Computer-assisted teleoperated surgical systems and methods

Abstract

This application relates to computer-assisted teleoperated surgical systems and methods. Systems and methods for minimally invasive computer-assisted teleoperation of surgery are described. A computer-assisted teleoperated surgical system includes a teleoperational instrument actuation pod. The surgical instrument actuation pod includes a plurality of linear actuators arranged about a surgical instrument. The linear actuators engage with actuator engagement members on the instrument to drive movable parts on the instrument. The actuation pod is mounted on a teleoperational manipulator. The instrument pod mass is close to the teleoperational manipulator to minimize the inertial, momentum, and gravitational effects of the pod on the manipulator.

Description

[0001] This application is a divisional application of Chinese patent application 2017800565047 (PCT / US2017 / 051846), entitled "Computer-assisted remote surgical system and method," filed on September 15, 2017, with an international filing date of September 15, 2017, and entering the national phase on March 14, 2019.

[0002] Copyright Notice

[0003] This patent document contains a portion of copyrighted material. The copyright holder does not object to any faxed copy of the patent document or any of the patent disclosures as they appear in the patent documents or records of the United States Patent and Trademark Office, but otherwise reserves all copyright.

[0004] Cross-references to related applications

[0005] This application claims priority to U.S. Provisional Patent Application No. 62 / 395,095 (filed September 15, 2016), which is incorporated herein by reference.

[0006] Statement regarding federally funded research or development

[0007] not applicable. Background Technology

[0008] Remotely operated surgical systems (often referred to as "robotic" surgical systems due to their use of robotics) and other computer-aided devices typically include one or more instrument manipulators for manipulating instruments used to perform tasks at the surgical site, and at least one manipulator for supporting image capture devices for capturing images of the surgical site. The manipulator arm includes multiple links coupled together via one or more active control joints. In many embodiments, multiple active control joints may be provided. The robotic arm may also include one or more passive joints that are not actively controlled but conform to the motion of the active control joints. Such active and passive joints can be of various types, including rotary joints or prismatic joints. The motion posture of the manipulator arm and its associated instruments or image capture devices can be determined by knowledge of the joint orientation and structure, the coupling of the links, and the application of known kinematic calculations.

[0009] Minimally invasive telesurgical systems are being developed to increase surgeon flexibility and allow surgeons to operate on patients from remote locations. Telesurgical surgery is a general term for surgical systems in which surgeons use some form of remote control (e.g., servo mechanisms) to manipulate surgical instruments instead of directly holding and moving them by hand. In such telesurgical systems, images of the surgical site are provided to the surgeon at a remote location. While observing a stereoscopic image of the surgical site, typically providing a depth illusion on a suitable observer or monitor, the surgeon performs surgical procedures on the patient by manipulating a master control input device, which in turn controls the movement of the corresponding telesurgical instruments. Telesurgical instruments can be inserted through small minimally invasive surgical openings or natural orifices to treat tissue at the surgical site within the patient's body, generally avoiding the trauma typically associated with access to the surgical site via open surgical techniques. These computer-aided telesurgical systems can move the working end (end effector) of surgical instruments with sufficient flexibility to perform fairly complex surgical tasks, typically by pivoting the axis of the instrument at the minimally invasive opening, sliding the axis axially through the opening, rotating the axis within the opening, etc. Summary of the Invention

[0010] The following summary describes certain aspects of the subject matter of the invention to provide a basic understanding. This summary is not a broad overview of the subject matter of the invention and is not intended to identify key or essential elements or to depict the scope of the subject matter. Although this summary contains information relating to various aspects and embodiments of the subject matter of the invention, its sole purpose is to present some aspects and embodiments in a general form as a prelude to the more detailed description that follows.

[0011] In one aspect, a remote surgical system includes an actuation pod and instruments mounted within the pod. The actuation pod has a longitudinal axis, and the axis of the instruments coincides with the longitudinal axis of the pod. The pod has linear actuators (e.g., motors, lead screws, and nuts screwed onto each lead screw). Each linear actuator engages an actuator input member on the instrument. In another aspect, the pod components are arranged such that the center of mass of the pod is placed on the longitudinal axis of the pod and distally toward the patient, such that the effects of inertia, momentum, and gravity on the pod are minimized when the manipulator orients itself on the longitudinal axis of the pod in pitch and yaw motions.

[0012] More generally, this disclosure provides apparatus and methods for performing minimally invasive robotic surgery using computer-assisted remote surgical devices. For example, this disclosure provides a surgical instrument actuator compartment for a computer-assisted remote surgical system. In some embodiments, the surgical instrument actuator compartment includes a plurality of threaded nuts simultaneously positioned in a common orientation along the longitudinal axis of the compartment. Some embodiments include a plurality of anti-rotation axes, each slidably coupled to two, but not more than two, threaded nuts.

[0013] In one aspect, this disclosure relates to a surgical instrument actuator compartment for a computer-aided remote surgical system. This surgical instrument actuator compartment includes: a plurality of motors; a plurality of lead screws, each lead screw being rotatably driven by a corresponding motor; and a plurality of threaded nuts, each threaded nut being threadedly coupled to a corresponding lead screw and releasably attached to a corresponding actuator engagement member of the surgical instrument. The compartment defines a longitudinal axis. All threaded nuts can be simultaneously positioned in a common orientation along the longitudinal axis.

[0014] This surgical instrument actuation chamber may optionally include one or more of the following features. The surgical instrument actuation chamber may also include a frame comprising: a distal plate; a proximal plate; and a plurality of anti-rotation shafts extending between the proximal and distal plates. Each lead screw may be rotatably coupled to the distal and proximal plates. The distal plate may include a fully circumferential annular plate defining an opening center for receiving the surgical instrument shaft. The proximal plate may include a C-shaped plate. Each motor may be mounted to the distal plate, while no motor is mounted to the proximal plate. Each anti-rotation shaft may be slidably coupled to no more than two threaded nuts. Adjacent pairs of threaded nuts may be slidably coupled to a corresponding anti-rotation shaft. All motors may be concentrically arranged about a longitudinal axis.

[0015] In another aspect, this disclosure relates to a surgical instrument actuator compartment for a computer-assisted remote surgical system. This surgical instrument actuator compartment includes: a plurality of motors; a plurality of lead screws, each lead screw being rotatably driven by a corresponding motor; a plurality of threaded nuts, each threaded nut being threadedly coupled to a corresponding lead screw and releasably attached to a corresponding actuator engagement member of the surgical instrument; and a plurality of anti-rotation shafts. Each anti-rotation shaft is slidably coupled to two, and no more than two, threaded nuts.

[0016] This surgical instrument actuator compartment may optionally include one or more of the following features: The compartment defines a longitudinal axis, and each threaded nut can be simultaneously positioned in a common orientation along the longitudinal axis. The compartment may also include a distal plate and a proximal plate. Multiple anti-rotation shafts may extend between the proximal and distal plates. The distal plate may include a fully circumferential annular plate defining the center of an opening for receiving the surgical instrument shaft. The proximal plate may include a C-shaped plate. Each motor may be mounted to the distal plate, while no motor is mounted to the proximal plate. Multiple motors may be concentrically arranged about the longitudinal axis. Each threaded nut may be slidably coupled to only one anti-rotation shaft.

[0017] In another aspect, this disclosure relates to a surgical instrument and a surgical instrument actuator chamber system for a computer-aided remote surgical system. The surgical instrument and surgical instrument actuator chamber system include a surgical instrument and a surgical instrument actuator chamber. The surgical instrument includes: a proximal portion; an instrument shaft extending from the proximal portion, the instrument shaft including a distal portion opposite to the proximal portion; an end effector coupled to the distal portion, the end effector being movable relative to the instrument shaft; and a plurality of actuator engagement members movably coupled to the proximal portion. The chamber includes: a distal plate including a fully circumferential annular plate defining an opening center for receiving the instrument shaft; a proximal plate including a C-shaped plate; a plurality of anti-rotation shafts extending between the proximal and distal plates; a plurality of motors mounted to the distal plate; a plurality of lead screws, each lead screw being rotatably driven by a corresponding motor; and a plurality of threaded nuts. Each threaded nut is threadedly coupled to a corresponding lead screw and releasably attached to a corresponding actuator engagement member.

[0018] Such surgical instruments and surgical instrument actuator chamber systems may optionally include one or more of the following features. A plurality of actuator engagement members may include a first actuator engagement member coupled to a first tensioning member extending along the instrument axis and a second actuator engagement member coupled to a second tensioning member extending along the instrument axis. The first and second tensioning members may each be coupled to an end effector such that moving the first actuator engagement member proximally will move the second actuator engagement member distally and move the end effector relative to the instrument axis in a first manner. Moving the second actuator engagement member proximally will move the first actuator engagement member distally and move the end effector relative to the instrument axis in a second manner (opposite to the first manner). The chamber defines a longitudinal axis, and when the surgical instrument is coupled to the chamber, each threaded nut may be simultaneously locatable in a common orientation along the longitudinal axis. Each anti-rotation shaft may be slidably coupled to two and no more than two threaded nuts. Each threaded nut may be slidably coupled to a single anti-rotation shaft. The chamber defines a longitudinal axis, and a plurality of motors may be arranged concentrically about the longitudinal axis. The proximal portion of the surgical instrument may include a handle configured to facilitate manual gripping and manipulation of the instrument. When the surgical instrument is coupled to the chamber, the handle may extend radially further than the adjacent portion of the chamber.

[0019] Some or all of the embodiments described herein may provide one or more of the following advantages. In some cases, the remote-operated surgical instrument actuator compartments provided herein are advantageously configured to counteract the effects of surgical instrument cable stretching. Cables within conventional remote-operated surgical instruments are pre-tensioned during manufacturing, but the tension may tend to decrease over time as the cables may stretch with instrument use. In some cases, this tension reduction may contribute to a decrease in the control accuracy of the remote-operated surgical instrument. Additionally, autoclaving remote-operated surgical instruments using heat and humidity may exacerbate cable stretching and the loss of cable tension. The remote-operated surgical instrument actuator compartments provided herein advantageously compensate for surgical instrument cable stretching without sacrificing the control accuracy of the instrument.

[0020] Furthermore, the remote-operated surgical instrument actuator compartment provided herein is advantageously constructed to be compact and has relatively low mass and inertia. Additionally, the mass distribution is substantially constant, making the inertia substantially constant and therefore predictable.

[0021] Furthermore, in some embodiments, the remotely operated surgical instrument actuator compartments provided herein are advantageously configured to engage with the surgical instrument in an easily detachable manner. For example, in some embodiments, the surgical instrument can be detached from the instrument drive system simply by actuating the latch mechanism and retracting the instrument proximally without engaging the drive system. This easily detachable interface between the surgical instrument and the instrument drive system can provide advantages such as rapid removal of the instrument in emergency situations and user convenience during the general switching from one surgical instrument to another.

[0022] Details of one or more embodiments are set forth in the accompanying drawings and the following description. Other features, objects, and advantages will be apparent from the specification, drawings, and claims. Attached Figure Description

[0023] Figure 1 This is a perspective view of an exemplary patient-side unit of a computer-assisted remote surgical system.

[0024] Figure 2 This is a front view of an exemplary surgeon control unit of a computer-assisted remote surgical system.

[0025] Figure 3 This is a side view of an exemplary manipulator assembly of a computer-assisted remote surgical system.

[0026] Figure 4 This is a perspective view of another type of patient-side computer-assisted remote surgical system.

[0027] Figure 5 This is a perspective view of the distal portion of an exemplary surgical instrument in a first position.

[0028] Figure 6 It is in the second posture. Figure 5 A perspective view of the distal portion of a surgical instrument.

[0029] Figure 7 It is in the third posture Figure 5 A perspective view of the distal portion of a surgical instrument.

[0030] Figure 8 This is a simplified schematic diagram of an exemplary remotely operated surgical instrument according to some embodiments.

[0031] Figure 9 It is coupled to an exemplary device drive system according to some embodiments. Figure 8 A schematic diagram of a remotely operated surgical instrument.

[0032] Figure 10 It is about Figure 9 The goal of the instrument and drive system.

[0033] Figure 11 It is an end effector with an example orientation. Figure 9 A schematic diagram of the instrument and drive system.

[0034] Figure 12 yes Figure 11 A schematic diagram of the instrument and drive system, wherein the instrument extends distally relative to the drive system, while the end effector remains oriented in the example pose.

[0035] Figure 13 yes Figure 11 A schematic diagram of the instrument and drive system, wherein the instrument is retracted proximally relative to the drive system, while the end effector remains oriented in the example pose.

[0036] Figure 14 yes Figure 11 A schematic diagram of a part of the instrument and drive system, showing an example location of a force sensor used to detect forces such as cable tension.

