surgical tool holder 308, an attachment interface 310, a channel 312, and a plurality of torque couplers 314. In some embodiments, the channel 312 includes a through-hole extending from one face of the IDM 300 to the opposite face of the IDM 300. The IDM 300 is compatible with a variety of surgical tools ( Figure 3 (Not shown) used together, the various surgical tools may include a handle and an elongated body (e.g., a shaft) and can be used as end effectors for laparoscopy, endoscopy or other types of surgical tools.

[0074] The base 302 allows the IDM 300 to be removably or permanently mounted to the surgical robotic arm of the surgical robotic system. Figure 3 In one embodiment, the base 302 is fixedly attached to the outer housing 306 of the surgical tool holder assembly 304. In another embodiment, the base 302 may be configured to include a platform adapted to rotatably receive the surgical tool holder 308 on a surface opposite to the attachment interface 310. The platform may include a channel aligned with channel 312 to receive an elongated body of a surgical tool, and in some embodiments, an additional elongated body of a second surgical tool coaxially mounted with a first surgical tool.

[0075] The surgical tool holder assembly 304 is configured to secure surgical tools to the IDM 300 and allow the surgical tools to rotate relative to the base 302. Mechanical and electrical connections are provided from the surgical arm to the base 302 and then to the surgical tool holder assembly 304 to allow the surgical tool holder 308 to rotate relative to the outer housing 306 and to transmit power and / or signals from the surgical arm to the surgical tool holder 308 and ultimately to the surgical tools. Signals may include pneumatic pressure signals, electrical power signals, electrical signals, and / or optical signals.

[0076] The outer housing 306 provides support for the surgical tool holder assembly 304 relative to the base 302. The outer housing 306 is fixedly attached to the base 302, maintaining its position relative to the base 302 while allowing the surgical tool holder 308 to rotate freely relative to the outer housing 306. Figure 3 In one embodiment, the outer housing 306 is cylindrical in shape and is completely external to the surgical tool holder 308. The outer housing 306 may be made of a rigid material (e.g., metal or hard plastic). In another embodiment, the shape of the housing may vary.

[0077] Surgical tool holder 308 secures surgical tools to IDM 300 via attachment interface 310. Surgical tool holder 308 is rotatable independently of outer housing 306. Surgical tool holder 308 rotates about rotation axis 316, which is coaxially aligned with the elongated body of the surgical tool, so that the surgical tool rotates together with surgical tool holder 308.

[0078] The attachment interface 310 is the attachment surface of the surgical tool holder 308 to the surgical tool. The attachment interface 310 includes a first portion of an attachment mechanism that reciprocates with a second portion of the attachment mechanism located on the surgical tool, which will, relative to... Figure 8A and Figure 8B This will be discussed in more detail. In some embodiments, the attachment interface 310 includes a plurality of torque couplers 314 that project outward from the attachment interface 310 and engage with corresponding instrument inputs on the surgical instrument. In some embodiments, a surgical cover coupled to a sterile adapter can be used to form a sterile boundary between the IDM 300 and the surgical instrument. In these embodiments, when the surgical instrument is secured to the IDM 300, the sterile adapter can be positioned between the attachment interface 310 and the surgical instrument, such that the surgical cover separates the surgical instrument and patient from the IDM 300 and the surgical robotic system.

[0079] Channel 312 is configured to receive the elongated body of a surgical tool when the surgical tool is attached to attachment interface 310. Figure 3 In one embodiment, the channel 312 is coaxially aligned with the longitudinal axis of the elongated body of the surgical instrument and the rotation axis 316 of the surgical instrument holder 308. The channel 312 allows the elongated body of the surgical instrument to rotate freely within the channel 312. This configuration allows the surgical instrument to rotate or roll continuously in either direction about the rotation axis 316 with minimal or no constraint.

[0080] Multiple torque couplers 314 are configured to engage and drive components of the surgical instrument when it is secured to the surgical instrument holder 308. Each torque coupler 314 inserts into a corresponding instrument input terminal located on the surgical instrument. The multiple torque couplers 314 can also be used to maintain rotational alignment between the surgical instrument and the surgical instrument holder 308. Figure 3 As shown, each torque coupler 314 is shaped as a cylindrical protrusion projecting outward from the attachment interface 310. Recesses 318 may be arranged along the outer surface region of the cylindrical protrusion. In some embodiments, the arrangement of the recesses 318 forms a spline interface. The instrument input end on the surgical tool is configured to have a geometry complementary to the torque coupler 314. For example, although... Figure 3Not shown, but the instrument input end of the surgical instrument may be cylindrical in shape and have multiple ridges that reciprocately engage with multiple recesses 318 on each torque coupler 314 and thus apply torque to the recesses 318. In an alternative embodiment, the top surface of the cylindrical protrusion may include multiple recesses 318 configured to engage with multiple ridges in the corresponding instrument input end. In this configuration, each torque coupler 314 is fully engaged with its corresponding instrument input end.

[0081] Additionally, each torque coupler 314 can be coupled to a spring that allows the torque coupler to translate. Figure 3 In one embodiment, the spring causes each torque coupler 314 to be biased to spring outward away from the attachment interface 310. The spring is configured to produce translation in the axial direction, i.e., extending away from the attachment interface 310 and retracting towards the surgical tool holder 308. In some embodiments, each torque coupler 314 is capable of partially retracting into the surgical tool holder 308. In other embodiments, each torque coupler 314 is capable of fully retracting into the surgical tool holder 308, such that the effective height of each torque coupler relative to the attachment interface 310 is zero. Figure 3 In the implementation scheme, the translation of each torque coupler 314 is actuated by an actuation mechanism, which will be relative to... Figure 7 Figure 8 illustrates this in more detail. In various implementations, each torque coupler 314 may be coupled to a single spring, multiple springs, or a corresponding spring for each torque coupler.

[0082] Furthermore, each torque coupler 314 is driven by a corresponding actuator that causes the torque coupler to rotate in either direction. Therefore, once engaged with the instrument input, each torque coupler 314 is able to transmit power to tighten or loosen a wire within the surgical instrument, thereby manipulating the end effector of the surgical instrument. Figure 3 In one embodiment, the IDM 300 includes five torque couplers 314, but in other embodiments, the number may vary according to the desired number of end effectors of the surgical instrument. In some embodiments, a surgical drape coupled to a sterile adapter may be used to form a sterile boundary between the IDM 300 and the surgical instrument. In these embodiments, when the surgical instrument is attached to the IDM 300, the sterile adapter may be positioned between the attachment interface 310 and the surgical instrument, and the sterile adapter may be configured to transmit power from each torque coupler 314 to the corresponding instrument input.

[0083] Figure 3The illustrated implementation of the IDM 300 can be used with surgical robotic systems in various configurations. The desired configuration may depend on the type of surgery being performed on the patient or the type of surgical instruments used during the surgery. For example, the desired configuration of the IDM 300 may differ for endoscopic surgery versus laparoscopic surgery.

[0084] In a first configuration, the IDM 300 can be removably or permanently attached to the surgical arm, such that the attachment interface 310 is proximal to the patient during surgery. In this configuration (hereinafter referred to as the "front-mounted configuration"), the surgical instrument is secured to the IDM 300 on the proximal side of the patient. Surgical instruments used with the front-mounted configuration are configured such that the elongated body of the surgical instrument extends from the side opposite to the attachment interface of the surgical instrument. When the surgical instrument is removed from the IDM 300 in the front-mounted configuration, the surgical instrument is removed in a proximal direction to the patient.

[0085] In the second configuration, the IDM 300 can be removably or permanently attached to the surgical arm, such that the attachment interface 310 is distal to the patient during surgery. In this configuration (hereinafter referred to as the "rear-mount configuration"), the surgical instrument is secured to the IDM 300 on the side distal to the patient. Surgical instruments used with the rear-mount configuration are configured such that the elongated body of the surgical instrument extends from the attachment interface of the surgical instrument. This configuration increases patient safety during removal of the instrument from the IDM 300. When the surgical instrument is removed from the rear-mount configuration of the IDM 300, the surgical instrument is removed distal to the patient.

[0086] In the third configuration, the IDM 300 can be removably or permanently attached to the surgical arm, such that at least a portion of the surgical instrument is positioned above the IDM 300, similar to... Figure 1A The configuration shown is shown below. In this configuration (hereinafter referred to as the "top" or "through" configuration), the surgical instrument extends axially downward through the IDM 300.

[0087] Certain configurations of surgical instruments can be designed to allow them to be used with an IDM in either a front-mounted or rear-mounted configuration. In these configurations, the surgical instrument includes attachment interfaces at both ends. For some surgical procedures, the surgeon may determine the configuration of the IDM based on the type of surgery being performed. For example, a rear-mounted configuration can be advantageous for laparoscopic procedures in which the laparoscopic instrument may be particularly long relative to other surgical instruments. The increased length of the laparoscopic instrument causes the surgical arm to swing around a larger arc as the surgical arm moves around during surgery, such as when the surgeon guides the distal end of the surgical instrument to a remote location on the patient (e.g., the lung or a blood vessel). Advantageously, the rear-mounted configuration reduces the effective tool length of the surgical instrument by receiving a portion of the elongated body through channel 312, thereby reducing the arc of motion required for the surgical arm to position the surgical instrument.

