Cannulation assembly

Abstract

A trocar assembly may include a cannula, a sealing cassette, and a occluder. The sealing cassette is configured to be releasably coupled to the cannula in a coupling configuration and is at least partially disposed within the cannula. The occluder is configured to be directly latched to the cannula in a coupling configuration and extends through the cannula and the sealing cassette.

Description

[0001] Cross-reference to related applications

[0002] This application claims the benefit and priority of U.S. Provisional Patent Application No. 63 / 008,652, filed April 10, 2020, and also claims the benefit and priority of U.S. Provisional Patent Application No. 63 / 086,013, filed September 30, 2020, the entire contents of each of which are incorporated herein by reference. Technical Field

[0003] The systems and methods disclosed herein relate to medical devices, and more specifically to intubation assemblies for medical procedures. Background Technology

[0004] Minimally invasive procedures allow access to target sites within a patient's body with minimal trauma. For example, laparoscopic surgery allows access to the patient's body cavities through a small incision in the abdomen. Intubation can create surgical passageways that allow instruments to enter the patient's body cavities. In some procedures, insufflation can be used to enlarge the access pathway and reduce trauma to the patient. Attached Figure Description

[0005] The disclosed aspects will be described below in conjunction with the accompanying drawings, which are provided to illustrate and not limit the disclosed aspects, wherein similar reference numerals denote similar elements.

[0006] Figure 1 An implementation scheme of a cart-based robotic system deployed for the diagnosis and / or treatment of bronchoscopy procedures is shown.

[0007] Figure 2 Depicting Figure 1 Another aspect of robotic systems.

[0008] Figure 3 The setup for ureteroscopy is shown. Figure 1 The implementation plan for the robot system.

[0009] Figure 4 The diagram shows the arrangement used for vascular procedures. Figure 1 The implementation plan for the robot system.

[0010] Figure 5 An implementation scheme of a table-based robotic system deployed for bronchoscopy procedures is shown.

[0011] Figure 6 Provided Figure 5 An alternative view of the robot system.

[0012] Figure 7An exemplary system configured to retract a robotic arm is shown.

[0013] Figure 8 An implementation scheme of a table-based robotic system constructed for ureteroscopy procedures is shown.

[0014] Figure 9 An implementation scheme of a table-based robotic system constructed for laparoscopic procedures is shown.

[0015] Figure 10 It shows Figures 5 to 9 An implementation scheme for a platform-based robot system with pitch and tilt adjustment.

[0016] Figure 11 Provided Figures 5 to 10 A detailed diagram of the interface between the platform and the column of the platform-based robotic system.

[0017] Figure 12 An alternative implementation of a stage-based robotic system is shown.

[0018] Figure 13 It shows Figure 12 An end view of a platform-based robotic system.

[0019] Figure 14 An end view of a platform-based robotic system with a robotic arm attached is shown.

[0020] Figure 15 An exemplary device driver is shown.

[0021] Figure 16 An exemplary medical device with paired instrument drivers is shown.

[0022] Figure 17 An alternative design of the instrument actuator and the instrument is shown, wherein the axis of the actuator is parallel to the axis of the slender axis of the instrument.

[0023] Figure 18 An instrument with an instrument-based insertion architecture is shown.

[0024] Figure 19 An example controller is shown.

[0025] Figure 20 A block diagram according to an exemplary embodiment is depicted, illustrating the estimation Figures 1 to 10 The location of one or more components of a robotic system (such as...) Figures 16 to 18 A positioning system for the location of instruments.

[0026] Figure 21 and Figure 22 An exemplary cannula assembly is shown.

[0027] Figure 23 An exemplary cannulation and docking arrangement in a robotic system is shown.

[0028] Figure 24 An exemplary cannula assembly is shown.

[0029] Figures 25A to 25D It shows the various assembly states. Figure 24 The cannulation assembly.

[0030] Figure 26 and Figure 27 A cross-section of the cannulation assembly is shown.

[0031] Figure 28 A perspective view of a cannula that can be used with a sealing box or cannula assembly is shown.

[0032] Figure 29 A perspective view of a cannula that can be used with a sealing box or cannula assembly is shown.

[0033] Figure 30 and Figure 31 Each shows a perspective view of a cannula that can be used with the sealing box or cannula assembly as described above.

[0034] Figure 32 A perspective view of the cannula assembly in its assembled state is shown.

[0035] Figure 33 It shows a semi-assembled state. Figure 32 A perspective view of the cannula assembly.

[0036] Figure 34 It shows the state of decomposition. Figure 32 A perspective view of the cannula assembly.

[0037] Figure 35 It shows Figure 32 A perspective view of the insertion of the cannula into the cannula assembly.

[0038] Figure 36 It shows the use of with Figure 32 A perspective view of another embodiment of the cannula used in conjunction with the cannula needle assembly.

[0039] Figure 37 It shows Figure 32 A perspective view of the sealing box of the cannula assembly.

[0040] Figure 38 It shows Figure 32 A perspective view of the occluder of the cannula assembly.

[0041] Figure 39It shows Figure 32 A perspective view of the latching mechanism of the occluder and the latching mechanism of the sealing box of the cannula assembly.

[0042] Figure 40 It shows Figure 32 A cross-sectional view of the cannula assembly, in which the latching mechanism of the occluder is shown in the engaged position.

[0043] Figure 41 It shows Figure 32 A cross-sectional view of the cannula assembly, in which the latching mechanism of the occluder is shown in the disengaged position.

[0044] Figure 42 A perspective view of the cannula assembly is shown.

[0045] Figure 43 yes Figure 42 A cross-sectional view of the cannula assembly.

[0046] Figure 44 yes Figure 42 A detailed cross-sectional view of the cannula assembly, with the latching mechanism in a free state.

[0047] Figure 45 yes Figure 42 A detailed cross-sectional view of the cannula assembly, with the latching mechanism in the depressed state. Detailed Implementation

[0048] 1. Overview

[0049] The aspects of this disclosure can be integrated into robot-enabled medical systems capable of performing a variety of medical procedures, including minimally invasive procedures such as laparoscopy and non-invasive procedures such as endoscopy. In endoscopic procedures, the system may be able to perform bronchoscopy, ureteroscopy, gastroscopy, etc.

[0050] In addition to executing a wide range of procedures, the system can provide additional benefits such as enhanced imaging and guidance to assist physicians. Furthermore, the system allows physicians to execute procedures from an ergonomic orientation, eliminating the need for cumbersome arm movements and positioning. Additionally, the system provides physicians with improved ease of use, enabling one or more instruments within the system to be controlled by a single user.

[0051] For illustrative purposes, various embodiments will be described below in conjunction with the accompanying drawings. It should be understood that many other specific embodiments of the disclosed concepts are possible, and various advantages can be achieved using the disclosed specific embodiments. Titles are included herein for reference and to aid in locating the various sections. These titled sections are not intended to limit the scope of the concepts described therein. Such concepts may be applicable throughout the specification.

[0052] A. Robotic System – Trolley

[0053] Robot-enabled medical systems can be constructed in a variety of ways, depending on specific procedures. Figure 1 An embodiment of a cart-based robot-enabled system 10 arranged for a diagnostic and / or therapeutic bronchoscopy procedure is illustrated. During bronchoscopy, system 10 may include a cart 11 having one or more robotic arms 12 to deliver medical instruments, such as a manipulable endoscope 13 (which may be a procedure-specific bronchoscope for bronchoscopy), to a natural orifice entry point (i.e., the patient's mouth positioned on the table in this example), to deliver diagnostic and / or therapeutic instruments. As shown, cart 11 may be positioned near the patient's upper torso to provide access to the entry point. Similarly, robotic arms 12 may be actuated to position the bronchoscope relative to the entry point. The same approach may be used when performing a GI procedure using a gastroscopy (a dedicated endoscope for gastrointestinal (GI) procedures). Figure 1 The layout within. Figure 2 An exemplary implementation of the cart is described in more detail.

[0054] Continue to refer to Figure 1Once the trolley 11 is correctly positioned, the robotic arm 12 can robotically, manually, or in combination thereof insert the maneuverable endoscope 13 into the patient. As shown, the maneuverable endoscope 13 may include at least two telescopic portions, such as an inner guide portion and an outer sheath portion, each portion being coupled to a separate instrument actuator from a set of instrument actuators 28, each instrument actuator being coupled to the distal end of a separate robotic arm. This linear arrangement of the instrument actuators 28, which facilitates coaxial alignment of the guide portion and the sheath portion, creates a “virtual track” 29, which can be repositioned in space by maneuvering one or more robotic arms 12 to different angles and / or positions. The virtual track described herein is depicted using dashed lines in the accompanying drawings, and therefore the dashed lines do not depict any physical structure of the system. Translation of the instrument actuators 28 along the virtual track 29 causes the inner guide portion to extend or retract relative to the outer sheath portion, or to advance or retract the endoscope 13 from the patient. The angle of the virtual track 29 can be adjusted, translated, and pivoted based on clinical application or physician preference. For example, in bronchoscopy, the angle and orientation of the virtual track 29 shown in the figure represent a trade-off between providing the physician with access to the endoscope 13 and minimizing friction caused by the endoscope 13 bending into the patient's mouth.

[0055] After insertion, endoscope 13 can be guided downwards through the patient's trachea and lungs using precise commands from the robotic system until the target destination or surgical site is reached. To enhance navigation through the patient's lung network and / or reach the desired target, endoscope 13 can be manipulated to telescopically extend the inner guide portion from the outer sheath portion to achieve enhanced joint movement and a larger radius of flexion. The use of separate instrument actuators 28 also allows the guide portion and sheath portion to be driven independently of each other.

[0056] For example, endoscope 13 can be guided to deliver a biopsy needle to a target, such as a lesion or nodule in a patient's lung. The needle can be deployed downwards along the working channel, which extends the length of the endoscope to obtain a tissue sample to be analyzed by a pathologist. Depending on the pathological findings, additional tools can be deployed downwards along the working channel of the endoscope for additional biopsies. After the nodule is identified as malignant, endoscope 13 can be used to deliver endoscopic tools to remove the potential cancerous tissue. In some cases, diagnostic and therapeutic procedures can be delivered in a separate procedure. In these cases, endoscope 13 can also be used to deliver a reference point to "mark" the location of the target nodule. In other cases, diagnostic and therapeutic procedures can be delivered during the same procedure.

[0057] System 10 may also include a movable tower 30, which can be connected to the trolley 11 via support cables to provide control, electronic, fluid, optical, sensor, and / or electrical support to the trolley 11. Placing such functionality in the tower 30 allows for a smaller form factor trolley 11 that can be more easily adjusted and / or repositioned by the operating physician and his / her staff. Additionally, the division of functionality between the trolley / table and the support tower 30 reduces operating room clutter and facilitates improved clinical workflow. While the trolley 11 can be positioned close to the patient, the tower 30 can be retracted in a remote location to avoid obstructing the path during procedures.

[0058] To support the aforementioned robotic system, tower 30 may include components of a computer-based control system that stores computer program instructions in a non-transitory computer-readable storage medium such as a permanent magnet memory drive, a solid-state drive, etc. Whether execution occurs within tower 30 or cart 11, the execution of these instructions can control the entire system or its subsystems. For example, when executed by the processor of the computer system, the instructions can cause components of the robotic system to actuate relevant brackets and arm mounts, actuate the robotic arm, and control medical devices. For instance, in response to receiving a control signal, a motor in the joint of the robotic arm can position the arm into a specific posture.

[0059] Tower 30 may also include pumps, flow meters, valve controllers, and / or fluid passages to provide controlled flushing and suction capabilities to a system that can be deployed via endoscope 13. These components may also be controlled using a computer system of tower 30. In some embodiments, flushing and suction capabilities may be delivered directly to endoscope 13 via a separate cable.

[0060] Tower 30 may include voltage and surge protectors designed to provide filtered and protected power to trolley 11, thereby avoiding the need to place power transformers and other auxiliary power components in trolley 11, resulting in a smaller and more mobile trolley 11.

[0061] Tower 30 may also include support devices for sensors deployed throughout the robotic system 10. For example, tower 30 may include optoelectronic devices for detecting, receiving, and processing data received from optical sensors or cameras throughout the robotic system 10. In conjunction with a control system, such optoelectronic devices can be used to generate real-time images for display in any number of consoles deployed throughout the system (including displays within tower 30). Similarly, tower 30 may also include electronic subsystems for receiving and processing signals received from deployed electromagnetic (EM) sensors. Tower 30 may also be used to house and position EM field generators for detection by EM sensors in or on a medical device.

[0062] In addition to other consoles available in the rest of the system (e.g., a console mounted on top of a cart), tower 30 may also include console 31. Console 31 may include a user interface and display, such as a touchscreen, for physician operators. Consoles in system 10 are generally designed to provide both robot control and preoperative and real-time information for procedures, such as navigation and positioning information for endoscope 13. When console 31 is not the only console available to the physician, it may be used by a second operator (such as a nurse) to monitor the patient's health or vital signs and system operation, as well as to provide procedure-specific data, such as navigation and positioning information. In other embodiments, console 30 is housed in a separate body from tower 30.

