Instrument insertion carriage for robotic surgical tools

Abstract

A robotic surgical tool for a robotic instrument driver includes a handle having a first end, at least one spline rotatably coupled to the handle and extending proximally from the first end, a carriage movably mounted to the at least one spline and including a first layer and a second layer, the second layer operably coupled to the first layer. The at least one spline extends through a portion of at least one of the first layer and the second layer, and the carriage translates along the at least one spline. The robotic surgical tool further includes an elongate shaft extending from the carriage and penetrating the first end, the shaft having an end effector arranged at a distal end thereof, and an activation mechanism coupled to one or both of the first layer and the second layer and actuatable to operate a function of the end effector.

Description

Technical Field

[0001] The systems and methods disclosed herein relate to robotic surgical systems, and more specifically to robotic surgical tools including a bracket movably mounted to the tool and having a hierarchical architecture configured to support at least one activation mechanism for operating the robotic tool. Background Technology

[0002] Minimally invasive surgical (MIS) instruments are generally superior to traditional open surgical devices due to reduced postoperative recovery time and minimized scarring. The most common MIS procedures can be endoscopic, and the most common form of endoscopic surgery is laparoscopic surgery, in which one or more small incisions are made in the patient's abdomen, and a cannula is inserted through these incisions to create access to the abdominal cavity. The cannula's insertion and sealing system is used to introduce various instruments and tools into the abdominal cavity and provides insufflation to elevate the abdominal wall above organs. Instruments can be used to engage and / or manipulate tissue in a variety of ways to achieve diagnostic or therapeutic effects.

[0003] Each surgical instrument typically includes an end effector positioned at its distal end. Exemplary end effectors include clamps, grippers, scissors, suture devices, suction irrigators, blades (i.e., RFs), and needle holders, and are similar to those used in routine (open) surgery, except that the end effector of each instrument is separated from its shank by an approximately 12-inch-long shaft. A camera or image-capturing device, such as an endoscope, is also typically introduced into the abdominal cavity to allow the surgeon to observe the surgical field and the operation of the end effector during the procedure. The surgeon can observe the surgery in real time via a visual monitor that communicates with the image-capturing device.

[0004] Various robotic systems have recently been developed to assist in MIS surgery. Robotic systems can achieve more intuitive hand movements by maintaining a natural hand-eye axis. They can also achieve greater degrees of freedom of movement through "wrist" joints that enable more natural hand-like joint movements and allow access to hard-to-reach spaces. The end effector of the instrument can perform joint movements (mobility) using motors and actuators that form part of a computerized motion system. A user (e.g., a surgeon) can remotely operate the end effector of the instrument by grasping and manipulating one or more controllers in space, which are connected to instrument actuators coupled to the surgical instruments. User input is processed by a computer system integrated into the robotic surgical system, and the instrument actuators respond by actuating the motors and actuators of the motion system. Moving drive cables and / or other mechanical mechanisms manipulates the end effector joints to desired positions and configurations.

[0005] Improvements to robot-enabled medical systems will provide physicians with the ability to perform endoscopic and laparoscopic procedures more efficiently and easily. Summary of the Invention

[0006] The following summary outlines various details of this disclosure to provide a basic understanding. This summary is not an exhaustive overview of the disclosure and is neither intended to identify certain elements of the disclosure nor to depict its scope. Rather, the primary purpose of this summary is to present some concepts of the disclosure in a simplified form before the more detailed description presented below.

[0007] The embodiments disclosed herein include a robotic surgical tool for a robotic instrument actuator, the robotic surgical tool comprising: a shank having a first end; at least one spline rotatably coupled to the shank and extending proximally from the first end; a bracket movably mounted to the at least one spline and comprising a first layer and a second layer, the second layer being operatively coupled to the first layer. The at least one spline extends through a portion of at least one of the first layer and the second layer, and the bracket translates along the at least one spline. The robotic surgical tool further comprises: an elongated shaft extending from the bracket and penetrating the first end, the shaft having an end effector disposed at its distal end; and an activation mechanism coupled to one or both of the first layer and the second layer and capable of being actuated to operate the end effector. In a further embodiment, the robotic surgical tool further includes: a drive input disposed at the first end and operatively coupled to the at least one spline, such that rotation of the drive input correspondingly rotates the at least one spline; and an instrument driver disposed at the end of the robotic arm and capable of engaging the shank at the first end, the instrument driver providing a drive output capable of engaging the drive input, such that rotation of the drive output correspondingly rotates the drive input, thereby actuating the activation mechanism. In another further embodiment, the at least one spline forms part of a plurality of splines, and each spline is rotatably attached to the first end of the shank and configured to mechanically communicate with a drive output of the robotic instrument driver, each spline being coupled to a separate activation mechanism, and rotation of the spline driving an associated function of the end effector. In another further embodiment, the activation mechanism includes a drive gear coupled to the at least one spline or forming part of the at least one spline, and rotation of the at least one spline correspondingly rotates the drive gear. In another further embodiment, the drive gear defines a channel whose shape is complementary to the cross-section of the at least one spline, and wherein the at least one spline extends through the channel. In another further embodiment, the activation mechanism includes a drive gear arranged adjacent to and in sliding contact with the at least one spline, and wherein rotation of the associated spline causes the gear of the activation mechanism to rotate. In another further embodiment, the drive gear defines gear teeth that mesh with gear teeth defined by the at least one spline. In another further embodiment, the bracket comprises three or more layers. In another further embodiment, the robotic surgical tool further includes a guide rail extending proximally from the first end and one or more recesses defined in the bracket and sized to receive the guide rail.As the bracket moves along the at least one spline, the guide slides within the one or more recesses. In another further embodiment, the guide bears the torsional load of the bracket, thereby minimizing rotation of the bracket relative to the handle. In another further embodiment, the one or more recesses are defined on the outer periphery of one or both of the first and second layers. In another further embodiment, the one or more recesses include a first recess and a second recess, and wherein the first recess and the second recess are located on circumferentially opposite sides of the bracket. In another further embodiment, the robotic surgical tool also includes a lead screw extending from the first end, wherein the bracket is movably mounted to the lead screw at a bracket nut fixed to the bracket, and wherein rotation of the lead screw causes axial movement of the bracket and the bracket nut toward and away from the first end, thereby moving the end effector distally or proximally. In another further embodiment, the first and second layers are removably secured to each other using one or more mechanical fasteners. In another further embodiment, the first layer and the second layer each include a coaxial alignment hole for receiving the one or more mechanical fasteners. In another further embodiment, the function of the end effector is selected from the group consisting of: articulation of the end effector, clamping of the jaws of the end effector, displacement of the cutting element of the end effector, displacement of the end effector, and any combination thereof. In another further embodiment, the robotic surgical tool also includes a second end opposite the first end of the handle, wherein the at least one spline extends between the first end and the second end, and wherein the bracket is configured to translate between the first end and the second end.

[0008] The embodiments disclosed herein may also include a method comprising positioning a robotic surgical tool near a patient, the robotic surgical tool comprising: a handle having a first end portion; at least one spline rotatably coupled to the handle and extending proximally from the first end portion; a bracket movably mounted to the at least one spline and comprising a first layer and a second layer operatively coupled to the first layer, wherein the at least one spline extends through a portion of at least one of the first layer and the second layer; an elongated shaft extending from the bracket and penetrating the first end portion, the shaft having an end effector disposed at its distal end portion; and an activation mechanism coupled to one or both of the first layer and the second layer. The method includes: rotating the at least one spline by actuating a drive input disposed at the first end portion and operatively coupled to the at least one spline; and actuating the activation mechanism as the at least one spline rotates, thereby activating the function of the end effector. In a further embodiment, the method further includes removably securing the first layer and the second layer to each other using one or more mechanical fasteners. In another further embodiment, the method further includes advancing the bracket distally and proximally along the at least one spline. In yet another further embodiment, the method further includes guiding the bracket toward and away from the first end using at least one guide rail extending from the first end.

[0009] The embodiments disclosed herein include a robotic surgical tool comprising: a handle having a first end and a second end opposite the first end; an exoskeleton extending between the first end and the second end and having a non-circular cross-section; and a bracket movably disposed within the exoskeleton and having a non-circular cross-section compatible with the non-circular cross-section of the exoskeleton. The robotic surgical tool further includes an elongated shaft extending from the bracket and penetrating the first end, the shaft having an end effector disposed at its distal end, the bracket being movable between the first end and the second end to advance or retract the end effector relative to the handle, wherein the exoskeleton guides the bracket between the first end and the second end. In a further embodiment, the distal end of the exoskeleton is capable of engaging the first end of the handle. In another further embodiment, the surgical tool further includes a guide screw extending between the first end and the second end, wherein the bracket is movably mounted to the guide screw at a bracket nut fixed to the bracket, and wherein rotation of the guide screw causes axial movement of the bracket and the bracket nut within the exoskeleton between the first end and the second end. In another further embodiment, the surgical tool further includes a spline rotatably coupled to the first end of the handle and extending between the first end and the second end, wherein the spline is operatively coupled to the bracket for activating the function of the surgical tool via rotation of the spline. In another further embodiment, the surgical tool further includes at least one fastener hole disposed on a sidewall of the exoskeleton and configured to receive a fastener for securing the exoskeleton to the first end of the handle. In another further embodiment, the surgical tool further includes a top cap removably attached to the second end of the handle. In another further embodiment, the surgical tool further includes at least one structural rib defined on the outer surface of the exoskeleton to provide structural stiffness to the exoskeleton. In another further embodiment, the exoskeleton provides a distal end and a proximal end opposite the distal end, wherein the at least one structural rib extends at least partially between the distal end and the proximal end. In another further embodiment, the surgical tool further includes at least one alignment feature extending outwardly from a sidewall of the exoskeleton; and an alignment recess defined in the first end of the handle, the alignment recess being sized to receive the at least one alignment feature. In another further embodiment, the surgical tool further includes a friction-enhancing material applied to the outer surface of the exoskeleton. In another further embodiment, the cross-section of the exoskeleton is symmetrical in shape. In another further embodiment, the cross-section of the exoskeleton is asymmetrical in shape.

[0010] The embodiments disclosed herein may also include a method comprising positioning a robotic surgical tool near a patient, the robotic surgical tool comprising: a handle having a first end and a second end opposite the first end; an exoskeleton extending between the first end and the second end and having a non-circular cross-section; and a bracket disposed within the exoskeleton and having a non-circular cross-section complementary to the non-circular cross-section of the exoskeleton. The surgical tool further includes an elongated shaft extending from the bracket and penetrating the first end, the shaft having an end effector disposed at its distal end; the method further comprising moving the bracket between the first end and the second end to advance or retract the end effector relative to the handle; and guiding the bracket between the first end and the second end using the exoskeleton. In a further embodiment, the method further includes using the exoskeleton to bear torsional loads borne by the bracket as the robotic surgical tool operates. In yet another further embodiment, the method further includes securing the exoskeleton to the first end of the handle using at least one fastener. In another further embodiment, the method further includes enhancing the gripping properties of the exoskeleton by applying a coating to the outer surface of the exoskeleton. In another further embodiment, the method further includes aligning the exoskeleton relative to the handle by engaging an alignment feature of the exoskeleton with an alignment recess defined in the first end of the handle. In another further embodiment, the exoskeleton provides a distal end and a proximal end opposite the distal end, and the method further includes attaching a top cap to the proximal end of the exoskeleton. In another further embodiment, the method further includes engaging the distal end of the exoskeleton with the first end of the handle. In another further embodiment, the method further includes attaching at least one spline to the handle and causing the at least one spline to extend within the exoskeleton between the first end and the second end.

[0011] The embodiments disclosed herein include a robotic surgical tool comprising: a shank having a first end and a second end; a lead screw rotatably coupled to the shank and extending between the first end and the second end; a spline rotatably coupled to the shank and extending between the first end and the second end; and a bracket movably mounted to the lead screw for translation between the first end and the second end. The surgical tool further includes at least one activation mechanism supported by the bracket and coupled to the spline, wherein the spline is arranged at a distance from the lead screw such that the lead screw bears a torsional load generated by the spline. In a further embodiment, the surgical tool further includes an elongated shaft extending from the bracket and penetrating the first end, the shaft having an end effector arranged at its distal end; and in another further embodiment, the stiffness of the lead screw is greater than the stiffness of the spline. In another further embodiment, the spline is a first spline and the distance is a first distance. The surgical tool also includes a second spline rotatably coupled to the shank and extending between the first end and the second end. The second spline is coupled to at least one activation mechanism supported by the bracket, wherein the second spline is arranged at a second distance from the lead screw such that the lead screw bears the torsional load generated by the second spline. In another further embodiment, the first spline has a larger torsional load than the second spline, and the first distance from the lead screw is smaller than the second distance from the lead screw. In another further embodiment, the first spline rotates in a first direction, and the second spline rotates in a second direction opposite to the first direction, wherein the first torsional load applied by the first spline is substantially equal to the second torsional load applied by the second spline. In another further embodiment, the spline is one of a plurality of splines, wherein the centerline of each of the plurality of splines is located at a radius from the lead screw, the radius being determined by the input torque associated with each spline, and wherein the greater the input torque of a given spline among the plurality of splines, the shorter the radius from the lead screw. In another further embodiment, the plurality of splines includes splines having at least two different cross-sectional areas. In another further embodiment, each of the plurality of splines includes a different cross-sectional area, and the cross-sectional area of ​​each spline is determined based on the input torque associated with that spline.

[0012] The embodiments disclosed herein may also include a robotic surgical tool comprising: a shank having a first end and a second end; a lead screw rotatably coupled to the shank and extending between the first end and the second end; a first spline and a second spline rotatably coupled to the shank and extending between the first end and the second end; and a bracket movably mounted to the lead screw for translation between the first end and the second end. The robotic surgical tool further includes a first activation mechanism supported by the bracket and coupled to the first spline, and a second activation mechanism supported by the bracket and coupled to the second spline, wherein a first torsional load generated by the first spline rotating in a first direction is balanced by a second torsional load generated by the second spline rotating in a second direction opposite to the first direction. In a further embodiment, the first spline is arranged at a first distance from the lead screw, and the second spline is arranged at a second distance from the lead screw, wherein the lead screw bears the torsional load generated by the first spline and the second spline. In another further embodiment, the first distance is equal to the second distance. In another further embodiment, the first distance is different from the second distance. In another further embodiment, the first spline generates a first torsional load greater than a second torsional load generated by the second spline, and wherein the first distance from the lead screw is less than the second distance. In another further embodiment, the first spline has a first cross-sectional area, and the second spline has a second cross-sectional area smaller than the first cross-sectional area. In another further embodiment, the first spline has a first cross-sectional area, and the second spline has a second cross-sectional area, the first cross-sectional area being approximately equal to the second cross-sectional area.

[0013] The embodiments disclosed herein may also include a method comprising an actuated robotic surgical tool, the robotic surgical tool comprising: a shank having a first end and a second end; at least one spline rotatably coupled to the shank and extending between the first end and the second end; and a lead screw rotatably coupled to the shank and extending between the first end and the second end and located in a screw position, wherein one of the lead screws and one of the splines of the at least one spline includes a load balancing member. A bracket is movably mounted to the lead screw, and an elongated shaft extends from the bracket and through the first end, the shaft having an end effector disposed at its distal end. The surgical tool includes an activation mechanism supported by the bracket. The method includes utilizing the load balancing member to bear the torsional force generated by the at least one spline acting on the bracket. In a further embodiment, the at least one spline includes a first spline and a second spline, the method further comprising rotating the first spline in a first direction and simultaneously rotating the second spline in a second direction different from the first direction. In another further embodiment, the at least one spline comprises a plurality of splines, and each spline exhibits a different cross-sectional area determined based on the input torque associated with each spline. In another further embodiment, the lead screw is the load balancing member, and the centerline of the at least one spline is located at a radius from the lead screw, the radius being determined by the input torque associated with each spline, wherein the greater the input torque of the at least one spline, the shorter the radius from the lead screw. Attached Figure Description

[0014] 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.

[0015] Figure 1 An implementation scheme of a cart-based robotic system deployed for the diagnosis and / or treatment of bronchoscopy procedures is shown.