[0088] Figures 5-6 A fixation to, according to one embodiment, is shown. Figure 3 An exploded perspective view of an exemplary surgical tool 500 of the instrument device manipulator 300. The surgical tool 500 includes a housing 502, an elongated body 504, and a plurality of instrument input ends 600. As previously described, the elongated body 504 may be a laparoscope, endoscope, or other surgical tool with an end effector. As shown, a plurality of torque couplers 314 protrude outward from an attachment interface 310 to engage with the instrument input ends 600 of the surgical tool. The structure of the instrument input ends 600 is visible in... Figure 6 In this embodiment, the instrument input end 600 has a geometry corresponding to the torque coupler 314 to ensure the engagement of a fixed surgical instrument.

[0089] During surgical procedures, surgical drapes can be used to maintain a sterile boundary between the IDM 300 and the external environment (i.e., the operating room). Figures 5-6 In one embodiment, the surgical drape includes a sterile adapter 506, a first protrusion 508, and a second protrusion 510. Although in Figures 5-6 Not shown, but a sterile sheet is attached to the sterile adapter and the second protrusion and draped around the IDM 300 to form a sterile boundary.

[0090] The sterile adapter 506 is configured to form a sterile interface between the IDM 300 and the surgical instrument 500 when secured to the IDM 300. Figures 5-6In one embodiment, the sterile adapter 506 has a disc-shaped geometry covering the attachment interface 310 of the IDM 300. The sterile adapter 506 includes a central aperture 508 configured to receive an elongated body 504 of the surgical instrument 500. In this configuration, when the surgical instrument 500 is attached to the IDM 300, the sterile adapter 506 is positioned between the attachment interface 310 and the surgical instrument 500, thereby forming a sterile boundary between the surgical instrument 500 and the IDM 300 and allowing the elongated body 504 to pass through the channel 312. In some embodiments, the sterile adapter 506 may be able to rotate with the surgical instrument holder 308, transmit rotational torque from a plurality of torque couplers 314 to the surgical instrument 500, transmit electrical signals between the IDM 300 and the surgical instrument 500, or some combination thereof.

[0091] exist Figures 5-6 In one embodiment, the sterile adapter 506 further includes a plurality of couplers 512. A first side of the coupler 512 is configured to engage with a corresponding torque coupler 314, while a second side of the coupler 512 is configured to engage with a corresponding instrument input 600.

[0092] Similar to the structure of multiple torque couplers 314, each coupler 512 is configured as a cylindrical protrusion including multiple notches. Each side of the coupler 512 has complementary geometry to fully engage with the corresponding torque coupler 314 and the corresponding instrument input 600. In some embodiments, one or more instrument inputs 600 are referred to as mechanical inputs. Each coupler 512 is configured to rotate together with the corresponding torque coupler 314 in a clockwise or counterclockwise direction. This configuration allows each coupler 512 to transmit rotational torque from the multiple torque couplers 314 of the IDM 300 to the multiple instrument inputs 600 of the surgical tool 500, and thus control the end effector of the surgical tool 500.

[0093] The first protrusion 508 and the second protrusion 510 are configured to pass through the channel 312 of the IDM 300 and mate with each other within the channel 312. Each protrusion 508, 510 is configured to allow the elongated body 504 to pass through the protrusion and thus through the channel 312. The connection between the first protrusion 508 and the second protrusion 510 forms a sterile boundary between the IDM 300 and the external environment (i.e., the operating room).

[0094] IV. Disengagement of surgical instruments

[0095] Figure 7 An enlarged perspective view is shown of an actuation mechanism for engaging and disengaging a surgical instrument 500 with a sterile adapter 506 of a surgical drape, according to one embodiment. As relative to... Figure 3In the configuration of the IDM 300, the axis of insertion of the surgical instrument into the patient's body during surgery is the same as the axis of removal of the surgical instrument. To ensure patient safety during surgical instrument removal, the surgical instrument 500 can be disengaged from the sterile adapter 506 and the IDM 300 before removal. Figure 7 In one embodiment, a plurality of couplers 512 are configured to translate in the axial direction, i.e., extend away from the sterile adapter 506 and retract toward the sterile adapter 506. The translation of the plurality of couplers 512 is actuated by an actuation mechanism that ensures disengagement of the surgical instrument 500 by disengaging the plurality of couplers 512 from their respective instrument inputs 600. The actuation mechanism includes a wedge 702 and a pusher plate 704.

[0096] The wedge 702 is a structural component that initiates the push plate 704 during the disengagement process of the surgical instrument. Figure 7 In one embodiment, the wedge 702 is located within the housing 502 along the outer periphery of the surgical instrument 500. As shown, the wedge 702 is oriented such that if the housing 502 of the surgical instrument 500 rotates clockwise relative to the sterile adapter 506, contact with the push plate 704 causes the push plate 704 to press down into the sterile adapter 506. In an alternative embodiment, the wedge 702 may be configured such that the housing 502 of the surgical instrument 500 rotates counterclockwise instead of clockwise. Geometry other than a wedge shape may be used, such as an arched ramp, as long as the structure can press down the push plate during rotation.

[0097] The push plate 704 is an actuator that disengages a plurality of couplers 512 from the surgical instrument 500. Similar to a plurality of torque couplers 314, each of the couplers 512 is coupled to one or more springs that bias each coupler 512 outwards away from the sterile adapter 506. The plurality of couplers 512 are further configured to translate in an axial direction, i.e., extend away from and retract into the sterile adapter 506. The push plate 704 actuates the translational movement of the couplers 512. When the push plate 704 is pressed down by the wedge 702, the push plate 704 causes compression of one or more springs coupled to each coupler 512, resulting in the coupler 512 retracting into the sterile adapter 506. Figure 7 In one implementation, the pusher plate 704 is configured to cause multiple couplers 512 to retract simultaneously. Alternatively, the couplers 512 may retract in a specific sequence or random order. Figure 7In one embodiment, the push plate 704 causes a plurality of couplers 512 to partially retract into the sterile adapter 506. This configuration allows the surgical instrument 500 to be disengaged from the sterile adapter 506 before removal. This configuration also allows the user to disengage the surgical instrument 500 from the sterile adapter 506 at any desired time without removing the surgical instrument 500. An alternative embodiment may cause the plurality of couplers 512 to retract completely into the sterile adapter 506, such that the effective height of each measured coupler 512 is zero. In some embodiments, the push plate 704 may cause a plurality of torque couplers 314 to retract synchronously with a plurality of corresponding couplers 512.

[0098] Figure 8A and Figure 8B The process of engaging and disengaging a surgical instrument with a sterile adapter according to one embodiment is shown. Figure 8A A sterile adapter 506 and a surgical instrument 500 are shown in a fixed position, such that the two components are secured together and multiple couplers 512 are fully engaged with the corresponding instrument input terminals 600 of the surgical instrument 500. To achieve... Figure 8A The fixed position shown allows the elongated body 504 (not shown) of the surgical tool 500 to pass through the central hole 508 (not shown) of the sterile adapter 506 until the mating surfaces of the surgical tool 500 and the sterile adapter 506 contact, and the surgical tool 500 and the sterile adapter 506 are secured to each other by a locking mechanism. Figure 8A and Figure 8B In the implementation scheme, the locking mechanism includes a crossbar 802 and a latch 804.

[0099] The crossbar 802 is a structural component that fixes the latch 804 in a fixed position. Figure 8A In one embodiment, the crossbar 802 is located within the housing 502 along the outer periphery of the surgical tool 500. For example... Figure 8A As shown, the crossbar 802 is oriented such that it rests below the protrusion on the latch 804, thereby preventing the latch 804 and thus the sterile adapter 506 from being pulled away from the surgical instrument 500 due to the elastic properties of the plurality of couplers 512, as relative to Figure 7 As stated above.

[0100] The latch 804 is a structural component that mates with the crossbar 802 in a fixed position. Figure 8A In one embodiment, the latch 804 protrudes from the mating surface of the sterile adapter 506. The latch 804 includes a protrusion configured to abut against a crossbar 802 when the surgical instrument 500 is secured to the sterile adapter 506. Figure 8AIn one embodiment, the housing 502 of the surgical instrument 500 is rotatable independently of the rest of the surgical instrument 500. This configuration allows the housing 502 to rotate relative to the sterile adapter 506, such that the crossbar 802 is secured against the latch 804, thereby securing the surgical instrument 500 to the sterile adapter 502. Figure 8A In one embodiment, housing 502 rotates counterclockwise to achieve a fixed position, but other embodiments may be configured for clockwise rotation. In an alternative embodiment, crossbar 802 and latch 804 may have various geometries for locking the sterile adapter 506 and surgical tool 500 in a fixed position.

[0101] Figure 8B A sterile adapter 506 and a surgical instrument 500 are shown in the disengaged position, in which the surgical instrument 500 can be removed from the sterile adapter 506. As previously described, the housing 502 of the surgical instrument 500 is rotatable independently of the rest of the surgical instrument 500. This configuration allows the housing 502 to rotate, even when multiple couplers 512 are engaged with the instrument inputs 600 of the surgical instrument 500. To change from the secured position to the disengaged position, the user rotates the housing 502 of the surgical instrument 500 clockwise relative to the sterile adapter 506. During this rotation, a wedge 702 contacts a push plate 704 and is gradually pressed down as the push plate 704 slides against the angled plane of the wedge 702, causing the multiple couplers 512 to retract into the sterile adapter 506 and disengage from the multiple instrument inputs 600. Further rotation causes a latch 804 to contact an axial cam 806, which is constructed similarly to the wedge 702. When latch 804 contacts axial cam 806 during rotation, axial cam 806 causes latch 804 to deflect outward away from surgical tool 500, causing latch 804 to shift from crossbar 802. Figure 8B In one embodiment, in this released position, the multiple couplers 512 retract, and the surgical tool 500 can be removed from the sterile adapter 506. In other embodiments, the axial cam 806 may have various geometries such that rotation causes the latch 804 to flex outward.

