Alignment and engagement of remotely actuated surgical instruments

Abstract

The invention relates to alignment and engagement of remotely actuated surgical instruments. An instrument sterile adapter for coupling a surgical instrument with an instrument carriage includes an adapter control surface that extends a control feature of a control surface of the instrument carriage and receives an instrument control surface of the surgical instrument. A curved surface extends from the adapter control surface. The curved surface receives a corresponding curved surface on the instrument control surface. A bullet portion on the curved surface is engageable with a bullet receiving feature in a corresponding curved surface on the instrument control surface. Locating pins or locating slots on the adapter control surface may engage locating slots or locating pins on the instrument control surface. The instrument control surface may be supported by a parking pad on the adapter control surface. A latch arm on the adapter control surface is engageable with a latch seat on the instrument control surface.

Description

[0001] This application is a divisional application of the divisional application 202010993620.5, whose application date is March 17, 2015 and whose invention name is “Alignment and engagement of remotely actuated surgical instruments”. The divisional application 202010993620.5 is a divisional application of the Chinese patent application 201580014408.7 (PCT / US2015 / 020882).

[0002] CROSS-REFERENCE TO RELATED APPLICATIONS

[0003] This application claims priority to the following earlier filed applications:

[0004] US 61 / 954,497 March 17, 2014 (17-03-2014)

[0005] US 61 / 954,502 March 17, 2014 (17-03-2014)

[0006] US 61 / 954,557 March 17, 2014 (17-03-2014)

[0007] US 61 / 954,571 March 17, 2014 (17-03-2014)

[0008] US 61 / 954,595 March 17, 2014 (17-03-2014)

[0009] US 62 / 019,318 June 30, 2014 (30-06-2014)

[0010] US 62 / 103,991 January 15, 2015 (15-01-2015)

[0011] US 62 / 104,306 January 16, 2015 (16-01-2015)

[0012] Each of these applications is specifically incorporated herein by reference to the maximum extent permitted. Technical Field

[0013] Embodiments of the present invention relate to the field of alignment guides; and more particularly, to alignment guides for attaching surgical instruments to remotely controlled actuators. Background Art

[0014] Minimally invasive medical techniques have been used to reduce the amount of external tissue that may be damaged during diagnosis or surgery, thereby reducing the patient's recovery time, discomfort, and harmful side effects. Traditional forms of minimally invasive surgery include endoscopy. One of the more common forms of endoscopy is laparoscopy, which is a minimally invasive examination or surgery within the abdominal cavity. In traditional laparoscopic surgery, gas is insufflated into the patient's abdominal cavity, and a cannula cannula is passed through a small (about 12 mm) incision in the muscle tissue of the patient's abdomen to provide an entry port through which laparoscopic surgical instruments can pass in a sealed manner.

[0015] Laparoscopic surgical instruments generally include a laparoscope for viewing the surgical field and a surgical instrument with an end effector. Typical surgical end effectors include, for example, clamps, graspers, scissors, staplers, and needle holders. These surgical instruments are similar to those used in conventional (open) surgery, except that the working end or end effector of each surgical instrument is separated from its handle by about 30 cm, such as a long extension tube, to allow the operator to introduce the end effector into the surgical site and control the movement of the end effector relative to the surgical site from outside the patient's body.

[0016] In order to provide improved control of the working tool, it may be desirable to control the surgical instrument with a remote actuator. The surgeon can control at a console to indirectly manipulate the instrument connected to the remote actuator. The surgical instrument is detachably coupled to the remote actuator so that the surgical instrument can be sterilized separately and selected for use as the instrument required for the surgical procedure to be performed. The surgical instrument can be replaced during the operation.

[0017] Performing surgery with remotely controlled surgical instruments creates new challenges. One challenge is the need to maintain sterile conditions in the area near the patient. However, the motors, sensors, encoders, and electrical connections necessary to control surgical instruments cannot usually be sterilized using conventional methods (such as steam, heat and pressure, or chemicals) because they would be damaged or destroyed during the sterilization process.