[0016] Figure 2 Depicting Figure 1 Another aspect of robotic systems.

[0017] Figure 3A The setup for ureteroscopy is shown. Figure 1 The implementation plan for the robot system.

[0018] Figure 3B The diagram shows the arrangement used for vascular procedures. Figure 1 The implementation plan for the robot system.

[0019] Figure 4An implementation scheme of a table-based robotic system deployed for bronchoscopy procedures is shown.

[0020] Figure 5 Provided Figure 4 An alternative view of the robot system.

[0021] Figure 6 An exemplary system configured to retract a robotic arm is shown.

[0022] Figure 7A An implementation scheme of a table-based robotic system constructed for ureteroscopy procedures is shown.

[0023] Figure 7B An implementation scheme of a table-based robotic system constructed for laparoscopic procedures is shown.

[0024] Figure 7C It shows Figures 4 to 7B An implementation scheme for a platform-based robot system with pitch and tilt adjustment.

[0025] Figure 8 Provided Figure 4 A detailed illustration of the interface between the platform and the column of the platform-based robot system in Figure 7.

[0026] Figure 9A An alternative implementation of a stage-based robotic system is shown.

[0027] Figure 9B It shows Figure 9A An end view of a platform-based robotic system.

[0028] Figure 9C An end view of a platform-based robotic system with a robotic arm attached is shown.

[0029] Figure 10 An exemplary device driver is shown.

[0030] Figure 11 An exemplary medical device with paired instrument drivers is shown.

[0031] Figure 12 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.

[0032] Figure 13 An instrument with an instrument-based insertion architecture is shown.

[0033] Figure 14 An example controller is shown.

[0034] Figure 15A block diagram according to an exemplary embodiment is depicted, illustrating the estimation Figures 1 to 7C The location of one or more components of a robotic system (such as...) Figures 11 to 13 A positioning system for the location of instruments.

[0035] Figure 16A It is an isometric side view of an exemplary surgical tool that can incorporate some or all of the principles of this disclosure.

[0036] Figure 16B It is an isometric side view of an exemplary surgical tool that can incorporate some or all of the principles of this disclosure.

[0037] Figure 17A It is a releasable connection to an exemplary device driver according to one or more embodiments. Figure 16A An isometric view of surgical tools.

[0038] Figure 17B Provided Figure 17A instrument driver and Figure 16A Separate isometric end views of surgical instruments.

[0039] Figure 18 It is an isometric side view of an exemplary bracket that can be incorporated into some or all of the principles of this disclosure.

[0040] Figure 19A An exemplary spline connected to an activation mechanism is shown, which can incorporate some or all of the principles of this disclosure.

[0041] Figure 19B Another exemplary spline is shown that can incorporate some or all of the principles of this disclosure to the activation mechanism.

[0042] Figure 19C An exemplary spline is shown that can be incorporated into some or all of the principles of this disclosure.

[0043] Figure 20 An exemplary spline connected to an activation mechanism is shown, which can incorporate some or all of the principles of this disclosure.

[0044] Figure 21A An exemplary surgical tool shield releasably coupled to an exemplary instrument driver is shown according to one or more embodiments.

[0045] Figure 21B It shows Figure 21A A top view of a surgical tool shield.

[0046] Figure 22A An isometric side view of an exemplary bracket and shield that can incorporate some or all of the principles of this disclosure is shown.

[0047] Figure 22B An isometric side view of another exemplary bracket and shield that can incorporate some or all of the principles of this disclosure is shown.

[0048] Figure 23A A cross-sectional view of an exemplary bracket mounted to a lead screw, which can incorporate some or all of the principles of this disclosure, is shown.

[0049] Figure 23B A cross-sectional view of another exemplary bracket for mounting to a lead screw, which can incorporate some or all of the principles of this disclosure, is shown.

[0050] Figure 23C A cross-sectional view of another exemplary bracket for mounting to a lead screw, which can incorporate some or all of the principles of this disclosure, is shown.

[0051] Figure 24A A top view of an exemplary bracket operatively connected to multiple splines is shown.

[0052] Figure 24B A top view of another exemplary bracket operatively connected to multiple splines is shown.

[0053] Figure 25A A top view shows multiple activation mechanisms connected to multiple splines.

[0054] Figure 25B It shows an operable connection to Figure 25A A top view of an exemplary bracket for the activation mechanism and spline.

[0055] Figure 25C It shows that it is constructed to accommodate Figure 25B Isometric view of the surgical tool handle and shield of the bracket. Detailed Implementation

[0056] 1. Overview .

[0057] The aspects of this disclosure can be integrated into robot-enabled medical systems capable of performing a variety of medical procedures, including both minimally invasive (e.g., laparoscopy) and non-invasive (e.g., endoscopy) procedures. In endoscopic procedures, the system may be able to perform bronchoscopy, ureteroscopy, gastroscopy, etc.

[0058] 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.

[0059] 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.

[0060] A. Robotic System – Cart .

[0061] Robot-enabled medical systems can be configured in a variety of ways, depending on specific procedures. Figure 1 An embodiment of a cart-based robot-enabled system 100 arranged for diagnostic and / or therapeutic bronchoscopy procedures is illustrated. For bronchoscopy procedures, the robot system 100 may include a cart 102 having one or more robotic arms 104 (three are shown) to deliver medical instruments (alternatively referred to as “surgical tools”) (such as a manipulable endoscope 106 (e.g., a surgery-specific bronchoscope for bronchoscopy)) to a natural orifice entry point (i.e., the patient’s mouth) to deliver diagnostic and / or therapeutic tools. As shown, the cart 102 may be positioned near the patient’s upper torso to provide access to the entry point. Similarly, the robotic arms 104 may be actuated to position the bronchoscope relative to the entry point. The same approach may be used when performing GI procedures using a gastroscope (a dedicated endoscope for gastrointestinal (GI) procedures). Figure 1 The layout within.

[0062] Once the trolley 102 is correctly positioned near the patient, the robotic arm 104 inserts the maneuverable endoscope 106 into the patient's body robotically, manually, or in a combination thereof. The maneuverable endoscope 106 may include at least two telescopic components, such as an inner guide portion and an outer sheath portion, each coupled to a separate instrument actuator in a set of instrument actuators 108. As shown, each instrument actuator 108 is coupled to the distal end of a corresponding robotic arm in the robotic arm 104. This linear arrangement of the instrument actuators 108, which facilitates coaxial alignment of the guide portion and the sheath portion, creates a “virtual track” 110, which can be repositioned in space by maneuvering the robotic arm 104 to different angles and / or positions. Translation of the instrument actuators 108 along the virtual track 110 causes the inner guide portion to extend or retract relative to the outer sheath portion, thus effectively advancing or retracting the endoscope 106 relative to the patient.

[0063] As shown in the figures, the virtual track 110 (and other virtual tracks described herein) is depicted using dashed lines and therefore does not constitute any physical structure of system 100. The angles of the virtual track 110 can be adjusted, translated, and pivoted based on clinical application or physician preference. For example, in bronchoscopy, the angles and positions of the virtual track 110, as shown, represent a trade-off between providing the physician with access to endoscope 106 and minimizing friction caused by the endoscope 106 bending into the patient's mouth.

[0064] After insertion into the patient's mouth, the endoscope 106 can be guided downwards through the patient's trachea and lungs using precise commands from the robotic system 100 until the target destination or surgical site is reached. To enhance navigation through the patient's lung network and / or reach the desired target, the endoscope 106 can be manipulated to telescopically extend the inner guide portion from the outer sheath portion to achieve enhanced articulation and a larger radius of flexion. The use of separate instrument actuators 108 also allows the guide portion and sheath portion to be driven independently of each other.

[0065] For example, endoscope 106 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 a working channel that extends the length of endoscope 106 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 tissue sample is identified as malignant, endoscope 106 can be used to deliver endoscopic tools to remove potentially cancerous tissue. In some cases, diagnostic and therapeutic procedures can be delivered in a separate procedure. In these cases, endoscope 106 can also be used to deliver reference markers to “mark” the location of the target nodule. In other cases, diagnostic and therapeutic procedures can be delivered during the same procedure.

[0066] System 100 may also include a movable tower 112, which can be connected to the cart 102 via support cables to provide control, electronic, fluid, optical, sensor, and / or electrical support to the cart 102. Placing such functionality in the tower 112 allows for easier adjustment and / or repositioning of the smaller form factor of the cart 102 by the operating physician and his / her staff. Additionally, the division between the cart / table and the support tower 112 reduces operating room clutter and facilitates improved clinical workflow. While the cart 102 can be positioned close to the patient, the tower 112 can optionally be retracted in a remote location to avoid obstructing the path during procedures.

[0067] To support the aforementioned robotic system, tower 112 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 in tower 112 or trolley 102, 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 example, in response to receiving a control signal, a motor in the joint of the robotic arm 104 can position the arm into a specific posture or angular orientation.

[0068] Tower 112 may also include one or more of a pump, flow meter, valve controller, and / or fluid passages to provide controlled flushing and suction capabilities to system 100, which can be deployed via endoscope 106. These components may also be controlled using a computer system of tower 112. In some embodiments, flushing and suction capabilities may be delivered directly to endoscope 106 via a separate cable.

[0069] Tower 112 may include voltage and surge protectors designed to provide filtered and protected power to cart 102, thereby avoiding the need to place power transformers and other auxiliary power components in cart 102, resulting in a smaller and more portable cart 102.

[0070] Tower 112 may also include support devices for sensors deployed throughout the robotic system 100. For example, tower 112 may include optoelectronic devices for detecting, receiving, and processing data received from optical sensors or cameras throughout the robotic system 100. 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 display in tower 112). Similarly, tower 112 may also include electronic subsystems for receiving and processing signals received from deployed electromagnetic (EM) sensors. Tower 112 may also be used to house and position an EM field generator for detection by EM sensors in or on a medical device.

[0071] In addition to other consoles available in the rest of the system (e.g., a console mounted to cart 102), tower 112 may also include console 114. Console 114 may include a user interface and display (e.g., a touchscreen) for physician operators. Consoles in system 100 are generally designed to provide both robot control and preoperative and real-time information for procedures, such as navigation and positioning information for endoscope 106. When console 114 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 114 may be housed within the main body, separate from tower 112.

[0072] Tower 112 can be connected to cart 102 and endoscope 106 via one or more cable connectors 116. In some embodiments, support functionality from tower 112 can be provided via a single cable 116 extending to cart 102, thus 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 cart 102 can be provided via a single cable, support for control, optics, fluid, and / or navigation can also be provided via one or more separate cables.

[0073] Figure 2 Provided from Figure 1 Detailed illustration of an implementation of a cart 102 in a cart-based robot-enabled system 100. The cart 102 typically includes an elongated support structure 202 (also referred to as a “post”), a cart base 204, and a console 206 at the top of the post 202. The post 202 may include one or more brackets, such as a bracket 208 (alternatively an “arm support”) for supporting the deployment of a robotic arm 104. The bracket 208 may include a separately configurable arm mount that rotates along a vertical axis to adjust the base 214 of the robotic arm 104 for better positioning relative to the patient. The bracket 208 also includes a bracket interface 210 that allows the bracket 208 to translate vertically along the post 202.

[0074] The bracket interface 210 is connected to the post 202 via a slot, such as slot 212, which is positioned on the opposite side of the post 202 to guide the vertical translation of the bracket 208. Slot 212 includes a vertical translation interface to position and hold the bracket 208 relative to the trolley base 204 at various vertical heights. The vertical translation of the bracket 208 allows the trolley 102 to adjust the reach of the robotic arm 104 to accommodate various table heights, patient sizes, and physician preferences. Similarly, individually configurable arm mounts on the bracket 208 allow the base 214 of the robotic arm 104 to be angled in various configurations.

[0075] In some embodiments, slot 212 may be supplemented with a slot cover (not shown) flush with and parallel to the slot surface to prevent dust and fluid from entering the internal cavity of column 202 and the vertical translation interface during vertical translation of bracket 208. The slot cover can be deployed via a pair of spring reels positioned near the vertical top and bottom of slot 212. The cover is coiled within the reels until it is deployed to extend and retract from its coiled state during vertical up-and-down translation of bracket 208. The spring load of the reels provides the force to retract the cover into the reels as bracket 208 translates toward the reels, while maintaining a tight seal as bracket 208 translates away from the reels. The cover can be attached to bracket 208 using, for example, a bracket in bracket interface 210 to ensure proper extension and retraction of the cover during translation of bracket 208.

[0076] The column 202 may internally include mechanisms such as gears and motors, which are designed to mechanically translate the bracket 208 using vertically aligned lead screws in response to control signals generated in response to user input (e.g., input from console 206).

[0077] A robotic arm 104 typically includes a robotic arm base 214 and end effectors 216 (three shown) separated by a series of links 218 connected by a corresponding series of joints 220, each joint 220 including an independent actuator, and each actuator including an independently controllable motor. Each independently controllable joint 220 represents an independent degree of freedom available to the corresponding robotic arm 104. In the illustrated embodiment, each arm 104 has seven joints 220, thus providing seven degrees of freedom. Multiple joints 220 result in multiple degrees of freedom, thereby allowing “redundant” degrees of freedom. Redundant degrees of freedom allow the robotic arm 104 to position its corresponding end effector 216 in a specific orientation, orientation, and trajectory in space using different link orientations and joint angles. This allows the system 100 to locate and guide medical devices from desired points in space, while allowing physicians to move the arm joints 220 to a clinically advantageous orientation away from the patient to achieve greater proximity while avoiding arm collisions.

[0078] The trolley base 204 balances the weight of the column 202, bracket 208, and arm 104 on the floor. Therefore, the trolley base 204 houses heavier components such as electronics, motors, power supplies, and components that enable the trolley to move and / or be secured. For example, the trolley base 204 includes rolling casters 222 that allow the trolley to be easily moved around the room before the procedure. Once in the correct position, the casters 222 can be secured with wheel locks to hold the trolley 102 in the correct position during the procedure.

[0079] The console 206, positioned at the vertical end of column 202, allows both a user interface for receiving user input and a display screen (or dual-purpose device, such as, for example, touchscreen 224) to provide both preoperative and intraoperative data to the physician user. Potential preoperative data on touchscreen 224 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 touchscreen 224 may include optical information from tools and sensors, coordinate information from sensors, and important patient statistics such as respiration, heart rate, and / or pulse. Console 206 can be positioned and tilted to allow the physician to access the console from the side of column 202 opposite to bracket 208. From this orientation, the physician can operate console 206 from behind cart 102 while simultaneously observing console 206, robotic arm 104, and the patient. As shown, console 206 also includes a handle 226 for assisting in manipulating and stabilizing cart 102.

[0080] Figure 3A The setup for ureteroscopy is shown. Figure 1 An implementation of system 100 is described. In a ureteroscopy procedure, a trolley 102 can be positioned to deliver a ureteroscope 302 (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 for the ureteroscope 302 to be directly aligned with the patient's urethra to reduce friction and force on sensitive anatomical structures. As shown, the trolley 102 can be aligned at the foot of the table to allow the robotic arm 104 to position the ureteroscope 302 for direct linear access into the patient's urethra. The robotic arm 104 can insert the ureteroscope 302 directly into the patient's lower abdomen through the urethra from the foot of the table along a virtual track 304.

[0081] After insertion into the urethra, using control techniques similar to those used in bronchoscopy, the ureteroscope 302 can be navigated to the bladder, ureter, and / or kidney for diagnostic and / or therapeutic applications. For example, the ureteroscope 302 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 302. After lithotripsy is complete, the resulting stone fragments can be removed using a basket deployed downwards along the working channel of the ureteroscope 302.

[0082] Figure 3B The diagram shows the arrangement used for vascular procedures. Figure 1Another embodiment of system 100. In vascular procedures, system 100 may be configured such that a trolley 102 can deliver a medical device 306 (such as a maneuverable catheter) to an entry point in the femoral artery in the patient's leg. The femoral artery presents both a 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 102 may be positioned toward the patient's leg and lower abdomen to allow robotic arm 104 to provide a virtual track 308 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 306 can be guided and advanced by translating device actuator 108. Alternatively, trolley 102 may be positioned around the patient's upper abdomen to reach alternative vascular entry points, such as, for example, the carotid and brachial arteries near the patient's shoulder and wrist.