[0102] In an alternative embodiment, the rotation direction of the housing 502 of the surgical instrument 500 can be configured to rotate counterclockwise to disengage the latch 804 from the crossbar 802. Alternatively, alternative embodiments may include similar components, but the positions of the components can be switched between the sterile adapter 506 and the surgical instrument 500. For example, the crossbar 802 may be located on the sterile adapter 506, while the latch 804 may be located on the surgical instrument 500. In other embodiments, the outer portion of the sterile adapter 506 may be rotatable relative to a plurality of couplers 512 rather than the housing 502 of the surgical instrument 500. Alternative embodiments may also include features for locking the rotation of the housing 502 of the surgical instrument 502 when the housing 502 is fully rotated relative to the instrument input 600. This configuration prevents rotation of the surgical instrument if the instrument input 600 has already disengaged from the coupler 512. In some implementations, the retraction and extension of coupler 512 may be coupled to the corresponding retraction and extension of torque coupler 314, such that coupler 512 engaged with torque coupler 314 will translate together.

[0103] Figure 9A and Figure 9B The process of engaging and disengaging a surgical instrument with a sterile adapter according to another embodiment is illustrated. Figure 9A and Figure 9B In one embodiment, the sterile adapter 900 may include an outer strap 902 for securing a surgical instrument 904 to the sterile adapter 900. For example... Figure 9A and 9B As shown, the surgical instrument 902 includes a ramp 906 on the outer surface of the housing 908. The ramp 906 includes a notch 910 configured to receive a circular protrusion 912 positioned on the inner surface of the outer strap 902 of the sterile adapter 900. The outer strap 902 is rotatable independently of and relative to the sterile adapter 900 and the surgical instrument 904. When the outer strap 902 rotates in a first direction, the circular protrusion 912 slides upward along the surface of the ramp 906 until it is nested within the notch 910, thereby securing the sterile adapter 900 and the surgical instrument 904 together. Rotation of the outer strap 902 in a second direction causes the sterile adapter 900 and the surgical instrument 904 to disengage from each other. In some embodiments, this mechanism can be combined with disengagement hinges of multiple couplers 914 on the sterile adapter 900, such as relative to... Figure 7 -As shown in Figure 8.

[0104] Alternative implementations of the surgical instrument disengagement mechanism may include additional features such as an impedance mode. Using the impedance mode, the surgical robot system can control whether the user can remove the surgical instrument from the sterile adapter. The user can initiate the disengagement mechanism by rotating the surgical instrument housing and releasing the surgical instrument from the sterile adapter, but the surgical robot system may not release the coupler from the instrument input. The coupler is only released and the user can remove the surgical instrument once the surgical robot system has switched to impedance mode. The advantage of maintaining surgical instrument engagement is that the surgical robot system can control and position the end effector of the surgical instrument before removal, minimizing damage to the surgical instrument. To activate the impedance mode, the push plate 704 may have a hard stop, allowing the push plate to be pressed down a certain distance. In some implementations, the hard stop of the push plate may be adjustable, such that the hard stop coincides with the maximum amount of rotation of the surgical instrument housing. Thus, once full rotation is achieved, the push plate encounters the hard stop. Multiple sensors can detect these events and trigger the impedance mode.

[0105] During surgical procedures where resistance modes may not be desired, emergency tool removal may be necessary in certain situations. In some embodiments, the hard stop of the push plate may be compliant, allowing the hard stop to buckle in an emergency. The hard stop of the push plate may be coupled to a spring, allowing the hard stop to buckle in response to an additional force. In other embodiments, the hard stop of the push plate may be rigid, allowing emergency tool removal by removing the latch that secures the surgical tool to the sterile adapter.

[0106] V. Rolling Mechanism

[0107] Figure 10A A perspective view is shown of a mechanism according to one embodiment for rolling a surgical tool holder 308 within an instrument manipulator 300. Figure 10A As shown, the attachment interface 310 is removed to expose the rolling mechanism. This mechanism allows the surgical tool holder 308 to rotate or "roll" continuously in either direction about the rotation axis 316. The rolling mechanism includes a stator gear 1002 and a rotor gear 1004.

[0108] The stator gear 1002 is a fixed gear configured to mesh with the rotor gear 1004. Figure 10AIn one embodiment, the stator gear 1002 is an annular gear comprising gear teeth along the inner circumference of the ring. The stator gear 1002 is fixedly attached to the outer housing 306 behind the attachment interface 310. The stator gear 1002 has the same tooth pitch as the rotor gear 1004, such that the gear teeth of the stator gear 1002 are configured to mesh with the gear teeth of the rotor gear 1004. The stator gear 1002 may be made of a rigid material (e.g., metal or hard plastic).

[0109] Rotor gear 1004 is a rotary gear configured to cause rotation of surgical tool holder 308. For example... Figure 10A As shown, the rotor gear 1004 is a circular gear with teeth along its outer circumference. The rotor gear 1004 is positioned behind the attachment interface 310 and within the inner circumference of the stator gear 1002, such that the teeth of the rotor gear 1004 mesh with the teeth of the stator gear. As previously stated, the rotor gear 1004 and the stator gear 1002 have the same tooth pitch. Figure 10A In one embodiment, rotor gear 1004 is coupled to a drive mechanism (e.g., a motor) that causes rotor gear 1004 to rotate in a clockwise or counterclockwise direction. The drive mechanism may receive signals from an integrated controller within the surgical tool holder assembly 304. When the drive mechanism causes rotor gear 1004 to rotate, rotor gear 1004 travels along the gear teeth of stator gear 1002, thereby causing surgical tool holder 308 to rotate. In this configuration, rotor gear 1004 is capable of continuous rotation in either direction, and thus allows surgical tool holder 308 to achieve infinite rolling about axis of rotation 316. Alternative embodiments may use similar mechanisms to allow infinite rolling, such as configurations of ring gears and pinions.

[0110] Figure 10B A cross-sectional view of an instrument manipulator 300 according to one embodiment is shown. Figure 10B As shown, the rolling mechanism is coupled to multiple bearings 1006. Bearings are mechanical components that reduce friction between moving parts and facilitate rotation about a fixed axis. When the surgical tool holder 308 rotates within the outer housing 306, a single bearing can individually support radial or torsional loads. Figure 10BIn one embodiment, the IDM 300 includes two bearings 1006a and 1006b, which are fixedly attached to the surgical tool holder 308 such that multiple components (such as balls or rollers) within the bearing 1006 contact the outer housing 306. The first bearing 1006a is fixed at a first end behind the attachment interface 310, and the second bearing 1006b is fixed at a second end. This configuration improves the rigidity and support between the first and second ends of the surgical tool holder 308 as it rotates within the outer housing 306. Alternative embodiments may include additional bearings that provide additional support along the length of the surgical tool holder.

[0111] Figure 10B A sealing component within an IDM 300 according to one embodiment is also shown. The IDM 300 includes a plurality of O-rings 1008 and a plurality of gaskets 1010, which are configured to seal a joint between two surfaces to prevent fluid from entering the joint. Figure 10B In one embodiment, the IDM includes O-rings 1008a, 1008b, 1008c, 1008d, and 1008e located between joints in the outer housing and washers 1010a and 1010b located between joints within the surgical tool holder 308. This configuration helps maintain the sterility of components within the IDM 300 during surgical procedures. The washers and O-rings are typically made of a highly elastomeric material (e.g., rubber).

[0112] VI. Electronic Components

[0113] Figure 10C A partial exploded perspective view of the internal components and certain electronic components of an instrument device manipulator according to one embodiment is shown. The internal components of the surgical tool rack 308 include multiple actuators 1102, a motor, a gear head (not shown), a torque sensor (not shown), a torque sensor amplifier 1110, a slip ring 1112, multiple encoder boards 1114, multiple motor power boards 1116, and an integrated controller 1118.

[0114] Multiple actuators 1102 drive the rotation of each of the multiple torque couplers 314. Figure 10CIn some embodiments, actuators such as 1102a or 1102b are coupled to torque couplers 314 via a motor shaft. The motor shaft may be a keyed shaft, such that it includes multiple grooves to allow the motor shaft to be fixedly fitted to the torque coupler 314. Actuator 1102 causes the motor shaft to rotate in a clockwise or counterclockwise direction, thereby causing the corresponding torque coupler 314 to rotate in that direction. In some embodiments, the motor shaft may be torsionally rigid but spring-compliant, thereby allowing the motor shaft and therefore the torque coupler 314 to rotate and translate in the axial direction. This configuration allows multiple torque couplers 314 to retract and extend within the surgical tool holder 308. Each actuator 1102 may receive an electrical signal from an integrated controller 1118 instructing the direction and amount of rotation of the motor shaft. Figure 10C In one embodiment, the surgical tool rack 308 includes five torque couplers 314 and therefore five actuators 1102.

