Adapter for manually actuating surgical instrument

Abstract

An adapter for manually actuating a surgical instrument. 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 robotic input drive member configured to engage with a robotic drive output of the teleoperated surgical system. The adapter output drive member is coupled to the adapter housing. The adapter housing is configured to be releasably coupled to a force transmitting mechanism of the robotic instrument such that the adapter output drive member is engageable with a robotic input drive member of the robotic instrument. The adapter output drive member includes a first plurality of splines configured to matingly engage a second plurality of splines on the robot input drive member such that movement of the adapter output drive member causes the robot input 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 the benefit of priority and the filing date of U.S. Provisional Patent Application No. 63 / 627,189, filed on January 31, 2024, entitled "Adapter for Manual Actuation of Surgical Instrument", the entire content of which is incorporated herein by reference. Technical Field

[0003] The embodiments described herein relate to medical devices and, more particularly, to robotic instruments. More specifically, the 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] In some known medical procedures, a surgeon may use a robotic instrument operably coupled to a remote operating system to perform various medical procedures. In some cases, a surgeon may desire to use a manually - operated medical device (e.g., a device such as a hand - held surgical instrument, where at least a portion of the force generated by a physical input from a user (such as squeezing a trigger, rotating a knob, or pressing an actuator) is transmitted via a mechanical means to the output of the device) to perform some portions of the procedure. For example, a surgeon may wish to use one or more manual instruments in combination with a robotic procedure, where the manual instruments are used simultaneously with the robotic instrument and / or where the robotic instrument is used for one portion of the procedure and the manual instrument is used for another portion of the procedure. For example, a surgeon may wish to open or close the jaws of a non - robotic, manually - actuated energy or non - energy surgical tool (e.g., scissors, grasper, vessel sealer, bipolar, monopolar, harmonic, or other tool) to manually perform aspects of the procedure without using or being coupled to a remote operating system, or to perform aspects that cannot be easily performed using an existing robotic instrument controlled by a remote operating system. This requires a surgeon to use two or more separate instruments to perform a particular medical procedure, one robotic instrument controlled by a remote operating system and a second manual instrument actuated by hand. Alternatively, in some medical procedures, a surgeon may wish to convert the use of an instrument from remote operation control to manual actuation control.

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

[0006] Accordingly, there is a need for an adapter that provides for easy conversion of a robotic tool between use with a remote operating system, in which the robotic tool is operated under the control of the remote operating system, and use with a manual actuator, in which the robotic tool is not controlled by the remote operating system but by manual input provided by a surgeon.

[0007] There is also a desire to provide such a manual adapter that can be coupled to the robotic tool and easily indexed to couple the input drive member of the robotic tool to the output drive member of the manual adapter without using a majority of the actuation stroke of the actuator of the manual adapter. SUMMARY OF THE INVENTION

[0008] This Summary of the Invention introduces certain aspects of the embodiments described herein to provide a basic understanding. This Summary of the Invention is not an extensive overview of the subject matter of the present invention and is not intended to identify key or important elements or to delineate the scope of the subject matter of the present invention.

[0009] 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 includes a robotic input drive member configured to engage a robotic drive output of a remote operating surgical system. An adapter output drive member is coupled to the adapter housing. The adapter housing is configured to be releasably coupled to the force transfer mechanism of the robotic instrument such that the adapter output drive member is capable of engaging the robotic input drive member of the robotic instrument. The adapter output drive member includes a first plurality of splines configured to matingly engage a second plurality of splines on the robotic input drive member such that movement of the adapter output drive member causes the robotic input drive member to operate one or more degrees of freedom of the robotic instrument.

[0010] In some embodiments, when the robotic instrument is not coupled to the remote operating surgical system, the adapter housing can be releasably coupled to the force transfer mechanism of the robotic instrument. In some embodiments, when the adapter output drive member is coupled to the robotic input drive member of the robotic instrument, engagement of the robotic input drive member of the robotic instrument with the robotic drive output of the remote operating surgical system is prevented.

[0011] In some embodiments, the first plurality of splines are located on the outer perimeter of the adapter output drive member, and the second plurality of splines are located on the inner wall of the robotic input drive member. In some embodiments, the first plurality of splines are located on the inner wall of the adapter output drive member, and the second plurality of splines are located on the outer perimeter of the robotic input drive member.

[0012] In some embodiments, the adapter output drive member of the manual drive adapter is a first adapter output drive member, the robotic input drive member of the robotic instrument is a first robotic input drive member, and the robotic drive output of the remote operating surgical system is a first robotic drive output. The manual drive adapter includes a second adapter output drive member, and the force transfer mechanism of the robotic instrument includes a second robotic input drive member configured to engage with a second robotic drive output of the remote operating surgical system. The second adapter output drive member includes a braking portion, and the second robotic input drive member includes a plurality of cavities. The second adapter output drive member is configured to be coupled to the instrument input drive member such that the braking portion is received in one of the plurality of cavities.

[0013] In some embodiments, the braking portion of the second adapter output member is a first braking portion, the second adapter output member includes a second braking portion, and the second adapter output member has a center point. The first braking portion and the second braking portion are both located on the second adapter output member at an equal distance from the center point. In some embodiments, the first braking portion, the second braking portion, and the center point are non - collinear. In some embodiments, the robotic instrument includes a wrist operably coupled to the instrument input drive member, and movement of the wrist is restricted when the braking portion is received in the one of the plurality of cavities. In some embodiments, the braking portion is spring - biased into the one of the plurality of cavities.

[0014] In some embodiments, the manual actuator is coupled to the second adapter output drive member and is configured to be rotated by a user to position the brake portion in one of the plurality of cavities. In some embodiments, the manual actuator is operatively coupled to the adapter output drive member such that movement of the manual actuator by the user causes the adapter output drive member to operate one or more degrees of freedom of the robotic instrument.

[0015] In some embodiments, the adapter output drive member is a first adapter output drive member, the robotic input drive member is a first robotic input drive member, the manual drive adapter further includes a second adapter output drive member, and the robotic instrument includes a second robotic input drive member. The adapter housing is configured to releasably couple to the force transfer mechanism of the robotic instrument such that the second adapter output drive member is capable of engaging the second robotic input drive member of the robotic instrument.

[0016] In some embodiments, the manual drive adapter includes a first manual actuator and a second manual actuator. The first manual actuator is operatively coupled to the first adapter output drive member such that movement of the first manual actuator by the user causes the first adapter output drive member to operate one or more degrees of freedom of the robotic instrument. The second manual actuator is operatively coupled to the second adapter output drive member such that movement of the second manual actuator by the user causes the second adapter output drive member to operate one or more degrees of freedom of the robotic instrument.

[0017] In some embodiments, the second adapter output drive member includes a third plurality of splines configured to matingly engage a fourth plurality of splines on the second robotic input drive member such that movement of the second adapter output drive member causes the second robotic input drive member to operate one or more degrees of freedom of the robotic instrument.

[0018] In some embodiments, 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, and the end effector includes a grasping tool and a cutting tool. The first manual actuator is configured to manually actuate the grasping 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 grasping tool when the second adapter output drive member is coupled to the second robotic input drive member of the robotic instrument.

[0019] In some embodiments, the manual drive adapter is provided within a sterile kit and configured for single use.

[0020] In some embodiments, a device includes a manual adapter configured to releasably couple to a force transfer mechanism of a robotic instrument. The force transfer mechanism of the robotic instrument includes a first robotic input drive member and a second robotic input drive member. The robotic instrument includes a distal bending section operably coupled to the second robotic input drive member. The first robotic input drive member is configured to engage a first robotic drive output of a remote operating surgical system, and the second robotic input drive member is configured to engage a second robotic drive output of the remote operating surgical system. The manual adapter includes a first adapter output drive member and a second adapter output drive member, the first adapter output drive member being configured to engage the first robotic input drive member, and the second adapter output drive member being configured to engage the second robotic input drive member when the manual adapter is releasably coupled to the force transfer mechanism of the robotic instrument. The first adapter output drive member includes a first plurality of splines configured to matingly engage a second plurality of splines on the first robotic input drive member such that movement of the first adapter output drive member causes the first robotic input drive member to operate one or more degrees of freedom of the robotic instrument. The second adapter output drive member includes a brake portion configured to matingly engage a cavity from a plurality of cavities of the second robotic input member to limit movement of the distal bending section.

[0021] In some embodiments, when the robotic instrument is not coupled to the remote operating surgical system, both the first adapter output drive member and the second adapter output drive member are capable of being releasably coupled to the force transfer mechanism of the robotic instrument. In some embodiments, when the first adapter output drive member is coupled to the first robotic input drive member of the robotic instrument and the second adapter output drive member is coupled to the second robotic input drive member of the robotic instrument, engagement of the robotic instrument with the first robotic drive output and the second robotic drive output of the remote operating surgical system is prevented.

[0022] In some embodiments, the first plurality of splines are positioned on an outer perimeter of the first adapter output drive member, and the second plurality of splines are positioned on an inner wall of the first robot input drive member. In some embodiments, the first plurality of splines are positioned on an inner wall of the first adapter output drive member, and the second plurality of splines are positioned on an outer perimeter of the first robot input drive member.

[0023] In some embodiments, the braking portion of the second adapter output member is a first braking portion, the second adapter output member includes a second braking portion, and the second adapter output member has a center point. The first braking portion and the second braking portion are both positioned on the second adapter output member at an equal distance from the center point. In some embodiments, the first braking portion, the second braking portion, and the center point are non - collinear. In some embodiments, the braking portion is biased by a spring into one of the plurality of cavities.

[0024] In some embodiments, the manual adapter includes a first manual actuator and a second manual actuator, the first manual actuator is coupled to the first adapter output drive member, and the second manual actuator is coupled to the second adapter output drive member. The first manual actuator is configured to be actuated by a user to cause the first adapter output drive member to operate one or more degrees of freedom of the robotic instrument, and the second manual actuator is configured to be rotated by the user to position the braking portion in one of the plurality of cavities.

[0025] In some embodiments, the manual adapter includes a third adapter output drive member configured to engage a third robot input drive member of the transfer mechanism of the robotic instrument when the adapter is releasably coupled to the force transfer mechanism of the robotic instrument. In some embodiments, the third adapter output drive member includes a third plurality of splines configured to matingly engage a fourth plurality of splines on the third robot input drive member such that movement of the third adapter output drive member causes the third robot input drive member to operate one or more degrees of freedom of the robotic instrument.

[0026] In some embodiments, the manual adapter includes a first manual actuator, a second manual actuator, and a third manual actuator. The first manual actuator is coupled to the first adapter output drive member, the second manual actuator is coupled to the second adapter output drive member, and the third manual actuator is coupled to the third adapter output drive member. The first manual actuator is configured to be actuated by a user to cause the first adapter output drive member to operate one or more degrees of freedom of the robotic instrument. The second manual actuator is configured to be rotated by the user to position the brake portion in one of the plurality of cavities. The third manual actuator is configured to be actuated by the user to cause the third adapter output drive member to operate one or more degrees of freedom of the robotic instrument.

[0027] In some embodiments, the shaft of the robotic instrument includes a proximal portion coupled to the force transfer mechanism of the robotic instrument and a distal portion coupled to the end effector of the robotic instrument, and the end effector includes a grasping tool and a cutting tool. The manual adapter further includes a first manual actuator and a second manual actuator. The first manual actuator is coupled to the first adapter output drive member and is configured to manually actuate the grasping tool when the first adapter output drive member is coupled to the first robotic input drive member of the robotic instrument. The second manual actuator is coupled to the third adapter output drive member and is configured to manually actuate the cutting tool to move relative to the jaws of the grasping tool when the third adapter output drive member is coupled to the second robotic input drive member of the robotic instrument.

[0028] In some embodiments, a device includes a robotic instrument configured to be releasably coupled to a remote surgical system and a manual adapter. The robotic instrument includes a force transfer mechanism having a first robotic input drive member and a second robotic input drive member. The first robotic input drive member is configured to operate at least a first degree of freedom of the robotic instrument, and the second robotic input drive member is configured to operate at least a second degree of freedom of the robotic instrument. The first robotic input drive member includes a first robotic engagement feature and a first manual engagement feature. The first robotic engagement feature is configured to matingly engage a first engagement feature of a first robotic drive output of the remote surgical system. The first manual engagement feature is configured to matingly engage a first adapter output drive member of the manual adapter. The second robotic input drive member includes a second robotic engagement feature and a second manual engagement feature. The second robotic engagement feature is configured to matingly engage a second engagement feature of a second robotic drive output of the remote surgical system. The second manual engagement feature is configured to matingly engage a second adapter output drive member of the manual adapter. The first manual engagement feature has a geometry different from that of the second manual engagement feature.