[0083] B. Robot System – Unit .

[0084] 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 4 An embodiment of such a robot-enabled system 400 arranged for a bronchoscopy procedure is shown. As shown, system 400 includes a support structure or column 402 for supporting a platform 404 (shown as a “table” or “bed”) on a floor. Much like trolley-based systems, the end effectors of the robotic arm 406 of system 400 include instrument actuators 408 designed to manipulate elongated medical instruments, such as a bronchoscope 410, via or along a virtual track 412 formed by the linear alignment of the instrument actuators 408. In practice, a C-arm for providing fluorescein imaging can be positioned above the patient’s upper abdominal region by placing the transmitter and detector around the table 404.

[0085] Figure 5An alternative view of a system 400 without a patient and medical devices is provided for discussion purposes. As shown, a column 402 may include one or more brackets 502, shown as annular in system 400, from which one or more robotic arms 406 may be based. The brackets 502 may translate along a vertical column interface 504 extending the length (height) of the column 402 to provide different vantage points from which the robotic arms 406 may be positioned to reach the patient. The brackets 502 may be rotated about the column 402 using mechanical motors positioned within the column 402 to allow the robotic arms 406 access to multiple sides of the table 404, such as the sides of the patient. In embodiments with multiple brackets 502, the brackets 502 may be individually positioned on the column 402 and may translate and / or rotate independently of the other brackets 502. While the brackets 502 need not be circular around the column 402, the annular shape shown facilitates rotation of the brackets 502 about the column 402 while maintaining structural balance. The rotation and translation of the bracket 502 allow the system 400 to align medical instruments such as endoscopes and laparoscopes to different entry points on the patient.

[0086] In (the following is relative to) Figure 9A In other embodiments (discussed in more detail), system 400 may include a patient examination table or bed with an adjustable arm support in the form of a rod or track extending beside the patient examination table or bed. One or more robotic arms 406 (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 406 can advantageously be compactly stored under the patient examination table or bed and subsequently raised during procedures.

[0087] Arm 406 can be mounted on bracket 502 via a set of arm mounts 506 comprising a series of joints, which can be individually rotatably and / or telescopically extended to provide additional constructability to robotic arm 406. Additionally, arm mounts 506 can be positioned on bracket 502 such that, when bracket 502 is properly rotated, arm mounts 506 can be positioned on the same side of table 404 (e.g., ...). Figure 5 As shown), on the opposite side of platform 404 (as shown) Figure 7B (as shown) or on the adjacent side of platform 404 (not shown).

[0088] Column 402 structurally supports platform 404 and provides a path for the vertical translation of bracket 502. Internally, column 402 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 402 may also transmit power and control signals to bracket 502 and the robotic arm 406 mounted thereon.

[0089] Taiwan Base 508 has the same Figure 2 The trolley base 204 of the illustrated trolley 102 functions similarly, accommodating heavier components to balance the table / bed 404, column 402, bracket 502, and robotic arm 406. The table base 508 may also incorporate rigid casters to provide stability during operation. Casters deployed from the bottom of the table base 508 extend in opposite directions on either side of the base 508 and retract when the system 400 requires movement.

[0090] In some embodiments, system 400 may also include a tower (not shown) that divides the functionality of system 400 between the table and the tower to reduce the form factor and volume of table 404. As in previously disclosed embodiments, the tower may provide table 404 with a variety of 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 table base 508 for potential retraction of the robotic arm 406. 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 (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 canisters to be used for inflatation.

[0091] In some implementations, the base can be retracted and stored when not in use. Figure 6 An embodiment of a system 400 configured to retract a robotic arm in a stage-based system implementation is shown. In system 400, one or more brackets 602 (not shown) are vertically translatable into a base 604 to retract one or more robotic arms 606, one or more arm mounts 608, and the brackets 602 within the base 604. A base cover 610 is translatable and retractable to open to deploy the brackets 602, arm mounts 608, and arms 606 around a post 612, and to close to retract the brackets, arm mounts, and arms, and to protect them when not in use. The base cover 610 may be sealed along the edge of its opening using a membrane 614 to prevent dust and fluid from entering when closed.

[0092] Figure 7AAn embodiment of a robot-enabled table-based system 400 configured for a ureteroscopy procedure is shown. During ureteroscopy, table 404 may include a rotating portion 702 for positioning the patient at an angle to the column 402 and table base 508. The rotating portion 702 may rotate or pivot about a pivot point (e.g., below the patient's head) to position the bottom portion of the rotating portion 702 away from the column 402. For example, pivoting of the rotating portion 702 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 404. By rotating a bracket (not shown) about the column 402, a robotic arm 406 can insert the ureteroscope 704 directly into the patient's groin region along a virtual track 706 to reach the urethra. During ureteroscopy, stirrups 708 may also be attached to the rotating portion 702 of table 404 to support the position of the patient's legs during the procedure and allow full access to the patient's groin region.

[0093] Figure 7B An embodiment of a system 400 arranged for a laparoscopic procedure is shown. In a laparoscopic procedure, minimally invasive instruments are inserted into the patient's anatomical structures through one or more small incisions in the patient's abdominal wall. In some embodiments, the minimally invasive instruments include elongated rigid members, 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 a scope, such as a laparoscope. Figure 7B As shown, the bracket 502 of the system 400 can be rotated and vertically adjusted to position the pair of robotic arms 406 on opposite sides of the table 404, so that the instrument 710 can be positioned through the smallest incision on both sides of the patient to reach his / her abdominal cavity using the arm mount 506.

[0094] To accommodate laparoscopic procedures, the system 400 can also tilt the platform to the desired angle. Figure 7C An embodiment of a system 400 with pitch or tilt adjustment is shown. For example... Figure 7C As shown, system 400 can adapt to the tilt of platform 404 to position one part of platform 404 at a greater distance from the base plate than another part. Additionally, arm mount 506 can rotate to match the tilt, ensuring that arm 406 maintains the same planar relationship with platform 404. To accommodate steeper angles, column 402 may also include a telescopic portion 712 that allows vertical extension of column 402 to prevent platform 404 from contacting the floor or colliding with base 508.

[0095] Figure 8Detailed illustrations are provided of the interface between stage 404 and column 402. The pitch-rotation mechanism 802 can be configured to change the pitch angle of stage 404 relative to column 402 with multiple degrees of freedom. The pitch-rotation mechanism 802 is achieved by positioning orthogonal axes A and B at the column interface, each axis being actuated by separate motors 804a and 804b in response to an electrical pitch angle command. Rotation along one screw 806a enables tilt adjustment along axis A, while rotation along the other screw 806b enables tilt adjustment along axis B. In some embodiments, a ball joint can be used to change the pitch angle of stage 404 relative to column 402 with multiple degrees of freedom.

[0096] 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.

[0097] Figure 9A and Figure 9B Isometric and end views of an alternative embodiment of a stage-based surgical robot system 900 are shown, respectively. The surgical robot system 900 includes components configured to support one or more robotic arms relative to a stage 904 (see, for example...). Figure 9C One or more adjustable arm supports 902 are provided. In the illustrated embodiment, a single adjustable arm support 902 is shown, but additional arm supports may be positioned on the opposite side of the stage 904. The adjustable arm support 902 may be configured such that it is movable relative to the stage 904 to adjust and / or change the orientation of the adjustable arm support 902 and / or any robotic arm attached to it relative to the stage 904. For example, the adjustable arm support 902 may be adjustable relative to the stage 904 with one or more degrees of freedom. The adjustable arm support 902 provides high flexibility to the system 900, including the ability to easily retract the one or more adjustable arm supports 902 and any robotic arms attached to them under the stage 904. The adjustable arm support 902 may be raised from a retracted orientation to an orientation below the upper surface of the stage 904. In other embodiments, the adjustable arm support 902 can be raised from a retracted position to a position above the upper surface of the platform 904.

[0098] The adjustable arm support 902 provides several degrees of freedom, including lifting, lateral translation, and tilting. Figure 9A and Figure 9B In the exemplary embodiment, the arm support 902 is configured to have four degrees of freedom, which are in Figure 9AThe arrows indicate the first degree of freedom, which allows adjustment of the adjustable arm support 902 in the z-direction (“Z-lift”). For example, the adjustable arm support 902 may include a bracket 906 configured to move up or down along or relative to the column 908 of the support platform 904. The second degree of freedom allows the adjustable arm support 902 to tilt. For example, the adjustable arm support 902 may include a rotary joint that allows the adjustable arm support 902 to be aligned with the bed in a head-down, feet-up position. The third degree of freedom allows the adjustable arm support 902 to “pivot upwards”, which can be used to adjust the distance between one side of the platform 904 and the adjustable arm support 902. The fourth degree of freedom allows the adjustable arm support 902 to translate along the longitudinal length of the platform.

[0099] Figure 9A and Figure 9B The surgical robot system 900 may include a platform 904 supported by a column 908 mounted to a base 910. The base 910 and column 908 support the platform 904 relative to a support surface. A floor axis 912 and a support axis 914 are... Figure 9B As shown in the image.

[0100] An adjustable arm support 902 may be mounted to a column 908. In other embodiments, the arm support 902 may be mounted to a platform 904 or a base 910. The adjustable arm support 902 may include a bracket 906, a rod or rail connector 916, and a rod or rail 918. In some embodiments, one or more robotic arms mounted to the rail 918 may translate and move relative to each other.

[0101] The bracket 906 can be attached to the post 908 via a first connector 920, which allows the bracket 906 to move relative to the post 908 (e.g., such as moving up and down along a first axis or vertical axis 922). The first connector 920 can provide a first degree of freedom (“Z-lift”) to the adjustable arm support 902. The adjustable arm support 902 may include a second connector 924, which provides a second degree of freedom (tilt) to the adjustable arm support 902. The adjustable arm support 902 may include a third connector 926, which provides a third degree of freedom (“upward pivot”) to the adjustable arm support 902. An additional connector 928 may be provided (in... Figure 9B (As shown in the diagram), the additional joint mechanically constrains the third joint 926 to maintain the orientation of the track 918 when the track connector 916 rotates about the third axis 930. The adjustable arm support 902 may include a fourth joint 932 that can provide a fourth degree of freedom (translation) for the adjustable arm support 902 along the fourth axis 934.

[0102] Figure 9CAn end view of a surgical robot system 900 with two adjustable arm supports 902a and 902b mounted on opposite sides of a stage 904 is shown. A first robotic arm 936a is attached to a rod or rail 918a of a first adjustable arm support 902a. The first robotic arm 936a includes a base 938a attached to the first rail 918a. The distal end of the first robotic arm 936a includes an instrument drive mechanism or input 940a that can be attached to one or more robotic medical instruments or tools. Similarly, a second robotic arm 936b includes a base 938a attached to a second rail 918b. The distal end of the second robotic arm 936b includes an instrument drive mechanism or input 940b configured to be attached to one or more robotic medical instruments or tools.

[0103] In some embodiments, one or more of the robotic arms 936a and 936b include an arm with seven or more degrees of freedom. In some embodiments, one or more of the robotic arms 936a and 936b 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 938a and 938b (including one degree of freedom for translation). In some embodiments, the insertion degree of freedom may be provided by the robotic arms 936a and 936b, while in other embodiments, the instrument itself provides insertion via an instrument-based insertion architecture.

[0104] C. Instrument drivers and interfaces .

[0105] The end effector of the system's robotic arm includes (i) an instrument actuator (alternatively referred to as an "instrument drive mechanism," "instrument device manipulator," and "drive input") 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.

[0106] Figure 10An exemplary instrument actuator 1000 according to one or more embodiments is illustrated. Positioned at the distal end of a robotic arm, the instrument actuator 1000 includes one or more drive outputs 1002 arranged parallel to the axis to provide controlled torque to a medical device via a corresponding drive shaft 1004. Each drive output 1002 includes a separate drive shaft 1004 for interacting with the device, a gear head 1006 for converting motor shaft rotation into desired torque, a motor 1008 for generating drive torque, and an encoder 1010 for measuring the speed of the motor shaft and providing feedback to a control circuit 1012, which can also be used to receive control signals and actuate the drive output 1002. Each drive output 1002 is independently controlled and motorized, and the instrument actuator 1000 can provide multiple (e.g., ...) drive outputs to the medical device. Figure 10 (At least two) independent drive outputs are shown. In operation, the control circuit 1012 receives a control signal, transmits a motor signal to the motor 1008, compares the motor speed measured by the encoder 1010 with the desired speed, and modulates the motor signal to generate the desired torque.

[0107] 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).

[0108] D. Medical devices .

[0109] Figure 11An exemplary medical device 1100 with paired instrument actuators 1102 is shown. Similar to other instruments designed for use with robotic systems, the medical device 1100 (alternatively referred to as a “surgical tool”) includes an elongated shaft 1104 (or elongated body) and an instrument base 1106. The instrument base 1106, also referred to as an “instrument handle” due to its intended design for manual interaction by a physician, typically includes rotatable drive inputs 1108 (e.g., jacks, pulleys, or reels) designed to mate with drive outputs 1110 on drive interfaces extending through the distal end of the robotic arm 1112. When physically connected, latched, and / or coupled, the mating drive inputs 1108 of the instrument base 1106 may share a rotational axis with the drive outputs 1110 in the instrument actuators 1102 to allow torque to be transmitted from the drive outputs 1110 to the drive inputs 1108. In some implementations, the drive output 1110 may include a spline designed to mate with a jack on the drive input 1108.

[0110] The elongated shaft 1104 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 1104 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 shaft 1104 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 1008 rotates in response to torque received from the drive output 1110 of the instrument driver 1102. When designed for use in endoscopy, the distal end of the flexible elongated shaft 1104 may include a manipulable or controllable bending segment that articulates and bends based on torque received from the drive output 1110 of the instrument actuator 1102.

[0111] In some embodiments, torque from the instrument actuator 1102 is transmitted downwards along the shaft 1104 to the elongated shaft 1104 using tendons. These individual tendons (e.g., traction cables) may be individually anchored to individual drive inputs 1108 within the instrument handle 1106. From the handle 1106, the tendons are guided downwards along one or more traction cavities of the elongated shaft 1104 and anchored at the distal portion of the elongated shaft 1104, 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 1108 transmits tension to the tendons, thereby causing the end effector to be actuated in some 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 tendon may be connected to one or more jaws of the gripper at the distal end of the elongated shaft 1104, wherein tension from the tendon causes the gripper to close.

[0112] During endoscopy, tendons can be attached via adhesives, control rings, or other mechanical fasteners to flexural or articulated segments positioned along an elongated axis 1104 (e.g., at the distal end). When fixedly attached to the distal end of a flexural segment, torque applied to a drive input 1108 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 1104 to allow controlled articulation within the desired flexural or articulated segment.

[0113] In endoscopic procedures, the elongated shaft 1104 accommodates 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 1104. The shaft 1104 may also accommodate wires and / or optical fibers to transmit signals to / from optical components at the distal end, which may include an optical camera. The shaft 1104 may also accommodate optical fibers to carry light from a proximal light source (such as a light-emitting diode) to the distal end of the shaft.

[0114] At the distal end of the instrument 1100, the distal end may also include an opening for delivering tools for diagnostic and / or treatment, irrigation, and aspiration to 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.

[0115] exist Figure 11 In the example, the axis of the drive shaft, and therefore the axis of the drive input, is orthogonal to the axis of the elongated shaft. However, this arrangement complicates the rolling capability of the elongated shaft 1104. Rolling the elongated shaft along its axis while keeping the drive input 1108 stationary can cause undesirable tangling of the tendon as it extends from the drive input 1108 and enters the traction cavity within the elongated shaft 1104. Such tangling of the tendon can disrupt any control algorithms designed to predict the movement of the flexible elongated shaft during endoscopic procedures.