[0063] Tower 30 can be connected to cart 11 and endoscope 13 via one or more cables or connectors (not shown). In some embodiments, support functions from tower 30 can be provided to cart 11 via a single cable, thereby simplifying the operating room and eliminating clutter. In other embodiments, specific functions can be coupled in separate wiring and connections. For example, while power to the cart can be provided via a single cable, support for control, optics, fluid, and / or navigation can also be provided via separate cables.

[0064] Figure 2 Provided from Figure 1 The illustration shows a detailed implementation of a cart-based robot-enabled system. The cart 11 typically includes an elongated support structure 14 (often referred to as a "post"), a cart base 15, and a console 16 at the top of the post 14. The post 14 may include one or more brackets, such as those for supporting one or more robotic arms 12. Figure 2 The bracket 17 (or alternatively, "arm support") is deployed in three configurations. The bracket 17 may include a separately configurable arm mount that rotates along a vertical axis to adjust the base of the robotic arm 12 for better positioning relative to the patient. The bracket 17 also includes a bracket interface 19 that allows the bracket 17 to translate vertically along the post 14.

[0065] The bracket interface 19 is connected to the post 14 via a slot, such as slot 20, positioned on the opposite side of the post 14 to guide the vertical translation of the bracket 17. Slot 20 includes a vertical translation interface to position and hold the bracket relative to the trolley base 15 at various vertical heights. The vertical translation of the bracket 17 allows the trolley 11 to adjust the reach of the robotic arm 12 to accommodate various table heights, patient sizes, and physician preferences. Similarly, separately configurable arm mounts on the bracket 17 allow the robotic arm base 21 of the robotic arm 12 to be angled in various configurations.

[0066] In some embodiments, slot 20 may be supplemented with a slot cover flush and parallel to the slot surface to prevent dust and fluid from entering the internal cavity of column 14 and the vertical translation interface during the vertical translation of bracket 17. The slot cover can be deployed via a pair of spring reels positioned near the vertical top and bottom of slot 20. The cover is coiled within the reels until it is deployed to extend and retract from its coiled state during the vertical up-and-down translation of bracket 17. The spring loading of the reels provides a force to retract the cover into the reels as bracket 17 translates toward the reels, while maintaining a tight seal as bracket 17 translates away from the reels. The cover can be attached to bracket 17 using, for example, a bracket in bracket interface 19, to ensure proper extension and retraction of the cover during the translation of bracket 17.

[0067] The column 14 may internally include mechanisms such as gears and motors, which are designed to mechanically translate the bracket 17 using vertically aligned lead screws in response to control signals generated in response to user input (e.g., input from the console 16).

[0068] A robotic arm 12 typically includes a robotic arm base 21 and an end effector 22 separated by a series of links 23 connected by a series of joints 24, each joint including an independent actuator, and each actuator including an independently controllable motor. Each independently controllable joint represents an independent degree of freedom available to the robotic arm. Each arm in the arm 12 has seven joints and thus provides seven degrees of freedom. Multiple joints result in multiple degrees of freedom, thus allowing for “redundant” degrees of freedom. Redundant degrees of freedom allow the robotic arm 12 to position its corresponding end effector 22 in a specific orientation, orientation, and trajectory in space using different link orientations and joint angles. This allows the system to locate and guide medical devices from a desired point in space, while allowing physicians to move the arm joints to a clinically advantageous orientation away from the patient to achieve greater proximity while avoiding arm collisions.

[0069] The trolley base 15 balances the weight of the column 14, bracket 17, and arm 12 on the floor. Therefore, the trolley base 15 houses heavier components such as electronics, motors, power supplies, and components that enable the trolley to move and / or remain stationary. For example, the trolley base 15 includes rollable wheel-shaped casters 25 that allow the trolley to move easily around the room before the procedure. Once in the correct position, the casters 25 can be secured using wheel locks to hold the trolley 11 in the correct position during the procedure.

[0070] The console 16, positioned at the vertical end of column 14, allows both a user interface for receiving user input and a display screen (or dual-purpose device, such as, for example, touchscreen 26) to provide both preoperative and intraoperative data to the physician user. Potential preoperative data on touchscreen 26 may include preoperative planning, navigation, and mapping data derived from preoperative computed tomography (CT) scans and / or records from preoperative patient interviews. Intraoperative data on the display screen may include optical information from tools and sensors, coordinate information from sensors, and important patient statistics such as respiration, heart rate, and / or pulse. The console 16 can be positioned and tilted to allow the physician to access it from the side of column 14 opposite to bracket 17. From this orientation, the physician can operate the console 16 from behind cart 11 while observing the console 16, robotic arm 12, and patient. As shown, the console 16 also includes a handle 27 for assisting in manipulating and stabilizing cart 11.

[0071] Figure 3 An embodiment of a robot-enabled system 10 arranged for ureteroscopy is shown. In a ureteroscopy procedure, a trolley 11 is positioned to deliver a ureteroscope 32 (a procedure-specific endoscope designed to traverse the patient's urethra and ureter) to the patient's lower abdominal region. During ureteroscopy, it is desirable to align the ureteroscope 32 directly with the patient's urethra to reduce friction and force on sensitive anatomical structures in that region. As shown, the trolley 11 can be aligned at the foot of the table to allow the robotic arm 12 to position the ureteroscope 32 for direct linear access into the patient's urethra. The robotic arm 12 can insert the ureteroscope 32 directly into the patient's lower abdomen through the urethra from the foot of the table along a virtual track 33.

[0072] After insertion into the urethra, using control techniques similar to those used in bronchoscopy, the ureteroscope 32 can be navigated to the bladder, ureter, and / or kidney for diagnostic and / or therapeutic applications. For example, the ureteroscope 32 can be guided into the ureter and kidney to break up accumulated kidney stones using a laser or ultrasonic lithotripsy device deployed downwards along the working channel of the ureteroscope 32. After lithotripsy is complete, the resulting stone fragments can be removed using a basket deployed downwards along the ureteroscope 32.

[0073] Figure 4A similar implementation of a robot-enabled system for vascular procedures is shown. In vascular procedures, system 10 can be configured such that a trolley 11 delivers a medical device 34 (such as a manipulable catheter) to an entry point in the femoral artery in the patient's leg. The femoral artery presents both a relatively large diameter for navigation and a relatively less circuitous and tortuous path to the patient's heart, which simplifies navigation. As in ureteroscopy procedures, trolley 11 can be positioned toward the patient's leg and lower abdomen to allow robotic arm 12 to provide a virtual track 35 for direct linear access to the femoral artery entry point in the patient's thigh / hip region. After insertion into the artery, the medical device 34 can be guided and inserted via translational device actuator 28. Alternatively, the trolley can be positioned around the patient's upper abdomen to reach alternative vascular entry points, such as the carotid and brachial arteries near the shoulder and wrist.

[0074] B. Robot System – Unit

[0075] Implementation plans for robot-enabled medical systems can also incorporate patient-integrated tables. Integrating tables reduces the amount of capital equipment in the operating room by removing trolleys, allowing for greater accessibility to the patient. Figure 5 An embodiment of such a robot-enabled system arranged for a bronchoscopy procedure is shown. System 36 includes a support structure or column 37 for supporting a platform 38 (shown as a “table” or “bed”) on a floor. Much like a trolley-based system, the end effector of the robotic arm 39 of system 36 includes an instrument actuator 42, which is designed to manipulate elongated medical instruments, such as… Figure 5 The bronchoscope 40 is used in the bronchoscopy. In practice, the C-arm used to provide fluorescence imaging can be positioned above the patient's upper abdominal region by placing the transmitter and detector around the stage 38.

[0076] Figure 6An alternative view of system 36 without a patient and medical devices is provided for discussion purposes. As shown, column 37 may include one or more brackets 43, shown as annular in system 36, upon which one or more robotic arms 39 may be based. The brackets 43 may translate along a vertical column interface 44 extending along the length of column 37 to provide different vantage points from which the robotic arms 39 may be positioned to reach the patient. The brackets 43 may be rotated about column 37 using mechanical motors positioned within column 37 to allow the robotic arms 39 to access multiple sides of table 38, such as both sides of the patient. In embodiments with multiple brackets, the brackets may be individually positioned on the column and may translate and / or rotate independently of other brackets. While the brackets 43 need not be circular or even encircling column 37, the annular shape shown facilitates rotation of the brackets 43 about column 37 while maintaining structural balance. Rotation and translation of the brackets 43 allow the system to align medical devices such as endoscopes and laparoscopes to different access points on the patient. In other embodiments (not shown), system 36 may include a patient examination table or bed with an adjustable arm support, which takes the form of a rod or rail extending beside the patient examination table or bed. One or more robotic arms 39 (e.g., via a shoulder with an elbow joint) may be attached to the adjustable arm support, which can be vertically adjusted. By providing vertical adjustment, the robotic arms 39 can advantageously be compactly stored under the patient examination table or bed and subsequently raised during procedures.

[0077] Arm 39 can be mounted on a bracket via a set of arm mounts 45 comprising a series of joints that can be individually rotated and / or telescopically extended to provide additional constructability to the robotic arm 39. Additionally, the arm mounts 45 can be positioned on the bracket 43 such that, when the bracket 43 is properly rotated, the arm mounts 45 are positioned on the same side of the platform 38 (e.g., ...). Figure 6 As shown), on the opposite side of platform 38 (as shown) Figure 9 (as shown) or on the adjacent side of platform 38 (not shown).

[0078] Column 37 structurally supports platform 38 and provides a path for the vertical translation of the bracket. Internally, column 37 may be equipped with a lead screw for guiding the vertical translation of the bracket, and a motor for mechanizing the translation of the bracket based on the lead screw. Column 37 may also transmit power and control signals to bracket 43 and robotic arm 39 mounted thereon.

[0079] Platform base 46 has with Figure 2The trolley base 15 in the illustrated trolley 11 functions similarly, accommodating heavier components to balance the table / bed 38, column 37, bracket 43, and robotic arm 39. The table base 46 may also incorporate rigid casters to provide stability during operation. Casters deployed from the bottom of the table base 46 can extend in opposite directions on either side of the base 46 and retract when the system 36 requires movement.

[0080] continue Figure 6 System 36 may also include a tower (not shown) that divides the functionality of system 36 between the table and the tower to reduce the form factor and volume of the table. As in previously disclosed embodiments, the tower may provide the table with various support functions such as processing, computing and control capabilities, electrical, fluid and / or optical, and sensor processing. The tower may also be movable to be positioned away from the patient, thereby improving physician access and eliminating clutter in the operating room. Additionally, placing components in the tower allows for more storage space in the base of the table for potential retraction of the robotic arm. The tower may also include a main controller or console that provides a user interface such as a keyboard and / or the tower for user input, and a display screen (or touchscreen) for preoperative and intraoperative information such as real-time imaging, navigation, and tracking information. In some embodiments, the tower may also include a holder for gas cylinders to be used for inflatation.

[0081] In some implementations, the base can be retracted and stored when not in use. Figure 7 A system 47 for retracting a robotic arm is illustrated in an embodiment of a platform-based system. In system 47, a bracket 48 can be vertically translated into a base 49 to retract the robotic arm 50, arm mount 51, and bracket 48 within the base 49. A base cover 52 can be translated and retracted to open to deploy the bracket 48, arm mount 51, and arm 50 around a post 53, and to close to retract the bracket, arm mount, and arm for protection when not in use. The base cover 52 can be sealed along the edge of its opening using a membrane 54 to prevent dust and fluid from entering when closed.

[0082] Figure 8An embodiment of a robot-enabled table-based system configured for a ureteroscopy procedure is illustrated. During ureteroscopy, table 38 may include a rotating portion 55 for positioning the patient at an angle to the column 37 and table base 46. The rotating portion 55 may rotate or pivot about a pivot point (e.g., below the patient's head) to position the lower portion of the rotating portion 55 away from the column 37. For example, pivoting of the rotating portion 55 allows a C-arm (not shown) to be positioned above the patient's lower abdomen without competing for space with the column (not shown) below table 38. By rotating a bracket 35 (not shown) about the column 37, a robotic arm 39 can insert a ureteroscope 56 directly into the patient's groin region along a virtual track 57 to reach the urethra. During ureteroscopy, stirrups 58 may also be fixed to the rotating portion 55 of table 38 to support the orientation of the patient's legs during the procedure and allow full access to the patient's groin region.

[0083] In laparoscopic procedures, minimally invasive instruments are inserted into the patient's anatomical structures through one or more small incisions in the abdominal wall. In some embodiments, the minimally invasive instruments include elongated rigid components, such as axes, for accessing the anatomical structures within the patient. After the patient's abdominal cavity is inflated, the instruments can be guided to perform surgical or medical tasks, such as grasping, cutting, ablation, suturing, etc. In some embodiments, the instruments may include endoscopes, such as laparoscopes. Figure 9 An implementation scheme of a robot-enabled platform-based system constructed for laparoscopic procedures is shown. For example... Figure 9 As shown, the bracket 43 of system 36 can be rotated and vertically adjusted to position the pair of robotic arms 39 on opposite sides of table 38, so that the instrument 59 can be positioned through the smallest incision on both sides of the patient to reach his / her abdominal cavity using arm mount 45.

