Adapters, components and systems for robotic manipulation of surgical tools

Abstract

An adapter for coupling a proximal portion of an elongated surgical tool to a motorized robotic surgical device, the adapter comprising: a recess shaped and sized to receive the proximal portion of the elongated surgical tool; one or more moving parts configured to contact and move a control assembly of the proximal portion; and a transmission coupling that couples the one or more moving parts to a motorized transmission assembly of the robotic surgical device.

Description

[0001] Related Applications

[0002] This application claims the benefit of priority to U.S. Provisional Patent Application No. 62 / 941,842 filed on November 28, 2019 and U.S. Provisional Patent Application No. 63 / 082,508 filed on September 24, 2020, the entire contents of which are incorporated herein by reference.

[0003] This application is also related to the commonly filed, commonly pending and commonly assigned PCT application entitled "DEVICE FOR AUTOMATICALLY INSERTING AND ADVANCING AMEDICAL TOOL INTO A BODILY LUMEN" (Agent Docket No. 83976), and the PCT application entitled "MODULAR ROBOTIC SYSTEM FOR DRIVING MOVEMENT OF SURGICAL TOOLS" (Agent Docket No. 84910), the entire contents of which are incorporated herein by reference.

[0004] Technical Field and Background Art

[0005] The present invention, in some embodiments thereof, relates to the motorized actuation of surgical tools, and more particularly, but not exclusively, to the motorized manipulation of a proximal handle portion of an elongated intraluminal tool.

[0006] U.S. Patent "US10543047" discloses: "A robotic instrument driver for a slender member includes a first slender member and at least one operator mechanism constructed to operate the first slender member, and at least one articulated driver constructed to articulate the first slender member, which can be positioned on a bed and next to a patient access site. The operator and the articulated driver are positioned relative to each other at a distance less than the insertable length of the first slender member and are fixed in place." Summary of the invention

[0007] According to an aspect of some embodiments, there is provided an adapter for coupling a proximal portion of an elongated surgical tool to a motorized robotic surgical device, the adapter comprising:

[0008] a recess shaped and dimensioned to receive a proximal portion of an elongated surgical tool;

[0009] One or more moving members configured to contact and move the control assembly of the proximal portion; and

[0010] A transmission coupling couples the one or more moving members to a motorized transmission of the robotic surgical device.

[0011] In some embodiments, the recess has a profile that matches at least a portion of an outer profile of a proximal portion of the tool, and the recess is sized to allow axial rotation of the proximal portion and limit lateral movement of the proximal portion when the proximal portion is located within the recess.

[0012] In some embodiments, each of the one or more moving parts is independently driven via a transmission coupling.

[0013] In some embodiments, the adapter further comprises a housing, the recess is defined in the housing, and the housing comprises the one or more moving parts and the transmission coupling.

[0014] In some embodiments, the interior of the adapter in which the recess is defined is at least partially configured to rotate with the proximal portion of the tool.

[0015] In some embodiments, the one or more moving members include a notch formed in the recess, the notch being shaped and sized to mate with a control assembly of the proximal portion of the tool.

[0016] In some embodiments, the drive coupling is disposed radially outside of the recess.

[0017] In some embodiments, the proximal portion consists of a handle, and wherein the control assembly, when moved, affects at least the distal portion of the elongated surgical tool.

[0018] In some embodiments, at least a portion of the housing is configured to slide linearly relative to the body of the handle along at least a portion of the length of the body.

[0019] In some embodiments, the control assembly is from the group of an axial slide, a lock, a rotatable knob.

[0020] In some embodiments, the drive coupling comprises an attachment connected to a lead screw, pin, or screw that is driven by a motorized drive of the robotic device.

[0021] In some embodiments, the housing includes one or more motors that drive the one or more moving parts.

[0022] In some embodiments, the housing is configured to rotate as a single unit about the long axis of the recess.

[0023] In some embodiments, the recess and the one or more moving members are configured to rotate while the drive coupling remains stationary.

[0024] In some embodiments, the housing includes mechanical and / or electrical connections that are configured and constructed to attach to the housing of the robotic surgical device.

[0025] In some embodiments, the adapter further comprises a clutch that decouples the one or more moving parts from the drive coupling.

[0026] In some embodiments, the adapter further comprises at least one sensor configured to indicate a relative position of the one or more moving parts.

[0027] In some embodiments, the at least one sensor comprises an optical encoder.

[0028] According to an aspect of some embodiments, there is provided an assembly comprising:

[0029] For example, an adapter is described herein, and an elongated surgical tool including a proximal portion engaged by the adapter.

[0030] In some embodiments, the proximal portion is removably received within the recess of the adapter.

[0031] In some embodiments, the elongated surgical tool comprises a guide wire.

[0032] In some embodiments, the elongated surgical tool comprises a microcatheter.

[0033] According to aspects of some embodiments, there is provided a method of operably coupling a proximal end manipulator of an elongated surgical tool to a motorized robotic surgical device, comprising:

[0034] Providing a robotic surgical apparatus for controlling and navigating at least one elongated surgical tool;

[0035] providing an adapter configured for coupling a control assembly of a proximal end manipulator of an elongated surgical tool with a motorized transmission of a robotic surgical device;

[0036] aligning a control assembly of the operator relative to the adapter; and

[0037] The adapter is coupled to a motorized transmission of the robotic surgical device.

[0038] In some embodiments, the method further comprises: driving a motorized transmission of the robotic surgical device for moving a control assembly of a proximal manipulator using an adapter, the control assembly causing at least one of: rotation of an elongated surgical tool; deflection of a distal portion of the elongated surgical tool; a change in the hardness and / or dimensional characteristics of the distal portion of the elongated surgical tool.

[0039] In some embodiments, the movement includes one or more of: sliding a slide of the operator; rotating a rotating assembly of the operator; rotating the handle as a single unit.

[0040] In some embodiments, the method further includes selecting an adapter from a plurality of available adapters that matches the geometry and functionality of a manipulator of a particular selected tool.

[0041] In some embodiments, the operator comprises a proximal handle of the tool.

[0042] According to an aspect of some embodiments, there is provided a system comprising:

[0043] a robotic device configured to operate at least one elongated surgical tool, the robotic device comprising one or more motors for driving movement of the at least one elongated surgical tool; and

[0044] An adapter configured to be operably attached to a robotic device, the adapter comprising:

[0045] A first member is shaped and configured to transmit motion driven by the one or more motors of the robotic device.

[0046] a second member shaped and configured to be received or mated to at least a portion of a proximal portion of an elongated surgical tool;

[0047] wherein movement of one or both of the first member and the second member driven by the one or more motors of the robotic device causes movement of at least a portion of the proximal portion engaged by the adapter.

[0048] In some embodiments, the robotic device includes a controller configured to control movement of the first member and the second member of the adapter to affect at least the distal portion of the elongated surgical tool.

[0049] In some embodiments, the system also includes a remote interface for controlling the controller.

[0050] In some embodiments, the adapter includes a plurality of moving parts that move components of the proximal portion, the moving parts being driven by the one or more motors of the robotic device.

[0051] In some embodiments, the moving member comprises one of: a mounting member mounted on a sliding component of the proximal portion of the tool, a gear configured to rotate a rotatable component of the proximal portion of the tool.

[0052] According to one aspect of some embodiments, there is provided an adapter for coupling a proximal handle of an elongated surgical tool to a motorized robotic surgical device, the adapter comprising:

[0053] a first geometric member shaped and dimensioned to engage a motor or motor transmission of a robotic surgical device;

[0054] a second geometric member shaped and dimensioned to engage at least a portion of a proximal handle of an elongated surgical tool;

[0055] Wherein the first geometric member and the second geometric member engage one another such that movement of one of the geometric members causes movement of at least one of the other geometric member or at least a portion of the proximal handle engaged by the adapter.

[0056] In some embodiments, the first geometric element and the second geometric element are coaxial, and wherein the first geometric element is located peripherally to the second geometric element.

[0057] In some embodiments, the second geometry defines at least one recess having a profile that matches at least a portion of an outer profile of the proximal handle engaged by the adapter.

[0058] In some embodiments, the recess is sized to surround at least a portion of the body of the proximal handle and matingly engage at least one component of the proximal handle that is integrally mounted to the body of the proximal handle.

[0059] In some embodiments, the recess is shaped and dimensioned to slide linearly relative to the body of the handle along at least a portion of the length of the body.

[0060] In some embodiments, the second geometric member includes at least one recess for receiving a motor transmission element of the surgical device, the motor transmission element including a lead screw, pin or screw driven by a motor or motor transmission of the robotic device.

[0061] In some embodiments, at least one of the first geometric element and the second geometric element is configured to rotate about a common axis of the first geometric element and the second geometric element.

[0062] In some embodiments, at least one of the first geometric member and the second geometric member is configured to slide axially.

[0063] In some embodiments, the first geometric member and the second geometric member are coupled to each other, and wherein movement of one of the geometric members results in similar movement of the other geometric member.

[0064] In some embodiments, the connection between the geometric pieces comprises an interference fit connection.

[0065] In some embodiments, the connection between the geometric pieces includes one of the geometric pieces being at least partially surrounded by the other geometric piece.

[0066] In some embodiments, the first geometric member and the second geometric member are formed as opposing surfaces of a single integral unit.

[0067] In some embodiments, the adapter includes a housing including a first geometric piece and a second geometric piece, the housing being configured to rotate as a single unit about a long axis of the adapter housing.

[0068] In some embodiments, the housing includes mechanical and / or electrical connectors that are configured and constructed to attach to the housing of the robotic surgical device.

