Manually actuated adapter for surgical instruments

Abstract

A manual drive adapter for a robotic instrument includes an adapter housing configured to be releasably coupled to a force transmitting mechanism of the robotic instrument. The force transfer mechanism includes a drive member interface and an input drive member configured to engage with a robotic drive output of a teleoperated surgical system. The adapter includes an output drive interface including an output drive member and coupled to the adapter housing. The output drive interface is configured to be releasably coupled to a drive member interface of the robotic instrument such that the output drive member is engageable with an input drive member of the robotic instrument. A manual actuator of the adapter is operably coupled to the output drive member such that movement of the manual actuator by a user causes the output drive member to operate one or more degrees of freedom of the robotic instrument.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims priority to U.S. Provisional Application Serial No. 63 / 394,076, filed on August 1, 2022, entitled “Adapter for Manual Actuation of Surgical Instrument,” the entire contents of which are incorporated herein by reference. Technical Field

[0003] Embodiments described herein relate to medical devices, and more particularly to robotic instruments. More particularly, embodiments described herein relate to medical devices including a manual drive adapter that can be removably coupled to a robotic instrument to provide manual actuation of the robotic instrument. Background Art

[0004] During some known medical procedures, surgeons can use robotic instruments operably coupled to a teleoperation system to perform various medical procedures. In some cases, surgeons may desire to use manually operated medical devices (e.g., devices such as handheld surgical instruments, in which at least a portion of the force generated by a physical input from a user (such as squeezing a trigger, rotating a button, or pressing an actuator) is transmitted to the output of the device via a mechanical device) to perform some parts of the procedure. For example, surgeons may wish to use one or more manual instruments in conjunction with a robotic procedure, wherein the manual instruments are used simultaneously with the robotic instruments and / or wherein the robotic instruments are used for one part of the procedure and the manual instruments are used for another part of the procedure. For example, surgeons may wish to open or close the jaws of non-robotic, manually actuated energy or non-energy surgical tools (e.g., scissors, graspers, vascular sealers, bipolar, monopolar, harmonic or other tools) to manually perform various aspects of the procedure without using or being coupled to a teleoperation system, or to perform various aspects that cannot be easily performed using existing robotic instruments controlled by a teleoperation system. This requires the surgeon to use two or more separate instruments to perform a specific medical procedure, a robotic instrument controlled by a teleoperation system and a second manual instrument actuated by hand. Alternatively, in some medical procedures, the surgeon may wish to convert use of the instrument from teleoperated control to manually actuated control.

[0005] Although some known robotic devices include an emergency release mechanism to allow a user to manually override the teleoperation controls, such release systems are typically used only for simple operations of the device (e.g., opening the jaws) and do not allow the device to be used to perform a procedure. Such known devices do not allow the surgeon to manually hold and actuate the robotic instrument, but rather disconnect from the teleoperation system, wherein the same robotic instrument is used in a teleoperated manner at other times during the procedure.

[0006] Therefore, there is a need for an adapter that provides for easily converting a robotic tool between use with a teleoperation system, in which the robotic tool is operated through the control of the teleoperation system, and use with a manual actuator, in which the robotic tool is not controlled through the teleoperation system, but rather through manual input provided by a surgeon. Summary of the invention

[0007] This summary introduces certain aspects of the embodiments described herein to provide a basic understanding. This summary is not an extensive overview of the inventive subject matter and is not intended to identify key or critical elements or to delineate the scope of the inventive subject matter.

[0008] In some embodiments, a manual drive adapter for a robotic instrument includes an adapter housing configured to be releasably coupled to a force transfer mechanism of the robotic instrument. The force transfer mechanism of the robotic instrument includes a drive member interface and an input drive member, the input drive member being configured to engage with a robotic drive output of a teleoperated surgical system. The output drive interface includes an output drive member and is coupled to the adapter housing. The output drive interface is configured to be releasably coupled to the drive member interface of the robotic instrument so that the output drive member can engage with the input drive member of the robotic instrument. A manual actuator is operably coupled to the output drive member so that movement of the manual actuator by a user causes the output drive member to operate one or more degrees of freedom of the robotic instrument. In some embodiments, when the output drive interface is coupled to the drive member interface of the robotic instrument, the input drive member of the robotic instrument is prevented from engaging with the robotic drive output of the teleoperated surgical system.

[0009] In some embodiments, the robotic instrument includes a shaft having a proximal portion coupled to a force transfer mechanism of the robotic instrument and a distal portion coupled to an end effector, wherein movement of a manual actuator by a user causes an output drive member to move an input drive member of the robotic instrument to actuate the end effector. In some embodiments, the end effector includes a gripping tool, and when the output drive member is coupled to the input drive member of the robotic instrument, movement of the manual actuator actuates the gripping tool. In some embodiments, the end effector includes a cutting tool, and when the output drive member is coupled to the input drive member of the robotic instrument, movement of the manual actuator actuates the cutting tool to move relative to a jaw of the end effector (i.e., proximally or distally).

[0010] In some embodiments, the output drive interface includes a plurality of output drive members configured to engage with a plurality of input drive members of the robotic instrument. In some such embodiments, the input drive member is a first input drive member of the plurality of input drive members, the manual actuator is a first manual actuator, and the output drive member is a first output drive member of the plurality of output drive members, and the manual drive adapter further includes a second manual actuator. The second manual actuator is operably coupled to a second output drive member of the plurality of output drive members, and when the adapter housing is coupled to the force transfer mechanism of the robotic instrument, the second manual actuator can be manually actuated by a user to cause the second output drive member to move the second input drive member of the plurality of input drive members of the robotic instrument.

[0011] In some embodiments having a second manual actuator, the robotic instrument includes a shaft having a proximal portion coupled to a force transfer mechanism of the robotic instrument and a distal portion coupled to an end effector, the end effector including a gripping tool and a cutting tool. In such embodiments, the first manual actuator is configured to manually actuate the gripping tool when the first output drive member is coupled to the first input drive member of the robotic instrument, and the second manual actuator is configured to manually actuate the cutting tool to move relative to a jaw of the end effector when the second output drive member is coupled to the second input drive member of the robotic instrument.

[0012] In some embodiments, the robotic instrument includes a shaft having a proximal portion coupled to the force transfer mechanism and a distal portion coupled to the wrist mechanism. The wrist mechanism is configured to rotate about a rotation axis to move the orientation of the wrist mechanism about the rotation axis, and a first manual actuator is configured to manually actuate the tool when the first output drive member is coupled to the first input drive member of the robotic instrument. The manual drive adapter includes a second manual actuator, the second manual actuator being configured to cause the wrist mechanism to be locked in a fixed orientation relative to the shaft.

[0013] In some embodiments having a first manual actuator and a second manual actuator, the distal end portion of the shaft is coupled to a connecting rod, the connecting rod is coupled to the gripping tool and the cutting tool, and the connecting rod is configured to rotate about the rotation axis to move the orientation of at least one of the gripping tool or the cutting tool about the rotation axis. In some such embodiments, the manual drive adapter further includes a third manual actuator configured to be manually actuated by a user to lock the connecting rod in a fixed orientation relative to the shaft and prevent at least one of the gripping tool or the cutting tool from moving about the rotation axis.

[0014] In some embodiments, the manual drive adapter further comprises a locking mechanism that prevents the second manual actuator from being actuated unless the first manual actuator is actuated. In some embodiments, the manual drive adapter further comprises a torque limiter that is coupled to the manual actuator and is configured to limit the torque applied to the drive member when the manual actuator is moved by a user. In some embodiments, the torque limiter comprises a torsion spring. In some embodiments, the power connection is configured such that when the adapter housing is coupled to the force transfer mechanism of the robotic instrument, the robotic instrument is electrically coupled to the power source. In some embodiments, the manual drive adapter is provided within a sterile kit and is configured for single use.

[0015] In some embodiments, a manual drive adapter includes an adapter housing configured to be releasably coupled to a housing of a robotic instrument. The force transfer mechanism of the robotic instrument includes a first input drive member and a second input drive member. The first input drive member is configured to engage with a first robotic drive output of a remotely operated surgical system, and the second input drive member is configured to engage with a second robotic drive output of the remotely operated surgical system. A first manual actuator is coupled to the adapter housing and is operably coupled to the first input drive member, such that movement of the first manual actuator causes the first input drive member to operate a first tool of the robotic instrument. A second manual actuator is coupled to the adapter housing and is operably coupled to the second input drive member, such that movement of the second manual actuator causes the second input drive member to operate a second tool of the surgical instrument.