[0115] A motor drives the rotation of the surgical tool holder 308 within the outer housing 306. The motor can be structurally equivalent to one of the actuators, except that it is coupled to the rotor gear 1004 and the stator gear 1002 (see [link to manual]). Figure 10A The motor is used to rotate the surgical tool holder 308 relative to the outer housing 306. The motor causes the rotor gear 1004 to rotate clockwise or counterclockwise, thereby causing the rotor gear 1004 to travel around the gear teeth of the stator gear 1002. This configuration allows the surgical tool holder 308 to roll or rotate continuously without being obstructed by potential tangles of cables or wires. The motor can receive electrical signals from the integrated controller 1118 instructing the direction and amount of rotation of the motor shaft.

[0116] The gear head controls the amount of torque delivered to the surgical instrument 500. For example, the gear head may increase the amount of torque delivered to the instrument input 600 of the surgical instrument 500. Alternatively, the gear head may be configured to decrease the amount of torque delivered to the instrument input 600.

[0117] A torque sensor measures the amount of torque generated on the rotating surgical tool holder 308. Figure 10C In the illustrated embodiment, the torque sensor is capable of measuring torque in both clockwise and counterclockwise directions. The torque measurements can be used to maintain specific tension in multiple tension lines of a surgical instrument. For example, some embodiments of a surgical robot system may have an automatic tensioning feature, where tension is pre-loaded onto the tension lines of the surgical instrument when the surgical robot system is powered on or when the surgical instrument is engaged with the IDM. The tension on each tension line can reach a threshold amount such that the tension lines are taut just enough to achieve tautness. The torque sensor amplifier 1110 includes circuitry for amplifying a signal measuring the amount of torque generated on the rotating surgical instrument holder 308. In some embodiments, the torque sensor is mounted to a motor.

[0118] The slip ring 1112 enables the transmission of electrical power and signals from a stationary structure to a rotating structure. Figure 10C In one embodiment, the slip ring 1112 is configured as a ring including a central hole configured to align with a channel 312 of the surgical tool holder 308, as also Figure 10D A further perspective view of the slip ring 1112 is shown. The first side of the slip ring 1112 includes a plurality of concentric grooves 1120, while the second side of the slip ring 1112 includes a plurality of electrical components for electrical connections provided from the surgical arm and the base 302, such as relative to... Figure 3 The slip ring 1112 is fixed to the outer housing 306 of the surgical tool holder 308 at a specific distance from the outer housing 306 to allocate space for these electrical connections. Multiple concentric grooves 1120 are configured to mate with multiple brushes 1122 attached to an integrated controller. The contact between the grooves 1120 and the brushes 1122 enables the transmission of electrical power and signals from the surgical arm and base to the surgical tool holder.

[0119] Multiple encoder boards 1114 read and process signals received from the surgical robot system via slip rings. Signals received from the surgical robot system may include signals indicating the amount and direction of rotation of surgical tools, signals indicating the amount and direction of rotation of the end effector and / or wrist of the surgical tools, signals operating light sources on the surgical tools, signals operating video or imaging devices on the surgical tools, and other signals operating various functions of the surgical tools. The configuration of the encoder boards 1114 allows the entire signal processing to be performed within the surgical tool holder 308. Multiple motor power boards 1116 each include circuitry for supplying power to the motors.

[0120] The integrated controller 1118 is a computing device within the surgical tool rack 308. Figure 10C In one embodiment, the integrated controller 1118 is configured as a ring including a central hole configured to align with a channel 312 of the surgical tool holder 308. The integrated controller 1118 includes a plurality of brushes 1122 on a first side. The brushes 1122 contact the slip ring 1112 and receive signals delivered from the surgical robot system through the surgical arm, base 302, and ultimately through the slip ring 1112 to the integrated controller 1118. Based on the received signals, the integrated controller 1118 is configured to send various signals to corresponding components within the surgical tool holder 308. In some embodiments, the functions of the encoder board 1114 and the integrated controller 1118 may be distributed in a manner different from that described herein, such that the encoder board 1114 and the integrated controller 1118 can perform the same function or some combination thereof.

[0121] Figure 10DA partial exploded perspective view of the internal components and certain electronic components of an instrument device manipulator according to one embodiment is shown. Figure 10D The implementation includes two encoder boards 1114a and 1114b, a torque sensor amplifier 1110, and three motor power boards 1116a, 1116b, and 1116c. These components are fixed to an integrated controller 1118 and protrude outwards, extending vertically from the integrated controller 1118. This configuration provides space for positioning multiple actuators 1102 and motors within the circuit board.

[0122] As relative to Figure 10C As discussed, slip ring 1112 is fixed at a specific distance from the outer housing 306. To ensure proper space allocation between slip ring 1112 and the outer housing 306 for the electrical connection from the surgical arm and base 302 to slip ring 1112, in Figure 10D In one embodiment, slip ring 1112 is supported by a plurality of alignment pins, a plurality of helical springs, and a washer. Slip ring 1112 includes a hole 1124 on each side of its central bore, the hole 1124 being configured to receive a first side of the alignment pin when the second side of the alignment pin is inserted into a corresponding hole in the outer housing 306. The alignment pins may be made of a rigid material (e.g., metal or hard plastic). The plurality of helical springs are fixed around the center of slip ring 1112 and configured to bridge the space between slip ring 1112 and outer housing 306 and maintain contact between them. The helical springs can advantageously absorb any impact on the IDM 300. The washer is an annular spacer positioned around the central bore of slip ring 1112 to add further support between slip ring 1112 and outer housing 306. Furthermore, these components provide stability to the slip ring 1112 as the plurality of brushes 1122 on the integrated controller 1118 contact and rotate against the plurality of concentric grooves 1120. In an alternative embodiment, the number of alignment pins, helical springs, and washers may be varied until the desired support between the slip ring 1112 and the outer housing 306 is achieved.

[0123] Figure 10E An enlarged perspective view of the electronic components of an instrument manipulator 300 according to one embodiment, used to perform rolling indexing of a surgical tool holder 308, is shown. The rolling indexing monitors the position of the surgical tool holder 308 relative to the outer housing 306, enabling the surgical robot system to continuously understand the position and orientation of the surgical tools 500. Figure 10EThe implementation includes a microswitch 1202 and a protrusion 1204. The microswitch 1202 and the protrusion 1204 are fixed within a surgical tool holder 308. The protrusion 1204 is a structure on the outer housing 306 configured to contact the microswitch 1202 when the surgical tool holder 308 rotates, thereby activating the microswitch each time it contacts the protrusion 1204. Figure 10E In one implementation, there is a protrusion 1204 that serves as a single reference point for the micro switch 1202.

[0124] VII. Instruments with instrument-based insertion architecture

[0125] Various tools or instruments can be attached to the IDM 300, including instruments for laparoscopic surgery, endoscopic surgery, and endoscopic surgery. The instruments described herein are particularly novel because they incorporate instrument-based insertion architectures that reduce reliance on robotic arms for insertion. In other words, the design and architecture of the instruments facilitate insertion (e.g., orientation toward the surgical site). For example, in some embodiments where the instrument includes an elongated shaft and a handle, the instrument's architecture allows the elongated shaft to translate relative to the handle along the insertion axis.

[0126] The instruments described herein incorporate a instrument-based insertion architecture that mitigates many problems. Instruments without an instrument-based insertion architecture rely on a robotic arm and its IDM for insertion. In this arrangement, inserting the instrument may require moving the IDM in and out, thus necessitating additional motor power and arm linkage size to move additional mass in a controlled manner. Furthermore, the larger volume results in a much larger sweep volume, which can lead to collisions during operation. By incorporating an instrument-based insertion architecture, the instruments described herein typically have reduced oscillating mass because the instrument itself (e.g., its axis) moves along the insertion axis with less reliance on the robotic arm.

[0127] Some embodiments of the apparatus described herein may have novel apparatus-based insertion architectures that not only allow insertion of the apparatus but also allow uninterrupted actuation of the apparatus's end effectors. For example, in some embodiments, the apparatus includes a first actuation mechanism for actuating the end effector and a second actuation mechanism for causing a portion of the apparatus (e.g., a shaft) to translate along the insertion axis. The first actuation mechanism is advantageously disengaged from the second actuation mechanism, such that actuation of the end effector is unaffected by the insertion of the apparatus, and vice versa.

[0128] Figure 11 A side view of a device with a device-based insertion architecture according to one embodiment is shown. The device 1200 is designed and architectured such that the device (e.g., its axis) can translate along the insertion axis with less reliance on the movement of a robotic arm for insertion.

[0129] The device 1200 includes an elongated shaft 1202, an end actuator 1212 connected to the shaft 1202, and a shank 1220 coupled to the shaft 1202. The elongated shaft 1202 includes a tubular member having a proximal portion 1204 and a distal portion 1206. The elongated shaft 1202 includes one or more channels or grooves 1208 along its outer surface. The groove 1208, most visible in a cross-sectional view of the shaft 1202, is configured to receive one or more wires or cables 1230 therethrough. Thus, one or more cables 1230 extend along the outer surface of the elongated shaft 1202. In other embodiments, the cables 1230 may also extend through the shaft 1202, such as... Figure 21 As shown in the schematic diagram. In some embodiments, the cable 1230 extending through the shaft 1202 is not exposed. In some embodiments, manipulation of one or more of these cables 1230 (e.g., via IDM 300) results in actuation of the end effector 1212.