[0069] Unless otherwise defined, all technical terms and / or scientific terms used herein have the same meaning as those generally understood by those of ordinary skill in the art to which the present invention belongs. Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of embodiments of the present invention, exemplary methods and / or materials are described below. In the event of a conflict, the patent specification including definitions shall prevail. In addition, these materials, methods and examples are illustrative only and are not intended to necessarily limit.

[0070] The implementation of the method and / or system of the embodiment of the present invention may include performing or completing the selected task manually, automatically or in combination thereof. In addition, according to the actual instrument and equipment of the embodiment of the method and / or system of the present invention, the operating system may be used to implement the tasks of several selections by hardware, software or firmware or a combination thereof.

[0071] For example, the hardware for performing the selected tasks according to the embodiments of the present invention can be implemented as a chip or circuit. As software, the selected tasks according to the embodiments of the present invention can be implemented as a plurality of software instructions executed by a computer using any suitable operating system. In an exemplary embodiment of the present invention, one or more tasks of the exemplary embodiments of the method and / or system as described herein are performed by a data processor such as a computing platform for executing a plurality of instructions. Optionally, the data processor includes a volatile memory for storing instructions and / or data and / or a non-volatile memory for storing instructions and / or data, such as a magnetic hard disk and / or a removable medium. Optionally, a network connection is also provided. A display and / or a user input device such as a keyboard or a mouse may also be selectively provided. BRIEF DESCRIPTION OF THE DRAWINGS

[0072] Some embodiments of the invention are described herein by way of example only with reference to the accompanying drawings. With reference now to the drawings in detail, it is emphasized that the details shown are exemplary and are for the purpose of illustrative discussion of the embodiments of the invention. In this regard, the description taken in conjunction with the drawings will make it apparent to those skilled in the art how to implement the embodiments of the invention.

[0073] In the attached picture:

[0074] Figure 1A is a schematic diagram of a mechanism for coupling a handle of an elongated surgical tool to a surgical robotic device and manipulating the handle via the robotic device to affect a distal end portion of the elongated surgical tool according to some embodiments;

[0075] Figure 1B is a schematic diagram of an adapter coupling a handle of an elongated surgical tool to a motorized driver according to some embodiments;

[0076] Figure 2 is a flow chart of an overall method for operably coupling a handle of an elongated surgical tool to a surgical robotic device according to some embodiments;

[0077] Figure 3 is a block diagram of a surgical robotic system configured for engaging and controlling a proximal portion (e.g., a handle) of an elongated surgical tool according to some embodiments;

[0078] Figure 4A and Figure 4B are isometric and side views of a robotic surgical system positioned relative to a patient according to some embodiments;

[0079] Figure 5A and Figure 5B is a cross-sectional view of an adapter for coupling a proximal handle of an elongated surgical tool to a surgical robotic device according to some embodiments;

[0080] Fig. 6A and Figure 6B is a cross-sectional view of an adapter for surgically coupling a proximal handle of an elongated surgical tool to a surgical robotic device according to some embodiments;

[0081] FIG. 7A to FIG. 7C schematically illustrates an example of an alternative configuration of an adapter according to some embodiments, wherein the adapter receives a handle of an elongated surgical tool for coupling the handle to a surgical robotic device;

[0082] FIG. 8A to FIG. 8F Schematically illustrates the handle of an elongated surgical tool according to some embodiments, for example, Figure 7B The various positions within the adapter described in and the corresponding resulting effects on the distal end portion of the elongated surgical tool;

[0083] 9A to 9D is an isometric view of an exemplary mechanism for engaging a proximal handle of an elongated surgical tool according to some embodiments ( Fig. 9A , Fig. 9C ) and Section View ( Fig. 9B , Fig.9D );

[0084] FIG. 10A to FIG. 10E According to some embodiments, a method for bonding such as Fig. 10A The guide wire handle shown and driven as Fig. 10A A first example of a mechanism for motorized movement of a guidewire handle is shown;

[0085] FIG. 11A to FIG. 11E According to some embodiments, a method for bonding such as Fig.11A The guide wire handle shown and driven as Fig.11A A second example of a mechanism for motorized movement of a guidewire handle is shown;

[0086] FIG. 12A to FIG. 12E According to some embodiments, a method for bonding such as Fig. 12A The proximal portion of the guidewire shown (which has no proximal handle) and driven as shown Fig. 12A A third example of a mechanism for motorized movement of a proximal portion of a guidewire (which lacks a proximal handle) is shown;

[0087] Fig.13A and Fig. 13B shows a housing of an adapter for engaging and driving motorized movement of a handle of an elongated surgical tool according to some embodiments;

[0088] Fig.14 schematically illustrates a module of a surgical robotic device configured to operably engage an adapter for coupling a proximal handle of an elongated surgical tool according to some embodiments; and

[0089] Fig.15 A motor engagement of the proximal portion of a "dual wire" guidewire is schematically illustrated according to some embodiments. DETAILED DESCRIPTION

[0090] The present invention, in some embodiments thereof, relates to powered drivers of elongated surgical tools, and more particularly, but not exclusively, to powered operation of a proximal portion of an elongated surgical tool, such as a handle of the tool or other proximal operating member of the tool.

[0091] Broad aspects of some embodiments relate to robotic manipulation of the proximal portion of an elongated surgical tool. In some embodiments, the proximal portion of the tool (such as an operating member or handle typically configured for manual manipulation) is operably attached to a robotic system that includes one or more motors for driving motion of the proximal portion of the tool and / or selected components of the portion.

[0092] Aspects of some embodiments relate to a joint between a proximal portion of an elongated surgical tool (e.g., a guidewire and / or a microcatheter) and a robotic system configured to drive movement of the tool. In some embodiments, the joint is in the form of an adapter that is shaped and configured to operably connect (or couple) the proximal portion to one or more motors or motor transmission elements of the robotic system.

[0093] In some embodiments, the adapter is configured to mechanically and / or electrically engage the proximal portion of the tool. In some embodiments, the adapter includes a first geometric piece (also referred to herein as the "first portion" or "first member") and a second geometric piece (also referred to herein as the "second portion" or "second member"), the first geometric piece being shaped and configured to connect with one or more elements (such as a helical gear, a rod, a gear) of the robotic system configured to transmit a motorized drive force, and the second geometric piece being shaped and configured to engage with the proximal portion of the tool.

[0094] In some embodiments, the first geometric member includes a drive coupling and the second geometric member includes one or more moving members driven via the drive coupling and positioned to contact a control portion of the proximal portion, e.g., a control assembly of the proximal portion, which drives the tool when moved. In some embodiments, the moving member includes a recess or notch (such as formed in an inner wall of an adapter) that contacts the control assembly of the proximal portion of the tool, and moves the control assembly when at least a portion of the adapter defining the recess or notch moves. Exemplary control assemblies of the handle may include a slide (e.g., which causes deflection of the tool tip when moved) and / or a knob (e.g., which causes rotation of the tool about the tool axis when rotated).

[0095] In some embodiments, the second geometric member is shaped to match the outer contour of the proximal portion, for example, to match the outer contour of at least a portion of the graspable handle. For example, the second geometric member includes a main recess and at least one extension of the recess, in which the main recess receives the main body of the proximal handle, and in which at least one extension receives a handle component integral with the handle body, such as a slide, a lock, a rotatable knob, etc.

[0096] In some embodiments, the primary recess is defined by an inner wall of the adapter housing that is shaped and positioned to support at least a portion of the proximal portion received in the recess. In some embodiments, the recess is sized to matingly engage the proximal portion, optionally shaped and / or sized to the proximal portion of the particular tool being engaged.

[0097] In some embodiments, the inner wall of the adapter housing defining the recess is positioned to counteract the force applied to the proximal portion by the moving part of the adapter. For example, when the sliding part of the handle is pressed and pushed by the moving part of the adapter, the wall at the recess limits the axial movement of the main body of the handle. In some embodiments, the shape and size of the recess are configured to provide rotation of the proximal portion around the major axis, but prevent axial movement and / or lateral (lateral) movement of the proximal portion within the recess. In some embodiments, the recess is shaped to allow only a predetermined amount of handle position and / or a predetermined degree of movement of the handle control assembly, and to limit other movements. In some embodiments, the moving part of the adapter can be selectively limited by the adapter housing within its range of movement. For example, the degree of axial sliding is limited, and the degree of rotation is limited.

[0098] In some embodiments, at least a portion of the adapter housing is configured to slide linearly relative to the body of the proximal portion received within the recess. Optionally, movement of a portion of the housing causes the proximal portion control assembly to move relative to the body of the proximal portion, for example, a slider that pushes or retracts the handle relative to the handle body.

[0099] In some embodiments, the first geometric element and the second geometric element are coaxial. In some embodiments, the first geometric element is positioned radially outward relative to the second (inner) geometric element. In some embodiments, one or more walls of the outer geometric element extend to at least partially surround the inner geometric element, or vice versa, such that movement of one of the geometric elements causes corresponding movement of the second geometric element.

[0100] In some embodiments, a control assembly at a proximal portion of a tool engaged with an adapter is moved relative to a body of the proximal portion by generating relative motion between a first geometric member and a second geometric member. In some embodiments, the motion comprises rotation (e.g., rotation of the second geometric member when the first geometric member is stationary; rotation of the first geometric member when the second geometric member is stationary; rotation of both geometric members). In some embodiments, the motion comprises axial advancement and / or retraction of one or both of the inner and outer geometric members.

[0101] In some embodiments, the proximal portion (including one or more integral components) is moved as a single unit by the adapter, for example, rotated about the long axis of the proximal portion.