[0116] Figure 12 An alternative design of a circular instrument actuator 1200 and a corresponding instrument 1202 (alternatively referred to as a "surgical tool") is shown, wherein the axis of the drive unit is parallel to the axis of the elongated shaft 1206 of the instrument 1202. As shown, the instrument actuator 1200 includes four drive units, wherein corresponding drive outputs 1208 are aligned parallel to each other at the end of the robotic arm 1210. The drive units and their respective drive outputs 1208 are housed in a rotating assembly 1212 of the instrument actuator 1200, driven by one of the drive units within the assembly 1212. In response to torque provided by the rotating drive unit, the rotating assembly 1212 rotates along a circular bearing that connects the rotating assembly 1212 to the non-rotating portion 1214 of the instrument actuator 1200. Electrical and control signals are transmitted from the non-rotating portion 1214 of the instrument actuator 1200 to the rotating assembly 1212 via electrical contacts, which are held by rotation of a brush slip ring connector (not shown). In other embodiments, the rotating assembly 1212 may be responsive to a separate drive unit integrated into the non-rotatable portion 1214 and is therefore not parallel to other drive units. The rotating assembly 1212 allows the instrument driver 1200 to allow the drive unit and its corresponding drive output 1208 to rotate as a single unit about the instrument driver axis 1216.

[0117] Similar to previously disclosed embodiments, the instrument 1202 may include an elongated shaft 1206 and an instrument base 1218 (shown in dashed lines) comprising a plurality of drive inputs 1220 (such as jacks, pulleys, and reels) configured to mate with a drive output 1208 of the instrument actuator 1200. Unlike previously disclosed embodiments, the instrument shaft 1206 extends from the center of the instrument base 1218, the axis of which is substantially parallel to the axes of the drive inputs 1220, rather than as... Figure 11 It is orthogonal as in the design.

[0118] When coupled to the rotating assembly 1212 of the instrument driver 1200, the medical instrument 1202, including the instrument base 1218 and the instrument shaft 1206, rotates in combination with the rotating assembly 1212 about the instrument driver axis 1216. Since the instrument shaft 1206 is positioned at the center of the instrument base 1218, it is coaxial with the instrument driver axis 1216 when attached. Therefore, rotation of the rotating assembly 1212 causes the instrument shaft 1206 to rotate about its own longitudinal axis. Furthermore, when the instrument base 1218 rotates together with the instrument shaft 1206, any tendons connected to the drive input 1220 in the instrument base 1218 do not become entangled during rotation. Therefore, the parallelism of the axes of the drive output 1208, the drive input 1220, and the instrument shaft 1206 allows the shaft to rotate without causing any control tendons to become entangled.

[0119] Figure 13 A medical device 1300 with a device-based insertion architecture according to some embodiments is illustrated. The device 1300 (alternatively referred to as a “surgical instrument”) is coupled to any of the device actuators discussed herein and, as shown, may include an elongated shaft 1302, an end actuator 1304 connected to the shaft 1302, and a shank 1306 coupled to the shaft 1302. The elongated shaft 1302 includes a tubular member having a proximal portion 1308a and a distal portion 1308b. The elongated shaft 1302 includes one or more channels or grooves 1310 along its outer surface and configured to receive one or more wires or cables 1312 passing through it. Thus, one or more cables 1312 extend along the outer surface of the elongated shaft 1302. In other embodiments, the cables 1312 may also extend through the elongated shaft 1302. Manipulation of cable 1312 (e.g., via a machine driver) causes actuation of end effector 1304.

[0120] The instrument handle 1306 (also referred to as the instrument base) typically includes an attachment interface 1314 having one or more mechanical inputs 1316, such as jacks, pulleys, or spools, which are designed to reciprocately engage with one or more drive outputs on the attachment surface of the instrument actuator.

[0121] In some embodiments, the instrument 1300 includes a series of pulleys or cables that enable the elongated shaft 1302 to translate relative to the handle 1306. In other words, the instrument 1300 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 1300. In other embodiments, the robotic arm may be largely responsible for the instrument insertion.

[0122] E. Controller .

[0123] 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.

[0124] Figure 14 This is a perspective view of an embodiment of controller 1400. In this embodiment, controller 1400 includes a hybrid controller that may have both impedance and admittance control. In other embodiments, controller 1400 may utilize only impedance or passive control. In other embodiments, controller 1400 may utilize only admittance control. By being a hybrid controller, controller 1400 advantageously has lower perceived inertia during use.

[0125] In the illustrated embodiment, the controller 1400 is configured to allow manipulation of two medical devices and includes two handles 1402. Each handle 1402 is connected to a universal joint 1404, and each universal joint 1404 is connected to a positioning platform 1406.

[0126] like Figure 14 As shown, each positioning platform 1406 includes a selectively compliant assembly robotic arm (SCARA) 1408 connected to a post 1410 via a prism joint 1412. The prism joint 1412 is configured to translate along the post 1410 (e.g., along track 1414) to allow each handle 1402 to translate in the z-direction, thus providing a first degree of freedom. The SCARA arm 1408 is configured to allow the handles 1402 to move in the xy-plane, thus providing two additional degrees of freedom.

[0127] In some embodiments, one or more load sensors are located within the controller 1400. For example, in some embodiments, load sensors (not shown) are located within the body of each gimbal in the gimbal 1404. By providing load sensors, portions of the controller 1400 can operate under admittance control, thereby advantageously reducing the sense inertia of the controller 1400 during use. In some embodiments, the positioning platform 1406 is configured for admittance control, while the gimbal 1404 is configured for impedance control. In other embodiments, the gimbal 1404 is configured for admittance control, while the positioning platform 1406 is configured for impedance control. Thus, for some embodiments, the translational or orientational degrees of freedom of the positioning platform 1406 may depend on admittance control, while the rotational degrees of freedom of the gimbal 1404 may depend on impedance control.

[0128] F. Navigation and Control .

[0129] 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.

[0130] Figure 15 This is a block diagram illustrating a positioning system 1500 for estimating the position of one or more components of a robotic system (such as the position of a machine) according to an exemplary embodiment. The positioning system 1500 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 device may be located in... Figure 1 Tower 112 shown Figures 1 to 3B The trolley 102 shown Figure 4 To the bed shown in Figure 9, etc.

[0131] like Figure 15As shown, the positioning system 1500 may include a positioning module 1502 that processes input data 1504a, 1504b, 1504c, and 1504d to generate position data 1506 for the distal end of a medical device. The position data 1506 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).

[0132] The various input data 1504a-d are now described in more detail. 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 1504a (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.

[0133] In some implementations, the device may be equipped with a camera to provide visual data 1504b. The positioning module 1502 may process the visual data 1504b to enable one or more vision-based position tracking methods. For example, preoperative model data may be used in conjunction with the visual data 1504b 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 1504a, a robotic system may generate a library of expected endoscope images based on the model, with each image linked to a position within the model, based on the expected path of the endoscope's travel. In operation, the robotic system may 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.

[0134] Other computer vision-based tracking techniques use feature tracking to determine camera motion, and thus, endoscope motion. Some features of the positioning module 1502 can identify circular geometries corresponding to anatomical cavities in the preoperative model data 1504a 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 topology maps can further enhance vision-based algorithms or techniques.

[0135] Optical flow (another computer vision-based technique) analyzes the displacement and translation of image pixels in a video sequence within visual data 1504b 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 iterative comparisons of multiple frames, the motion and position of the camera (and therefore the endoscope) can be determined.

[0136] The positioning module 1502 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 1504c. 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.

[0137] Robot commands and kinematic data 1504d can also be used by the positioning module 1502 to provide orientation data 1506 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.

[0138] Figure 15 As shown, the positioning module 1502 can use multiple other input data. For example, although in Figure 15 Although not shown, the device using shape sensing fibers can provide shape data, which the positioning module 1502 can use to determine the position and shape of the device.

[0139] The localization module 1502 can use the input data 1504a-d in combination. In some cases, this combination can use a probabilistic method, where the localization module 1502 assigns confidence weights to the position determined from each of the input data 1504a-d. Therefore, in cases where the EM data 1504c may be unreliable (possibly due to EM interference), the confidence of the position determined by the EM data 1504c may be reduced, and the localization module 1502 may rely more heavily on the visual data 1504b and / or robot commands and kinematic data 1504d.

[0140] 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 position in a global coordinate system, anatomical diagrams, etc.

[0141] 2. Introduction .

[0142] Embodiments of this disclosure relate to structural considerations and techniques for robotic surgical tools used in robotic instrument actuators. The robotic surgical tool may include: a shank having a first end; at least one spline rotatably coupled to the shank and extending proximally from the first end. The robotic surgical tool includes a layered bracket architecture. That is, the bracket is movably mounted to the at least one spline and includes a first layer and a second layer, the second layer being operatively coupled to the first layer. The at least one spline extends through a portion of at least one of the first layer and the second layer, and the bracket translates along the at least one spline. The robotic surgical tool further includes: an elongated shaft extending from the bracket and penetrating the first end, the shaft having an end effector disposed at its distal end; and an activation mechanism coupled to one or both of the first and second layers and capable of actuation to operate the end effector.

[0143] 3. Description

[0144] Figure 16A This is an isometric side view of an exemplary surgical tool 1600 incorporating some or all of the principles of this disclosure. The surgical tool 1600 may be similar in some respects to the above references. Figures 11 to 13 Any of the aforementioned medical devices, and therefore compatible with robotic surgical systems (such as...) Figures 1 to 13The surgical tool 1600 is used in conjunction with robot enabling systems 100, 400, and 900. As shown, the surgical tool 1600 includes an elongated shaft 1602, an end effector 1604 disposed at the distal end of the shaft 1602, and an articulated wrist 1606 (optionally referred to as a "wrist connector") inserted between the end effector 1604 and the distal end of the shaft 1602 and connecting the end effector to the distal end of the shaft.

[0145] The terms "proximal" and "distal" are defined herein with respect to a robotic surgical system having an interface configured to mechanically and electrically connect surgical instruments 1600 to a robotic manipulator. The term "proximal" refers to the location of an element closer to the robotic manipulator, and the term "distal" refers to the location of an element closer to the end effector 1604 and therefore closer to the patient during operation. Furthermore, directional terms such as above, below, up, down, upward, downward, left, right, etc., are used with respect to exemplary embodiments as they are shown in the figures, with upward or upper direction pointing towards the top of the corresponding figure, and downward or lower direction pointing towards the bottom of the corresponding figure.

[0146] Surgical tool 1600 may have any of a variety of configurations capable of performing one or more surgical functions. In an illustrated embodiment, end effector 1604 includes a surgical stapler configured to cut and suture (tighten) tissue, alternatively referred to as a "linear cutter". As shown, end effector 1604 includes opposing jaws 1610, 1612 configured to move (articularly) between an open position and a closed position. Alternatively, end effector 1604 may include other types of instruments requiring opposing jaws, such as, but not limited to, tissue grippers, surgical scissors, advanced-energy vascular closure devices, clamps, needle actuators, Babcock forceps including a pair of opposing gripping jaws, bipolar jaws (e.g., bipolar Maryland grippers, clamps, perforated grippers, etc.). In other embodiments, end effector 1604 may alternatively include any end effector or instrument capable of operating in conjunction with currently disclosed robotic surgical systems and methods. Such end effectors or instruments include, but are not limited to, suction flushers, endoscopes (e.g., cameras), or any combination thereof.

[0147] One or both of jaws 1610 and 1612 may be configured to pivot to actuate end effector 1604 between an open position and a closed position. In the illustrated example, the second jaw 1612 is rotatable (pivotable) relative to the first jaw 1610 to move between an open, unclamped position and a closed, clamped position. However, in other embodiments, without departing from the scope of this disclosure, the first jaw 1610 may move (rotate) relative to the second jaw 1612. In still other embodiments, both jaws 1610 and 1612 may be movable to actuate end effector 1604 between an open position and a closed position.

[0148] In the illustrated example, the first jaw 1610 is referred to as a “cabin” or “channel” jaw, and the second jaw 1612 is referred to as an “anvil” jaw. The first jaw 1610 may include a frame that houses or supports the staple cartridge, and the second jaw 1612 is pivotally supported relative to the first jaw 1610 and defines a surface that operates as an anvil to deform staples ejected from the staple cartridge during operation.

[0149] The wrist 1606 enables the end effector 1604 to articulate (pivot) relative to the axis 1602, thereby positioning the end effector 1604 in various desired orientations and positions relative to the surgical site. In the illustrated embodiment, the wrist 1606 is designed to allow the end effector 1604 to pivot (rotate) left and right relative to the longitudinal axis A1 of the axis 1602. However, in other embodiments, the wrist 1606 may be designed to provide multiple degrees of freedom, including one or more translational variables (i.e., forward and backward, heave and yaw) and / or one or more rotational variables (i.e., Euler angles or roll, pitch and yaw). Translational and rotational variables describe the position and orientation of a component of the surgical system (e.g., the end effector 1604) relative to a given reference Cartesian coordinate system. "Forward and backward" refers to forward and backward translational movements, "heave and yaw" refers to up and down translational movements, and "yaw" refers to left and right translational movements. Regarding rotational terms, "roll" refers to left and right tilting, "pitch" refers to forward and backward tilting, and "yaw" refers to left and right rotation.

[0150] In the illustrated embodiment, the pivoting movement at wrist 1606 is restricted to movement in a single plane, e.g., yaw movement only relative to the longitudinal axis A1. End effector 1604 in Figure 16AThe image is shown in a non-jointed position, in which the longitudinal axis of the end effector 1604 is substantially aligned with the longitudinal axis A1 of the shaft 1602, such that the end effector 1604 forms a substantially zero angle with respect to the shaft 1602. In the jointed position, the longitudinal axis of the end effector 1604 will be angularly offset from the longitudinal axis A1, such that the end effector 1604 will be oriented at a non-zero angle with respect to the shaft 1602.

[0151] See still Figure 16A The surgical tool 1600 may include a drive housing or "handle" 1614 that operates as an actuation system designed to facilitate joint movement of the wrist 1606 and actuation (operation) of the end effector 1604 (e.g., gripping, firing, rotation, joint movement, energy delivery, etc.). As described in more detail below, the handle 1614 provides various connection features for releasably coupling the surgical tool 1600 to an instrument actuator of a robotic surgical system.

[0152] The handle 1614 includes a plurality of drive members extending to the wrist 1606 and the end effector 1604 (in Figure 16A (Obscured). Selective actuation of one or more of the drive members causes the end effector 1604 to articulate (pivot) relative to the axis 1602 at the wrist 1606. Selective actuation of one or more other drive members causes the end effector 1604 to be actuated (operated). Actuating the end effector 1604 may include closing and / or opening the jaws 1610, 1612, thereby enabling the end effector 1604 to grasp (clamp) onto tissue. Once tissue is grasped or clamped between the opposing jaws 1610, 1612, actuating the end effector 1604 may also include “firing” the end effector 1604, which may refer to causing a cutting element or blade (not visible) to advance distally within a slot 1616 defined in the first jaw 1610. As it moves distally, the cutting element transversely cuts any tissue grasped between the opposing jaws 1610, 1612. Furthermore, as the cutting element advances distally, multiple staples contained within the staple cartridge (e.g., housed within the first jaw 1610) are pushed (cam-driven) into deformable contact with corresponding anvil surfaces (e.g., recesses) disposed on the second jaw 1612. The deployed staples can form multiple rows of staples sealing opposite sides of the transversely cut tissue.

[0153] As shown, the handle 1614 has a first end or "distal" end 1618a and a second end or "proximal" end 1618b opposite to the first end 1618a. In some embodiments, one or more support bars 1620 (two shown) extend longitudinally between the first end 1618a and the second end 1618b to help fix the distance between the first end 1618a and the second end 1618b, provide structural stability to the handle 1614, and secure the first end 1618a to the second end 1618b. However, in other embodiments, the support bars 1620 may be omitted without departing from the scope of this disclosure.