[0084] To accommodate laparoscopic procedures, the robot-enabled platform system can also tilt the platform to the desired angle. Figure 10 An implementation scheme for a robot-enabled medical system with pitch or tilt adjustment is shown. For example... Figure 10 As shown, system 36 can adapt to the tilt of platform 38 to position one part of the platform at a greater distance from the base plate than the other part. Additionally, arm mount 45 can rotate to match the tilt, ensuring that arm 39 maintains the same planar relationship with platform 38. To accommodate steeper angles, column 37 may also include a telescopic portion 60 that allows vertical extension of column 37 to prevent platform 38 from contacting the floor or colliding with base 46.

[0085] Figure 11Detailed illustrations are provided of the interface between platform 38 and column 37. The pitch-rotation mechanism 61 can be configured to change the pitch angle of platform 38 relative to column 37 in multiple degrees of freedom. The pitch-rotation mechanism 61 can be implemented by positioning orthogonal axes 1, 2 at the column interface, each axis being actuated by separate motors 3, 4 in response to electrical pitch angle commands. Rotation along one screw 5 enables tilt adjustment along axis 1, while rotation along another screw 6 enables tilt adjustment along another axis 2. In some embodiments, ball joints may be used to change the pitch angle of platform 38 relative to column 37 in multiple degrees of freedom.

[0086] For example, pitch adjustment is particularly useful when attempting to position the table in the Trendrenburg position (i.e., positioning the patient's lower abdomen higher than the floor) for lower abdominal surgery. The head-down, feet-up position causes the patient's internal organs to slide down to his / her upper abdomen by gravity, clearing the abdominal cavity to allow minimally invasive instruments to enter and perform lower abdominal surgical or medical procedures, such as laparoscopic prostatectomy.

[0087] Figure 12 and Figure 13 Isometric and end views of an alternative embodiment of a stage-based surgical robot system 100 are shown. The surgical robot system 100 includes one or more robotic arms (see, for example) that can be configured to support a stage 101 relative to it. Figure 14 One or more adjustable arm supports 105 are provided. In the illustrated embodiment, a single adjustable arm support 105 is shown, but additional arm supports may be positioned on opposite sides of the platform 101. The adjustable arm support 105 may be configured such that it is movable relative to the platform 101 to adjust and / or change the orientation of the adjustable arm support 105 and / or any robotic arm attached to it relative to the platform 101. For example, the adjustable arm support 105 may be adjusted with one or more degrees of freedom relative to the platform 101. The adjustable arm support 105 provides high flexibility to the system 100, including the ability to easily retract one or more adjustable arm supports 105 and any robotic arms attached thereto under the platform 101. The adjustable arm support 105 may be raised from a retracted orientation to an orientation below the upper surface of the platform 101. In other embodiments, the adjustable arm support 105 can be raised from a retracted position to a position above the upper surface of the platform 101.

[0088] The adjustable arm support 105 provides several degrees of freedom, including lifting, lateral translation, and tilting. Figure 12 and Figure 13 In the exemplary embodiment, the arm support 105 is configured to have four degrees of freedom, which are in Figure 12The arrows indicate the first degree of freedom, which allows adjustment of the adjustable arm support 105 in the z-direction (“Z-lift”). For example, the adjustable arm support 105 may include a bracket 109 configured to move up or down along or relative to the column 102 of the support platform 101. The second degree of freedom allows the adjustable arm support 105 to tilt. For example, the adjustable arm support 105 may include a rotary joint that allows the adjustable arm support 105 to be aligned with the bed in a head-down, feet-up position. The third degree of freedom allows the adjustable arm support 105 to “pivot upwards”, which can be used to adjust the distance between one side of the platform 101 and the adjustable arm support 105. The fourth degree of freedom allows the adjustable arm support 105 to translate along the longitudinal length of the platform.

[0089] Figure 12 and Figure 13 The surgical robot system 100 may include a platform supported by a column 102 mounted to a base 103. The base 103 and the column 102 support the platform 101 relative to a support surface. A floor axis 131 and a support axis 133 are... Figure 13 As shown in the image.

[0090] The adjustable arm support 105 can be mounted to the column 102. In other embodiments, the arm support 105 can be mounted to the platform 101 or the base 103. The adjustable arm support 105 may include a bracket 109, a rod or rail connector 111, and a rod or rail 107. In some embodiments, one or more robotic arms mounted to the rail 107 can translate and move relative to each other.

[0091] The bracket 109 can be attached to the post 102 via a first joint 113, which allows the bracket 109 to move relative to the post 102 (e.g., such as up and down movement along a first axis or vertical axis 123). The first joint 113 can provide a first degree of freedom (“Z-lift”) to the adjustable arm support 105. The adjustable arm support 105 may include a second joint 115 that provides a second degree of freedom (tilt). The adjustable arm support 105 may include a third joint 117 that provides a third degree of freedom (“upward pivot”). An additional joint 119 may be provided (in... Figure 13 (As shown in the diagram), the additional joint mechanically constrains the third joint 117 to maintain the orientation of the guide rail 107 as the guide rail connector 111 rotates about the third axis 127. The adjustable arm support 105 may include a fourth joint 121 that can provide a fourth degree of freedom (translation) for the adjustable arm support 105 along the fourth axis 129.

[0092] Figure 14An end view of a surgical robot system 140A according to one embodiment, having two adjustable arm supports 105A, 105B mounted on opposite sides of a stage 101, is shown. A first robotic arm 142A is attached to a rod or rail 107A of the first adjustable arm support 105B. The first robotic arm 142A includes a base 144A attached to the rail 107A. The distal end of the first robotic arm 142A includes an instrument drive mechanism 146A that can be attached to one or more robotic medical instruments or tools. Similarly, a second robotic arm 142B includes a base 144B attached to the rail 107B. The distal end of the second robotic arm 142B includes an instrument drive mechanism 146B. The instrument drive mechanism 146B can be configured to be attached to one or more robotic medical instruments or tools.

[0093] In some embodiments, one or more of the robotic arms 142A, 142B include an arm with seven or more degrees of freedom. In some embodiments, one or more of the robotic arms 142A, 142B may include eight degrees of freedom, including an insertion axis (including one degree of freedom for insertion), a wrist (including three degrees of freedom for wrist pitch, yaw, and roll), an elbow (including one degree of freedom for elbow pitch), a shoulder (including two degrees of freedom for shoulder pitch and yaw), and a base 144A, 144B (including one degree of freedom for translation). In some embodiments, the insertion degree of freedom may be provided by the robotic arms 142A, 142B, while in other embodiments, the instrument itself provides insertion via an instrument-based insertion architecture.

[0094] C. Instrument drivers and interfaces

[0095] The end effector of the system's robotic arm includes (i) an instrument actuator (alternatively referred to as an "instrument drive mechanism" or "instrument device manipulator") incorporating electromechanical devices for actuating the medical device, and (ii) a removable or detachable medical device that may not contain any electromechanical components, such as motors. This dichotomy may be driven by the need to sterilize medical devices used in medical procedures, and the inability to adequately sterilize expensive capital equipment due to its complex mechanical components and sensitive electronics. Therefore, the medical device can be designed to be detached, removed, and interchanged from the instrument actuator (and thus from the system) for individual sterilization or disposal by a physician or physician staff. In contrast, the instrument actuator does not need to be altered or sterilized and can be covered for protection.

[0096] Figure 15An example instrument actuator is shown. The instrument actuator 62, positioned at the distal end of a robotic arm, includes one or more drive units 63 arranged parallel to the axis to provide controlled torque to a medical device via a drive shaft 64. Each drive unit 63 includes a separate drive shaft 64 for interacting with the device, a gear head 65 for converting motor shaft rotation into desired torque, a motor 66 for generating drive torque, an encoder 67 for measuring the speed of the motor shaft and providing feedback to control circuitry, and control circuitry 68 for receiving control signals and actuating the drive unit. Each drive unit 63 is independently controlled and motorized, and the instrument actuator 62 can provide multiple (e.g., ...) to the medical device. Figure 15 Four independent drive outputs are shown. In operation, the control circuit 68 receives control signals, transmits motor signals to the motor 66, compares the motor speed measured by the encoder 67 with the desired speed, and modulates the motor signals to generate the desired torque.

[0097] For procedures requiring a sterile environment, the robotic system can incorporate a drive interface, such as a sterile adapter connected to a sterile cover, positioned between the instrument actuator and the medical device. The primary purpose of the sterile adapter is to transmit angular motion from the drive shaft of the instrument actuator to the drive input of the device, while maintaining physical separation between the drive shaft and the drive input, thus preserving sterility. Therefore, an exemplary sterile adapter may include a series of rotary inputs and rotary outputs designed to mate with the drive shaft of the instrument actuator and the drive input on the device. The sterile cover, composed of a thin, flexible material (such as transparent or translucent plastic), is connected to the sterile adapter and designed to cover capital devices, such as instrument actuators, robotic arms, and trolleys (in trolley-based systems) or tables (in table-based systems). The use of the cover allows the capital device to be positioned near the patient while still within an area that does not require sterilization (i.e., a non-sterile area). On the other side of the sterile cover, the medical device can dock with the patient in an area that requires sterilization (i.e., a sterile area).

[0098] D. Medical devices

[0099] Figure 16An exemplary medical device with paired instrument actuators is shown. Similar to other devices designed for use with robotic systems, the medical device 70 includes an elongated shaft 71 (or elongated body) and an instrument base 72. The instrument base 72, also referred to as the “instrument handle” due to its intended design for manual interaction by a physician, typically includes a rotatable drive input 73 (e.g., a socket, pulley, or reel) designed to mate with a drive output 74 on a drive interface extending through the distal end of the robotic arm 76. When physically connected, latched, and / or coupled, the mating drive input 73 of the instrument base 72 may share a rotational axis with the drive output 74 in the instrument driver 75 to allow torque to be transmitted from the drive output 74 to the drive input 73. In some embodiments, the drive output 74 may include a spline designed to mate with a socket on the drive input 73.

[0100] The elongated shaft 71 is designed to be delivered through an anatomical opening or cavity (e.g., as in endoscopy) or through a minimally invasive incision (e.g., as in laparoscopy). The elongated shaft 71 can be flexible (e.g., having endoscope-like properties) or rigid (e.g., having laparoscopy-like properties), or a customized combination of both flexible and rigid portions. When designed for laparoscopy, the distal end of the rigid elongated shaft can be connected to an end effector extending from a connector wrist formed by a connecting fork having at least one degree of freedom and a surgical tool or medical instrument (such as, for example, a gripper or scissors), which can be actuated based on forces from a tendon when the drive input rotates in response to torque received from the drive output 74 of the instrument actuator 75. When designed for endoscopy, the distal end of the flexible elongated shaft can include a manipulable or controllable bending segment that articulates and bends based on torque received from the drive output 74 of the instrument actuator 75.

[0101] Torque from the instrument actuator 75 is transmitted downwards along shaft 71 to the elongated shaft 71 via tendons. These individual tendons (e.g., traction cables) may be individually anchored to individual drive inputs 73 within the instrument handle 72. From the handle 72, the tendons are guided downwards along one or more traction chambers of the elongated shaft 71 and anchored at the distal portion of the elongated shaft 71, or at the wrist at the distal portion of the elongated shaft. During surgical procedures such as laparoscopy, endoscopy, or hybrid procedures, these tendons may be coupled to distally mounted end effectors, such as wrists, grippers, or scissors. In such an arrangement, torque applied to the drive input 73 transmits tension to the tendons, thereby actuating the end effector in a certain way. In some embodiments, during surgical procedures, the tendons may cause the connector to rotate about the axis, thereby causing the end effector to move in one direction or the other. Alternatively, the tendons may be coupled to one or more jaws of a gripper at the distal end of the elongated shaft 71, wherein tension from the tendons causes the gripper to close.

[0102] During endoscopy, tendons can be attached via adhesives, control rings, or other mechanical fasteners to flexural or articulated segments positioned along an elongated axis 71 (e.g., at the distal end). When fixedly attached to the distal end of a flexural segment, torque applied to drive input 73 is transmitted down the tendon, causing the softer flexural segment (sometimes referred to as an articulated segment or region) to flex or articulate. Along non-flexural segments, it can be advantageous to helve or coil individual traction cavities that guide individual tendons along the wall (or inside) of the endoscope axis to balance radial forces caused by tension in the traction lines. For specific purposes, the angle of the helices and / or the spacing between them can be varied or designed, with tighter helices exhibiting less axial compression under load, while lower helical amounts cause greater axial compression under load but also exhibit restricted flexion. Alternatively, traction cavities can be guided parallel to the longitudinal axis of the elongated axis 71 to allow controlled articulation within the desired flexural or articulated segment.

[0103] In endoscopic procedures, the elongated shaft 71 houses multiple components to assist in robotic procedures. The shaft may include a working channel for deploying surgical instruments (or medical devices), irrigation components, and / or suction components to an operating area at the distal end of the shaft 71. The shaft 71 may also house wires and / or optical fibers to transmit signals to / from optical components at the distal end, which may include an optical camera. The shaft 71 may also house optical fibers to carry light from a proximal light source (e.g., a light-emitting diode) to the distal end of the shaft.