[0037] Figure 15 It is based on Figure 9 The diagram shows a perspective view of an exemplary surgical instrument configuration.

[0038] Figure 16 yes Figure 15 A perspective view of the proximal portion of a surgical instrument.

[0039] Figure 17 yes Figure 15 Another perspective view of the surgical instruments.

[0040] Figure 18 yes Figure 15 A proximal view of the surgical instruments.

[0041] Figure 19 Depicting according to some embodiments Figure 15 How can surgical instruments be coupled to an exemplary instrument drive system?

[0042] Figure 20 This is a perspective view of the surgical instrument actuator chamber.

[0043] Figure 21-25 This is a perspective view of the surgical instrument actuator compartment with its cover removed.

[0044] Figure 26 This is a cross-sectional view of the surgical instruments installed in the actuation chamber.

[0045] Figure 27-29 It is a perspective view of surgical instruments installed in the actuation chamber and positioned at various insertion depths. Detailed Implementation

[0046] This specification and accompanying drawings, which illustrate inventive aspects, embodiments, implementation methods, or applications, should not be considered limiting, as the claims define the protected invention. Various mechanical, compositional, structural, electrical, and operational changes may be made without departing from the spirit and scope of this specification and claims. In some cases, well-known circuits, structures, or techniques have not been shown or described in detail so as not to obscure the invention. Identical numbers in two or more figures denote identical or similar elements.

[0047] Furthermore, the specific words chosen to describe one or more embodiments and optional elements or features are not intended to limit the invention. For example, spatially relative terms (such as “below,” “under,” “lower,” “above,” “over,” “near,” “far”, etc.) may be used to describe the relationship between one element or feature shown in the figures and another element or feature. In addition to the positions and orientations shown in the figures, these spatially relative terms are intended to also cover different positions (i.e., translational arrangements) and orientations (i.e., rotational arrangements) of the device in use or operation. For example, if the device in the figures is flipped, an element described as “below” or “under” other elements or features will be “above” or “over” other elements or features. Thus, the exemplary term “below” can cover both above and below positions and orientations. The device may be oriented in other ways (e.g., rotated 90 degrees or in other orientations), and the spatially relative descriptors used herein are interpreted accordingly. Similarly, descriptions of movement along (translation) and about (rotation) various axes include various specific device positions and orientations. The combination of the position and orientation of the body defines the posture of the body.

[0048] Similarly, unless the context otherwise requires, geometric terms such as “parallel,” “perpendicular,” “circular,” or “square” are not intended to demand absolute mathematical precision. Rather, such geometric terms allow for variations due to manufacturing or equivalent functionality. For example, if an element is described as “circular” or “generally circular,” this specification still covers components that are not precisely circular (e.g., components that are slightly elliptical or polygonal with multiple sides). The words “comprising” or “having” mean including but not limited to.

[0049] It should be understood that while this manual has been made clear, concise, and accurate enough, strict and exhaustive linguistic precision is not always feasible or desirable, as manuals should maintain a reasonable length and that a skilled reader will understand the background and related technology. For example, considering video signals, a skilled reader will understand that an oscilloscope described as displaying a signal does not display the signal itself, but rather its representation, and a video monitor described as displaying a signal does not display the signal itself, but rather the video information carried by the signal.

[0050] Furthermore, unless the context otherwise requires, the singular forms “a,” “an,” and “the” are intended to also include the plural forms. Moreover, the terms “comprising,” “including,” “having,” etc., specify the presence of the stated feature, step, operation, element, and / or component, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and / or groups. Furthermore, unless otherwise stated, each of one or more separately listed items should be considered optional in order to describe various combinations of items without requiring an exhaustive list of every possible combination. The auxiliary verb “may / can” similarly implies that a feature, step, operation, element, or component is optional.

[0051] In practice, elements described in detail with reference to one embodiment, implementation, or application may optionally be included in other embodiments, implementations, or applications in which they are not specifically shown or described. For example, if an element is described in detail with reference to one embodiment and not with reference to a second embodiment, that element may still be claimed as included in the second embodiment. Therefore, to avoid unnecessary repetition in the following description, unless explicitly stated otherwise, unless one or more elements would render an embodiment or implementation inoperable, or unless two or more elements provide conflicting functionality, one or more elements shown and described in connection with one embodiment, implementation, or application may be incorporated into other embodiments, implementations, or aspects.

[0052] Elements described as coupled can be electrically or mechanically directly coupled, or they can be indirectly coupled via one or more intermediate components.

[0053] The term “flexible” in relation to parts (e.g., mechanical structures, components, or component assemblies) should be interpreted broadly. Essentially, the term means that the part can be repeatedly bent and return to its original shape without damage. Many “rigid” objects possess a slight inherent elastic “bending” due to material properties, although these objects are not considered “flexible” when the term is used herein. Flexible parts can have infinite degrees of freedom (DOF). Examples of such parts include closed, bendable tubes (made of, for example, Nitinol, polymers, soft rubber, etc.), helical coil springs, etc., which can be bent into various simple or compound curves, typically without significant cross-sectional deformation. Other flexible parts can be approximated by using a series of closely spaced components, resembling a serpentine arrangement of continuous “vertebrae.” In such a vertebral arrangement, each component is a short link in a kinematic chain, and movable mechanical constraints between each link (e.g., pin hinges, ball-and-socket joints, movable hinges, etc.) can allow one (e.g., pitch) or two (e.g., pitch and yaw) DOFs of relative movement between the links. A short, flexible part can function as a single mechanical constraint (joint) and be modeled that provides one or more degrees of freedom (DOF) between two links in a kinematic chain, even if the flexible part itself is a kinematic chain made up of several coupled links. Those skilled in the art will understand that the flexibility of a part can be expressed in terms of its stiffness.

[0054] Unless otherwise stated in this specification, flexible parts (such as mechanical structures, components, or component assemblies) can be either actively or passively flexible. Actively flexible parts can be bent by using forces inherently associated with the part itself. For example, one or more tendons can be arranged along the length of the part and offset from the longitudinal axis of the part, such that tension on one or more tendons causes the part or a portion of the part to bend. Other ways of actively bending actively flexible parts include, but are not limited to, using pneumatic or hydraulic power, gears, electroactive polymers (more generally, "artificial muscles"), etc. Passively flexible parts can be bent by using forces external to the part (e.g., applied mechanical or electromagnetic forces). Passively flexible parts can retain their bent shape until bent again, or they can have an inherent property that tends to restore the part to its original shape. Examples of passively flexible parts with inherent stiffness are plastic rods or elastic rubber tubes. Actively flexible parts can be passively flexible when not driven by their inherent associated forces. A single part can be made from one or more actively and passively flexible parts connected in series.

[0055] One example of a remote surgical system is the da, commercially available from Intuitive Surgical, Sunnyvale, California. Surgical systems. The inventive aspect relates to computer-assisted remote surgical systems. Those skilled in the art will understand that the inventive aspect disclosed herein can be embodied and implemented in various ways, including computer-assisted embodiments and implementations, as well as hybrid combinations of manual and computer-assisted embodiments and implementations. Where applicable, the inventive aspect can be embodied and implemented in relatively small handheld manual operating devices and relatively large systems with additional mechanical support, as well as in other embodiments of computer-assisted remote medical devices. Furthermore, the inventive aspect is associated with advancements in computer-assisted surgical systems that include autonomous rather than remotely operated actions, and therefore includes both remotely operated surgical systems and autonomous surgical systems, although the description focuses on remote operating systems.

[0056] A computer is a machine that performs mathematical or logical functions on input information according to programmed instructions to produce processed output information. A computer includes logic units that perform mathematical or logical functions, and memory that stores programming instructions, input information, and output information. The term "computer" and similar terms (e.g., "processor" or "controller") include centralized, single-location implementations and distributed implementations.

[0057] This disclosure provides improved surgical and remote surgical apparatus, systems, and methods. The inventive concept is particularly advantageous for use with remote surgical systems in which multiple surgical tools or instruments are mounted on associated multiple remote manipulators and moved by these manipulators during surgery. Remote surgical systems typically include remote robotic systems, remote surgical systems, and / or remote presentation systems, which include processors configured as master-slave controllers. By providing remote surgical systems that employ appropriately configured processors to move manipulator assemblies via articulated linkages with a relatively large number of degrees of freedom, the movement of the linkages can be adjusted through minimally invasive access sites. The large number of degrees of freedom also allows the processor to position the manipulators to avoid interference or collisions between these moving structures.

[0058] Manipulator assemblies described herein typically include remotely operated manipulators and tools mounted thereon (which typically include surgical instruments in surgical situations); however, the term "manipulator assembly" also encompasses manipulators without tools mounted thereon. The term "tool" encompasses general-purpose or industrial robotic tools and specialized robotic surgical instruments, the latter typically including end effectors suitable for tissue manipulation, tissue treatment, tissue imaging, etc. Tool / manipulator interfaces are typically quick-disconnect tool holders or couplers to allow for rapid removal and replacement of tools with alternative tools. Manipulator assemblies typically have a base that is fixed in space during at least a portion of a remote surgical procedure, and the manipulator assembly may include multiple degrees of freedom between the base and the end effector of the tool. Actuation of the end effector (such as opening or closing the jaws of a gripper, providing power to an electrosurgical plate, etc.) is typically decoupled from and attached to these degrees of freedom of the manipulator assembly.

[0059] End effectors typically move within a workspace with 2 to 6 degrees of freedom. As used herein, the term "position" includes both location and orientation. Thus, a change in the orientation of an end effector can involve translation of the end effector from a first position to a second position, rotation of the end effector from a first orientation to a second orientation, or a combination of both. As used herein, the term "end effector" therefore includes, but is not limited to, functions that change the orientation or orientation of its most distal part or multiple parts (e.g., jaws, etc.) (e.g., "wrist" function, parallel motion function).

[0060] When used in minimally invasive remote-operated surgery, the movement of the manipulator assembly can be controlled by the system's processor, constraining the axis or intermediate portion of the tool or instrument to safe movement through the minimally invasive surgical entry site or other orifice. This movement can include, for example, axial insertion of the axis through the orifice, rotation of the axis about its axis, and pivoting of the axis about a pivot point near the entry site, but excessive lateral movement of the axis is generally prevented, which could otherwise inadvertently tear tissue near the orifice or enlarge the entry site. Some or all of these constraints on the manipulator movement at the entry site can be applied using mechanical manipulator joint linkages that suppress incorrect movement, or such constraints can be applied partially or entirely using robotic data processing and control techniques. Therefore, this minimally invasive orifice-constrained movement of the manipulator assembly can employ zero to three degrees of freedom for the manipulator assembly.

[0061] Many of the exemplary manipulator assemblies described herein will have more degrees of freedom than are required to position and move an end effector within a surgical site. For example, a surgical end effector that can be positioned with six degrees of freedom at an internal surgical site through a minimally invasive incision may have nine degrees of freedom in some embodiments (six end effector degrees of freedom (three for position, three for orientation) plus three degrees of freedom to conform to access site constraints), but typically ten or more degrees of freedom. A highly configurable manipulator assembly having more degrees of freedom than required for a given end effector orientation can be described as having or providing sufficient degrees of freedom to allow a range of joint states for the end effector orientation in the workspace. For example, for a given end effector orientation, the manipulator assembly may occupy (and be driven therein) any of a range of alternative manipulator linkage orientations. Similarly, for a given end effector velocity vector, the manipulator assembly may have a range of different joint motion velocities for various joints of the manipulator assembly.

[0062] See Figure 1 and Figure 2 Systems for minimally invasive computer-assisted remote surgery (referred to herein as “minimally invasive robotic surgery”) may include a patient-side unit 100 and a surgeon control unit 40. Remote surgery is a general term for surgical systems in which a surgeon manipulates surgical instruments using robotic technology, rather than directly holding and moving the instruments by hand, employing some form of remote control (e.g., a servo mechanism, etc.). Robotically operable surgical instruments can be inserted through small, minimally invasive surgical openings to treat tissue at the surgical site within the patient's body, avoiding the trauma associated with open surgery. These robotic systems can move the working ends of surgical instruments with sufficient flexibility to perform fairly complex surgical tasks, typically achieved by pivoting the axis of the instrument at the minimally invasive opening, sliding the axis axially through the opening, rotating the axis within the opening, and / or similar actions.

[0063] In the illustrated embodiment, the patient-side unit 100 includes a base 110, a first robotic arm assembly 120, a second robotic arm assembly 130, a third robotic arm assembly 140, and a fourth robotic arm assembly 150. As shown, the base 110 includes a portion resting on the floor, a vertical column, and a horizontal boom, and may optionally utilize other base configurations that mechanically ground the patient-side unit. Each robotic arm assembly 120, 130, 140, and 150 is pivotally coupled to the base 110. In some embodiments, fewer than or more than four robotic arm assemblies may be included as part of the patient-side unit 100. While in the illustrated embodiment, the base 110 includes casters for ease of movement, in some embodiments, the patient-side unit 100 is fixedly mounted to the floor, ceiling, operating table, structural frame, etc.

