Gas circulation system with gas-sealed access cover and valve-sealed access cover for robotically-assisted surgery

Abstract

A gas circulation system for use in robotically assisted surgical procedures in a surgical cavity of a patient includes a multi-lumen tube set including a dual lumen portion having a pressurized gas line and a return gas line and a single lumen portion having a gas supply and sensing line; a valve sealed access cap for cooperative receipt within a first robotic cannula and having an inlet path for communication with the gas supply and sensing line of the tube set; and a gas sealed access cap for cooperative receipt within a second robotic cannula and having an inlet path for communication with the pressurized gas line of the tube set and an outlet path for communication with the return gas line of the tube set.

Description

[0001] This application is a divisional application of the application filed on March 25, 2020, with national application number 202080023652.0 (international application number PCT / US2020 / 024711) and entitled "Gas circulation system with gas-sealed inlet cap and valve-sealed inlet cap for robot-assisted surgery".

[0002] Cross-references to related applications

[0003] This application claims priority to U.S. Provisional Patent Application Serial No. 62 / 823,848, filed March 26, 2019; U.S. Provisional Patent Application Serial No. 62 / 876,141, filed July 19, 2019; U.S. Provisional Patent Application Serial No. 62 / 925,424, filed October 24, 2019; and U.S. Patent Application Serial No. 16 / 829,694, filed March 25, 2020, the disclosures of which are incorporated herein by reference in their entirety. Technical Field

[0004] This invention relates to endoscopic surgery, and more particularly to a surgical gas circulation system having a gas-tight inlet cap and a valve-tight inlet cap for use during robot-assisted laparoscopic surgery. Background Technology

[0005] Laparoscopic, or "minimally invasive," surgical techniques are becoming increasingly common in procedures such as cholecystectomy, appendectomy, hernia repair, and nephrectomy. The benefits of such procedures include reduced trauma to the patient, a lower risk of infection, and shorter recovery time. These procedures, performed within the abdominal (peritoneal) cavity, are typically performed using a device called a trocar or cannula, which facilitates the introduction of laparoscopic instruments into the patient's abdominal cavity.

[0006] Additionally, such procedures typically involve filling or “inflating” the abdominal cavity with a pressurized fluid such as carbon dioxide to create a surgical space known as pneumoperitoneum. Inflation can be performed via a surgical access device, such as a cannula, equipped to deliver the inflation fluid, or via a separate inflation device, such as an inflation (pneumoperitoneum) needle. The aim is to introduce surgical instruments into the pneumoperitoneum to maintain it without significant loss of inflation gas.

[0007] During a typical laparoscopic procedure, the surgeon makes three to four small incisions, each typically no larger than about twelve millimeters. These incisions are usually formed by the surgical access device itself using a separate insert or packing placed within the device. After insertion, the packing is removed, and a cannula allows instruments to be inserted into the abdominal cavity. A typical cannula provides a pathway for abdominal infusion, giving the surgeon an open internal space to work within.

[0008] The cannula must also provide a way to maintain intracavitary pressure while still allowing at least a minimum degree of freedom of movement for the surgical instrument by sealing between the cannula and the surgical instrument being used. Such instruments may include, for example, scissors, grasping and occluding instruments, cauterization units, cameras, light sources, and other surgical instruments. Sealing elements or mechanisms are typically provided on the cannula to prevent the leakage of inflated gas from the abdominal cavity. These sealing mechanisms typically include a duckbill-shaped valve made of a relatively flexible material to seal the outer surface of the surgical instrument passing through the cannula.

[0009] SurgiQuest, Inc., a wholly owned subsidiary of ConMed Corporation, has developed unique gas-sealed surgical access devices that allow immediate access to inflated surgical cavities without the need for conventional mechanical valve seals, as described, for example, in U.S. Patent No. 7,854,724. These devices consist of several nested components comprising an inner tubular body portion and a coaxial outer tubular body portion. The inner tubular body portion defines a central lumen for introducing conventional laparoscopic surgical instruments into the patient's abdominal cavity, and the outer tubular body portion defines an annular lumen surrounding the inner tubular body portion for delivering inflated gas into the patient's abdominal cavity and for facilitating periodic sensing of abdominal pressure.

[0010] Robot-assisted minimally invasive surgery is becoming increasingly common. One well-known system used to perform these procedures is the Da Vinci robotic surgical system, manufactured and marketed by Intuitive Surgical, Inc., Sunnyvale, CA. The Da Vinci system utilizes a proprietary cannula or trocar adapted and configured to receive robotic instruments and engage by a robotic arm. The proprietary Da Vinci cannula has a proximal housing that forms a bowl shape for receiving components such as an airtight seal assembly, as disclosed, for example, in U.S. Patent No. 10,463,395. The DaVinci airtight seal assembly utilizes a mechanical seal to seal around the outer surface of the surgical instrument passing through the cannula and prevents inflated gas from escaping from the abdominal cavity.

[0011] It is believed that it is advantageous to provide a sealing assembly for use with the Da Vinci cannula, which allows immediate access to the inflated surgical cavity without the need for a mechanical sealing assembly. In fact, a recent example of such a pneumatic sealing assembly is disclosed in jointly assigned U.S. Patent Application Publication No. 2018 / 0256207. The present invention provides an improvement to this earlier gas-sealed access device, which, along with other novel devices and systems, is described in detail below. Summary of the Invention

[0012] This invention relates to a novel and useful gas circulation system for performing robot-assisted surgery within a patient's surgical cavity. The system includes a multi-lumen assembly having a dual-lumen portion and a single-lumen portion. The dual-lumen portion has pressurized gas lines and return gas lines for facilitating gas recirculation relative to the patient's surgical cavity. The single-lumen portion has gas supply and sensing lines for delivering inflated gas to the patient's abdominal cavity and for periodically sensing the pressure within the patient's surgical cavity.

[0013] The system also includes a valve-sealed inlet cap and a gas-sealed inlet cap, the valve-sealed inlet cap being adapted and configured to cooperatively receive within the proximal bowl portion of the first robotic sleeve and having an inlet path for communication with the gas supply and sensing lines of the tubing assembly, and the gas-sealed inlet cap being adapted and configured to cooperatively receive within the proximal bowl portion of the second robotic sleeve and having an inlet path for communication with the pressurized gas line of the tubing assembly and an outlet path for communication with the return gas line of the tubing assembly.