[0130] The end effector 1212 includes one or more laparoscopic, endoscopic, or endoscopic components designed to provide action at a surgical site. For example, the end effector 1212 may include a wrist, gripper, teeth, clamp, scissors, or clamp. Figure 11 In the illustrated embodiment, one or more cables of the cables 1230 extending along the groove 1208 on the outer surface of the shaft 1202 actuate the end actuator 1212. One or more cables 1230 pass through the shank 1220 from the proximal portion 1204 of the shaft 1202 and extend toward the distal portion 1206 of the shaft 1202, where the one or more cables 1230 actuate the end actuator 1212.

[0131] The instrument handle 1220 (also referred to as the instrument base) typically includes an attachment interface 1222 having one or more mechanical input ends 1224, such as sockets, pulleys, or reels, which are designed to connect to (e.g.,...) Figure 3One or more torque couplers 314 on the attachment interface 310 of the IDM 300 (shown) reciprocally engage. The attachment interface 1222 can be attached to the IDM 300 via front mounting, rear mounting, and / or top mounting. When physically connected, latched, and / or coupled, the engaging mechanical input 1224 of the instrument handle 1220 can share a rotation axis with the torque coupler 314 of the IDM 300, thereby allowing torque to be transmitted from the IDM 300 to the instrument handle 1220. In some embodiments, the torque coupler 314 may include a spline designed to engage a socket on the mechanical input. The cable 1230 of the actuating end effector 1212 engages a socket, pulley, or reel of the handle 1220 such that the transmission of torque from the IDM 300 to the instrument handle 1220 results in actuation of the end effector.

[0132] Some embodiments of the device 1200 include a first actuation mechanism that controls the actuation of the end effector 1212. Embodiments of such a first actuation mechanism include... Figure 12 The diagram is schematically shown. Furthermore, the device 1200 includes a second actuation mechanism that enables the shaft 1202 to translate relative to the handle 1220 along the insertion axis. Embodiments of such a second actuation mechanism are shown in... Figure 17 As shown in the figure. Advantageously, the first actuation mechanism is disengaged from the second actuation mechanism, such that the actuation of the end effector 1212 is unaffected by the translation of the shaft 1202, and vice versa. Embodiments of the first and second actuation mechanisms that can be incorporated into the tool or instrument 1200 are referenced below. Figures 12-20 To describe in more detail.

[0133] Figure 12A schematic diagram of a first actuation mechanism for actuating an end effector according to one embodiment is shown. In some embodiments, the first actuation mechanism provides N+1 wrist movements, where N is the number of degrees of freedom provided by N+1 cables. The first actuation mechanism for actuating the end effector 1212 includes at least one cable or cable segment 1230a extending through at least one set of pulleys 1250. In this embodiment, the first cable or cable segment 1230a extends through pulley members 1250a, 1250b, 1250c, while a second cable or cable segment 1230a extends through pulley members 1250d, 1250e, 1250f. At least one cable 1230a is grounded at or near the proximal end 1205 of the shaft 1202, then extends through at least one set of pulleys 1250 (located within the handle 1220), and then terminates at the end effector 1212. Actuation of the end effector 1212 is achieved by grounding each cable 1230a at or near the proximal end 1205 of the shaft 1202 to maintain a constant total cable path length and by changing the relative length by moving pulleys (e.g., pulley members 1250b and 1250e) relative to each other (see arrows). In some embodiments, the pulleys may be moved via linear or rotary motion of the corresponding mechanical input 1224. This first actuation mechanism advantageously allows free movement of the instrument shaft 1202 relative to the actuating pulley 1250 (which will be achieved by the second actuation mechanism described below), thereby allowing the inclusion of additional cables to permit insertion and retraction of the instrument shaft 1202 during actuation of the end effector 1212.

[0134] Figure 13 An embodiment is shown. Figure 11 An enlarged side view of the first actuation mechanism of the device. The first actuation mechanism and... Figure 12 The schematic diagram shown corresponds to this and is designed to actuate the end effector 1212 while allowing a separate second actuation mechanism to translate the shaft 1202 relative to the handle 1220. As shown... Figure 13 As shown, the handle 1220 includes a set of bearings, a roller, pulleys or pulley components 1250a, 1250b, 1250c, 1250d, 1250e (where pulleys 1250a, 1250b, 1250c correspond to...). Figure 12 (The same set of pulleys). Cable 1230a extends through pulleys 1250a, 1250d, 1250b, 1250e, and 1250c. Mechanical input end (in...) Figure 13The manipulation of pulleys 1250d, 1250b, and 1250e (identified as 1224') causes them to rotate. This rotational movement of pulleys 1250d, 1250b, and 1250e changes the amount of cable 1230 received in the handle 1220, thereby actuating the end effector. The rotational movement of the pulleys on cable 1230a acts on… Figure 15 and Figure 16 As shown in the diagram. Depending on the direction of rotational movement, pulleys 1250d and 1250e can wind or "retract" the cable 1230 in the handle 1220, or unwind and "expose" the cable 1230a in the handle 1220. In either case, the length of the cable 1230a changes within the handle 1220, thereby actuating the end effector 1212. Although Figure 13 The embodiments described herein depict a pulley system modified by rotational motion; however, in other embodiments, the pulley system may be modified by linear and / or rotational motion. Furthermore, those skilled in the art will recognize that variations in the length of the cable 1230a in the handle 1220 can also alter the cable tension.

[0135] Figure 14 An embodiment is shown. Figure 11 An enlarged perspective view of the first actuation mechanism of the device. Different details of pulleys 1250a-e can be seen from this view, including the reels of pulleys 1250a and 1250c.

[0136] Figure 15 and Figure 16 An embodiment is shown. Figure 11 A front view of the pulley assembly 1250e and cable of the device, front and rear of the actuating pulley assembly. A torque is applied to the mechanical input end 1224' to rotate pulleys 1250e, 1250b, and 1250d. Figure 15 As shown, cable 1230a can extend along one side of pulley 1250e before actuating pulley 1250e. For example... Figure 16 As shown, after actuating pulley 1250e, cable 1230a is then wound and retracted by pulley, thereby increasing the amount of cable 1230a in handle 1220 to actuate the end effector.

[0137] Although Figures 11-16 The embodiments disclosed in the text disclose one or more pulleys mounted on a rotating axis to change the relative cable length; however, in other embodiments, mounting the pulleys on a rod-, gear-, or rail-based system to adjust their position is an alternative. Furthermore, a spherical spline rotating shaft traveling along the length of the tool can also be used to transmit force mechanically over long distances.

[0138] Figure 17A side view is shown of a second actuation mechanism including a reel for shaft translation according to one embodiment. The second actuation mechanism is designed to translate the shaft 1202 relative to the shank 1220 along an insertion axis. Similar to the first actuation mechanism of the actuating end actuator 1212, the second actuation mechanism may also be incorporated within the shank 1220.

[0139] The second actuation mechanism includes a cable or cable segment 1230b engaging a set of spools 1270a, 1270b, 1270c, and 1270d. One end of the cable 1230b may be attached to or near the proximal end 1205 of the shaft 1202, while the other end of the cable 1230b may be attached to or near the distal end 1207 of the shaft 1202. The cable 1230b extends through the set of spools 1270a, 1270b, and 1270c, wherein the spool 1270b is a winch. Rotating the mechanical input end of the handle 1220 causes the winch to rotate, thereby driving the cable 1230b in and out of the winch. When the cable 1230b is driven in and out of the winch, this causes the shaft 1202 to translate relative to the handle 1220. Advantageously, by applying sufficient pretension to the cable 1230b attached to the proximal and distal ends of the shaft 1202, friction can be used to drive the cable 1230b in and out, thereby moving the shaft 1202 relative to the handle 1220 without slipping.

[0140] In this embodiment, winch 1270b includes a zero-travel winch. In other embodiments, such as Figure 18 and Figure 19 As shown, a winch that allows cable wandering can be incorporated into the handle 1220. The zero-wandering winch architecture helps manage the multiple wrappings of cable 1230b around winch 1270b without helix angles in the grooves, preventing cable wandering across winch 1270b, which could affect the overall path length and alter the tension in the cable. By placing an additional pulley 1270d on an inclined surface adjacent to winch 1270b, a parallel path to winch 1270b can be achieved, resulting in no wandering of cable 1230b on winch 1270b.

[0141] Figure 18 and Figure 19 Presented Figure 17Alternative embodiments of the zero-wandering winch are shown. In these embodiments, the winch into which the drive shaft is inserted is an enlarged winch 1270e that can be incorporated into the architecture of a second actuation mechanism. With a sufficiently large drive winch 1270e and a sufficiently small insertion stroke, the number of rotations of the winch is small. For example, with a 22mm drive winch 1270e and a 350mm insertion stroke, the number of rotations of the winch 1270e to achieve the full insertion range is 5 rotations. If the distance traveled by the cable is sufficiently large compared to the cable wander range of the winch 1270e, the amount of deviation angle and the change in path length on the cable during insertion are small enough to be negligible. In some embodiments, the deviation angle may be between + / - 2 degrees.

[0142] Figure 18 A perspective view of an alternative reel using a single cable for shaft translation according to one embodiment is shown. The alternative reel includes an enlarged winch 1270e engaged by a single cable 1230b. In this embodiment, the single cable 1230b has a sufficiently large wrap angle to provide sufficient winch friction for actuation of the drive shaft insertion. In some embodiments, the single cable 1230b is continuous and wound around the winch 1270e multiple times (e.g., 3, 4, or more) to provide a sufficiently large wrap angle to drive the winch and insertion.