[0064] In typical applications, two of the robotic arm assemblies 120, 130, 140, or 150 hold surgical instruments, while a third holds a stereoscopic endoscope. The remaining robotic arm assemblies are available to allow the introduction of another instrument at the work site. Alternatively, the remaining robotic arm assemblies can be used to introduce a second endoscope or another image-capturing device (e.g., an ultrasonic transducer) into the work site.

[0065] Each of the robotic arm assemblies 120, 130, 140, and 150 is typically formed by links coupled together and manipulated by actuable joints. Each of the robotic arm assemblies 120, 130, 140, and 150 includes a setup arm and a device manipulator. The setup arm positions its held device such that a pivot point is created at its access port into the patient's body. The device manipulator can then manipulate its held device (tool; surgical instrument) such that it can pivot about the pivot point, insert and retract from the access port, and rotate about its axis.

[0066] In the illustrated embodiment, the surgeon's console 40 includes a stereoscopic display 45, allowing the user to view the surgical site stereoscopically from images captured by a stereoscopic camera on the patient-side trolley 100. A left eyepiece 46 and a right eyepiece 47 are provided in the stereoscopic display 45, allowing the user to view the left and right displays within the display 45 with their left and right eyes, respectively. Typically, while viewing images of the surgical site on a suitable observer or display, the surgeon performs surgical procedures on the patient by manipulating a main control input device, which in turn controls the movement of robotic instruments.

[0067] The surgeon's console 40 also includes a left input device 41 and a right input device 42, which the user can grasp with his / her left and right hands, respectively, to manipulate devices (e.g., surgical instruments) held by the robotic manipulator assemblies 120, 130, 140, and 150 of the patient-side trolley 100 in preferably six degrees of freedom (“DOF”). A foot pedal 44 with toe and heel controls is provided on the surgeon's console 40, allowing the user to control the movement and / or actuation of devices associated with the foot pedal. Additional inputs to the system can be made via one or more other inputs (e.g., buttons, touchpads, voice, etc.), as shown in input 49.

[0068] A processor 43 is provided in the surgeon's console 40 for control and other purposes. The processor 43 performs various functions within the medical robotic system. One function performed by the processor 43 is to translate and transmit the mechanical movements of the input devices 41, 42 to actuate their respective joints in their associated robotic manipulator assemblies 120, 130, 140, and 150, enabling the surgeon to effectively manipulate the devices (e.g., surgical instruments). Another function of the processor 43 is to implement the methods, cross-coupled control logic, and controllers described herein.

[0069] Although described as a processor, it should be understood that processor 43 can be implemented by any combination of hardware, software, and firmware. Furthermore, its functions as described herein can be performed by a single unit or divided among multiple subunits, each of which can in turn be implemented by any combination of hardware, software, and firmware. Moreover, although shown as part of or physically adjacent to the surgeon control unit 40, processor 43 can also be distributed as a subunit throughout the remote surgical system. Therefore, the control aspects mentioned herein are implemented via processor 43 in a centralized or distributed manner.

[0070] Also refer to Figure 3 Robotic arm assemblies 120, 130, 140, and 150 can manipulate devices such as surgical instruments to perform minimally invasive surgery. For example, in the illustrated arrangement, robotic arm assembly 120 is pivotally coupled to instrument holder 122. Cannula 180 and surgical instrument 200 are further releasably coupled to instrument holder 122. Cannula 180 is a tubular member located at the patient interface site during surgery. Cannula 180 defines an inner lumen in which the elongated shaft 220 of surgical instrument 200 is slidably disposed. As further described below, in some embodiments, cannula 180 includes a distal portion having a body wall retractor member.

[0071] Instrument retainer 122 is pivotally coupled to the distal end of robotic arm assembly 120. In some embodiments, the pivotable coupler between instrument retainer 122 and the distal end of robotic arm assembly 120 is a motor joint actuable from surgeon console 40 and processor 43.

[0072] The instrument retainer 122 includes an instrument retainer frame 124, a cannula clamp 126, and an instrument retainer bracket 128. In the illustrated embodiment, the cannula clamp 126 is secured to the distal end of the instrument retainer frame 124. The cannula clamp 126 can be actuated to couple with or disengage from the cannula 180. The instrument retainer bracket 128 is movably coupled to the instrument retainer frame 124. More specifically, the instrument retainer bracket 128 is linearly translatable along the instrument retainer frame 124. In some embodiments, the movement of the instrument retainer bracket 128 along the instrument retainer frame 124 is a mechanized translational movement actuated / controlled by the processor 43.

[0073] Surgical instrument 200 includes a drive assembly 210, an elongated shaft 220, and an end effector 230. The drive assembly 210 is releasably coupled to an instrument holder bracket 128. The shaft 220 extends distally from the drive assembly 210. The end effector 230 is located at the distal end of the shaft 220.

[0074] Shaft 220 defines a longitudinal axis 222, which coincides with the longitudinal axis of the cannula 180. As the instrument holder bracket 128 translates along the instrument holder frame 124, the elongated shaft 220 of the surgical instrument 200 moves along the longitudinal axis 222. In this manner, the end effector 230 can be inserted into and / or retracted from the surgical workspace within the patient's body.

[0075] Also refer to Figure 4 Another exemplary patient-side system 160 for minimally invasive computer-assisted remote surgery includes a first robotic arm assembly 162 and a second robotic arm assembly 164, each robotic arm assembly being mounted to the operating table 10. In some cases, this configuration of the patient-side system 160 can be used as... Figure 1 An alternative example of the patient-side unit 100. Although only two robotic arm assemblies 162 and 164 are depicted, it should be understood that more than two (e.g., three, four, five, six and more than six) robotic arm assemblies may be included in some configurations.

[0076] In some cases, the operating table 10 can be moved or reconfigured during surgery. For example, in some cases, the operating table 10 can tilt, raise, lower, pivot, rotate, etc., around various axes. In some cases, by manipulating the orientation of the operating table 10, clinicians can use gravity to position the patient's internal organs in a position that facilitates surgical access. In some cases, this movement of the operating table 10 can be integrated as part of a computer-aided remote surgical system and controlled by that system.

[0077] Also refer to Figure 5-7 Various alternative computer-aided remote surgical instruments of different types and different end effectors 230 can be used, with at least some of the instruments being removed and replaced during the procedure. Some of these end effectors (including, for example, DeBakey forceps 56i, miniature forceps 56ii, and Potts scissors 56iii) include a first end effector element 56a and a second end effector element 56b, which pivot relative to each other to define a pair of end effector jaws. Other end effectors, including scalpels and electrocautery probes, have a single end effector element. For instruments with end effector jaws, the jaws are typically actuated by squeezing the gripping members of the input devices 41, 42.

[0078] In some cases, computer-aided remote surgical instruments include multiple degrees of freedom, such as, but not limited to, roll, pitch, yaw, insertion depth, jaw opening / closing, staple delivery actuation, and activation of electrocautery. At least some of these degrees of freedom can be actuated by an instrument drive system, to which the surgical instrument can be selectively coupled.

[0079] In some embodiments, computer-assisted remotely operated surgical instruments include an end effector having two independently movable parts, such as, but not limited to, opposing jaws designed for grasping or cutting. When the first independently movable part moves while the second independently movable part remains substantially stationary or moves in the opposite direction, the end effector can perform useful movements, such as opening and closing, for grasping, cutting, releasing, etc. When the two parts move synchronously in the same direction, at the same speed, and with the same distance, the resulting movement is a pitch or yaw motion of the end effector. Thus, in some surgical instrument embodiments having an end effector with two independently movable parts (e.g., jaws), this arrangement provides two degrees of freedom (e.g., pitch / yaw motion and opening / closing motion).

[0080] The elongated shaft 220 allows the distal end of the end effector 230 and the shaft 220 to be inserted distally into the surgical work site through a micro-orifice (via cannula 180), typically through the body wall (e.g., abdominal wall). In some cases, a body wall retractor member on the distal end of cannula 180 can be used to support the body wall, thereby increasing the size of the surgical workspace. In some cases, the surgical work site can be inflated, and movement of the end effector 230 within the patient's body is typically achieved at least partially by pivoting the instrument 200 about the position where the shaft 220 passes through the micro-orifice. In other words, the robotic arm assemblies 120, 130, 140, and 150 will move the transmission assembly 210 outside the patient's body such that the shaft 220 extends through the micro-orifice position to help provide the desired movement of the end effector 50. Therefore, the robotic arm assemblies 120, 130, 140, and 150 often undergo significant movement outside the patient's body during surgical procedures.

[0081] refer to Figure 8 The illustration schematically depicts an exemplary surgical instrument 300 that can be used as part of a computer-assisted remote surgical system. The surgical instrument 300 includes an instrument axis 302 (similar to axes 220, 640) having a proximal (away from the surgical site) end portion 310 and a distal (towards the surgical site) end portion 320 opposite to the proximal end portion 310. The surgical instrument 300 also includes an end effector 330 (similar to end effectors 230, 650). In this schematic, the end effector 330 is depicted as having a single degree of freedom relative to the instrument axis 302 (i.e., a degree of freedom to yaw the end effector 330 in a rotational or pivoting manner). However, it should be understood that the end effector 330 of the surgical instrument described herein may have more than one degree of freedom (e.g., two, three, four, five, six, or more than six degrees of freedom). Furthermore, it should be understood that the concepts described in the context of a single degree of freedom of the end effector 330 can be extended to each of the multiple degrees of freedom of the surgical instrument 300 and other types of surgical instruments for computer-assisted remote surgical systems.

[0082] The exemplary surgical instrument 300 also includes a first tensioning member 340, a first actuator engagement member 350, a second tensioning member 360, and a second actuator engagement member 370. The first tensioning member 340 is coupled to the end effector 330 and extends along the instrument axis 302, where it terminates at the first actuator engagement member 350. Similarly, the second tensioning member 360 is coupled to the end effector 330 and extends along the instrument axis 302, where it terminates at the second actuator engagement member 370. The first actuator engagement member 350 and the second actuator engagement member 370 are movably coupled to the proximal portion 310 of the surgical instrument. In some embodiments, the first actuator engagement member 350 and the second actuator engagement member 370 are slidably coupled to the proximal portion 310 of the surgical instrument.

[0083] While the illustrated embodiments include sliding actuator engagement members 350 and 370, in some embodiments, one or more other types of actuator engagement members may be included in the surgical instrument 300. For example, in some embodiments, a rotatable actuator engagement member is included. Such a rotatable actuator engagement member may be coupled to a winch or pulley that engages with tensioning members 340 and 360. Rotation of the rotatable actuator engagement member can apply or relieve tension on the respective tensioning members 340 and 360. Thus, the movement of the end effector 330 and the tensioning of the tensioning members 340 and 360 can be controlled by the rotatable actuator engagement member.

[0084] In some embodiments, some or all portions of the first tensioning member 340 and the second tensioning member 360 comprise flexible cables (e.g., but not limited to stranded tungsten cables, stainless steel cables, etc.). In some embodiments, the first tensioning member 340 and the second tensioning member 360 are different portions of a single continuous cable. In some embodiments, the first tensioning member 340 and the second tensioning member 360 are separate cables. The first tensioning member 340 and the second tensioning member 360 may additionally or alternatively include other components, such as, but not limited to, hypo-tubes.

[0085] Both the first tensioning member 340 and the second tensioning member 360 are coupled to the end effector 330. In the illustrated embodiment, both the first tensioning member 340 and the second tensioning member 360 are coupled to the end effector 330 via a pulley 332 (which may be a winch, crank arm, rotary drive member, etc.). Therefore, proximal movement of the first actuator engagement member 350 causes distal movement of the second actuator engagement member 370 and moves the end effector 330 relative to the instrument axis 302 in a first manner. Conversely, proximal movement of the second actuator engagement member 370 causes distal movement of the first actuator engagement member 350 and moves the end effector 330 relative to the instrument axis 302 in a second manner. In this way, the desired movement of the end effector 330 can be facilitated in a controlled manner. Furthermore, as further described below, when the movement and / or posture of the end effector 330 is controlled using the actuator engagement members 350 and 370, the tension in the tensioning members 340 and 360 can be controlled simultaneously. In fact, two degrees of freedom of the surgical instrument 300 (e.g., the position of the end effector 330 and the tension of the tensioning members 340 and 360) can be controlled simultaneously according to the apparatus and method described herein.