[0018] Another challenge with teleoperated surgical systems is that multiple connections are required between the surgical instrument and the teleoperated actuator and its controller. The connections are required to transmit actuation forces, electrical signals, and data. This complicates the attachment of the surgical instrument to the teleoperated actuator and its controller.

[0019] It would be desirable to provide an easier, more efficient way to engage and disengage a surgical instrument and a remotely actuated drive while preventing contamination of the remotely actuated drive and allowing for quick, reliable attachment of a range of surgical instruments that maintains a sterile field around the surgical instruments. Summary of the invention

[0020] A sterile adapter for connecting a surgical instrument to an instrument carriage includes an adapter control surface that extends the control features of the control surface of the instrument carriage and receives the instrument control surface of the surgical instrument. A curved surface is extended from the adapter control surface. The curved surface receives a corresponding curved surface on the instrument control surface. A bullet portion on the curved surface can engage with a bullet receiving feature in a corresponding curved surface on the instrument control surface. A locating pin or locating slot on the adapter control surface can engage with a locating slot or locating pin on the instrument control surface. The instrument control surface can be supported by a landing pad on the adapter control surface. A latch arm on the adapter control surface can engage with a latch seat on the instrument control surface.

[0021] Other features and advantages of the present invention will become apparent from the accompanying drawings and the following detailed description. BRIEF DESCRIPTION OF THE DRAWINGS

[0022] The present invention may be best understood by reference to the following description and accompanying drawings which illustrate embodiments of the present invention by way of example and not limitation. In the accompanying drawings, like reference numerals represent like elements:

[0023] Figure 1 is an illustrative patient-side portion view of a teleoperated surgical system.

[0024] Figure 2 is a side view of a surgical instrument for use with a remotely operated actuator.

[0025] Figure 3 is a perspective view of a sterile instrument adapter (ISA).

[0026] Figure 4 is a top perspective view of the latch plate.

[0027] Figure 5 is a bottom perspective view of the latch plate.

[0028] Figure 6 It is an elevation view of the latch plate.

[0029] Figure 7 is a perspective view of the control surface of the instrument.

[0030] Figure 8 A plan view of a portion of an instrument's control surface.

[0031] Fig. 9 is a perspective view of the control surface of the instrument.

[0032] Fig.10 It is a side view of ISA.

[0033] Fig.11This is a top view of the ISA.

[0034] Figure 12-15 The control surfaces of the ISA and the corresponding control surfaces of the instrument control surfaces are shown at different stages of engagement. DETAILED DESCRIPTION

[0035] In the following description, a number of specific details are set forth. However, it should be understood that embodiments of the present invention may be practiced without these specific details. In other cases, well-known circuits, structures, and techniques are not shown in detail in order not to obscure the understanding of this specification.

[0036] In the following description, reference is made to the accompanying drawings, which illustrate several embodiments of the present invention. It should be understood that other embodiments may be utilized and that mechanical, structural, electrical, and operational changes may be made without departing from the spirit and scope of the present disclosure. The following detailed description should not be construed as limiting, and the scope of the embodiments of the present invention is solely limited by the claims of the issued patents.

[0037] The terms used herein are only used for the purpose of describing specific embodiments and are not intended to limit the present invention. For ease of description, spatial relative terms such as "below", "below", "lower", "above", "upper", etc. can be used herein to describe the relationship between an element or feature and another (multiple) element or feature, as shown in the figures. It will be understood that these spatial relative terms are intended to cover different orientations of the device in use or operation except for the orientation depicted in the accompanying drawings. For example, if the device is turned over in the accompanying drawings, the elements described as "below" or "below" of other elements or features will be oriented "above" of other elements or features. Therefore, the exemplary term "below" can cover the orientation of the top and bottom. The device can be oriented in addition (e.g., rotated 90 degrees or in other orientations), and the spatial relative descriptors used herein are explained accordingly.

[0038] Unless the context indicates otherwise, as used herein, the singular forms "a", "an", and "the" are intended to include the plural forms as well. It should be further understood that the terms "comprises" and / or "comprising" indicate the presence of stated features, steps, operations, elements, and / or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and / or groups thereof.