[0154] The shank 1614 may also include a lead screw 1622 and one or more splines 1624, which also extend longitudinally between the first end 1618a and the second end 1618b. In the illustrated embodiment, the shank 1614 includes a first spline 1624a, a second spline 1624b, and a third spline 1624c. Although only three splines 1624a-c are shown in the shank 1614, more or fewer splines may be included without departing from the scope of this disclosure. Unlike the support bar 1620, the lead screw 1622 and splines 1624a-c are rotatably mounted to the first end 1618a and the second end 1618b. As described in more detail below, selective rotation of the lead screw 1622 and splines 1624a-c causes various functions of the shank 1614 to occur, such as translating the end effector 1604 along the longitudinal axis A1 (e.g., translation along the z-axis), thereby causing the end effector 1604 to articulate (pivot) at the wrist 1606, causing the jaws 1610, 1612 to open and close, and causing the end effector 1604 to fire (operate).

[0155] The shank 1614 also includes a bracket 1626 movably mounted along the lead screw 1622 and splines 1624a-c, and houses various activation mechanisms configured to induce specific functional operations of the end effector 1604. The bracket 1626 may include two or more layers. Figure 16AThe layers shown are a first layer 1628a, a second layer 1628b, a third layer 1628c, a fourth layer 1628d, and a fifth layer 1628e. Lead screws 1622 and splines 1624a-c each extend through portions of one or more of the layers 1628a-e to allow the bracket 1626 to translate relative to the lead screws 1622 and splines 1624a-c along the longitudinal axis A1. In some embodiments, the layers 1628a-e may be secured in series with each other using one or more mechanical fasteners 1630 (two visible) extending between the first layer 1628a and the fifth layer 1628e and passing through coaxial alignment holes defined in some or all of the layers 1628a-e. Although five layers 1628a-e are shown, more or fewer layers may be included in the bracket 1626 without departing from the scope of this disclosure.

[0156] Shaft 1602 is coupled to bracket 1626 and extends distally from the bracket through a first end 1618a of shank 1614. In an illustrated embodiment, for example, shaft 1602 penetrates the first end 1618a at a central hole 1632 defined through it. Bracket 1626 is movable (e.g., z-axis translation) along longitudinal axis A1 between the first end 1618a and the second end 1618b, thereby enabling the advancement or retraction of end actuator 1604 relative to shank 1614, as indicated by arrow B. More specifically, in some embodiments, bracket 1626 includes bracket nut 1634 mounted to lead screw 1622 and secured between third layer 1628c and fourth layer 1628d. The outer surface of lead screw 1622 defines an external helical thread, and bracket nut 1634 defines a corresponding internal helical thread (not shown) capable of engaging with the external helical thread of lead screw 1622. Therefore, the rotation of the lead screw 1622 causes the bracket nut 1634 to advance or retract the bracket 1626 along the longitudinal axis A1, and correspondingly advance or retract the end actuator 1604 relative to the shank 1614.

[0157] As indicated, the lead screw 1622 and splines 1624a-c are rotatably mounted to the first end 1618a and the second end 1618b. More specifically, the first end 1618a of the shank 1614 may include one or more rotatable drive inputs actuated to independently drive (rotate) the lead screw 1622 and splines 1624a-c. In the illustrated embodiment, the shank 1614 includes a first drive input 1636a, a second drive input 1636b, and a third drive input 1636c (covered by the shaft 1602, see [link]). Figure 17BThe fourth drive input 1636a-d is described below. Each drive input 1636a-d can cooperate with a corresponding drive output of the instrument actuator, such that movement (rotation) of a given drive output correspondingly moves (rotates) the associated drive input 1636a-d, thereby rotating the mating lead screw 1622 or splines 1624a-c. Although only four drive inputs 1636a-d are shown, depending on the specific application, the handle 1614 may include more or fewer than four drive inputs.

[0158] The first drive input 1636a is operably coupled to the lead screw 1622 such that rotation of the first drive input 1636a correspondingly rotates the lead screw 1622, causing the bracket nut 1634 and the bracket 1626 to advance or retract along the longitudinal axis A1 according to the direction of rotation of the lead screw 1622. As used herein, the phrase "operably coupled" refers to a direct or indirect coupling in which movement of one component causes a corresponding movement of the other component. Such operable coupling with respect to the first drive input 1636a operably coupled to the lead screw 1622 can be facilitated by intermeshing gears (not shown) arranged in the second end 1618a, but can alternatively be facilitated by other mechanical means (such as cables, pulleys, drive rods, direct couplings, etc.) without departing from the scope of this disclosure.

[0159] The second drive input 1636b is operably coupled to the first spline 1624a, such that rotation of the second drive input 1636b correspondingly rotates the first spline 1624a. In some embodiments, the first spline 1624a is operably coupled to the first activation mechanism 1638a of the bracket 1626, and the first activation mechanism 1638a is operable to open and close the jaws 1610, 1612. Therefore, depending on the direction of rotation of the first spline 1624a, rotating the second drive input 1636b will correspondingly actuate the first activation mechanism 1638a, thereby opening or closing the jaws 1610, 1612.

[0160] The third drive input 1636c can be operatively coupled to the second spline 1624b, such that rotation of the third drive input 1636c correspondingly rotates the second spline 1624b. In some embodiments, the second spline 1624b can be operatively coupled to the second activation mechanism 1638b of the bracket 1626, and the second activation mechanism 1638b can be operatively configured to articulate the end effector 1604 at the wrist 1606. Therefore, depending on the direction of rotation of the second spline 1624b, rotation of the third drive input 1636c will correspondingly actuate the second activation mechanism 1638b, thereby causing the wrist 1606 to articulate with at least one degree of freedom.

[0161] The fourth drive input 1636d is operably coupled to the third spline 1624c, such that rotation of the fourth drive input 1636d correspondingly rotates the third spline 1624c. In some embodiments, the third spline 1624c is operably coupled to the third activation mechanism 1638c of the bracket 1626, and the third activation mechanism 1638c may be operable to actuate the cutting element (blade) at the end effector 1604. Therefore, depending on the direction of rotation of the third spline 1624c, rotation of the fourth drive input 1636d will correspondingly actuate the third activation mechanism 1638c, thereby causing the blade to advance or retract.

[0162] In the illustrated embodiments, and as described in more detail below, the activation mechanism 1838a-c includes intermeshing transmission components, which include one or more drive gears driven by rotation of the corresponding splines 1624a-c and configured to drive one or more corresponding driven gears that cause a specific functional operation of the end effector 1604.

[0163] In some embodiments, the handle 1614 may include a cover 1640 sized to receive and otherwise surround the bracket 1626, the lead screw 1622, and the splines 1624a-c. In an illustrated embodiment, the cover 1640 includes a tubular or cylindrical structure having a first end 1642a capable of engaging with a first end 1618a of the handle 1614 and a second end 1642b capable of engaging with a second end 1618b of the handle 1614. The bracket 1626, the lead screw 1622, and the splines 1624a-c may all be accommodated within the cover 1640, and the bracket 1626 may engage with one or more tracks 1644 (shown in dashed lines) fixed to the cover 1640 and move (travel) back and forth on said tracks. The track 1644 extends longitudinally and parallel to the lead screw 1622, and is sized to be received within corresponding recesses 1646 defined on the outer periphery of the bracket 1626, and more specifically on the outer periphery of one or more bracket layers 1628a-e. As the bracket 1626 translates along the longitudinal axis A1, the track 1644 helps maintain the angular position of the bracket 1626 and bears any torsional loads that might otherwise adversely affect the movement or operation of the bracket 1626.

[0164] Figure 16B This is an isometric view of another exemplary embodiment of the surgical tool 1600 according to one or more additional embodiments. Figure 16B The surgical tools 1600 are basically similar to Figure 16AThe surgical tool 1600 differs in that the handle 1614 has only a first end or "distal" end 1618a to which the lead screw 1622 and one or more splines 1624 are rotatably mounted and extend longitudinally. That is, there is no second end 1618b to which the splines 1624 and lead screw 1622 are rotatably mounted. Instead, the splines 1624 and lead screw 1622 cantilever into the air, having a cantilevered proximal portion 1625.

[0165] The bracket 1626 is movably mounted along the lead screw 1622 and splines 1624a-c and houses various activation mechanisms configured to induce specific functional operations of the end effector 1604. The lead screw 1622 and splines 1624a-c each extend portions through one or more of the layers 1628a-e to allow the bracket 1626 to translate relative to the lead screw 1622 and splines 1624a-c along the longitudinal axis A1. The bracket 1626 can be translated from the distal end 1618a of the shank to the cantilevered proximal portion 1625. Without the added mass of the second end 1618b, the mass distribution of the surgical tool 1600 is optimized more towards the first end 1618a compared to the original surgical tool 1600.

[0166] Figure 17A It is releasably coupled to the exemplary instrument driver 1702 according to one or more embodiments. Figure 16A An isometric view of the surgical instrument 1600. The instrument actuator 1702 is similar in some respects to... Figure 11 and Figure 12 The instrument actuators 1102 and 1200 are used, and therefore can be best understood with reference to them. Similar to, for example, instrument actuators 1102 and 1200, instrument actuator 1702 may be mounted to or otherwise positioned at the end of a robotic arm (not shown) and is designed to provide the prime mover required to operate surgical tool 1600. However, unlike instrument actuators 1102 and 1200, the shaft 1602 of surgical tool 1600 extends through and penetrates instrument actuator 1702.

[0167] The instrument actuator 1702 has a body 1704 having a first end or "proximal" end 1706a and a second end or "distal" end 1706b opposite the first end 1706a. In the illustrated embodiment, the first end 1706a of the instrument actuator 1702 is capable of engaging with and releasably coupled to the first end 1618a of the handle 1614, and the shaft 1602 of the surgical tool 1600 extends through the body 1704 and extends distally from the second end 1706b.

[0168] Figure 17B Depicting Figure 17A Separate isometric end views of the instrument actuator 1702 and the surgical tool 1600. With jaws 1610, 1612 closed, shaft 1602 and end effector 1604 can penetrate the instrument actuator 1702 by extending longitudinally through a central bore 1708 defined by the body 1704 between the first end 1706a and the second end 1706b. To align the surgical tool 1600 with the instrument actuator 1702 at a suitable angular orientation, one or more alignment guides 1710 may be disposed or otherwise defined within the central bore 1708 and configured to engage one or more corresponding alignment features 1712 disposed on the surgical tool 1600. In the illustrated embodiment, alignment feature 1712 includes a protrusion or projection defined on or otherwise provided by an alignment nozzle 1714 extending distally from a first end 1618a of the shank 1614. In one or more embodiments, the alignment guide 1710 may include a curved or arched shoulder or lip configured to receive and guide the alignment feature 1712 as the alignment nozzle 1714 enters the central bore 1708. As a result, as the alignment nozzle 1714 is advanced distally through the central bore 1708, the surgical instrument 1600 is oriented to be aligned at an appropriate angle with the instrument actuator 1702. In other embodiments, without departing from the scope of this disclosure, the alignment nozzle 1714 may be omitted and the alignment feature 1712 may alternatively be provided on the shaft 1602.

[0169] As shown in the figure, a drive interface 1716 is located at a first end 1706a of the instrument actuator 1702, and a driven interface 1718 is located at a first end 1618a of the handle 1614. The drive interface 1716 and the driven interface 1718 can be configured to mechanically, magnetically, and / or electrically connect the handle 1614 to the instrument actuator 1702. To achieve this, the drive interface 1716 and the driven interface 1718 can provide one or more mating positioning features configured to secure the handle 1614 to the instrument actuator 1702. In an illustrated embodiment, for example, the drive interface 1716 provides one or more interlocking feature structures 1720 (three are shown) configured to position and engage one or more complementary recesses 1722 (two are shown, one is obscured) on the driven interface 1718. In some embodiments, feature 1720 may be configured to engage and align with recess 1722, for example, via an interference fit or snap-fit.

[0170] The instrument driver 1702 also includes one or more drive outputs extending through the drive interface 1716 to mate with drive inputs 1636a-d disposed at a first end 1618a of the handle 1614. More specifically, the instrument driver 1702 includes a first drive output 1724a mateable with the first drive input 1636a, a second drive output 1724b mateable with the second drive input 1636b, a third drive output 1724b mateable with the third drive input 1636c, and a fourth drive output 1724d mateable with the fourth drive input 1636d. In some embodiments, as shown, the drive outputs 1724a-d may define splines or features designed to mate with corresponding spline sockets of the drive inputs 1636a-d. Once properly engaged, the drive inputs 1636a-d will share a rotational axis with their corresponding drive outputs 1724a-d, allowing rotational torque to be transmitted from the drive outputs 1724a-d to the corresponding drive inputs 1636a-d. In some embodiments, each drive output 1724a-d may be spring-loaded and originally biased outwards away from the drive interface 1716. Each drive output 1724a-d may be able to retract partially or completely into the drive interface 1716.

[0171] In some implementations, the instrument driver 1702 may include additional drive outputs, in Figure 17B The fifth drive output 1724e and the sixth drive output 1724f are depicted in the diagram. The fifth drive output 1724e and the sixth drive output 1724f can be configured to engage with an additional drive input (not shown) of the handle 1614 to assist in performing one or more additional functions of the surgical tool 1600. However, in the illustrated embodiment, the handle 1614 does not include an additional drive input capable of engaging with the fifth drive output 1724e and the sixth drive output 1724f. Instead, the driven interface 1718 defines corresponding recesses 1726 configured to receive the fifth drive output 1724e and the sixth drive output 1724f. However, in other applications, a fifth drive input and / or a sixth drive input (not shown) may be included in the handle 1614 to cooperate with the fifth drive output 1724e and the sixth drive output 1724f, or the surgical tool 1600 may be replaced with another surgical tool having a fifth drive input and / or a sixth drive input that will be driven by the fifth drive output 1724e and / or the sixth drive output 1724f.

[0172] Although not shown, in some embodiments, an instrument sterile adapter (ISA) may be placed at the interface between the instrument driver 1702 and the surgical instrument 1600. In such applications, the interlocking feature structure 1720 may operate as an alignment feature and possibly a latch for placing, stabilizing, and securing the ISA. The stability of the ISA may be achieved by a nasal cone feature provided by the ISA and extending into the central bore 1708 of the instrument driver 1702. The latch may occur with the interlocking feature structure 1720 or at other locations at the interface. In some cases, the ISA will provide means to aid alignment and facilitate latching the surgical instrument 1600 to the ISA and simultaneously to the instrument driver 1702.

[0173] Layered brackets

[0174] Figure 18 It is based on one or more implementation schemes. Figure 16A An enlarged side view of an exemplary embodiment of the bracket 1626. According to some aspects of this disclosure, the bracket 1626 is configured to accommodate various instrument-specific functions independent of the insertion function (z-axis translation of the bracket 1626). As discussed above, the bracket 1626 may include two or more structural layers operably coupled in series with each other for synergistic z-axis translation, wherein each layer is associated with at least one function of the surgical instrument 1600. In other words, the two or more structural layers operate the end effector 1604 ( Figure 16A The end effector is detached from the insertion axis of the surgical tool 1600 and is capable of translating along the insertion axis of the surgical tool.

[0175] The bracket 1626 includes structural layers 1628a-e stacked together to form a bracket frame. Layers 1628a-e contain or accommodate one or more activation mechanisms operatively coupled to corresponding splines extending through portions of layers 1628a-e for performing individual functions of an end effector positioned distally on the tool axis. The bracket 1626 and structural layers 1628a-e enable axial reciprocating movement of the drive splines during instrument insertion (z-translation) without affecting end effector functionality (e.g., wrist movement, grasping, etc.). While the illustrated embodiment shows five structural layers 1628a-e, it should be understood that the number of layers is not limiting and can vary, for example, in relation to the number of functions desired for the associated surgical instrument. For example, the number of layers 1628a-e can be equal to the number of desired tool functions.

[0176] Each structural layer 1628a-e includes a layer body 1829a-e having a distal surface and spaced-apart proximal surfaces. For example... Figure 18As shown in exemplary embodiments, each layer body 1829a-e includes a substantially flat distal surface and a substantially flat proximal surface. For example, a second structural layer 1628b having a second layer body 1829b includes a substantially flat distal surface 1851d and a substantially flat proximal surface 1851p opposite to the distal surface 1851d. The second layer body 1829b has a length Lb, which is defined as the distance between the two spaced-apart surfaces 1851d, 1851p, and in the direction of the insertion axis of the surgical instrument. In some embodiments, the second layer body 1829b accommodates a corresponding activation mechanism 1638b or otherwise helps to secure the activation mechanism within the length Lb.