[0016] In some embodiments, the robotic instrument includes a shaft having a proximal portion coupled to a force transfer mechanism of the robotic instrument and a distal portion coupled to a link. The link is coupled to a first tool and is configured to rotate about an axis of rotation to move an orientation of the first tool about the axis of rotation. In some such embodiments, the manual drive adapter further includes a third actuator configured to be manually actuated to lock the link in a fixed orientation relative to the shaft and prevent the first tool from moving about the axis of rotation.

[0017] In some embodiments, the first tool is a gripping tool and the second tool is a cutting tool. When the adapter housing is coupled to the force transfer mechanism of the robotic instrument, movement of the first manual actuator actuates the gripping tool and movement of the second manual actuator actuates the cutting tool to move relative to the jaws of the gripping tool.

[0018] After reading the following drawings and detailed description, other medical devices, related components, medical device systems and / or methods according to the embodiments will be or become apparent to those skilled in the art. It is intended that all such additional medical devices, related components, medical device systems and / or methods included in the specification are within the scope of the present disclosure. BRIEF DESCRIPTION OF THE DRAWINGS

[0019] Figure 1 is a plan view of a minimally invasive teleoperated medical system for performing a medical procedure, such as surgery, according to an embodiment.

[0020] Figure 2 yes Figure 1 A perspective view of an optional auxiliary unit of a minimally invasive teleoperated surgical system is shown.

[0021] Figure 3 yes Figure 1 A perspective view of a user console for a minimally invasive teleoperated surgical system is shown.

[0022] Figure 4 yes Figure 1 A front view of a manipulator unit including a plurality of instruments of a minimally invasive teleoperated surgical system is shown.

[0023] Figure 5A According to the embodiment Figure 1 Illustration of a portion of a remote operation system illustrating an instrument carriage of a manipulator unit.

[0024] Figure 5B is shown as a sterile adapter coupled to a manipulator unit and a robotic instrument coupled thereto Figure 5A Illustration of an instrument carriage.

[0025] Figure 5C yes Figure 5B Exploded view of the instrument carriage, sterile adapters, and robotic instruments.

[0026] Fig. 6A is a schematic illustration of a robotic machine coupled to a teleoperation system according to an embodiment.

[0027] Figure 6B is shown as disconnected from the remote operating system Fig. 6A Schematic illustration of a robotic instrument.

[0028] Figure 6C is shown coupled to a manual drive adapter according to an embodiment Figure 6B Schematic illustration of a robotic instrument.

[0029] Figure 7is a schematic illustration of a manual drive adapter according to an embodiment shown coupled to a robotic instrument according to an embodiment.

[0030] Fig. 8A Illustrated is a manual drive adapter shown coupled to a robotic instrument according to an embodiment.

[0031] Figure 8B The diagram is shown separated from the robotic instrument. Fig. 8A Manual drive adapter.

[0032] Fig. 9 is a side view of a robotic instrument and a manual drive adapter according to an embodiment.

[0033] Fig.10 yes Fig. 9 A distal perspective view of a portion of a robotic instrument and a manual drive adapter.

[0034] Fig.11 yes Fig. 9 0026] A perspective view of a robotic instrument illustrating a distal view of a drive member interface of the robotic instrument.

[0035] Fig. 12A yes Fig.11 An enlarged perspective view of a portion of a robotic instrument.

[0036] Fig. 12B yes Fig. 12A An enlarged perspective view of a portion of a robotic instrument illustrating a coupling portion of a drive member interface.

[0037] Fig.13A yes Fig. 9 A perspective view of the distal portion of a robotic instrument.

[0038] Fig. 13B yes Fig. 9 A perspective view of a portion of an end effector of a robotic instrument with a portion of a tool assembly removed for illustration purposes.

[0039] Fig. 13C yes Fig. 9 A partial exploded view of a portion of an end effector of a robotic instrument.

[0040] Fig.14 yes Fig. 9 0026] A side view of a manual drive adapter illustrating a first manual actuator in an unactuated position.

[0041] Fig.15 yes Fig.14 0026] A side view of a manual drive adapter illustrating a first manual actuator in an actuated position.

[0042] Fig.16 yes Fig. 9 A perspective view of a manually driven actuator illustrating a proximal side view of an output drive interface of a manually driven adapter.

[0043] Fig.17 yes Fig. 9 Top view of the manual drive adapter.

[0044] Fig.18 yes Fig. 9 A proximal side view of a manual drive adapter illustrating a proximal side view of the output drive interface.

[0045] Fig.19 yes Fig. 9 Distal perspective view of the manual drive adapter.

[0046] Fig. 20 yes Fig. 9 A distal perspective view of a portion of a manually driven actuator of FIG. 1 with selected components removed for illustration purposes.

[0047] Fig.21 yes Fig. 9 A distal perspective view of a portion of a manually driven actuator of FIG. 1 with selected components removed for illustration purposes.

[0048] Fig. 22 yes Fig. 9 A distal perspective view of a portion of a manually driven actuator of FIG. 1 with selected components removed for illustration purposes.

[0049] Fig.23 yes Fig. 9 A distal perspective view of a portion of a manually driven actuator of FIG. 1 with selected components removed for illustration purposes.

[0050] Fig.24A yes Fig. 9 A perspective view of a portion of a manual drive adapter illustrating a second manual actuator in a ready position.

[0051] Fig. 24B yes Fig. 9 A perspective view of a portion of a manual drive adapter illustrating a second manual actuator in an actuated position. DETAILED DESCRIPTION

[0052] The embodiments described herein can be advantageously used for various grasping, cutting and manipulation operations associated with minimally invasive surgery. In some embodiments, the end effector of the medical device can move relative to the body of the device in at least three mechanical degrees of freedom (DOF), such as pitch, yaw and roll (axial roll). In some embodiments, there may also be one or more mechanical DOFs in the end effector itself, the end effector being, for example, two jaws, each jaw rotating relative to the clevis (2 DOFs) and a distal clevis rotating relative to the proximal clevis (1 DOF). In some embodiments, the medical device can have, for example, 5 DOFs. For example, in some embodiments, the medical device can have one DOF for axial roll, one DOF for pitch and one DOF for yaw (e.g., in the wrist), one DOF for movement of the clamping tool, and one DOF for movement of the knife. In some embodiments, the medical device can include an end effector having a clamp with 2 DOFs and a knife providing 1 DOF. However, in various embodiments, the medical device can have more or fewer DOFs.

[0053] In some embodiments, the medical device of the present application realizes the movement of a robotic instrument (also referred to as a medical instrument) in at least three degrees of freedom (e.g., around a pitch axis, a yaw axis, and an axis axis). In addition, the robotic instrument described herein includes one or more actuating elements (such as cables) that can be fixed to a force transfer mechanism of the instrument and fixed to an end effector at the distal end of the robotic instrument. In some embodiments, the force transfer mechanism can be at the proximal end of the instrument, but the present disclosure is not limited to this or thereby, and in other embodiments, the force transfer mechanism can be positioned at the middle portion of the instrument between the proximal and distal ends of the instrument. As described herein, the robotic instrument can be used within a remote operation system, and the cable can be driven by one or more actuators (e.g., an electric motor) to move the end effector of the robotic instrument.

[0054] In some medical procedures, surgeons can use robotic instruments operably coupled to a teleoperation system to perform various medical procedures. In some cases, surgeons may be expected to use manually operated medical devices to perform some parts of the procedure. For example, surgeons may wish to turn on non-robotic, manually actuated energy or non-energy surgical tools (e.g., scissors, graspers, vascular sealers, bipolar, monopolar, harmonic or other tools) to manually perform various aspects of the procedure without using a teleoperation system, or perform various aspects that cannot be easily performed using existing robotic tools controlled by a teleoperation system. In some cases, surgeons can use two or more separate tools to perform a specific medical procedure.

[0055] As described herein, a manual drive adapter for releasably attaching to a robotic instrument to manually hold and actuate the robotic instrument is provided. The robotic instrument can be coupled to and operated by a teleoperation system, and the instrument can be detached from the teleoperation system and coupled to a manual drive adapter to perform a portion of a medical procedure. This allows a surgeon to use the same robotic instrument during the robotic operation portion of a medical procedure and the manual operation portion of the procedure. The manual drive adapter can eliminate the time and expense of using a separate new tool, which can provide greater flexibility to the operator and reduce the overall cost of the procedure by eliminating the need to use additional tools. Such an adapter can also provide consistency within the procedure by allowing the surgeon to use familiar tools with expected and / or preferred performance within the procedure. In some embodiments, the manual drive adapter is provided in a sterile kit and is provided for single use.

[0056] As used herein, the term "about" when used in conjunction with a reference numerical designation refers to the reference numerical designation plus or minus up to ten percent of the reference numerical designation. For example, the term "about 50" encompasses a range of 45 to 55. Similarly, the term "about 5" encompasses a range of 4.5 to 5.5.