[0029] In some embodiments, the first robotic engagement feature and the second robotic engagement feature have the same geometry. In some embodiments, the first manual engagement feature includes a first plurality of splines configured to matingly engage a second plurality of splines on the first adapter output drive member of the manual adapter, and the second manual engagement feature includes a plurality of cavities configured to matingly engage a braking portion on the second adapter output drive member of the manual adapter.

[0030] In some embodiments, a device includes a robotic instrument configured to be releasably coupled to each of a remote surgical system and a manual adapter. The robotic instrument includes a force transfer mechanism having a robotic input drive member configured to operate at least one degree of freedom of the robotic instrument. The robotic input drive member includes a robotic engagement feature and a manual engagement feature. The robotic engagement feature is configured to matingly engage an engagement feature of a robotic drive output of the remote surgical system, and the manual engagement feature is configured to matingly engage an adapter output drive member of the manual adapter. The robotic engagement feature is different from the manual engagement feature. When the robotic engagement feature is matingly engaged with the engagement feature of the robotic drive output of the remote surgical system, the manual engagement feature is prevented from engaging the engagement feature of the robotic drive output of the remote surgical system.

[0031] Clause 1. A manual drive adapter for a robotic instrument, comprising:

[0032] An adapter housing configured to be releasably coupled to a force transfer mechanism of the robotic instrument, wherein the force transfer mechanism of the robotic instrument includes a robotic input drive member configured to engage a robotic drive output of a remote surgical system;

[0033] An adapter output drive member coupled to the adapter housing, wherein the adapter housing is configured to be releasably coupled to the force transfer mechanism of the robotic instrument such that the adapter output drive member can engage the robotic input drive member of the robotic instrument,

[0034] The adapter output drive member includes a first plurality of splines configured to matingly engage a second plurality of splines on the robotic input drive member such that movement of the adapter output drive member causes the robotic input drive member to operate one or more degrees of freedom of the robotic instrument.

[0035] Clause 2. The manual drive adapter according to Clause 1, wherein the adapter housing is capable of being releasably coupled to the force transfer mechanism of the robotic instrument when the robotic instrument is not coupled to the remote surgical system.

[0036] Clause 3. The manually-driven adapter according to Clause 1, wherein when the adapter output drive member is coupled to the robotic input drive member of the robotic instrument, the robotic input drive member of the robotic instrument is prevented from engaging with the robotic drive output of the remote surgical system.

[0037] Clause 4. The manually-driven adapter according to Clause 1, wherein:

[0038] The first plurality of splines are positioned on an outer periphery of the adapter output drive member, and the second plurality of splines are positioned on an inner wall of the robotic input drive member.

[0039] Clause 5. The manually-driven adapter according to Clause 1, wherein:

[0040] The first plurality of splines are positioned on an inner wall of the adapter output drive member, and the second plurality of splines are positioned on an outer periphery of the robotic input drive member.

[0041] Clause 6. The manually-driven adapter according to Clause 1, wherein the adapter output drive member is a first adapter output drive member, the robotic input drive member is a first robotic input drive member, and the robotic drive output is a first robotic drive output, wherein:

[0042] The force transmission mechanism of the robotic instrument includes a second robotic input drive member configured to engage with a second robotic drive output of the remote surgical system,

[0043] The manually-driven adapter includes a second adapter output drive member including a braking portion, the second robotic input drive member includes a plurality of cavities, and

[0044] The second adapter output drive member is configured to be coupled to the second robotic input drive member such that the braking portion is received in one of the plurality of cavities.

[0045] Clause 7. The manually-driven adapter according to Clause 6, wherein the braking portion of the second adapter output member is a first braking portion, the second adapter output member includes a second braking portion, and the second adapter output member has a center point,

[0046] Both the first braking portion and the second braking portion are positioned at an equal distance from the center point.

[0047] Clause 8. The manually driven adapter according to Clause 7, wherein the first braking portion, the central point, and the second braking portion are non - collinear.

[0048] Clause 9. The manually driven adapter according to Clause 6, wherein:

[0049] the robotic instrument includes a wrist that is operably coupled to the instrument input drive member, and

[0050] when the braking portion is received in one of the plurality of cavities, the movement of the wrist is restricted.

[0051] Clause 10. The manually driven adapter according to Clause 6, wherein the braking portion is spring - biased into one of the plurality of cavities.

[0052] Clause 11. The manually driven adapter according to Clause 6, further comprising:

[0053] a manual actuator that is coupled to the second adapter output drive member and is configured to be rotated by a user to position the braking portion in one of the plurality of cavities.

[0054] Clause 12. The manually driven adapter according to Clause 1, further comprising:

[0055] a manual actuator that is operably coupled to the adapter output drive member such that movement of the manual actuator by the user causes the adapter output drive member to operate one or more degrees of freedom of the robotic instrument.

[0056] Clause 13. The manually driven adapter according to Clause 1, wherein the adapter output drive member is a first adapter output drive member and the robotic input drive member is a first robotic input drive member, the manually driven adapter further comprising:

[0057] the adapter includes a second adapter output drive member and the robotic instrument includes a second robotic input drive member, wherein the adapter housing is configured to be releasably coupled to the force - transfer mechanism of the robotic instrument such that the second adapter output drive member can engage with the second robotic input drive member of the robotic instrument.

[0058] Clause 14. The manually driven adapter according to Clause 13, further comprising:

[0059] A first manual actuator operably coupled to the first adapter output drive member such that movement of the first manual actuator by a user causes the first adapter output drive member to operate one or more degrees of freedom of the robotic instrument; and

[0060] A second manual actuator operably coupled to the second adapter output drive member such that movement of the second manual actuator by the user causes the second adapter output drive member to operate one or more degrees of freedom of the robotic instrument.

[0061] Clause 15. The manually driven adapter according to Clause 13, wherein:

[0062] The second adapter output drive member includes a third plurality of splines configured to matingly engage a fourth plurality of splines on the second robotic input drive member such that movement of the second adapter output drive member causes the second robotic input drive member to operate one or more degrees of freedom of the robotic instrument.

[0063] Clause 16. The manually driven adapter according to Clause 14, wherein:

[0064] The robotic instrument includes a shaft having a proximal portion coupled to the force transmission mechanism of the robotic instrument and a distal portion coupled to an end effector of the robotic instrument, the end effector including a grasping tool and a cutting tool;

[0065] The first manual actuator is configured to manually actuate the grasping tool when the first adapter output drive member is coupled to the first robotic input drive member of the robotic instrument; and

[0066] The second manual actuator is configured to manually actuate the cutting tool to move relative to the jaws of the grasping tool when the second adapter output drive member is coupled to a second robotic input drive member of the robotic instrument.

[0067] Clause 17. The manually driven adapter according to any one of Clauses 1-16, wherein the manually driven adapter is provided within a sterile kit and configured for single use.

[0068] Clause 18. An apparatus comprising:

[0069] A manual adapter configured to releasably couple to a force transfer mechanism of a robotic instrument, the force transfer mechanism of the robotic instrument including a first robotic input drive member and a second robotic input drive member, the robotic instrument including a distal bending section operably coupled to the second robotic input drive member, the first robotic input drive member configured to engage a first robotic drive output of a remote operating surgical system, and the second robotic input drive member configured to engage a second robotic drive output of the remote operating surgical system;

[0070] The manual adapter includes a first adapter output drive member and a second adapter output drive member, the first adapter output drive member configured to engage the first robotic input drive member, and the second adapter output drive member configured to engage the second robotic input drive member when the manual adapter is releasably coupled to the force transfer mechanism of the robotic instrument;

[0071] The first adapter output drive member includes a first plurality of splines configured to matingly engage a second plurality of splines on the first robotic input drive member such that movement of the first adapter output drive member causes the first robotic input drive member to operate one or more degrees of freedom of the robotic instrument; and

[0072] The second adapter output drive member includes a braking portion configured to matingly engage one of a plurality of cavities from the second robotic input member to limit movement of the distal bending section.

[0073] Clause 19. The apparatus according to Clause 18, wherein when the robotic instrument is not coupled to the remote operating surgical system, both the first adapter output drive member and the second adapter output drive member are capable of being releasably coupled to the force transfer mechanism of the robotic instrument.

[0074] Clause 20. The apparatus according to Clause 18, wherein when the first adapter output drive member is coupled to the first robotic input drive member of the robotic instrument and the second adapter output drive member is coupled to the second robotic input drive member of the robotic instrument, engagement of the robotic instrument with the first robotic drive output and the second robotic drive output of the remote operating surgical system is prevented.

[0075] Clause 21. The apparatus according to Clause 18, wherein:

[0076] The first plurality of splines are positioned on an outer perimeter of the first adapter output drive member, and the second plurality of splines are positioned on an inner wall of the first robot input drive member.

[0077] Clause 22. The apparatus according to clause 18, wherein:

[0078] The first plurality of splines are positioned on an inner wall of the first adapter output drive member, and the second plurality of splines are positioned on an outer perimeter of the first robot input drive member.

[0079] Clause 23. The manually-driven adapter according to clause 18, wherein the braking portion of the second adapter output member is a first braking portion, the second adapter output member includes a second braking portion, and the second adapter output member has a center point,

[0080] Both the first braking portion and the second braking portion are positioned at an equal distance from the center point.

[0081] Clause 24. The manually-driven adapter according to clause 23, wherein the first braking portion, the center point, and the second braking portion are non-collinear.

[0082] Clause 25. The apparatus according to clause 18, wherein the braking portion is biased by a spring into the one cavity from the plurality of cavities.

[0083] Clause 26. The apparatus according to clause 18, further comprising:

[0084] A first manual actuator coupled to the first adapter output drive member; and

[0085] A second manual actuator coupled to the second adapter output drive member,

[0086] The first manual actuator is configured to be actuated by a user to cause the first adapter output drive member to operate the one or more degrees of freedom of the robotic instrument, and the second manual actuator is configured to be rotated by the user to position the braking portion in the one cavity from the plurality of cavities.

[0087] Clause 27. The apparatus according to clause 18, further comprising:

[0088] A third adapter output drive member configured to engage a third robot input drive member of the transmission mechanism of the robotic instrument when the adapter is releasably coupled to the force transmission mechanism of the robotic instrument.

[0089] Clause 28. The apparatus according to clause 27 further comprises:

[0090] A first manual actuator coupled to the first adapter output drive member;

[0091] A second manual actuator coupled to the second adapter output drive member; and

[0092] A third manual actuator coupled to the third adapter output drive member,

[0093] The first manual actuator is configured to be actuated by a user to cause the first adapter output drive member to operate one or more degrees of freedom of the robotic instrument,

[0094] The second manual actuator is configured to be rotated by the user to position the brake portion in one of the plurality of cavities, and

[0095] The third manual actuator is configured to be actuated by the user to cause the third adapter output drive member to operate one or more degrees of freedom of the robotic instrument.

[0096] Clause 29. The apparatus according to clause 27, wherein:

[0097] The third adapter output drive member includes a third plurality of splines configured to matingly engage a fourth plurality of splines on the third robotic input drive member such that movement of the third adapter output drive member causes the third robotic input drive member to operate one or more degrees of freedom of the robotic instrument.

[0098] Clause 30. The apparatus according to clause 27, wherein:

[0099] The shaft of the robotic instrument includes a proximal portion coupled to the force transmission mechanism of the robotic instrument and a distal portion coupled to the end effector of the robotic instrument, the end effector including a gripping tool and a cutting tool,

[0100] The apparatus further comprises a first manual actuator coupled to the first adapter output drive member and 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

[0101] A second manual actuator, the second manual actuator being coupled to the third adapter output drive member and configured to manually actuate the cutting tool to move relative to the jaws of the gripping tool when the third adapter output drive member is coupled to the second robotic input drive member of the robotic instrument.

[0102] Clause 31. The device according to any one of Clauses 18 - 30, wherein the device is provided within a sterile kit and configured for single use.