[0102] In an example, the proximal portion of an elongated surgical tool includes a handle having a body (e.g., a cylindrical body) and a slide mounted on the body and configured to move axially along at least a portion of the handle body (e.g., for causing deflection of the distal end portion of the tool (e.g., a guidewire)). An adapter for operably coupling the handle to one or more motors of a robotic device may include: a housing in which at least a portion of the handle is received; an internal geometry that matches at least a portion of the outer contour of the handle and cooperatively surrounds the slide; and an external geometry that is attached to a lead screw or pin that extends from the robotic device and is driven (e.g., advanced or retracted) by one or more motors of the robotic device. In use, the linear movement of the lead screw or pin drives the external geometry to move linearly back and forth. Since the external geometry of the adapter is connected to the internal geometry of the adapter (such as via at least a portion of the housing and / or an interference fit connection), the linear movement of the external geometry causes the internal geometry to move together, thereby causing the slide to slide relative to the body of the handle that remains stationary. In another example of use, the adapter is rotated (either the adapter as a whole or just the internal geometry) to cause the handle as a whole to rotate, thereby producing a rotation of the elongated tool about the long axis of the elongated tool. In another example, the handle includes a rotatable knob for fine rotational adjustment of the elongated tool tip, and the knob is engaged by a moving member (e.g., a gear) of the adapter, which in turn rotates the knob.

[0103] Aspects of some embodiments relate to the operation of the proximal portion of an elongated surgical tool via a robotic system. In some embodiments, the proximal portion is controlled by one or more controllers of the system. Optionally, the proximal portion is remotely controlled via a remote control device. In some embodiments, the robotic system is additionally configured to operate the more distal portion extending from the proximal portion of the tool (e.g., the more proximal portion located at the distal side relative to the proximal portion for driving a guide wire) and optionally an additional tool (e.g., a microcatheter, a guide catheter). In some embodiments, the operation of the proximal portion of the tool (such as the operation via an adapter) is coordinated with other operations performed by the robotic system on the tool, for example, the axial advancement and / or retraction of the tool, the rotation of the tool. The potential advantages of controlling the proximal portion in coordination with the operation of the more distal portion of the tool can include obtaining or improving fine control of the most distal portion of the tool, for example, obtaining or improving fine control of the movement of the tool end. Potential advantages of controlling the proximal portion in coordination with operation of a more distal portion of the tool can include additional support for performing such operation, such as by rotating both the proximal portion and the tool itself at a more distal location, rather than rotating only the tool and causing the proximal portion to passively rotate with the tool, or even interfere with the rotation operation.

[0104] Aspects of some embodiments relate to providing various adapter configurations for engaging corresponding various tool proximal portion configurations. In some embodiments, the various adapter configurations are provided in the form of various single-unit adapters, or in the form of various two-part adapters, each adapter having a different internal adapter geometry that connects to the same external adapter geometry (i.e., an external adapter geometry common to the various adapter configurations). Whether provided as a single-unit adapter or as a two-part adapter, each of the various configurations is configured to structurally and functionally match the proximal portion of the tool.

[0105] In some embodiments, the adapter includes a plurality of moving parts, each of which is shaped and configured to engage the proximal portion assembly: for example, the moving part is configured as a slidable mounting part assembled on a sliding member; the moving part is configured as a rotating gear for rotating a knob located in the proximal portion. In some embodiments, the moving part is integrated with a recess having a size and shape for holding the proximal portion and cooperating with a control assembly of the proximal portion. For example, the moving part is formed as a recess extending radially outward from the recess receiving the proximal portion. In an example, the shape and size of the recess in the recess are set to be matched to the sliding member of the handle. In some embodiments, the adapter directly or indirectly (such as via a mechanical transmission) attaches the proximal portion to one or more motors of the robotic system, and the motor drives the movement of the moving part and / or the adapter portion and / or the adapter as a whole. Additionally or optionally, the adapter includes one or more integrated motors.

[0106] In some embodiments, the operation of the proximal portion assembly by the moving member of the adapter is configured to match the type and / or degree and / or speed of motion specific to the design of the proximal portion of the tool. Optionally, the operation of the proximal portion assembly by the moving member of the adapter (e.g., pushing of a slide, rotation of a knob) is performed in increments and / or is selected to match the range and / or direction and / or degree of motion of the proximal portion assembly.

[0107] In some embodiments, the movement of the proximal portion components is performed relative to the calibration (original) position of these components, for example, the position of the proximal portion components relative to the body of the proximal portion, the proximal portion components being movably attached to the body of the proximal portion (for example, the position of a slide along the longitudinal extension of the handle body). Optionally, the calibration position is specific to the proximal portion and the adapter moving parts are preset accordingly. In some embodiments, the presetting is performed by controlling one or more motors that drive the moving parts of the adapter to position (optionally return) the moving parts to the position where the proximal portion components are in their original positions. In some embodiments, the return to the original position occurs automatically, such as when opening and / or closing the system, when the adapter is engaged with the proximal portion and / or other.

[0108] In some embodiments, a user (e.g., a physician, a technician) inputs the type of proximal portion being used into the system and sets activation parameters of the adapter and / or its moving parts accordingly. Additionally or alternatively, the system identifies the type (e.g., structure) of the proximal portion being used (e.g., handle, torque unit) and sets activation parameters accordingly. The system may use one or more sensors (such as, proximity sensors, magnetic sensors, encoders, etc.) to identify the presence of the proximal portion (e.g., identify the connection to the adapter) and / or identify the type and / or shape of the proximal portion. In some embodiments, the system uses an imaging device to identify the presence and / or type and / or shape of the proximal portion. In some embodiments, the system uses an identification device such as an RFID tag to identify the presence and / or type and / or shape of the proximal portion.

[0109] In some embodiments, the adapter is configured to allow manual operation of the adapter moving member and / or to allow use of the proximal portion to directly manually operate the proximal portion assembly.

[0110] In some embodiments, the adapter includes a removable cover through which a user can manually directly access the moving part and / or the proximal portion assembly of the adapter. Optionally, if manual operation is performed, the motor drive of the moving part of the adapter is stopped, for example by means of a clutch that disengages the motor from the moving part and / or one or more force transmission elements that transmit force from the motor to the moving part of the adapter.

[0111] In some embodiments, the adapter includes a quick ejection mechanism for releasing the proximal portion to provide manual operation of the proximal portion.

[0112] Although some examples are described herein with respect to guidewires, it is noted that the mechanisms and / or methods as described can be used with any elongated surgical tool, such as a microcatheter, an operable catheter, a stent retriever, and / or any other elongated tool whose motion and / or mechanical properties are affected by operation of a proximal portion of the tool (such as a handle of the tool).

[0113] As referred to herein, a tool "proximal portion" or "handle" may include, for example, a tool portion that is configured to affect and / or control the motion and / or mechanical properties (e.g., stiffness) of a more distal tool portion (optionally, the distal tip of the tool). For example, a control assembly (e.g., a slider, a knob) at the proximal portion of the tool is configured to produce deflection of the distal tip of the tool, rotation (e.g., rotation) of the distal tip of the tool when actuated.

[0114] In some embodiments, the proximal portion (in some embodiments, the handle) includes a graspable or otherwise manually engageable portion. Optionally, the proximal portion is typically manually operated (e.g., engaged with a user's hand and / or fingers). In some embodiments, the proximal portion is located at the proximal end of the elongated surgical tool.

[0115] Before explaining at least one embodiment of the present invention in detail, it will be understood that the present invention is not necessarily limited in its application to the details of construction and arrangement of components and / or methods set forth in the following description and / or shown in the drawings and / or examples. The present invention is capable of other embodiments that can be practiced or implemented in various ways.

[0116] Before explaining at least one embodiment of the invention in detail, it should be understood that the invention is not necessarily limited in its application to the details set forth in the following description or illustrated by the Examples. The invention is capable of other embodiments that can be practiced or carried out in various ways.

[0117] Exemplary Adapter Coupling and Operation

[0118] Now referring to the accompanying drawings, Figure 1A is a schematic diagram of a mechanism 101 for coupling an exemplary guidewire handle to a surgical robotic device and manipulating the handle via the robotic device, according to some embodiments.

[0119] In some embodiments, the guidewire handle is operably coupled to a robotic device, for example, to one or more motors of the robotic device 103 , via the adapter 105 .

[0120] In some embodiments, the adapter 105 is shaped and configured to engage a guidewire handle so as to operably couple the handle to one or more motors (and / or motor transmissions) of a robotic device. In some embodiments, the adapter comprises a first motor engagement geometry 109 shaped to attach to one or more motors (or motor transmissions) of a robotic device and a second handle engagement geometry 107 shaped to attach to or receive a guidewire handle.

[0121] In some embodiments, the one or more motors 103 are controlled by a controller 111 of the surgical robotic device. In some embodiments, the controller communicates with a user interface device (eg, a remote control device) and is programmed to receive instructions from the user interface device and drive the one or more motors accordingly.

[0122] In some embodiments, in use, the operation of one or more components of the guidewire handle engaged with the adapter is performed by driving one or more motors or associated transmissions of the surgical device. In some embodiments, the adapter is configured to operably contact one or more handle components, such as a slider element, a rotatable knob, a button, a removable lock. When the one or more motors of the robotic device are driven by the controller, the motor engagement geometry moves, and thereby generates movement of the handle engagement geometry, which in turn moves the components of the guidewire handle.