[0104] At the distal end of the instrument 70, the distal end may further include an opening for delivering tools for diagnosis and / or treatment, and for a working channel for rinsing and aspirating the surgical site. The distal end may also include a port for a camera (such as a fiberoptic endoscope or digital camera) to capture images of the internal anatomical space. Relatedly, the distal end may also include a port for a light source used to illuminate the anatomical space when the camera is used.

[0105] exist Figure 16 In the example, the axis of the drive shaft, and therefore the drive input axis, is orthogonal to the axis of the elongated shaft. However, this arrangement complicates the rolling capability of the elongated shaft 71. Rolling the elongated shaft 71 along its axis while keeping the drive input 73 stationary can cause undesirable tangling of the tendons as they extend from the drive input 73 and enter the traction cavity within the elongated shaft 71. Such tangling of tendons can disrupt any control algorithms designed to predict the movement of the flexible elongated shaft during endoscopic procedures.

[0106] Figure 17 An alternative design of the instrument actuator and instrument is shown, wherein the axis of the drive unit is parallel to the axis of the slender axis of the instrument. As shown, the circular instrument actuator 80 includes four drive units whose drive outputs 81 are aligned parallel to each other at the end of the robot arm 82. The drive units and their respective drive outputs 81 are housed in a rotating assembly 83 of the instrument actuator 80, driven by one of the drive units within assembly 83. In response to torque provided by the rotating drive unit, the rotating assembly 83 rotates along a circular bearing that connects the rotating assembly 83 to the non-rotating portion 84 of the instrument actuator. Electrical and control signals can be transmitted from the non-rotating portion 84 of the instrument actuator 80 to the rotating assembly 83 via electrical contacts, which can be maintained by rotation of a brush slip ring connection (not shown). In other embodiments, the rotating assembly 83 may be responsive to a separate drive unit integrated into the non-rotating portion 84 and therefore not parallel to the other drive units. The rotation mechanism 83 allows the instrument actuator 80 to allow the drive units and their respective drive outputs 81 to rotate as a single unit about the instrument actuator axis 85.

[0107] Similar to previously disclosed embodiments, the device 86 may include an elongated shaft portion 88 and a device base 87 (shown as having a transparent outer surface for discussion purposes), the device base including a plurality of drive inputs 89 (such as sockets, pulleys, and reels) configured to receive drive outputs 81 in the device driver 80. Unlike previously disclosed embodiments, the device shaft 88 extends from the center of the device base 87, and the axis of the device base is substantially parallel to the axes of the drive inputs 89, rather than... Figure 16 It is orthogonal as in the design.

[0108] When coupled to the rotating assembly 83 of the instrument driver 80, the medical instrument 86, including the instrument base 87 and the instrument shaft 88, rotates in combination with the rotating assembly 83 about the instrument driver axis 85. Since the instrument shaft 88 is positioned at the center of the instrument base 87, it is coaxial with the instrument driver axis 85 when attached. Therefore, rotation of the rotating assembly 83 causes the instrument shaft 88 to rotate about its own longitudinal axis. Furthermore, when the instrument base 87 rotates together with the instrument shaft 88, any tendons connected to the drive input 89 in the instrument base 87 do not become entangled during rotation. Therefore, the parallelism of the axes of the drive output 81, the drive input 89, and the instrument shaft 88 allows the shaft to rotate without causing any control tendons to become entangled.

[0109] Figure 18 An instrument with an instrument-based insertion architecture according to some embodiments is shown. Instrument 150 is connectable to any of the instrument drivers described above. Instrument 150 includes an elongated shaft 152, an end effector 162 connected to the shaft 152, and a shank 170 connected to the shaft 152. The elongated shaft 152 includes a tubular member having a proximal portion 154 and a distal portion 156. The elongated shaft 152 includes one or more channels or grooves 158 along its outer surface. The grooves 158 are configured to receive one or more wires or cables 180 passing through the grooves. Thus, one or more cables 180 extend along the outer surface of the elongated shaft 152. In other embodiments, the cables 180 may also pass through the elongated shaft 152. Manipulation of the one or more cables 180 (e.g., via an instrument driver) actuates the end effector 162.

[0110] The instrument handle 170 (also referred to as the instrument base) typically includes an attachment interface 172 having one or more mechanical inputs 174, such as jacks, pulleys, or spools, which are designed to reciprocately engage with one or more torque couplers on the attachment surface of the instrument actuator.

[0111] In some embodiments, the instrument 150 includes a series of pulleys or cables that enable the elongated shaft 152 to translate relative to the handle 170. In other words, the instrument 150 itself includes an instrument-based insertion architecture that adapts to the insertion of the instrument, thereby minimizing reliance on a robotic arm to provide the insertion of the instrument 150. In other embodiments, the robotic arm may be largely responsible for the instrument insertion.

[0112] E. Controller

[0113] Any of the robotic systems described herein may include an input device or controller for manipulating a device attached to a robotic arm. In some embodiments, the controller may be coupled to the device (e.g., communicatively, electronically, electrically, wirelessly, and / or mechanically) such that manipulation of the controller, for example via master-slave control, causes corresponding manipulation of the device.

[0114] Figure 19 This is a perspective view of an embodiment of controller 182. In this embodiment, controller 182 includes a hybrid controller that may have both impedance and admittance control. In other embodiments, controller 182 may utilize only impedance or passive control. In other embodiments, controller 182 may utilize only admittance control. By being a hybrid controller, controller 182 advantageously has lower perceived inertia during use.

[0115] In the illustrated embodiment, controller 182 is configured to allow manipulation of two medical devices and includes two handles 184. Each handle 184 is connected to a universal joint 186. Each universal joint 186 is connected to a positioning platform 188.

[0116] like Figure 19 As shown, each positioning platform 188 includes a SCARA arm (selective compliant assembly robot arm) 198 connected to a post 194 via a prism joint 196. The prism joint 196 is configured to translate along the post 194 (e.g., along guide rail 197) to allow each handle 184 to translate in the z-direction, thus providing a first degree of freedom. The SCARA arm 198 is configured to allow the handle 184 to move in the xy-plane, thus providing two additional degrees of freedom.

[0117] In some embodiments, one or more load sensors are located within the controller. For example, in some embodiments, load sensors (not shown) are located within the body of each gimbal in gimbal 186. By providing load sensors, portions of controller 182 are capable of operating under admittance control, thereby advantageously reducing the sense inertia of the controller during use. In some embodiments, positioning platform 188 is configured for admittance control, while gimbal 186 is configured for impedance control. In other embodiments, gimbal 186 is configured for admittance control, while positioning platform 188 is configured for impedance control. Thus, for some embodiments, the translational or orientational degrees of freedom of positioning platform 188 may depend on admittance control, while the rotational degrees of freedom of gimbal 186 may depend on impedance control.

[0118] F. Navigation and Control

[0119] Traditional endoscopy can involve the use of fluoroscopy (e.g., delivered via a C-arm) and other forms of radiation-based imaging modalities to provide intracavitary guidance to the operating physician. In contrast, the robotic system envisioned in this disclosure can provide radiation-free navigation and positioning, reducing physician exposure to radiation and the amount of equipment required in the operating room. As used herein, the term "positioning" can refer to determining and / or monitoring the orientation of an object in a reference coordinate system. Techniques such as preoperative mapping, computer vision, real-time EM tracking, and robot command data can be used individually or in combination to achieve a radiation-free operating environment. In other cases where radiation-based imaging modalities are still used, preoperative mapping, computer vision, real-time EM tracking, and robot command data can be used individually or in combination to improve upon information obtained solely through radiation-based imaging modalities.

[0120] Figure 20 This is a block diagram illustrating a positioning system 90 for estimating the position of one or more components of a robotic system (such as the position of a machine) according to an example embodiment. The positioning system 90 may be a group of one or more computer devices configured to execute one or more instructions. The computer devices may be embodied by a processor (or multiple processors) and computer-readable storage among the components discussed above. By way of example and not limitation, the computer devices may be located in... Figure 1 Tower 30 shown Figures 1 to 4 The cart shown Figures 5 to 14 The bed, etc. shown.

[0121] like Figure 20 As shown, the positioning system 90 may include a positioning module 95 that processes input data 91-94 to generate position data 96 for the distal end of a medical device. The position data 96 may be data or logic representing the position and / or orientation of the distal end of the device relative to a reference frame. The reference frame may be relative to a patient's anatomy or a known object (such as an EM field generator) (see the discussion of EM field generators below).

[0122] The various input data are now described in more detail 91-94. Preoperative mapping can be accomplished using a collection of low-dose CT scans. The preoperative CT scans are reconstructed into three-dimensional images, which are visualized, for example, as “slices” of cross-sectional views of the patient’s internal anatomy. When analyzed in whole, image-based models of the anatomical cavities, spaces, and structures of the patient’s anatomical structures, such as the patient’s lung network, can be generated. Techniques such as centerline geometry can be determined and approximated from CT images to form a three-dimensional volume of the patient’s anatomy, which is referred to as model data 91 (also referred to as “preoperative model data” when generated using only preoperative CT scans). The use of centerline geometry is discussed in U.S. Patent Application 14 / 523,760, the contents of which are incorporated herein by reference in their entirety. Network topology models can also be derived from CT images and are particularly well-suited for bronchoscopy.

[0123] In some implementations, the device may be equipped with a camera to provide visual data 92. The positioning module 95 can process the visual data to enable one or more vision-based position tracking methods. For example, preoperative model data can be used in conjunction with visual data 92 to enable computer vision-based tracking of a medical device (e.g., an endoscope or an instrument propelled through the working channel of an endoscope). For example, using preoperative model data 91, the robotic system can generate a library of expected endoscope images based on the model, with each image linked to a location within the model, based on the expected path of the endoscope's movement. In operation, the robotic system can refer to this library to compare real-time images captured at a camera (e.g., a camera at the distal end of the endoscope) with those images in the image library to aid in positioning.

[0124] Other computer vision-based tracking techniques use feature tracking to determine camera motion, and thus, endoscope motion. Some features of the localization module 95 can identify circular geometries corresponding to anatomical cavities in the preoperative model data 91 and track changes in those geometries to determine which anatomical cavity has been selected, as well as track the relative rotation and / or translational motion of the camera. The use of a topology map can further enhance vision-based algorithms or techniques.

[0125] Optical flow (another computer vision-based technique) can analyze the displacement and translation of image pixels in a video sequence within visual data 92 to infer camera motion. Examples of optical flow techniques can include motion detection, object segmentation computation, brightness, motion compensation coding, stereo parallax measurement, and more. Through multiple iterations and comparisons of multiple frames, the motion and position of the camera (and therefore the endoscope) can be determined.

[0126] The positioning module 95 can use real-time EM tracking to generate the real-time position of the endoscope in a global coordinate system that can be registered to the patient's anatomy represented by a preoperative model. In EM tracking, an EM sensor (or tracker), including one or more sensor coils embedded in one or more locations and orientations within the medical instrument (e.g., an endoscopic tool), measures changes in the EM field generated by one or more static EM field generators positioned at known locations. The positional information detected by the EM sensor is stored as EM data 93. The EM field generator (or transmitter) can be placed close to the patient to generate a low-intensity magnetic field detectable by the embedded sensor. The magnetic field induces a small current in the sensor coil of the EM sensor, which can be analyzed to determine the distance and angle between the EM sensor and the EM field generator. These distances and orientations can be "registered" to the patient's anatomy (e.g., a preoperative model) during surgery to determine the geometric transformations that align a single location in the coordinate system with its orientation in the preoperative model of the patient's anatomy. Once registered, an embedded EM tracker in one or more orientations of the medical device (e.g., the distal end of an endoscope) can provide real-time indication of the medical device’s progress through the patient’s anatomy.

[0127] Robot commands and kinematic data 94 can also be used by the positioning module 95 to provide orientation data 96 for the robotic system. Device pitch and yaw, derived from joint movement commands, can be determined during preoperative calibration. During surgery, these calibration measurements can be combined with known insertion depth information to estimate the instrument's orientation. Alternatively, these calculations can be analyzed in conjunction with EM, vision, and / or topology modeling to estimate the medical device's orientation within the network.

[0128] like Figure 20 As shown, the positioning module 95 can use multiple other input data. For example, although in Figure 20 Although not shown, the device using shape sensing fibers can provide shape data, which the positioning module 95 can use to determine the position and shape of the device.

[0129] The localization module 95 can use the input data 91-94 in combination. In some cases, such combination can use a probabilistic method, where the localization module 95 assigns confidence weights to the location determined based on each of the input data 91-94. Therefore, in cases where the EM data may be unreliable (e.g., in the presence of EM interference), the confidence of the location determined by the EM data 93 may be reduced, and the localization module 95 may rely more heavily on the visual data 92 and / or robot commands and kinematic data 94.