[0039] The term "object" generally refers to a component or a group of components. For example, an object may refer to a bag or a boss of a disc within the specification or claims. Throughout the specification and claims, the terms "object", "component", "portion", "portion" and "block" are used interchangeably.

[0040] The terms "instrument" and "surgical instrument" are used herein to describe a medical device configured to be inserted into a patient and used to perform a surgical or diagnostic procedure. The instrument includes an end effector. The end effector can be a surgical tool associated with one or more surgical tasks, such as forceps, needle drivers, scissors, bipolar cautery, tissue stabilizers or retractors, clip appliers, stapling devices, imaging devices (such as endoscopes or ultrasound probes), etc. Some instruments used with embodiments of the present invention further provide an articulated support (sometimes referred to as a "wrist") for the surgical tool so that the position and orientation of the surgical tool can be manipulated with one or more mechanical degrees of freedom relative to the axis of the instrument. Further, many surgical end effectors include functional mechanical degrees of freedom, such as jaws that open or close or knives that translate along a path. The surgical instrument may also contain information stored (e.g., stored on a semiconductor memory within the instrument), which may be permanent or updateable by the surgical system. Therefore, the system can provide one-way or two-way information communication between the instrument and one or more system components.

[0041] The terms "or" and "and / or" as used herein are interpreted to include or mean any one or any combination. Thus, "A, B or C" or "A, B and / or C" means "any of the following: A; B; C; A and B; A and C; B and C; A, B and C". An exception to this definition will occur only if a combination of elements, functions, steps or actions are inherently mutually exclusive in some way.

[0042] Figure 11 is a view of an illustrative patient-side portion 100 of a teleoperated surgical system according to an embodiment of the present invention. The patient-side portion 100 includes a support assembly 110, and one or more surgical instrument manipulators 112 located at the end of each support assembly. The support assembly optionally includes one or more non-powered, lockable setting joints that are used to position the surgical instrument manipulators 112 with reference to the patient undergoing surgery. As depicted, the patient-side portion 100 rests on the floor. In other embodiments, the patient-side portion can be mounted on a wall, a ceiling, an operating table 126 (which also supports the patient's body 122), or other operating room facilities. Further, although the patient-side portion 100 is shown to include four manipulators 112, more or fewer manipulators 112 can also be used. Still further, the patient-side portion 100 can be composed of a single component as shown, or it can include two or more different components, each of which is optionally mounted in a variety of possible ways.

[0043] Each surgical instrument manipulator 112 supports one or more surgical instruments 120 that operate at a surgical site within a patient's body 122. Each manipulator 112 may be provided in a variety of forms that allow the associated surgical instrument to move in one or more mechanical degrees of freedom (e.g., all six Cartesian degrees of freedom, five or fewer Cartesian degrees of freedom, etc.) Typically, mechanical or control constraints restrict each manipulator 112 from moving its associated surgical instrument about a center of motion of the instrument that remains stationary with reference to the patient, and this center of motion is typically located at the location where the instrument enters the body.

[0044] A functional teleoperated surgical system will generally include a visual system portion (not shown) that enables the operator to view the surgical site from outside the patient's body 122. The visual system typically includes a surgical instrument with a video image capture function 128 ("camera") and one or more video displays for displaying the captured images. In some surgical system configurations, the camera 128 includes optics that transmit images from the distal end of the camera 128 to one or more imaging sensors (e.g., CCD or CMOS sensors) outside the patient's body 122. Alternatively, the imaging sensor(s) may be positioned at the distal end of the camera 128, and the signals generated by the sensor(s) may be transmitted along wires or wirelessly for processing and display on the video display. An illustrative video display is a stereoscopic display on a surgeon's console in a surgical system sold by Intuitive Surgical Inc. of Sunnyvale, California.

[0045] The functional teleoperated surgical system will further include a control system portion (not shown) for controlling the movement of the surgical instrument 120 while the instrument is within the patient's body. The control system portion may be located at a single location in the surgical system, or it may be distributed at two or more locations in the system (e.g., in a dedicated system console, or in a separate facility rack, components of the control system portion may be located in the patient side portion 100 of the system). Depending on the degree of control required, the size of the surgical assembly being controlled, and other factors, teleoperated master / slave control may be accomplished in a variety of ways. In some embodiments, the control system portion includes one or more manually operated input devices, such as joysticks, exoskeletal gloves, power and gravity compensating manipulators, and the like. These input devices control teleoperated motors, which in turn control the movement of the surgical instrument.