[0143] Figure 19 A perspective view of an alternative reel for axial translation using more than one cable, according to one embodiment, is shown. The alternative reel includes an enlarged winch 1270e joined by two separate segments 1230b' and 1230b'" of a single cable 1230b. Each of segments 1230b' and 1230b'" terminates on the winch 1270e. Figure 18 Unlike the previous implementation, this implementation does not rely on winch friction to drive shaft insertion. In this implementation, cable 1230b is spirally connected to the outside and then terminated at both the top and bottom of the reel. Figure 19 The advantage of the double-ended connection method shown is that it is resilient to cable tension loss. Because the double-ended connection method relies on forced engagement rather than friction, slippage does not occur.

[0144] Figure 20 The following is shown according to one embodiment: Figure 18 A front view of the shank of the reel. This view shows a possible position of the reel (e.g., winch 1270e) within the shank 1220. Advantageously, additional reels and pulleys can be disposed within the shank 1220 to actuate the end actuator 1212. For example, as... Figure 12 The pulley system shown for actuating the end effector can be combined with... Figure 20The handle 1220 is located within the shank. Therefore, the shank 1220 can be combined with multiple mechanisms for actuating and / or driving both the end effector and the inserter. For example... Figure 20 As shown, cable 1230 is guided to one or more pulleys on winch 1270e for positioning across the handle to increase cable distance. If the distance traveled by the cable is sufficiently large compared to the cable travel range of winch 1270e, the amount of deviation angle and path length variation on the cable during insertion is small enough to be negligible. In some embodiments, it is possible to have a conventional spiral winch and keep the length variation and deviation angle to a minimum.

[0145] Figure 21 A schematic diagram is shown illustrating an alternative architecture for actuating an end effector and shaft insertion according to one embodiment. This architecture combines a first actuation mechanism for actuating the end effector and a second actuation mechanism for shaft insertion. Similar to previous embodiments, the first and second actuation mechanisms are disengaged, such that actuation of the end effector does not affect shaft insertion, and vice versa. However, in this embodiment, the first actuation mechanism includes one or more cables for actuating the end effector, which terminate at the insertion reel (which also serves as part of the second actuation mechanism for shaft insertion), rather than as in... Figure 12 As in the implementation scheme, the cables are terminated on the proximal and distal portions of the shaft. Due to this architecture, during shaft insertion via the second actuation mechanism, the length of one or more cables wound by the insertion reel is substantially counterbalanced by the length of one or more cables unwound from the insertion reel (used in the first actuation mechanism to actuate the end effector). During actuation of the end effector via the first actuation mechanism, the path length of the cable detached from the insertion reel is weighed.

[0146] like Figure 21 As shown, an alternative architecture for end effector actuation and shaft insertion includes a shaft 1302 having a proximal portion 1304 and a distal portion 1306, with the end effector located at the distal portion 1306. One or more reels 1370a, 1370b, 1370c, 1370d, 1370e (which are parts of a shank) are positioned about the shaft 1302. Reel 1370c includes an insertion reel. Rotation of the insertion reel 1370c in a first direction causes an axial translation relative to the shank in the first direction (e.g., in the insertion direction), while rotation of the insertion reel 1370c in a second direction causes an axial translation relative to the shank in the second direction (e.g., in the retraction direction). One or more cables or cable segments 1330a are connected at one end to the end effector (e.g., wrist) and at the other end to the insertion reel. Before the termination at, near, or toward the distal portion 1306 of the spool 1302, one or more additional cables or cable segments 1330b also begin at the insertion spool 1370c.

[0147] In this embodiment, a first actuation mechanism is provided, wherein manipulation of one or more reels (e.g., reels 1370a, 1370d) via linear or rotary movement causes a change in the length of one or more cables 1330a within the handle. In some embodiments, the change in the length of one or more cables 1330a within the handle may include a change in the path length of one or more cables or cable segments within the handle. In this first actuation mechanism, one or more cables 1330a may be considered as “end-effector” cables. Any change in the length of one or more cables 1330a in the handle causing actuation of the end-effector is counterbalanced by the length of one or more cables 1330b.

[0148] In this embodiment, a second actuation mechanism is provided, wherein manipulation of the insertion reel 1370c via linear or rotary movement causes a change in the length of one or more cables 1330b within the handle. In this second actuation mechanism, one or more cables 1330b can be considered as "insertion" cables. Any change in the length of one or more cables 1330b in the handle causing insertion or retraction of the shaft is counterbalanced by the length of one or more cables 1330a. Tension is maintained during insertion and retraction because an equal amount of one or more end-actuator cables 1330a is released when one or more insertion cables 1330b are retracted. The relative path lengths of one or more end-actuator cables 1330a remain constant, therefore the end-actuators do not move during insertion.

[0149] Figure 22A The combination according to one implementation scheme is shown. Figure 21 An enlarged front view of an instrument with an alternative architecture for actuating end effectors and shaft insertion. Figure 22B It shows the combination of Figure 21 Top perspective view of an alternative architecture for actuating end effectors and shaft insertion. Instrument 1300 incorporates... Figure 21 The first and second actuation mechanisms are shown, and include a handle 1320 with one or more mechanical inputs 1324, each corresponding to one or more reels 1370a-1370e, wherein at least one reel (1370c) includes an insert reel. One or more cables or cable segments 1330a', 1330a”, 1330a”', and 1330a””, each corresponding to a separate mechanical input 1324, are terminated at the drive reel 1370c. Each of these cables 1330a', 1330a”, 1330a”', and 1330a”” may resemble one or more cables 1330a (in Figure 21(As shown in the schematic diagram) engages with one or more reels. In the first actuation mechanism, these cables can be used as end effector cables, such that actuation of their corresponding mechanical input 1324 causes a change in the length of the cables within the handle. In some embodiments, the change in the length of one or more cables within the handle may include a change in the path length of one or more cables or cable segments within the handle. In some embodiments, the path length of the cables within the handle is changed. In some cases, the length change of one or more cables 1330a', 1330a”, 1330a”’ and 1330a”” within the handle 1320 of the actuating end effector is caused by a change similar to Figure 21 The length of cable 1330b, similar to reference cable 1330b, is counterbalanced. In other cases, under pure end-actuator actuation, the length of cable 1330b in the handle remains unchanged. In the second actuation mechanism, cable 1330b can be used as an insertion cable, such that actuation of its corresponding mechanical input 1324 causes cable 1330b to wind around insertion reel 1370c. The amount of cable 1330b wound around insertion reel 1370c causing shaft insertion is counterbalanced by the lengths of one or more unwound cables 1330a', 1330a”, 1330a”’, and 1330a””.

[0150] Figure 23 A top perspective view of the handle and shaft of an instrument according to one embodiment is shown. Shaft 1202 is translatable relative to handle 1220. One or more mechanical inputs 1224 actuating an end effector during rotation are visible in this view. Furthermore, one or more mechanical inputs 1324 allowing shaft 1202 to translate relative to handle 1220 along an insertion axis during rotation are also visible. Attachment interface 1222 includes one or more mechanical inputs 1224, 1324, such as sockets, pulleys, or reels, which are designed to connect with (e.g.,...) Figure 3 One or more torque couplers 314 on the attachment interface 310 of the IDM 300 (shown) reciprocate.

[0151] Figure 24A It shows the use of Figure 12 The diagram shows a cross-sectional view of the instrument axis of the insertion architecture. Figure 24B It shows the use of Figure 21 A schematic diagram of the cross-section of the instrument axis of the alternative insertion architecture shown. Although not visible, Figure 24A and 24B Each of the cross-sections includes an opening or cavity extending through it. For example... Figure 24A As shown, Figure 12 The insertion architecture produces one or more cables 1230 extending through a groove or channel 1208 extending along the outer surface of the shaft 1202. In contrast, as... Figure 24B As shown, Figure 21 The insertion architecture produces one or more cables 1330b extending through fewer grooves or channels 1308 (here, a single channel) along the outer surface of the shaft 1202. This is because in Figure 21 In alternative architectures, the cables tend to extend within the body of shaft 1302. For example, there are no end effector cables on the exterior of shaft 1302. With fewer cables extending on the exterior of shaft 1302, Figure 21 The architecture in this design can produce a smoother overall shaft surface with fewer grooves or channels extending on the outer surface.

[0152] VIII. Implementation schemes for insertion architectures for specific devices

[0153] The above architecture (e.g., in) Figure 12 and Figure 21 (As shown in the diagram) These architectures can be used to actuate end effectors and adapt to instrument insertion. Furthermore, these architectures can be incorporated into specific types of instruments to facilitate surgical procedures.

[0154] One such device is a vascular closure device. Using a vascular closure device, a knife or cutter can be driven through to cut tissue. In some embodiments, the movement of the knife is rotational. In other embodiments, the movement of the knife is translational. Figures 25-27 Different architectures are shown that can be incorporated into a vascular closure device to drive a knife through the vascular closure device. The architectures shown in these figures are similar to... Figure 12 The architecture and related mechanisms shown are as described, but in other implementations, the architecture may be similar. Figure 21 The architecture and related institutions are shown.