[0086] The surgical instrument 300 is depicted herein as being detached from the instrument drive system. Therefore, in some embodiments, the tension in the first tensioning member 340 and the second tensioning member 360 may be less than the tension used during operation of the surgical instrument 300. In some cases, relatively low tension in the first tensioning member 340 and the second tensioning member 360 when the surgical instrument 300 is not in use may be advantageous (e.g., reducing the possibility of cable stretching). In some embodiments, a preloaded tensioning member (e.g., a spring not shown) may be included in the surgical instrument 300 to maintain minimal tension in the first tensioning member 340 and the second tensioning member 360 when the surgical instrument 300 is detached from the instrument drive system. This minimal pretension helps ensure that the first tensioning member 340 and the second tensioning member 360 remain oriented within the surgical instrument 300 as needed.

[0087] Although surgical instrument 300 is depicted as having a single degree of freedom, it should be understood that this is a simplified schematic diagram, and surgical instrument 300 may have two or more degrees of freedom. The concepts described herein with reference to the single degree of freedom of surgical instrument 300 (as shown) can be extrapolated to two or more degrees of freedom of the surgical instruments provided herein. For example, when the end effector 330 includes two separately movable parts (e.g., opposing jaws designed as described above for grasping or cutting), this arrangement provides two degrees of freedom (e.g., pitch / yaw motion when the parts move synchronously and opening / closing motion when the parts move asynchronously or in opposite directions). Extending the concepts described with reference to surgical instrument 300 to such an end effector would result in an instrument having four actuator engagement members and four tensioning members to actuate two degrees of freedom.

[0088] refer to Figure 9 Surgical instrument 300 can be selectively coupled to instrument drive system 400. That is, surgical instrument 300 can be coupled to instrument drive system 400 to operate as part of a computer-aided remote surgical system. Alternatively, surgical instrument 300 can be decoupled from instrument drive system 400 (e.g., for replacement with another type of surgical instrument, for sterilization of surgical instrument 300, etc.).

[0089] In some embodiments, the instrument drive system 400 may be mounted to a manipulator assembly, which in turn may be mounted to another structure or base. In some cases, the instrument drive system 400 may be interchangeably mounted to the manipulator assembly. That is, in some embodiments, the instrument drive system 400 is designed to be easily detached from the manipulator assembly, allowing it to be easily interchanged with another instrument drive system. Therefore, the instrument drive system 400 may also be referred to as a pod 400. As used herein, the term "pod" refers to some interchangeable aspects of the instrument drive system relative to the manipulator assembly—that is, a pod can be removed from the manipulator assembly and replaced with a second pod having the same, similar, or different configuration. In some embodiments, the instrument drive system 400 is attached to the manipulator assembly in a manner that makes the instrument drive system 400 difficult to detach or interchange.

[0090] In some embodiments, the surgical instrument 300 may be slidably coupled to the instrument drive system 400. That is, the surgical instrument 300 may extend distally and retract proximally relative to the instrument drive system 400.

[0091] In the illustrated embodiment, the instrument drive system 400 includes a first actuator 410, a second actuator 420, and a shaft actuator 430. The first actuator 410 may be releasably coupled to a first actuator engagement member 350. Thus, the first actuator 410 may induce tension in a first tension member 340. The second actuator 420 may be releasably coupled to a second actuator engagement member 370. Thus, the second actuator 420 may induce tension in a second tension member 360. Actuators 410, 420 are shown in a non-clamping engagement with their respective actuator engagement members 350, 370. Alternatively, actuators 410, 420 may be in a latching engagement with their respective actuator engagement members 350, 370 (e.g., a latch). In a latching engagement, two objects are (releasably or otherwise) secured together such that when one object moves, the other object moves accordingly. In a non-clamping engagement, the two objects are not fixed together, so if one object moves toward the other, the other object moves, but if one object moves away from the other, the other object will not move.

[0092] Given the arrangement of the surgical instrument 300 and the first actuator 410 and the second actuator 420 of the instrument drive system 400 as described above, it is conceivable that coordinated modulation of the forces applied from the first actuator 410 and the second actuator 420 to the first actuator engagement member 350 and the second actuator engagement member 370, respectively, can result in controlled movement of the end effector 330 in its degrees of freedom. Furthermore, it is also conceivable (as further described below) that the tension in the first tension member 340 and the second tension member 360 can also be controlled by coordinated modulation of the forces applied from the first actuator 410 and the second actuator 420 to the first actuator engagement member 350 and the second actuator engagement member 370, respectively. Furthermore, it can be envisioned that the tension in the first tensioning member 340 and the second tensioning member 360 can be controlled by the coordinated modulation of the forces applied from the first actuator 410 and the second actuator 420 to the first actuator engagement member 350 and the second actuator engagement member 370, respectively. Simultaneously, the coordinated modulation of the forces applied from the first actuator 410 and the second actuator 420 to the first actuator engagement member 350 and the second actuator engagement member 370 also induces the desired movement of the end effector 330. More simply, the tension in the first tensioning member 340 and the second tensioning member 360 can be controlled to a desired tension force, while simultaneously inducing movement of the end effector 330 as needed. This concept can be referred to herein as "dynamic tension control" or "dynamic tension and orientation control."

[0093] Still referencing Figure 9The instrument drive system 400 also includes a shaft actuator 430, which engages with a corresponding shaft actuator engagement member on the surgical instrument in a non-clamping or clamping manner. As shown, an example of non-clamping engagement is engagement with a portion of the distal portion 310 serving as the shaft actuator engagement member. An example of clamping engagement is latching engagement as described below. The shaft actuator 430 is releasably coupled to the instrument shaft 302 for both clamping and non-clamping engagement.

[0094] In some embodiments, the shaft actuator 430 is releasably coupled to the instrument shaft 302 (or a configuration coupled to the instrument shaft 302) using a latching mechanism. Thus, in some such embodiments, when the shaft actuator 430 is locked to the instrument 300, the shaft actuator 430 is capable of applying a distally or proximally directed force to extend or retract the instrument 300 distally relative to the instrument drive system 400 as desired. It should be understood that such a latching mechanism for coupling the shaft actuator 430 to the instrument shaft 302 is not necessary in all embodiments. Furthermore, in some embodiments, the shaft actuator 430 is configured to apply only a distally directed force to the instrument 300 (i.e., no proximally directed force). The dynamic tension and orientation control concepts described herein can still be achieved while the shaft actuator 430 is configured to apply only a distally directed force to the instrument 300.

[0095] Actuators 410, 420, and 430 can be of various types. In some embodiments, the first actuator 410, the second actuator 420, and the shaft actuator 430 each include an electric motor coupled to a lead screw that linearly drives a nut member on the thread of the lead screw. In some embodiments, the entire assembly of the surgical instrument 300, combined with the instrument drive system 400, can be driven together to produce a desired movement of the end effector, such as a rolling motion about the longitudinal axis of the surgical instrument 300.

[0096] Also refer to Figure 10 The diagram 500, used in conjunction with the instrument drive system 400, further describes the structure and operation of the surgical instrument 300. The body 301 represents the surgical instrument 300. Force f1 represents the force applied to the first engagement member 350 by the first actuator 410. Force f2 represents the force applied to the second engagement member 370 by the second actuator 420. s This indicates the force applied to the machine shaft 302 by the shaft actuator 430.

[0097] Force f s The direction of force f is opposite to that of forces f1 and f2. Therefore, in a static environment, force f s It equals the sum of forces f1 and f2. In a dynamic environment, if force f sIf the force is greater than the sum of forces f1 and f2, then the main body 301 will be under force f s It moves in the direction of. Conversely, if the force f s If the force is less than the sum of forces f1 and f2, then the main body 301 will move in the direction of forces f1 and f2.

[0098] By applying the aforementioned principles regarding force 500 to a similar arrangement of surgical instrument 300 and instrument drive system 400, the following concept can be envisioned. When the surgical instrument 300 and instrument drive system 400 are in a constant spatial relationship (i.e., in a static environment), the sum of the forces applied from the first actuator 410 and the second actuator 420 to the first actuator engagement member 350 and the second actuator engagement member 370 is equal to the force applied from the shaft actuator 430 to the instrument shaft 302. Furthermore, when the sum of the forces applied from the first actuator 410 and the second actuator 420 to the first actuator engagement member 350 and the second actuator engagement member 370 is greater than the force applied from the shaft actuator 430 to the instrument shaft 302, the surgical instrument 300 will move proximally relative to the instrument drive system 400. Furthermore, when the sum of the forces applied from the first actuator 410 and the second actuator 420 to the first actuator engagement member 350 and the second actuator engagement member 370 is less than the force applied from the shaft actuator 430 to the instrument shaft 302, the surgical instrument 300 will move distally relative to the instrument drive system 400.

[0099] For clarity, the combination of forces from actuators 410, 420, and 430 that cause proximal and distal movement of the surgical instrument 300 relative to the instrument drive system 400 involves the sum of forces applied from the first actuator 410 and the second actuator 420 to the first actuator engagement member 350 and the second actuator engagement member 370. Therefore, it is conceivable that the forces applied from the first actuator 410 and the second actuator 420 to the first actuator engagement member 350 and the second actuator engagement member 370 may be equal to or different from each other, while the sum remains the total amount suitable for producing the desired distal / proximal movement and / or orientation between the surgical instrument 300 and the instrument drive system 400. For example, when the forces applied from the first actuator 410 and the second actuator 420 to the first actuator engagement member 350 and the second actuator engagement member 370 are different from each other, movement of the end effector 330 will occur; when the forces applied from the first actuator 410 and the second actuators 410 and 420 to the first actuator engagement member 350 and the second actuator engagement member 370 are equal from each other, the end effector 330 will remain stationary relative to the instrument axis 302. Similarly, it should be understood that, using the structural and operational concepts provided herein, distal / proximal movement of the surgical instrument 300 relative to the instrument drive system 400 can occur simultaneously with movement of the end effector 300 relative to the instrument axis 302. Moreover, these two movements can occur simultaneously while the tension in the first tension member 340 and the second tension member 360 is maintained at a desired tension level (e.g., within the target range of the desired tension).

[0100] It should be understood that the force applied by actuator 430 can be the primary moving force, thus the insertion and withdrawal of instrument 330 is directly controlled by actuator 430, and actuators 410 and 420 apply forces sufficient to maintain tension in tension elements 340 and 360 and to maintain or change the orientation of end effector 330 during insertion and withdrawal of the instrument. Therefore, in one aspect, actuator 430 controls the insertion and withdrawal position of instrument 300, while actuators 410 and 420 react to changes in position to control tension on tension elements 340 and 360. For example, when actuator 430 slightly increases the force to insert the instrument shaft, a slight increase in tension in tension elements 340 and 360 is sensed, and actuators 410 and 420 reduce the force to return tension elements 340 and 360 to the desired value. Alternatively, the insertion and withdrawal of the instrument 330 are controlled by actuators 410, 420, and 430, which work together to control the tension on tensioning elements 340 and 360. These tensioning elements 340 and 360, in turn, control the insertion and withdrawal positions of the instrument 300, while simultaneously controlling the relative tension between tensioning elements 340 and 360 through the combined action of actuators 410 and 420, thereby maintaining or altering the orientation of the end effector 330. For example, when actuator 430 slightly increases the force to insert the instrument shaft, actuators 410 and 420 simultaneously decrease the force to maintain the tension in tensioning elements 340 and 360 at a desired value. It is understood that these two aspects of tension control apply to opposite situations, where actuators 410 and 420 act together to apply the primary moving force for insertion / withdrawal, and actuator 430 controls the tension in the tensioning elements. Moreover, it is understandable that these tension control aspects are applicable to more complex motions, where the instrument axis is moved for insertion / withdrawal and the end effector moves with one or more degrees of freedom.

[0101] Also refer to Figure 11-13 The above concept can be further described by using illustrations of surgical instruments 300 in various positions relative to the instrument drive system 400.

[0102] In the first example, it can be done in the following way Figure 9 The layout is converted Figure 11Arrangement: Compared to the force applied by the second actuator 420 to the second actuator engagement member 370, the force applied by the first actuator 410 to the first actuator engagement member 350 is temporarily increased, while maintaining the sum of the two forces equal to the force applied by the shaft actuator 430 to the instrument shaft 302. As a result, the end effector 330 will move relative to the instrument shaft 302, while the surgical instrument 300 maintains a constant spatial relationship relative to the instrument driver 400 (i.e., no distal or proximal movement). This movement can be performed while the tension in the first tension member 340 and the second tension member 360 is maintained at a desired tension level (e.g., within the target range of the desired tension).