[0123] In some embodiments, movement of the handle assembly affects a more distal portion and / or distal end of the guidewire 113. For example, movement of the handle assembly produces guidewire manipulations, such as: rotation of the guidewire (i.e., rotation about the long axis of the guidewire); deflection of the distal portion of the guidewire; changes in guidewire stiffness (e.g., by advancing or retracting a wire in a guidewire comprised of multiple wires, such as moving a wire in a dual-wire guidewire), expansion of the tool diameter (e.g., by introducing a fluid into the tool, optionally by injection), and deployment of structures initially enclosed within the tool.

[0124] Figure 1B is a schematic diagram of an adapter that couples a guidewire handle to a motorized driver, according to some embodiments.

[0125] In some embodiments, the adapter 151 is configured to couple a proximal portion of the guidewire 153 (eg, the handle 160 ) to the surgical robotic device 169 .

[0126] In some embodiments, the adapter 151 includes a housing defining a recess 159 in which at least a portion of the guidewire handle is received. In some embodiments, the housing receives at least one moving member, such as a moving member 161, a moving member 163, which is positioned and configured to mechanically engage one or more control components of the guidewire handle received in the recess. In some embodiments, the moving member is configured to rotate, slide, and / or otherwise move to cause a corresponding movement of the handle assembly. In some embodiments, each moving member is independently coupled to a transmission member. Optionally, the moving members are activated independently of each other.

[0127] In the example shown, the moving member 161 is arranged to contact the sliding member 164 of the handle so that it moves the sliding member when driven; and the moving member 163 is arranged to contact the rotatable knob 166 of the handle so that it rotates the knob when driven.

[0128] In some embodiments, electrical and / or mechanical driving of one or more moving parts is performed by one or more motors 165 and / or motor transmissions 167 of the surgical robotic device 169 .

[0129] In some embodiments, the motor transmission element includes a lead screw, a screw, a gear, and / or any other element suitable for mechanically transmitting the motor motion to one or more moving parts of the adapter.

[0130] In some embodiments, the inner wall of the housing 150 at the recess 159 is shaped to match the profile of the handle 160. Optionally, the handle is received in the recess in a fitting manner, for example, so that lateral movement of the handle in the recess is prevented. In some embodiments, the handle is allowed to rotate around its axis in the recess.

[0131] In some embodiments, the inner wall of the housing supports the handle, such as the body of the handle, from at least two faces. In some embodiments, the handle is received in the recess so that the inner wall of the housing counteracts the force applied to the handle, such as the force applied by the moving members 161, 163. In an example, the moving member 161 is pressed against the sliding member 164 to move the sliding member axially, while the body of the handle remains held and supported by the wall of the housing at the recess so that the body of the handle does not move and only the sliding member moves. In some embodiments, the adapter 151 includes one or more sensors 170, which are configured to measure or otherwise indicate, for example: whether the handle has been received in the recess; the position of one or more moving members relative to the handle; the position of the handle assembly (e.g., the axial position of the sliding member, the rotation angle of the knob). In some embodiments, the relative position of the moving member is indicated by sensing the position of the motor and / or motor transmission member, which drives the moving member (e.g., via a counter that counts the motor rotations). In some embodiments, an encoder (e.g., an optical encoder) is used to sense the position of the moving member and / or the handle assembly. In an example, an encoder is constructed along the axial path along which the moving member that pushes the handle slide moves, and is configured to measure the extent of the axial movement and optionally transmit the distance range to the system controller. In some embodiments, one or more sensors are integrated and / or mounted on a transmission member of the moving member, for example, integrated and / or mounted on a pin or rod that couples the moving member to a device motor.

[0132] In some embodiments, the adapter 151 includes an integrated power supply (or power source) 162, such as a battery. Optionally, the power supply supplies power to the moving member and / or one or more sensors of the adapter. In an example, the battery is activated only when the adapter is used. In a specific example, the zinc-air type battery is activated when exposed to air, for example, inserting the handle into the recess can move a slider covering the battery, exposing the battery to activate the battery.

[0133] In some embodiments, at least a portion of the guidewire 153 is operably received within the robotic device 169. In some embodiments, a proximal-most portion of the guidewire (e.g., the handle) is received within the adapter 151; a mid-portion of the guidewire is received within the robotic device 169; and a distal portion of the guidewire extends for insertion into a patient.

[0134] In some embodiments, the robotic device 169 is configured to manipulate the guidewire, for example, to rotate the guidewire and / or to move the guidewire axially (ie, to advance and / or retract the guidewire).

[0135] In some embodiments, the robotic device 169 includes a tool motion element, such as a wheel, that engages the guidewire at a location distal to the handle to drive movement of the guidewire.

[0136] In some embodiments, the robotic device 169 is configured to receive and drive the movement of a plurality of elongated surgical tools (eg, guidewires, microcatheters, guide catheters).

[0137] In some embodiments, the operation of the guidewire via the guidewire handle (e.g., as described herein) is coordinated (e.g., synchronized) with the motion of the guidewire performed by the robotic device. For example, if the rotation of the guidewire is driven via the guidewire handle, the tool motion element of the robotic device can be driven to produce a similar rotation of the more distal portion of the guidewire, thereby potentially preventing the twisting of the guidewire. In another example, the deflection of the guidewire distal end via the handle can be performed simultaneously with the axial advancement and / or retraction of the guidewire by the robotic device and / or the rotation of the guidewire. In another example, the hardness of the guidewire (e.g., a double-wire guidewire) can be changed during the axial movement and / or rotation of the guidewire (e.g., by pulling back one of the internal threads of the guidewire).

[0138] In some embodiments, the operation of the guidewire handle is performed considering the arrangement of the more distal portion of the guidewire held or received in the robotic device. For example, the guidewire held by the robotic device can be turned (e.g., with a U-shaped curvature) once or multiple times. Optionally, when the guidewire is held by the robotic device at two positions, for example, at the handle and at a more distal position along the guidewire length, the length of the guidewire between the two positions can be selectively changed according to the advancement or retraction of the distal portion of the guidewire in the patient. In some embodiments, the housing of the robotic device allows the guidewire to extend to the outside of the housing between the two positions to allow the intermediate section to increase or decrease in length without being limited by the housing.

[0139] For example, manipulation of tools such as guidewires by robotic devices is described in U.S. Provisional Application No. 62 / 941,842 (Attorney Docket No. 83238) and / or U.S. Provisional Application No. 63 / 082,508 (Attorney Docket No. 83116), which are incorporated herein by reference.

[0140] Exemplary method for operably coupling a tool handle to a robotic system

[0141] Figure 2 is a flow chart of a general method for operably coupling, for example, a guidewire handle to a surgical robotic device, according to some embodiments.

[0142] In some embodiments, a robotic system (201) for operating at least one elongated surgical tool is provided.

[0143] In some embodiments, an adapter (203) is provided for connecting the proximal portion of an elongated surgical tool to a surgical system. Optionally, the adapter is selected from a plurality of adapters having different shapes and / or sizes. In some embodiments, the adapter is selected based on the geometry and / or function of the proximal portion of the tool. For example, for a tool handle including a rotatable knob, an adapter is selected that includes a moving part suitable for rotating the knob. For example, for a guidewire handle including a sliding member, an adapter is selected that includes a moving part suitable for advancing and / or retracting the sliding member. In some embodiments, at least a portion of the adapter (e.g., only the motor engaging portion of the adapter, or the entire adapter) is configured as part of the robotic system in step 201.

[0144] In some embodiments, the adapter is designed to engage a handle of a particular design. Optionally, different adapters are designed to engage handles of different shapes and / or designs, such as tool handles from different manufacturers. Since different handles can have different "neutral" (or calibrated) positions for tools, in some embodiments, the adapter is designed to match the neutral position indicated by the handle, for example, so that operations of the handle can be performed relative to a specific neutral position. In some embodiments, the adapter includes a portion shaped to match the outer contour of the handle.

[0145] Additionally or alternatively, the adapter may include at least one adjustable portion that can be moved, enlarged, reduced, and / or otherwise altered to engage more than one handle type or configuration.

[0146] In some embodiments, the proximal portion of the tool (e.g., handle) is attached to the adapter (205). Optionally, the attachment is performed by a user (e.g., a doctor, nurse, and / or other clinical personnel). In some embodiments, the attachment includes inserting at least a portion of the handle into a designated recess of the adapter. Additionally or alternatively, the adapter is "dressed" or fitted onto the handle.

[0147] In some embodiments, the adapter is connected to the robotic system (207) together with the tool handle that is engaged therewith. Alternatively, in some embodiments, the adapter is constructed as an integral part of the robotic system and does not need to be attached to the system separately. Alternatively, in some embodiments, the adapter is preassembled onto the guide wire (e.g., to the guide wire handle) and provided with the guide wire. Alternatively, the user then connects the assembly of the adapter and the guide wire to the system. In some embodiments, the adapter and the guide wire are preloaded with the robotic system.

[0148] In some embodiments, connecting the adapter to the robotic system establishes a mechanical coupling of the adapter to one or more motors and / or to a motor transmission of the robotic system. In some embodiments, connecting the adapter to the robotic system establishes an electrical coupling of the adapter to the robotic system, such as an electrical connection to an electrical power supply of the system.

[0149] In some embodiments, the proximal portion of the tool (e.g., a guidewire handle) is then manipulated via the robotic system to affect the motion and / or mechanical properties of the tool (209). In some embodiments, a user controlling the robotic system (such as a user controlling the robot via a user interface (optionally configured as a remote control)) manipulates the proximal handle of the tool.