[0130] As discussed above, the robotic systems discussed in this paper can be designed as a combination of one or more of the technologies mentioned above. The computer-based control system of a robotic system located in a tower, bed, and / or trolley can store computer program instructions in, for example, a non-transitory computer-readable storage medium (such as a permanent magnetic storage drive, a solid-state drive, etc.). When executed, these computer program instructions cause the system to receive and analyze sensor data and user commands, generate control signals for the entire system, and display navigation and positioning data, such as the instrument's orientation in a global coordinate system and anatomical diagrams.

[0131] 2. Cannula assembly

[0132] Embodiments of this disclosure include systems and techniques related to cannula assemblies and cannulation, such as cannula assemblies for laparoscopic procedures, for example.

[0133] The components disclosed herein overcome one or more challenges found with certain conventional cannula assemblies. In some cannula assemblies, clinicians may find it difficult to engage and disengage the sealing cartridge from the cannula. Therefore, during some procedures, clinicians may require additional time to insert or remove the sealing cartridge or may fail to fully engage it, potentially impairing airflow into the patient's body cavity. Furthermore, in some cannula assemblies, the sealing cartridge is located within the upper portion of the cannula. Therefore, the configuration of some cannula assemblies interferes with robust inline latching of the cannula to the robotic arm or detection of the cannula by the robotic system. Advantageously, the disclosed cannula assembly allows for easy engagement and disengagement of the sealing cartridge from the cannula while allowing for safe engagement for procedures. As will be understood, the configuration of the disclosed cannula assembly can reduce clinical error, decrease procedure time, and streamline workflow.

[0134] refer to Figures 21 to 22 An exemplary cannula assembly 200 is shown, which includes a occluder 210, a sealing box 240, and a cannula 260. Figure 21 The cannula assembly 200 is shown in an assembled state. Figure 22 It shows the unassembled state. Figure 23An exploded view of the cannula assembly 200. In the depicted example, the cannula assembly 200 displaces or dissects soft tissue to allow insertion of the cannula 260 into a patient's body cavity to provide access to a surgical site. According to some embodiments, the cannula assembly 200 is configured to provide access to a surgical site for laparoscopic procedures. Additionally or alternatively, the cannula assembly 200 may be configured to provide access to sites for urological, endoscopic, percutaneous, orthopedic, and / or other medical or minimally invasive procedures, wherein a medical device is introduced to the site via the cannula assembly. In some applications, the cannula assembly 200 provides access to a surgical site for a robotic laparoscopic procedure performed by the robotic system described herein. Additionally or alternatively, the cannula assembly 200 may be configured for manual laparoscopic procedures.

[0135] In the depicted example, the occluder 210 and cannula 260 of the cannula assembly 200 can dissect or puncture soft tissue to allow the cannula assembly 200 to enter a surgical site. As shown, the proximal portion of the cannula 260 is configured as a funnel portion 262 that allows insertion of a tool containing the occluder 210. The cannula shaft 280 is configured as a tubular portion that extends distally from the funnel portion and provides an inner lumen through which the occluder shaft 212 extends. In the assembled configuration, the occluder shaft 212 extends through the inner lumen 282 of the cannula shaft 280. The occluder shaft 212 may be longer than the cannula shaft 280, such that the occluder shaft extends beyond the distal end portion 284 of the cannula shaft 280.

[0136] The occluder shaft 212 may include a distal end 214 that is angled or otherwise pointed and configured to anatomize or puncture soft tissue. During insertion, the distal end 214 of the occluder shaft 212 may displace the soft tissue to allow the cannula shaft 280 to be inserted into the patient's body cavity. The occluder 210 may be advanced by a clinician applying force or otherwise manipulating the proximal portion 220 of the occluder 210. Optionally, the proximal portion 220 may be used by a clinician or other user as a handle to generally apply force or otherwise advance the occluder 210 and / or the cannula assembly 200. As shown, the proximal portion 220 of the occluder 210 may have a radius generally larger than that of the shaft 212 to allow the user to easily apply more force to the shaft 212. Furthermore, the proximal portion 220 may include a gripping portion or a planar surface to allow the clinician to advance the occluder 210.

[0137] As shown in the figure, the occluders 210 and 260 of the cannula assembly 200 can be coupled together to collaboratively dissect or puncture soft tissue to allow the cannula assembly 200 to enter the surgical site. Therefore, in the assembled configuration, the cannula 260 can be advanced together with the occluder 210. As will be understood, the distal end portion 284 of the cannula shaft 280 can further displace soft tissue to allow the cannula shaft 280 to be inserted into the patient's body cavity.

[0138] While the cannula assembly 200 is inserted into the patient's body cavity, the occluder 210 can be removed from the cannula 260. After the occluder 210 is removed from the cannula 260, the cannula lumen 282 can provide a working gallery or channel through which other tools such as laparoscopic instruments, surgical instruments, and / or endoscopes can be inserted, manipulated, and / or removed. Optionally, the movement of the cannula 260 and the tools can be manipulated or controlled by the robotic system described herein.

[0139] Optionally, the latching mechanism 230 of the occluder 210 may allow the occluder 210 to engage with or release from the cannula 260. In some embodiments, the latching mechanism 230 may extend from the proximal portion 220 of the occluder 210 to releasably engage with other portions of the trocar assembly 200.

[0140] In some applications, the cannula assembly 200 can allow airflow into a patient's body cavity during procedures to provide access within the cavity while minimizing trauma to the patient. After gas is introduced into the patient's body cavity, a sealing box 240 maintains the airflow. The sealing box 240 can be configured, for example, as a removable subassembly or sealing pouch, providing an airtight seal with the cannula 260. The sealing box 240 can be coupled to the cannula 260 to seal the cannula lumen 282 from the environment to maintain airflow into the patient's body cavity. During operation, the sealing box 240 maintains isolation of the patient's body cavity while allowing tools such as the occluder 210 to pass through the channel of the sealing box 240. Furthermore, the sealing box 240 can be sealed against the cannula funnel 262 to maintain airflow into the patient's body cavity. As shown, the sealing box 240 can be located at the proximal portion of the cannula 260. For example, the sealing box 240 can be at least partially located within the funnel portion 262 of the cannula.

[0141] In some applications, the sealing cartridge 240 can be removed from the cannula 260. Optionally, the sealing cartridge 240 and the cannula 260 may have different useful lives facilitated by the removable engagement of the sealing cartridge 240 relative to the cannula 260. For example, the sealing cartridge 240 may be configured as a single-use, disposable device (e.g., made of plastic), while the cannula 260 may be configured to be sterilized and reused (e.g., made of metal). As described herein, a latching mechanism 252 of the sealing cartridge 240 may allow the sealing cartridge 240 to engage with or release from the cannula 260. In some embodiments, the latching mechanism 252 may releasably engage with other portions of the cannula assembly 200.

[0142] According to some implementations, the cannula 260 can be configured for robot enablement. As described, the cannula 260 and the sealing housing 240 assembled therewith can be mated to a robotic manipulator. For example, the cannula 260 can be latched or otherwise attached to a robotic arm and / or instrument actuator to engage the cannula 260 to the robot after removal of the occluder 210. Maturing the cannula 260 to the robot can facilitate robotic manipulation of surgical instruments via the cannula.

[0143] Figure 23 An exemplary cannulation and docking arrangement in the robotic system 100 is shown. Figure 23 The arrangement shown utilizes a compact instrument actuator architecture, in which a robotic actuator is internally coupled to the cannula from the proximal end of the cannula.

[0144] As shown, the instrument actuator 110 may have an accessory or cannula attachment interface 140 on a first side of the instrument actuator 110, which is configured to attach to a cannula 160. The opposite side of the instrument actuator 110 may have an instrument attachment interface 120 configured to connect to a medical device 130. A channel 112 extends through the instrument actuator 110 to allow the instrument shaft 132 to be inserted or retracted through the channel 112. The channel 112 may, for example, be configured to extend through an inner cavity of the instrument actuator 110, the diameter of which is larger than the outer diameter of the instrument shaft 132. The channel 112 allows the instrument shaft 132 to be extended or retracted through the channel 112.

[0145] According to some embodiments, the instrument actuator 110 can be configured to operate a mechanism in the instrument 130 to insert or retract the instrument shaft 132 through the channel 112. For example, one or more drive outputs at the instrument attachment interface 120 of the instrument actuator 110 can operate one or more inputs on the instrument base 134 of the instrument 130. Such inputs can be coupled to draw cables, gears, screws, and / or other mechanisms to convert the rotational motion of the inputs into translational motion of the instrument shaft 132, thereby driving the instrument shaft to translate axially through the instrument actuator 110.

[0146] As described herein, cannula 160 can be configured as an access port that provides access to a patient's body cavity for medical procedures such as laparoscopy. To facilitate the insertion of instrument 130 through the cannula, proximal 161 of cannula 160 can be attached to instrument actuator 110, wherein the axis or working channel 192 of cannula 160 is aligned with channel 112 of instrument actuator 110. Cannula attachment interface 140 can retain cannula 160, wherein a latching mechanism engages cannula 160 directly or through a sterile barrier, such as a sterile drape and / or a sterile adapter.

[0147] Before inserting a tool or instrument into the patient, the cannula 160 may be inserted and / or positioned within the patient's body cavity. The robotic arm may be movable or positioned to allow the instrument actuator 110 and the robotic arm to dock and attach to the cannula 160. After docking with the cannula 160, the cannula attachment interface 140 of the robotic arm can hold the cannula 160 together with the robotic arm or the instrument actuator 110. In some embodiments, the instrument actuator 110 is configured to detect the cannula in order to facilitate docking, determine its presence, and / or identify the cannula using any suitable sensing arrangement.

[0148] Figure 24 An intubation assembly 300 is shown, which includes an intubation cannula 360 and a sealing cartridge 340, wherein the occluder is removed. The intubation assembly 300 can be used with, as described above... Figures 21 to 22 The described cannula assembly 200 and / or Figure 23 The robot docking arrangement shown is used in conjunction with this. The cannula 360 includes a sealing housing 340 that facilitates removable attachment of the cannula 360 without interfering with the robot's capabilities. The cannula assembly 300 may, for example, prevent interference between the sealing housing 340 and a cannula latch on the instrument actuator, which securely engages the cannula 360 in a mechanically robust manner. Alternatively or in combination, the sealing housing 340 may prevent obstruction of cannula detection sensors or sensors that may be employed in the instrument actuator, maintaining a distance from the proximal end of the cannula. Alternatively or in combination, the cannula assembly may facilitate attachment and / or removal of the sealing housing in a user-friendly manner.

[0149] refer to Figure 24 Upon insertion, the cannula 360 provides access to a patient's body cavity. As shown, the cannula 360 includes a shaft 380 extending from the upper portion or funnel 362 of the cannula 360. The shaft 380 defines an axial lumen therein that provides access between an end portion 384 and the cannula funnel 362. As described herein, the end portion 384 of the shaft 380 can be advanced into a patient's body cavity to allow access through the funnel 362.

[0150] During surgical procedures, the axial lumen allows instruments to enter the patient's body cavity. The axial lumen may have a generally circular inner cross-sectional profile to allow the instrument to rotate within it. The axial lumen may have an inner diameter suitable for allowing the instrument to pass through it. The shaft 380 may also have a generally circular outer cross-sectional profile to allow the cannula 360 to rotate relative to the patient's body cavity.

[0151] The funnel portion 362 has an increased inner diameter, which results in a narrowing of the inner diameter defined by the lumen of the cannula shaft 380. This increased geometry facilitates the insertion of tools and / or sealing cartridges into the proximal portion of the cannula 360. For example, during the insertion of tools (such as occluders 210 and / or instruments 130), the geometry of the funnel 362 can guide the tool shaft into the shaft lumen. In some embodiments, the funnel 362 may include a stepped geometry. As shown, the funnel 362 may include an upper funnel portion 363a and a lower funnel portion 363b. The lower funnel portion 363b may have a reduced diameter relative to the upper funnel portion 363a. Optionally, the funnel 362 may include a transition portion 363c between the upper tapering portion 363a and the lower tapering portion 363b.

[0152] The sealing box 340 can be connected to the cannula 360 via the funnel portion 362. The geometry of the funnel 362 allows devices such as the sealing box 340 to be disposed within the funnel 362 of the cannula 360. For example, as Figure 24 As can be seen, the sealing box 340 can be located within the funnel portion 362 of the cannula 360, so that the sealing box does not protrude beyond the proximal end of the cannula 360.

[0153] like Figure 24 As shown, when the sealing box 340 is located within the funnel 362, the funnel wall of the funnel 362 can extend beyond the sealing box 340 to allow the sealing box 340 to be recessed within the funnel 362. As will be understood, by recessing the sealing box 340 within the cannula 360, the sealing box 340 allows the proximal end of the cannula 360 to be securely attached and mated with other components, such as the occluder 210 and / or the robotic arm. Although shown in a recessed arrangement, it is also contemplated that, in an assembled or coupled configuration, the proximal end of the sealing box 340 can be substantially flush with the proximal end of the cannula 360. Furthermore, it is contemplated that, when assembled with the cannula 360, certain principles of this disclosure can be applied to embodiments in which the sealing box 340 proximally protrudes beyond the proximal end of the cannula funnel portion 362.