[0103] In the second example, it can be done in the following way Figure 9 The layout is converted Figure 12 Arrangement: Compared to the force applied by the second actuator 420 to the second actuator engagement member 370, the force applied by the first actuator 410 to the first actuator engagement member 350 is temporarily increased, while the sum of the two forces is temporarily less than the force applied by the shaft actuator 430 to the instrument shaft 302. As a result, the end effector 330 will move relative to the instrument shaft 302, and the surgical instrument 300 will extend distally relative to the instrument driver 400. This movement can be performed while the tension in the first tension member 340 and the second tension member 360 is maintained at a desired tension level (e.g., within the target range of the desired tension).

[0104] In the third example, it can be done in the following way Figure 9 The layout is converted Figure 13 Arrangement: Compared to the force applied by the second actuator 420 to the second actuator engagement member 370, the force applied by the first actuator 410 to the first actuator engagement member 350 is temporarily increased, while the sum of the two forces is temporarily greater than the force applied by the shaft actuator 430 to the instrument shaft 302. As a result, the end effector 330 will move relative to the instrument shaft 302, and the surgical instrument 300 will retract proximally relative to the instrument driver 400. This movement can be performed while the tension in the first tension member 340 and the second tension member 360 is maintained at a desired tension level (e.g., within the target range of the desired tension).

[0105] In the fourth example, it can be done in the following way Figure 12 The layout is converted Figure 13The arrangement is such that the force applied by the first actuator 410 to the first actuator engagement member 350 and the force applied by the second actuator 420 to the second actuator engagement member 370 are kept equal, while the sum of the two forces is temporarily greater than the force applied by the shaft actuator 430 to the instrument shaft 302. As a result, the end effector 330 will not move relative to the instrument shaft 302, and the surgical instrument 300 will retract proximally relative to the instrument driver 400. This movement can be performed while the tension in the first tension member 340 and the second tension member 360 is maintained at a desired tension level (e.g., within the target range of the desired tension).

[0106] In the fifth example, it can be done in the following way: Figure 12 The layout is converted Figure 13 The arrangement is such that the force applied by the first actuator 410 to the first actuator engagement member 350 and the force applied by the second actuator 420 to the second actuator engagement member 370 are kept equal, while the sum of the two forces is temporarily less than the force applied by the shaft actuator 430 to the instrument shaft 302. As a result, the end effector 330 will move relative to the instrument shaft 302, and the surgical instrument 300 will extend distally relative to the instrument driver 400. This movement can be performed while the tension in the first tension member 340 and the second tension member 360 is maintained at a desired tension level (e.g., within the target range of the desired tension).

[0107] The examples to date have shown that the first and second actuators of the drive unit apply proximal compressive forces to their respective first and second actuator engagement members, and that the shaft actuator of the drive unit applies a distal compressive force to the instrument shaft. However, on the other hand, these forces are oriented in opposite directions, such that the first and second actuators of the drive unit apply distal compressive forces to their respective first and second actuator engagement members, and that the shaft actuator of the drive unit applies a proximal compressive force to the instrument shaft. In this respect, tensioning members can be arranged above pulleys such that distal movement of the actuator engagement member causes tension in the corresponding tensioning member and associated end effector movement. Alternatively, the tensioning member can be replaced by a compression member (e.g., a push rod coupled to the end effector), such that distal movement of the actuator engagement member causes compression in the corresponding compression member and associated end effector movement.

[0108] refer to Figure 14 In some embodiments, the force applied to the surgical instrument 300 by the actuators 410, 420 and / or 430 can be detected by using one or more force detection devices. The outputs of such force detection devices can be used to control the actuators 410, 420 and / or 430 (i.e., control the movement of the surgical instrument 300 and / or control the tension of the first tensioning member 340 and the second tensioning member 360).

[0109] In a first non-limiting example, the arrangement shown includes a force sensor of the type 510, located at or near the junction between the first actuator 410 and the first actuator engagement member 350. In another example, the arrangement shown includes a force sensor of the type 520, located near the connection point between the first actuator 410 and the structural member 401 of the instrument drive system 400. In some embodiments, the instrument drive system 400 may be a cabin (i.e., readily interchangeable with respect to mounting on the manipulator assembly).

[0110] In some embodiments, other sensors and / or other devices may be used to detect the forces applied to the surgical instrument 300 by actuators 410, 420, and / or 430. For example, in some embodiments, strain gauges may be located on actuator engagement members, such as the first actuator engagement member 350. In another embodiment, the current drawn by the electric motors of actuators 410, 420, and / or 430 may be measured and used as an indication of the forces applied to the surgical instrument 300 by actuators 410, 420, and / or 430. In some embodiments, a combination of such force detection devices and techniques may be used.

[0111] See Figure 15-18 An exemplary surgical instrument 600, which can be used as part of a computer-assisted remote surgical system, includes a proximal portion 610, an instrument shaft 640, and an end effector 650. The surgical instrument 600 is based on the above schematic diagram (e.g., Figure 8 , Figure 9 and Figure 11-14 Example of a surgical instrument configuration. Therefore, surgical instrument 600 can function according to the above schematic diagram.

[0112] Instrument axis 640 extends distally from proximal portion 610. Instrument axis 640 includes a distal portion to which end effector 650 is coupled. Instrument axis 640 defines a longitudinal axis 602 along which surgical instrument 600 is inserted into and withdrawn from the patient.

[0113] The end effector of the surgical instrument described herein (e.g., end effector 650) can be any type of surgical end effector (e.g., a grasper, cutter, cauterization instrument, stapler, forceps, camera, etc.). The end effector of the surgical instrument described herein (e.g., end effector 650) can have one or more degrees of freedom (e.g., two, three, four, five, six, seven, eight, or more than eight degrees of freedom). Furthermore, it should be understood that the concepts described herein in the context of a single degree of freedom of the end effector can be extended to each of the multiple degrees of freedom of surgical instrument 600 and other types of surgical instruments for computer-assisted remote surgical systems.

[0114] In the illustrated embodiment, the proximal portion 610 includes a handle 612, a plurality of actuator engagement members (described herein as being disposed in a group 630 at the same longitudinal position along the longitudinal axis 602), and an instrument axis actuator engagement member 620. The plurality of actuator engagement members 630 are movably coupled to the proximal portion 610. In the illustrated embodiment, the plurality of actuator engagement members 630 are slidably coupled to the proximal portion 610 such that the plurality of actuator engagement members 630 can translate parallel to the longitudinal axis 602. The instrument axis actuator engagement member 620 is coupled to the proximal portion 610. In the illustrated embodiment, the instrument axis actuator engagement member 620 is pivotally coupled to the proximal portion 610.

[0115] Handle 612 extends radially from longitudinal axis 602. In the illustrated embodiment, handle 612 is the radially furthest portion of the proximal portion 610 and the entire surgical instrument 600. Handle 612 is configured to facilitate manual gripping and manipulation of the surgical instrument 600.

[0116] In some embodiments, the handle 612 includes a marker identifying the type of surgical instrument 600. For example, in the illustrated embodiment, the handle 612 includes a visible marker, which is an icon 614, depicting the surgical instrument 600 as a gripper device. In some embodiments, the handle 612 includes a machine-readable marker, such as an RFID chip or NFC tag, which can be used to store and transmit information about the surgical instrument 600. For example, such information about the surgical instrument 600 may include, but is not limited to, a unique identifier or serial number, the type of instrument, the number of times the instrument has been used in one or more surgical procedures, etc.

[0117] In some embodiments, the handle 612 may optionally include one or more magnets that the instrument drive system can use to sense the presence of a surgical instrument 600 mounted on the instrument drive system.

[0118] The proximal portion 610 includes a plurality of actuator engagement members. As shown, the actuator engagement members are disposed in group 630 at a common longitudinal position along the longitudinal axis 602. Optionally, they may be located at two or more longitudinal positions along the longitudinal axis 602, such that a first pair of actuator engagement members is in a first longitudinal position and a second pair of actuator engagement members is in a second longitudinal position, or each actuator engagement member of a pair of coupling members is located at a different longitudinal position. (Refer to the above...) Figure 8-14 The actuator engagement members are configured to releasably engage with actuators that drive corresponding movements of the actuator engagement members and the end effector 650. As shown, each individual actuator engagement member slides longitudinally in a corresponding individual longitudinal slot within the proximal portion 610. However, in other alternative aspects, the individual actuator engagement members may have different configurations (e.g., levers, rotating elements such as discs or gears, cam surfaces, etc.). As shown, all individual actuator engagement members extend radially outward slightly beyond the outer periphery of the proximal portion 610, such that the associated actuator does not extend into the proximal portion 610. Alternatively, one or more individual actuator engagement members may not extend into or beyond the outer periphery of the proximal portion (e.g., they are slightly within the proximal portion 610), thus making them less susceptible to damage or snagging on objects. In this alternative configuration, the associated actuator extends slightly into the proximal portion 610 to engage the actuator engagement member of the instrument. All actuator engagement components may have the same configuration, or two or more actuator engagement components may be used in a single device, provided that the actuator engagement components conform to the reference. Figure 8-14 The operating principle described is sufficient. In the illustrated embodiments, the following exemplary actuator engagement members are included: 632a, 632b, 634a, 634b, 636a, 636b, and 638. In some embodiments, more or fewer actuator engagement members may be included.

[0119] Actuator engagement members (e.g., actuator engagement members 632a, 632b, 634a, 634b, 636a, 636b, and 638) are coupled to a tensioning member (e.g., including flexible cables (e.g., 2-10 mm scale) that can be routed over small-radius pulleys, semi-flexible cables that cannot be routed over small-radius pulleys, rigid hysteresis tubes, tie rods, etc.) that extend along the instrument axis 640 and are movably coupled to the end effector 650. Therefore, movement of the actuator engagement members causes movement of the end effector 650.

[0120] In some cases, actuator engaging members are paired (e.g., actuator engaging members 632a and 632b, actuator engaging members 634a and 634b, and actuator engaging members 636a and 636b) such that proximal movement of one actuator engaging member in a pair causes a corresponding distal movement of the other actuator engaging member in the pair. For example, proximal movement of actuator engaging member 632a causes a corresponding distal movement of actuator engaging member 632b, and proximal movement of actuator engaging member 632b causes a corresponding distal movement of actuator engaging member 632a. In other words, the actuator engaging members move relative to each other.

[0121] When the surgical instrument 600 includes actuator engagement members (e.g., actuator engagement members 632a, 632b, 634a, 634b, 636a, 636b, and 638) coupled to a flexible tension cable, it is conceivable that distal movement of an actuator engagement member without a corresponding proximal movement of a mating actuator engagement member will not move the end effector 650. Instead, the flexible tension cable attached to a positively distally moving actuator engagement member will simply become slack (due to the limited column strength / stiffness of the flexible tension cable). Therefore, it can be said that in some embodiments, actuator engagement members 632a, 632b, 634a, 634b, 636a, 636b, and 638 are configured to move the end effector 650 in response to receiving a proximal directional force, and are configured not to move the end effector 650 in response to receiving a distal directional force. However, in some embodiments, one or more of the actuator engagement members (e.g., actuator engagement member 638 that does not pair with another actuator engagement member) are configured to move the end effector 650 in both directions (proximal and distal). That is, such actuator engagement members may optionally drive flexible or semi-flexible members in a manner similar to Bowdin cable operation, or drive rigid members in a manner similar to push / pull lever operation. For example, in some embodiments, actuator engagement member 638 may be configured to operate the blade of end effector 650 or, in the case where end effector 650 includes a stapler, to operate a clamp. In the example of the blade, actuator engagement member 638 operates in opposition to a spring (cutting and springing back under actuation). In the example of the stapler, actuator engagement member 638 moves distally to drive a firing sequence, while a gripping open actuation causes actuator engagement member 638 to return proximally.

[0122] Still referencing Figure 15-18In the arrangement of the surgical instrument 600 shown, actuator engagement members 632a, 632b, 634a, 634b, 636a, 636b, and 638 are all positioned at the same longitudinal location along the longitudinal axis 602 of the surgical instrument. However, during use of the surgical instrument 600, actuator engagement members 632a, 632b, 634a, 634b, 636a, 636b, and 638 move to various longitudinal positions along the longitudinal axis 602 of the surgical instrument. The following examples further illustrate this.