[0177] The distal and proximal surfaces of each layer body 1829a-e facilitate the stacking arrangement of layers 1628a-e. Specifically, the proximal surface of one layer (e.g., proximal surface 1850p of layer 1628a) is complementary in shape to the distal surface 1851d of the adjacent layer 1628b. Although in Figure 18 The diagram shows a substantially flat planar surface; however, it should be understood that other complementary surface configurations may be employed, such as adjacent convex and concave surfaces. In other words, each structural layer is configured to abut at least one surface of an adjacent layer. For example, the first structural layer 1628a includes a proximal abutment surface 1850p that abuts the distal abutment surface 1851d of the adjacent second structural layer 1628b. Although not shown, it is conceivable that gaskets or washers may be present between the entire surface and / or portions of the surfaces of adjacent layers, for example, between surfaces 1850p and 1851d, wherein these layers are arranged in series and generally aligned along the axis of the surgical instrument.

[0178] As briefly mentioned above, layers 1628a-e can be removably secured in series with each other using one or more mechanical fasteners 1630 (three visible). Since each layer 1628a-e houses or helps to contain an activation mechanism, which typically corresponds to a specific function of the associated surgical tool, the function of the surgical tool can be disabled by disconnecting the associated layer and the associated activation mechanism. Disabling features can be advantageous when it is necessary to disable the tool or certain functions. For example, if a robotic system is unable to perform a specific function, disconnecting the associated layer allows the instrument to be removed from the instrument actuator.

[0179] exist Figure 18In this embodiment, some or all of the layers 1628a-e include coaxial alignment holes in each layer body 1829a-e, these holes being configured to receive mechanical fasteners 1630. Mechanical fasteners 1630 can connect two or more layers in series by extending through the coaxial alignment holes in each layer 1628a-e. In this manner, each layer 1628a-e can be disconnected from the bracket assembly 1626 by removing the corresponding fastener 1630. In other embodiments, the bracket 1626 is configured to allow each layer 1628a-e to be mechanically connected to an adjacent layer via discrete fasteners. In this manner, each layer 1628a-e can be disconnected segmentally. Mechanical fasteners 1630 can include any conventional fasteners, including but not limited to screws, bolts, nuts, or snap-fit ​​connectors.

[0180] As briefly mentioned above, bracket 1626 may define or otherwise provide one or more recesses configured to engage guide rail 1644 of handle 1614. Figure 16A Each guide rail 1644 may include an elongated structure that extends substantially longitudinally along the axial length of the handle 1614 and may be configured to help maintain the angular position of the bracket 1626. In an illustrated embodiment, the guide rail 1644 is received within recesses 1646b, 1646c, respectively defined in the second layer 1628b and the third layer 1628c. More specifically, recesses 1646b and 1646c are defined in the outer periphery of the bodies 1829b, 1829c of the second structural layer 1628b and the third structural layer 1628c, respectively. The recesses 1646b, 1646c are complementary in shape to the cross-section of the guide rail 1644, thereby allowing a sliding relationship between the bracket 1626 and the guide rail 1644.

[0181] In some embodiments, the bracket 1626 is guided to move back and forth along the length of the handle 1614 by at least two bracket rails 1644 received in corresponding recesses, these recesses providing resistance to torsional loads borne by the bracket 1626. In some cases, a single layer includes two recesses, each configured to engage a separate rail. In other cases, at least one layer includes a recess configured to engage a first rail, and another connecting layer includes a recess configured to engage a second rail, wherein the second rail is opposite the first rail. For example, a third layer 1628c includes a recess 1646c capable of engaging the first rail 1644, while another connecting layer (e.g., one or more of layers 1628a, 1628b, 1628d, 1628e) includes a recess on an opposite side (covered by the bracket 1626), the connecting layer being configured to move slidably back and forth on a second rail (not shown).

[0182] The main body 1829a-e is configured to secure and support one or more activation mechanisms. The activation mechanisms described herein are energized or otherwise actuated by rotation of one or more drive outputs, correspondingly driving one or more mechanical functions of the surgical instrument. For example, but not limited to, the activation mechanisms may include interlocking transmission or cable systems that cause actuation of the surgical instrument's functions. Figure 18 In an exemplary embodiment, the activation mechanism is implemented as an engaging transmission device that rotates together with a drive spline coupled to a drive output member, as generally described above. More specifically, the first spline 1624a can be operatively coupled to the first activation mechanism 1638a, such that (via FIG. 16 and Figure 17B The rotation of the second drive input 1636b causes the first spline 1624a to rotate, which in turn actuates the first activation mechanism 1638a, thereby performing a function according to the rotation direction of the first spline 1624a, such as opening or closing the end actuator 1604. Figure 16A ) jaws 1610, 1612 ( Figure 16A ).

[0183] As shown, a first spline 1624a extends longitudinally through a coaxial alignment hole 1821 (only one visible) defined in the first layer 1628a and the second layer 1628b of the bracket 1626. A drive gear 1838a may be included together with the first spline 1624a and located between adjacent portions of the first layer 1628a and the second layer 1628b. The first spline 1624a may have a cross-sectional shape capable of engaging with a corresponding internal shape channel (described in more detail below) extending through the entire body of the drive gear 1838a. Rotation of the first spline 1624a correspondingly drives rotation of the drive gear 1838a. In such embodiments, as the bracket 1626 moves along the longitudinal axis A1 ( Figure 16A As the first spline 1624a moves, the drive gear 1838a will correspondingly move along the length of the first spline 1624a, as if trapped between the first layer 1628a and the second layer 1628b. However, in other embodiments, the first spline 1624a may be shaped as a drive gear and otherwise configured to operate as a drive gear. In such embodiments, the drive gear 1838a can be omitted to advantageously reduce the number of components.

[0184] The first activation mechanism 1638a may include at least one additional gear, such as a driven gear (described below). Figure 20The driven gear 1838a can be positioned on the bracket 1626 to engage with the driven gear or otherwise mesh with it. Therefore, as the first spline 1624a rotates, the drive gear 1838a can drive the driven gear to rotate, thereby actuating the first activation mechanism 1638a.

[0185] According to another aspect of this disclosure, the spline of the mechanism that operably connects the drive input of the instrument handle to the activation mechanism of the bracket can have various shapes and configurations to reduce the mass of the tool and minimize friction, while possessing sufficient rigidity to efficiently transmit rotation. For example, Figure 19A The mechanical connection component of a splined drive gear 1938a, embodied as a structural layer 1928a, is shown. This splined drive gear is rotatably and slidably coupled to spline 1924a. Splined gear 1938a includes a channel 1939a extending through the entire gear body. In some embodiments, as shown, channel 1939a has a shape complementary in form to the cross-section of the associated spline 1924a. In this way, spline 1924a is configured to be received within splined gear 1938a and to allow splined gear 1938a to slide along the length of spline 1924a in the z-direction, while maintaining the ability of spline 1924a to transmit rotational torque to splined gear 1938a at any location along the length of spline 1924a. In the illustrated embodiment, spline 1924a and channel 1939a are star-shaped, i.e., the cross-section of each is a six-pointed star.

[0186] exist Figure 19B In an exemplary embodiment, spline 1924b is shaped as a semicircle, i.e., having a substantially circular portion 1940 and a substantially flat edge 1941. Spline gear 1938b is fixed to structural layer 1928b or otherwise included in structural layer. Due to the complementary shapes of spline 1924b and spline gear 1938b, rotation of spline 1924b will correspondingly drive rotation of spline gear 1938b.

[0187] Although the spline shape is Figure 19A and Figure 19B The splines and spline gear channels are shown in star and semi-circular shapes, but their shapes are not limited to the examples shown. For example, splines and spline gear channels can have other shapes, including but not limited to... Figure 19C The shapes shown, such as spline 1924c with a rectangular cross-section, spline 1924d with a square cross-section, and spline 1924e with a triangular cross-section, are examples. Furthermore, splines can be solid, such as... Figure 19C As shown, or it can be hollow, such as Figure 19A and Figure 19BAs shown, this is done to reduce the mass of the spline. Reducing the spline mass decreases the moment of inertia of the spline and facilitates changes in the rotational speed of the drive components (drive input, drive output, spline, and spline gear).

[0188] The shapes of the splines and complementary gear channels (e.g., splines 1924a, 1924b and complementary channels 1939a, 1939b) are selected based on a variety of factors. In some embodiments, when the carrier carrying at least one splined gear translates along at least one spline, the contact surface area between the spline and the complementary gear channel is preferably reduced to decrease friction between the two components. In some embodiments, a non-circular cross-section is preferred, making it less likely for the two to separate or slip during the transmission of rotation from the spline to the splined gear.

[0189] Splines can be made of any suitable material with sufficient rigidity to transmit torque from the drive input to the spline gear via spline gear channels (e.g., spline gear 1938a and channel 1939a). Generally, the stiffer or more ridged the spline (i.e., the more complex the geometry), the greater the torque it can transmit. In some embodiments, splines are made of metallic materials, such as, but not limited to, stainless steel. In other embodiments, splines are made of plastic materials. Splines can be formed by a variety of methods, including but not limited to machining, extrusion, injection molding, and 3D printing.

[0190] In some embodiments, the splines or spline channels (e.g., spline 1924a, spline channel 1939a) are coated to reduce friction. For example, but not limited to, the surface of the splines may be coated with a drag-reducing agent, including but not limited to polymer coatings such as baked Krytox. TM Polytetrafluoroethylene

[0191] Figure 20Exemplary splines connected to an activation mechanism are shown, incorporating some or all of the principles of this disclosure. More specifically, spline 2024, idler gear 2038, and driven gear 2048 are shown. Idler gear 2038 and driven gear 2048 may be rotatably fixed to structural layer 2028 or otherwise accommodated within structural layer. Idler gear 2038 is operatively connected to adjacent spline 2024 and adjacent driven gear 2048 for transmitting rotation from spline 2024 to driven gear 2048. More specifically, instead of drive gears sliding through channels of complementary shapes of gears (e.g., channels 1939a, 1939b of gears 1938a, 1938b), idler gear 2038 defines elongated teeth that mesh with corresponding elongated teeth of adjacent spline 2024. The idler gear 2038 is capable of sliding along the axial length of the adjacent spline 2024 while maintaining the ability to rotate in response to rotation of the spline 2024 at any position along the axial length of the spline 2024. In some cases, the idler gear 2038 may be directly coupled to the tool shaft. In other cases, rotation of the idler gear 2038 may correspondingly drive the driven gear 2048, and the driven gear 2048 may be configured to drive the surgical tool 1600. Figure 16A It is part of the mechanism for activating the mechanical function of a machine.

[0192] Structural exoskeleton

[0193] Figure 21A and Figure 21B These are based on one or more implementation schemes. Figure 16A Exploded isometric view and end view of an alternative embodiment of the handle 1614. As described herein, the shroud 1640 of the handle 1614 ( Figure 16A ) can be constructed to provide surgical tools 1600 ( Figure 16A This adds structural benefits, including but not limited to bracket guidance and stability. For example... Figure 21A As shown, the handle 1614 is operably coupled to the instrument driver 2102 at its first end 1618a. The instrument driver 2102 includes one or more drive outputs extending through a drive interface to mate with drive inputs 2136a-d disposed at the first end 1618a of the handle 1614. Each drive input 2136a-d is configured to be operably coupled to a corresponding spline (similar to...). Figure 16A The splines 1624a-c extend along the longitudinal axis of the shank 1614, such that rotation of the drive inputs 2136a-d correspondingly rotates the associated splines. As described above, the center hole 1632 is configured to receive the shaft 1602 of the surgical tool 1600. Figure 16A ).

[0194] Figure 21A It also shows Figure 16A An alternative implementation of the protective shield 1640, in Figure 21A The shield 2140 is designated as 2140. The shield 2140 is characterized as a rigid, hollow exoskeleton with a continuous exoskeleton wall 2141, its dimensions set to receive a bracket 2126 having a compatible (e.g., complementary) cross-section. Figure 21B ) and the lead screw and spline connecting to the drive input 2136a-d. The bracket 2126 can be connected to Figure 16A The bracket 1626 is similar or identical. In the illustrated embodiment, the shield 2140 (also referred to herein as "exoskeleton 2140") includes a non-circular tubular structure having a distal end 2142a capable of engaging with a first end 1618a of the handle 1614 and a proximal end 2142b opposite to the distal end 2142a.

[0195] The exoskeleton 2140 has a non-circular cross-section that prevents rotation of the complementary-shaped bracket 2126 received within it. The exoskeleton 2140 may exhibit one or more non-circular features, including but not limited to recesses 2145, edges 2146, corners 2147, ridges / lobes 2148, chambers, convex surfaces, concave surfaces, protrusions, projections, and any combination thereof. Such non-circular features can prove advantageous in aiding in guiding the similarly shaped bracket 2126 as it moves back and forth between the distal end 2142a and the proximal end 2142b. More specifically, the non-circular features serve to maintain the angular orientation of the bracket 2126 and bear any torsional loads applied to the bracket 2126 during operation. Additionally, the non-circular geometry of the exoskeleton 2140 prevents the tool from rolling on flat surfaces. For example, if a surgical instrument is placed on a flat surface, such as on a table to one side, a non-circular geometry prevents the surgical instrument from rolling across the flat surface, potentially causing it to fall and damage the instrument or injure nearby objects / people.

[0196] In some embodiments, the non-circular geometry of the exoskeleton 2140 may exhibit symmetry, i.e., it may be symmetrical in shape, including but not limited to axial symmetry. For example, the exoskeleton 2140 may exhibit symmetry about an axis of symmetry S. That is, the axis of symmetry divides the cross-section of the exoskeleton 2140 into two identical halves (left-right symmetry). Although one axis of symmetry S is shown, it is conceivable that the exoskeleton may have multiple axes of symmetry about its cross-section. However, in other embodiments, the non-circular cross-section may be asymmetrical in shape, i.e., it may not exhibit symmetry. For example, this could be... Figure 25BThis can be seen in the non-circular cross-section of the exoskeleton 2540. In some embodiments, the shape of the non-circular cross-section is designed to minimize the cross-sectional area of ​​the handle 1614, thus potentially saving manufacturing costs. In some embodiments, the non-circular cross-section includes recesses 2145 and ridges 2148 related to the location and size of the spline (discussed in more detail below) and / or the activation mechanism of the bracket 2126.

[0197] As described above, the non-circular cross-section of the exoskeleton 2140 helps prevent the bracket 2126 from twisting or rotating within the exoskeleton 2140 when it bears torsional loads during operation. That is, the configuration of the exoskeleton 2140 can be functionally similar to that described above with respect to Figure 16 and... Figure 18 The guide rail 1644 is discussed. Instead of omitting both the exoskeleton 2140 and the guide rail 1644, which provide substantially the same function, the complexity of surgical instruments can be reduced by using only the exoskeleton, thereby saving costs, weight, and materials. Once the bracket 2126 is aligned and inserted into the shaped hollow exoskeleton 2140, the bracket 2126 is rotatably fixed relative to the exoskeleton 2140 as the bracket advances and retracts between the distal end 2142a and the proximal end 2142b.

[0198] As described above, bracket 2126 can be coupled to a shaft having an end effector. The shaft and end effector may be similar in some respects to... Figure 16A The shaft 1602 and end effector 1604 are thus best understood with reference to them. Translation of the bracket 2126 within the exoskeleton 2140 causes the end effector to advance and retract relative to the handle 1614, and prevents undesirable rotation of the shaft and end effector due to the complementary geometry of the exoskeleton 2140 and the bracket 2126. The bracket 2126 may also be movably mounted to at least one spline also housed within the exoskeleton 2140. In some embodiments, the bracket 2126 may also be movably mounted to a lead screw (e.g., Figure 16A (lead screw 1622). The torsional load generated by the rotation of the spline and / or lead screw is transmitted to the exoskeleton wall 2141, which provides stability to the end effector during functional operation.