[0057] As used in this specification and the appended claims, the word "distal" refers to a direction toward a working site, and the word "proximal" refers to a direction away from a working site. Thus, for example, the end of a medical device closest to a target tissue would be the distal end of the medical device, and the end opposite the distal end would be the proximal end of the medical device.

[0058] In addition, the specific words selected to describe one or more embodiments and optional elements or features are not intended to limit the present invention. For example, spatial relative terms, such as "below ... ", "below", "lower", "above ... ", "upper", "near side", "distal side" and similar terms, can be used to describe the relationship between an element or feature and another element or feature shown in the figure. These spatially relative terms, in addition to the orientation and orientation shown in the figure, are also intended to cover the different orientations (i.e., translation placement) and orientations (i.e., rotation placement) of the device in use or operation. For example, if the device in the figure is reversed, the element described as "below" or "below" other elements or features will be "above" or "above" other elements or features. Therefore, the term "below" can include the orientation and orientation above and below. The device can be oriented in other ways (rotated 90 degrees or in other orientations) and the spatial relative descriptors used in this article are correspondingly explained. Similarly, the description of the movement along (translation) and around (rotation) various axes includes various spatial orientations and orientations. The combination of the orientation and orientation of the body defines the posture of the body.

[0059] Similarly, unless the context indicates otherwise, geometric terms such as "parallel," "perpendicular," "circular," or "square" are not intended to require absolute mathematical precision. Rather, such geometric terms allow for variations due to manufacturing or equivalent functions. For example, if an element is described as "circular" or "substantially circular," the description still includes components that are not exactly circular (e.g., components that are slightly elliptical or multi-sided polygons).

[0060] In addition, unless the context clearly indicates otherwise, the singular forms "a", "an" and "the" are intended to include the plural forms as well. The terms "comprising", "including", "having" and similar terms specify the presence of stated features, steps, operations, elements, components, etc., but do not exclude the presence or addition of one or more other features, steps, operations, elements, components or groups.

[0061] Unless otherwise specified, the terms equipment, medical device, medical instrument and their variations are used interchangeably.

[0062] Aspects of the present invention are mainly based on using da The surgical system is described in detail with reference to an embodiment of the present invention. The da Vinci surgical system is sold by Intuitive Surgical, Inc. of Sunnyvale, California. An example of such a surgical system is the da Vinci Surgical system (model IS4000), da Vinci Surgical System (Model IS4200) and da Vinci Surgical System (Model IS3000). However, those skilled in the art will appreciate that the various inventive aspects disclosed herein may be embodied and implemented in a variety of ways, including computer-assisted, non-computer-assisted, and hybrid combinations of manual and computer-assisted embodiments and implementations. The embodiments of the surgical system (e.g., Model IS4200, Model IS4000, Model IS3000, Model IS2000, Model IS1200, Model SP1099) are presented only as examples and should not be considered to limit the scope of the various inventive aspects disclosed herein. Where applicable, various aspects of the invention can be embodied and implemented in relatively small handheld manually operated devices that are not mechanically grounded in the world reference frame and in relatively larger systems with additional mechanical supports that are grounded in the world reference frame.

[0063] Figure 11 is a plan view illustration of a remotely operated surgical system 1000 ("telesurgical system") that operates at least in part with computer assistance. The telesurgical system 1000 and its components are considered medical devices. The teleoperation system 1000 is a minimally invasive robotic surgery (MIRS) system for performing minimally invasive diagnostic or surgical procedures on a patient P lying on an operating table 1010. The system 1000 can have any number of components, such as a user control unit 1100 used by a surgeon or other skilled surgeon S during the procedure. The MIRS system 1000 can also include a manipulator unit 1200 (commonly referred to as a surgical robot) and an optional auxiliary equipment unit 1150. The manipulator unit 1200 can include an arm assembly 1300 and a surgical instrument 1400 removably coupled to the arm assembly 1300. When the surgeon S observes the surgical site and controls the movement of the instrument 1400 through the control unit 1100, the manipulator unit 1200 can manipulate at least one removably coupled instrument 1400 through a minimally invasive incision or a natural orifice in the body of the patient P. The image of the surgical site is obtained by an endoscope (not shown) such as a stereo endoscope, which can be manipulated by the manipulator unit 1200 to orient the endoscope. The auxiliary device unit 1150 can be used to process the image of the surgical site so that it is then displayed to the surgeon S through the user control unit 1100. The number of instruments 1400 used at one time will generally depend on the diagnostic or surgical procedure and the space limitations in the operating room and other factors. If it is necessary to replace one or more instruments 1400 being used during the procedure, the assistant removes the instrument 1400 from the manipulator unit 1200 and replaces it with another instrument 1400 from the tray 1020 in the operating room. Although shown as being used with the instrument 1400, any instrument described herein can be used with the MIRS 1000.

[0064] Figure 2 11 is a perspective view of the control unit 1100. The user control unit 1100 includes a left-eye display 1112 and a right-eye display 1114 for presenting a coordinated stereoscopic view of the surgical site to the surgeon S that enables depth perception. The user control unit 1100 also includes one or more input control devices 1116, which in turn cause the manipulator unit 1200 ( Figure 1The input control device 1116 provides at least the same degrees of freedom as the instrument 1400 (the instrument 1400 is associated with the input control device 1116), thereby providing the surgeon S with telepresence, or the perception that the input control device 1116 is integral with (or directly connected to) the instrument 1400. In this way, the user control unit 1100 provides the surgeon S with a strong sense of directly controlling the instrument 1400. To this end, position, force, strain or tactile feedback sensors (not shown), or any combination of these senses, are sent from the instrument 1400 back to the surgeon's hand through one or more input control devices 1116.

[0065] The user control unit 1100 Figure 1 1100 and the surgeon S may be in a different room from the patient, a completely different building, or other remote location from the patient, thereby allowing for remote surgical procedures.

[0066] Figure 3 is a perspective view of the auxiliary equipment unit 1150. The auxiliary equipment unit 1150 can be coupled to an endoscope (not shown) and can include one or more processors to process the captured images for subsequent display, such as via the user control unit 1100, or on another appropriate display located locally (e.g., as shown, on the unit 1150 itself, on a wall-mounted display) and / or remotely. For example, in the case of a stereoscopic endoscope, the auxiliary equipment unit 1150 can process the captured images to present a coordinated stereoscopic image of the surgical site to the surgeon S via the left eye display 1112 and the right eye display 1114. Such coordination can include alignment between relative images, and can include adjusting the stereo working distance of the stereoscopic endoscope. As another example, the image processing can include using previously determined camera calibration parameters to compensate for imaging errors of the image capture device, such as optical aberrations.

[0067] Figure 4A front perspective view of the manipulator unit 1200 is shown. The manipulator unit 1200 includes components (e.g., arms, linkages, motors, sensors, etc.) that provide for manipulation of the instrument 1400 and an imaging device (not shown), such as a stereo endoscope, for capturing images of the site of the procedure. Specifically, the instrument 1400 and the imaging device can be manipulated by a remote operating mechanism having one or more mechanical joints. In addition, the instrument 1400 and the imaging device are positioned and manipulated through an incision or natural orifice in the patient P in such a manner that the center of motion away from the manipulator and typically located at a position along the instrument axis is maintained at the incision or orifice by kinematic mechanical constraints or software constraints. In this way, the incision size can be minimized.

[0068] Figure 5A 13 is a perspective view of a portion of an arm assembly 1300 and an instrument carriage 1330 to which an instrument 1400 may be removably coupled. The instrument carriage 1330 includes a remotely operated actuator to provide controller motion to the instrument 1400, which is translated into various movements of one or more tools at the distal end of the instrument 1400. The arm assembly 1300 includes a connection portion 1324 in which the instrument carriage 1330 may be coupled. The instrument carriage 1330 may be translatable relative to the arm assembly 1300, for example, along an insertion axis extending between the proximal and distal ends of the arm assembly 1300 to insert and remove the instrument from the patient's body. In addition, the arm assembly 1300 may provide additional degrees of freedom to orient and position the instrument carriage 1330 and the instrument 1400 at a desired location. When the instrument 1400 is coupled to the instrument carriage 1330, inputs provided by the surgeon to the user control unit 1100 ("master" commands) are converted into corresponding actions of the surgical instrument 1400 ("slave" responses) via the robotic drive outputs 1320 of the instrument carriage 1330, which are operably coupled to inputs on the instrument 1400 (see Figure 5C ).