[0154] Fluids, such as blown gas, can be introduced into a patient's body cavity via a fluid port 365 of the cannulation assembly 300. Some examples of gases that can be introduced via the fluid port 365 to inflate the abdominal cavity include carbon dioxide and air. Alternatively or in combination, the fluid port 365 can be configured to introduce or transfer other fluids, such as saline, liquids, or other fluid media, for irrigation, expansion of orthopedic joints, or expansion of other patient body cavities. In some embodiments, the fluid port may be formed within the cannula. In the depicted example, the fluid port 365 is formed within a sealing housing 340. As shown, the fluid port 365 is attached to and extends from the body of the sealing housing 340. In some embodiments, the fluid port 365 extends radially from the body of the sealing housing 340. When the sealing housing and the cannula are coupled together in an assembled configuration, the fluid port 365 can be in fluid communication with the lumen of the cannula. The fluid port 365 can be configured as a valve, such as a stop plug, which allows flow through the port to be opened, closed, or otherwise controlled. In the depicted example, fluid port 365 includes a lever 366 that can be manually controlled by a user to open and close the port. Fluid port 365 is also shown with a connector interface 369, such as a Luer fitting, which allows for the connection or removal of a blow-in line or other fluid conduit from cannulation assembly 300 as needed.

[0155] The funnel 362 may include features that allow the sealing box 340 to be held or otherwise attached to the funnel 362. As shown, the sealing box 340 includes a latching mechanism 330 that can engage features of the funnel portion 362 to secure the sealing box 340 to the cannula 360. The latching mechanism 330 includes one or more release buttons 338 that can be operated to release the latching mechanism 330 and disengage the sealing box from the cannula 360.

[0156] The cannula 360 includes features along a sidewall 391 that allow access to portions of the sealing box via the sidewall. In some applications, the engagement or latching mechanism of the sealing box 340 may be accessed via one or more windows or gaps 370 formed through the funnel wall. For example, the gap 370 may be configured as a latching window that allows the user to actuate a release button 338 via the sidewall 391. In some embodiments, the funnel 362 may include two opposing latching windows 370 arranged radially intersecting each other to allow access to two opposing release buttons 338 of the sealing box 340. As shown, the latching windows 370 may be formed by the funnel wall of the upper funnel portion 363a. Optionally, the funnel 362 may include additional latching windows or gaps arranged at various intervals along the cannula, such as various angular orientations along the sidewall 391. The latching windows 370 may have any shape that can accommodate and allow access to portions of the latching mechanism, such as the release button 338. In some implementations, the latch window 370 is larger or wider than the release button 338. A wider window can, for example, provide tolerances in the direction of rotation in which the sealing box 340 can be assembled to the cannula 360, while still allowing access to the release button 338 through the latch window when the sealing box is assembled around the longitudinal axis of the cannula with different rotational or angular orientations.

[0157] Alternatively, or in combination with a latching mechanism gap, the cannula 360 may include one or more gaps 371 to allow the fluid port 365 of the sealing box 340 to extend through the funnel wall. Advantageously, by allowing the fluid port 365 of the sealing box 340 to extend through the funnel wall, the sealing box 340 may be recessed within the funnel 362 while allowing access to the fluid port 365 for blow-in.

[0158] Figures 25A to 25D It shows the various assembly states. Figure 24 The cannulation assembly 300. (Reference) Figures 25A to 25D During insertion of the sealing box 340 into the cannula 360, the sealing box 340 may pivot or tilt to allow the fluid port 365 to enter the window 370 before latching or otherwise engaging the sealing box 340 within the cannula. For example, the sealing box 340 may be pressed... Figures 25A to 25D The sequence shown pivots or tilts into the funnel portion 362 of the cannula 360. During removal of the sealing cartridge 340, the sealing cartridge 340 can be disengaged by actuating the release button 338 and then pivoted to allow the fluid port 365 to pass through the window after the opposite portion of the sealing cartridge 340 has been removed. For example, the sealing cartridge 340 can be pressed against... Figures 25A to 25D The sequence shown is reversed, pivoting or tilting away from the funnel portion 362 of the cannula 360.

[0159] Figure 26 and Figure 27A cross-section of the cannulation assembly 300 is shown. Figure 26 It is the cross-section taken through the sealing latch mechanism 330. Figure 27 It is a cross-section taken through the fluid port 365.

[0160] refer to Figure 26 and Figure 27 The sealing box 340 can be latched or otherwise engaged with the cannula 360. In the depicted example, the sealing box 340 includes a latching mechanism 330 to retain or otherwise engage the sealing box 340 with the cannula 360. As shown, the latching mechanism 330 extends from the sealing box 340 to engage with the cannula 360 to retain the sealing box 340 with the cannula 360. In the depicted example, the latching mechanism 330 includes a latching hook 354 extending from the latching mechanism 330. The latching hook 354 can engage with features of the funnel 362, such as a snap-fit ​​feature 364. The snap-fit ​​feature 364 can be, for example, as... Figure 26 As shown, the inner protruding lip extends radially inward within the funnel portion 362. As shown, the latch hook 354 can engage the funnel at the transition portion 363c. The latch hook 354 also includes, for example, an introduction surface at its distal end to facilitate engagement of the sealing box 340 by moving the sealing box 340 distally until the latching mechanism engages.

[0161] like Figure 27 As shown, the cannula funnel portion 360 may further include a flange, lip, or stop member 390, which prevents the sealing box from being excessively pressed down in the distal direction when the sealing box 340 impacts the stop member 390. In the illustrated example, the stop member 390 is also provided at the transition portion 363c.

[0162] The release button 338 can be inserted through the cannula sidewall 391 via a gap 370 extending through the sidewall. For example... Figure 26 As seen in the example, the latching mechanism may include a pair of opposing release buttons 338 on radially opposite sides of the cannula funnel portion 362, and the cannula funnel portion 362 may include a pair of corresponding gaps to allow access to the release buttons 338. As will be understood, a clinician may press the release buttons 338 to disengage the latching mechanism 330 from the cannula 360 to remove the sealing cartridge 340. Optionally, the release buttons 338 may include ridged or recessed portions to facilitate engagement of the release buttons 338 by the clinician.

[0163] In some embodiments, the latching mechanism 330 is biased outward to extend and engage the cannula 360. Optionally, for example, as shown in the figure... Figure 26As can be seen, the biasing member can be configured as a compliant tab or flexure integrated with the latching mechanism to abut against the radially outward biasing hook feature 354 of the insertion funnel portion. In the depicted example, pressing the release button 338 actuates the latch from an outward or engaged position to an inward or disengaged position.

[0164] It should be understood that although a specific form of the latching mechanism is shown, various modifications can be made to it. For example, although hook and snap engagement features are shown on the sealing box and the insertion tube respectively, these features can be reversed, or the engagement features for securing the latch can take other forms or geometries. Alternatively, although a biasing mechanism based on a compliant flexural portion is shown, coil springs, magnets, or other types of biasing members can be used. Alternatively, although the latch release device is shown as being constructed as a button, it is conceivable that a slider or other type of contact point can provide a release mechanism for disengaging the sealing box from the funnel portion.

[0165] Tools such as occluders may be disposed on the top or proximal surface of the sealing housing 340. In the illustrated embodiment, the sealing housing 340 may include one or more latch slots 356 to allow the occluder to engage with the sealing housing 340. In some embodiments, the latching mechanism of the occluder may extend into the latch slot 356 to engage the occluder with the sealing housing 340.

[0166] In the depicted example, the sealing box 340 allows the tool to extend through the axial lumen of the cannula 360 while maintaining airflow into the patient's body cavity. In the depicted example, the sealing box 340 defines a central lumen 342 to allow the tool to pass through the sealing box 340 and into the axial lumen of the cannula 360.

[0167] like Figure 26 and Figure 27 As can be seen, the sealing box 340 includes a sealing system to maintain an airtight seal within the lumen of the cannula. The sealing box 340 includes an inner seal 343 disposed within a central lumen 342 to maintain airflow into the patient's body cavity. During operation, the inner seal 343 prevents gas from escaping through the central lumen 342. The inner seal 343 can conform to the axis of an instrument, such as a occluder axis, to prevent gas from escaping when the instrument passes through the sealing box 340. As will be understood, the inner seal 343 can also seal the central lumen 342 in the absence of an instrument passing through it. The inner seal 343 can be formed of an elastomer or other elastic material, including but not limited to rubber, polymers, etc. In some applications, the inner seal 343 may include an upper sealing portion 343a that seals against the tool axis when the tool is present, and a lower sealing portion 343b that provides a seal when the tool is absent. The lower sealing portion 343b can be implemented, for example, as a duckbill valve.

[0168] In some embodiments, the sealing cartridge 340 includes an outer sealing member 345 disposed around the outer surface of the sealing cartridge 340 to maintain airflow into the patient's body cavity. During operation, the outer sealing member 345 prevents gas from escaping between the sealing cartridge 340 and the funnel 362 of the cannula 360. The outer sealing portion 345 may conform to the funnel wall of the funnel 362 to prevent gas escape. The outer sealing member 345 may be formed of an elastomer or other elastic material, including but not limited to rubber, polymers, etc. In the depicted example, the outer sealing member 345 is configured as an O-ring.

[0169] Figures 28 to 31 Various configurations of the openings that can be incorporated into the cannulation funnel section to allow access to the sealing box are shown.

[0170] Figure 28 A perspective view of a cannula 460, which can be used with the sealing cartridge or cannula assembly as described above, is shown. In the depicted example, the fluid port window 471 includes features that further facilitate alignment of the sealing cartridge within the funnel.

[0171] As shown, the fluid port window 471 includes a notch 473 to receive the fluid port of the sealing cartridge. Advantageously, the notch 473 allows the sealing cartridge to be rotatably aligned relative to the cannula 460. As shown, the notch 473 may be located at the lower edge of the fluid port window 471 to provide tactile feedback when the fluid port falls into the notch 473. In some embodiments, the sealing cartridge may be further recessed into the funnel 462 when the fluid port falls into the notch. During insertion, the notch 473 can prevent or resist rotation of the sealing cartridge from the aligned position and loss of alignment. The notch 473 may have a generally semi-circular profile to receive the fluid port.

[0172] Alternatively or concurrently, the notched fluid port window 471 can provide a visual indicator for clinicians to identify the fluid port window 471 relative to other latch windows 470. Furthermore, clinicians can orient the sealing box based on the position of the fluid port window 471 for insertion into the cannula 460. Advantageously, by allowing identification of the fluid port window 471, the sealing box can be installed quickly.

[0173] Figure 29 A perspective view of a cannula 560 that can be used with the sealing cartridge or cannula assembly as described above is shown. In the depicted example, the cannula 560 may be configured to receive the sealing cartridge in multiple rotational orientations.

[0174] As shown, funnel 562 includes a plurality of gaps or windows 570 formed through the funnel wall to allow the latching mechanism or fluid port of the sealing box to extend through the funnel wall. In some embodiments, each window 570 may have the same size, thereby allowing the latching mechanism or fluid port to extend through any window. In some embodiments, the sealing box may be introduced and engaged relative to the cannula 560 in various rotational arrangements. Optionally, the windows 570 are arranged symmetrically. In some embodiments, the windows 570 are larger than the latching mechanism of the sealing box, thereby allowing the sealing box to rotate within funnel 562 while remaining engaged or otherwise axially retained.

[0175] In the depicted example, each window 570 includes a notch 573 to receive the fluid port of the sealing box. As described herein, the notch 573 allows the sealing box to be rotatedally aligned relative to the cannula 560 by aligning the fluid port within the respective window 570. Thus, the sealing box can be inserted in various rotational orientations, allowing the fluid port of the sealing box to extend through any of the windows 570 and fall within the respective notch 573, thereby aligning the fluid port and, consequently, the sealing box relative to the window 570. In another example, each port can be arranged symmetrically without a notch in each window. In the depicted example, four windows are included to facilitate engagement with the sealing box, wherein the sealing box has a fluid port offset by 90 degrees relative to a pair of opposing sealing latch buttons. Advantageously, by allowing various rotational orientations of the sealing box relative to the cannula 560, the sealing box can be installed more quickly.

[0176] Figure 30 and Figure 31 Each shows a perspective view of a cannula 660 that can be used with the sealing box or cannula assembly as described above. Figure 30 The cannula and sealing box are shown in an unconnected configuration, while Figure 31 It shows Figure 30 The cannula 660, in which the sealing box is connected to the cannula. (Reference) Figure 30 and Figure 31 In some embodiments, cannula 660 may include an axially extending slot 671 to allow the fluid port 665 of the sealing cassette 640 to extend through the funnel wall. As shown, slot 671 may extend from the proximal end of funnel 662 and distally from edge 672, and through at least a portion of the funnel wall. Slot 671 may form discontinuities in the circular profile of edge 672 and funnel wall. As will be understood, slot 671 may rotatably guide the sealing cassette 640 as it is inserted into funnel 662 to rotatably align the sealing cassette 640 relative to cannula 660. Advantageously, the sealing cassette 640 can be inserted into cannula 660 without pivoting or tilting.