[0103] Clause 32. A device comprising:

[0104] A robotic instrument configured to be releasably coupled to a remote - operated surgical system;

[0105] And

[0106] A manual adapter,

[0107] The robotic instrument includes a force - transmission mechanism having a first robotic input drive member and a second robotic input drive member, the first robotic input drive member being configured to operate at least a first degree of freedom of the robotic instrument, and the second robotic input drive member being configured to operate at least a second degree of freedom of the robotic instrument,

[0108] The first robotic input drive member includes a first robotic engagement feature and a first manual engagement feature, the first robotic engagement feature being configured to matingly engage a first engagement feature of a first robotic drive output of the remote - operated surgical system, and the first manual engagement feature being configured to matingly engage a first adapter output drive member of the manual adapter; and

[0109] The second robotic input drive member includes a second robotic engagement feature and a second manual engagement feature, the second robotic engagement feature being configured to matingly engage a second engagement feature of a second robotic drive output of the remote - operated surgical system, and the second manual engagement feature being configured to matingly engage a second adapter output drive member of the manual adapter, the first manual engagement feature having a geometry different from that of the second manual engagement feature.

[0110] Clause 33. The device according to Clause 32, wherein:

[0111] The first robotic engagement feature and the second robotic engagement feature have the same geometry.

[0112] Clause 34. The device according to Clause 32, wherein:

[0113] The first manual engagement feature includes a first plurality of splines configured to matingly engage a second plurality of splines on the first adapter output drive member of the manual adapter; and

[0114] The second manual engagement feature includes a plurality of cavities configured to matingly engage a braking portion on the second adapter output drive member of the manual adapter.

[0115] Clause 35. An apparatus, comprising:

[0116] A robotic instrument configured to be releasably coupled to each of a remote operating surgical system and a manual adapter,

[0117] The robotic instrument includes a force transmission mechanism having a robotic input drive member configured to operate at least one degree of freedom of the robotic instrument, and

[0118] The robotic input drive member includes a robotic engagement feature and a manual engagement feature, the robotic engagement feature being configured to matingly engage an engagement feature of a robotic drive output of the remote operating surgical system, and the manual engagement feature being configured to matingly engage an adapter output drive member of the manual adapter, the robotic engagement feature being different from the manual engagement feature, and

[0119] wherein when the robotic engagement feature matingly engages the engagement feature of the robotic drive output of the remote operating surgical system, the manual engagement feature is prevented from engaging the engagement feature of the robotic drive output of the remote operating surgical system.

[0120] After reading the following drawings and detailed description, other medical devices, related components, medical device systems, and / or methods according to 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 this specification are within the scope of the present disclosure. BRIEF DESCRIPTION OF THE DRAWINGS

[0121] Figure 1 is a plan view of a minimally invasive remote operating medical system for performing a medical procedure such as surgery according to an embodiment.

[0122] Figure 2 is Figure 1 a perspective view of a user console of the minimally invasive remote operating surgical system shown.

[0123] Figure 3 isFigure 1 Perspective view of an optional auxiliary unit of the minimally invasive teleoperated surgical system shown.

[0124] Figure 4 is Figure 1 Front view of a manipulator unit of the minimally invasive teleoperated surgical system shown, including multiple instruments.

[0125] Figure 5A is part of a remote operation system according to an embodiment, showing the instrument carriage of the manipulator unit. Figure 1

[0126] Figure 5B is a view of the instrument carriage shown as coupled to the manipulator unit, a sterile adapter, and a robotic instrument coupled thereto. Figure 5A

[0127] Figure 5C is Figure 5B Exploded view of the instrument carriage, sterile adapter, and robotic instrument.

[0128] Figure 6A Schematic illustration of a robotic instrument coupled to a remote operation system according to an embodiment.

[0129] Figure 6B is a schematic illustration of a robotic instrument shown as disconnected from the remote operation system. Figure 6A

[0130] Figure 6C is a schematic illustration of a robotic instrument shown as coupled to a manual drive adapter according to an embodiment. Figure 6B

[0131] Figure 7 Schematic illustration of a manual drive adapter shown as coupled to a robotic instrument according to an embodiment.

[0132] Figure 8A Illustrates a manual drive adapter shown as coupled to a robotic instrument according to an embodiment.

[0133] Figure 8B Illustrates a manual drive adapter shown as separated from the robotic instrument. Figure 8A

[0134] Figure 9 Side view of a robotic instrument and a manual drive adapter according to an embodiment.

[0135] Figure 10 is Figure 9 Distal perspective view of a part of the robotic instrument and the manual drive adapter.

[0136] Figure 11 is Figure 9 a perspective view of a robotic instrument.

[0137] Figure 12A is Figure 11 an enlarged perspective view of a portion of the robotic instrument.

[0138] Figure 12B is Figure 12A an enlarged perspective view of a portion of the robotic instrument, showing a coupling portion of a drive member interface.

[0139] Figure 13A is Figure 9 a perspective view of the distal portion of the robotic instrument.

[0140] Figure 13B is Figure 9 a perspective view of a portion of the end effector of the robotic instrument, with a portion of the tool member removed for purposes of illustration.

[0141] Figure 13C is Figure 9 a partial exploded view of a portion of the end effector of the robotic instrument.

[0142] Figure 14 is Figure 9 a side view of a manual drive adapter, showing a first manual actuator in an unactuated position.

[0143] Figure 15 is Figure 14 a side view of a manual drive adapter, showing a first manual actuator in an actuated position.

[0144] Figure 16 is Figure 9 a perspective view of a manual drive actuator, showing a proximal view of the output drive interface of the manual drive adapter.

[0145] Figure 17 is Figure 9 a top view of a manual drive adapter.

[0146] Figure 18 is Figure 9 a proximal view of a manual drive adapter, showing a proximal view of the output drive interface.

[0147] Figure 19 is Figure 9 a distal perspective view of a manual drive adapter.

[0148] Figure 20 is Figure 9Distal perspective view of a portion of a manually driven actuator, with selected components removed for purposes of illustration.

[0149] Figure 21 is Figure 9 Distal perspective view of a portion of a manually driven actuator, with selected components removed for purposes of illustration.

[0150] Figure 22 is Figure 9 Distal perspective view of a portion of a manually driven actuator, with selected components removed for purposes of illustration.

[0151] Figure 23 is Figure 9 Distal perspective view of a portion of a manually driven actuator, with selected components removed for purposes of illustration.

[0152] Figure 24A is Figure 9 Perspective view of a portion of a manually driven adapter, illustrating a second manual actuator in a ready position.

[0153] Figure 24B is Figure 9 Perspective view of a portion of a manually driven adapter, illustrating a second manual actuator in an actuated position.

[0154] Figure 25A Schematic illustration of a manually driven adapter coupled to a robotic instrument, according to an embodiment.

[0155] Figure 25B is Figure 25A Schematic illustration of a proximal view of an adapter output drive member of a manually driven adapter.

[0156] Figure 25C is Figure 25A Schematic illustration of a distal view of a robotic input drive member of a robotic instrument.

[0157] Figure 26A Schematic illustration of a manually driven adapter coupled to a robotic instrument, according to an embodiment.

[0158] Figure 26B is Figure 26A Schematic illustration of a proximal view of an adapter output drive member of a manually driven adapter.

[0159] Figure 26C is Figure 26A Schematic illustration of a distal view of a robotic input drive member of a robotic instrument.

[0160] Figure 27ASchematic illustration of a manual drive adapter coupled to a robotic instrument according to an embodiment.

[0161] Figure 27B is Figure 27A Schematic illustration of a proximal view of an adapter output drive member of the manual drive adapter of.

[0162] Figure 27C is Figure 27A Schematic illustration of a distal view of a robotic input drive member of the robotic instrument of.

[0163] Figure 28 Perspective view of a manual drive adapter according to another embodiment.

[0164] Figure 29 is Figure 28 Perspective view of a part of the manual drive adapter of.

[0165] Figure 30 is Figure 28 Enlarged perspective view of a part of the manual drive adapter of.

[0166] Figure 31A and Figure 31B are respectively Figure 28 Perspective view and end view of an adapter output drive member of the manual drive adapter of.

[0167] Figure 32A and Figure 32B are respectively perspective view and end view of an input drive member of a robotic instrument according to an embodiment.

[0168] Figure 33 is Figure 28 the manual drive adapter and Figure 32A and Figure 32B Perspective view of a part of the input drive member of.

[0169] Figure 34 is Figure 28 Enlarged perspective view of a part of the manual drive adapter of.

[0170] Figure 35A and Figure 35B are respectively Figure 28 Perspective view and end view of an adapter output drive member of the manual drive adapter of.

[0171] Figure 36A and Figure 36B are respectively perspective view and end view of an input drive member of a robotic instrument according to another embodiment.

[0172] Figure 37 is Figure 28 the manual drive adapter andFigure 36A and Figure 36B A side perspective view of a portion of the input drive member of

[0173] Figure 38 is Figure 28 the manual drive adapter of Figure 36A and Figure 36B Another side perspective view of a portion of the input drive member of Detailed Description of the Invention

[0174] The embodiments described herein can be advantageously used for various grasping, cutting, and manipulation operations related to 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) (e.g., pitch, yaw, and roll (axial roll)). In some embodiments, there may also be one or more mechanical DOFs within the end effector itself, e.g., two jaws, each jaw rotating relative to the clip (2 DOFs), and a distal clip rotating relative to the proximal clip (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 the movement of the grasping tool, and one DOF for the movement of the blade. In some embodiments, the medical device can include an end effector having a gripper with 2 DOFs and a blade providing 1 DOF. However, in various embodiments, the medical device can have more or fewer DOFs.

[0175] In some embodiments, the medical device of the present application enables the movement of a robotic instrument (also referred to as a medical device) in at least three degrees of freedom (e.g., about the pitch axis, yaw axis, and roll axis). Additionally, the robotic instrument described herein includes one or more actuating elements (such as cables) that can be fixed to a force transmission mechanism of the instrument and fixed to the end effector at the distal end of the robotic instrument. In some embodiments, the force transmission 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 transmission mechanism can be located at an intermediate 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 operating system, and the cables can be driven by one or more actuators (e.g., electric motors) to move the end effector of the robotic instrument.

[0176] In some medical procedures, a surgeon may use a robotic instrument operably coupled to a remote operating system to perform various medical procedures. In some cases, a surgeon may desire to use a manually operated medical device to perform some portions of the procedure. For example, a surgeon may wish to use a non-robotic, manually actuated energy or non-energy surgical tool (e.g., scissors, grippers, vessel sealers, bipolar, monopolar, harmonic, or other tools) to manually perform aspects of the procedure without using the remote operating system, or to perform aspects that cannot be easily performed using existing robotic tools controlled by the remote operating system. In certain cases, a surgeon may use two or more separate tools to perform a particular medical procedure.

[0177] As described herein, a manually actuated adapter is provided for releasably attaching to a robotic instrument to manually hold and actuate the robotic instrument. The robotic instrument may be coupled to and operated by a remote operating system, and the instrument may be detached from the remote operating system and coupled to the manually actuated adapter to perform a portion of a medical procedure. This allows a surgeon to use the same robotic instrument during the robotic portion and the manually operated portion of a medical procedure. The manually actuated adapter can eliminate the time and expense of using a separate new tool, which can provide greater flexibility for 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 a surgeon to use a familiar tool with expected and / or preferred performance within the procedure. In some embodiments, the manually actuated adapter is provided in a sterile kit and is provided for single use.

[0178] As used herein, the term “about” when used in conjunction with a reference numeral indication means plus or minus up to ten percent of the reference numeral indication. For example, the phrase “about 50” encompasses the range of 45 to 55. Similarly, the phrase “about 5” encompasses the range of 4.5 to 5.5.

[0179] As used in this specification and the appended claims, the word “distal” refers to the direction toward the working site, and the word “proximal” refers to the direction away from the working site. Thus, for example, the end of a medical device closest to the target tissue will be the distal end of the medical device, and the end opposite the distal end will be the proximal end of the medical device.