[0150] In an example, a user indicates (e.g., via a remote control device) to deflect the distal end of a tool (e.g., a guide wire). Then, the movement of one or more moving parts in one or more motor drive adapters of the robotic system, which in turn contacts a handle assembly (e.g., a slide), causes the slide to move to deflect the distal end of the tool. In another example, a user indicates (e.g., via a remote control device) to rotate a tool (e.g., a guide wire or an operable catheter). Then, the movement of one or more moving parts in one or more motor drive adapters of the robotic system, which in turn contacts a handle assembly (e.g., a rotation knob), causes the knob to rotate to rotate the tool (such as, rotating the guide wire around the long axis of the guide wire). In another example, a user indicates (e.g., via a remote control device) to change the mechanical properties of the tool, such as the hardness of the distal portion of the tool. Then, the movement of one or more moving parts in one or more motor drive adapters of the robotic system, which in turn contacts a handle assembly (e.g., a puller / propeller), which is constructed to advance or retract the wire of a double-wire guide wire, thereby affecting the hardness of the guide wire. Examples of double-wire guidewires include a guidewire having an inner wire disposed within a lumen of an outer wire; or a guidewire comprising two wires adjacent to each other or passing through a main wire profile. In some embodiments, deflection of the distal end portion of the guidewire is achieved by moving a screw (e.g., advancing or retracting).

[0151] In some embodiments, the degree and / or speed of movement of the handle assembly (e.g., degree of rotation of a knob; distance of movement of a pad slide) is set according to the specific handle type engaged by the system. For example, the motorized movement of a slide by a robotic system is controlled to advance and / or retract the slide within a distance range determined for a specific handle. For example, the motorized movement of a rotating knob by a robotic system is controlled to rotate the knob at a rotation speed and / or degree of rotation appropriate for a specific knob. In some embodiments, an adapter configured to engage a specific handle type includes and / or is preset with motor drive parameters for driving the adapter moving member in a manner that matches the specific movement of the handle assembly. For example, the motor drive parameters are set to control the speed of movement, the direction of movement, the degree or range of movement.

[0152] Exemplary Robotic Systems

[0153] Figure 3 is a block diagram of a surgical robotic system configured to engage and control a proximal portion (eg, a handle) of, for example, a guidewire, according to some embodiments.

[0154] In some embodiments, the robotic system 301 is suitable for use in an operating room. Optionally, one or more system components (such as control components, imaging components) are physically separated from the rest of the system and can be used remotely.

[0155] In some embodiments, system 301 is configured to receive one or more surgical tools (eg, guidewires, microcatheters, guide catheters, intermediate catheters, and / or other elongated and / or intraluminal surgical tools) and drive movement of the tools.

[0156] In some embodiments, the system is configured to drive linear motion (e.g., advancement and / or retraction) of a tool received therein, and / or drive rotational motion (e.g., axial rotation) of a tool received therein. In some embodiments, linear motion and rotational motion are driven simultaneously.

[0157] In some embodiments, the system 301 includes a robotic device (or surgical robotic device) 303, which includes one or more of the following components:

[0158] • One or more drives, such as one or more motors 305, and optionally associated motor transmissions.

[0159] • A tool movement element 317 (such as a wheel) configured to operably contact a tool received by the system to move the tool (eg, advance, retract, rotate the tool).

[0160] Controller 307, configured to receive operating signals from and / or send operating signals to universal control unit 309. Universal control unit 309 can be configured as a remote control device, a console, a control unit physically attached to a base of the system, or a combination thereof. In some embodiments, controller 307 is configured to coordinate the operation (e.g., linear motion, rotation) of a tool received and operated by the robotic system.

[0161] • Power supply (or power source) 311, comprising, for example, batteries and / or connection means for mains power.

[0162] Sensing device (sensing member) 315, for example, one or more sensors, configured to detect, for example: whether the tool has been inserted; the relative position of the tool; the position of the tool moving element (e.g., wheel); the actual movement of the tool moving element (e.g., via a counter that counts the number of wheel rotations); sensors for communicating with other system sensors and / or for other measurements and / or indications. In some embodiments, the sensor is configured to detect the motor state, for example, motor position, motor speed. Various types of sensors can be used, such as optical sensors, pressure sensors, force sensors, speed sensors, sensors for detecting current, flow sensors, position sensors (e.g., optical, magnetic, electrical position sensors).

[0163] ·Memory 313, which stores, for example: parameters related to tool movement, such as movement speed, rotation, translation, angle, deflection angle; indications obtained by one or more system sensors, such as measurement of forces acting on the tool, hardness of the tool; parameters related to the patient's body and sensed by the inserted tool (e.g., heart rate, blood pressure, temperature, oxygenation level and / or other sensed parameters).

[0164] In some embodiments, system 301 includes an integrated imaging module 319. Optionally, the system is configured to be operably attached to (e.g., communicate with) an existing imaging module. The imaging module may include, for example, X-ray fluoroscopy, CT, cone beam CT, CT fluoroscopy, MRI, ultrasound, or any other suitable imaging module.

[0165] In some embodiments, the system 301 includes a mount 321 for positioning the device 303 relative to the patient and / or relative to the operating table. In some embodiments, the mount includes or is configured to be attached to an adjustable fixture. Optionally, the height and / or angle and / or distance of the system relative to the patient (e.g., relative to the position of the body entrance) and / or relative to the table is adjustable.

[0166] In some embodiments, optionally as part of the device 303, the system 301 includes or is configured to engage an adapter 323 for operably engaging a proximal portion of a tool, such as a handle.

[0167] In some embodiments, the adapter defines a mechanical engagement between one or more motors 305 and one or more components of the handle that cause the tool to move. For example, the adapter connects one or more motors or related transmissions to the following components: a slider and / or knob assembly of the handle that deflects the tool tip when sliding; a knob assembly of the handle that rotates the tool when rotating; and / or other handle components. Additionally or alternatively, the adapter itself includes one or more integrated motors for driving the movement of the handle assembly.

[0168] In some embodiments, when attached to the system, the adapter can be driven via a system controller, for example, via a remote control device controlled by a user. Additionally or alternatively, the adapter can be directly controlled, for example, by manual engagement by a user. Additionally or alternatively, the handle can be removed from the adapter and optionally manually controlled.

[0169] In some embodiments, the adapter includes one or more sensors. Optionally, the sensors are configured to measure and / or indicate one or more of the following: whether the tool handle has been engaged by the adapter; the relative position of the handle components (such as a slide or a rotation knob) (e.g., relative to their calibrated positions or intermediate positions); the relative positions of the parts of the adapter (such as internal and external geometric parts); the speed of movement of the adapter parts and / or the handle parts; the speed of movement of the handle as a whole (e.g., rotational speed), for example, by rotation of the adapter as a whole and / or rotation of the internal geometric parts of the adapter.

[0170] Example Positioning of Robotic Systems

[0171] Figure 4A and Figure 4B are isometric and side views of a robotic surgical system positioned relative to a patient, according to some embodiments.

[0172] In some embodiments, the robotic system 401 is positioned relative to the patient 403, and optionally relative to a surgical body entry point in the patient. The entry point may be selected from, but not limited to, the patient's groin (i.e., femoral artery), arm (i.e., radial artery), or neck (i.e., jugular vein).

[0173] In some embodiments, the system 401 is mounted on a rigid fixture 405. In some embodiments, the fixture is positioned and / or restrained to the patient's body. Additionally or alternatively, the fixture is attached to a surgical bed.

[0174] In some embodiments, the fixture 405 is adjustable to control one or more positioning parameters of the system 401, such as: height, angle (e.g., angle of insertion into the body entry point), and distance from the patient (e.g., distance from the entry point). Optionally, the fixture 405 includes a rail on which the system 401 can slide to be advanced toward the patient and / or retracted from the patient.

[0175] In some embodiments, the fixture 405 is manually adjustable, for example, via a plurality of adjustable knobs 407 .

[0176] Potential advantages of a relatively small and compact system may include that the system may be positioned relatively close to the patient (e.g., a body entry point), for example, at a distance of less than 2cm, 3cm, 5cm, 10cm, or intermediate, longer, or shorter distances from the entry point.

[0177] In some embodiments, system 401 is compact and occupies a relatively small volume (e.g., less than 2000 cm 3 、2500cm 3 、3500cm 3 、5000cm 3 , 9000cm 3 The system can be mounted on the patient's body (e.g., close to a surgical entry point in the body) in a manner that allows the system to be placed close to the patient (e.g., close to a surgical entry point in the body). Optionally, the system is mounted directly on the patient in accordance with the surgical entry point, for example, assembled on the patient's leg or arm. In some embodiments, the system is small enough so as not to interfere with other operating room equipment, such as imaging modules used during the procedure. Optionally, the system has only a minimal footprint or no floor footprint and / or ceiling footprint.

[0178] In some embodiments, the attachment of the system to the operating bed and / or the patient can be implemented using ropes, straps, rigid mounts, and / or other connecting devices. In some embodiments, the attachment to the bed is implemented using a bracket that is stable relative to the track and / or floor of the mattress and / or bed. The system can then be mounted on the bracket, for example, by a snap-fit ​​mechanism, a magnetic device, a rope (e.g., Velcro), and / or other attachments. In some embodiments, the bracket is adjustable so that it can be used in patients of various sizes and / or different bed heights, etc. In some embodiments, when setting the position of the system, one or more of the height of the system relative to the patient, the angle of entry into the body, and the alignment are selected. The system position can be defined relative to the patient's body or part thereof (e.g., relative to a surgical entry point) and / or relative to the operating bed and / or relative to other operating room equipment (e.g., relative to an imaging module).