[0177] Similar to cannula 560, cannula 660 may include a plurality of gaps or windows 670 formed through the funnel wall to allow the latching mechanism of sealing box 640 to extend through the funnel wall. As shown, windows 670 may be positioned approximately 180 degrees apart from each other. Furthermore, windows 670 may be evenly spaced relative to slot 671, such that each window 670 is positioned approximately 90 degrees apart from slot 671. In some embodiments, windows 670 may be configured to allow various rotational arrangements of sealing box 640 relative to cannula 660.

[0178] As should be understood from the foregoing examples, this disclosure envisions various features that can be employed in cannulation assemblies. In some embodiments, the cannula includes a funnel portion having sidewalls, a tubular portion extending distally from the funnel portion, and one or more gaps in the sidewalls of the funnel portion that allow access through the sidewalls to a sealed box.

[0179] In some embodiments, the cannula includes a funnel portion having sidewalls and a circular periphery, a tubular portion extending distally from the funnel portion, and a box slot formed in the funnel portion, the box slot including a discontinuity in the edge of the funnel portion that opens into a gap in the sidewall of the funnel portion to allow fluid to enter the sealed box through the sidewall.

[0180] In some embodiments, the method of assembling the cannula assembly includes: inserting a fluid port of a sealing box through a gap in a funnel portion of the cannula, the funnel portion having sidewalls and a tubular portion extending distally from the funnel portion, the gap in the funnel portion extending through the sidewalls of the funnel portion; and attaching the sealing box to the cannula within the funnel portion.

[0181] In some implementations, the cannula assembly may be configured to allow a tool (such as a occluder) to latch directly onto the cannula. Figure 32 A perspective view of the cannula assembly 700 in its assembled state is shown. Figure 33 It shows a semi-assembled state. Figure 32 A perspective view of the cannula assembly 700. Figure 34 It shows the state of decomposition. Figure 32 A perspective view of the cannula assembly 700. As will be understood, the cannula assembly 700 may include features similar to those of the cannula assembly 200. Therefore, unless otherwise stated, similar features may be referenced using similar reference numerals.

[0182] In the depicted example, the latching mechanism 730 of the occluder 710 allows the occluder 710 to engage with or disengage from the cannula 760. In some embodiments, the latching mechanism 730 may extend from the upper portion 720 of the occluder 710 to releasably engage with other portions of the cannula assembly 700. In some embodiments, the latching mechanism 730 includes one or more release buttons 738 that can be operated to release the latching mechanism 730 and disengage the occluder from the cannula 760.

[0183] In the illustrated embodiment, the latching mechanism 730 may extend into the latching window 770 defined in the cannula 760 to engage the occluder 710 with the cannula 760. The latching mechanism 730 of the occluder 710 may be outwardly biased to maintain engagement between the occluder 710 and the cannula 760 or other portions of the trocar assembly 700.

[0184] In some applications, the cannula assembly 700 can allow for the blowing into a patient's body cavity during the procedure to provide access within the patient's body cavity while minimizing trauma to the patient. In the depicted example, gas can be introduced into the patient's body cavity via a gas port 765 formed in the cannula 760; however, the gas port 765 can alternatively be configured as part of a removable sealing cartridge 740, as described previously. Figures 24 to 31 In some implementations, the gas port 765 is in fluid communication with the cannula lumen 782.

[0185] The cannula assembly 700 may include a sealing box 740 to maintain airflow into the patient's body cavity after gas has been introduced. The sealing box 740 may be coupled to the cannula 760 to seal the cannula lumen 782 from the environment to maintain airflow into the patient's body cavity. During operation, the sealing box 740 maintains isolation of the patient's body cavity while allowing tools such as an occluder 710 to pass through its channels. Furthermore, the sealing box 740 may be sealed against the cannula funnel 762 to maintain airflow into the patient's body cavity. As shown, the sealing box 740 may be seated within the funnel portion 762 of the cannula 760. In some embodiments, the sealing box 740 is completely seated within the funnel portion 762 and does not extend beyond it.

[0186] In some applications, the sealing cartridge 740 can be removed from the cannula 760. As described herein, the sealing cartridge 740 and the cannula 760 can have different useful lives facilitated by the removable engagement of the sealing cartridge 740 relative to the cannula 760. For example, the sealing cartridge 740 can be configured as a single-use, disposable device, while the cannula 760 can be configured to be sterilized and reused. In some applications, when the sealing cartridge 740 is removed from the cannula 760, the blown gas is released from the patient's body cavity. As can be understood, it is undesirable to unintentionally or otherwise prematurely release the blown gas from the patient's body cavity, as loss of blown gas may increase patient trauma and reduce access within the patient's body cavity.

[0187] As described herein, the latching mechanism 752 of the sealing cartridge 740 allows the sealing cartridge 740 to be engaged with or released from the cannula 760. In some embodiments, the latching mechanism 752 may releasably engage with other portions of the cannula assembly 700. In the illustrated embodiment, the latching mechanism 752 may extend from the body of the sealing cartridge 740 into a latching window 770 defined in the cannula 760 to engage the sealing cartridge 740 with the cannula 760. The latching mechanism 752 of the sealing cartridge 740 may be outwardly biased to maintain engagement between the occluder 710 and the sealing cartridge 740. In some embodiments, the occluder 710 may latch to the sealing cartridge 740.

[0188] In some embodiments, the latching mechanism 752 includes one or more release buttons 758 that can be operated to release the latching mechanism 752 and disengage the sealing cartridge 740 from the cannula 760. Optionally, the release button 738 of the occluder 710 can be rotatably aligned with the release button 758 of the sealing cartridge 740.

[0189] Advantageously, the cannula assembly 700 is configured to prevent unintentional removal of the sealing cartridge 740, thereby preventing unintentional loss of the cannula during blow-in. In the depicted example, when the occluder 710 is engaged with the cannula 760, the sealing cartridge 740 is held between the upper portion of the occluder 710 and the cannula funnel 762. Therefore, the sealing cartridge 740 cannot be unintentionally removed from the cannula 760 before the occluder 710 is removed from the cannula 760.

[0190] Figure 35 It shows Figure 32A perspective view of the cannula of the cannula assembly. In the depicted example, the geometry of the funnel 762 allows various parts of the tool, such as the occluder 710 and / or the sealing box 740, to be at least partially disposed within the funnel 762 of the cannula 760. As will be understood, by disposing parts of the occluder 710 and / or the sealing box 740 within the funnel 762, the occluder 710 and / or the sealing box 740 can move together with the cannula 760 and reduce the assembled size of the cannula assembly 700. In some embodiments, the occluder 710 and / or the sealing box 740 can be coupled to the cannula 760 via the funnel 762.

[0191] In some embodiments, the sealing box 740 may be disposed within the lower tapering portion 763b and a portion of the upper tapering portion 763a of the funnel 762. For example... Figure 33 As shown, when the sealing box 740 is located within the funnel 762, the funnel wall of the funnel 762 can extend beyond the sealing box 740 to allow the sealing box 740 to be recessed into the funnel 762. In some embodiments, the sealing box 740 can extend beyond the funnel 762.

[0192] In some embodiments, funnel 762 may include features that allow the sealing box 740 to be retained or otherwise engaged with funnel 762. For example, in some applications, an engagement or latching mechanism of the sealing box 740 may engage the transition portion 763c of funnel 762 to axially retain the sealing box 740 within funnel 762. Optionally, the sealing box 740 may engage with a recess or protrusion of the transition portion 763c.

[0193] In some applications, the engagement or latching mechanism of the sealing box 740 may engage with a latching window 770 formed through the funnel wall. For example, the latching mechanism of the sealing box 740 may extend through the latching window 770 of the cannula 760 to retain the sealing box 740 within the cannula 760. In some embodiments, the funnel 762 may include two latching windows 770 arranged radially intersecting each other. As shown, the latching windows 770 may be formed through the funnel wall of the upper tapering portion 763a. Optionally, the funnel 762 may include additional latching windows 770 arranged at various intervals. The latching windows 770 may have a generally rectangular shape. As will be understood, the sealing box 740 may engage with other portions of the cannula 760 and / or other components of the cannula assembly 700.

[0194] Furthermore, the upper portion or head portion 720 of the occluder 710 may be at least partially disposed within the upper tapering portion 763a of the funnel 762. In some embodiments, the funnel 762 may include features that allow the occluder 710 to be held or otherwise engaged with the funnel 762. For example, in some applications, the engagement or latching mechanism of the occluder 710 may releasably engage the edge 772 of the funnel 762 to axially retain the occluder 710 relative to the cannula 760. The occluder 710 may engage a protruding portion of the edge 772. Optionally, the edge 772 may include a recessed portion 773 to accommodate features of the engagement or latching mechanism of the occluder 710.

[0195] In some applications, the engagement or latching mechanism of the occluder 710 may also engage with a latching window 770 formed through the funnel wall. For example, the latching mechanism of the occluder 710 may extend through the latching window 770 of the cannula 760 to retain the occluder 710 relative to the cannula 760. Optionally, the edge 772 of the cannula 760 may define an edge or boundary of the latching window 770. As will be understood, the occluder 710 may engage with other portions of the cannula 760 and / or other components of the cannula assembly 700.

[0196] As described herein, the cannula 760 allows for the insufflation of a patient's body cavity. In the depicted example, the cannula 760 includes a gas port 765 formed in the lower portion of the funnel 762, which allows gas to flow into the shaft cavity 782. In some embodiments, the gas port 765 is in fluid communication with the shaft cavity 782. The gas port 765 can be sealed or isolated from the upper portion of the funnel 762 by a sealing housing 740.

[0197] Figure 36 It shows the use of with Figure 32 A perspective view of another embodiment of the cannula used in conjunction with the cannula needle assembly. Similar to cannula 760, cannula 760' allows the engagement or latching mechanism of occluder 710 to releasably engage the edge 772' of funnel 762 to axially retain occluder 710 relative to cannula 760'. In the depicted example, edge 772' can maintain a constant thickness or inner diameter on the circumference of edge 772'.

[0198] Figure 37 It shows Figure 32 A perspective view of the sealing box of the cannula assembly. In the depicted example, the sealing box 740 allows the tool to pass through the axial lumen 782 of the insertion cannula 760 while maintaining airflow into the patient's body cavity.

[0199] In the depicted example, the sealing box 740 defines a central cavity 742 to allow a tool (such as a occluder 710) to pass through the sealing box 740 and enter the axial cavity 782 of the cannula 760.

[0200] In some embodiments, the sealing cartridge 740 includes an inner sealing member 743 disposed within the central cavity 742 to maintain airflow into the patient's body cavity. During operation, the inner sealing member 743 prevents gas flow from escaping through the central cavity 742. The inner sealing member 743 may conform to an axis of an tool, such as a occluder axis 712, to prevent gas flow from escaping when the tool passes through the sealing cartridge 740. As will be understood, the inner sealing member 743 may expand to seal the central cavity 742 in the absence of a tool passing through it. The inner sealing member 743 may be formed of an elastomer or other elastic material, including but not limited to rubber, polymers, etc. In some applications, the inner sealing member 743 may be implemented as a duckbill valve.

[0201] In some embodiments, the sealing cartridge 740 includes an outer sealing member 745 disposed around the outer surface of the sealing cartridge 740 to maintain airflow into the patient's body cavity. During operation, the outer sealing member 745 prevents gas from escaping between the sealing cartridge 740 and the funnel 762 of the cannula 760. The outer sealing member 745 may conform to the funnel wall of the funnel 762 to prevent gas escape. The outer sealing member 745 may be formed of an elastomer or other elastic material, including but not limited to rubber, polymers, etc.

[0202] Figure 38 It shows Figure 32 A perspective view of the occluder of the cannula assembly.

[0203] In the depicted example, the occluder 710 can displace tissue to allow the cannula assembly 700 to be inserted into a patient's body cavity. As shown, the occluder 710 includes a shaft 712 extending from the upper portion 720 of the occluder 710. In some applications, when the occluder 710 is coupled to a cannula 760, the shaft 712 may extend beyond the end portion 784 of the cannula 760. The shaft 712 may have a generally cylindrical shape, which allows the occluder 710 to rotate within the patient's body cavity.

[0204] The shaft 712 may include a tapered, beveled, or otherwise arrow-shaped end or tip 714. During operation, by advancing the occluder 710, the shaft 712 may puncture, displace, or otherwise dissect patient tissue to allow the occluder 710 and the coupled cannula 760 into the patient's body cavity.

[0205] Optionally, the clinician can use the upper portion 720 as a handle to typically apply force or otherwise advance the occluder 710 and / or the cannula assembly 700. As shown, the upper portion 720 of the occluder 710 may have a radius generally larger than the shaft 712 to allow the clinician to easily apply more force to the shaft 712. Furthermore, the upper portion 720 may include a gripping portion or a planar surface to allow the clinician to advance the occluder 710. In some embodiments, as described herein, when the occluder 710 is also coupled to the cannula 760, the increased geometry of the upper portion 720 can retain the sealing cartridge 740 within the cannula 760.