[0046] The forces generated by the teleoperated motors are transmitted via a powertrain mechanism that transmits the forces from the teleoperated motors to the surgical instrument 120. In some telesurgery embodiments, an input device for controlling the manipulator(s) may be located in or outside the patient's room, remote from the patient. Input signals from the input device are then transmitted to the control system portion. Those familiar with telecontrol, telesurgery, and telepresence surgery will recognize such systems and components thereof, such as the da Surgical systems and originally manufactured by Computer Motion Systems such as surgical systems and components thereof and various illustrative components of such systems.

[0047] As shown, the surgical instrument 120 and the optional entry guide 124 (e.g., a cannula in the patient's abdomen) are both removably coupled to the distal end of the manipulator 112, through which the surgical instrument 120 is inserted. The remote actuators in the manipulator 112 move the surgical instrument 120 as a whole. The manipulator 112 further includes an instrument carriage 130. The surgical instrument 120 is removably connected to the carriage 130. The remote actuators housed in the carriage 130 provide a plurality of control movements that translate the surgical instrument 120 into a variety of movements of the end effector on the surgical instrument. Thus, the remote actuators in the carriage 130 only move one or more components of the surgical instrument 120, rather than moving the instrument as a whole. The input used to control the entire instrument or components of the instrument is such that the input provided by the surgeon to the control system portion ("master" command) is translated into a corresponding action of the surgical instrument ("slave" reaction).

[0048] Figure 2 2 is a side view of an illustrative embodiment of a surgical instrument 120, including a distal portion 250 and a proximal control mechanism 240 coupled via an elongated tube 210. The distal portion 250 of the surgical instrument 120 can provide any of a variety of end effectors, such as forceps 254, a needle driver, a cautery device, a cutting tool, an imaging device (e.g., an endoscope or ultrasound probe), or a combination device including a combination of two or more different tools and imaging devices. In the illustrated embodiment, the end effector 254 is coupled to the elongated tube 210 via a "wrist" 252 that allows the orientation of the end effector to be manipulated with reference to the instrument tube 210.

[0049] The surgical instrument used with the present invention can control its end effector (surgical tool) with multiple rods and / or flexible cables. The rod, which can be in the form of a tube, can be combined with a cable to provide "push / pull" control for the end effector, wherein the cable provides a flexible segment as needed. The typical elongated tube 210 used for the surgical instrument 120 is small, and may be five to eight millimeters in diameter, which is roughly the diameter of a large soda straw. The small size of these mechanisms in the surgical instrument 120 creates unique mechanical conditions and is equipped with the construction of these mechanisms, which is not like those found in similar mechanisms constructed with larger sizes, because the force and strength of the material are not proportional to the size of these mechanisms at the same ratio. These cables must be assembled in the elongated tube 210 and can be bent when it passes through the wrist joint 252.

[0050] In order to provide a sterile operating area while using a functional teleoperated surgical system, a barrier is preferably placed between the non-sterile system and the sterile surgical field. Therefore, a sterile component, such as an instrument sterile adapter (ISA), is placed between the surgical instrument 120 and the teleoperated surgical instrument manipulator 130. Placing an instrument sterile adapter between the surgical instrument 120 and the surgical instrument manipulator 130 includes the benefit of ensuring a sterile connection point between the surgical instrument 120 and the surgical instrument manipulator 130. This allows the surgical instrument to be removed from the surgical instrument manipulator 130 and interchanged with other surgical instruments during surgery.

[0051] Figure 3310 is a perspective view of a setting joint supporting a carriage 130 and in turn supporting a surgical instrument 120 on a pillar 310. In surgical preparation, a sterile drape 300 is used to cover the setting joint. The sterile drape protects the setting joint from contamination and provides a sterile surface around the setting joint. Most of the sterile drapes 300 are plastic sheets that can be in the form of a tube or bag, which cover the arms of the setting joint. For example, a single layer of thermoplastic polyurethane (TPU) can be used. A lubricant can be included to reduce the stickiness of the plastic. The sheet can be about 100 microns (0.004 inches) thick. Other suitable materials can be used for the sheet.