[0014] The valve sealing inlet cover includes an outer housing portion and an inner body portion, with an annular channel formed between the outer housing portion and the inner body portion, communicating with the inlet path. An internal O-ring seals the annular channel between the outer housing portion and the inner housing portion to prevent gas leakage.

[0015] The outer housing portion includes a pair of diametrically opposed flexible clamps adapted and configured to releasably latch onto the proximal bowl portion of the first robotic sleeve. An external O-ring is positioned between the outer housing portion and the proximal bowl portion of the first robotic sleeve to provide frictional engagement and prevent gas leakage therebetween.

[0016] The internal body of the valve seal inlet cover supports the main valve and the auxiliary valve. The main valve is a circular diaphragm valve, while the auxiliary valve is a duckbill valve. The main valve is located near the auxiliary valve. Sound-attenuating foam material is positioned within the valve seal inlet cover, near the main valve, to reduce the sound level and help hold the main and auxiliary valves in place during instrument insertion, removal, and manipulation.

[0017] The cap engages proximal to the outer housing portion to secure the inner body portion within the outer housing portion and provide safety during instrument insertion, removal, and manipulation. The cap further secures the inner body portion, sound-damping foam material, main valve, and auxiliary valve relative to the inner body portion within the outer housing portion.

[0018] Preferably, the inlet path is formed together with the outer housing portion, and a Luer-type connector is operatively associated therewith for communication with the gas supply and sensing lines of the manifold. The Luer-type connector is selectively sized to achieve a desired amount of airflow into the inlet path.

[0019] The distal surface of the inner body portion compressively engages with the inner distal surface of the inwardly tapering distal wall of the outer housing portion to close the annular channel. In one embodiment of the invention, the annular channel communicates with the proximal bowl-shaped portion of the first robotic sleeve through a plurality of circumferentially spaced holes formed in the inwardly tapering distal wall of the outer housing portion. The plurality of holes may be elliptical and extend radially outward from the central axis of the outer housing portion, or the plurality of holes may extend substantially tangentially relative to the central axis of the outer housing portion. The holes may also be triangular and extend radially outward from the central axis of the outer housing portion. Those skilled in the art will readily understand that the number and / or size of the holes can be selected to provide the desired airflow.

[0020] In another embodiment of the invention, the annular channel communicates with the proximal bowl-shaped portion of the first robot sleeve through an annular hole defined between the inwardly tapering distal wall of the inner body portion and the inwardly tapering distal wall of the outer shell portion.

[0021] The gas-tight inlet cap includes a main housing portion defining an internal cavity that supports an annular jet assembly for receiving pressurized gas from an inlet path and for creating a gas-tight zone within a second robotic cannula to maintain stable pressure within the patient's surgical cavity. Acoustic damping foam material is positioned within the gas-tight inlet cap, proximal to the annular jet assembly. The cap engages proximal to an outer housing portion to secure the annular jet assembly and acoustic damping foam material within the main housing portion.

[0022] Additionally, the main housing portion includes an integrally formed set of circumferentially spaced blades for guiding gas from the gas-tight zone to the outlet path of the gas-tight inlet cap. The set of circumferentially spaced blades extends distally to form a tubular extension that extends into the proximal bowl-shaped portion of the second robotic sleeve.

[0023] An external O-ring is positioned between the main housing portion of the gas-tight inlet cap and the proximal bowl-shaped portion of the second robotic sleeve. The inlet and outlet paths of the gas-tight inlet cap communicate with a manifold associated with bullseye connector fittings for communication with the pressurized gas lines and return gas lines of the tubing assembly. The bullseye connector fittings have a plurality of circumferentially spaced, radially outwardly extending engagement lugs formed thereon.

[0024] In one embodiment of the invention, the bullseye connector fitting is a dual-lumen bullseye connector fitting for communication with the pressurized gas line and return gas line of the tubing assembly. In another embodiment, the bullseye connector fitting is a triple-lumen bullseye connector fitting for communication with the pressurized gas line and return gas line of the tubing assembly, but not with the gas supply and sensing lines of the tubing assembly.

[0025] In one embodiment of the invention, the double-lumen portion of the tube assembly includes a connector having a circumferentially arranged bayonet-type fastening channel formed therein for mechanical engagement with an engagement lug of a bullseye connector fitting. In another embodiment of the invention, the double-lumen portion of the tube assembly includes a connector having a helically arranged bayonet-type fastening channel formed therein for mechanical engagement with an engagement lug of a bullseye connector fitting.

[0026] In one embodiment of the invention, the main outer housing portion of the gas-tight access cap includes a pair of diametrically opposed flexible clamps adapted and configured to releasably latch onto the proximal bowl portion of the second robotic sleeve. In another embodiment of the invention, the main outer housing portion of the gas-tight access cap includes a compressible annular skirt adapted and configured to releasably latch onto the proximal bowl portion of the second robotic sleeve. Alternatively, the proximal bowl portion of the second robotic sleeve includes a movable, compressible annular skirt adapted and configured to releasably latch onto the main outer housing portion of the gas-tight access cap.

[0027] In another embodiment of the invention, the main outer housing portion of the gas-tight access cap includes a spring-biased hinge latch adapted and configured to releasably latch onto the proximal bowl portion of the second robotic sleeve. In another embodiment of the invention, the main outer housing portion of the gas-tight access cap includes a magnetic skirt adapted to releasably secure to the proximal bowl portion of the second robotic sleeve.

[0028] In one embodiment of the invention, a three-lumen bullseye connector fitting is adapted and configured to communicate with a three-lumen bullseye connector associated with the distal end of the double-lumen portion of a tube assembly. Additionally, a three-lumen bullseye plug is provided for engagement with the three-lumen bullseye connector.

[0029] In an embodiment of the invention, the second robotic cannula has an elongated tubular body portion extending distally from its proximal bowl-shaped portion. This elongated tubular body portion includes a plurality of circumferentially spaced longitudinal beads on its inner surface for receiving airflow around a surgical instrument extending through the tubular body portion. In another embodiment of the invention, the second robotic cannula has an elongated tubular body portion extending distally from its proximal bowl-shaped portion. This elongated tubular body portion includes a plurality of circumferentially spaced longitudinal channels in its inner surface for receiving airflow around a surgical instrument extending through the tubular body portion. In yet another embodiment of the invention, the second robotic cannula has an elongated tubular body portion extending distally from its proximal bowl-shaped portion. This elongated tubular body portion includes helical beads on its inner surface for receiving airflow around a surgical instrument extending through the tubular body portion.