[0123] When the surgical instrument 600 is coupled to the instrument drive system, the actuators of the instrument drive system will be releasably coupled to actuator engagement members 632a, 632b, 634a, 634b, 636a, 636b, and 638. For example, the actuator will engage the actuator engagement member by moving proximally until a reaction force indicating engagement is sensed. For the paired actuator engagement members 632a and 632b, the first actuator moves proximally until actuator engagement member 632a is engaged, and the second actuator moves proximally until actuator engagement member 632b is engaged. Then, the first and second actuators can adjust the longitudinal position of the respective actuator engagement members 632a and 632b to set the desired tension in the respective pairs of tensioning members coupled to the distal component, such that all slack or backlash is removed from the drive system between the actuator engagement member and the respective distal component, and movement of the actuator engagement member causes immediate movement of the respective distal component. That is, one or more instrument drive system actuators engage one or more corresponding instrument actuator engagement members and set a dynamic preload tension (which may be a supplement to the static preload tension described below) in one or more instrument tensioning members between one or more actuator engagement members and the respective distal instrument component (e.g., wrist or end effector component).

[0124] Then, in response to the input (e.g. from...) Figure 2In the surgical console 40, the actuators of the instrument drive system accordingly move some or all of the actuator engagement members (e.g., actuator engagement members 632a, 632b, 634a, 634b, 636a, 636a and / or 636b) proximally to actuate the desired movement of the end effector 650 or other distal components. For example, for a pair of actuator engagement members 632a and 632b, the first actuator of the instrument drive system may move actuator engagement member 632a proximally. Consistent with the proximal movement of actuator engagement member 632a, the second actuator of the instrument drive system may resist distal movement of actuator engagement member 632b, thereby maintaining tension on the corresponding tensioning member of actuator engagement member 632b, but still allowing distal movement of actuator engagement member 632b. The resistance of the second actuator to the distal movement of the actuator engagement member 632b is adjusted to maintain the desired tension in the tensioning members corresponding to the actuator engagement members 632a and 632b. This operation is based on the above reference. Figure 8-14 The concept of dynamic tension is described to be implemented.

[0125] In one aspect, as the tensioning member moves the corresponding end effector, the control system ensures that the tension in each of the paired tensioning members is equal. However, in another aspect, the control system controls the tension in the tensioning members to generate the required load force in the loaded tensioning member and maintain minimum tension in the unloaded tensioning member.

[0126] To illustrate this differential force aspect by example, consider a pair of actuator engagement members 632a and 632b. When their respective end effectors are in a neutral position (e.g., centered on the longitudinal axis of the instrument and not engaged with another object), not moving, and not experiencing a load, the control system can induce the application of equal forces to actuator engagement members 632a and 632b. This equal force is equal to or greater than the minimum force required to eliminate backlash from the tensioning member connection between the end effector and the actuator engagement members for effective control. However, the equal force is kept low to reduce frictional and tensile loads that lead to mechanical wear.

[0127] To move the associated end effector, the control system causes actuator engagement members 632a and 632b to move in opposite directions. The end effector movement caused by proximal movement of actuator engagement member 632a can be unresisted (e.g., the end effector moves freely) or resisted (e.g., the end effector moves against tissue or another part of the end effector, such as one jaw moving against another during a grip). Friction in the drivetrain can also result in a load that requires a greater force to be applied to actuator engagement member 632a than is needed for effective control to hold the end effector in a neutral position. Therefore, the actuator associated with actuator engagement member 632a must increase its force against actuator engagement member 632 to continue moving the corresponding end effector or to maintain the corresponding end effector against resistance. However, in this case, it is not necessary for the actuator associated with the paired actuator engagement member 632b to apply the same force on actuator engagement member 632b as it does on actuator engagement member 632a. What is required is that the force applied to the actuator engagement member 632b is equal to or higher than the minimum threshold required to keep the associated tensioning member from slackening or deviating from its path (e.g., leaving the pulley).

[0128] As further explanation, if the control system causes actuator engagement member 632a to receive the maximum permissible force from its associated drive unit actuator to generate the maximum force at the corresponding end effector (e.g., to generate the maximum possible end effector clamping force), the control system can cause actuator engagement member 632b to receive only the minimum required force to ensure that its associated tensioning member does not slack off and does not deviate from its correct path, or to receive a force between that minimum force and the force applied to actuator engagement member 632a. Moreover, while this aspect applies to the maximum force applied to actuator engagement member 632a, it also applies when smaller forces are applied, thereby minimizing conflicting tensions caused by the force applied to actuator engagement member 632b. It should be understood that if the end effector is subsequently moved in the opposite direction, the required load force is applied to actuator engagement member 632b, and the required tension holding force is applied to actuator engagement member 632a. It should also be understood that if compression rather than tension is used to move the end effector, this differential force aspect still applies, thereby reducing or minimizing any unnecessary compressive force.

[0129] In some embodiments of the surgical instrument 600, a preloaded tensioning member (e.g., spring 633) may be included to maintain a minimum tension—static preloaded tension—in the tensioning member when the surgical instrument 600 is disengaged from the instrument drive system. This minimum pretension helps ensure that the tensioning member remains in its orientation and wiring within the surgical instrument 600 as needed. In the illustrated embodiment, the compression spring 633 applies a proximal directional force to actuator engagement members 632a, 632b, 634a, 634b, 636a, 636b, and 638 to maintain a minimum tension in the tensioning member when the surgical instrument 600 is disengaged from the instrument drive system. In some embodiments, other types of preloaded tensioning members may be used, such as, but not limited to, flexures formed as part of shaft 640 or proximal portion 610, tension springs, torsion springs, leaf springs, etc. Furthermore, in embodiments that include a compression member instead of a tensioning member, a preloaded compression member similar to these preloaded tensioning members may be used to eliminate mechanical backlash in the drivetrain between the actuator engagement member and the end effector.

[0130] Still referencing Figure 15-18 The proximal portion 610 includes an instrument shaft actuator engagement member 620. The instrument shaft actuator engagement member 620 is used to releasably couple the proximal portion 610 to an actuator of the instrument drive system. Since the instrument shaft 640 is rigidly coupled to the proximal portion 610, the instrument shaft actuator engagement member 620 can also releasably couple the instrument shaft 640 to an actuator of the instrument drive system. The above is illustrated by schematic diagrams and descriptions thereof (e.g., via...). Figure 9 The present invention (including a shaft actuator 430 releasably coupled to the instrument shaft 302) describes the concept of coupling an actuator to the proximal portion 610 and the instrument shaft 640 using an instrument shaft actuator engagement member 620. Therefore, the instrument shaft actuator engagement member 620, when coupled to the actuator of the instrument drive system, is used to move the entire surgical instrument 600 proximally and / or distally relative to the instrument drive system. Additionally (see reference...) Figure 10 As described in the force diagram, the instrument shaft actuator engagement member 620, when coupled with the actuator of the instrument drive system, is used to balance the proximal directional forces applied by the actuator to the actuator engagement members 632a, 632b, 634a, 634b, 636a, 636b and 638.

[0131] In the illustrated embodiment, actuator engagement members 632a, 632b, 634a, 634b, 636a, 636b, and 638 are configured to receive proximal directional forces from the actuators of the instrument drive system, but are not configured to receive distal directional forces from the actuators of the instrument drive system. In other words, actuator engagement members 632a, 632b, 634a, 634b, 636a, 636b, and 638 are not latched (not immovably coupled; non-latched engagement) to the actuators of the instrument drive system. In other words, actuator engagement members 632a, 632b, 634a, 634b, 636a, 636b, and 638 are all configured to directly actuate (cause) movement of the end effector 650 in response to receiving a proximal directional force from the respective actuator, and each is not configured to directly actuate movement of the end effector 650 in response to receiving a distal directional force from the respective actuator. Conversely, in the illustrated embodiment, the instrument shaft actuator engagement member 620 is configured to directly facilitate proximal movement of the entire surgical instrument 600 in response to receiving a proximal directional force, and is also configured to directly facilitate distal movement of the entire surgical instrument 600 in response to receiving a distal directional force. This is because the instrument shaft actuator engagement member 620 is configured to be releasably latched onto the actuator of the instrument drive system. For example, in the illustrated embodiment, the instrument shaft actuator engagement member 620 is a latching mechanism that can be used to releasably latch the proximal portion 610 and the instrument shaft 640 onto the actuator of the instrument drive system. It should be understood that a latching mechanism for the instrument shaft actuator engagement member 620 is not required in all embodiments, and other suitable coupling mechanisms at different locations on the instrument can be used.

[0132] Furthermore, in some embodiments, the instrument shaft actuator engagement member 620 is configured such that the instrument drive system applies only a distal directional force (i.e., not a proximal directional force) to the surgical instrument 600. The dynamic tension and orientation control concepts described herein can still be performed even when the instrument shaft actuator engagement member 620 is configured to receive only the distal directional force from the instrument drive system. In this respect, the distal directional force on the instrument's shaft actuator engagement member is balanced with the proximal directional force on the instrument's actuator engagement member.

[0133] Special Reference Figure 18In some embodiments, the surgical instrument 600 is configured with one or more connectors or contacts for supplying energy (e.g., energy for cauterization) to the end effector 650. For example, in some embodiments, the surgical instrument may be configured to use monopolar RF, bipolar RF, or another form of energy. In this case, in some embodiments, one or more connectors are located on the proximal region 613 of the handle 612. Such a location allows easy access to one or more connectors for connection to one or more cables supplying energy. Such a location also allows for connection and / or disconnection when the surgical instrument 600 is coupled to an instrument drive system.

[0134] refer to Figure 19 Surgical instrument 600 can be selectively coupled to a compatible instrument drive system 700 (also referred to as cabin 700), which defines a longitudinal axis 702 of a space configured to receive surgical instrument 600. According to a typical embodiment of computer-assisted remote surgery, instrument drive system 700 can be coupled to a manipulator assembly 800 having multiple degrees of freedom. In some embodiments, cabin 700 can be easily detached from manipulator assembly 800, allowing cabin 700 to be readily interchanged with another cabin. Manipulator assembly 800 can be attached to various types of support structures (e.g., see...). Figure 3 and Figure 4 The instrument shaft 640 can slidably extend through the sleeve 740, which can optionally be releasably mounted to the manipulator assembly 800 or the instrument drive system 700.

[0135] In the illustrated embodiment, the surgical instrument 600 can be releasably coupled to the instrument drive system 700 by moving it distally into an opening at the proximal end 704 of the instrument drive system 700. Specifically, the longitudinal axis 602 of the surgical instrument 600 can initially be aligned with the longitudinal axis 702 of the instrument drive system 700. Then, the surgical instrument 600 can slide distally relative to the instrument drive system 700 until the instrument shaft engagement member 620 is coupled to the instrument drive system 700.

[0136] When the surgical instrument is coupled to the instrument drive system, at least some portions of the handle 612 and the instrument shaft engagement member 620 extend radially further than adjacent portions of the instrument drive system 700, causing the handle 612 to protrude beyond the housing 700. Therefore, the handle 612 and the instrument shaft engagement member 620 are accessible to the user's hand. This accessibility advantageously facilitates easy decoupling of the surgical instrument 600 from the instrument drive system 700.

[0137] Although not visible, the instrument drive system 700 includes multiple actuators (in) Figure 9 and Figure 11-14(Illustrated schematically) These actuators are releasably coupled to actuator engagement members 632a, 632b, 634a, 634b, 636a, 636b, and 638 while the surgical instrument 600 is coupled to the instrument drive system 700. In some embodiments, the actuators are linear actuators comprising a lead screw and a lead screw nut member, and other suitable linear actuators (e.g., chain, belt, hydraulic, pneumatic, electromagnetic, etc.) may be used. In some embodiments, nonlinear actuators, such as rotary actuators, or a combination of linear and nonlinear actuators, may be used to generate the described counterforce aspect. In some embodiments, one or more force sensors are included in the instrument drive system 700, by which the forces applied to the actuator engagement members 632a, 632b, 634a, 634b, 636a, 636b, and / or 638 can be determined and fed back to the processor 43. Figure 2 ).

[0138] In some embodiments, the entire surgical instrument 600 coupled to the instrument drive system 700 can rotate or roll as a single unit about longitudinal axes 602 and 702. The instrument actuator engagement member 620, when coupled to the chamber 700 via the instrument shaft insertion / retraction actuator or directly to the chamber 700, is used to secure the instrument shaft during roll about the longitudinal axis 602 as the chamber 700 rotates about its longitudinal axis 702. Additionally, the handle 612 can provide additional support for the chamber 700 for roll. A motor at the distal end of the chamber 700 (within the chamber 700 or a portion of the manipulator 800) rotates the assembly of the chamber 700 and the instrument 600. Thus, the instrument shaft and the distal actuator can be simultaneously inserted / retracted and rolled.

[0139] refer to Figure 20 The surgical instrument actuator compartment 700 is shown isolated from the surgical instrument 600 and the manipulator assembly 800. The compartment 700 includes a proximal end 704 and a distal end 706. The compartment 700 defines a longitudinal axis 702 along which surgical instruments (or other devices such as endoscopic cameras) can be mounted.