[0180] Moreover, the particular words chosen to describe one or more embodiments and optional elements or features are not intended to limit the invention. For example, spatial relative terms such as "below", "beneath", "lower", "above", "upper", "proximal", "distal", etc. may be used to describe the relationship of one element or feature to another shown in the figures. These spatially relative terms are intended to cover different positions (i.e., translational placement) and orientations (i.e., rotational placement) of the device in use or operation in addition to the positions and orientations shown in the figures. For example, if the device in the figure is inverted, an element described as "below" or "beneath" other elements or features will be "above" or "over" the other elements or features. Thus, the term "below" can include both above and below positions and orientations. The device may be oriented in other ways (e.g., rotated 90 degrees or in other orientations), and the spatially relative descriptors used herein are to be interpreted accordingly. Similarly, descriptions of movement along (translation) and around (rotation) various axes include a variety of spatial positions and orientations. A combination of the position and orientation of a body defines the pose of the body.

[0181] Similarly, unless the context clearly indicates otherwise, geometric terms such as "parallel", "perpendicular", "circular", or "square" are not intended to require absolute mathematical precision. Instead, such geometric terms allow for variations due to manufacturing or equivalent functionality. For example, if an element is described as "circular" or "substantially circular", the description still includes components that are not precisely circular (e.g., slightly oval or polygonal components).

[0182] In addition, unless the context clearly indicates otherwise, the singular forms "a", "an", and "the" are intended to also include the plural forms. The terms "comprising", "including", "having", etc. specify the presence of the stated features, steps, operations, elements, and / or components, etc., but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, or groups.

[0183] Unless otherwise specified, the terms "apparatus", "medical device", "medical instrument", and their variants may be used interchangeably.

[0184] Aspects of the invention are mainly described in terms of the use of a surgical system, which is sold by Intuitive Surgical, Inc. of Sunnyvale, California. Examples of such surgical systems are the da Vinci Surgical system (Model IS4200) and da Vinci Surgical system (Model IS3000). However, those skilled in the art will understand that the various inventive aspects disclosed herein can be embodied and implemented in various ways, including computer-aided, non-computer-aided, and hybrid combinations of manual and computer-aided embodiments and implementations. Regarding da Embodiments of the da 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 as limiting the scope of the various inventive aspects disclosed herein. Where applicable, the aspects of the present invention can be embodied and implemented in relatively small hand-held manual operating devices that are not mechanically grounded in the world reference frame and relatively large systems having additional mechanical supports that are grounded in the world reference frame.

[0185] Figure 1A plan view illustration of a remotely operated surgical system 1000 (“remote surgical system”) that is operated at least in part with computer assistance. The remote surgical system 1000 and its components are all considered medical devices. The remote operating 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 accessory device 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 natural orifice in the body of the patient P. Images of the surgical site are obtained by an endoscope such as a stereoscopic endoscope (not shown), which can be manipulated by the manipulator unit 1200 to orient the endoscope. The accessory device unit 1150 can be used to process images of the surgical site for subsequent display to the surgeon S through the user control unit 1100. The number of single-use instruments 1400 will typically depend on the diagnostic or surgical procedure and space limitations in the operating room and other factors. If it is necessary to replace one or more of the instruments 1400 being used during the procedure, an assistant removes the instrument 1400 from the manipulator unit 1200 and replaces it with another instrument 1400 from a tray 1020 in the operating room. Although shown as being used with the instrument 1400, any of the instruments described herein can be used with the MIRS 1000.

[0186] Figure 2 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 the surgeon S with a coordinated stereoscopic view of the surgical site 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 1manipulates one or more tools. The 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 telepresence for the surgeon S, or a sense 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 sensations, are returned from the instrument 1400 to the surgeon's hand through one or more input control devices 1116.

[0187] The user control unit 1100 is shown in Figure 1 the same room as the patient so that the surgeon S can directly monitor the procedure, be physically present if necessary or desired, and can directly communicate with an assistant, rather than via telephone or other communication media. However, in other embodiments, the user control unit 1100 and the surgeon S can be in a different room from the patient, in a completely different building, or at some other location remote from the patient, thereby allowing a remote surgical procedure.

[0188] Figure 3 is a perspective view of the auxiliary device unit 1150. The auxiliary device 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 suitable 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 using a stereoscopic endoscope, the auxiliary device 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 the relative images and can include adjusting the stereoscopic working distance of the stereoscopic endoscope. As another example, image processing can include using previously determined camera calibration parameters to compensate for imaging errors of the image capture device, such as optical aberrations.

[0189] Figure 4A front perspective view of the manipulator unit 1200 is shown. The manipulator unit 1200 includes components for providing manipulation of the instrument 1400 (e.g., arms, linkages, motors, sensors, etc.) and an imaging device (not shown) for capturing images of the site of the procedure, such as a stereoscopic endoscope. Specifically, the instrument 1400 and the imaging device can be manipulated by a remote operation mechanism having one or more mechanical joints. In addition, the instrument 1400 and the imaging device are positioned and manipulated through an incision or a natural orifice in the patient P in such a way that the center of motion, which is remote from the manipulator and is typically located along the axis of the instrument, is held at the incision or orifice by kinematic mechanical constraints or software constraints. In this way, the incision size can be minimized.

[0190] Figure 5A is a perspective view of a part of the arm assembly 1300 and the instrument carriage 1330 to which the instrument 1400 can be removably coupled. The instrument carriage 1330 includes a remote operation actuator to provide control motion to the instrument 1400, and this control motion is translated into various movements of one or more tools at the distal end of the instrument 1400. The arm assembly 1300 includes a connecting portion 1324 in which the instrument carriage 1330 can be coupled. The instrument carriage 1330 can be translated 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 the instrument into and remove the instrument from the patient. Additionally, the arm assembly 1300 can provide additional degrees of freedom to orient and position the instrument carriage 1330 and the instrument 1400 at a desired position. When the instrument 1400 is coupled to the instrument carriage 1330, an input (“master” command) provided by the surgeon to the user control unit 1100 is converted via the robotic drive output 1320 of the instrument carriage 1330 into a corresponding action (“slave” response) of the surgical instrument 1400, and the robotic drive output 1320 is operably coupled to an input on the instrument 1400 (see Figure 5C ).

[0191] The surgical instrument 1400 includes a force transmission mechanism 1700 (see Figure 5B ) and an elongate shaft having one or more surgical end effectors at the distal end (not shown in Figure 6A - 6C ), see, for example, Figure 6A - 6CThe shaft 2410). One or more actuating elements (such as rods, cables, etc.) that are coupled to the wrist mechanism and / or the end effector at the distal end (for example, see the end effectors 4460 and 5460 described herein) and are coupled to the force transmission mechanism 1700 at the proximal end are used to control the movement of the distal surgical tool. A 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, where the cable provides a flexible section as needed. In some embodiments, the force transmission mechanism 1700 may be at the proximal end of the instrument, but the present disclosure is not limited to or thereby, and in other embodiments, the force transmission mechanism 1700 may be located at an intermediate portion of the instrument between the proximal and distal ends of the instrument.

[0192] To provide a sterile operating area when using a functional teleoperated surgical system, in some embodiments, optionally, a barrier is placed between the non-sterile components of the system and the sterile surgical area. Thus, sterile components such as the Instrument Sterile Adapter (ISA) 1340 are optionally placed between the surgical instrument 1400 and the teleoperated 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 ensuring the benefits of 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.

[0193] As Figure 5B and Figure 5C shown, the sterile adapter 1340 is releasably coupled to the instrument carriage 1330, and the force transmission mechanism 1700 of the instrument 1400 is releasably coupled to the sterile adapter 1340. More specifically, the sterile adapter 1340 includes a pair of latches 1305 having latch receivers 1315 ( Figure 5C(only one is shown in the figure). The force transmission mechanism 1700 includes a housing 1760 and a drive member interface 1725 coupled to the distal portion of the housing 1760. The drive member interface 1725 includes a coupling portion (not shown) that is matingly coupled to the latch 1305 and has a connector received within the latch receiver 1315 of the latch 1305. For example, the latch receiver 1315 may be coupled to the coupling portion of the drive member interface 1725 using a snap connection. The latch 1305 may be squeezed to release the latch from the coupling portion of the drive member interface 1725, thereby separating the robotic instrument 1400 from the sterile adapter 1340. In some embodiments, the latch 1305 and latch receiver 1315 of the sterile adapter 1340 and the coupling portion of the force transmission mechanism 1700 may be the same as or similar to the coupling mechanism shown and described, for example, in U.S. Patent No. 10,420,622, filed August 24, 2016, entitled "Latch to Secure Teleoperated Surgical Instrument to Actuator", which is incorporated herein by reference in its entirety.

[0194] As Figure 5C shown in the exploded view of, the instrument carriage 1330 includes a carriage interface 1335 that includes a robotic drive output 1320 configured to be operatively coupled to the input end of the instrument at the drive member interface 1725. In embodiments that utilize a sterile adapter, the robotic drive output 1320 may be matingly coupled to the coupler 1325 of the instrument sterile adapter 1340. The instrument carriage 1330 also includes a notch or cutout region 1310 (as Figure 5A shown) through which an axis (not shown) of the instrument 1400 may extend when the instrument 1400 is coupled to the system. In some embodiments, the robotic drive output 1320 of the carriage 1330 may be directly coupled to the input end of the drive member interface 1725 of the instrument without an intervening sterile adapter 1340.

[0195] Figure 6A - 6C is a schematic illustration of a robotic instrument 2400 (also referred to as a "medical device"), a remote operating system 2000, and a manual drive adapter 2800 according to an embodiment. Figure 6A Illustrated is the robotic instrument 2400 releasably coupled to the remote operating system 2000. Figure 6B Illustrated is the robotic instrument 2400 detached from the remote operating system 2000, and Figure 6CIllustrated is a robotic instrument 2400 that is releasably coupled to a manual drive adapter 2800. In some embodiments, the remote operating system 2000 may include components and features that are the same as or similar to those of the system 1000 described above. For example, the remote operating 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, etc. 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.

[0196] The robotic instrument 2400 includes a force transmission mechanism 2700 that has 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 may be releasably coupled to a portion of the remote operating system 2000, as described above for the system 1000. The robotic instrument 2400 further includes a shaft 2410 coupled to the force transmission mechanism 2700, as Figure 6A - 6C shown. The robotic instrument 2400 may include one or more tools (e.g., end effectors, 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, and the one or more tools may be controlled using the remote operating system 2000.

[0197] The remote operating system 2000 includes one or more robotic drive outputs 2320, and each robotic drive output 2320 may 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 may include one or more coupling portions (not shown) that may be releasably coupled to a portion of the remote operating system 2000. For example, the remote operating system 2000 may optionally include an instrument carriage (not shown, but which may be similar to the instrument carriage 1330 described above), and the (one or more) robotic drive outputs 2320 may reside within or be attached to the instrument carriage. In some embodiments, the instrument carriage may optionally be coupled to a sterile adapter (not shown) that is similar to or the same as the sterile adapter 1340 described above.

[0198] As previously described, during a surgical procedure using the remote operating 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 a procedure. The robotic instrument 2400 may be detached from the remote operating system 2000, as Figure 6B shown, and then releasably coupled to the manual drive adapter 2800, as Figure 6CAs shown. Thus, the same instrument (i.e., robotic instrument 2400) can be used with the remote operating system 2000 and manually with the manual drive adapter 2800. As described in further detail below, the manual drive adapter 2800 is configured to couple to the same instrument output of the robotic instrument 2400 when the instrument 2400 is detached from the remote operating system 2000.

[0199] 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 how the robotic instrument 2400 is coupled to the remote operating system 2000. For example, in some embodiments, the output drive interface 2815 of the manual drive adapter 2800 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 input drive interface 2815 of the manual drive adapter can be coupled to the 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 the output drive members 2822 of the manual drive adapter 2800 such that the robotic instrument can be actuated using the manual actuator 2820. Thus, the robotic instrument 240 can be releasably coupled to and controlled by the remote operating system 2000, and releasably coupled to the manual drive adapter 2800 and controlled by the manual actuator 2820 when detached from the remote operating system 2000.

[0200] Figure 7 Illustrated is a robotic instrument 3400 and a manual drive adapter 3800 according to another embodiment. As with other embodiments described herein, the robotic instrument 3400 can be releasably coupled to a remote operating system (e.g., systems 1000, 2000), and can also be releasably coupled to the manual drive adapter 3800 when detached from the remote operating system ( Figure 7 (not shown).