[0179] Exemplary Universal Adapter Structure

[0180] Figure 5A and Figure 5B is a cross-sectional view of an adapter for coupling a guidewire proximal handle to a surgical robotic device, according to some embodiments. Figure 5A is a cross-sectional view along the short (width) axis of the adapter; Figure 5B is a cross-sectional view along the major (length) axis of the adapter.

[0181] In some embodiments, the adapter 501 defines an internal geometry 503 shaped and configured for connection to a proximal handle of a tool (e.g., a guidewire handle) and an external geometry 505 shaped and configured for connection to a robotic device.

[0182] In some embodiments, the internal geometry 503 defines a main recess 507 in which the handle (i.e., the body of the handle, not shown) is received. Optionally, one or more transverse recesses (such as recess 509) are provided to receive a handle of a particular configuration. For example, the shape and size of recess 509 are configured to cooperatively receive a sliding member of a guidewire handle. In this example, the main recess 507 defines a circular cross-sectional profile along its width (forming a cylindrical lumen, such as Figure 5B), but other recess profiles are also contemplated, such as square cross-sectional profiles, rectangular profiles, triangular profiles, elliptical profiles, arbitrary profiles, and / or other profiles shaped to match the outer profile of the tool handle engaged by the adapter. In some embodiments, the shape and / or size of the main recess 507 allows the adapter to slide axially relative to the handle body received therein. Optionally, the main recess is sized so that a radial distance is provided between the outermost wall of the handle body and the innermost wall of the main recess, such as at least 0.1 mm, 1 mm, 5 mm, 10 mm, or intermediate, longer, or shorter distances.

[0183] In some embodiments, the external geometry 505 defines one or more features for coupling to a robotic device. For example, the external geometry includes a recess 511 in which a lead screw 513 (or pin, and / or any other elongated element) protruding from the robotic device (such as from a housing of the robotic device) is received.

[0184] In some embodiments, the inner geometry is configured to move relative to the outer geometry, or vice versa. Alternatively, the two geometries move together as a single unit.

[0185] In some embodiments, the motion comprises rotation (e.g., rotation of the inner geometry while the outer geometry is stationary; rotation of the outer geometry while the inner geometry is stationary; rotation of both geometries). In some embodiments, the motion comprises axial advancement and / or retraction of one or both of the inner geometry and the outer geometry.

[0186] In the example shown here, only the internal geometry 503 is constructed to rotate with the rotation of the handle, such as causing the guide wire to turn, while the external geometry 505 remains stationary. In some embodiments, the handle (not shown) is rotated (for example, by extending from the robotic device and rotating at least the pin or lead screw of the internal geometry), rotating with a sliding member that is part of the handle. Since the sliding member is cooperatively received in the recess 509 of the internal geometry, the rotation of the handle causes the internal geometry to rotate together with it, or vice versa. In some embodiments, the rotation of the more distal end of the tool causes the handle to rotate within the adapter, or rotate with the adapter.

[0187] In some embodiments, the outer geometry 505 moves axially (e.g., by axial movement of a rod or pin received in the recess 511). When the outer geometry moves axially, it moves the inner geometry axially with it. In turn, the slide advances or retracts relative to the body of the handle received in the main recess 507.

[0188] In some embodiments, the inner geometry is at least partially enclosed within the outer geometry, e.g. Figure 5B As shown in: the sidewall 517 of the outer geometry extends to at least partially cover the inner geometry. Additionally or alternatively, portions of the inner geometry extend to cover portions of the outer geometry. Additionally or alternatively, an interference fit coupling (e.g., corresponding protrusions and recesses) couples between the two geometries. In some embodiments, the coupling between the two geometries is configured to provide one or more of the following: rotation of the inner geometry will simultaneously rotate the outer geometry; rotation of the outer geometry will simultaneously rotate the inner geometry; axial movement of the outer geometry will simultaneously move the inner geometry axially.

[0189] In some embodiments, the handle is inserted into the adapter by sliding (e.g., screwing) the handle body into the main recess of the adapter. Optionally, the handle is manually placed in the recess of the adapter. Additionally or alternatively, the adapter includes a movable part and / or a separable part (e.g., a plurality of independent parts that can be connected to each other) and is configured to be mounted on or on the handle. Additionally or alternatively, the adapter includes a cover (e.g., a lid) that can be moved to allow the tool handle to be inserted into its designated recess.

[0190] Fig. 6A and Figure 6B is a cross-sectional view of an adapter for coupling, for example, a guidewire proximal handle to a surgical robotic device, according to some embodiments.

[0191] In this example, the entire adapter 601 (including both the internal geometry 603 and the external geometry 605) is configured to rotate with the guidewire handle received therein when the adapter is rotated.

[0192] In the adapter structure shown, the external geometry 605 is attached to the robotic device via a pin 607. A circumferential groove 609 is defined along the external geometry to receive the pin 607 regardless of the current rotational orientation of the adapter. In use, this coupling ensures that in all rotational positions of the adapter, the pin maintains the attachment of the adapter to the robotic device.

[0193] FIG. 7A to FIG. 7C Examples of alternative configurations of an adapter in accordance with some embodiments are schematically illustrated, wherein the adapter receives a guidewire handle for coupling the handle to a surgical robotic device.

[0194] exist Fig. 7AIn the embodiment of the present invention, according to some embodiments, the adapter housing 701 rotates with the handle 703 held therein. The slider 705 of the handle is received in a designated recess 707 in the adapter housing. In some embodiments, the moving member 709 of the adapter is configured to cause the adapter housing to move axially relative to the handle, thereby generating an axial movement of the slider relative to the handle (i.e., relative to the body of the handle 706).

[0195] exist Figure 7B In the embodiment, only the handle 703 rotates while the adapter housing 711 remains stationary. The slider 705 of the handle is allowed to rotate together with the handle in the designated circumferential groove 713.

[0196] exist Figure 7C , the adapter 715 includes an integrated motor 717. In use, the motor drives the axial translation of the moving member 719, which in turn causes the axial movement of the slide 705. As further shown, the adapter 715 rotates (with the motor 717 and the moving member 719) to rotate the handle 703 as a whole (i.e., including the body of the handle and the slide).

[0197] Typically, when the handle body rotates, the slider will rotate with the handle body. In some embodiments, rotating the slider will push the wall of the internal geometry of the adapter and cause the internal geometry to rotate with the handle. Alternatively, the internal geometry will push the slider wall, causing the handle to rotate with it.

[0198] In some embodiments, rotation of the inner geometry will further cause rotation of the outer geometry (eg, due to an interference fit and / or the inner geometry being enclosed by the outer geometry, or vice versa), and the two geometries will rotate together.

[0199] FIG. 8A to FIG. 8F Schematically illustrates a method according to some embodiments, for example Figure 7B Various positions of the guidewire handle within the adapter described in, and the corresponding resulting effects on the distal end portion of the guidewire.

[0200] The adapters shown in these figures are, for example, Figure 7B described.

[0201] exist Fig. 8A In the embodiment, the handle 703 rotates while allowing the slider 705 to rotate within the designated circumferential groove 713. The rotation of the handle produces a rotation of the more distal portion 801 of the guidewire (or the guidewire as a whole), such as Figure 8B as shown in .

[0202] exist Figure 8C, the adapter housing 711 moves (e.g., pushes) relative to the handle 703 in a proximal direction (see arrow 712), pushing the slider 705 proximally. The axial movement of the slider causes a deflection of the more distal portion 801 of the guidewire, for example, Fig.8D In some embodiments, when the adapter housing moves in the opposite direction (towards the distal end), the slider is pushed distally, causing the guidewire tip to deflect to the opposite side.

[0203] exist Fig. 8E In the embodiment, the rotation of the handle 703 after proximally pushing the adapter housing 711 (which proximally pushes the slider 705) causes the guide wire to deflect and rotate at the end of the guide wire, such as Fig.8F as shown in .

[0204] Fig. 9A and Fig. 9B is an isometric view of an exemplary mechanism for engaging a proximal handle of a guidewire according to some embodiments ( Fig. 9A ) and Section View ( Fig. 9B ).

[0205] In some embodiments, the robotic device 901 is configured to operably engage a proximal handle 903 of a tool (eg, a guidewire) operated by the robotic device.

[0206] In some embodiments, one or more extensions of the device (such as a lead screw 905 or a pin 907) may optionally protrude outwardly via the adapter 909 to engage the tool handle. In the example shown, the lead screw 905 is received within a recess defined in the outer geometry 911 of the adapter. In some embodiments, as shown, the inner geometry defines a recess 913 in which the slider 915 of the handle is cooperatively received. In use, the lead screw 905 is configured to move axially toward and / or away from the device (optionally, rotating the screw to cause it to advance / retract), thereby pulling the outer geometry 911 to move with it. Moving the outer geometry 911 axially will in turn move the inner geometry together, thereby causing the slider 915 to move axially relative to the body 917 of the handle 903.

[0207] In some embodiments, the pin 907 is coupled to the handle body 917 to rotate the handle body. In some embodiments, the pin 907 is an integral part of the handle. In such embodiments, the pin can be coupled to a motor that drives its rotation by a mechanical attachment such as a snap fit, press fit, interference fit, etc. Alternatively, the pin 907 is an integral part of the adapter. Alternatively, the pin 907 is an integral part of the robotic device. In use, rotation of the pin causes the handle body and the attached slide to rotate together, and the slide causes rotation of the internal geometry 919 of the adapter.

[0208] In some embodiments, the movement of the lead screw and / or pin and / or other elements used to transmit axial and / or rotational motion to the adapter and / or directly to the handle is driven by one or more motors (not shown) received within the robotic device 901.