[0069] Surgical instrument 1400 includes a force transfer mechanism 1700 (see Figure 5B ) and having one or more surgical end effectors at a distal end ( Figure 6A-6C ) (see, e.g. Figure 6A-6C2410 in the figure). One or more actuating elements (such as rods, cables, or the like) coupled to a wrist mechanism and / or an end effector (e.g., see end effectors 4460 and 5460 described herein) at the distal end and coupled to a force transfer mechanism 1700 at the proximal end are used to control the movement of the distal surgical tool. The rod, which may be in the form of a tubular member, may be combined with a cable to provide "push / pull" control of the distal tool end effector, wherein the cable provides a flexible section as needed. In some embodiments, the force transfer mechanism 1700 may be at the proximal end of the instrument, but the present disclosure is not limited thereto or thereby, and in other embodiments, the force transfer mechanism 1700 may be positioned at an intermediate portion of the instrument between the proximal and distal ends of the instrument.

[0070] In order to provide a sterile operating area when using a functional remotely operated surgical system, in some embodiments, a barrier is optionally placed between the non-sterile components of the system and the sterile surgical area. Therefore, a sterile component such as an instrument sterile adapter (ISA) 1340 is optionally placed between the surgical instrument 1400 and the remotely operated surgical instrument manipulator unit 1200. The placement of the instrument sterile adapter 1340 between the surgical instrument 1400 and the surgical instrument manipulator unit 1200 includes the benefit of ensuring a sterile coupling point for the surgical instrument 1400 and the surgical instrument manipulator unit 1200. This allows the surgical instrument 1400 to be removed from the surgical instrument manipulator unit 1200 and exchanged with other surgical instruments during the course of a surgical procedure.

[0071] like Figure 5B and Figure 5C As shown, sterile adapter 1340 is releasably coupled to instrument carriage 1330, and force transfer mechanism 1700 of instrument 1400 is releasably coupled to sterile adapter 1340. More specifically, sterile adapter 1340 includes a pair of latches 1305 ( Figure 5C1700 is a schematic diagram showing a schematic diagram of ... In some embodiments, the latch 1305 and latch receiver 1315 of the sterile adapter 1340 and the coupling portion of the force transfer mechanism 1700 can be the same or similar to the coupling mechanism shown and described, for example, in U.S. Patent No. 10,420,622 (filed on August 24, 2016), entitled “Latch to Secure Teleoperated Surgical Instrument to Actuator,” which is incorporated herein by reference in its entirety.

[0072] like Figure 5C As shown in the exploded view of , the instrument carriage 1330 includes a carriage interface 1335, which includes a robotic drive output 1320 configured to be operably coupled to the input of the instrument at the drive member interface 1725. In embodiments utilizing a sterile adapter, the robotic drive output 1320 can be matingly coupled to the coupler 1325 of the instrument sterile adapter 1340. The instrument carriage 1330 also includes a notch or cutout area 1310 (e.g., Figure 5A ), when the instrument 1400 is coupled to the system, the shaft (not shown) of the instrument 1400 can extend in the notch or cutout area 1310. In some embodiments, the robotic drive output 1320 of the carriage 1330 can be directly coupled to the input of the instrument's drive member interface 1725 without an intermediate sterile adapter 1340.

[0073] Figure 6A-6C is a schematic illustration of a robotic instrument 2400 (also referred to as a "medical device"), a teleoperation system 2000, and a manual drive adapter 2800, according to an embodiment. Fig. 6A The robotic instrument 2400 is illustrated releasably coupled to the teleoperation system 2000 . Figure 6B The robotic device 2400 is shown detached from the teleoperation system 2000, and Figure 6CThe robotic instrument 2400 is illustrated releasably coupled to a manual drive adapter 2800. In some embodiments, the teleoperation system 2000 may include the same or similar components and features as the system 1000 described above. For example, the teleoperation system 2000 may be used to perform a surgical procedure and may include a manipulator unit, a control unit, a series of kinematic linkages and joints, a series of cannulas, or the like. The medical device 2400 (and any instrument described herein) may be used in any suitable surgical system, such as the MIRS system 1000 shown and described above.

[0074] The robotic instrument 2400 includes a force transfer mechanism 2700 having a housing 2760, a drive member interface 2725 coupled to the housing 2760, and one or more input drive members 2710. The robotic instrument 2400 can be releasably coupled to a portion of a teleoperation system 2000, as described above with respect to the system 1000. The robotic instrument 2400 also includes a shaft 2410 coupled to the force transfer mechanism 2700, as described above with respect to the system 1000. Figure 6A-6C The robotic instrument 2400 may include one or more tools (eg, an end effector, not shown, but which may be similar to the end effectors 4460 and 5460 described herein) coupled to the distal end of the shaft 2410 , which may be controlled using the teleoperation system 2000 .

[0075] The teleoperation system 2000 includes one or more robotic drive outputs 2320, each of which can be operably coupled to a corresponding input drive member 2710 of the robotic instrument 2400 when the robotic instrument 2400 is coupled thereto. The drive member interface 2725 can include one or more coupling portions (not shown) that can be releasably coupled to a portion of the teleoperation system 2000. For example, the teleoperation system 2000 can optionally include an instrument carriage (not shown, but which can be similar to the instrument carriage 1330 described above), and the (one or more) robotic drive outputs 2320 can reside in or on the instrument carriage. In some embodiments, the instrument carriage can optionally be coupled to a sterile adapter (not shown) similar to or identical to the sterile adapter 1340 described above.

[0076] As previously mentioned, during a surgical procedure using the teleoperation system 2000 and the robotic instrument 2400, it may be desirable to use a manually actuated medical device to perform some portions of the procedure. The manual drive adapter 2800 may be used for such procedures. The robotic instrument 2400 may be detachable from the teleoperation system 2000, such as Figure 6B and then releasably coupled to the manual drive adapter 2800, as shown Figure 6CThus, the same instrument (i.e., robotic instrument 2400) can be used with teleoperation system 2000 and manually with manual drive adapter 2800. As described in further detail below, manual drive adapter 2800 is configured to couple to the same instrument output of robotic instrument 2400 when instrument 2400 is separated from teleoperation system 2000.

[0077] The manual drive adapter 2800 includes an adapter housing 2810, an output drive interface 2815, and a manual actuator 2820 coupled to one or more output drive members 2822. The robotic instrument 2400 can be releasably coupled to the manual drive adapter 2800 in a manner similar to the coupling of the robotic instrument 2400 to the teleoperation system 2000. For example, in some embodiments, the input drive interface 2815 can include a coupling portion as described above for the sterile adapter 1340 (e.g., a latch 1305 having a latch receiver 1315). The coupling portion of the input drive interface 2815 of the manual drive adapter 2800 can be coupled to a mating coupling portion of the drive member interface 2725 of the robotic instrument 2400. When the robotic instrument 2400 is coupled to the manual drive adapter 2800, the (one or more) input drive members 2710 engage with the output drive members 2822 of the manual drive adapter 2800 so that the robotic instrument can be actuated using the manual actuator 2820. Thus, the robotic instrument 2400 may be releasably coupled to and controlled by the teleoperation system 2000 , and releasably coupled to the manual drive adapter 2800 and controlled by the manual actuator 2820 when separated from the teleoperation system 2000 .

[0078] Figure 7 A robotic instrument 3400 and a manual drive adapter 3800 according to another embodiment are illustrated. As with other embodiments described herein, the robotic instrument 3400 can be releasably coupled to a remote operating system (e.g., system 1000, 2000) and when operated from the remote operating system ( Figure 7 3800) can also be releasably coupled to a manual drive adapter 3800 when removed.

[0079] The robotic instrument 3400 includes a force transfer mechanism 3700, a first input drive component 3710, and a second input drive component 3720, which are, for example, coupled to or disposed within a housing of the force transfer mechanism 3700. In some embodiments, the robotic instrument 3400 may optionally include a shaft 3410 coupled to the force transfer mechanism 3700. The robotic instrument 3400 may include one or more wrist mechanisms and / or end effectors (e.g., similar to the end effectors 4460 and 5460 described herein) coupled to the distal end of the shaft 3410, which may be controlled using a teleoperation system (e.g., teleoperation system 1000 or 2000 described above) and / or using a manual drive adapter 3800.

[0080] The manual drive adapter 3800 includes an adapter housing 3810, a first manual actuator 3820 coupled to a first output drive member 3822, and a second manual actuator 3830 coupled to a second output drive member 3832. The robotic instrument 3400 can be releasably coupled to the manual drive adapter 3800 in a manner similar to the coupling of the robotic instrument 3400 to the teleoperation system, as described for other embodiments. For example, in some embodiments, the manual drive adapter 3800 can include an output drive interface (not shown) that can include a coupling portion (e.g., a latch 1305 having a latch receiver 1315) as described above for the sterile adapter 1340. The coupling portion of the manual drive adapter 3800 can be coupled to a mating coupling portion of a drive member interface (not shown) of the robotic instrument 3400. When the robotic instrument 3400 is coupled to the manual drive adapter 3800, the first input drive member 3710 engages with the first output drive member 3822 of the manual drive adapter 3800, and the second input drive member 3720 engages with the second output drive member 3832 of the manual drive adapter 3800, so that the robotic instrument 3400 can be actuated using the first manual actuator 3820 and the second manual actuator 3830. Therefore, the robotic instrument 3400 can be releasably coupled to the remote operation system and controlled by the remote operation instrument, and when the robotic instrument 3400 is detached from the remote operation system, it can be releasably coupled to the manual drive adapter 3800 and controlled by the manual actuator 3820.