[0030] These and other features of the gas circulation system of the present invention will become more apparent to those skilled in the art from the following detailed description of preferred embodiments in conjunction with the accompanying drawings. Attached Figure Description

[0031] To enable those skilled in the art to readily understand how to manufacture and use the gas circulation system of the present invention without excessive experimentation, preferred embodiments thereof will now be described in detail with reference to the accompanying drawings, wherein:

[0032] Figure 1 This is a perspective view of the gas circulation system of the present invention in use during a robot-assisted laparoscopic surgery, wherein the system includes a valve-sealed inlet cap and a multi-lumen filter assembly, the valve-sealed inlet cap being detachably engaged with a first robotic cannula, the multi-lumen filter assembly having a dual-lumen portion connected to a gas-sealed inlet cap, the gas-sealed inlet cap being detachably engaged with a second robotic cannula.

[0033] Figure 2 yes Figure 1 A perspective view of the multi-lumen filter assembly shown, together with a gas-tight inlet cap detachably engaged with a second robotic sleeve and a valve-tight inlet cap detachably engaged with a first robotic sleeve.

[0034] Figure 3 This is a perspective view of the valve seal access cover of the present invention, which is detachably engaged within the proximal housing of the robot cannula.

[0035] Figure 4 This is a perspective view of the valve seal inlet cap of the present invention, separated from the proximal housing of the robot cannula;

[0036] Figure 5 From Figure 4An enlarged partial perspective view of one of the diametrically opposed flexible grippers, which is associated with a valve-sealed inlet cap for releasably latching the flange of the proximal housing to the robot sleeve.

[0037] Figure 6 This is an exploded perspective view of the valve sealing inlet cover of the present invention, wherein the parts are separated for ease of explanation;

[0038] Figure 7 From Figure 6 Enlarged partial perspective view of a cut-out Luer connector used to connect a valve seal inlet cap to a single lumen of a filter assembly;

[0039] Figure 8 It is along Figure 3 The cross-sectional view taken from line 8-8 shows the Luer connector attached to the Luer fitting of the valve seal inlet cover;

[0040] Figure 9 It is along Figure 6 The sectional view taken from line 9-9 shows the distal portion of the valve seal entering the cover;

[0041] Figure 10 It is along Figure 6 The sectional view taken from line 10-10 shows a set of elliptical filling holes formed in the distal portion of the valve seal inlet cap;

[0042] Figure 11 A set of triangular filling holes formed in the distal portion of the valve seal inlet cap is shown;

[0043] Figure 12 Another set of elliptical filling holes is shown in the distal portion of the valve seal inlet cap;

[0044] Figure 13 This shows another set of elliptical filling holes formed in the distal portion of the valve seal inlet cap;

[0045] Figure 14 An annular filling gap is shown in the distal portion of the valve seal inlet cap;

[0046] Figure 15 This is a perspective view of the gas-tight access cap of the present invention, which is engaged within the robotic cannula, together with an occluder for obtaining initial access to the patient's abdominal cavity.

[0047] Figure 16 This is a perspective view of the gas-tight inlet cap of the present invention, which is detachably attached to the proximal housing of the robot cannula.

[0048] Figure 17This is a perspective view of the gas-tight inlet cap of the present invention, separated from the proximal housing of the robot cannula;

[0049] Figure 18 This is an exploded perspective view of the gas-tight inlet cover of the present invention, wherein the parts are separated for ease of explanation;

[0050] Figure 19 It is along Figure 18 The sectional view taken by line 19-19 shows the internal structure of the housing integrally formed by the gas-tight entry into the cover;

[0051] Figure 20 This is an exploded perspective view of another embodiment of the gas-tight inlet cover of the present invention, wherein the parts are separated for ease of illustration;

[0052] Figure 21 yes Figure 20 Enlarged plan view of the bullseye connector of the gas-tight inlet cap;

[0053] Figure 22 This is a perspective view of the multi-lumen filter tube assembly of the present invention, wherein the dual-lumen portion of the tube assembly has a three-lumen connector for connection with the gas-tight inlet cap of the present invention.

[0054] Figure 23 This is a perspective view of a dual-lumen connector for connection with the gas-tight inlet cap of the present invention, the dual-lumen connector including bayonet-type connection features;

[0055] Figure 24 yes Figure 23 A perspective view of a dual-lumen connector associated with the dual-lumen portion of the filter assembly of the present invention and connected to the dual-lumen fitting of the gas-tight inlet cap of the present invention.

[0056] Figure 25 and Figure 26 From Figure 24 The enlarged partial view shows the engagement of the bayonet channel of the dual-lumen connector with the lug on the fitting of the gas-tight inlet cap;

[0057] Figure 27 This is a perspective view of another dual-lumen connector for connection with the gas-tight inlet cap of the present invention, the dual-lumen connector including another bayonet-type connection feature;

[0058] Figure 28 yes Figure 27 A perspective view of a dual-lumen connector associated with the dual-lumen portion of the filter assembly of the present invention and connected to the dual-lumen fitting of the gas-tight inlet cap of the present invention.

[0059] Figure 29 and Figure 30 This is a magnified partial view, showing... Figure 27 The bayonet channel of the dual-lumen connector and such Figure 28 The engagement of the lugs on the fittings of the gas-tight inlet cap is shown;

[0060] Figure 31 This is a perspective view of the gas-tight access cover of the present invention, which has a compressible skirt for removably engaging the access cover to the proximal housing of a robot cannula.

[0061] Figure 32 yes Figure 31 An exploded perspective view of the gas-tight inlet cap, in which the parts are separated for ease of illustration;

[0062] Figure 33 It is along Figure 31 A sectional view taken from line 33-33;

[0063] Figure 34 It is along Figure 31 A sectional view taken from line 34-34;

[0064] Figure 35 yes Figure 32 A top plan view of the gas-tight inlet port, showing how the compressible skirt is released from engagement with the proximal housing of the robotic sleeve;

[0065] Figure 36 yes Figure 31 A perspective view of the gas-tight inlet cap separated from the proximal housing of the robotic cannula, as shown.

[0066] Figure 37 This is a perspective view of the gas-tight access cover of the present invention, which has a spring-biased latch for removably engaging the access cover to the proximal housing of a robot sleeve.

[0067] Figure 38 yes Figure 37 A perspective view of the gas-tight inlet cap separated from the proximal housing of the robotic cannula, as shown.