[0209] Fig. 9C and Fig.9D is an isometric view of another exemplary mechanism for engaging the proximal handle of a guidewire according to some embodiments ( Fig. 9C ) and Section View ( Fig.9D ).

[0210] In this exemplary configuration, the adapter outer geometry 931 comprises separable parts 933 , 935 which can be fitted onto an adapter inner geometry 939 and subsequently a tool shank 936 and then connected to one another, for example via a snap connection 937 .

[0211] As further shown in this example, in some embodiments, portions of the internal geometry 939 of the adapter (e.g., the proximal and distal surfaces of the internal geometry, as shown) extend to at least partially cover or surround portions of the external geometry 941, e.g., Fig. 9C as shown in .

[0212] As further shown in this example, in some embodiments, a guidewire 938 extending from handle 936 is received by robotic device 943. Optionally, at least a portion of the guidewire is inserted into the lumen of a microcatheter 945 that also extends through the robotic device for manipulation therethrough.

[0213] Exemplary adapter structures for different types of tool handles

[0214] exist FIG. 10A to FIG. 12E In the following description of the drawings, reference numerals for components described in the drawings are indicated where the components are most easily seen.

[0215] FIG. 10A to FIG. 10E According to some embodiments, a method for bonding, for example, Fig. 10A The guide wire handle shown and driving, for example, Fig. 10A A first example of a mechanism for motorized movement of a guidewire handle is shown.

[0216] Fig. 10AA tool handle (e.g., a guidewire handle) 1001 is shown having: a substantially rectangular (e.g., box-shaped) body 1003; a slide 1005 that moves linearly along at least a portion of the length of the handle body (to deflect the distal end 1009 of the guidewire); and a vertically oriented rotatable knob 1010 that is rotated (to cause fine rotational adjustment of the terminal portion of the guidewire 1009).

[0217] In some embodiments, in order to operably couple the handle to the robotic device, an adapter 1011 is provided. In some embodiments, the adapter includes an outer housing 1013 and a plurality of moving parts configured to engage handle components (such as a slide and a rotating knob) to move them. In some embodiments, the moving parts include a slide engaging moving part 1015 that fits directly on the slide 1005 and is configured to move the slide with it (e.g., advance or retract) when moved. In some embodiments, the moving part includes a knob engaging gear 1017 that is positioned and configured to rotate the knob 1010 when rotated.

[0218] In some embodiments, the movement of the slider engagement moving piece 1015 is driven by a motor 1019. In some embodiments, the rotation of the knob engagement gear 1017 is driven by a motor gear 1021. In some embodiments, the rotation of the adapter as a whole (to cause the guidewire to rotate by rotating the handle as a single piece) is driven by a gear 1023 driven by a motor 1025. Optionally, the gear 1023 is externally coupled to the adapter housing 1013.

[0219] In some embodiments, a moving member such as 1015 is configured to be directly manually engaged by a user. For example, manual engagement can be performed in the event of a device failure, a medical emergency, and / or when a specific manual operation (e.g., for fine-tuning the end of a tool) is required. Optionally, the moving member in the adapter is coupled to a clutch mechanism that releases the moving member from its associated transmission member when manually actuated. In the example shown, a button 1020 on the moving member 1015, when pushed, disengages the moving member 1015 from its transmission member (sliding pin 1022), for example, by releasing a set of clasping legs 1024 that couple the moving member 1015 to a pin 1022. Once the moving member is separated from its transmission member, it can be manually moved (e.g., slid) to move the handle slide 1005.

[0220] FIG. 11A to FIG. 11E shows the use of bonding as Fig.11A The guide wire handle shown in FIG. Fig.11A A second example of a mechanism for motorized movement of a guidewire handle is shown in FIG.

[0221] Fig.11A A tool handle (e.g., a guidewire handle) 1101 is shown having: a body 1103; a horizontally oriented rotatable knob 1110 that is rotated (to cause deflection of the end portion of the guidewire 1109); and a lock 1105 that locks the guidewire end in a desired deflected position, for example by interfering with rotation of the knob 1110.

[0222] In some embodiments, to operably couple the handle to the robotic device, an adapter 1111 is provided. In some embodiments, the adapter includes an outer housing 1113 and a plurality of moving parts configured to engage handle components (such as a lock and a rotating knob). In some embodiments, the moving parts include a lock engaging moving part 1115 that fits directly on the lock and is configured to move the lock 1105 (e.g., advance or retract, push downward) when moved.

[0223] In some embodiments, the moving member includes a knob engaging gear 1117 that is positioned and configured to rotate the knob 1110 when rotated.

[0224] In some embodiments, the movement of the locking engagement moving member 1115 is driven by a motor 1119. In some embodiments, the rotation of the knob engagement gear 1117 is driven by a motor gear 1121.

[0225] In some embodiments, rotation of the adapter as a whole (to cause rotation of the guidewire by rotating the handle as a single piece) is driven by a gear 1123 driven by a motor 1125. Optionally, the gear 1123 is externally coupled to the adapter housing 1113.

[0226] FIG. 12A to FIG. 12E According to some embodiments, a method for bonding such as Fig. 12A The proximal portion of the guidewire shown (which does not have a proximal handle) and actuates as shown Fig. 12A A third example of a mechanism for motorized movement of a proximal portion of a guidewire (which does not have a proximal handle) is shown.

[0227] Fig. 12A A proximal portion of a guidewire is shown, which includes two grippers 1201, 1203. In some embodiments, each gripper holds a proximal portion of a wire that makes up a dual-wire guidewire 1204. For example, gripper 1201 holds a first wire and gripper 1203 holds a second wire. In use, translation of the grippers relative to each other causes a pull of one wire relative to the other, thereby producing a deflection at the distal portion of the guidewire.

[0228] In some embodiments, in order to operably couple the dual-wire guidewire to the robotic device, an adapter 1205 is provided. In this example, the adapter includes a moving piece 1207, which covers at least the gripper 1201 and is configured to move the gripper 1201 relative to the gripper 1203 (e.g., axial sliding), thereby causing the deflection of the distal end of the guidewire. Optionally, the movement of the moving piece 1207 is driven by a motor 1209.

[0229] In some embodiments, rotation of the adapter as a whole (to cause rotation of the guidewire by rotating the handle as a single piece) is driven by a gear 1223 driven by a motor 1225. Optionally, the gear 1223 is externally coupled to the adapter housing 1213.

[0230] Fig.13A and Fig. 13B A housing of an adapter for engaging a guidewire handle and driving motorized movement of the guidewire handle is shown in accordance with some embodiments.

[0231] In some embodiments, the adapter constitutes a separate unit that can be mounted on and / or placed adjacent to a robotic device. In some embodiments, the adapter itself receives one or more motors and / or controllers for performing operations on the tool handle via one or more moving parts of the adapter. Additionally or alternatively, the adapter is mechanically and / or electrically connected to the robotic system, and the driving of the one or more moving parts of the adapter is performed by one or more motors of the robotic device.

[0232] In the example shown, adapter housing 1301 includes one or more electrical connectors, such as connectors 1303, 1305. Optionally, the electrical connectors are arranged and positioned according to the locations of corresponding electrical connections of a robotic device (not shown).

[0233] In some embodiments, the adapter housing defines one or more mechanical connectors. For example, as shown, attachment legs 1307 extend from the housing to be mounted to and / or received within the housing of the robotic device.

[0234] In some embodiments, the adapter housing includes a conduit or opening 1309 through which a tool (eg, a guidewire) extending from the handle passes.

[0235] In some embodiments, the size of the adapter housing is determined by the size of the handle that the adapter is engaged with. For example, the length 1311 of the housing can be between, for example, 2 cm and 20 cm; the width 1313 of the housing can be between, for example, 0.5 cm and 10 cm; the height (thickness) 1315 of the housing can be between, for example, 0.5 cm and 10 cm. The exemplary dimensions listed can be suitable for an adapter that accepts a handle that is about 1.5 to 20 cm long, about 0.4 cm to 10 cm wide, and about 0.4 cm to 10 cm high.

[0236] Fig.14 Schematically illustrated is a module 1400 of a surgical robotic device configured to operably engage an adapter for coupling a proximal handle of a guidewire, according to some embodiments.

[0237] In some embodiments, the robotic device includes mechanical and / or electrical couplings for connecting to the adapter. For example, one or more protrusions such as at least a portion of the gear 1401 and / or knob 1403 extend outwardly relative to the housing 1407 of the robotic device to engage the adapter. In some embodiments, an electrical connector 1405 is provided to electrically connect the adapter to the robotic device.

[0238] Fig.15 Schematically illustrates the motor engagement of the proximal portion of a "dual wire" guidewire 1501 according to some embodiments.

[0239] In some embodiments, multiple wires (see 1503, 1505) of the guide wire (e.g., 2, 3, 4, 6 wires or a medium, higher or lower number) can be coupled to one or more motors and / or motor transmissions and / or moving parts driven by motors, such as gears 1507, at their proximal ends. In use, the rotation of the gears 1507 connected to the wires can pull the wires, for example, shortening the effective length of the wires. Optionally, the shortened wire in a pair of wires pulls the guide wire, thereby deflecting the distal end portion of the guide wire in the direction of the pulled wire.

[0240] In some embodiments, a multi-wire guidewire can include wires arranged adjacent to each other (e.g., arranged side by side, optionally connected at the proximal and / or distal ends of the guidewire) and / or coaxially arranged wires, such as an inner wire located within the lumen of an outer wire.