[0201] The robotic instrument 3400 includes a force transmission mechanism 3700, a first input drive member 3710, and a second input drive member 3720. The first input drive member 3710 and the second input drive member 3720 are, for example, coupled to the housing of the force transmission mechanism 3700 or disposed within the housing of the force transmission mechanism 3700. In some embodiments, the robotic instrument 3400 may optionally include a shaft 3410 coupled to the force transmission 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 remote operating system (e.g., the remote operating systems 1000 or 2000 described above) and / or using a manual drive adapter 3800.

[0202] 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 may be releasably coupled to the manual drive adapter 3800 in a manner similar to how the robotic instrument 3400 is coupled to a remote operating system, as described for other embodiments. For example, in some embodiments, the manual drive adapter 3800 may include an output drive interface (not shown) that may 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 may 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 of the robotic instrument 3400 engages the first output drive member 3822 of the manual drive adapter 3800, and the second input drive member 3720 of the robotic instrument 3400 engages the second output drive member 3832 of the manual drive adapter 3800, such that the robotic instrument 3400 can be actuated using the first manual actuator 3820 and the second manual actuator 3830 of the manual drive adapter 3800. Thus, the robotic instrument 3400 may be releasably coupled to a remote operating system and controlled by a remote operating instrument, and when the robotic instrument 3400 is detached from the remote operating system, it may be releasably coupled to the manual drive adapter 3800 and controlled by the manual actuator 3820.

[0203] Figure 8A and Figure 8B illustrates a manual drive adapter 4800 and coupled to Figure 8A the manual drive adapter 4800 in and associated with Figure 8BAnother embodiment of the robotic instrument 4400 separated from the manual drive adapter 4800 in []. 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 the manual actuator of the manual drive adapter 4800. For example, as described herein, during a procedure using the 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 portions 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 single use. For example, in some embodiments, the manual drive adapter 4800 can be stored within a sterile package prior to use. The package can be, for example, a sealed biocompatible plastic package that maintains the manual drive adapter 4800 in a sterile environment prior to use. In some embodiments, the package can be constructed of a material that prevents the transfer of microorganisms into the package. In use, the manual drive adapter 4800 can first be removed from the sterile package 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 maintain the robotic instrument 4400 and / or its coupling location 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.

[0204] The robotic instrument 4400 includes a force transfer mechanism 4700, a drive member interface 4725 coupled to the force transfer mechanism 4700, and a shaft 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 may have additional input drive members (e.g., three, four, five, or a different number of input drive members). The shaft 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 includes a grasping tool, and the second tool includes a cutting tool; however, other tools may be included in addition to or in place of 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 grasping operation, and the second tool is disposed between the opposing jaws and translates in proximal and distal directions along the longitudinal axis of the jaws (also referred to as the z-axis). The wrist mechanism 4500 provides articulating movement, and the shaft 4410 is rotatable. The jaws of the grasping tool can be operated to grasp tissue and may additionally be configured to deliver electrosurgical energy to fuse the tissue together, e.g., to fuse the tissue of an anatomical vessel in order to seal the ends of the anatomical vessel. Each jaw may optionally include an electrode that receives energy from an associated electrical conductor. Embodiments of a medical device having a grasping tool and a cutting tool are described below with reference to the robotic instrument 5400. Other example embodiments of such medical devices are described in U.S. Patent No. 9,055,961, filed February 17, 2012, titled "Fusing and Cutting Surgical Instrument and Related Methods", U.S. Patent No. 9,043,027, filed May 30, 2012, titled "Positive Control of Robotic Surgical Instrument End Effector", and U.S. Patent Publication No. 20210177495, filed October 30, 2020, titled "Electrosurgical Instruments for Sealing and Dissecting", the respective disclosures of which are incorporated herein by reference in their entirety.

[0205] 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 knob 4817 that may be coupled to the shaft 4410 and is 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 knob 4817 may drive the roll input of the shaft 4410 by means of a series of gears (or cables, belts, etc.). In alternative embodiments, the knob 4817 may be coupled to an instrument input for controlling shaft roll rather than directly to the shaft 4410. The robotic instrument 4400 may be releasably coupled to a remote operating system (not shown, but which may be similar to the remote operating systems 1000 and 2000), and when separated from the remote operating system, is 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 may include a coupling portion (e.g., latch 1305) as described above for the sterile adapter 1340. The coupling portion may be coupled to a mating coupling portion of the drive member interface 4725 of the robotic instrument 4400.

[0206] When the robotic instrument 4400 is coupled to the manual drive adapter 4800, the first input drive member of the robotic instrument 4400 engages the first output drive member of the manual drive adapter 4800, and the second input drive member of the robotic instrument 4400 engages the second output drive member of the manual drive adapter 4800, such 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 a second tool (e.g., to cut using a cutting element 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. Similarly, 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, engagement of the input drive members of the robotic instrument 4400 with the robotic drive output of the remote operating surgical system is prevented. Referring below to Figure 9 - 22 provides further details regarding the components and actuation of the manual drive adapter 5800. The manual drive adapter 4800 can include components and functions that are the same as or similar to those of the manual drive adapter 5800.

[0207] In some embodiments, the wrist mechanism 4500 of the robotic instrument 4400 includes a linkage (not identified in Figure 8A and 8B coupled to the distal end of the shaft 4410 and to the first tool 4462 and / or a second tool (not shown). The linkage, which can be a U-shaped clamp or other suitable kinematic linkage of the wrist mechanism 4500, is configured to rotate about a rotational axis to move the position of the first tool 4462 and / or the second tool about the rotational axis (e.g., in a pitch and / or deflection motion). In some embodiments, the manual drive adapter 4800 includes a third manual actuator ( Figure 8A and Figure 8B(not shown in the figure). The third manual actuator can be configured to be manually actuated by a user to lock the linkage in a fixed position relative to the shaft 4410 and prevent at least one of the first tool 4462 or the second tool from moving about the axis of rotation. In some embodiments, the manual drive adapter 4800 has a locking mechanism incorporated into any of the manual actuators (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 can include a material within the manual actuator, the output drive interface 4815, and / or the coupler (which mates to the coupling portion of the drive member interface 4725) that has a high coefficient of friction (e.g., a rubber material) such that it holds the wrist in place by friction. In some embodiments, the friction can be high enough such that the wrist can be prevented from moving even by an external or reverse driving force. In some embodiments, the locking member can be configured with a controlled amount of friction that allows the wrist to be held in place and also allows the wrist to be adjusted by the user (e.g., via a reverse driving 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.

[0208] In some embodiments, the manual drive adapter 4800 can optionally include a latching mechanism ( Figure 8A and Figure 8B (not shown in the figure) that prevents the second manual actuator 4830 from being actuated unless the first manual actuator 4820 is actuated. For example, the latching 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 can include a torque limiter ( Figure 8A and Figure 8B (not shown in the figure) that 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 can include a torsion spring as described in U.S. Patent No. 9,913,694, titled "Grip Force Control in a Robotic Surgical Instrument," issued on March 13, 2018, the entire disclosure of which is incorporated herein by reference.

[0209] The robotic instrument 4400 may also 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 remote operating system or provided separately. Thus, the robotic instrument 4400 may be releasably coupled to the remote operating system and controlled by the remote operating instrument, and may be releasably coupled to the manual drive adapter 4800 and controlled by the manual actuators 4820 and 4830. Similarly, when the robotic instrument 4400 is coupled to the remote operating system, the end effector (and tools) may be controlled by the remote operating system, and when the robotic instrument 4400 is coupled to the manual drive adapter 4800, the end effector (and tools) may also be controlled by the manual drive adapter 4800.

[0210] Figure 9 - 24B Illustrated is a robotic instrument 5400 and a manual drive adapter 5800 according to another embodiment. Figure 9 and Figure 10 Shown is the robotic instrument 5400 coupled to the manual drive adapter 5800. The robotic instrument 5400 may be releasably coupled to a remote operating system (not shown) and operated by the remote operating system, as described herein for other embodiments. The robotic instrument 5400 may also be releasably coupled to the manual drive adapter 5800 and operated and controlled by the manual actuators of the manual drive adapter 5800 described in more detail below.

[0211] 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 Figure 13A ), and a shaft 5410. The force transmission 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 depicted in Figure 11 and Figure 12A and discussed in more detail below. The shaft 5410 includes a proximal end coupled to the force transmission mechanism 5700 and a distal end coupled to the wrist mechanism 5500.

[0212] As Figure 13A - 13C shown, the end effector 5460 includes a first tool 5462 and a second tool 5463 (see Figure 13B), the first tool 5462 includes a grasping tool, and the second tool 5463 includes a cutting element 5482. The cutting tool can be, for example, an electrocautery cutting tool or a mechanical cutting tool. The first tool 5462 includes a pair of jaws 5464 and 5465 that open and close to perform a grasping operation. The jaws 5464 and 5465 of the grasping tool can be operated to grasp tissue and, additionally and / or optionally, can be configured to deliver electro-surgical energy to fuse the tissue together, for example, to fuse the tissue of an anatomical blood vessel in order to seal the ends of the anatomical blood vessel. For example, each of the jaws 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 opposing 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 member 5483. When the second tool 5463 is actuated, the cutting element 5482 moves between a proximal position and a distal position, in the proximal position, the cutting element 5482 is disposed within a notch 5521 in a proximal staple pin 5520 (see Figure 13B ), and in the distal position, the cutting element 5482 is disposed at the distal end of a groove 5467 in the jaw 5464 and at a corresponding groove (not shown) in the jaw 5465. Other example embodiments of medical devices having a grasping 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.

[0213] The wrist mechanism 5500 of the robotic instrument 5400 includes a proximal link 5515 rotatably coupled to a distal link 5615 (see Figure 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 axis of rotation A1 relative to the proximal link 5515 to move the positions 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. Additionally, additional actuation elements can be coupled to additional input drive members of the force transmission mechanism 5700 and coupled to the wrist mechanism to control the movement of the wrist mechanism.

[0214] The robotic instrument 5400 may further include a power cord 5434 that can be connected to a power source (not shown) such that when the manual drive adapter 5800 is coupled to the robotic instrument 5400, the first tool 5462 and / or the second tool 5463 can be electrically coupled to the power source. The power source can be included in the remote operating system or provided separately.

[0215] The robotic instrument 5400 can be releasably coupled to the remote operating system and the manual drive adapter 5800 in a manner similar to that 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 the robotic drive output of the remote operating surgical system (not shown). The input drive members 5710, 5720 of the robotic instrument 5400 can be actuated using the robotic actuators of the remote operating system when coupled to the remote operating system and can be actuated by the manual actuators of the manual drive adapter 5800 when coupled to the manual drive adapter 5800, as described in more detail below.

[0216] The manual drive adapter 5800 includes an adapter housing 5810, an output drive interface 5815 coupled to the adapter housing, a gripping 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, for example Figure 16 , Figure 18 , and Figure 21 ). Although the adapter housing 5810 is shown as being coupled to the gripping handle 5824 by one or more rods or structures, in other embodiments, the adapter housing 5810 and the gripping 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 knob (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 for controlling the shaft roll. In some embodiments, the knob 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 the latch receiver 5806 may be the same as or similar to the latch 1305 and the latch receiver 1315 described above for the sterile adapter 1335. The latch 5805 may 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 transmission mechanism 5700 includes a coupling portion 5735 that receives the latch 5805 (see Figure 12A and Figure 12B ) and an internal connector 5736 that is received within the latch receiver 5806 (see Figure 12B ). For example, the latch receiver 5806 may be coupled to the internal connector 5736 of the drive member interface 5725 using a snap connection. The latch 5805 may 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 the latch receiver 5806 of the manual drive adapter 5800 and the coupling portion 5735 and the internal connector 5736 of the force transmission mechanism 5700 may be the same as or similar to the coupling mechanism shown and described in, for example, U.S. Patent No. 10,420,622, which is hereby incorporated by reference in its entirety. As Figure 16As shown, the output drive interface 5815 further includes a notch or cutout region 5826 in which the shaft 5410 of the robotic instrument 5400 can extend when the robotic instrument 5400 is coupled to the manual drive adapter 5800.

[0217] 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 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 the second output drive member 5832 of the manual drive adapter 5800, such 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. Similarly, movement of the second manual actuator 5820 by the user causes the second output drive member 5832 to move (i.e., rotate) the second input drive member 5720 of the robotic instrument 5400 to actuate the second tool 5463 of the end effector 5460. Figure 14 The first manual actuator 5820 is shown in a ready position (non-actuated position), and Figure 15 the first manual actuator 5820 is shown in an actuated position (moved by the user).