[0068] Figure 39 yes Figure 37 A magnified partial view of the hinge of the spring-biased latch of the gas-tight inlet cover shown in the figure.

[0069] Figure 40 It is along Figure 37 A sectional view taken from line 40-40;

[0070] Figure 41This is a perspective view of the gas-tight access cover of the present invention, which has a magnetic skirt for removably engaging the access cover to the proximal housing of a robot cannula.

[0071] Figure 42 It is along Figure 41 A sectional view taken from line 42-42;

[0072] Figure 43 yes Figure 41 An exploded perspective view of the gas-tight inlet cap, in which the parts are separated for ease of illustration;

[0073] Figure 44 This is a perspective view of the gas-tight access cover of the present invention, which has an axially movable inverted compressible skirt for removably engaging the access cover to the proximal housing of a robot sleeve.

[0074] Figure 45 yes Figure 44 An exploded perspective view of the gas-tight inlet cap, in which the parts are separated for ease of illustration;

[0075] Figure 46 It is along Figure 44 A sectional view taken from line 46-46;

[0076] Figure 47 This is a perspective view of a bullseye connector plug for engaging a three-lumen connector associated with the distal end of the dual-lumen portion of the filter assembly of the present invention.

[0077] Figure 48 This is a side front view of a standard Da Vinci Xi robotic cannula, which has a tubular body portion with an inner diameter sized to accommodate robotic surgical instruments.

[0078] Figure 49 It is a perspective view of the distal portion of the tubular body of a modified robotic cannula with an extended inner diameter having a plurality of circumferentially spaced elongated beads to create internal flow channels for gas.

[0079] Figure 50 This is a perspective view of the distal portion of the tubular body of a modified robotic cannula with an extended inner diameter having multiple circumferentially spaced elongated channels for airflow formed in the inner surface of the tubular body; and

[0080] Figure 51 and Figure 52 This is a cross-sectional view of the tubular body of a modified robotic sleeve, which has spiral beads formed on its inner surface to create a spiral flow path for gas. Detailed Implementation

[0081] Referring now to the accompanying drawings, where similar reference numerals identify similar structural elements and features of the invention, Figure 1 The figure shows a gas circulation system for performing endoscopic surgery in a patient's surgical cavity, and more specifically, for performing robot-assisted laparoscopic surgery in a patient's abdominal cavity, the gas circulation system being constructed according to a preferred embodiment of the present disclosure and generally indicated by reference numeral 10.

[0082] The gas circulation system 10 of the present invention is specifically designed to cooperate with a programmable, multi-mode gas delivery system 12. The gas delivery system 12 is of the type described in commonly assigned U.S. Patent No. 9,375,539, the entire disclosure of which is incorporated herein by reference. The gas delivery system 12 includes a graphical user interface 14 for setting operating parameters and a pump 16 for facilitating the recirculation of pressurized gas relative to the patient's surgical cavity. The gas delivery system 12 is connected to a surgical gas source 18 for delivering filling gas to the patient's surgical cavity.

[0083] In short, the gas circulation system 10 includes a multi-lumen filter assembly 20 having a dual-lumen portion 22 and a single-lumen portion 24. The single-lumen portion 24 of the assembly 20 is operatively connected to a valve-sealed inlet cap 30 associated with a first robotic sleeve 32. The dual-lumen portion 22 of the assembly 20 is operatively connected to a gas-sealed inlet cap 26 associated with a second robotic sleeve 28. Each of these components of the gas circulation system 10 and its variations will be described in more detail below.

[0084] See Figure 2 The dual-lumen portion 22 of the tubing assembly 20 has a pressurized gas line 34 and a return gas line 36 for facilitating gas recirculation relative to the patient's surgical cavity and for facilitating the expulsion of fumes-filled gases generated by electrocautery procedures, etc., from the surgical cavity. The single-lumen portion 24 of the tubing assembly 20 defines two gas supply and sensing lines 38 with different functions. These facilitate the delivery of filling gas to the patient's surgical cavity and also facilitate the periodic sensing of pressure within the patient's surgical cavity.

[0085] Tube assembly 20 is operatively associated with multipath filter cartridge assembly 40. More specifically, the gas lines of tube assembly 20 extend from fitting 42 on end cap 44 of filter cartridge assembly 40. A filter cartridge assembly of this type is disclosed, for example, in commonly assigned U.S. Patent No. 9,067,030, the entire disclosure of which is incorporated herein by reference. Filter cartridge assembly 40 is preferably designed for single use and subsequently discardable. It is specifically designed to be used with… Figure 1 The multi-mode gas delivery system 12 shown in the diagram cooperates.

[0086] Although not shown here, the filter cartridge assembly 40 includes a first filtration flow path communicating with the pressurized gas line 34 of the dual-lumen section 22 of the tube assembly 20, a second filtration flow path communicating with the return gas line 36 of the dual-lumen section 22 of the tube assembly 20, and a third filtration flow path communicating with the gas supply and sensing line 38 of the single-lumen section 24 of the tube assembly 20.

[0087] like Figure 2 As shown, the single-lumen portion 24 of the tube assembly 20 includes an enlarged Luer-type connector fitting 46 for engagement with the valve sealing inlet cap 30. Reference will be made below. Figure 7 and Figure 8 The enlarged Luer-type connector fitting 46 is discussed in more detail. The dual-lumen portion 22 of the tube assembly 20 includes a multi-lumen connector fitting 48 for engagement with the gas-tight inlet cap portion 26. As described in more detail below, the invention describes several different embodiments of the multi-lumen connector fitting 48 for the dual-lumen portion 22 of the tube assembly 20.

[0088] See now Figures 3 to 8 The valve-sealed inlet cap 30 of the gas circulation system 10 is adapted and configured to cooperate within the proximal bowl-shaped portion 50 of the robot sleeve 32, which also includes an elongated tubular body portion 52. The valve-sealed inlet cap 30 has an inlet path 54 for communication with the gas supply and sensing line 38 of the tubing assembly 20. More specifically, as explained in more detail below, the inlet path 54 is a Luer-type connector that cooperates with a Luer-type connector fitting 46 at the distal end of the gas supply and sensing line 38.