[0081] Fig. 8A and Figure 8B The manual drive adapter 4800 is shown coupled to Fig. 8A Manual drive adapter 4800 in and with Figure 8BAnother embodiment of a robotic instrument 4400 separated from a manual drive adapter 4800 in the embodiment of the present invention. The robotic instrument 4400 can be releasably coupled to a remote operating system and operated by the remote operating system, as described herein for other embodiments. The robotic instrument 4400 can also be releasably coupled to the manual drive adapter 4800 and operated and controlled by a manual actuator of the manual drive adapter 4800. For example, as described herein, during a procedure using a robotic instrument 4400 coupled to and operated by a remote operating system, a surgeon may wish to disconnect from the remote operating system and perform some parts of the procedure using a manual actuation device. The robotic instrument 4400 can be disconnected from the remote operating system and releasably coupled to the manual drive adapter 4800. In some embodiments, the manual drive adapter 4800 can be provided in a sterile kit and provided for a single use. For example, in some embodiments, the manual drive adapter 4800 can be stored in a sterile package before use. The package can be, for example, a sealed biocompatible plastic package that keeps the manual drive adapter 4800 in a sterile environment before use. In some embodiments, the package can be made of a material that prevents microorganisms from being transferred to the package. In use, the manual drive adapter 4800 can first be removed from the sterile packaging and coupled to the robotic instrument, as described above. In other embodiments, the manual drive adapter 4800 (and any manual drive adapter described herein) can include a sterile drape or other suitable barrier to keep the robotic instrument 4400 and / or its coupling position in a sterile environment separate from the manual actuator. In other embodiments, the manual drive adapter 4800 (and any of the manual drive adapters described herein) can be coupled to a separate sterile adapter placed between the robotic instrument 4400 and the manual drive adapter 4800. In other embodiments, the manual drive adapter 4800 can be provided for multiple uses. For example, the manual drive adapter 4800 can be configured to be cleaned and sterilized for repeated use in multiple procedures. In some embodiments, a sterile drape may not be required.

[0082] The robotic instrument 4400 includes a force transfer mechanism 4700, a drive member interface 4725 coupled to the force transfer mechanism 4700, and an axis 4410. The force transfer mechanism 4700 includes a housing 4760 and a first input drive member (not shown) and a second input drive member (not shown) coupled within the housing 4760. In some embodiments, the force transfer mechanism 4700 can have additional input drive members (e.g., three, four, five, or a different number of input drive members). The axis 4410 has a proximal end coupled to the force transfer mechanism 4700 and a distal end coupled to the wrist mechanism 4500 and the end effector 4460. The end effector 4460 includes a first tool 4462 and a second tool (not shown), the first tool 4462 including a gripping tool and the second tool including a cutting tool; however, other tools may be included in addition to or as an alternative to the first and second tools. The cutting tool may be a mechanically actuated blade or an electrocautery tool. The first tool 4462 includes a pair of jaws that open and close to perform a clamping operation, and a second tool is disposed between the opposing jaws and translates in a proximal and distal direction along a longitudinal axis (also referred to as a z-axis) of the jaws. The wrist mechanism 4500 provides articulating motion, and the shaft 4410 can rotate. The jaws of the clamping tool can be operated to clamp tissue, and can additionally be configured to deliver electrosurgical energy to fuse tissue together, for example, to fuse tissue of a anatomical vessel so as to seal the ends of the anatomical vessel. Each jaw can optionally include an electrode that receives energy from an associated electrical conductor. An embodiment of a medical device having a clamping tool and a cutting tool is described below with reference to a robotic instrument 5400. Other example embodiments of such medical devices are described in U.S. Patent No. 9,055,961, entitled “Fusing and Cutting Surgical Instrument and Related Methods” (filed on February 17, 2012), U.S. Patent No. 9,043,027, entitled “Positive Control of Robotic Surgical Instrument End Effector” (filed on May 30, 2012), and U.S. Patent Publication No. 20210177495, entitled “Electrosurgical Instruments for Sealing and Dissecting” (filed on October 30, 2020), the disclosures of each of which are incorporated herein by reference in their entirety.

[0083] The manual drive adapter 4800 includes an adapter housing 4810, an output drive interface 4815 coupled to the adapter housing 4810, a first manual actuator 4820 coupled to a first output drive member (not shown) within the adapter housing 4810, and a second manual actuator 4830 coupled to a second output drive member (not shown) within the adapter housing 4810. The manual drive adapter 4800 also includes a rotation button 4817 that can be coupled to the shaft 4410 and used to manually rotate the shaft 4410 about the longitudinal axis of the shaft 4410 relative to the adapter housing 4810 and lock the shaft 4410 in place. In some embodiments, the button 4817 can drive the roll input end of the shaft 4410 by means of a series of gears (or cables, belts, etc.). In alternative embodiments, the rotation button 4817 can be coupled to an instrument input end that controls the roll of the shaft, rather than being directly coupled to the shaft 4410. The robotic instrument 4400 can be releasably coupled to a teleoperation system (not shown, but which can be similar to teleoperation systems 1000 and 2000), and when separated from the teleoperation system, releasably coupled to the manual drive adapter 4800 in a manner similar to that described herein for other embodiments. For example, in some embodiments, the output drive interface 4815 of the manual drive adapter 4800 can include a coupling portion (e.g., latch 1305) as described above for the sterile adapter 1340. The coupling portion can be coupled to a mating coupling portion of the drive member interface 4725 of the robotic instrument 4400.

[0084] When the robotic instrument 4400 is coupled to the manual drive adapter 4800, the first input drive member of the robotic instrument 4400 engages with the first output drive member of the manual drive adapter 4800, and the second input drive member of the robotic instrument 4400 engages with the second output drive member of the manual drive adapter 4800, so that the robotic instrument 4400 can be actuated using the first manual actuator 4820 and the second manual actuator 4830. More specifically, the first manual actuator 4820 can be used to actuate the first tool 4462 (e.g., to close the jaws of the instrument 4400 and apply a clamping force), and the second manual actuator can be used to actuate the second tool (e.g., to perform a cut once the jaws have been closed) (not shown). Thus, movement of the first manual actuator 4820 by the user causes the first output drive member to move the first input drive member of the robotic instrument 4400 to actuate the first tool 4462 of the end effector 4460. Likewise, movement of the second manual actuator 4820 by the user causes the second output drive member to move the second input drive member of the robotic instrument 4400 to actuate the second tool of the end effector 4460. When the output drive interface 4815 of the manual drive adapter 4800 is coupled to the drive member interface 4725 of the robotic instrument 4400, the input drive member of the robotic instrument 4400 is prevented from engaging with the robotic drive output of the teleoperated surgical system. Figure 9-Figure 22 Further details are provided regarding the components and actuation of manual drive adapter 5800. Manual drive adapter 4800 may include the same or similar components and functionality as manual drive adapter 5800.

[0085] In some embodiments, the wrist mechanism 4500 of the robotic instrument 4400 includes a link (at the distal end of the shaft 4410) coupled to the first tool 4462 and / or the second tool (not shown). Fig. 8A and Figure 8B The link (which may be a U-clip or other suitable kinematic link of the wrist mechanism 4500) is configured to rotate about the rotation axis to move the position of the first tool 4462 and / or the second tool about the rotation axis (e.g., in pitch and / or yaw motion). In some embodiments, the manual drive adapter 4800 includes a third manual actuator ( Fig. 8A and Figure 8B4462 or the second tool 4462 is prevented from moving about the rotation axis. In some embodiments, the manual drive adapter 4800 has a locking mechanism that is incorporated into any manual actuator (e.g., the first manual actuator 4820 or the second manual actuator 4830) or other parts of the manual drive adapter 4800 described herein. The locking mechanism may include a material within the manual actuator, the output drive interface 4815, and / or the coupling member (which fits into the coupling portion of the drive member interface 4725) that has a high coefficient of friction (e.g., a rubber material) so that it holds the wrist in place by friction. In some embodiments, the friction may be high enough to prevent the wrist from moving even by an external or reverse drive force. In some embodiments, the locking component may be configured with a controlled amount of friction that allows the wrist to remain in place and also allows the wrist to be adjusted by the user (e.g., via a reverse drive force or movement of the manual actuator). In other embodiments, the manual drive adapter 4800 has a third manual actuator that can be manually actuated by the user to actuate the wrist.