[0155] Figures 25-27 A schematic diagram illustrating different architectures for driving a knife in a vascular closure device is shown. The architecture creates a difference in path length between the cables and translates this variation in path length into linear motion of the knife. Figure 25 and Figure 26 In the implementation scheme, the two cables 1430a and 1430b are placed under reverse tension, while Figure 27 In one embodiment, a single cable 1430 and a spring 1490 are used for reverse tension. In an embodiment where two cables are placed under reverse tension, linear movement of the cutter is achieved by having two differences in opposite directions on the same input axis (e.g., one is an unwinding cable, and the other is a winding cable). The double-opposed cable method also utilizes a reorienting pulley to close the tension ring, and this can be installed at or near the proximal end of the shaft or at or near the distal end of the shaft (respectively at...). Figure 25 and Figure 26(As shown in the diagram). Once the cable is in place and pulled out, the blade can be coupled to a section of the cable to create the blade's in-and-out movement.

[0156] Figure 25 A schematic diagram of an architecture for driving a knife 1482 in a vascular closure device 1480 is shown. The architecture includes a first cable 1430a and a second cable 1430b, wherein the first cable 1430a and the second cable 1430b are under reverse tension. The architecture also includes one or more reel or pulley members 1470a, 1470b, 1470c engaged by the first cable 1430a, and one or more reel or pulley members 1470d, 1470e, 1470f engaged by the second cable 1430b, and a reorienting reel or pulley 1470g that closes the tension ring. The reorienting pulley 1470g is positioned at or near the proximal portion of the shaft. With the first cable 1430a and the second cable 1430b under opposing tensions, the blade 1482 can be coupled to a segment of the cable (e.g., the first cable 1430a) via a connector such as an elongated member 1484, thereby creating an in-and-out movement of the blade 1482 relative to the vascular closure device 1480. In some embodiments, the elongated member 1484 includes a push rod. In other embodiments, the elongated member 1484 withstands a driving compressive force without buckling.

[0157] Figure 26 A schematic diagram shows an alternative architecture for driving a knife in a vascular closure device. This architecture is similar to... Figure 25 The architecture shown; however, in this embodiment, the reorientation pulley is positioned at or near the distal portion of the shaft.

[0158] Figure 27 A schematic diagram shows yet another alternative architecture for driving a knife in a vascular closure device. (Compared to...) Figure 25 and Figure 26 Unlike previous embodiments, the architecture in this embodiment utilizes a single cable 1430 under reverse tension with the spring 1490. The architecture also includes one or more reel or pulley components 1470a, 1470b, 1470c engaged by the first cable 1430a. With the cable 1430 and spring 1490 under reverse tension, a blade 1482 can be coupled to a section of the cable 1430, thereby creating an in-and-out movement of the blade 1482 relative to the vascular closure device 1480.

[0159] Another device that can be used as an insertion instrument is a camera. Cameras can be used in endoscopic surgery. The architecture can vary depending on whether the camera is rigid or articulated; for articulated cameras, an actuation mechanism for the articulation must be provided.

[0160] Figure 28A schematic diagram showing the architecture for enabling a rigid camera as an insertion instrument is shown. Camera 1500 includes a distal image payload connected via a shaft 1502 to a camera handle 1530 having an interface button and a cable extending from the interface button. The cable 1530 is received in a channel or groove formed on the exterior of the shaft 1502, while the insertion handle 1520 is positioned about the shaft 1502. This effectively adds a second handle to the endoscope, thereby enabling insertion capability. Cable 1530 extends through one or more reels 1570a, 1570b, 1570c. In this embodiment, reel 1570b may be a winch. In some embodiments, the winch may include a zero-travel winch (e.g., Figure 17 As shown), while in other embodiments, the winch may allow the cable to travel (e.g. Figure 18 and Figure 19 (As shown). The camera can be translated along the insertion axis via a winch mechanism. In some embodiments, the core payload maintains the same sealing architecture as the rigid endoscope, thus allowing for sterilization using the same method. For a rigid endoscope, this means it can be autoclaved. From a sterilization perspective, the additional insertion handle 1520 can also appear as an instrument and can also be autoclaved.

[0161] Although Figure 28 An architecture for using a rigid camera as an insertion device is shown, but articulated cameras present additional complexities because mechanisms are added to the camera to enable articulation. For articulated cameras, one or more cables (e.g., actuation cables or wrist cables) can be provided to accommodate articulated movement. The camera can also be housed in a sealed area, allowing for the formation of a sealed compartment for cameras without one or more cables if one or more cables are to extend externally. In this architecture, some particles and debris may enter the small spaces within the sealed area. In some embodiments, to prevent contamination, one solution is to add two articulated motors within the sealed camera area, rather than relying on an IDM for articulated movement. This greatly simplifies the cleaning and sealing of the camera components by removing the cables from the outside of the tube and placing them inside the seal. Another beneficial effect of adding two articulated motors within the sealed camera is that the camera's articulation can be controlled as soon as it is inserted into the vision box. This enables features such as keeping the camera upright during installation or removal and being able to articulate the camera from the camera handle to look around when out of use with the robot. Then, from a disinfection perspective, this makes the articulated camera look very much like a rigid camera, making it possible to perform high-pressure disinfection.

[0162] If the camera cannot be autoclaved, it may be necessary to separate the sealed camera core and insertion section for cleaning and insertion. This is because autoclaving of the insertion handle is desired for reliable sterilization. Figure 29A first insertion architecture is shown that allows the camera to be partially separated from the insertion handle, thereby allowing for better sterilization. Figure 30 and Figure 31 A second insertion architecture is shown that allows the camera to be separated from the insertion handle, thereby allowing for better disinfection.

[0163] Figure 29 A first insertion architecture allowing the camera to be separated from the insertion handle is shown. This architecture has a pressure-sterilizable insertion handle 1620 that latches onto the IDM and is separable from the camera core 1600. The camera core 1600 includes a shaft 1602 extending through the handle 1620. The handle 1620 includes one or more wires 1630a, 1630b extending through reels 1670a, 1670b, 1670c, 1670d. In this embodiment, the reel 1670b includes a winch. In some embodiments, the reel 1670b includes a lead screw. In some embodiments, the winch is a zero-travel winch (e.g., Figure 17 (As shown), in other embodiments, the winch allows the cable to travel. The insertion handle 1620 can be removably attached to the camera core 1600 via a connector 1640. In some embodiments, the connector 1640 includes a bracket. In other embodiments, the connector 1640 includes a vertical plate to which the camera is latched. When the insertion handle 1620 is removably attached to the camera core 1600, they can each be detached for cleaning.

[0164] Figure 30 and Figure 31 A second architecture is shown that allows the camera to be separated from the insertion handle. In this embodiment, an outer tube 1780 is provided, which has an insertion cable 1730 attached thereto, and a camera 1700 can be mounted through the outer tube 1780 for use in surgery. Figure 30 The image shows the camera 1700 detached and separated from the outer tube 1780, while Figure 31 A camera 1700 is shown loaded into an outer tube 1780. For loading the camera 1700 into the outer tube, the distal end 1706 of the camera 1700 and the shaft 1702 pass through the outer tube 1780. The outer tube 1780 is connected to a handle 1720, which houses a spool 1770 in the form of a winch. This configuration has the advantage that the camera 1700 can be kept separate from the insertion handle 1720 if needed, allowing for easy cleaning of both components. Furthermore, the camera 1700 remains slim during use as it fits into the outer tube 1780. When the insertion handle 1720 is removably attached to the camera core 1700, they can each be separated for cleaning.

[0165] Figure 32A diagram illustrates an alternative architecture for shaft translation according to another embodiment. In this embodiment, the instrument includes a shaft 1902 having a proximal portion 1904 and a distal portion 1906. Insertion of the shaft 1902 can be driven by rack teeth 1912 and pinion 1914, wherein rotation of the pinion 1914 causes translation of the rack teeth 1912 and the shaft 1902 coupled to the rack teeth 1912. In some embodiments, the rack teeth 1912 are positioned on the instrument shaft 1902, while the pinion 1914 is positioned within the housing of the instrument handle. A motor driver can be used to translate the shaft 1902 relative to the handle. In some embodiments, a spur gear may be used in addition to the cycloidal pinion rack profile. In some embodiments, the rack teeth 1912 and pinion 1914 may be used alone to cause insertion or translation of the shaft 1902. In other embodiments, the rack teeth 1912 and pinion 1914 may accompany and complement any of the insertion mechanisms described above. The rack tooth 1912 and pinion 1914 can be used with any of the above-mentioned types of instruments to provide linear insertion of the instrument shaft relative to the handle.

[0166] IX. Surgical Instrument Seal

[0167] When performing surgical procedures such as laparoscopic surgery, surgeons use the air-insertion method. This means that the cannula inserted into the patient's body is sealed against the surgical tool's shaft to maintain positive pressure inside the patient's body. A seal is coupled to the surgical tool's shaft to prevent air leakage from the patient's body. These seals are typically designed to accommodate tools with a circular cross-section. It may be difficult to apply the same seal to tools with a non-circular shape and concave features on the outer surface of the shaft, because the channels formed by these surfaces could allow air pressure to be released at the tool seal. For example, instruments with a device-based insertion architecture may have a cross-section with grooves 1208 (e.g., Figure 24A As shown in the diagram, air can leak from the patient at trench 1208.