[0089] like Figure 6 and Figure 8 As best viewed, the valve seal inlet cover 30 comprises an elongated, generally cylindrical outer housing portion 56 and an elongated, generally cylindrical inner body portion 58, the dimensions and configuration of which are designed to nest within the outer housing portion 56. An annular flow channel 60 is advantageously formed between the outer housing portion 56 and the inner body portion 58, which communicates with the inlet path 54. An internal O-ring 62 seals the annular channel 60 between the outer housing portion 56 and the inner housing portion 58 to provide frictional engagement and prevent gas leakage therebetween.

[0090] The outer housing portion 56 of the valve seal access cover 30 includes a pair of diametrically opposed flexible clamps 64a, 64b adapted and configured to releasably latch onto the upper annular flange 66 of the proximal bowl portion 50 of the robotic sleeve 32. (As...) Figure 5As best seen, as an example, the flexible clamp 64a includes an upper portion 65 that can be easily bent inward to release the lower clamp portion 67. The opposite flexible clamp 64b is constructed similarly. An outer O-ring 68 surrounds the periphery of the outer housing portion 56 such that it is positioned between the outer housing portion 56 and the inner wall of the proximal bowl-shaped portion 50 of the robot sleeve 32 to provide frictional engagement and prevent gas leakage therebetween.

[0091] The internal body portion 58 of the valve seal inlet cover 30 supports the main valve 70 and the auxiliary valve 72. Preferably, the main valve 70 is a circular diaphragm valve, while the auxiliary valve 72 is a duckbill valve. Other types of mechanical valve seals known in the art may also be used. The main valve 70 is nested within and located proximal to the auxiliary valve 72. A sound attenuation disc 74, made of foam material, is positioned within the valve seal inlet cover 30, proximal to the main valve 70, to reduce the sound level and to help hold the main valve 70 and auxiliary valve 72 in place during instrument insertion, removal, and manipulation.

[0092] The cap 76 engages proximal to the outer housing portion 56 to secure the inner body portion 58 within the outer housing portion 56 and to provide safety during instrument insertion, removal, and manipulation. The cap 76 defines an inlet channel or port 78 through which surgical instruments, etc., are introduced into the cannula 32. The cap 76 can be mechanically attached to the outer housing portion 56 by clamps or tabs, or it can be thermally welded, spin-welded, or glued in place. The cap 76 further secures the inner body portion 58, the sound attenuation disc 74, the main valve 70, and the secondary valve 72 relative to the inner body portion 58 within the outer housing portion 56.

[0093] See now Figure 7 and Figure 8 Preferably, the inlet path 54, integrally formed with the outer housing portion 56 of the access cover 30, is a Luer-type connector. Therefore, it has a threaded form 55 configured to mate with the Luer-type connector fitting 46 (see...). Figure 6 The Luer-type fitting 46 has an elongated rod 80 with a proximal skirt 82 and a barbed distal tip 84. The proximal skirt 82 mates with a threaded form 55 of the inlet path 54, and the distal tip 84 mates with the filling and sensing line 38 of the tubing assembly 20. The Luer-type fitting 46 and the inlet path connector 54 are selectively sized to achieve a desired amount of airflow into the inlet path 54. Thus, it will be readily understood by those skilled in the art that the dimensions or size of these features of the gas circulation system 10 are larger than those of standard Luer-type fittings known and used in the art. This advantageously eliminates obstructions in the flow path into the inlet cap 30 and maximizes the mass flow rate through it for a given drive pressure.

[0094] like Figure 8 and Figure 9 As best seen, the inwardly tapering distal surface 86 of the inner body portion 58 of the access cover 30 abuts against the inwardly tapering distal sidewall 90 of the outer shell portion 56 of the access cover 30, and they engage tightly to seal the annular airflow passage 60 in an airtight manner.

[0095] In one embodiment of the invention, the annular channel 60 communicates with the proximal bowl-shaped portion 50 of the robot sleeve 32 through a plurality of circumferentially spaced holes or openings 92 formed in the inwardly tapering distal wall 90 of the outer housing portion 56. Here, as Figure 10 and Figure 12 As shown, the plurality of holes 92 are elliptical and extend radially outward from the central axis of the outer housing portion 56. Those skilled in the art will readily understand that the number, shape, and / or size of the holes can be selected to provide the desired airflow.

[0096] Alternatively, such as Figure 13 As shown, multiple elliptical holes 92 can extend approximately tangentially relative to the central axis of the outer housing portion. Figure 11 As shown, a plurality of triangular holes 94 may be provided, which extend radially outward from the central axis of the outer housing portion 56. Figure 14 In another embodiment of the invention shown, the annular channel 60 communicates with the proximal bowl-shaped portion 50 of the robot sleeve 32 through an annular hole 96 defined between the inwardly tapering distal wall 86 of the inner body portion 58 and the inwardly tapering distal wall 88 of the outer housing portion 56.

[0097] See now Figures 15 to 19 The gas-tight inlet cap 26 of the gas circulation system 10 is adapted and configured for cooperative reception within the proximal bowl-shaped portion 110 of the robot sleeve 28, which also includes an elongated tubular body portion 112. Figure 15 As shown, the gas-tight access cap 26 is adapted and configured to cooperate with the occluder 100 to achieve initial access to the patient's abdominal cavity. The occluder 100 includes a proximal handle portion 102 for cooperatively engaging the access cap 26, an elongated tubular shaft 104 sized to extend through the robotic cannula 28, and a sharp cutting tip 106 for puncturing through the abdominal wall. Those skilled in the art will readily appreciate that the occluder 100 can also be used in conjunction with the aforementioned valve-tight access cap 30 and robotic cannula 32.

[0098] The gas-tight inlet cap 26 has a multi-lumen connector 114 for communication with a multi-lumen connector 48 associated with the dual-lumen portion 22 of the tube assembly 20. In this embodiment of the invention, the multi-lumen connector 114 is a dual-lumen bullseye connector comprising a radially outer gas inlet lumen 116 and a central gas outlet lumen 118. The gas inlet lumen 116 of connector 114 communicates with the pressurized gas line 34 of the dual-lumen portion 22 of tube assembly 20, and the gas outlet lumen 118 of connector 114 communicates with the return gas line 36 of the dual-lumen portion 22 of tube assembly 20. The dual-lumen connector 114 extends to the mounting manifold 120 and includes a plurality of circumferentially spaced, radially outwardly extending lugs or posts 145 for interaction with the multi-lumen connector fitting 48, as described in more detail below.