[0241] Manipulation of the wires (e.g., by pulling and / or advancing the wires of a dual-wire arrangement) can deflect the guidewire and / or affect the stiffness of the distal portion of the guidewire, for example, if the inner wire is pulled proximally from the lumen of the outer wire, thereby potentially affecting the stiffness of the guidewire.

[0242] The terms "includes," "comprising," "having," "having" and variations thereof mean "including but not limited to."

[0243] The term "consisting of" means "including and limited to."

[0244] The term "consisting essentially of" means that the composition, method or structure may include additional ingredients, steps and / or parts, but only when the additional ingredients, steps and / or parts do not materially change the basic and novel characteristics of the claimed composition, method or structure.

[0245] As used herein, unless the context clearly indicates otherwise, the singular forms "one" and "the" include plural references. For example, the term "compound" or "at least one compound" may include a variety of compounds, including mixtures thereof. Throughout this application, various embodiments of the present invention may be presented in range form. It should be understood that the description in range form is merely for convenience and brevity, and should not be interpreted as an inflexible limitation on the scope of the present invention. Therefore, the description of the range should be considered to have specifically disclosed all possible sub-ranges and individual numerical values ​​within the range. For example, the description of the range from 1 to 6 should be considered to have specifically disclosed sub-ranges such as 1 to 3, 1 to 4, 1 to 5, 2 to 4, 2 to 6, 3 to 6, etc., as well as individual numbers within the range, such as 1, 2, 3, 4, 5 and 6. This applies regardless of the width of the range.

[0246] Whenever a numerical range is indicated herein, it is meant to include any cited numeral (fractional or integral) within the indicated range. The expressions "ranging between" a first indicated numeral and a second indicated numeral and "ranging from" a first indicated numeral "to" a second indicated numeral are used interchangeably herein and are meant to include the first indicated numeral and the second indicated numeral and all fractions and integers therebetween.

[0247] As used herein, the term "method" refers to ways, means, techniques, and procedures for accomplishing a given task, including but not limited to those ways, means, techniques, and procedures known to practitioners in the fields of chemistry, pharmacology, biology, biochemistry, and medicine, or those ways, means, techniques, and procedures that can be readily developed by practitioners in the fields of chemistry, pharmacology, biology, biochemistry, and medicine from known ways, means, techniques, and procedures.

[0248] As used herein, the term "treating" includes abrogating, substantially inhibiting, slowing or reversing the progression of a disorder, substantially ameliorating the clinical or aesthetic symptoms of a disorder, or substantially preventing the appearance of clinical or aesthetic symptoms of a disorder.

[0249] It should be understood that certain features of the invention described in the context of separate embodiments for the sake of clarity may also be provided in combination in a single embodiment. Conversely, various features of the invention described in the context of a single embodiment for the sake of brevity may also be provided individually, or in any suitable sub-combination, or in any suitable manner in any other described embodiment of the invention. Certain features described in the context of various embodiments should not be considered essential features of those embodiments, unless the embodiment does not function without those elements.

[0250] Although the present invention has been described in conjunction with specific embodiments thereof, it is clear that many substitutions, modifications and variations will be apparent to those skilled in the art. Therefore, it is intended to encompass all such substitutions, modifications and variations that fall within the spirit and broad scope of the appended claims.

[0251] It is the intention of the applicant that all publications, patents and patent applications mentioned in this specification are incorporated by reference in their entirety into the specification, just as each individual publication, patent or patent application is specifically and individually noted to be incorporated by reference herein when cited. In addition, the citation or identification of any reference in this application should not be construed as an admission that such reference can serve as prior art of the present invention. To the extent that section headings are used, they should not be construed as necessarily limiting. In addition, the entire contents of any one or more priority documents of this application are incorporated herein by reference.

Claims

1. An adapter for coupling a proximal portion of an elongated surgical tool to a powered robotic surgical device, the elongated surgical tool comprising a distal end and a proximal portion, the proximal portion comprising one or more control assemblies, the adapter comprising: a. a housing shaped and sized to accommodate a proximal portion of an elongated surgical tool; The housing comprises: (i) a main recess defined by an inner wall of the housing and configured to allow an axial rotation of the proximal portion relative to the adapter when the proximal portion is received in the main recess; (ii) the main recess further includes a recess shaped and sized to accommodate at least one of the one or more control components; b. one or more moving members located within the housing and positioned to contact and move the one or more control components to affect the distal end of the elongated surgical tool; c. a transmission coupling member located within the housing, coupling the one or more moving members to a motorized transmission member of the robotic surgical device; and d. a first motor configured to drive the one or more moving parts, e. A second motor configured to drive a gear that causes rotation of the elongated surgical tool by rotating the proximal portion of the elongated surgical tool to rotate the adapter.

2. The adapter according to claim 1, wherein: The proximal portion is the handle of the elongated surgical tool.

3. The adapter according to claim 1, wherein: Affecting the distal end includes one or more of: affecting the stiffness of the distal end; affecting the deflection of the distal end; affecting the rotation of the distal end; affecting the expansion of the elongated surgical tool; and affecting the deployment of a structure in the elongated surgical tool.

4. The adapter according to claim 1, wherein: Operations of the proximal portion are coordinated with other operations performed on the elongated surgical tool by the motorized robotic surgical device, including one or more of linear and rotational motions.

5. The adapter according to claim 1, wherein: Each of the one or more moving parts is independently driven via a transmission coupling.

6. The adapter according to claim 1, wherein: The inner wall of the housing defining the main recess is positioned to prevent movement of the proximal portion within the main recess when a force is applied to the one or more control components through a moving member of the adapter.

7. The adapter according to claim 1, wherein: The main recess is shaped and dimensioned to provide for the axial rotation of the proximal portion about a major axis of the proximal portion while preventing an axial and / or lateral movement of the proximal portion within the main recess.

8. The adapter of claim 1, wherein at least an interior portion of the adapter defining the recess is configured to rotate with a proximal portion of the tool.

9. The adapter according to claim 1, wherein: The one or more moving members include a notch formed in the recess, the notch being shaped and sized to fit over a control assembly of the proximal portion of the tool.

10. The adapter according to claim 1, wherein: The transmission coupling is arranged radially outside the recess.

11. The adapter according to claim 1, wherein: At least a portion of the housing is configured to slide linearly relative to the body of the proximal portion along at least a portion of the length of the body.

12. The adapter according to claim 1, wherein: The one or more control components are selected from the group of an axial slide, a lock, a rotatable knob.

13. The adapter according to claim 1, wherein: The drive coupling comprises an attachment connected to a lead screw, pin or lead screw which is driven by a motorized drive of the robotic device.

14. The adapter according to claim 1, wherein: The housing is configured to rotate as a single unit about the long axis of the recess.

15. The adapter according to claim 1, wherein: The recess and the one or more moving members are configured to rotate while the drive coupling remains stationary.

16. The adapter according to claim 1, wherein: The housing includes mechanical and / or electrical connections that are arranged and configured to be attached to a housing of a robotic surgical device.

17. The adapter of claim 1, further comprising a clutch that decouples the one or more moving members from the drive coupling.

18. The adapter of claim 1, further comprising at least one sensor configured to indicate a relative position of the one or more moving parts.

19. The adapter according to claim 18, wherein: The at least one sensor comprises an optical encoder.

20. An assembly comprising: The adapter according to claim 1; An elongated surgical tool includes a proximal portion engaged by an adapter.

21. The assembly of claim 20, wherein: The proximal portion is removably received in the recess of the adapter.

22. The assembly of claim 20, wherein: The elongated surgical tool includes at least one of a guide wire, a microcatheter, or a combination thereof.

23. A method of operably coupling a proximal end manipulator of an elongated surgical tool to a motorized robotic surgical device, comprising: a. Providing a robotic surgical device for controlling and navigating at least one elongated surgical tool; b. Providing an adapter according to claim 1, wherein the adapter is configured to couple a control assembly of a proximal end manipulator of an elongated surgical tool to a motorized transmission member of a robotic surgical device; c. Aligning the control assembly of the operator relative to the adapter; as well as d. Attach the adapter to the motorized transmission of the robotic surgical device.

24. The method according to claim 23, further comprising: The motorized transmission of the robotic surgical device is driven to move the control assembly to cause at least one of: rotation of the elongated surgical tool; deflection of the distal portion of the elongated surgical tool; changes in the stiffness and / or dimensional characteristics of the distal portion of the elongated surgical tool.

25. The method according to claim 24, wherein: The movement includes one or more of: sliding a slider assembly of the operator; rotating a rotation assembly of the operator; rotating the proximal operator as a single unit.

26. The method of claim 23, further comprising selecting an adapter from a plurality of available adapters that matches the geometry and functionality of a particular manipulator of the tool selected for use.

27. The method according to claim 23, wherein: The operator includes a proximal handle of the tool.

28. A system comprising: a. A robotic device configured to operate at least one elongated surgical tool, the robotic device comprising one or more motors for driving movement of the at least one elongated surgical tool; as well as b. The adapter of claim 1, configured to be operably attached to a robotic device.

29. The system of claim 28, wherein: The robotic device includes a controller configured to control movement of the first member and the second member of the adapter to affect at least a distal portion of the elongated surgical tool.

30. The system of claim 29, further comprising a remote interface for controlling the controller.

31. The system of claim 28, wherein: The adapter includes a plurality of moving members for moving a plurality of said at least one control assembly of the proximal portion, the moving members being driven by said one or more motors of the robotic device.

32. The system of claim 31, wherein: The moving member includes one of the following: a mounting member mounted on a sliding component of the proximal end portion of the tool, and a gear configured to rotate a rotatable component of the proximal end portion of the tool.

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