[0218] In some embodiments, the manual drive adapter 5800 includes a third manual actuator (not shown) that may be configured to be manually actuated by a user to lock the linkage 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 axis of rotation. As described above for the previous embodiments, in some embodiments, the manual drive adapter 5800 may include a locking mechanism 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 may include a material within the manual actuator, the output drive interface 5815, and / or the coupler (which mates to the coupling portion of the drive member interface 5725) that has a high coefficient of friction (e.g., a rubber material) such that the locking mechanism holds the wrist in place by friction. In some embodiments, the friction may be high enough such that the wrist is prevented from moving even by an external or reverse driving force. In some embodiments, the locking mechanism may be configured with a controlled amount of friction that allows the wrist to be held in place and also allows the wrist to be adjusted by the user (e.g., via a reverse driving force or movement of the manual actuator). In other embodiments, the manual drive adapter 5800 has a third manual actuator that may be manually actuated by the user to actuate the wrist.

[0219] In addition, the manual drive adapter 5800 may optionally include a latching 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 the actuated / moved position, as Figure 15 shown.

[0220] 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 may actuate the movement of the first tool 5462, and the second output drive member 5832 may actuate the movement of the second tool 5463. As described above and as shown, for example, in Figure 13A - 13C FIG., the first tool 5462 includes a pair of jaws 5464 and 5465 and may be used as a gripping tool, and the second tool 5463 includes a cutting element 5482.

[0221] To actuate and move the first tool 5462 (e.g., the gripping tool) using the manual drive adapter 5800, the user, as Figure 15Move (e.g., squeeze) the first manual actuator 5820 towards the gripping handle 5824 as shown, such that the first manual actuator 5820 rotates about axis A2 (see Figure ). The first manual actuator 5820 is coupled to or is part of a torsion spring driver member 5836, which is coupled to a torsion spring 5838. When the first manual actuator 5820 rotates, the torsion spring driver member 5836 activates the torsion spring 5838 to maintain a constant and limited gripping pressure at the first tool 5462. Thus, the torsion spring 5838 acts as a torque limiter. In alternative embodiments, other types of torque limiters may be used. The torsion spring 5838 contacts the crown gear 5840 at a contact point 5841 (see ​ ), 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, ​ ), which are coupled to a first output drive shaft 5845 (e.g., a gripper drive shaft). The gripper drive shaft 5845 is coupled to an output drive member 5822, which in turn drives a first input drive member 5710 of the robotic instrument 5400. In this way, rotation of the first manual actuator 5820 about axis A2 causes rotation of the gripper drive shaft 5845 and the output drive member 5822, which in turn causes rotation of the first input drive member 5710. As described above, the first input 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).

[0222] To actuate and move the second tool 5463 (e.g., a cutting tool) using the manual drive adapter 5800, the user first moves the first manual actuator 5820 to the actuating position as shown in ​ . With the first manual actuator 5820 held in the actuating position, the user can move the second manual actuator 5830 in a direction towards the first manual actuator 5820. In other words, the user moves the second manual actuator 5830 such that it rotates about axis A3 in the direction of arrow B as shown in ​ (see ​ ). ​ shows the second manual actuator 5830 in a ready position (non-actuated position), and ​ shows the second manual actuator 5830 in the actuating position.

[0223] When the second manual actuator 5830 rotates about axis A3, the second manual actuator 5830 drives a linkage 5846 coupled to the second manual actuator 5830 to move the linkage 5846 substantially linearly. The linkage 5846 includes a pin 5849 disposed within a helical groove of a helical member 5848 coupled to a second output drive shaft 5850 (e.g., a cutter drive). Thus, when the linkage 5846 moves (see, e.g., ​ and ​ ), corresponding movement of the pin 5849 within the helical groove of the helical member 5848 causes the helical member 5848 to rotate, and thus causes the cutter drive 5850 to rotate. In this manner, rotation of the second manual actuator 5830 causes linear movement of the linkage 5846, which is translated into rotational movement of the cutter drive 5850 (see, e.g., ​ and ​ ). The cutter drive 5850 is coupled to a second output drive member 5832, which in turn drives a second input drive member 5720 of the robotic instrument 5400, which causes a second tool 5463 (e.g., a cutting tool) to translate along the z-axis (i.e., proximally and distally). As described above, the second input drive member 5720 of the robotic instrument 5400 is coupled to an actuating element (e.g., a cable), which is coupled to the end effector 5460 and the second tool 5463 and can control movement of the second tool 5463 (e.g., and a cutter element 5482) in the z-axis direction (proximally and distally).

[0224] ​ is a schematic illustration of a robotic instrument 6400 (also referred to as a “medical device”) and a manual drive adapter 6800 according to an embodiment. As with other embodiments described herein, the robotic instrument 6400 can be releasably coupled to a remote operating system (e.g., systems 1000, 2000), and can also be releasably coupled to the manual drive adapter 6800 when the robotic instrument 6400 is detached from the remote operating system ( ​ not shown). ​ Illustrated is the robotic instrument 6400 releasably coupled to the manual drive adapter 6800. The remote operating system can include components and features similar or identical to those of the system 1000 described above. For example, the remote operating system can be used to perform a surgical procedure and can include a manipulator unit, a control unit, a series of kinematic linkages and joints, a series of cannulas, etc. The robotic instrument 6400 (and any instrument described herein) can be used in any suitable surgical system, such as the MIRS system 1000 shown and described above.

[0225] The robotic instrument 6400 includes a force transmission mechanism 6700 and a robotic input drive member 6710. The robotic input drive member 6710 is, for example, coupled to or disposed within the housing of the force transmission mechanism 6700. In some embodiments, the robotic instrument 6400 may optionally include a shaft 6410 coupled to the force transmission mechanism 6700. The robotic instrument 6400 may include one or more distal bending segments, such as a wrist mechanism and / or an end effector (e.g., similar to the end effectors 4460 and 5460 described herein) coupled to the distal end of the shaft 6410. The one or more distal bending segments may be controlled using a remote operating system (e.g., the remote operating systems 1000 or 2000 described above) and / or using a manual drive adapter 6800.

[0226] The manual drive adapter 6800 includes an adapter housing 6810 and an adapter output drive member 6822. The robotic instrument 6400 may be releasably coupled to the manual drive adapter 6800 in a manner similar to how the robotic instrument 6400 is coupled to a remote operating system, as described for other embodiments. For example, the manual drive adapter 6800 may include an output drive interface (not shown) that may 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 6800 may be coupled to a mating coupling portion of a drive member interface (not shown) of the robotic instrument 6400. When the robotic instrument 6400 is coupled to the manual drive adapter 6800, the robotic input drive member 6710 engages the adapter output drive member 6822 of the manual drive adapter 6800 such that the robotic instrument 6400 can be actuated using a manual actuator ( ​ not shown in). Thus, the robotic instrument 6400 may be releasably coupled to a remote operating system and controlled by a remote operating instrument, and when the robotic instrument 6400 is detached from the remote operating system, the robotic instrument 6400 may be releasably coupled to the manual drive adapter 6800 and controlled by the manual actuator of the manual drive adapter 6800. For example, when the robotic instrument 6400 is coupled to the manual adapter 6800 and the robotic input drive member 6710 engages the adapter output drive member 6822, the adapter output drive member 6822 may be actuated to cause the robotic input drive member 6710 to operate one or more degrees of freedom of the robotic instrument 6400. For example, when the adapter output drive member 6822 is actuated (e.g., rotated), the robotic input drive member 6710 moves (e.g., rotates). The movement (e.g., rotation) of the robotic input drive member 6710 may in turn cause one or more drive members (e.g., cables) within the shaft 6410 to move, thereby actuating a wrist or an end effector (not shown).

[0227] More specifically, in the present embodiment, the adapter output drive member 6822 includes a first plurality of splines 6855 on the proximal facing end of the adapter output drive member 6822 (see ​ ), the first plurality of splines 6855 being configured to matingly engage a second plurality of splines 6722 on the distal facing end of the robotic input drive member 6710 (see ​ ), such that movement of the adapter output drive member 6822 causes the robotic input drive member 6710 to operate one or more degrees of freedom of the robotic instrument 6400. Further details and illustrations of embodiments having such spline engagement are described below with respect to the manual adapter 9800 and the robotic instrument 9400.

[0228] In some embodiments, the first plurality of splines 6855 are located on the outer periphery of a portion of the adapter output drive member 6822, and the second plurality of splines 6722 are located on the inner wall of a portion of the robotic input drive member 6710 that defines an internal volume 6726. Thus, when engaged with the second plurality of splines 6722, the first plurality of splines 6855 are received within the internal volume 6726.

[0229] In some embodiments, the first plurality of splines 6855 are located on the inner wall of a portion of the adapter output drive member 6822 that defines an internal volume (not shown), and the second plurality of splines 6722 are located on the outer periphery of a portion of the robotic input drive member 6720. Thus, in such embodiments, when engaged with the first plurality of splines 6855, the second plurality of splines 6722 are received within the internal volume of the adapter output drive member 6822.

[0230] As previously described, during a surgical procedure using a remote operating system (e.g., system 2000) and a robotic instrument 6400, it may be desirable to use a manually actuated medical device to perform a portion of the procedure. The manual drive adapter 6800 can be used for such a procedure. The robotic instrument 6400 can be detached from the remote operating system (e.g., as shown for instrument 2400 in ​ ), and then releasably coupled to the manual drive adapter 6800, as shown in ​ . Thus, the same instrument (i.e., the robotic instrument 6400) can be used with the remote operating system and manually with the manual drive adapter 6800. As described herein, the manual drive adapter 6800 is configured to couple to the same instrument drive member of the robotic instrument 6400 when the instrument 6400 is separated from the remote operating system.

[0231] When a user attaches the robotic instrument 6400 to the manual drive adapter 6800, the user can apply less than the full stroke of an actuator (e.g., such as actuator 5820) that is operably coupled to the adapter output drive member 6822 to cause engagement of the adapter output drive member 6822 and the robotic input drive member 6710. Specifically, an initial movement of the actuator causes the adapter output drive member 6822 to rotate slightly and allows the first plurality of splines 6855 and the second plurality of splines 6722 to align and engage with each other. This places the manual drive adapter 6800 in a ready-to-use (i.e., engaged) configuration. When the manual drive adapter 6800 is in the engaged configuration, further movement of the actuator (not shown) will actuate the instrument 6400. In some embodiments, when moving to the engaged configuration, the manual actuator can be actuated up to about no more than 9 degrees of its rotational travel such that the maximum travel of the actuator (not shown, but which can be similar to the first actuator 9820) is available for initial use. In other words, spline engagement allows alignment of the first adapter output drive member 6822 and the first robotic input drive member 6710 without having to exhaust most of the travel of the manual actuator to set the robotic instrument in the ready-to-use position. In other embodiments, the manual actuator can be actuated by a different amount of rotational travel for initial engagement (e.g., based on a different number of spline teeth present, etc.).

[0232] ​ is a schematic illustration of a robotic instrument 7400 (also referred to as a "medical device") and a manual drive adapter 7800 according to an embodiment. Like other embodiments described herein, the robotic instrument 7400 can be releasably coupled to a remote operating system (e.g., systems 1000, 2000), and is also releasably coupled to the manual drive adapter 7800 when the robotic instrument 7400 is detached from the remote operating system ( ​ not shown). ​ Illustrated is the robotic instrument 7400 releasably coupled to the manual drive adapter 7800. The remote operating system can include components and features similar or identical to those of the system 1000 described above. For example, the remote operating system can be used to perform a surgical procedure and can include a manipulator unit, a control unit, a series of kinematic linkages and joints, a series of cannulas, etc. The robotic instrument 7400 (and any instrument described herein) can be used in any suitable surgical system (such as the MIRS system 1000 shown and described above).

[0233] The robotic instrument 7400 includes a force transmission mechanism 7700, a first robotic input drive member 7710, and a second robotic input drive member 7730. The first robotic input drive member 7710 and the second robotic input drive member 7730 are, for example, coupled to the housing of the force transmission mechanism 7700 or disposed within the housing of the force transmission mechanism 7700. In some embodiments, the robotic instrument 7400 may optionally include a shaft 7410 coupled to the force transmission mechanism 7700. The robotic instrument 7400 may include one or more distal bending sections 7465, such as a wrist mechanism and / or an end effector (e.g., similar to the end effectors 4460 and 5460 described herein) coupled to the distal end of the shaft 7410. The one or more distal bending sections 7465 may be controlled using a remote operating system (e.g., the remote operating systems 1000 or 2000 described above) and / or using a manual drive adapter 7800.