[0099] See Figure 18 The gas-tight inlet cap 28 includes a main housing portion 122 defining an internal cavity 124 that supports a two-piece annular jet assembly 126 for receiving pressurized gas from an inlet port 128 communicating with a gas inlet lumen 116 of the connector 114. The annular jet assembly 126 is adapted and configured to create a gas-tight zone within the robotic cannula 28 to maintain stable pressure within the patient's surgical cavity. The structure and function of the jet assembly 126 are described in commonly assigned U.S. Patent No. 8,795,223, the entire disclosure of which is incorporated herein by reference.

[0100] The main housing portion 122 of the access cover 28 includes a mounting flange 125 for cooperatively receiving a manifold 120 of a multi-lumen connector 114. A sound attenuation disc 128, made of foam material, is positioned within the main housing portion 122 of the gas-tight access cover 26, proximal to the annular jet assembly 126, to reduce the sound level generated by pressurized gas flowing through the jet assembly 126. A cap 130 engages proximal to the outer housing portion 122 to secure the annular jet assembly 126 and the sound attenuation disc 128 within the main housing portion 122. The cap 130 defines a main access port 135 for the gas-tight access cover 26, through which surgical instruments, etc., are introduced into the robotic cannula 28.

[0101] In addition, such as Figure 19 As best viewed, the main housing portion 122 of the gas-tight inlet cover 26 includes an integrally formed body of circumferentially spaced blades 132 for guiding exhaust gas from the gas-tight zone to the outlet lumen 118 of the connector 114 through the outlet port 134 in the main housing portion 122 of the gas-tight inlet cover 26. Figure 1 In the multi-mode gas delivery system 12 shown, this waste gas is extracted from the area via a recirculation flow generated by pump 16. In some cases, the waste gas may include a smoke-filled gas generated in the operating room.

[0102] The integrally formed, circumferentially spaced blades 132 surround the inner periphery of the internal cavity 124 of the main housing portion 122, and extend distally into an inwardly tapering integral tubular extension 136 that extends distally into the proximal bowl-shaped portion 110 of the robotic sleeve 28. Similar guide blades are described in commonly assigned U.S. Patent No. 8,795,223, but they are not integrally formed with the housing.

[0103] An outer O-ring 138 surrounds the lower section of the main housing portion 122, positioning it between the main housing portion 122 of the gas-tight access cover 26 and the proximal bowl portion 110 of the robot sleeve 28 to form a gas-tight seal therebetween. The main housing portion 122 of the gas-tight access cover 26 also includes a pair of diametrically opposed flexible clamps 140a, 140b adapted and configured to releasably latch onto the upper annular flange 142 of the proximal bowl portion 110 of the robot sleeve 28, such as, for example… Figure 15 and Figure 16 As shown.

[0104] See now Figures 20 to 22 In another embodiment of the invention, the multi-lumen connector of the gas-tight inlet port 26 is a three-lumen bullseye connector, generally indicated by reference numeral 214. This type of three-lumen connector is disclosed in commonly assigned U.S. Patent No. 9,526,886, the entire disclosure of which is incorporated herein by reference. This feature is currently used in commercially available AirSeal inlet port products manufactured and sold by SurgiQuest, Inc., a wholly owned subsidiary of ConMed Corporation, and is therefore an readily available component. For this reason, it can be readily adapted for use with the gas-tight inlet cap 26, thereby reducing manufacturing costs and time-to-market for such new inlet devices.

[0105] More specifically, such as Figure 20 and Figure 21 As shown, the three-lumen bullseye connector 214 for accessing the cover 26 includes an outer lumen 216 for receiving gas from the pressurized gas line 34, a central lumen 218 for discharging exhaust gas to the gas return line 36, and an intermediate lumen 217 therebetween. In this case, the intermediate lumen 217 is not connected to any gas line of the tube assembly 20, and the inlet region 137 located within the boundary of the mounting flange 125 is obstructed or otherwise obscured, thus rendering the intermediate lumen 217 unimportant. It is essentially a residual or unused feature of the connector 214. Therefore, Figure 22The three-lumen bullseye fitting 248 shown is associated only with the two-lumen portions 22 (i.e., lumens 34 and 36) of the tube assembly 20, even though fitting 248 is adapted and configured to mate with the three-lumen connector 214.

[0106] Now go to Figures 23 to 26 Another embodiment of a bullseye connector fitting for rotatable engagement with a connector 114 of a gas-tight inlet cap 26 of the present invention is shown, the bullseye connector fitting generally indicated by reference numeral 150. The bullseye connector fitting 150 includes a proximal portion 152 for receiving a double-lumen portion 22 of a tube assembly 20 and a distal portion 154 for engaging with spaced-apart lugs or posts 145 on the connector 114. The distal portion 154 of the connector fitting 150 includes a set of generally J-shaped slots 156 for receiving the lugs 145.

[0107] like Figure 25 and Figure 26 As best viewed, each J-shaped slot 156 has a front outrigger section 158 and a rear outrigger section 160. An enlarged sphere 162 is formed at the entrance channel to the rear outrigger section 158 of the slot 156; this enlarged sphere must be overcome by a rotational force during engagement so that the lug 145 can be locked in place. Those skilled in the art will readily understand that... Figures 23 to 26 The connection features shown can be used with dual-cavity connector fittings or triple-cavity connector fittings according to the present invention.

[0108] See Figures 27 to 30 This illustration shows another embodiment of a bullseye connector fitting for rotatable engagement with a connector 114 of a gas-tight inlet cap 26 of the present invention, the bullseye connector fitting generally indicated by reference numeral 170. The connector fitting 170 includes a proximal portion 172 for the double-lumen portion 22 of the receiving tube assembly 20 and a distal portion 174 for engagement with spaced-apart lugs or posts 145 on the connector 114.

[0109] The distal portion 174 of the connector fitting 170 includes a set of circumferentially spaced, generally hockey stick-shaped slots 176 defining a helical coupling feature for receiving a lug 145 and for frictionally retaining the lug 145 in a locked position within the slots 176 during clockwise rotation of the fitting 170 relative to the connector 114. Figure 29 and Figure 30 The best view is available. Those skilled in the art will readily understand. Figures 27 to 30 The connection features shown can be used with dual-cavity connector fittings or triple-cavity connector fittings according to the present invention.