[0052] Figure 4 1 is a partial perspective view of the support 310 of the carriage 130 with the joints provided. The sterile sheet is not shown to allow a clearer view of the carriage 130. A surface 400 of the carriage provides a plurality of mechanical and electrical interfaces for communication of mechanical motion and data signals between the control system, the remote actuator and the surgical instrument. It will be appreciated that the connector to the surgical instrument needs to pass through the sterile sheet. It is difficult to provide a plastic sheet that is compatible with the connector between the carriage 130 and the surgical instrument. Further, the carriage 130 is shaped so as to allow the elongated tube 210 ( Figure 2 ) along one side of the slide through the indentation 410. Due to the shape of the slide, it is difficult to cover the slide with a plastic sheet.

[0053] Figure 5 1 is a perspective view of a portion of the sterile drape that is configured to be placed around the carriage 130. The sterile drape includes three parts. The first part is the plastic sheet 300 as described above. The second part is a pouch 500 that is shaped to fit around the carriage 130. The third part is a primarily rigid instrument sterile adapter (ISA) 510 that engages the control features 400 of the carriage 130 and provides a sterile counterpart to the control features for connection of surgical instruments. The sterile drape is a disposable component.

[0054] The pouch 500 may be made of a material such as molded urethane. The pouch 500 may be flexible, but it should return to its original shape when not stressed. The pouch provides a portion of a sheet that fits loosely around the carriage 130 to provide a clear working space for the remote actuator and surgical instruments.

[0055] An aperture 520 is formed in the plastic sheet 300 where the pouch 500 is connected to the plastic sheet. The plastic sheet may be connected to the pouch by any method compatible with the materials of the sheet and the pouch, such as by heat welding.

[0056] Figure 6is a perspective view of the carriage's control surface 400, the ISA 510, and the proximal control 240 of the surgical instrument rotated to show the instrument control surface 242. The ISA 510 is coupled to the carriage's control surface 400, as suggested in the figure. The ISA 510 provides an adapter control surface that extends the control features of the control surface 400 of the carriage 130 to serve as a sterile primary surface capable of receiving the proximal control 240 of the remotely actuated surgical instrument 120 and engaging with the control features of the instrument control surface 242.

[0057] ISA 510 includes a curved surface 606 that receives a corresponding curved surface 600 on instrument control surface 242 when the instrument is placed on the ISA. The curved surface 606 of the ISA is oriented substantially perpendicular to the adapter control surface. The curved surfaces 600, 606 act in concert with the position of the instrument shaft 210 in the entry guide 124 and the shaft receiving slot 616 in the ISA to position the instrument generally in a plane parallel to the control surface of the ISA. The entry guide 124 constrains the instrument shaft 210 to rotate about the cylindrical axis of the instrument shaft and to translate axially along the cylindrical axis of the instrument shaft. The curved surfaces 600, 606 of the ISA and the instrument control surface 242 tend to constrain the instrument control surface to rotate about the cylindrical axis of the ISA curved surface 606 and to translate along the ISA curved surface. Because the cylindrical axis of the instrument shaft is spaced from the cylindrical axis of the ISA curved surface, they provide an effective constraint on the position of the instrument control surface.

[0058] Further insertion of the instrument shaft 210 into the guide 124 causes the bullet receiving feature 604 of the instrument to engage the bullet portion 608 of the ISA curve 606. This combination more tightly constrains movement of the instrument.

[0059] As the instrument control surface 242 approaches the ISA, the latch arm 614 on the ISA enters the latch seat 618 on the proximal control 240 of the surgical instrument. The latch seat 618 may provide a ramp to further assist in positioning the instrument control surface 242. It should be appreciated that the latch arm 614 is movable and its positioning function is secondary to its primary latching function.