[0199] In some embodiments, the exoskeleton 2140 includes at least one fastener hole 2150 extending at least partially between a distal end 2142a and a proximal end 2142b. The fastener hole 2150 is configured to receive a mechanical fastener for securing the exoskeleton 2140 to a first end of the handle 1614. In some embodiments, the fastener hole 2150 is integrated into or otherwise defined by the exoskeleton wall 2141 of the exoskeleton 2140. In other embodiments, and as... Figure 21AAs shown in an exemplary embodiment, the fastener hole 2150 includes a through hole defined by an alignment feature 2151 that axially passes through the exoskeleton 2140.

[0200] More specifically, the exoskeleton 2140 may include at least one sidewall protrusion 2151 that projects outward from the exoskeleton wall 2141 and extends longitudinally between a distal end 2142a and a proximal end 2142b. In some embodiments, the sidewall protrusion 2151 may include, or otherwise include, a physical alignment feature for engaging the exoskeleton 2140 with a first end 1618a of the handle 1614. That is, the first end 1618a of the handle 1614 includes at least one alignment recess 2152 that is shaped to complement the sidewall protrusion 2151, such that when the exoskeleton 2140 is engaged with the first end 1618a, the alignment feature 2151 is nested within the alignment recess 2152. In this way, the exoskeleton 2140 and the bracket 2126 housed therein can be suitably aligned and engaged with various drive inputs 2136a, 2136b, for example via spline engagement extending the length of the handle 1614. In some embodiments, as shown in the figure, the exoskeleton 2140 may include a plurality of alignment features 2151, and each alignment feature 2151 may be configured to engage with a corresponding alignment recess 2152 of the handle 1614.

[0201] Continue to refer to Figure 21A The proximal end 2142b of the exoskeleton 2140 may be configured to receive a top cover 2160. The top cover 2160 may be shaped similarly to the cross-section of the exoskeleton 2140. In some embodiments, the top cover 2160 may help provide a sealing interface at the proximal end 2142b, thereby substantially sealing the internal volume V of the exoskeleton 2140 from the external environment. This also prevents dust, debris, and fluids from migrating into the interior and potentially damaging the tool. In some embodiments, a gasket (not shown), such as a rubber gasket, may be placed between the top cover 2160 and the exoskeleton 2140 to enhance the sealing quality of the internal volume V. The top cover 2160 may also help prevent the bracket 2126 from being removed from the exoskeleton 2140. For example, if the tool tips over, the top cover 2160 secured to the proximal end 2142b will prevent the bracket 2126 from falling out of the hollow exoskeleton 2140.

[0202] In some embodiments, the top cover 2160 may be engaged with the proximal end 2142b of the exoskeleton 2140 via a snap-fit ​​connection. In other embodiments, or additionally, the top cover 2160 may define at least one hole 2162 positioned to align with a fastener hole 2150 of the exoskeleton 2140 and configured to receive a mechanical fastener. The mechanical fastener may be used to secure the top cover 2160 separately to the exoskeleton 2140, or the mechanical fastener may extend through both the hole 2162 and the fastener hole 2150 to secure both the top cover 2160 and the exoskeleton 2140 to a first end 1618a of the handle 1614.

[0203] The top cover 2160 may also provide ergonomic features to enhance the gripping experience of surgical instruments. For example, in some embodiments, the top cover 2160 may define or otherwise provide a rounded peripheral edge 2161. The top cover 2160 may include other features (not shown), such as protrusions or handles, for ergonomically adapting to the placement of the user's hand.

[0204] The exoskeleton 2140 may also include structures and features that facilitate gripping and / or enhance structural integrity. For example... Figure 21B As depicted, for example, exoskeleton 2140 may define or otherwise provide a plurality of structural ribs 2155 extending outwardly from exoskeleton wall 2141. Ribs 2155 may extend at least partially between distal end 2142a and proximal end 2142b and / or circumferentially around a non-circular cross-section. In some embodiments, ribs 2155 add support and stiffness to exoskeleton 2140. That is, the placement of ribs 2155 around the periphery of exoskeleton wall 2141 allows for minimization of the thickness of exoskeleton wall 2141 (reducing weight and saving material) while still maintaining sufficient stiffness to withstand torsional loads applied to bracket 1614 during translation or activation of surgical tool function.

[0205] In some embodiments, an outer coating 2156 may be applied to the outer surface of the exoskeleton 2140 to enhance the gripping properties of the surgical instrument. For example, the exoskeleton 2140 may be coated with a material having a high coefficient of friction, which helps prevent unwanted slippage when grasped by an operator's hand 2190. Several suitable materials with a high coefficient of friction may be used for the outer coating, such as siloxane elastomers. Other types of coatings, including but not limited to hydrophobic coatings, are also contemplated herein for application to the outer surface of the exoskeleton 2140.

[0206] In some embodiments, the exoskeleton 2140 may include a coating applied to its inner surface to enhance the sliding relationship between the bracket 1614 and the exoskeleton 2140. For example, the exoskeleton 2140 may be internally coated with a material having a low coefficient of friction. The low-friction material allows the bracket 1614 to slide smoothly along the guide cross-section, thereby preventing restraint.

[0207] The exoskeleton 2140 may be constructed of a suitable material that imparts sufficient rigidity to allow translation of the support 2126 subjected to forces of varying direction associated with the operation of the surgical tool being designed. In some embodiments, the exoskeleton 2140 is made of a metallic material, such as, but not limited to, steel (e.g., stainless steel), aluminum, any alloy thereof, or any combination thereof. In other embodiments, the exoskeleton 2140 may be made of a polymeric or plastic material, such as, but not limited to, polyurethane, polycarbonate, acrylonitrile butadiene styrene (ABS), and polyethylene, which may include filler polymers, including but not limited to glass or carbon fiber. In other embodiments, the exoskeleton 2140 may be made of a composite material, such as glass fiber or carbon fiber.

[0208] Figure 22A and Figure 22B An alternative embodiment of the handle 1614 of a surgical tool 1600 according to one or more additional embodiments is shown. As shown, the handle 1614 includes a layered bracket 2226, which is similar in some respects to those in Figures 16 and 17. Figure 18 The bracket 1626, and the bracket 2226 is movably connected to at least one spline 2222. Exoskeleton 2240a ( Figure 22A ) or exoskeleton 2240b ( Figure 22B The exoskeletons 2240a and 2240b may be configured to guide the bracket 2226 as it moves axially along the spline 2222 and to bear torsional loads applied to the bracket during operation. Furthermore, the exoskeletons 2240a and 2240b may be configured to help maintain the angular orientation of the bracket 2226 as it translates along the spline 2222.

[0209] exist Figure 22A In this context, the cross-section or geometry of the first exoskeleton 2240a is non-circular and complementary in shape to the cross-section or geometry of the bracket 2226, as referenced above. Figures 21A to 21B In a general description, in the illustrated embodiments, for example, the geometry of exoskeleton 2240a includes a plurality (four) of lobes extending from the centerline of the shield 2240a, and bracket 2226 similarly defines or otherwise provides a plurality (four) of lobes that mate with or otherwise engage with the lobes of exoskeleton 2240a. The inner surface of the exoskeleton wall 2241 of exoskeleton 2240a may slide in contact with bracket 2226, thereby operating to absorb any torsional loads borne by bracket 2226 during operation.

[0210] exist Figure 22BIn this embodiment, the second exoskeleton 2240b is generally circular in shape, and a filler material 2243 may be deposited between the bracket 2226 and the inner wall of the exoskeleton 2240b. In such embodiments, the filler material 2243 may define an aperture 2245 configured to accommodate the generally cross-sectional shape of the bracket 2226. Therefore, the bracket 2226 does not slide against the inner surface of the exoskeleton wall 2241 of the exoskeleton 2240b; instead, the bracket 2226 engages with and slides against the filler material 2243. The filler material 2243 may comprise a variety of rigid or semi-rigid materials. In some embodiments, for example, the filler material 2243 may include, but is not limited to, polymeric materials such as polycarbonate, polyurethane, closed-cell or open-cell foams such as polyurethane, chloroprene rubber, ethylene propylene diene monomer, chloroprene rubber, styrene-butadiene rubber, or any combination thereof. The filler material 2243 may also have a structure or frame, such as a honeycomb.

[0211] drive mode

[0212] Figures 23A to 23C It is based on one or more additional implementation schemes. Figure 16A A partial cross-sectional side view of an alternative embodiment of the shank 1614. As described herein, mounting the bracket to the lead screw for z-axis translation is configured to reduce bracket rotation and minimize constraints on the bracket while increasing bracket stability. As shown, the shank 1614 includes components that are in some respects similar to... Figure 16A The bracket 1626 is a bracket 2326. For example, the bracket 2326 is movable between a first end 1618a and a second end 1618b of the handle 1614 along a longitudinal axis A1 (i.e., translation along the z-axis), and the shaft 1602 extends distally from the bracket 2326. Thus, as the bracket 2326 moves along the longitudinal axis A1, the bracket 2326 is thus able to advance or retract relative to the handle 1614 to the end actuator (e.g., the end effector attached to the distal end of the shaft 1602). Figure 16A End effector 1604).

[0213] In the illustrated implementation, bracket 2326 includes mounting to a similar Figure 16A The guide nut 2334 is a rotatable guide screw 2322 of the guide screw 1622. The outer surface of the guide screw 2322 defines a helical thread, and the guide nut 2334 defines a corresponding inner helical thread (not shown) that can mate with the outer helical thread of the guide screw 2322. Therefore, rotation of the guide screw 2322 causes the guide nut 2334 to advance or retract the bracket 2326 along the longitudinal axis A1, and correspondingly advance or retract the bracket 2326 and the shaft 2302 relative to the shank 1614.

[0214] Figure 23AA single bracket nut 2334 is shown located at or near the distal end 2327 of bracket 2326. During operation of shank 1614, such as activating end actuator 1604... Figure 16A During its various functions, the bracket 2326 can be subjected to various torsional and axial forces F, which cause the bracket 2326 to rotate or displace in the direction R. Displacement of the bracket 2326 in the direction R can constrain or inhibit movement of the bracket 2326 along the handle 1614. According to embodiments of the present disclosure, by positioning portions of the bracket nut 2334 at or near the distal and proximal ends of the bracket 2326, the bracket 2326 can be stabilized and rotation in the direction R minimized or eliminated. In such embodiments, the bracket 2326 can be mounted to the lead screw 2322 at two or more spaced locations or otherwise across the substantial length of the bracket 2326, as described in more detail below.

[0215] exist Figure 23B In this design, bracket 2326 includes at least two bracket nuts configured to increase the stability of bracket 2326, i.e., to minimize torsion and rotation of bracket 2326 about lead screw 2322. More specifically, bracket 2326 may include a first bracket nut 2334a and a second bracket nut 2334b. The first bracket nut 2334a may be positioned at or near the distal end 2327 of bracket 2326, and the second bracket nut 2334b may be positioned at or near the proximal end 2329 of bracket 2326. Bracket nuts 2334a and 2334b are each mounted to the rotatable lead screw 2322 and are supported by bracket 2326 in a spaced-apart relationship, typically located at opposite ends of bracket 2326.

[0216] In embodiments where the bracket 2326 comprises multiple layers, the bracket nut may be present on at least two layers to allow the bracket to translate in response to rotation of the guide screw 2322. For example, in Figure 23B In this embodiment, the bracket 2326 comprises four stacked layers, depicted as a first layer 2328a, a second layer 2328b, a third layer 2328c, and a fourth layer 2328d. Although four layers are shown, it should be understood that the bracket 2326 may have more or fewer layers without departing from the scope of this disclosure. The first layer 2328a may alternatively be referred to as the "distal layer 2328a," and the fourth layer 2328d may alternatively be referred to as the "proximal layer 2328d." In such embodiments, a first bracket nut 2334a may be coupled to the distal layer 2328a, and a second bracket nut 2334b may be coupled to the proximal layer 2328d. Although not shown, additional bracket nuts coupled to other layers (e.g., the second layer 2328b and the third layer 2328c) are contemplated herein.

[0217] In some implementations, as shown in the figure, the first bracket nut 2334a may be attached to or otherwise surround or span two or more layers of the bracket 2326. For example, in Figure 23B In this configuration, the first bracket nut 2334a is attached to the distal layer 2328a, or otherwise supported by the distal layer and extends into the adjacent second layer 2328b. Thus, in some embodiments, the first bracket nut 2334a may extend across both layers 2328a, 2328b, and the second bracket nut 2334b may be secured to a single layer 2328d.

[0218] exist Figure 23C In this embodiment, bracket 2326 includes an elongated bracket nut 2334 that extends substantially from the distal end 2327 of bracket 2326 to the proximal end 2329. Furthermore, bracket 2326 includes a platform layer 2328e that supports other layers 2328f-h of bracket 2326. In the illustrated embodiment, a portion of the platform layer 2328e extends substantially between the distal end 2327 and the proximal end 2329 of bracket 2326, but alternatively, without departing from the scope of this disclosure, it may extend only a portion of the distance between the distal end 2327 and the proximal end 2329, or it may extend further than the distance between the distal end 2327 and the proximal end 2329.

[0219] The bracket nut 2334 is mounted to the platform layer 2328e, thus the bracket layer 2328e-h responsible for the connection translates along the guide screw 2322. In some embodiments, the bracket nut 2334 may extend along the entire axial length of the platform layer 2328e, but alternatively may extend only along a portion of the axial length of the platform layer 2328e. Although not shown, it is contemplated that a second layer in a stack of two or more layers may incorporate an elongated bracket nut similar to the elongated nut 2334, having a proximal portion 2334p and a distal portion 2334d, supporting the first layer distally and the third layer proximally.

[0220] Figure 24A and Figure 24B This is a top view of an exemplary embodiment of a surgical tool 1600 according to one or more embodiments of the present disclosure. According to another aspect of the present disclosure, the position of the high-load spline and activation mechanism can be optimized relative to the bracket and exoskeleton to reduce torsional loads and minimize the cross-section of the shank. Certain functions of the associated end effector triggered by the activation mechanism incorporated within the bracket require high torsional loads. For example, surgical staplers typically undergo high torsional loads associated with firing and closing functions. As stated above regarding... Figure 16AAs described, the bracket track 1644 located on the shield 1640 can bear any torsional load that would otherwise adversely affect the stability of the bracket 1612. However, placing the high-torsional spline and / or activation mechanism near the load-balancing member of the surgical tool 1600 helps reduce torsional load and sliding friction. That is, the spline centerline is configured such that the high-torsional-load spline centerline is as close as possible to the load-balancing member, for example, by translating the lead screw centerline and / or the axis of the shaft, thereby reducing the net torsional force on the system by optimizing the spline placement.

[0221] This configuration also allows for a more elongated geometry in the surgical instrument 1600, minimizing weight and enhancing ergonomic grip. Torsional loads on the bracket are managed by applying torque to a lead screw, other splines, or struts located near the high-torque input. As described below, this configuration results in a non-circular cross-section of the bracket that balances the load and provides a more elongated geometry for the surgical device.

[0222] like Figures 24A to 24B As shown, brackets 2426a and 2426b are received within surgical instruments 1600, and each bracket 2426a and 2426b has a non-circular cross-section. Furthermore, each bracket 2462a and 2462b is movably mounted to a plurality of splines 2424a-c driven by the output of instrument driver 2402. The brackets 2426a, 2426b and splines 2424a-c may be similar in some respects to... Figure 16A The bracket 1626 and spline 1624a-c, and the instrument driver 2402 may be similar in some respects to each other. Figure 11 , Figure 12 The instrument actuators 1102, 1200, and 1702 of Figure 17 are used for best understanding. A shaft 1602 is coupled to brackets 2426a and 2426b and extends distally from these brackets through a first end of the shank. In the illustrated embodiment, shaft 1602 penetrates a bore 1708 in instrument actuator 2402. Bracket 2426a includes a plurality of activation mechanisms 2428a-c, each supported by brackets 2426a and 2426b and associated with a specific function of the end effector. Splines 2424a-c are each rotatably mounted to a first end of the shank and extend between the ends of the shank. Each spline 2424a-c is operatively coupled to one of the activation mechanisms 2428a-c to drive the associated function of the end effector.