[0168] To address this challenge, a system comprising multiple seals can be provided to prevent air leakage within the patient's body. Specifically, novel seals can be provided that work in conjunction with cannula seals having a circular external shape, which is conventional for instruments with a circular cross-section. The novel seals can pass through the circular cannula seals, thereby providing a consistent rotational seal. The novel seals will advantageously discretize any rotational and linear motions to form two boundaries where the seal is formed. Discretization is achieved by using seals with intermediate tooling.

[0169] Figure 33 A side sectional view of an instrument with multiple seals to prevent air leakage from the patient is shown. Figure 34 A front sectional view of an instrument with multiple seals is shown. The instrument 1200 is inserted into the cannula 50 and is similar to... Figure 11 The device shown has a device-based insertion architecture. The device may include a shaft 1202 that is translatable relative to a handle 1220. The shaft 1202 may have one or more channels or grooves 1208 extending along its outer surface, thereby forming a channel that allows air to leak from the patient.

[0170] To prevent air leakage, a multi-seal system is advantageously coupled to the instrument. In some embodiments, the multi-seal system includes a first seal 1810 and a second seal 1820, which work together to reduce the risk of air leakage. In some embodiments, the first seal 1810 and the second seal 1820 are coaxial. Figure 32 As shown, the second seal 1820 can be received inside the first seal 1810. The first seal 1810 may have a cross-section with a circular outer periphery and a circular inner periphery, while the second seal 1820 may have a cross-section with a circular outer periphery and an inner periphery, the inner periphery having an internal protrusion, tab, or bump 1822, such as... Figure 34 As shown. The advantage of having a second seal 1820 with an internal protrusion is that the internal protrusion can fill gaps, such as grooves 1208, that can extend externally along the instrument axis 1202, thereby reducing the risk of air leakage from the patient during surgery.

[0171] Multiple seals advantageously discretize rotational and linear motions to form two boundaries where a seal is formed. The second seal 1820, due to its internal protrusions 1822, is slidable along the external groove of the instrument shaft 1202, thus forming a sliding linear seal for the movement of the instrument shaft. Those skilled in the art will appreciate that although the second seal 1820 is shown as having a plurality of rounded internal protrusions spaced substantially symmetrically around its inner periphery, the internal portion of the second seal 1820 can also take other shapes, provided that the molding process substantially mates the interior of the second seal 1820 with the outer surface of the instrument shaft 1202. When received in the groove 1208 of the instrument 1200, each of the internal protrusions 1822 of the second seal 1820 forms a rotational sealing point 1824. These rotational sealing points allow the instrument 1200 and the second seal 1820 to be rotationally locked and rotate together as the instrument shaft 1202 rotates. While this embodiment illustrates a multi-seal configuration with dual seals, in other embodiments, three, four, or more seals may work together to reduce the risk of air leakage from the patient during surgery.

[0172] X. Additional Notes

[0173] Upon reading this disclosure, those skilled in the art will understand alternative structural and functional designs based on the principles disclosed herein. Therefore, while specific embodiments and applications have been illustrated and described, it should be understood that the disclosed embodiments are not limited to the precise constructions and components disclosed herein. It will be apparent to those skilled in the art that various modifications, alterations, and variations can be made to the arrangement, operation, and details of the methods and apparatus disclosed herein without departing from the spirit and scope defined in the appended claims.

[0174] As used herein, any reference to “an embodiment” or “implementation” means that a particular element, feature, structure, or characteristic described in connection with an embodiment is included in at least one embodiment. The phrase “in an embodiment” appearing throughout the specification does not necessarily refer to the same embodiment.

[0175] Some implementations may use the expressions “coupled” and “connected” along with their derivatives. For example, some implementations may use the term “coupled” to indicate that two or more elements are in direct physical or electrical contact. However, the term “coupled” may also mean that two or more elements are not in direct contact with each other, but rather cooperate or interact with each other. Unless otherwise explicitly stated, implementations are not limited to this context.

[0176] As used herein, the terms “comprises,” “comprising,” “includes,” “including,” “has,” “having,” or any other variations thereof are intended to cover non-exclusive inclusion. For example, a process, method, article, or apparatus that includes a list of elements is not necessarily limited to those elements, but may include other elements not expressly listed or inherent in such a process, method, article, or apparatus. Furthermore, unless expressly stated otherwise, “or” means inclusive or not exclusive. For example, condition A or B is satisfied by any of the following: A is true (or exists) and B is false (or does not exist); A is false (or does not exist) and B is true (or exists); and both A and B are true (or exist).

[0177] Furthermore, the terms "an" or "a" are used to describe elements and components of the embodiments herein. This is done for convenience only and to give a general meaning of the invention. The description should be understood to include one or at least one, and unless explicitly indicated otherwise, the singular includes the plural.

Claims

1. A medical device comprising: A shaft, comprising a proximal portion and a distal portion; An end effector, the end effector being connected to the distal portion of the shaft; and A shank mechanically coupled to the shaft, wherein the shank includes a first mechanical input end and a second mechanical input end, wherein the first mechanical input end is configured to actuate the end effector via a first actuation mechanism, and the second mechanical input end is configured to actuate the shaft relative to the shank via a second actuation mechanism. The first actuation mechanism includes one or more cables extending through a first set of pulleys, and the second actuation mechanism includes one or more cables and an insertion reel, wherein at least one of the one or more cables of the first actuation mechanism is terminated on the insertion reel. During the translation of the shaft relative to the handle, one or more cables of the second actuation mechanism are wound by the insert reel, and during the translation of the shaft relative to the handle, one or more cables of the first actuation mechanism are unwound by the insert reel, wherein the length of the one or more cables wound by the insert reel is substantially balanced in the opposite direction by the unwound one or more cables.

2. The medical device of claim 1, wherein the first actuation mechanism is disengaged from the second actuation mechanism such that actuation of the end effector does not affect insertion of the shaft, and vice versa.

3. The medical device of claim 2, wherein the first actuation mechanism includes a first cable extending through a first set of pulleys, wherein manipulation of at least one of the pulleys in the first set of pulleys via the first mechanical input causes a change in the length of the first cable within the handle, thereby actuating the end effector.

4. The medical device of claim 3, wherein the second actuation mechanism comprises a second cable engaging a reel, wherein manipulation of the reel via the second mechanical input causes the shaft to translate relative to the handle.

5. The medical device of claim 4, wherein the change in length of the first cable within the handle that causes actuation of the end effector is not affected by the second actuation mechanism that translates the shaft relative to the handle.

6. The medical device of claim 3, wherein the first cable of the first actuation mechanism extends from the proximal portion of the shaft through the first set of pulleys and reaches the distal portion of the shaft.

7. The medical device of claim 6, wherein manipulation of at least one pulley in the first set of pulleys that causes a change in the length of the first cable within the handle comprises linear or rotational movement of the at least one pulley.

8. The medical device of claim 4, wherein the reel comprises a winch.

9. The medical device of claim 8, wherein the winch comprises a zero-travel winch.

10. The medical device of claim 8, wherein rotation of the second mechanical input causes rotation of the winch.

11. The medical device of claim 1, wherein the one or more cables of the first actuation mechanism include end effector cables, and the one or more cables of the second actuation mechanism include insertion cables.

12. The medical device of claim 1, wherein rotation of the second mechanical input end causes rotation of the insertion spool, thereby causing translation of the spool relative to the handle.

13. A medical system comprising: Base; A tool holder coupled to the base, the tool holder including an attachment interface; and Instrument, wherein the instrument includes: A shaft, comprising a proximal portion and a distal portion, An end effector, the end effector extending from the distal portion of the shaft, and A handle mechanically coupled to the shaft, the handle including a reciprocating interface releasably attachable to the attachment interface, a first mechanical input end and a second mechanical input end, wherein the first mechanical input end is configured to actuate the end effector via a first actuation mechanism, and the second mechanical input end is configured to actuate the shaft relative to the handle via a second actuation mechanism. The first actuation mechanism includes one or more cables extending through a first set of pulleys, and the second actuation mechanism includes one or more cables and an insertion reel, wherein at least one of the one or more cables of the first actuation mechanism is terminated on the insertion reel. During the translation of the shaft relative to the handle, one or more cables of the second actuation mechanism are wound by the insert reel, and during the translation of the shaft relative to the handle, one or more cables of the first actuation mechanism are unwound by the insert reel, wherein the length of the one or more cables wound by the insert reel is substantially balanced in the opposite direction by the unwound one or more cables.

14. The medical system of claim 13, further comprising a robotic arm located between the base and the tool holder.

15. The medical system of claim 14, wherein the first actuation mechanism is disengaged from the second actuation mechanism such that actuation of the end effector does not affect insertion of the shaft, and vice versa.

16. The medical system of claim 15, wherein the first actuation mechanism includes a first cable extending through a first set of pulleys, wherein manipulation of at least one of the pulleys in the first set of pulleys via the first mechanical input causes a change in the length of the first cable within the handle, thereby actuating the end effector, and wherein the translation of the shaft relative to the handle is performed via a second actuation mechanism, the second actuation mechanism including a second cable engaging a spool, wherein manipulation of the spool via the second mechanical input causes the shaft to translate relative to the handle.

17. The medical system of claim 16, wherein the change in length of the first cable within the handle that causes actuation of the end effector is not affected by the second actuation mechanism that translates the shaft relative to the handle.

18. The medical system of claim 17, wherein manipulation of at least one pulley in the first set of pulleys that causes a change in the length of the first cable within the handle comprises linear or rotational movement of the at least one pulley.

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