[0086] In some embodiments, the manual drive adapter 4800 may optionally include a locking mechanism ( Fig. 8A and Figure 8B ), the locking mechanism prevents the second manual actuator 4830 from being actuated unless the first manual actuator 4820 is actuated. For example, the locking mechanism can prevent actuation of the cutting mechanism until the jaws of the end effector are closed. In some embodiments, the manual drive adapter 4800 may include a torque limiter ( Fig. 8A and Figure 8B ), the torque limiter is coupled to the first manual actuator 4820 and is configured to limit the torque applied to the first output drive member when the user moves the first manual actuator. In some embodiments, the torque limiter includes a torsion spring. Such embodiments are described below with reference to the manual drive adapter 5800. In some embodiments, the torque limiter may include a torsion spring as described in U.S. Patent 9,913,694, entitled "Grip Force Control in a Robotic Surgical Instrument," issued on March 13, 2018, the entire disclosure of which is incorporated herein by reference.

[0087] The robotic instrument 4400 may further include a power cord 4434 that may be connected to a power source 4436 such that when the manual drive adapter 4800 is coupled to the robotic instrument 4400, the first tool and / or the second tool may be electrically coupled to the power source 4436. The power source 4436 may be included in the teleoperation system or provided separately. Thus, the robotic instrument 4400 may be releasably coupled to the teleoperation system and controlled by the teleoperation instrument, and releasably coupled to the manual drive adapter 4800 and controlled by the manual actuators 4820 and 4830. Likewise, when the robotic instrument 4400 is coupled to the teleoperation system, the end effector (and tool) may be controlled by the teleoperation system, and when the robotic instrument 4400 is coupled to the manual drive adapter 4800, the end effector (and tool) may also be controlled by the manual drive adapter 4800.

[0088] Figure 9-24B A robotic instrument 5400 and a manual drive adapter 5800 are illustrated according to another embodiment. Fig. 9 and Fig.10 The robotic instrument 5400 is shown coupled to a manual drive adapter 5800. The robotic instrument 5400 can be releasably coupled to and operated by a teleoperation system (not shown), as described herein for other embodiments. The robotic instrument 5400 can also be releasably coupled to the manual drive adapter 5800 and operated and controlled by a manual actuator of the manual drive adapter 5800 described in more detail below.

[0089] The robotic instrument 5400 includes a force transmission mechanism 5700, a drive member interface 5725 coupled to the force transmission mechanism 5700, a wrist mechanism 5500 (see Fig.13A ) and shaft 5410. The force transfer mechanism 5700 includes a housing 5760 and a plurality of input drive members coupled to the housing 5760 or at least partially disposed within the housing 5760. The plurality of input drive members including a first input drive member 5710 and a second input drive member 5720 are arranged in Fig.11 and Fig. 12A The shaft 5410 includes a proximal end coupled to the force transfer mechanism 5700 and a distal end coupled to the wrist mechanism 5500.

[0090] like Figure 13A-13C As shown, the end effector 5460 includes a first tool 5462 and a second tool 5463 (see Fig. 13B), the first tool 5462 includes a clamping tool, and the second tool 5463 includes a cutting element 5482. The cutting tool can be an electrocautery cutting tool. The first tool 5462 includes a pair of jaws 5464 and 5465 that open and close to perform a clamping operation. The jaws 5464 and 5465 of the clamping tool can be operated to clamp tissue, and can additionally and / or optionally be configured to deliver electrosurgical energy to fuse tissue together, for example, to fuse tissue of a anatomical vessel so as to seal the end of the anatomical vessel. For example, each jaw 5464 and 5465 can optionally include an electrode (not shown) that receives energy from an associated electrical conductor. The second tool 5463 is disposed between the relative jaws 5464 and 5465 of the first tool 5462 and translates in the proximal and distal directions along the longitudinal z-axis direction. The second tool 5463 includes a cutting element 5482 and a cutting element drive component 5483. When the second tool 5463 is actuated, the cutting element 5482 moves between a proximal position and a distal position, in which the cutting element 5482 is disposed proximal to the clevis pin 5520 (see Fig. 13B ), in a distal position, the cutting element 5482 is disposed at the distal end of the groove 5467 in the jaw 5462 and a corresponding groove (not shown) in the jaw 5463. Other example embodiments of medical devices having a gripping tool and a cutting tool are described in U.S. Patent Nos. 9,055,961 and 9,043,027 and U.S. Publication No. 20210177495, the disclosures of which are incorporated herein by reference.

[0091] The wrist mechanism 5500 of the robotic instrument 5400 includes a proximal link 5515 rotatably coupled to a distal link 5615 (see Fig.13A). The distal link 5615 is coupled to the distal end of the shaft 5410 via the proximal link 5515, and is coupled to the first tool 5462 and the second tool 5463. The distal link 5615 is configured to rotate about the rotation axis A1 relative to the proximal link 5515 to move the position of the first tool 5462 and the second tool 5463. One or more actuation elements (not shown) (such as cables) are coupled to the input drive members 5710, 5720, extend through the shaft 5410 and the wrist mechanism 5500, and are coupled to the end effector 5460. The cables can be used to control the movement of the end effector 5460. For example, when the input drive members 5710 and 5720 are actuated (e.g., moved), the cables in turn cause movement at the end effector 5460. It should be understood that the input drive members 5710 and 5720 are by way of example, and in some embodiments, additional input drive members of the interface 5725 can be coupled to the end effector 5460. Furthermore, additional actuation elements may be coupled to additional input drive members of the force transfer mechanism 5700 and to the wrist mechanism to control movement of the wrist mechanism.

[0092] The robotic instrument 5400 may also include a power cord 5434 that may be connected to a power source (not shown) such that the first tool 5462 and / or the second tool 5463 may be electrically coupled to the power source when the manual drive adapter 5800 is coupled to the robotic instrument 5400. The power source may be included in the teleoperation system or provided separately.

[0093] The robotic instrument 5400 can be releasably coupled to a teleoperation system and a manual drive adapter 5800 in a similar manner as described herein for other embodiments. As described for other embodiments, the drive member interface 5725 of the robotic instrument 5400 can be coupled to the output drive interface 5815 of the manual drive adapter 5800, as described in more detail below. When the drive member interface 5725 of the robotic instrument 5400 is coupled to the input drive interface 5815 of the manual drive adapter 5800, the input drive members 5710 and 5720 of the robotic instrument 5400 are prevented from engaging with the robotic drive output of a teleoperation surgical system (not shown). The input drive members 5710, 5720 can be actuated using a robotic actuator of the teleoperation system when coupled to the teleoperation system, and can be actuated by a manual actuator of the manual drive adapter 5800 when coupled to the manual drive adapter 5800, as described in more detail below.

[0094] The manual drive adapter 5800 includes an adapter housing 5810, an output drive interface 5815 coupled to the adapter housing, a clamping handle 5824, a first manual actuator 5820 coupled to a first output drive member 5822, and a second manual actuator 5830 coupled to a second output drive member 5832 (see, e.g., Fig.16 , Fig.18 and Fig.21 ). Although the adapter housing 5810 is shown as being coupled to the clamping handle 5824 via one or more rods or structures, in other embodiments, the adapter housing 5810 and the clamping handle 5824 may be integrally constructed (e.g., similar to the structure of the manual drive adapter 4800 described above). The manual drive adapter 5800 may also optionally include a rotation button (not shown) that may be coupled to the shaft 5410 and used to manually rotate the shaft 5410 about the longitudinal axis of the shaft 5410 relative to the adapter housing and lock the shaft 5410 in place. As described above for the previous embodiments, the knob is alternatively coupled to the instrument input that controls the roll of the shaft. In some embodiments, the button may drive the roll input of the shaft 4410 by means of a series of gears (or cables, belts, etc.). The output drive interface 5815 of the manual drive adapter 5800 includes a latch 5805 having a latch receiver 5806. The latch 5805 and latch receiver 5806 can be the same or similar to the latch 1305 and latch receiver 1315 described above for the sterile adapter 1335. The latch 5805 can be used to releasably couple the robotic instrument 5400 to the manual drive adapter 5800 in a manner similar to that described above. More specifically, the drive member interface 5725 of the force transfer mechanism 5700 includes a coupling portion 5735 (see FIG. 57A ) that receives the latch 5805. Fig. 12A and Fig. 12B ) and received within the latch receiver 5806 internal connector 5736 (see Fig. 12B ). For example, the latch receiver 5806 can be coupled to the internal connector 5736 of the drive member interface 5725 using a snap connection. The latch 5805 can be squeezed to release the internal connector 5736 from the latch receiver 5806, thereby separating the robotic instrument 5400 from the manual drive adapter 5800. In some embodiments, the latch 5805 and latch receiver 5806 of the manual drive adapter 5800 and the coupling portion 5735 and internal connector 5736 of the force transfer mechanism 5700 can be the same or similar to the coupling mechanism shown and described in, for example, U.S. Patent No. 10,420,622, which is incorporated herein by reference in its entirety. Fig.16As shown, the output drive interface 5815 also includes a notch or cutout area 5826 into which the shaft 5410 of the robotic instrument 5400 may extend when the robotic instrument 5400 is coupled to the manual drive adapter 5800 .