[0140] In the illustrated embodiment, the cabin 700 includes a proximal plate 705, a distal plate 707, and a housing 710. The housing 710 extends between the proximal end 704 and the distal end 706.

[0141] In the illustrated embodiment, the proximal plate 705 is a C-shaped plate, while the distal plate 707 is a fully circumferential plate defining an open central region. The C-shaped opening in the proximal plate 705 is aligned with a slot opening 712 defined by the housing 710. The slot opening 712 and the opening in the C-shaped proximal plate 705 provide clearance for the handle 612 of the surgical instrument 600 to project radially from the housing 710 when the surgical instrument 600 is coupled to the instrument drive system 700.

[0142] As further described below, the proximal plate 705 and distal plate 707 are structural components of the frame of the chamber 700. Alternatively, the end plates may be integrated with the housing or other chamber components as part of the frame or separate from the frame. In the illustrated embodiment, the frame also includes a chamber rotation gear 708 located at the distal end 706. When the chamber 700 is coupled to the manipulator assembly 800, the chamber rotation gear 708 meshes with and is driven by the drive gear of the manipulator assembly 800. When the chamber rotation gear 708 is driven, the entire chamber 700 rotates about a longitudinal axis 702, which is the chamber's roll axis. When the surgical instrument 600 engages with the chamber 700, it is aligned with this roll axis, so when the chamber rotation gear 708 is driven by the drive gear of the manipulator assembly 800, the surgical instrument 600 also rotates or rolls about the longitudinal axis 702. That is, rolling the chamber about its longitudinal axis rotates the instrument axis, which in turn introduces the roll into the instrument end effector. In this way, when the device is installed in the chamber, the longitudinal axis 702 of the chamber coincides with the roll axis of the device axis, and when the device is inserted into and withdrawn from the patient relative to the chamber, the longitudinal axis 702 of the chamber also coincides with the insertion and withdrawal axis of the device.

[0143] refer to Figure 21 An exploded view of the surgical instrument actuation chamber 700 provides visualization of the components of the chamber housed within the housing 710. As will be described in more detail, the chamber 700 includes a plurality of motors 720, a plurality of lead screws 730, a plurality of threaded nuts 740, and a plurality of anti-rotation shafts 750. Throughout this specification, the chamber embodiment is generally described as including motors, lead screws, and threaded nuts; however, it should be understood that this assembly is an illustration of any equivalent linear actuator capable of producing the desired linear motion, such as a motor-driven ball screw, a linear actuator, a piezoelectric motor, etc. Thus, the motor, lead screw, and nut assembly is an example of a linear actuator that engages with the actuation engagement member of the surgical instrument to function as described above.

[0144] In the illustrated embodiment, a plurality of motors 720 are mounted at the distal end of the compartment and arranged concentrically about the longitudinal axis 702. As shown, the motors 720 may optionally be mounted to the distal end plate 707. In the illustrated embodiment, no motor is mounted at the proximal end of the compartment, for example, to the proximal end plate 705.

[0145] Each of the plurality of lead screws 730 is driven by a corresponding motor of the plurality of motors 720. The lead screws 730 extend distally or proximally within the cabin about the center of the instrument. In the illustrated embodiment, the lead screw 730 is rotatably coupled at its proximal end to a proximal endplate 705 and rotatably coupled at its distal end to a distal endplate 707. Alternatively, the lead screw may be coupled to a corresponding proximal end of a motor, or to another generally distal structural support within the cabin.

[0146] Each of the plurality of threaded nuts 740 is threadedly engaged with a corresponding lead screw of the plurality of lead screws 730. Therefore, when the plurality of lead screws 730 are rotatably driven by the plurality of motors 720, the plurality of threaded nuts 740 translate parallel to the longitudinal axis 702.

[0147] Multiple anti-rotation shafts 750 extend between the proximal end plate 705 and the distal end plate 707, and they slidably engage with multiple threaded nuts 740. Therefore, when the multiple lead screws 730 rotate, the multiple anti-rotation shafts 750 constrain the multiple threaded nuts 740 from rotating. Consequently, when the lead screws rotate, each nut translates along its corresponding lead screw.

[0148] One or more electronic circuit boards (not shown) for the operation of cabin 700 may be contained within housing 710. For example, such circuit boards may be mounted on end plates 707 and / or 705. In some embodiments, one or more circuit boards may be located directly above one or more motors 720. These locations of the circuit boards within housing 710 should not be considered limiting, and one or more circuit boards may be additionally or alternatively located in various other locations within housing 710. Alternatively, one or more circuit boards may be located outside the cabin, and the electronic connections between the one or more boards and the cabin motors may be adapted to cabin rotation.

[0149] See Figure 22-25 The illustrated embodiment includes eight motors 720a, 720b, 720c, 720d, 720e, 720f, 720g, and 720h. The illustrated embodiment also includes eight lead screws 730a, 730b, 730c, 730d, 730e, 730f, 730g, and 730h. Each motor 720a, 720b, 720c, 720d, 720e, 720f, 720g, and 720h is coupled to a drive gear 722. Figure 23 The drive gear 722 is coupled to the corresponding driven gear 732 of the corresponding lead screws 730a, 730b, 730c, 730d, 730e, 730f, 730g and 730h. Figure 23 and Figure 25Engagement. Therefore, each of motors 720a, 720b, 720c, 720d, 720e, 720f, 720g, and 720h can rotate one of its corresponding lead screws 730a, 730b, 730c, 730d, 730e, 730f, 730g, and 730h in both directions. That is, motor 720a can rotate lead screw 730a in both directions; motor 720b can rotate lead screw 730b in both directions; motor 720c can rotate lead screw 730c in both directions; motor 720d can rotate lead screw 730d in both directions; motor 720e can rotate lead screw 730e in both directions; motor 720f can rotate lead screw 730f in both directions; motor 720g can rotate lead screw 730g in both directions; and motor 720h can rotate lead screw 730h in both directions.

[0150] Although the illustrated embodiment includes eight motor and lead screw pairs, some embodiments include more or fewer than eight motor and lead screw pairs, depending on the number of control inputs required for the various instruments to be mounted in the surgical chamber. For example, in some embodiments, the instrument actuation chamber includes two, three, four, five, six, seven, nine, ten, eleven, twelve, or more than twelve motor and lead screw pairs. All these variations are within the scope of this disclosure.

[0151] In some embodiments, the cabin 700 further includes one or more motors that drive rotational movement of the cabin 700 relative to the manipulator assembly 800, i.e., the aforementioned roll about the longitudinal axis 702. Alternatively or additionally, in some embodiments, one or more motors for driving the roll movement of the cabin 700 relative to the manipulator assembly 800 may be mounted to the manipulator assembly 800.

[0152] Positioning the motor distally within the cabin advantageously positions the cabin's center of gravity closer to the actuator supporting it. Furthermore, other cabin components (gears, load bearings, control circuits, sensors, etc.) are advantageously arranged distally, bringing the cabin's center of gravity closer to the actuator. By keeping the center of gravity close to the actuator, inertia is minimized. As a result, actuator control of the machinery mounted within the cabin can be faster, smoother, and more precise compared to positioning the center of gravity further away from the actuator. Additionally, a smaller actuator motor can be used for the actuator.

[0153] Each lead screw 730a, 730b, 730c, 730d, 730e, 730f, 730g, and 730h has a threaded nut 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h that is threadedly coupled to it. That is, lead screw 730a is threadedly coupled to threaded nut 740a; lead screw 730b is threadedly coupled to threaded nut 740b; lead screw 730c is threadedly coupled to threaded nut 740c; lead screw 730d is threadedly coupled to threaded nut 740d; lead screw 730e is threadedly coupled to threaded nut 740e; lead screw 730f is threadedly coupled to threaded nut 740f; lead screw 730g is threadedly coupled to threaded nut 740g; and lead screw 730h is threadedly coupled to threaded nut 740h.

[0154] For example, such as Figure 22 As shown, all threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h can be simultaneously positioned in one or more common orientations along the longitudinal axis 702. When the chamber 700 is used, the orientation of each threaded nut 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h will be longitudinally translated parallel to the longitudinal axis 702 to move surgical instruments and their components (e.g., surgical instrument 600 described above) in response to the surgeon's input. Therefore, threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h will not always share (but may share) a common longitudinal orientation along the longitudinal axis 702.

[0155] In the illustrated embodiment, the compartment 700 further includes four anti-rotation shafts 750a-b, 750c-d, 750e-f, and 750g-h. As shown, the anti-rotation shafts 750a-b, 750c-d, 750e-f, and 750g-h extend proximally, for example, between the proximal end plate 705 and the distal end plate 707. In some embodiments, the anti-rotation shafts 750a-b, 750c-d, 750e-f, and 750g-h are attached to the proximal end plate 705 and the distal end plate 707, such that the anti-rotation shafts 750a-b, 750c-d, 750e-f, and 750g-h serve as longitudinally extending structural frame members of the compartment 700.

[0156] In the illustrated embodiment, each anti-rotation shaft 750a-b, 750c-d, 750e-f, and 750g-h is slidably coupled to two of the threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h. More specifically, in the illustrated embodiment, each anti-rotation shaft 750a-b, 750c-d, 750e-f, and 750g-h is slidably coupled to an adjacent pair of threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h. That is, anti-rotation shafts 750a-b are slidably coupled to threaded nuts 740a and 740b; anti-rotation shafts 750c-d are slidably coupled to threaded nuts 740c and 740d; anti-rotation shafts 750e-f are slidably coupled to threaded nuts 740e and 740f; and anti-rotation shafts 750g-h are slidably coupled to threaded nuts 740g and 740h. In the illustrated embodiment, each anti-rotation shaft 750a-b, 750c-d, 750e-f, and 750g-h is slidably coupled to no more than two of the threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h. Furthermore, in the illustrated embodiment, each of the threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h is slidably coupled to only one of the anti-rotation shafts 750a-b, 750c-d, 750e-f, or 750g-h.

[0157] Anti-rotation shafts 750a-b, 750c-d, 750e-f and 750g-h prevent rotation of threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g and 740h, while allowing longitudinal translation of threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g and 740h. Because the anti-rotation shafts 750a-b, 750c-d, 750e-f, and 750g-h are slidably coupled to the threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h, rotation of the lead screws 730a, 730b, 730c, 730d, 730e, 730f, 730g, and 730h will cause the threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h to translate longitudinally along the longitudinal axis of the lead screws 730a, 730b, 730c, 730d, 730e, 730f, 730g, and 730h.

[0158] As described above, four anti-rotation shafts (one for every two threaded nuts) are used in the illustrated embodiment to keep the center of gravity of the housing as far to the farthest possible. However, a smaller ratio of anti-rotation shafts to threaded nuts can be used. And although the illustrated embodiment uses anti-rotation shafts 750a-b, 750c-d, 750e-f, and 750g-h to ensure longitudinal translation of threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h in response to rotation of lead screws 730a, 730b, 730c, 730d, 730e, 730f, 730g, and 730h, other mechanisms are used in some embodiments. For example, in some alternative embodiments, housing 710 ( Figure 20 and Figure 21 This includes a protrusion extending radially inward from the inner diameter of the housing 710 and slidably engaging with threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h. This protrusion mechanically restricts rotation of the threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h, which could otherwise result in a response to rotation of the lead screws 730a, 730b, 730c, 730d, 730e, 730f, 730g, and 730h.

[0159] Now, also refer to Figure 9-14 The schematic diagram shows that actuators 410, 420, and 430 correspond (in the context of compartment 700) to combinations of the following: (i) a motor, (ii) a corresponding drive gear, (iii) a corresponding driven gear, (iv) a corresponding lead screw, and (v) a corresponding threaded nut. That is, in the illustrated embodiment, compartment 700 includes eight actuators, each of which includes at least a motor, a lead screw, and a threaded nut.

[0160] For reference Figure 14 In some embodiments, the forces applied to the surgical instruments by the respective actuators can be detected by using one or more force detection devices. The outputs of such force detection devices (multiple devices) can be used to control the actuators, which in turn control the movement of the surgical instruments and the tension of the tensioning components of the surgical instruments.

[0161] In the illustrated embodiment, pressure sensing elements are used to detect longitudinal forces on lead screws 730a, 730b, 730c, 730d, 730e, 730f, 730g, and 730h. For example, pressure sensing elements coupled to the distal end plate 707 are located at the distal ends of each lead screw 730a, 730b, 730c, 730d, 730e, 730f, 730g, and 730h. Thus, such pressure sensing elements can be used to detect the distal directional forces on each lead screw 730a, 730b, 730c, 730d, 730e, 730f, 730g, and 730h. When the surgical instrument is coupled to the chamber 700, the distal directional forces of the respective lead screws 730a, 730b, 730c, 730d, 730e, 730f, 730g, and 730h are substantially equal to the tension of the corresponding tensioning member of the surgical instrument. Alternatively or additionally, in some embodiments, one or more pressure sensing elements may be coupled to the proximal plate 705. For example, in some embodiments, pressure sensing elements coupled to the proximal plate 705 are used to detect forces associated with the insertion of the surgical instrument 600 (see below). Figure 27-29 (Further description). It should be remembered that, as mentioned above, depending on the instrument design, actuators can actuate their component nuts in either the proximal or distal direction, and therefore the pressure-sensing element layout takes into account the direction of the actuating force applied to the instrument for tensioning or compression.