[0110] See Figures 31 to 36An attachment mechanism for sealing gas into cap 26 is shown, releasably attached to the proximal bowl portion 110 of robotic sleeve 28, rather than as previously described herein and... Figure 16 and Figure 17 The flexible clamps 140a and 140b are shown opposite each other along the diametrical direction. More specifically, Figures 31 to 36 An elliptical compressible clamping skirt 220 is shown that is integral with the lower section of the main housing portion 122 of the gas-tight inlet cover 26 and surrounds the lower section.

[0111] The compressible clamping skirt 220 has two diametrically opposed compression tabs 222a and 222b and two diametrically opposed clamping protrusions 223a and 223b, the clamping protrusions having windows 227a and 227b for moldability. The compression tabs 222a and 222b are adapted and configured such that manual force can be applied to the skirt 220 in a radially inward direction, as... Figure 35 As shown. This causes the skirt 220 to extend radially outward along an axis generally transverse to the force vector, allowing the clamping protrusions 223a, 223b to be physically released from beneath the proximal flange 142 of the bowl-shaped portion 110 entering the cover 26. Opposite C-shaped cutouts 229a, 229b along the diametrical direction are formed in the clamping skirt 220 adjacent to the compression tabs 222a, 222b, respectively, to allow for greater displacement of the clamping protrusions 223a, 223b and to reduce the overall stiffness of the clamping skirt 220.

[0112] like Figure 33 As best viewed, the compressible ring 226 is positioned below the clamping skirt 220 such that it sits between the clamping skirt 220 and the proximal flange 142 of the cup-shaped portion 110 to provide a seal and resilient biasing force therebetween, thereby enhancing the security of the clamping skirt 220. It is conceivable that the gasket 226 may be an overmolded elastomer, a flat O-ring, or a foam material. Those skilled in the art will readily understand that... Figures 31 to 36 The attachment features shown can be used together with the valve seal inlet cover 30 according to the invention.

[0113] See now Figures 37 to 40 An attachment mechanism is shown for an embodiment of sealing gas into cap 26, releasably attached to the proximal cup-shaped portion 110 of robotic sleeve 28, defined by a spring-biased and hinged latch assembly 230. The latch assembly 230 includes a pair of C-shaped latch portions 232a, 232b hinged to each other about a pivot pin 234, as shown. Figure 39 The best view is achieved in the center. The latch assembly 230 can be supported on the lower annular flange 224 of the main housing portion 122 of the access cover 26, or it can be a separate component.

[0114] The two latch portions 232a, 232b are typically biased toward each other by a torsion spring 236 associated with the pivot pin 234. Figure 37 The closed and locked positions are shown. The latch assembly 230 is adapted and configured to... Figure 38 The opening position shown and Figure 37 The open position allows for easy manual separation of the gas-tight inlet cap 26 from the cup-shaped portion 110 of the robotic sleeve 28, where the latch portions 232a, 232b close around the annular flange 224 on the main housing portion 122 of the inlet cap 26 and the proximal flange 142 of the cup-shaped portion 110 of the robotic sleeve 28, securing them firmly through a frictional engagement. Figure 40 The best view is available. Those skilled in the art will readily understand. Figures 37 to 40 The snap-on attachment feature shown can be used together with the valve seal inlet cover 30 according to the invention.

[0115] See now Figures 41 to 43 This illustrates another attachment mechanism for releasably attaching an embodiment of a gas-tight inlet cap 26 to the proximal bowl portion 110 of a robotic sleeve 28, defined by a magnetic skirt assembly 240. The magnetic skirt assembly 240 includes a magnetic ring 242 that can be overmolded onto the underside of a housing flange 224, allowing it to directly interact with the metallic proximal flange 142 of the bowl portion 110 of the sleeve 28, such as... Figure 42 The best view is as shown. Alternatively, the magnetic ring 242 can be ultrasonically welded between two clamp-free plastic skirts 244 and 246, and the assembly can then be secured together to the lower surface of the annular flange 224 of the housing 122, as shown. Figure 43 As shown. Those skilled in the art will readily understand, Figures 41 to 43 The magnetic attachment feature shown can be used together with the valve seal inlet cover 30 according to the invention.

[0116] See Figures 44 to 46 An attachment mechanism is shown for releasably attaching to the proximal bowl-shaped portion 110 of a robotic sleeve 28 for sealing gas into the cap 26. This attachment mechanism comprises structures and functions consistent with... Figure 36 Similar compressible clamping skirts 250 are defined as shown in the illustration, but in this embodiment of the invention, which is schematically shown, the compressible clamping skirt 250 is inverted and mounted to be axially movable relative to the cup-shaped portion 110 of the sleeve 28, as... Figure 45 The best view in the middle.

[0117] More specifically, the axially movable inverted clamping skirt 250 can be raised and lowered relative to the cup-shaped portion 110 of the robot sleeve 28 to facilitate the releasable attachment of the gas-tight seal to the cap 26 to the robot sleeve 28. Those skilled in the art will readily understand that... Figures 44 to 46 The movable clamping skirt feature shown can be used together with the valve seal inlet cover 30 according to the invention.

[0118] See now Figure 47 This illustrates a three-lumen bullseye plug 260, adapted and configured to fit snugly with a three-lumen bullseye connector fitting 248, which... Figure 22 The double-lumen portion 22 of the tube assembly 20 shown is associated with this. For example, during the initial filling phase of robot-assisted surgery, when the double-lumen portion 22 of the tube assembly 20 is not used, but rather the single-lumen portion 24 of the tube assembly 20 is used, a bullseye plug 260 is used. When the bullseye plug 260 is installed, it creates a negative pressure in the double-lumen portion 22 of the tube assembly 20, which indicates to the pressure sensor in the gas delivery system 12 that a standard filling mode is in progress. At this time, the pump 16 within the gas delivery system 12 will not operate.

[0119] Now go to Figure 48 The Da Vinci robotic sleeve 28, used in conjunction with the gas-tight inlet cap 26 of the present invention, is shown in detail, as previously illustrated, for example in... Figure 1 As shown in the diagram, the elongated body portion 112 of the robot sleeve 28 has an internal bore 115 with an inner diameter D of approximately 8.89 mm, and its dimensions are designed to accommodate a shaft of a robotic instrument with an outer diameter of approximately 8.55 mm, which is not shown. This allows for a gap of 0.39 mm for airflow. However, the gas-tight inlet cap 26 requires a larger gap to function effectively. To enhance the functionality of the gas-tight inlet cap 26 of the present invention, a sleeve with a larger inner diameter is required, allowing pressurized gas to flow more easily between the inner periphery of the internal bore 115 and the outer periphery of the robotic instrument extending through it.