[0223] exist Figure 24AIn this configuration, splines 2424a-c are arranged such that the spline with the highest operating torsional load is located near the load balancing member 2422. The load balancing member 2422 includes an elongated structure extending between a first and a second end of the shank and has an outer diameter D. The load balancing member 2422 has sufficient stiffness to minimize the torsion of the bracket 2426a during operation of high-load functions, such as the closing and firing of the end effector. The load balancing member 2422 can be rod-shaped and can exhibit any cross-sectional configuration. In some embodiments, the load balancing member 2422 includes a configuration similar to... Figure 16A The support bar 1620. The spline 2424a-c, based on its torque relative to the load balancing member 2422, results in the bracket 2426a having a non-circular cross-section.

[0224] End actuator 1604 is located at the distal end of shaft 1602. Figure 16A The end effector 1604 is capable of articulating, firing, and clamping, as broadly described above. A first activation mechanism 2428a is driven by a first spline 2424a to perform a high-torsional clamping function of the end effector 1604. A second activation mechanism 2428b is driven by a second spline 2424b to perform a high-torsional firing function of the end effector 1604. A third activation mechanism 2428c is driven by a third spline 2424c to articulate the end effector 1604, wherein the articulation function does not require the torque value associated with the clamping or firing function; for example, the torque of the articulation function is less than the torque required for clamping and / or firing. Each spline 2428a, 2428b associated with high-torsional operation (via activation mechanisms 2428a, 2428b, respectively) is positioned near the load balancing member 2422 to minimize the torsion of the bracket 2426a during operation.

[0225] In some embodiments, the load balancing member 2422 includes a lead screw, which is similar in some respects to those in Figure 16. Figures 22A to 22B and Figures 23A to 23B The guide screws 1622, 2222, and 2322. Therefore, the load balancing member 2422 may alternatively be referred to herein as "guide screw 2422," which facilitates translation of the bracket 2426a along the longitudinal axis of the shank ("insertion axis") (e.g., between the first and second ends). In the illustrated embodiment, the shaft 1602 occupies or otherwise is located at the center of the instrument actuator 2402 and the center of the bracket 2426a. Here, the guide screw 2422 is eccentrically positioned relative to the bracket 2426a and the instrument actuator 2402. The guide screw 2422 is generally configured to have sufficient stiffness to provide translational capability for the bracket 2426a, wherein the stiffness characteristics are also used to resist the movement of the end actuator 1604 ( Figure 16ADuring the firing and / or clamping functions of the bracket 2426a, the torsion of the bracket 2426a is mitigated. That is, due to the potentially larger cross-sectional dimensions and / or harder materials (e.g., the lead screw 2422 may be made of a hard metal such as stainless steel), the high torsional load splines 2428a, 2428b are placed as close as possible to the load balancing lead screw 2422 to help balance the torsional load on the bracket 2426a, thereby minimizing undesirable rotation of the bracket 2426a.

[0226] exist Figure 24B In this context, the load balancing component can be represented by adjacent splines. That is, it is configured to perform end effector 1604 ( Figure 16A The first spline 2424a, which provides high torsional clamping capability, may be located near a load balancing member, characterized herein and referred to as the second spline 2422b, and configured to perform the high torsional firing function of the end effector 1604. In these embodiments, the first spline 2424a may be configured to rotate in a first direction (e.g., clockwise), and the load balancing member 2424b may be configured to rotate in a second direction opposite to the first direction (e.g., counterclockwise). That is, splines 2424a and 2424b are configured such that when one or more splines are engaged simultaneously, the torsional load applied by one spline is equal to and opposite to the torsional load applied by the other spline. Figure 24B The diameter of the load balancing member 2422b can be larger than the diameter of the first spline 2424a having a high operating torsional load. In other embodiments, the stiffness of the load balancing member 2422b is greater than the stiffness of the spline having the highest operating torsional load.

[0227] Figure 25A and Figure 25B A cross-sectional top view of another embodiment of the surgical tool 1600 according to one or more additional embodiments is shown. According to another aspect of this disclosure, the dimensions and location of each spline coupled to the bracket can be optimized to reduce the torsional load experienced by the bracket and to minimize the cross-sectional area of ​​the bracket / handle. Instead of making the splines substantially the same diameter, the spline diameter can correspond to the torque value required for the associated function of that spline (the activation mechanism coupled to the bracket). The greater the torque required to perform the function, the larger the spline diameter (conferring increased durability / stiffness), and the smaller the torque required to perform the function, the smaller the spline diameter. Multiple spline size designs allow for creatively compact designs of the bracket and activation mechanism and provide a non-circular cross-section for the tool handle (e.g., bracket and shield / exoskeleton).

[0228] As shown in the figure, the surgical tool 1600 may include tools respectively with Figure 16AThe activation mechanisms 1638a-c and bracket 1626 are substantially similar to the activation mechanisms 2528a-d and bracket 2526. Each activation mechanism 2528a-d is respectively coupled to a separate spline 2524a-d driven by the output of the instrument driver 2402. Each spline 2524a-d is rotatably mounted to the handle (e.g., Figure 16A The handle 1614) extends to the end of the handle and between the ends of the handle, thereby allowing the bracket 2526 supporting the drive mechanism 2528a-d to move back and forth along the length of the handle, while the activation of the associated end actuator function is decoupled from the translation of the z-axis.

[0229] Each activation mechanism 2428a-d and one or more idler gears 2504 are supported by a bracket 2526 and are associated with the individual function of the end effector. Figures 25A to 25B In an exemplary embodiment, the surgical tool 1600 is a surgical suture device, and a first spline 2524a drives a first activation mechanism 2528a to perform a high-torsional clamping function of the associated end effector. The first spline 2524a has a first cross-sectional area and a diameter C. The first activation mechanism 2528a includes a drive gear 2538a directly or indirectly coupled to the shaft 1602. A second activation mechanism 2528b is driven by the second spline 2524b to perform a high-torsional firing function of the end effector. The second spline 2524b has a second cross-sectional area and a diameter F. The second activation mechanism 2528b includes a drive gear 2538b coupled to the second spline 2524b for transmitting torque to the second activation mechanism. A third activation mechanism 2528c is driven by the third spline 2524c to articulate the end effector, wherein the articulation function does not require the torque values ​​associated with the first spline 2528a and the second spline 2528b; for example, the torque of the articulation function is less than the torque required for clamping and / or firing. The third spline 2524c has a third cross-sectional area and a diameter A. The third activation mechanism 2528c includes a drive gear 2538c coupled to the third spline 2524c for transmitting torque to the third activation mechanism. The fourth activation mechanism 2528d is driven by the fourth spline 2524d to axially translate the bracket 2526. The fourth spline 2528d has a fourth cross-sectional area and a diameter T. The fourth activation mechanism 2528d includes a drive gear 2538d coupled to the shaft 1602 via at least one idler gear 2504.

[0230] In some embodiments, splines 2528a-d exhibit at least two distinct cross-sectional areas and / or diameters, such as diameters C, F, A, and T. That is, the surgical tool 1600 includes at least one spline associated with a high-torque function (e.g., clamping) having a large "high-torque" cross-section (e.g., corresponding to diameter C or F). The surgical tool 1600 also includes at least one spline associated with a low-torque function (e.g., joint movement) having a low-torque cross-section (e.g., corresponding to diameter A or T). In these embodiments, the area of ​​the high-torque cross-section of the spline associated with the high-torque function is larger than the area of ​​the low-torque cross-section spline associated with the low-torque function. In this way, higher-torque functions are driven by stiffer splines with larger cross-sections and / or diameters, while other functions are driven by splines with smaller cross-sections and / or smaller diameters. Dimensioning splines 2528a-d based on input torque requirements allows for a reduction in the rotational mass of the smaller-load splines and the overall weight and cross-section of the surgical tool 1600.

[0231] In some implementations, the cross-section of the tool shank with optimized spline dimensions can be symmetrical, i.e., respectively similar to... Figures 21A to 22B The exoskeletons 2140 and 2240a, 2240b have non-circular cross-sectional shapes. In other embodiments, and as... Figures 25A to 25B As shown in the exemplary implementation, the non-circular cross-section of the exoskeleton 2540 with optimized spline dimensions can be asymmetrical in shape.

[0232] In some implementations, each spline 2524a-d has a different cross-sectional area related to the input torque requirements of the associated end effector function. For example, the input torque Tc required for clamping is greater than the input torque Tf required for firing, the input torque Tf required for firing is greater than the input torque Tt required for translation, and the input torque Tt required for translation is greater than the input torque Ta required for the joint movement of the end effector. Therefore, Tc>Tf>Tt>Ta. Similarly, the cross-sectional area / diameter C of the first spline 2524a associated with clamping is greater than the cross-sectional area / diameter F of the second spline 2524b associated with firing, F is greater than the cross-sectional area / diameter T of the third spline 2524c associated with translation, and T is greater than the cross-sectional area / diameter A of the fourth spline 2524d associated with joint movement. Therefore, in terms of diameter, C>F>T>A.

[0233] In some implementation schemes, and as such Figures 25A to 25BAs shown, multiple splines 2524a-d and / or associated activation mechanisms 2524a-b are positioned in a planetary relationship relative to the axis 1602. In other words, the center of each spline 2524a-d is located at a distance (radius) ra-rd from the axis 1602. In some embodiments, the distance from the axis to the center of each spline is approximately the same for each spline, such as in… Figure 22A As depicted in the exemplary embodiments. In other embodiments, such as Figure 25B As shown, at least two radii (e.g., ra, rb) extending from the shaft to the center of the spline are different. In some other embodiments, at least three radii (e.g., ra, rb, rc) extending from the shaft to the center of the spline are different. In other words, the center of each spline 2524a-d is configured to lie at least at the radius of the spline plus the radius of the shaft 1602. In still other embodiments, the distance from the shaft 1602 to the center of each spline is different. In each of these embodiments, the bracket 2526 may have a cross-sectional shape corresponding to the general shape of the spline arrangement.

[0234] In some embodiments, splines 2524a-d may be arranged such that the external cross-sectional profile 2541 of the exoskeleton 2540 corresponds to the placement and size of the internal splines 2524a-d and / or activation mechanisms 2528a-d. That is, the exoskeleton 2540 is organized according to the internal components (i.e., the bracket 2425, splines 2524a-d, and / or activation mechanisms 2528a-d) to reduce mass, provide bracket guidance, increase handle stiffness, minimize system torsion, and / or provide an ergonomic shape factor for the surgical tool 1600. While regarding... Figures 25A to 25B Planetary arrangements have been explicitly discussed, but it should be understood that other implementation schemes also demonstrate planetary arrangements, including but not limited to... Figure 21B , Figures 22A to 22B and Figures 24A to 24B The implementation schemes shown in the figure.

[0235] Figure 25C This shows the structure within an organized, shaped exoskeleton. Figure 25B A transparent isometric view of the spline bracket 2526. As described above, the dimensions and arrangement of the splines 2524a-d and the associated activation mechanisms 2528a-d allow the external profile 2541 of the exoskeleton 2540 to conform to the internal position and size design of the component housed therein. That is, the non-circular features of the exoskeleton 2540 correspond to and adapt to the position and size design of the splines and activation mechanisms. For example, the ridge / leaf 2548 corresponds to the first spline 2524a ( Figure 25A ) and the first activation mechanism 2528a ( Figure 25AThe dimensions and position of the bracket are related. Furthermore, the notch 2545 corresponds to a portion of the surgical tool 1600, where the internal components have been optimized to reduce the cross-sectional area of ​​the handle. These non-circular features also serve to maintain the angular position of the bracket 2526, thereby absorbing any torsional loads that would otherwise adversely affect the bracket.

[0236] 4. Implementation System and Terminology .

[0237] The specific embodiments disclosed herein provide systems, methods, and apparatus for use with robotic systems. It should be noted that, as used herein, the terms “couple,” “coupling,” “coupled,” or other variations of the word “couple” can indicate 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 via another component or directly connected to the second component.

[0238] 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.

[0239] 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.

[0240] 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”.

[0241] As used herein, the terms “usually” and “substantially” are intended to cover structural or quantitative modifications that do not significantly affect the purpose of the element or quantity modified by the term.

[0242] The titles used herein are intended to facilitate the reader of this application and any resulting patents, and are not intended to limit the scope of this disclosure.

[0243] In order to assist the Patent Office and any reader of this application and any obtained patent in interpreting the claims appended herein, the applicant does not expect any appended claim or claim element to invoke 35 USC112(f) unless the words “means for…” or “steps for…” are expressly used in a particular claim.

[0244] 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 surgical tool for actuating a robotic instrument, comprising: The handle portion has a first end portion; At least one spline, the at least one spline being rotatably connected to the shank and extending proximally from the first end; A bracket, movably mounted to the at least one spline and comprising a first layer and a second layer, the second layer being operatively coupled to the first layer, wherein the at least one spline extends through a portion of at least one of the first layer and the second layer and the bracket translates along the at least one spline, wherein the first layer and the second layer are removably secured to each other using one or more mechanical fasteners; An elongated shaft extending from the bracket and penetrating the first end, the shaft having an end effector disposed at its distal end; and An activation mechanism is connected to each of the first and second layers and is actuated to operate the function of the end effector.

2. The surgical tool according to claim 1, further comprising: A drive input element is disposed at the first end and operably coupled to the at least one spline, such that rotation of the drive input element correspondingly rotates the at least one spline. and A device actuator, disposed at the end of the robot arm and capable of engaging with the handle at the first end, provides a drive output that engages with the drive input such that rotation of the drive output correspondingly rotates the drive input, thereby actuating the activation mechanism.

3. The surgical tool of claim 1, wherein, The at least one spline forms part of a plurality of splines, and wherein each spline is rotatably attached to the first end of the shank and configured to be mechanically connected to a drive output of a robot instrument actuator, each spline is coupled to a separate activation mechanism, and wherein rotation of the spline drives the associated function of the end effector.

4. The surgical tool of claim 1, wherein, The activation mechanism includes a drive gear coupled to or forming part of the at least one spline, wherein rotation of the at least one spline correspondingly causes rotation of the drive gear.

5. The surgical tool of claim 4, wherein, The drive gear is defined in a channel whose shape is complementary to the cross-section of the at least one spline, and wherein the at least one spline extends through the channel.

6. The surgical tool of claim 1, wherein, The activation mechanism includes a drive gear arranged adjacent to and in sliding contact with the at least one spline, wherein rotation of the associated spline causes the gear of the activation mechanism to rotate.

7. The surgical tool of claim 6, wherein, The drive gear defines gear teeth that mesh with gear teeth defined by the at least one spline.

8. The surgical tool of claim 1, wherein, The bracket comprises three or more layers.

9. The surgical instrument according to claim 1, further comprising: A guide rail that extends from the first end toward the proximal side; and One or more recesses are defined in the bracket and sized to receive the guide rail, wherein the guide rail slides within the one or more recesses as the bracket moves along the at least one spline.

10. The surgical tool according to claim 9, wherein, The guide rail bears the torsional load of the bracket, thereby minimizing the rotation of the bracket relative to the handle.

11. The surgical tool of claim 9, wherein, The one or more notches are defined on the outer periphery of one or both of the first layer and the second layer.

12. The surgical tool of claim 9, wherein, The one or more recesses include a first recess and a second recess, wherein the first recess and the second recess are located on opposite circumferential sides of the bracket.

13. The surgical tool of claim 1, further comprising a lead screw extending from the first end, wherein, The bracket is movably mounted to the lead screw at a bracket nut fixed to the bracket, and wherein rotation of the lead screw causes the bracket and the bracket nut to move axially toward and away from the first end, thereby causing the end actuator to move toward the distal or proximal side.

14. The surgical tool of claim 13, wherein, The first layer and the second layer each include a coaxial alignment hole for receiving the one or more mechanical fasteners.

15. The surgical instrument according to claim 1, wherein, The functions of the end effector include: joint movement of the end effector, clamping of the jaws of the end effector, displacement of the cutting element of the end effector, displacement of the end effector, or any combination thereof.

16. The surgical tool of claim 1, further comprising a second end opposite the first end of the handle, wherein, The at least one spline extends between the first end and the second end, and wherein the bracket is configured to translate between the first end and the second end.

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