[0060] When the instrument is fully mounted on the ISA control surface, the locating pins 610 on the ISA enter the locating slots 612 on the instrument control surface 242 to tightly constrain the movement of the proximal control 240 in the plane of the instrument control surface 242. The parking pads 602 on the ISA that support the instrument's control surface 242 further constrain the proximal control 240. When the proximal control 240 is locked to the ISA, the parking pads 602 on the ISA tightly constrain the movement of the proximal control 240 perpendicular to the plane of the instrument control surface 242.

[0061] Figure 7 is a perspective view of the instrument control surface 242 as it is initially mounted on the ISA 510. The curved surface 600 on the instrument control surface 242 is shown as it engages with a corresponding curved surface 606 on the ISA 510. The remainder of the proximal control of the surgical instrument is not shown to allow the curved surface 600 on the instrument control surface 242 to be more clearly seen.

[0062] Figure 8 6 is a plan view of a portion of the instrument control surface 242 showing the detent slot 612 that receives the detent pin 610. The lower end of the bullet portion 608 acts somewhat like a pin in a hole, although it is half a pin in a half hole and it does not completely constrain the position of the instrument control surface 242. The bullet portion 608 works with the detent pin 610 and the detent slot 612 to control the orientation of the instrument control surface 242 to rotate in reaction to the applied rotational control torque. The detent slot 612 extends longitudinally only a small amount to compensate for the lack of control of the bullet feature. In another embodiment, not shown, the detent pin is located on the instrument control surface and the detent slot is located on the ISA.

[0063] Fig. 9 is a perspective view of the instrument control surface 242 fully mounted on the ISA 510.

[0064] Fig.10 606 on the ISA 510 provides a locating surface. As the instrument control surface moves closer to the ISA, the bullet portion 608 provides a locating surface. The latch arm 614 helps locate the instrument control surface as it moves closer to the ISA. The locating pin 610 engages the instrument control surface and provides final location and restraint of the instrument control surface 242 as the lower surface reaches the parking pad 602.

[0065] Fig.11 is a top view of ISA 510. The control surfaces have been highlighted with bold lines: parking pad 602, curved surface 606, bullet portion 608, locating pin 610, latch arm 614 and shaft receiving slot 616.

[0066] Figure 12-15 The control surfaces of the ISA 510 and corresponding control surfaces of the instrument control surfaces 242 are shown at different stages of engagement.

[0067] Fig.12 The initial engagement of the instrument control surface 242 with the ISA 510 is shown. The position of the instrument control surface 242 is constrained by the engagement of the curved surface 600 on the instrument control surface 242 with the corresponding curved surface 606 on the ISA 510, and by the instrument shaft 210 and the shaft receiving slot 616 in the instrument guide (not shown). As can be seen, the instrument control surface 242 is only loosely constrained during the initial engagement process. This allows the surgical instrument to be easily engaged with the ISA to initiate the process of accurately positioning the surgical instrument into locking engagement with the ISA. It should be recognized that surgical drapes and other visual obstructions associated with the ISA may require that the surgical instrument be attached to the ISA with little or no view of the surface to be engaged.

[0068] Fig.13 The instrument control surface 242 is shown when the bullet receiving feature 604 on the instrument control surface 242 engages the bullet portion 608 on the ISA 510. As can be seen, engaging the bullet portion 608 greatly increases the restriction on the position of the instrument control surface 242. The leading portion of the bullet portion 608 is tapered to facilitate engagement with the bullet portion. However, the engagement of the curved surface 600 on the instrument control surface 242 with the corresponding curved surface 606 on the ISA 510 allows the instrument control surface to move along the control path, facilitating engagement of the bullet portion 608 even when the bullet receiving feature 604 is not initially aligned with the leading portion of the bullet portion.

[0069] Fig.14 The instrument control surface 242 is shown as the latch arms 614 on the ISA 510 enter the latch seats 618 on the instrument control surface. Although the engagement of the bullet portion 608 is primarily to align the instrument control surface 242 so that the latch arms 614 can easily enter the latch seats 618, the latch seats can be shaped so that engagement of the latch arms can further position the instrument control surface.