[0234] The manual drive adapter 7800 includes an adapter housing 7810, a first adapter output drive member 7822, and a second adapter output drive member 7832. The robotic instrument 7400 may be releasably coupled to the manual drive adapter 7800 in a manner similar to how the robotic instrument 7400 is coupled to a remote operating system and as described for other embodiments. For example, the manual drive adapter 7800 may include an output drive interface (not shown) that may 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 7800 may be coupled to a mating coupling portion of a drive member interface (not shown) of the robotic instrument 7400. When the robotic instrument 7400 is coupled to the manual drive adapter 7800, the first robotic input drive member 7710 engages the first adapter output drive member 7822 of the manual drive adapter 7800, and the second robotic input drive member 7730 engages the second adapter output drive member 7852, such that the robotic instrument 7400 can be actuated using one or more manual actuators ( ​ not shown) of the manual drive adapter 7800.

[0235] Accordingly, the robotic instrument 7400 can be releasably coupled to a remote operating system and controlled by a remote operating instrument, and when the robotic instrument 7400 is detached from the remote operating system, the robotic instrument 7400 can be releasably coupled to a manual drive adapter 7800 and controlled by a manual actuator of the manual drive adapter 7800. For example, when the robotic instrument 7400 is coupled to the manual adapter 7800, a first adapter output drive member 7822 can be actuated to cause a first robotic input drive member 7710 to operate a first degree of freedom of the robotic instrument 7400, and a second adapter output drive member 7852 can be actuated to cause a second robotic drive member 7730 to operate a second degree of freedom of the robotic instrument 7400.

[0236] More specifically, in this embodiment, the first adapter output drive member 7822 can be configured to be the same as the adapter output drive member 6822 and can include a first plurality of splines (not shown) on a proximally facing end of the first adapter output drive member 7822 (e.g., see the splines on 6822 in ​ . The first plurality of splines on the first adapter output drive member 7822 are configured to matingly engage a second plurality of splines (not shown) on a distally facing end of the first robotic input drive member 7710, and the second plurality of splines can be configured to be the same as the splines on the robotic input drive member 6722 ( ​ shown). As described for the adapter 6800 and the robotic instrument 6400, when the first adapter output drive member 7822 engages the first robotic input drive member 7710, movement of the first adapter output drive member 7822 causes the robotic input drive member 7710 to operate one or more degrees of freedom of the robotic instrument 7400. For example, the manual drive adapter 7800 can be used to operate an end effector at the distal end of the shaft 7410.

[0237] In this embodiment, as ​As shown, the second adapter output drive member 7852 includes a brake portion 7853 on the proximal facing end of the second adapter output drive member 7852. The second robotic input drive member 7730 includes a plurality of cavities 7725 on the distal facing end of the second robotic input drive member 7730. The brake portion 7853 is configured to be received within one of the plurality of cavities 7725 to limit movement of the distal bending section 7465. For example, in some embodiments, the brake portion 7853 may be biased into the cavity �725 using one or more springs. In some embodiments, the spring is formed as a cantilever spring within the second adapter output drive member 7852, and the brake portion 7853 is disposed on the cantilever spring. The brake portion 7853 is biased into the cavity 7725 by the spring, creating a frictional force against the second robotic input drive member 7730. In some alternative embodiments, a helical spring is coupled to the second adapter output drive member 7852 and forces the second adapter output drive member 7852 against the second robotic input drive member 7730 and the brake portion 7853 into the cavity 7725. In some embodiments, both the cantilever spring and the helical spring are included on the manual drive adapter 7800. Further details regarding such springs are shown and described with reference to the manual adapter 9800.

[0238] In some embodiments, there are a plurality of brake portions 7853 and are configured to be received within corresponding ones of the cavities 7725. In some embodiments, the second adapter output drive member 7852 includes a first brake portion 7853 and a second brake portion (not shown), and the first brake portion 7853 and the second brake portion are positioned at an equal distance from the center point of the second adapter output drive member 7852. In some embodiments, the first brake portion 7853, the center point, and the second brake portion are positioned non - collinearly. In some embodiments, there may be additional third, fourth, etc. brake portions.

[0239] As previously described, during a surgical procedure using a remote operating system (e.g., system 2000) and a robotic instrument 7400, it may be desirable to use a manually actuated medical device to perform a portion of the procedure. The manual drive adapter 7800 can be used for such a procedure. The robotic instrument 7400 can be detached from the remote operating system (e.g., as ​ shown for instrument 2400), and then releasably coupled to the manual drive adapter 7800, as ​ shown. Thus, the same instrument (i.e., robotic instrument 7400) can be used with the remote operating system and manually with the manual drive adapter 7800. As described herein, the manual drive adapter 7800 is configured to couple to the same instrument drive members of the robotic instrument 7400 when the instrument 7400 is separated from the remote operating system.

[0240] When a user attaches the robotic instrument 7400 to the manual drive adapter 7800, the user can apply less than the full stroke of a first manual actuator (e.g., such as actuator 5820) that is operably coupled to the first adapter output drive member 7822 to cause engagement of the adapter output drive member 7822 and the robotic input drive member 7710. The initial movement of the actuator causes the first adapter output drive member 7822 to rotate slightly and allows a first plurality of splines (not shown) and a second plurality of splines (not shown) to align and engage with each other. In some embodiments, when moving to the engaged configuration, the first manual actuator can be actuated up to about no more than 9 degrees such that the maximum travel of the first manual actuator is available for initial use. In other words, the spline engagement allows alignment of the first adapter output drive member 7822 and the first robotic input drive member 7710 without having to exhaust most of the travel of the first manual actuator to set the robotic instrument in a ready-to-use position.

[0241] Similarly, the user can manually actuate a second actuator (e.g., see actuator 9825 described below) that is operably coupled to the second adapter output drive member 7852 to manually rotate the second adapter output drive member 7852 slightly, thereby aligning the brake portion 7853 with the cavity 7725 of the second robotic input drive member 7730. One or more springs (as discussed above) force the brake portion 7853 into the cavity 7725 and help maintain engagement of the second adapter drive member 7730 with the first robotic input drive member 7710. This places the manual drive adapter 7800 in a ready-to-use position where the distal bending section 7465 (e.g., the wrist mechanism) is locked in the desired orientation.

[0242] ​ FIG. is a schematic illustration of a robotic instrument 8400 (also referred to as a "medical device") and a manual drive adapter 8800 according to an embodiment. As with other embodiments described herein, the robotic instrument 8400 can be releasably coupled to a remote operating system (e.g., systems 1000, 2000) and is also releasably coupled to the manual drive adapter 8800 when the robotic instrument 8400 is detached from the remote operating system ( ​ not shown). ​Illustrated is a robotic instrument 8400 releasably coupled to a manual drive adapter 8800. The remote operating system may include components and features that are the same as or similar to those of the above-described system 1000. For example, the remote operating system 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, and the like. The robotic instrument 8400 (and any instrument described herein) may be used in any suitable surgical system, such as the MIRS system 1000 shown and described above.

[0243] The robotic instrument 8400 includes a force transmission mechanism 8700, a first robotic input drive member 8710, and a second robotic input drive member 8730. The first robotic input drive member 8710 and the second robotic input drive member 8730 are, for example, coupled to or disposed within a housing of the force transmission mechanism 8700. In some embodiments, the robotic instrument 8400 may optionally include a shaft 8410 coupled to the force transmission mechanism 8700. The robotic instrument 8400 may include one or more distal bending sections (not shown), such as a wrist mechanism and / or an end effector (e.g., similar to the end effectors 4460 and 5460 described herein) coupled to the distal end of the shaft 8410. The one or more distal bending sections may be controlled using the remote operating system (e.g., the remote operating system 1000 or 2000 described above) and / or using the manual drive adapter 8800. For example, when the first robotic input drive member 8710 and / or the second robotic input drive member 8730 move (e.g., rotate), one or more drive members (not shown, but which may be cables) within the shaft 6410 move, thereby actuating the wrist or end effector (not shown).

[0244] The manual drive adapter 8800 includes an adapter housing 8810, a first adapter output drive member 8822, and a second adapter output drive member 8832. The robotic instrument 8400 can be releasably coupled to the manual drive adapter 8800 in a manner similar to how the robotic instrument 8400 is coupled to a remote operating system and as described for other embodiments. For example, the manual drive adapter 8800 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 8800 can be coupled to a mating coupling portion of a drive member interface (not shown) of the robotic instrument 8400. When the robotic instrument 8400 is coupled to the manual drive adapter 8800, the first robotic input drive member 8710 engages the first adapter output drive member 8822 of the manual drive adapter 8800, and the second robotic input drive member 8730 engages the second adapter output drive member 8852, such that the robotic instrument 8400 can be actuated using one or more manual actuators ( ​ not shown) of the manual drive adapter 8800.

[0245] Accordingly, the robotic instrument 8400 can be releasably coupled to a remote operating system and controlled by a remote operating instrument, and when the robotic instrument 8400 is detached from the remote operating system, the robotic instrument 8400 can be releasably coupled to the manual drive adapter 8800 and controlled by the manual actuators of the manual drive adapter 8800. For example, when the robotic instrument 8400 is coupled to the manual drive adapter 8800, the first adapter output drive member 8822 can be actuated to cause the first robotic input drive member 8710 to operate a first degree of freedom of the robotic instrument 8400, and the second adapter output drive member 8852 can be actuated to cause the second robotic drive member 8730 to operate a second degree of freedom of the robotic instrument 8400.

[0246] More specifically, in this embodiment, the first robotic input drive member 8710 includes a first robotic engagement feature 8723 and a first manual engagement feature 8722. The first robotic engagement feature 8723 is configured to matingly engage a first engagement feature (not shown) of a first robotic drive output of a remote surgical system (not shown), and the first manual engagement feature 8722 is configured to matingly engage a first adapter output drive member 8822 of a manual drive adapter 8800. Similarly, the second robotic input drive member 8730 includes a second robotic engagement feature 8727 and a second manual engagement feature 8725. The second robotic engagement feature 8727 is configured to matingly engage a second engagement feature (not shown) of a second robotic drive output of a remote surgical system (not shown), and the second manual engagement feature 8725 is configured to matingly engage a second adapter output drive member 8852 of the manual drive adapter 8800.

[0247] As ​ and ​ shown, the first manual engagement feature 8722 ( ​ ) has a different geometry from the second manual engagement feature 8725 ( ​ ). The first robotic engagement feature 8723 and the second robotic engagement feature 8727 have the same geometry, but may have different geometries in other embodiments. The geometry of the engagement features may include, for example, the shape, size, type, etc. of the engagement. In some embodiments, the first manual engagement feature 8722 includes a first plurality of splines configured to matingly engage a second plurality of splines on the first adapter output drive member 8822 of the manual adapter 8800. The second plurality of splines on the first adapter output drive member 8822 may be the same as the splines on the adapter output drive element 6822 and may be disposed on the proximal facing end of the first adapter output transmission member 8822 as described above. The first plurality of splines of the first robotic input drive member may be disposed on the distal facing end of the first robotic input transmission member 8710 (see ​ ).

[0248] In some embodiments, the second manual engagement feature 8725 includes a plurality of cavities on the distal facing end of the second robotic input drive member 8730, the plurality of cavities being configured as described above for the manual drive adapter 7800 (see ​) is received on the proximal facing end of the second adapter output drive member 8852 as described above. The brake portion is configured to be selectively received in one of the multiple cavities to limit the movement of the distal bending section (such as a wrist mechanism or end effector). For example, in some embodiments, the brake portion can be biased into one of the multiple cavities using one or more springs. In some embodiments, the spring is formed as a cantilever spring in the second adapter output drive member 8852, and the brake portion is disposed on the cantilever spring and is spring-biased into the cavity, thereby generating a friction force against the second robot input drive member 8730. In some embodiments, a coil spring is coupled to the second adapter output drive member 8852 and urges the second adapter output drive member 8852 and the brake portion against the second robot input drive member 8730. Further details regarding such springs are shown and described with reference to the manual adapter 9800.