[0120] in this regard, Figure 49 A robotic cannula body 270 is shown, having a set of circumferentially spaced linear beads 272 formed or otherwise disposed on the inner surface of the robotic cannula body to provide enhanced airflow for the gas-tight inlet cap 26. Similarly, Figure 50 A robotic cannula body 280 is shown, having a set of circumferentially spaced linear channels 284 formed in the inner surface of the robotic cannula body to provide enhanced airflow for the gas-tight inlet cap 26. Finally, Figure 51A robotic cannula body 290 is shown, which has continuous spiral beads 292 formed or otherwise disposed on the inner surface of the robotic cannula body to provide enhanced airflow between the inner wall of the cannula body 290 and the robotic instrument 300 extending through it, such as... Figure 52 The best view is provided. Those skilled in the art will readily understand that these features of the sleeve body also provide enhanced airflow when used in conjunction with the valve seal inlet cap 30.

[0121] Although the gas circulation system of this disclosure has been shown and described with reference to preferred embodiments, those skilled in the art will readily understand that changes and / or modifications can be made thereto without departing from the scope of this disclosure.

Claims

1. A gas-tight inlet cap for a robotic cannula, comprising: a) A housing having a cap defining a central inlet port extending to support an annular jet assembly for receiving pressurized gas from an inlet port of the housing, wherein the annular jet assembly includes a central orifice aligned with the central inlet port of the cap and is adapted to create a gas-sealed zone within the robotic cannula to maintain a stable pressure within the patient's surgical cavity; b) A plurality of circumferentially spaced, radially inwardly extending blades, the blades being integrally formed with the housing and located within the internal cavity of the housing below the annular injection assembly, for guiding exhaust gas from the gas-sealed area to the outlet port of the housing; and c) A central inlet tube aligned with the central inlet port of the housing and the central orifice of the annular injection assembly, and extending distally from the internal cavity of the housing below the blade for communication with the tubular portion of the robot cannula, wherein the housing of the inlet cap is sized and configured to be received within the proximal bowl-shaped portion of the robot cannula. The manifold, including the three-lumen bullseye connector, is operatively associated with a mounting flange on the housing of the inlet cover. The three-lumen bullseye connector includes an outer lumen for receiving pressurized gas, a central lumen for discharging exhaust gas, and a residual intermediate lumen between the outer lumen and the central lumen. The outer lumen communicates with an inlet port in the housing within the mounting flange, and the central lumen communicates with an outlet port in the housing within the mounting flange. An inlet region within the mounting flange corresponding to the intermediate lumen is blocked, rendering the intermediate lumen unimportant while allowing the three-lumen bullseye connector to mate with a three-lumen bullseye fitting.

2. The gas-tight inlet cover according to claim 1, wherein, A pair of flexible clamps, diametrically opposed, are integrally formed with the outer surface of the housing for releasably securing the access cover to the proximal bowl-shaped portion of the robot sleeve.

3. The gas-tight inlet cover according to claim 1, wherein, The sound attenuation disc is positioned within the housing between the cover and the annular injection assembly.

4. The gas-tight inlet cover according to claim 3, wherein, The sound attenuation disc is made of foam material.

5. The gas-tight inlet cover according to claim 1, wherein, The mounting flange is formed on the outer surface of the housing.

6. The gas-tight inlet cover according to claim 5, wherein, The manifold is formed separately from the housing of the inlet cover.

7. The gas-tight inlet cover according to claim 1, wherein, The distal end of the housing extends distally beyond the distal end of the central inlet tube.

8. The gas-tight inlet cover according to claim 1, wherein, The distal end of the central inlet tube extends distally beyond the distal end of the housing.

9. The gas-tight inlet cover according to claim 1, wherein, An external O-ring seal surrounds the distal portion of the housing to provide a seal between the housing and the proximal bowl-shaped portion of the robot cannula.

10. A gas-tight inlet cap for a robotic cannula, comprising: a) A housing having a cap defining a central inlet port extending to support an annular jet assembly for receiving pressurized gas from an inlet port of the housing, wherein the annular jet assembly includes a central orifice aligned with the central inlet port of the cap and is adapted to create a gas-sealed zone within the robotic cannula to maintain a stable pressure within the patient's surgical cavity; b) A plurality of circumferentially spaced, radially inwardly extending blades, the blades being integrally formed with the housing and located within the internal cavity of the housing below the annular injection assembly, for guiding exhaust gas from the gas-sealed area to the outlet port of the housing; and c) A central inlet tube aligned with the central inlet port of the housing and the central orifice of the annular injection assembly, and extending distally from the internal cavity of the housing below the blade for communication with the tubular portion of the robot cannula, wherein the distal end of the central inlet tube extends distally beyond the distal end of the housing, and wherein the housing of the inlet cap is sized and configured for reception within the proximal bowl-shaped portion of the robot cannula. The manifold, including the three-lumen bullseye connector, is operatively associated with a mounting flange on the housing of the inlet cover. The three-lumen bullseye connector includes an outer lumen for receiving pressurized gas, a central lumen for discharging exhaust gas, and a residual intermediate lumen between the outer lumen and the central lumen. The outer lumen communicates with an inlet port in the housing within the mounting flange, and the central lumen communicates with an outlet port in the housing within the mounting flange. An inlet region within the mounting flange corresponding to the intermediate lumen is blocked, rendering the intermediate lumen unimportant while allowing the three-lumen bullseye connector to mate with a three-lumen bullseye fitting.

11. The gas-tight inlet cover according to claim 10, wherein, A pair of flexible clamps, diametrically opposed, are integrally formed with the outer surface of the housing for releasably securing the access cover to the proximal bowl-shaped portion of the robot sleeve.

12. The gas-tight inlet cover according to claim 10, wherein, The sound attenuation disc is positioned within the housing between the cover and the annular injection assembly.

13. The gas-tight inlet cover according to claim 12, wherein, The sound attenuation disc is made of foam material.

14. The gas-tight inlet cover according to claim 10, wherein, The mounting flange is formed on the outer surface of the housing.

15. The gas-tight inlet cover according to claim 14, wherein, The manifold is formed separately from the housing of the inlet cover.

16. The gas-tight inlet cover according to claim 10, wherein, An external O-ring seal surrounds the distal portion of the housing to provide a seal between the housing and the proximal bowl-shaped portion of the robot cannula.

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