[0070] Fig.15The instrument control surface 242 is shown when the locating pin 610 on the ISA 510 has engaged the locating slot 612 on the instrument control surface. Engaging the locating pin 610 on the ISA 510 with the locating slot 612 on the instrument control surface and the bullet receiving feature 604 on the instrument control surface 242 with the bullet portion 608 on the ISA 510 constrains movement between the instrument control surface and the ISA parallel to the plane of the instrument control surface (parallel to the plane in the figure). As previously discussed, the locating pin 610 and bullet portion 608 also provide a torque reaction feature to prevent twisting of the proximal control 240 of the surgical instrument under the action of torque applied to the instrument by the remote actuators when transmitted through the ISA 510.

[0071] Although certain exemplary embodiments have been described and shown in the drawings, it is to be understood that these embodiments are merely illustrative and not restrictive of the broad inventive concept, and that the invention is not limited to the specific constructions and arrangements shown and described, since various other modifications may be made by one of ordinary skill in the art. The description is therefore to be regarded as illustrative and not restrictive.

Claims

1. A method for aligning a surgical instrument with an instrument sterile adapter, the instrument sterile adapter being used to couple the surgical instrument with an instrument carriage, the method comprising: inserting an instrument shaft of the surgical instrument into an entry guide held in a fixed relationship with respect to the instrument carriage and the instrument sterile adapter; Inserting the instrument shaft into the entry guide constrains the surgical instrument to rotation about a first cylindrical axis of the instrument shaft and to axial translation along the first cylindrical axis of the instrument shaft; as well as Pass the instrument shaft of the surgical instrument through the shaft receiving slot of the instrument sterile adapter.

2. The method of claim 1, wherein: The method further includes engaging a curved surface of the instrument sterile adapter with a corresponding curved surface on an instrument control surface of the surgical instrument to constrain rotation about the first cylindrical axis of the instrument shaft; and The curved surface has a second cylindrical axis spaced apart from the first cylindrical axis of the instrument shaft.

3. The method of claim 2, wherein: The method also includes engaging a bullet portion on the curved surface of the instrument sterile adapter with a bullet receiving feature in a corresponding curved surface on the instrument control surface to further constrain the surgical instrument.

4. The method of claim 3, wherein: The method also includes engaging a tapered guide portion of the bullet portion to guide the bullet receiving feature onto the bullet portion.

5. The method according to any one of claims 1 to 4, wherein: The method also includes engaging a detent pin on an adapter control surface of the sterile instrument adapter with a detent slot on the instrument control surface to further restrain the surgical instrument.

6. The method of any one of claims 1 to 4, wherein: The method also includes engaging a detent on an adapter control surface of the sterile instrument adapter with a detent on the instrument control surface to further restrain the surgical instrument.

7. The method of any one of claims 1 to 4, wherein: The method also includes supporting the instrument control surface on a plurality of parking pads on an adapter control surface of the instrument sterile adapter.

8. The method of any one of claims 1 to 4, wherein: The method also includes engaging a latch arm on an adapter control surface of the instrument sterile adapter with a latch seat on the instrument control surface.

9. An instrument sterile adapter for connecting a surgical instrument and an instrument carriage, the instrument sterile adapter comprising: means for extending control features of a control surface of the instrument carriage to an instrument control surface of the surgical instrument; as well as means for receiving the elongated tube of the surgical instrument through the means for extending with the means for extending receiving the instrument control surface; The elongated tube of the surgical instrument couples a control mechanism of the surgical instrument to an end effector of the surgical instrument.

10. The sterile instrument adapter of claim 9, wherein: a first cylindrical axis defined by said elongated tube of said surgical instrument; The instrument sterile adapter further includes means for constraining rotation of the surgical instrument about the first cylindrical axis and axial translation along the first cylindrical axis; The instrument sterile adapter further includes means for limiting an amount of said rotation of said surgical instrument about said first cylindrical axis; The instrument sterile adapter also includes a curved surface; a second cylindrical axis defined by the curved surface of the instrument sterile adapter; and The sterile instrument adapter also includes means for constraining rotation of the surgical instrument about the second cylindrical axis.

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