[0095] When the robotic instrument 5400 is coupled to the manual drive adapter 5800, the first input drive member 5710 of the robotic instrument 5400 engages with the first output drive member 5822 of the manual drive adapter 5800, and the second input drive member 5720 of the robotic instrument 5400 engages with the second output drive member 5832 of the manual drive adapter 5800, so that the robotic instrument 5400 can be actuated using the first manual actuator 5820 and the second manual actuator 5830. More specifically, the first manual actuator 5820 can be used to actuate the first tool 5462 of the robotic instrument 5400, and the second manual actuator 5830 can be used to actuate the second tool 5463 of the robotic instrument 5400. Thus, movement of the first manual actuator 5820 by the user causes the first output drive member 5822 to move (i.e., rotate) the first input drive member 5710 of the robotic instrument 5400 to actuate the first tool 5464 of the end effector 5460. Likewise, movement of the second manual actuator 5820 by the user causes the second output drive member 5832 to move (ie, rotate) the second input drive member 5720 of the robotic instrument 5400 to actuate the second tool 5465 of the end effector 5460 . Fig.14 The first manual actuator 5820 is illustrated in a ready position, and Fig.15 The first manual actuator 5820 is illustrated in an actuated position (as moved by a user).

[0096] In some embodiments, the manual drive adapter 4800 has a locking mechanism that is incorporated into any manual actuator (e.g., the first manual actuator 4820 or the second manual actuator 4830) or other parts of the manual drive adapter 4800 described herein. The locking mechanism may include a material within the manual actuator, the output drive interface 4815, and / or the coupling member (which fits into the coupling portion of the drive member interface 4725) that has a high coefficient of friction (e.g., a rubber material) so that it holds the wrist in place by friction. In some embodiments, the friction may be high enough to prevent the wrist from moving even by an external or reverse drive force. In some embodiments, the locking component may be configured with a controlled amount of friction that allows the wrist to remain in place and also allows the wrist to be adjusted by the user (e.g., via a reverse drive force or movement of the manual actuator). In other embodiments, the manual drive adapter 4800 has a third manual actuator that can be manually actuated by the user to actuate the wrist.

[0097] In some embodiments, the manual drive adapter 5800 includes a third manual actuator (not shown) that can be configured to be manually actuated by a user to lock the link and / or wrist mechanism 5500 in a fixed position relative to the shaft 5410 and prevent at least one of the first tool 5462 or the second tool 5463 from moving about the rotation axis. As described above with respect to the previous embodiments, the manual drive adapter 5800 can include a locking mechanism that is incorporated into any manual actuator (e.g., the first manual actuator 5820 or the second manual actuator 5830) or other parts of the manual drive adapter 5800 described herein. The locking mechanism can include a material within the manual actuator, the output drive interface 5815, and / or the coupling member (which fits into the coupling portion of the drive member interface 5725) that has a high coefficient of friction (e.g., a rubber material) so that it holds the wrist in place by friction. In some embodiments, the friction can be high enough to prevent the wrist from moving even by an external or reverse drive force. In some embodiments, the locking member can be configured with a controlled amount of friction that allows the wrist to remain in position and also allows the wrist to be adjusted by the user (e.g., via a back-drive force or movement of a manual actuator). In other embodiments, the manual drive adapter 5800 has a third manual actuator that can be manually actuated by the user to actuate the wrist.

[0098] In addition, the manual drive adapter 5800 may optionally include a locking mechanism (not shown) that prevents the second manual actuator 5830 from being actuated unless the first manual actuator 5820 is actuated. In other words, in order to actuate the second manual actuator 5830, the first manual actuator 5820 must be in an actuated / moving orientation, such as Fig.15 shown.

[0099] As described above, the first manual actuator 5820 is coupled to the first output drive member 5822, and the second manual actuator 5830 is coupled to the second output drive member 5832. The first output drive member 5822 can actuate the movement of the first tool 5462, and the second output drive member 5832 can actuate the movement of the second tool 5463. As described above and as shown in the figure, for example, in Figure 13A-13C , the first tool 5462 includes a pair of jaws 5464 and 5465 and can be used as a clamping tool, and the second tool 5463 includes a cutting element 5482.

[0100] To actuate and move the first tool 5462 (e.g., a gripping tool) using the manual drive adapter 5800, the user Fig.15As shown, the first manual actuator 5820 is moved (eg, squeezed) toward the clamping handle 5824 so that the first manual actuator 5820 rotates about the axis A2 (see Fig.16 ). The first manual actuator 5820 is coupled to or is part of a torsion spring driver component 5836, which is coupled to a torsion spring 5838. When the first manual actuator 5820 is rotated, the torsion spring driver component 5836 activates the torsion spring 5838 to maintain a constant and limited clamping pressure at the first tool 5462. Therefore, the torsion spring 5838 acts as a torque limiter. In alternative embodiments, other types of torque limiters may be used. The torsion spring 5838 is at the contact point 5841 (see Fig. 20 ) contacts the crown gear 5840, and the torsion spring 5838 drives the crown gear 5840. The crown gear 5840 then drives three transmission gears 5842, 5843 and 5844 (see, for example Figure 21-23 ), the three transmission gears are coupled to the first output drive shaft 5845 (e.g., a gripper drive shaft). The gripper drive shaft 5845 is coupled to the output drive member 5822, which in turn drives the first output drive member 5710 of the robotic instrument 5400. In this way, rotation of the first manual actuator 5820 about the axis A2 causes rotation of the gripper drive shaft 5845 and the output drive member 5822, which in turn rotates the first output drive member 5710. As described above, the first output drive member 5710 is coupled to an actuating element (e.g., a cable), which is coupled to the end effector 5460 and the first tool 5462 and can control the movement of the first tool 5462 (e.g., a gripper tool).

[0101] In order to actuate and move the second tool 5463 (e.g., a cutting tool) using the manual drive adapter 5800, the user must first move the first manual actuator 5820 to a position such as Fig.15 By keeping the first manual actuator 5820 in the actuated position, the user can move the second manual actuator 5830 in the direction toward the first manual actuator 5820. In other words, the user moves the second manual actuator 5830 so that it Fig.15 The rotation direction of the arrow B is about the axis A3 (see Fig.15 ). Fig.24A The second manual actuator 5830 is shown in a ready position, and Fig. 24B The second manual actuator 5830 is illustrated in an actuated position.

[0102] When the second manual actuator 5830 rotates about the axis A3, the second manual actuator 5830 drives the linkage mechanism 5846 coupled to the second manual actuator 5830 to move the linkage mechanism 5846 substantially linearly. The linkage mechanism 5846 includes a pin 5849 disposed in a spiral groove of a spiral member 5848 coupled to a second output drive shaft 5850 (e.g., a cutter drive). Thus, when the linkage mechanism 5846 moves (see, e.g., Fig.24A and Fig. 24B ), corresponding movement of the pin 5849 coupled to the helical groove of the helical member 5848 causes the helical member 5848 to rotate, and thus causes the cutter driver 5850 to rotate. In this way, the rotation of the second manual actuator 5830 causes the linear motion of the linkage 5846, which is converted into the rotational motion of the cutter driver 5850 (see, e.g. Fig.24A and Fig. 24B ). The cutter driver 5850 is coupled to the second output drive member 5832, which in turn drives the second output drive member 5720 of the robotic instrument 5400, which causes the second tool 5463 (e.g., a cutting tool) to translate along the z-axis (i.e., proximally and distally). As described above, the second output drive member 5720 is coupled to an actuating element (e.g., a cable) that is coupled to the end effector 5460 and the second tool 5463 and can control the movement of the second tool 5463 (e.g., and the cutter element 5482) along the z-axis direction (proximally and distally).

[0103] Although various embodiments have been described above, it should be understood that they are presented by way of example only and not limitation. Where the above methods and / or schematics indicate certain events and / or flow patterns occurring in certain sequences, the order of certain events and / or operations may be modified. Although embodiments have been specifically shown and described, it should be understood that various changes in form and detail may be made.