[0206] Figure 39 It shows Figure 32 A perspective view of the latching mechanism of the occluder and the latching mechanism of the sealing box of the cannula assembly. Figure 40 It shows Figure 32 A cross-sectional view of the cannula assembly, with the latching mechanism of the occluder shown in the engaged position. (Reference) Figure 39 and Figure 40 The sealing box 740 and the occluder 710 can be latched or otherwise engaged with the cannula 760.

[0207] In the depicted example, the sealing box 740 includes a latching mechanism 752 for holding or otherwise engaging the sealing box 740 with the cannula 760. As shown, the latching mechanism 752 extends from the sealing box 740 to engage with the cannula 760 to hold the sealing box 740 together with the cannula 760. In some embodiments, the latching mechanism 752 includes a latching hook 754 extending from the latching mechanism 752. The latching hook 754 may engage features of the funnel 762, such as a transition portion 763c, to engage the cannula 760.

[0208] The latching mechanism 750 may further include an extension 753. The extension 753 may engage with features of the funnel 762. For example, the extension 753 may extend through a latching window 770 of the cannula 760. In some embodiments, the latching mechanism 752 includes a biasing member to bias the latching mechanism 752 outward to extend and engage the cannula 760. Optionally, the biasing member may be integral with the latching mechanism.

[0209] As will be understood, a clinician may depress the extension 753 to disengage the latching mechanism 752 from the cannula 760 to remove the sealing cartridge 740. Optionally, the extension 753 may include a ridged or recessed portion to allow the clinician to engage the latching mechanism 752. In some embodiments, portions of the sealing cartridge 740 may extend over the cannula funnel 762 to engage or otherwise latch with the outer edge 772 of the cannula edge or other features of the cannula 760.

[0210] In the depicted example, the occluder 710 includes a latching mechanism 730 for holding or otherwise engaging the occluder 710 with the cannula 760. As shown, the latching mechanism 730 extends from the occluder 710 to engage with the cannula 760 to hold the occluder 710 with the cannula 760. In some embodiments, the latching mechanism 730 includes a latching hook 734 extending from the latching mechanism 730. The latching hook 734 may engage features of the funnel 762, such as an edge 772, to engage the cannula 760.

[0211] The latching mechanism 730 may further include an extension 732. The extension 732 may engage with features of the funnel 762. For example, the extension 732 may extend through a latching window 770 of the cannula 760. In some embodiments, the latching mechanism 730 includes a biasing member to bias the latching mechanism 730 outward to extend and engage the cannula 760. Optionally, the biasing member may be integral with the latching mechanism.

[0212] As shown, the latching mechanism 730 of the occluder 710 and the latching mechanism 752 of the sealing cartridge 740 are rotatably aligned. This rotatable alignment allows the windows 770 to serve a dual purpose: they not only provide access to the sealing cartridge release button but also function as features in the cannula funnel 762 that can engage with the latch hook 734 of the latching mechanism 730 of the occluder 710. This avoids the need to fabricate additional latching features on the cannula funnel 762 for engaging the latching mechanism 730 of the occluder 710. In some embodiments, the latching mechanism 730 of the occluder 710 and the latching mechanism 752 of the sealing cartridge 740 are rotatably spaced apart.

[0213] In some applications, because the occluder 710 latches directly to the cannula 760, the cannula assembly 700 can be configured to prevent unintentional removal of the sealing cartridge 740, thereby preventing unintentional blow-in loss. In the depicted example, when the occluder 710 is engaged with the cannula 760, the upper portion 720 of the occluder 710 retains the sealing cartridge 740 within the funnel 762, thereby preventing the sealing cartridge 740 from being removed from the cannula 760 before the occluder 710 is removed from the cannula 760. As will be understood, the occluder 710 can retain the sealing cartridge 740 within the funnel 762 if the latching mechanism 752 of the sealing cartridge 740 is unintentionally released. In some embodiments, portions of the occluder 710 can extend over the cannula funnel 762 to engage or otherwise latch with the outer edge of the cannula edge 772 or other features of the cannula 760.

[0214] Figure 41 It shows Figure 32 A cross-sectional view of the cannula assembly, with the latching mechanism of the occluder shown in the disengaged position. (Reference) Figure 41 The clinician can depress the extension 732 of the latching mechanism 730 to disengage the latching mechanism 730 from the cannula 760 to remove the occluder 710. Optionally, the extension 732 may include a ridged or recessed portion to allow the clinician to engage the latching mechanism 730. After disengaging the occluder 710 from the cannula 760, the clinician can depress the extension 753 to disengage the latching mechanism 752 from the cannula 760 to remove the sealing cartridge 740. Optionally, the sealing cartridge 740 and the occluder 710 are removed together from the cannula 760.

[0215] Figure 42 A perspective view of the cannula assembly 800 is shown. Figure 43 yes Figure 42 Cross-sectional view of the cannula assembly 800. Figure 42 and Figure 43 The cannula assembly may include features similar to those of cannula assembly 200. Similar features of cannula assembly 800 may be referenced using similar reference numerals. As described herein, a latching mechanism 852 of the sealing cartridge 840 may allow the sealing cartridge 840 to be engaged with or released from the cannula 860. In some embodiments, the latching mechanism 852 may releasably engage with other portions of the cannula assembly 800. In the illustrated embodiment, the latching mechanism 852 may extend from the body of the sealing cartridge 840 into a latching window 870 defined in the cannula 860 to engage the sealing cartridge 840 with the cannula 860. In some embodiments, the latching mechanism 852 includes a latching hook 854 extending from the latching mechanism 852. The latching hook 854 may engage features of the funnel 862, such as a transition portion 863c, to engage the cannula 860.

[0216] The latching mechanism 852 may further include an extension 853. The extension 853 may engage with a feature of the funnel 862. In the depicted example, the extension 853 is movable between an extended or engaged position and a retracted or disengaged position.

[0217] Figure 44 yes Figure 42 A detailed cross-sectional view of the cannula assembly 800, wherein the latching mechanism 852 is in a free state. Figure 45 yes Figure 42 A detailed cross-sectional view of the cannula assembly 800, wherein the latching mechanism 852 is in a depressed state. In the free or extended position, the extension portion 853 may extend through the latch window 870 of the cannula 860. In some embodiments, the latching mechanism 852 includes a biasing member to bias the latching mechanism 852 outward to extend and engage the cannula 860. Optionally, the biasing member may be integral with the latching mechanism.

[0218] In the retracted or depressed position, the extension 853 may be retracted or spaced apart relative to the latch window 870 of the cannula 860. As will be understood, a clinician may depress the extension 853 to disengage the latch mechanism 852 from the cannula 860 to remove the sealing cartridge 840. Optionally, the extension 853 may include a ridged or recessed portion to allow the clinician to engage the latch mechanism 852.

[0219] As shown, during actuation, the extension portion 853 of the latching mechanism 852 can be restricted to rotate or pivot between an extended position and a retracted position. In some embodiments, the extension portion 853 can rotate inward or upward from the extended position to the retracted position. As shown, the upper portion 855 of the extension portion 853 can rotate upward as the extension portion 853 moves from the extended position to the retracted position.

[0220] Similar to other embodiments, a tool such as a stopper may be positioned on the top or proximal surface of the sealing housing 840. In the illustrated embodiment, the sealing housing 840 may include one or more latching slots 856 to allow the stopper to engage with the sealing housing 840. In some embodiments, the latching mechanism of the stopper may extend into the latching slot 856 to engage the stopper or other tool with the sealing housing 840.

[0221] Advantageously, the sealing box 840 is configured to prevent unintentional removal of the sealing box 840 during removal of the occluder or other tool, thereby preventing unintentional loss of the blown-in material. In the depicted example, when the occluder or other tool is engaged with the sealing box 840, the latching mechanism 852 of the sealing box 840 prevents the sealing box 840 from being removed from the cannula 860. Therefore, the sealing box 840 cannot be unintentionally removed from the cannula 860 before the occluder is removed from the cannula 860.

[0222] In the depicted example, the sealing box 860 prevents the latching mechanism 852 from being pressed down or otherwise actuated before the stopper or other tool is removed from the sealing box 840. As shown, when the stopper is engaged with the sealing box 840, the inner surface of the stopper prevents the extension 853 of the latching mechanism 852 from rotating upward, thereby preventing the extension 853 from moving to the retracted position and preventing the latching mechanism 852 from releasing the sealing box 840.

[0223] As can be understood, when disengaging the occluder from the sealing cartridge 840, the clinician may depress the extension 853 to disengage the latching mechanism 852 from the cannula 860 to remove the sealing cartridge 840.

[0224] 3. Implementation System and Terminology

[0225] The specific embodiments disclosed herein provide systems, methods, and apparatus for operatively connecting occluders and cannulas.

[0226] It should be noted that, as used herein, the terms “couple,” “coupling,” “coupled,” or other variations of the word “couple” can indicate an indirect or direct connection. For example, if a first component is “coupled” to a second component, the first component may be indirectly connected to the second component or directly connected to the second component via another component.

[0227] The methods disclosed herein include one or more steps or actions for implementing the methods. The method steps and / or actions may be interchanged without departing from the scope of the claims. In other words, the order and / or use of specific steps and / or actions may be modified without departing from the scope of the claims unless proper operation of the described method requires a specific order of steps or actions.

[0228] As used herein, the term "multiple" means two or more. For example, multiple components indicates two or more components. The term "determine" encompasses a variety of actions, and therefore, "determine" can include calculation, operation, processing, derivation, investigation, lookup (e.g., searching in a table, database, or another data structure), ascertainment, etc. Additionally, "determine" can include receiving (e.g., receiving information), accessing (e.g., accessing data in memory), etc. Furthermore, "determine" can include parsing, selecting, picking, building, etc.

[0229] Unless otherwise explicitly stated, the phrase “based on” does not mean “based on only”. In other words, the phrase “based on” describes both “based on only” and “based on at least”.

[0230] The foregoing description of the disclosed specific embodiments is provided to enable any person skilled in the art to make or use the invention. Various modifications to these specific embodiments will be readily apparent to those skilled in the art, and the general principles defined herein may be applied to other specific embodiments without departing from the scope of the invention. For example, it should be understood that those skilled in the art will be able to employ numerous corresponding alternatives and equivalent structural details, such as equivalent means of fastening, mounting, connecting, or engaging tool components, equivalent mechanisms for generating specific actuating movements, and equivalent mechanisms for delivering electrical energy. Therefore, the invention is not intended to be limited to the specific embodiments shown herein, but is endowed with the broadest scope consistent with the principles and novel features disclosed herein.

Claims

1. A cannula assembly, comprising: The cannula includes a first window that allows entry through the side wall of the cannula; A sealing box, configured to be releasably coupled to the cannula in a coupling configuration and at least partially disposed within the cannula, the sealing box including a release button pressable to release the release button and disengage the sealing box from the cannula, wherein, in the coupling configuration of the sealing box, the release button is accessible through the first window; as well as A occluder configured to directly latch onto the cannula in a coupling configuration and extend through the cannula and the sealing box.

2. The cannula assembly according to claim 1, wherein, The occluder is configured to directly latch onto the edge of the cannula in the connection configuration of the occluder.

3. The cannula assembly according to claim 1 or 2, wherein, The occluder is configured to directly latch onto the inner surface of the cannula in the aforementioned coupling configuration.

4. The cannula assembly according to claim 1 or 2, wherein, The occluder is configured to directly latch onto the outer surface of the cannula in the aforementioned coupling configuration.

5. The cannula assembly according to claim 1 or 2, wherein, The sealing box is configured to directly latch onto the cannula and form a seal with the cannula in the connection configuration of the sealing box.

6. The cannula assembly according to claim 1 or 2, wherein, The occluder, in the aforementioned coupling configuration, prevents the sealing box from being removed from the cannula.

7. The cannula assembly according to claim 1 or 2, wherein, The occluder includes a release button that is rotatably aligned with the release button of the sealing box in the coupling configuration of the occluder.

8. The cannula assembly according to claim 1 or 2, wherein, The occluder includes a release button that is rotatably offset from the release button of the sealing box in the coupling configuration of the occluder.

9. The cannula assembly according to claim 8, wherein, The blocker is configured to latch onto the first window in the connection configuration of the blocker.

10. The cannula assembly according to claim 8, wherein, The cannula includes a second window positioned approximately 180 degrees apart from the first window.

11. The cannula assembly according to claim 10, wherein, The cannula includes a slot that allows fluid access to the fluid port of the sealing box through the sidewall of the cannula in the connection configuration of the sealing box.

12. The cannula assembly according to claim 11, wherein, The first window and the second window are each set at approximately 90 degrees to the slot.

13. The cannula assembly according to claim 1 or 2, wherein: The cannula includes a funnel portion and a tubular portion extending distally from the funnel portion; The occluder includes a head portion, a shaft portion extending distally from the head portion, and an end portion located at the distal end of the shaft portion. The head portion of the occluder engages the funnel portion of the cannula in the coupling configuration of the occluder; The shaft portion of the occluder extends through the tubular portion of the cannula in the coupling configuration of the occluder; and The distal end of the shaft portion extends distally beyond the distal end of the cannula in the coupling configuration of the occluder.

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