[0162] Pressure sensing elements are not required in all embodiments. In some embodiments, other sensors and / or other devices may be used to detect the force applied to the surgical instrument by the actuator. For example, in some embodiments, strain gauges may be located on the actuator engagement member or elsewhere. In some embodiments, the current drawn by the actuator's electric motor may be measured and used as an indication of the force applied to the surgical instrument by the actuator. In some embodiments, such a combination of force sensing devices and techniques may be used to enhance the robustness and redundancy of force sensing for instrument control and associated tension or compression sensing.

[0163] In some embodiments, the apparatus and techniques are used to detect the orientation of actuators (e.g., threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h and / or motors 720a, 720b, 720c, 720d, 720e, 720f, 720g, and 720h). For example, in the illustrated embodiment, an encoder is coupled to a remote board 707 and to each of the motors 720a, 720b, 720c, 720d, 720e, 720f, 720g, and 720h. Furthermore, in some embodiments, a travel end sensor (e.g., an optical sensor, a proximity sensor, etc.) may be included for the threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h. In some embodiments, the end-of-stroke orientation of the threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h can be detected by monitoring the current consumption of the motors 720a, 720b, 720c, 720d, 720e, 720f, 720g, and 720h (the current consumption increases when the threaded nuts 740a, 740b, 740c, 740d, 740e, 740f, 740g, and 740h are at their end-of-stroke limits).

[0164] Figure 26 A partial longitudinal section of a surgical instrument 600 coupled to a surgical instrument actuator compartment 700 is shown, thus depicting an exemplary arrangement of engagement between a threaded nut for the compartment 700 and an actuator engagement member of the surgical instrument 600. Specifically, in the illustrated embodiment, the actuator engagement member 634a includes a laterally extending protrusion that engages with a complementary socket defined by a threaded nut 740e. In this arrangement, a proximal directional force from the threaded nut 740e can be applied to the actuator engagement member 634a (e.g., to tension a tensioning member coupled to the actuator engagement member 634a). However, since the threaded nut 740e is not secured or locked to the actuator engagement member 634a in this embodiment (i.e., non-clamping engagement), the threaded nut 740e cannot apply a distal directional force to the actuator engagement member 634a. Therefore, the actuator engagement member 634a will be easily decoupled from the threaded nut 740e (e.g., when the surgical instrument 600 is translated proximally relative to the chamber 700 to decouple the surgical instrument 600 from the chamber 700). It may be recalled that, in an alternative embodiment, a portion of the threaded nut extends laterally inward to engage a corresponding actuator engagement member in the instrument.

[0165] While not required in all embodiments, in the illustrated embodiment, the engagement between the threaded nut 740a and the instrument shaft engagement member 620 differs from the engagement between other threaded nuts and other actuator engagement members. That is, in the illustrated embodiment, the instrument shaft engagement member 620 is releasably locked to the threaded nut 740a (i.e., a latching engagement). Therefore, both proximal and distal directional forces from the threaded nut 740a can be applied to the instrument shaft engagement member 620 (e.g., for the translational insertion and / or retraction of the surgical instrument 600 relative to the chamber 700 along the longitudinal axis 702).

[0166] See Figure 27-29 The surgical instrument 600, arranged in complete coupling with the surgical instrument actuator compartment 700, is shown at three different insertion depths. Figure 27 In this position, the surgical instrument 600 is inserted at a shallow (nearest side) depth relative to the chamber 700. Figure 28 In the middle, the surgical instrument 600 is at the intermediate insertion depth relative to the chamber 700. Figure 29 In the middle, the surgical instrument 600 is at the deep (farthest side) insertion depth relative to the chamber 700.

[0167] The insertion depth of the surgical instrument 600 can be changed by the movement of a linear actuator (shown here in part as a threaded nut 740a of the chamber 700) as described above. When the threaded nut 740a moves proximally and distally to adjust the insertion depth of the surgical instrument 600, the other threaded nuts 740 (collectively referred to herein as threaded nuts 740) and the actuator engagement member also move proximally and distally (by means of actuation of the chamber 700). If the position of the end effector 650 remains constant when adjusting the insertion depth of the surgical instrument 600, the other threaded nuts 740 move proximally and distally by the same distance as the threaded nut 740a. If the orientation of the end effector 650 and the insertion depth of the surgical instrument 600 change simultaneously, although the average orientation of adjacent pairs of threaded nuts (and corresponding pairs of actuator engagement members) moves proximally and distally by the same distance as the threaded nut 740a, the pairs of threaded nuts (and corresponding pairs of actuator engagement members) move differentially proximally and distally relative to each other. As described above, this differential movement of the pairs of threaded nuts (and corresponding pairs of actuator engagement members) adjusts the orientation of the end effector 650 along one or more degrees of freedom of the end effector 650. By using the dynamic tension and orientation control concepts described herein, all these movements (i.e., changing the orientation of the end effector 650 and / or changing the insertion depth of the entire instrument 600, which in turn changes the insertion depth of the end effector) can be actuated while controlling the tension of the tensioning member of the surgical instrument 600 to achieve the desired pulling force.

[0168] In some embodiments, components of the surgical instrument 600 coupled to the instrument drive system 700 (or cabin 700) rotate or roll about a longitudinal axis 702. Figure 21-29 As can be seen, multiple motors, lead screws, and anti-rotation shafts are typically positioned around the surgical instruments mounted in the cabin. By positioning these components around the instruments (e.g., motors and lead screws equidistant from the longitudinal axis), the cabin's inertia relative to its longitudinal axis is advantageously and effectively independent of its orientation around the longitudinal axis of the cabin. Therefore, if the end effector roll orientation is changed by rolling the cabin around the longitudinal axis, while the end effector azimuth is changed by pitch and / or yaw along the longitudinal axis, pitch and yaw control do not need to consider changes in inertia dependent on the cabin's roll orientation. Therefore, some inventive aspects include embodiments in which the cabin components are arranged to position the cabin's center of mass along the longitudinal axis of the cabin (the axis around which the cabin rolls). Additionally, some inventive aspects include embodiments in which the cabin components are advantageously positioned as close as possible to the longitudinal axis, also within the actuator (see, for example...). Figure 19 When the control assembly 800 changes the orientation of the cabin (e.g., changes the pitch or yaw of the cabin's longitudinal axis), inertia is minimized. And as described above, the cabin components are arranged to position the center of mass distally (in some cases as far as possible) along the cabin's longitudinal axis in order to minimize the influence of the cabin's center of gravity on the control of the cabin's longitudinal orientation about the control axis of roll.

[0169] While this specification contains numerous specific implementation details, these should not be construed as limiting any invention or potentially claimed scope, but rather as descriptions of features specific to particular embodiments of a particular invention. Certain functions described in the context of independent embodiments within this specification may also be implemented in combination in a single embodiment. Conversely, various features described in the context of a single embodiment may also be implemented individually or in any suitable sub-combination in multiple embodiments. Furthermore, while features may be described herein as functioning in certain combinations, and even initially stated so, in some cases one or more features from a claimed combination may be removed from the combination, and the claimed combination may be for sub-combinations or variations thereof.

[0170] Similarly, although operations are depicted in a specific order in the accompanying drawings, this should not be construed as requiring these operations to be performed in the specific order shown or sequentially, or to perform all of the shown operations to achieve the desired result. In some cases, multitasking and parallel processing may be advantageous. Furthermore, the separation of various system modules and components in the embodiments described herein should not be construed as requiring such separation in all embodiments, and it should be understood that the described program components and systems can generally be integrated together in a single product or packaged into multiple products.

[0171] Specific embodiments of the subject matter have been described. Other embodiments are within the scope of the appended claims. For example, the actions recited in the claims can be performed in a different order and still achieve the desired result. As an example, the processes depicted in the drawings do not necessarily require the specific or sequential order shown to achieve the desired result. In some embodiments, multitasking and parallel processing may be advantageous.

Claims

1. A remote surgical instrument actuator for surgical instruments, the remote surgical instrument actuator comprising: Proximal components; The distal component, wherein the central longitudinal axis of the remote surgical instrument actuator is defined between the proximal component and the distal component; as well as A plurality of linear actuators arranged around and extending along the central longitudinal axis, the plurality of linear actuators being configured to apply a force to the surgical instrument and comprising: At least one anti-rotation shaft; Multiple motors, said multiple motors being mounted to the distal component; and Multiple lead screws, wherein each of the multiple motors is coupled to drive a corresponding lead screw among the multiple lead screws, and The plurality of lead screws extend proximal to the plurality of motors.

2. The remote surgical instrument actuator of claim 1, wherein the plurality of lead screws are rotatably mounted to the distal component.

3. The remote surgical instrument actuator of claim 2, wherein the plurality of lead screws are rotatably mounted to the proximal member.

4. The remote surgical instrument actuator according to claim 1, wherein the plurality of motors are equidistant from the central longitudinal axis.

5. The remote surgical instrument actuator of claim 4, wherein the plurality of motors are radially outside the plurality of lead screws.

6. The remote surgical instrument actuator according to claim 5, wherein the plurality of lead screws are equidistant from the central longitudinal axis.

7. The remote surgical instrument actuator of claim 6, wherein the plurality of lead screws extend parallel to the central longitudinal axis.

8. The remote surgical instrument actuator according to any one of claims 1 to 7, wherein the at least one anti-rotation axis is a plurality of anti-rotation axes attached to the proximal member and the distal member.

9. The remote surgical instrument actuator of claim 8, wherein the plurality of linear actuators further comprises a plurality of threaded nuts, wherein each of the plurality of threaded nuts is coupled to a corresponding lead screw among the plurality of lead screws.

10. The remote surgical instrument actuator of claim 9, wherein each of the plurality of threaded nuts is coupled to a corresponding anti-rotation shaft of the plurality of anti-rotation shafts.

11. The remote surgical instrument actuator according to any one of claims 1 to 7, wherein the plurality of linear actuators further comprises a surgical instrument insertion guide screw and a surgical instrument insertion nut engaging with the surgical instrument insertion guide screw, wherein the surgical instrument insertion nut is configured to engage with a surgical instrument.

12. A remote surgical instrument actuator, comprising: A plurality of linear actuators are arranged around the central longitudinal axis of the remote surgical instrument actuator, the plurality of linear actuators comprising: Multiple motors; A plurality of lead screws, wherein each of the plurality of motors is coupled to drive a corresponding lead screw among the plurality of lead screws; At least one anti-rotation shaft; and A plurality of threaded nuts, wherein each of the plurality of threaded nuts is coupled to a corresponding guide screw in the plurality of guide screws; The plurality of lead screws extend along the plurality of motors and proximal to the plurality of motors; and The at least one anti-rotation shaft is slidably coupled to two of the plurality of threaded nuts.

13. The remote surgical instrument actuator of claim 12, wherein the plurality of motors are mounted to a distal component of the remote surgical instrument actuator.

14. The remote surgical instrument actuator of claim 13, further comprising a proximal member, wherein the plurality of lead screws are rotatably coupled to the proximal member and the distal member and extend between the proximal member and the distal member.

15. The remote surgical instrument actuator of claim 14, wherein the plurality of motors are not mounted to the proximal component.

16. The remote surgical instrument actuator of claim 14, wherein the proximal member comprises a C-shaped plate, and wherein the distal member is a fully circumferential plate defining an open central region.

17. The remote surgical instrument actuator of claim 14, wherein the plurality of linear actuators further comprises a plurality of anti-rotation shafts having the at least one anti-rotation shaft, the plurality of anti-rotation shafts being attached to the proximal member and the distal member.

18. The remote surgical instrument actuator of claim 17, wherein each of the plurality of threaded nuts is coupled to a corresponding anti-rotation shaft of the plurality of anti-rotation shafts.

19. The remote surgical instrument actuator according to any one of claims 12 to 18, wherein the plurality of motors are equidistant from the central longitudinal axis, and wherein the plurality of motors are radially outside the plurality of lead screws.

20. The remote surgical instrument actuator of claim 19, wherein the plurality of lead screws are equidistant from the central longitudinal axis, and wherein the plurality of lead screws extend parallel to the central longitudinal axis.

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