[0104] For example, any instrument described herein (and components therein) is optionally part of a surgical assembly for performing a minimally invasive surgical procedure, and may include a manipulator unit, a series of kinematic linkages, a series of sleeves, or the like. Therefore, any instrument described herein may be used in any suitable surgical system, such as the MIRS system 1000 shown and described above. In addition, any instrument shown and described herein may be used to manipulate target tissue during a surgical procedure. Such target tissue may be cancer cells, tumor cells, lesions, vascular occlusion, thrombosis, stones, uterine fibroids, bone metastasis, adenomyosis, or any other body tissue. The examples of the target tissue presented are not an exhaustive list. In addition, the target structure may also include an artificial substance (or non-tissue) inside the human body or associated with the human body, such as, for example, a part of a stent, an artificial tube, a fastener inside the human body, or the like.

[0105] Any of the components of the surgical instruments described herein may be constructed from any material, such as medical grade stainless steel, nickel alloys, titanium alloys, or the like. In addition, any of the connecting rods, tool members, tensioning members, or components described herein may be constructed from multiple pieces that are subsequently joined together. For example, in some embodiments, a connecting rod may be constructed by joining together separately constructed components. However, in other embodiments, any of the connecting rods, tool members, tensioning members, or components described herein may be constructed integrally.

[0106] Although various embodiments have been described as having specific features and / or combinations of components, other embodiments may also have any combination of features and / or components from any of the embodiments described above. Although aspects have been described in the general context of medical devices, and more specifically surgical instruments, aspects of the invention are not necessarily limited to use in medical devices.

Claims

1. A manual drive adapter for a robotic instrument, comprising: an adapter housing configured to releasably couple to a force transfer mechanism of the robotic instrument, wherein the force transfer mechanism of the robotic instrument includes a robotic drive member interface and a robotic input drive member configured to engage a robotic drive output of a teleoperated surgical system; an adapter output drive interface comprising an adapter output drive member, wherein the adapter output drive interface is coupled to the adapter housing and is configured to releasably couple to the robot drive member interface of the robotic instrument such that the adapter output drive member is engageable with the robot input drive member of the robotic instrument; as well as A manual actuator is operably coupled to the adapter output drive member such that movement of the manual actuator by a user causes the adapter output drive member to operate one or more degrees of freedom of the robotic instrument.

2. The manual drive adapter of claim 1 , wherein the robotic input drive member of the robotic instrument is prevented from engaging a robotic drive output of a teleoperated surgical system when the adapter output drive interface of the manual drive adapter is coupled to the robotic drive member interface of the robotic instrument.

3. The manual drive adapter according to claim 1, wherein: The robotic instrument includes a shaft having a proximal end portion coupled to the robotic input drive member of the robotic instrument and a distal end portion coupled to an end effector, and Movement of the manual actuator by the user causes the adapter output drive member to move the robotic input drive member of the robotic instrument to actuate the end effector.

4. The manual drive adapter according to claim 3, wherein: The end effector includes a gripping tool that is actuated by movement of the manual actuator when the adapter output drive member is coupled to the robotic input drive member of the robotic instrument.

5. The manual drive adapter according to claim 3, wherein: The end effector includes a cutting tool, and movement of the manual actuator actuates the cutting tool to move relative to a jaw of the end effector when the adapter output drive member is coupled to the robotic input drive member of the robotic instrument.

6. The manual drive adapter of claim 1, wherein the adapter output drive interface of the manual drive adapter comprises a plurality of adapter output drive members configured to engage with a plurality of robotic input drive members of the robotic instrument.

7. The manual drive adapter of claim 6, wherein: The robot input drive member is a first robot input drive member of the plurality of robot input drive members of the robotic instrument, the manual actuator is a first manual actuator, and the adapter output drive member is a first adapter output drive member of the plurality of adapter output drive members of the manual drive adapter, the manual drive adapter further comprising: and a second manual actuator operably coupled to a second adapter output drive member of the plurality of adapter output drive members, wherein when the adapter housing is coupled to the force transfer mechanism of the robotic instrument, the second manual actuator can be manually actuatable by the user to cause the second adapter output drive member to move a second input drive member of the plurality of input drive members of the robotic instrument.

8. The manual drive adapter of claim 7, wherein: The robotic instrument includes a shaft having a proximal portion coupled to the force transfer mechanism of the robotic instrument and a distal portion coupled to an end effector of the robotic instrument, the end effector including a gripping tool and a cutting tool; the first manual actuator being configured to manually actuate the gripping tool when the first adapter output drive member is coupled to the first robotic input drive member of the robotic instrument; and The second manual actuator is configured to manually actuate the cutting tool to move relative to the jaws of the gripping tool when the second adapter output drive member is coupled to a second robotic input drive member of the robotic instrument.

9. The manual drive adapter of claim 7, wherein: The robotic instrument includes a shaft having a proximal portion coupled to the force transfer mechanism of the robotic instrument and a distal portion coupled to a wrist mechanism of the robotic instrument, the wrist mechanism being configured to rotate about a rotation axis to move an orientation of the wrist mechanism about the rotation axis; the first manual actuator being configured to manually actuate the wrist mechanism when the first adapter output drive member is coupled to the first robotic input drive member of the robotic instrument; as well as A second manual actuator is configured to cause the wrist mechanism to be locked in a fixed position relative to the shaft.

10. The manual drive adapter of claim 8, wherein: The distal end portion of the shaft is coupled to a link, the link is coupled to the gripping tool and the cutting tool, the link is configured to rotate about a rotation axis to move the orientation of at least one of the gripping tool or the cutting tool about the rotation axis, the manual drive adapter further comprising: A third manual actuator is configured to be manually actuated by the user to lock the connecting rod in a fixed orientation relative to the shaft and prevent at least one of the gripping tool or the cutting tool from moving about the rotational axis.

11. The manual drive adapter according to any one of claims 7 to 10, further comprising: A locking mechanism prevents the second manual actuator from being actuated unless the first manual actuator is actuated.

12. The manual drive adapter according to any one of claims 1 to 5, further comprising: A torque limiter is coupled to the manual actuator and is configured to limit torque applied to the adapter output drive member when the manual actuator is moved by the user.

13. The manual drive adapter of claim 12, wherein the torque limiter comprises a torsion spring.

14. The manual drive adapter according to any one of claims 1 to 5, further comprising: A power connection is configured such that when the adapter housing is coupled to the force transfer mechanism of the robotic instrument, the robotic instrument is electrically coupled to a power source.

15. The manual actuation adapter of any one of claims 1-5, wherein the manual actuation adapter is provided in a sterile kit and is configured for a single use.

16. A manual drive adapter, comprising: an adapter housing configured to releasably couple to a force transfer mechanism of a robotic instrument, the force transfer mechanism of the robotic instrument comprising a first robotic input drive member configured to engage a first robotic drive output of a teleoperated surgical system and a second robotic input drive member configured to engage a second robotic drive output of the teleoperated surgical system; a first manual actuator coupled to the adapter housing and configured to couple to the first robotic input drive member such that movement of the first manual actuator causes the first robotic input drive member to operate a first tool of the robotic instrument; as well as A second manual actuator is coupled to the adapter housing and is configured to couple to the second robotic input drive member such that movement of the second manual actuator causes the second robotic input drive member to operate a second tool of the robotic instrument.

17. The manual drive adapter of claim 16, wherein the robotic instrument comprises a shaft having a proximal portion coupled to the force transfer mechanism of the robotic instrument and a distal portion coupled to a link, the link being coupled to the first tool and configured to rotate about an axis of rotation to move the orientation of the first tool about the axis of rotation, the manual drive adapter further comprising: A third actuator is configured to be manually actuated to lock the connecting rod in a fixed orientation relative to the shaft and prevent the first tool from moving about the rotational axis.

18. The manual drive adapter according to any one of claims 16-17, wherein: The first tool is a gripping tool, movement of the first manual actuator actuates the gripping tool when the adapter housing is coupled to the force transfer mechanism of the robotic instrument, and The second tool is a cutting tool, and movement of the second manual actuator actuates the cutting tool to move relative to the jaws of the gripping tool when the adapter housing is coupled to the force transfer mechanism of the robotic instrument.

19. The manual drive adapter according to any one of claims 16-17, further comprising: A locking mechanism is configured to prevent the second manual actuator from being actuated unless the first manual actuator is actuated.

20. The manual drive adapter according to any one of claims 16-17, further comprising: A torque limiter is coupled to the first manual actuator and is configured to limit torque applied to the first robotic input drive member when the first manual actuator moves.

21. The manual drive adapter according to any one of claims 16-17, further comprising: A power connection is configured such that when the adapter housing is coupled to the force transfer mechanism of the robotic instrument, the second tool is electrically coupled to a power source.

22. The manual actuation adapter of any one of claims 16-17, wherein the manual actuation adapter is provided in a sterile kit and is configured for a single use.

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