[0249] As described above with respect to the previous embodiments, when the first robot input drive member 8710 is engaged with the first adapter output drive member 8822, movement of the first adapter output drive member 8822 causes the robot input drive member 8710 to operate a first degree of freedom of the robotic instrument 8400. For example, the manual drive adapter 8800 can be used to control an end effector at the distal end of the shaft 8410. Similarly, when the second robot input drive member 8730 is engaged with the second adapter output drive member 8852, movement of the second adapter output drive member 8852 causes the second robot input drive member 8730 to operate a second degree of freedom of the robotic instrument 8400. For example, the manual drive adapter 8800 can be used to control a wrist mechanism at the distal end of the shaft 8410.

[0250] As previously mentioned, during a surgical procedure using a teleoperation system (e.g., system 2000) and a robotic instrument 8400, it may be desirable to use a manually actuated medical device to perform a portion of the procedure. The manual drive adapter 8800 may be used for such procedures. The robotic instrument 8400 may be detachable from the teleoperation system (e.g., system 2000). ​ 2400) and then releasably coupled to the manual drive adapter 8800, as shown in FIG. ​ Thus, the same instrument (ie, robotic instrument 8400 ) can be used with a teleoperated system and manually with the manual drive adapter 8800 .

[0251] ​ A manual drive adapter 9800 according to another embodiment is illustrated. As with other embodiments described herein, the manual drive adapter 9800 can be releasably coupled to a robotic instrument ( ​(not shown in the figure), such as any robotic instrument described herein. The robotic instrument can be releasably coupled to a remote operating system (e.g., systems 1000, 2000) and operated by the remote operating system, and when detached from the remote operating system ( ​ (not shown in the figure), it can also be releasably coupled to and operated by the manual actuator of the manual drive adapter 9800. The remote operating system can include components and features similar to or the same as those of the above-described system 1000. For example, the remote operating system can be used to perform a surgical procedure and can include a manipulator unit, a control unit, a series of kinematic linkages and joints, a series of cannulas, etc. The robotic instrument (and any instrument described herein) can be used in any suitable surgical system (such as the MIRS system 1000 shown and described above).

[0252] The robotic instrument can be any robotic instrument described herein and can include the same components and functions as the robotic instruments described herein. For example, the robotic instrument can include a force transmission mechanism ( ​ (not shown in the figure) and an input drive member that engages with the adapter output drive member of the manual drive adapter 9800. The robotic instrument can be releasably coupled to the remote operating system and the manual drive adapter 9800 in a similar manner as described herein for other embodiments. For example, the drive member interface of the robotic instrument (not shown) can be coupled to the output drive interface 9815 of the manual drive adapter 9800 as described herein. When the drive member interface of the robotic instrument is coupled to the input drive interface 9815 of the manual drive adapter 9800, the input drive member of the robotic instrument is prevented from engaging with the robotic drive output of the remote-operated surgical system (not shown). The input drive member can be actuated using the robotic actuator of the remote operating system when coupled to the remote operating system and can be actuated by the manual actuator of the manual drive adapter 9800 when coupled to the manual actuator of the manual drive adapter 9800, as described in more detail below.

[0253] The manual drive adapter 9800 includes an adapter housing 9810, an output drive interface 9815 coupled to the adapter housing 9810, a gripping handle 9824, a first manual actuator 9820 coupled to a first adapter output drive member 9822, a second manual actuator 9830 coupled to a second adapter output drive member 9832, and a third manual actuator 9825 coupled to a third adapter output drive member 9852 (see ​ , ​ and ​)。The manual drive adapter 9800 also includes a fourth adapter output drive member 9842 that can be coupled to a fourth manual actuator (not shown). The adapter housing 9810 can be coupled to the grip handle 9824 by one or more rods or structures, or can be integrally constructed (e.g., similar to the structure of the manual drive adapter 4800 described above). The manual drive adapter 9800 can also include other components described herein for other embodiments of manual drive adapters that are not necessarily shown or described for the manual drive adapter 9800, such as a knob (not shown) that can be coupled to the shaft of the robotic instrument and used to manually rotate the shaft about the longitudinal axis of the shaft relative to the adapter housing 9810 and lock the shaft in place.

[0254] The output drive interface 9815 of the manual drive adapter 9800 includes a latch 9805 having a latch receiver 9806 (e.g., see ​ ). The latch 9805 and the latch receiver 9806 can be the same or similar to the latch 1305 and the latch receiver 1315 described above for the sterile adapter 1335. The latch 9805 can be used to releasably couple the robotic instrument to the manual drive adapter 9800 in a manner similar to that described above. More specifically, the drive member interface of the force transfer mechanism of the robotic instrument can include a coupling portion that receives the latch 9805 (e.g., see the coupling portion 5735 in ​ and ​ ) and an internal connector received within the latch receiver 9806 (see the internal connector 5736 in ​ ). For example, the latch receiver 9806 can be coupled to the internal connector of the drive member interface using a snap connection. The latch 9805 can be squeezed to release the internal connector from the latch receiver 9806, thereby separating the robotic instrument from the manual drive adapter 9800.

[0255] When the robotic instrument is coupled to the manual drive adapter 9800, the first input drive member 9710 of the robotic instrument (see ​ , ​ ) engages the first adapter output drive member 9822 of the manual drive adapter 9800, a second input drive member (not shown) of the robotic instrument engages the second output drive member 9832 of the manual drive adapter 9800, and the third input drive member 9730 of the robotic instrument (see ​ , ​) engages with the third adapter output drive member 9852. As described above with respect to the robotic instrument 5400 and the manual drive adapter 5800, the first manual actuator 9820 can be configured similarly to the manual actuator 5820 and can be used to actuate the first tool of the robotic instrument, and the second manual actuator 9830 can be configured similarly to the manual actuator 5830 and can be used to actuate the second tool of the robotic instrument. Thus, user movement of the first manual actuator 9820 causes the first adapter output drive member 9822 to move (i.e., rotate) the first input drive member 9710 of the robotic instrument to actuate the first tool of the robotic instrument. Similarly, user movement of the second manual actuator 9830 causes the second adapter output drive member 9832 to move (i.e., rotate) the second input drive member (not shown) of the robotic instrument to actuate the second tool. Furthermore, in this embodiment, the third manual actuator 9825 can be used to control and limit movement of a distal component, such as a wrist mechanism (e.g., wrist mechanism 5500) described in more detail below.

[0256] As described above for the previous embodiments, the first adapter output drive member 9822 and the second adapter output drive member 9832 each include a spline portion 9856 on the proximal facing end of each of the first adapter output drive member 9822 and the second adapter output drive member 9832, which spline portion includes a plurality of splines 9855. ​ 、 ​ and ​ A first adapter output drive member 9822 is shown, and it should be understood that the second adapter output drive member 9832 is similarly configured. The plurality of splines 9855 on the first adapter output drive member 9822 are configured to matingly engage the first robot input drive member 9710 (see, e.g., FIG. ​ 、 ​ and ​ ) on the distal end thereof, and the plurality of splines 9855 on the second adapter output drive member 9832 are configured to matingly engage the plurality of splines on the spline portion on the second robot input drive member (not shown). As shown in FIG31 , the splines 9855 are positioned on the outer periphery of the spline portion 9856 of the first adapter output drive member 9822. ​ and ​ As shown, the plurality of splines on the first robotic input drive member 9710 are on an inner wall defining an interior volume 9726. When the robotic instrument 9400 is coupled to the manual drive adapter 9800, the spline portion 9856 and the plurality of splines 9855 are received within the interior volume 9726 and engage the plurality of splines 9722.

[0257] In an alternative embodiment, a plurality of splines 9855 may be provided on an inner wall of a portion of an adapter output drive member 9822 that defines an internal volume (not shown), and a plurality of splines 9722 are on an outer perimeter of a portion of a robotic input drive member 9710. Thus, in such an embodiment, when engaged with the plurality of splines 9855, the plurality of splines 9722 are received within the internal volume of the adapter output drive member 9822.

[0258] In this embodiment, as ​ , ​ and ​ shown, a third adapter output drive member 9852 and a fourth adapter output drive member 9842 each include a proximally facing end, a first braking portion 9853 and a second braking portion 9857 on the proximally facing end. Additional braking portions may be present. ​ and ​ illustrate the third adapter output drive member 9852, and it should be understood that the fourth adapter output drive member 9842 may be configured the same as the third adapter output drive member 9852. As ​ shown, the third adapter output drive member 9852 has a center point CP, and the first braking portion 9853 and the second braking portion 9857 are each positioned at an equal distance from the center point CP on an end of the third adapter output drive member 9852. In other words, the first braking portion 9853 is positioned at a first distance D1 from the center point CP, and the second braking portion 9857 is positioned at a second distance D2 from the center point CP, and distance D1 is equal to distance D2. The first braking portion 9853 is provided on a cantilever spring 9854, which is described in more detail below. Further, the first braking portion 9853, the second braking portion 9857, and the center point are non-linearly positioned, as ​ shown. The first braking portion 9853 and the second braking portion 9857 are each configured to be received within corresponding cavities on a first robotic input drive member 9710 of a robotic instrument. More specifically, as ​ and ​ shown, the first robotic input drive member 9710 includes a plurality of cavities 9725 on a distally facing end of the first robotic input drive member 9310. When the robotic instrument is coupled to the manual drive adapter 9800, the first braking portion 9853 and the second braking portion 9857 are each positioned within a corresponding one of the cavities 9725.

[0259] The first braking portion 9853 and the second braking portion 9857 are configured to be received within respective cavities 9725 of the robotic input drive member 9730 to limit movement of a distal bending section (such as a wrist mechanism or an end effector) operatively coupled to the third robotic input drive member 9730. For example, the first braking portion 9853 may be biased into the cavity 9725 by the spring force of a cantilever spring 9854, thereby creating a frictional force against the third robotic input drive member 9730. More specifically, in some embodiments, the cantilever spring 9854 may be biased in a slightly outward position such that when the third manual actuator 9825 rotates (which causes the third adapter output drive member 9852 to rotate), if the first braking portion 9853 is not within the cavity 9725, the cantilever spring 9854 will be pushed inward by the first braking portion 9853. When the first braking portion 9853 moves into the cavity 9725 as the third adapter output drive member 9852 rotates, the biasing force of the spring 9854 will hold the first braking portion 9853 in place within the cavity 9725. The second braking portion 9857 will also move into the cavity 9725 as the third adapter output drive member 9852 rotates, which further helps to maintain engagement of the third adapter drive output member 9852 with the third robotic input drive member 9730. The second braking portion 9857 may optionally be located on the cantilever spring.

[0260] In the illustrated embodiment, a helical spring 9823 is coupled to the third adapter output drive member 9852 and the third manual actuator 9825. The helical spring 9823 also forces the third adapter output drive member 9852, the first braking portion 9853, and the second braking portion 9857 against the third robotic input drive member 9730 and helps to maintain engagement of the third adapter output drive member 9852 with the third robotic input drive member 9730. Although the cantilever spring 9854 and the helical spring 9823 are shown and described in the manual drive adapter 9800, in alternative embodiments, only one spring may be included. For example, in some embodiments, only the helical spring 9823 is present, in other embodiments, only the cantilever spring 9854 is present, and in additional embodiments, no springs are present.

[0261] For example, as ​ and ​As shown, the first robotic input drive member 9710 further includes a first robotic engagement feature 9723 and a second robotic engagement feature 9724 configured to respectively and matingly engage a first robotic drive output of a remote surgical system (not shown). Accordingly, the first robotic input drive member 9710 of the instrument includes engagement features that permit operable and releasable coupling to the drive output features of a remote surgical system and different engagement features that permit operable and releasable coupling to a manual drive adapter 9800.

[0262] For example, as ​ and ​ shown, the third robotic input drive member 9730 further includes a first robotic engagement feature 9727 and a second robotic engagement feature 9728 configured to respectively and matingly engage a first robotic drive output of a remote surgical system (not shown). Accordingly, the third robotic input drive member 9730 includes engagement features that permit operable and releasable coupling to the drive output of a remote surgical system and different engagement features that permit operable and releasable coupling to a manual drive adapter.

[0263] In addition, for example, as ​ 、 ​ 、 ​ and ​ shown, the robotic engagement features (9723 and 9724) on the first robotic input drive member 9710 have the same geometry as the robotic engagement features (9727 and 9728) on the third robotic input drive member 9730. For example, the robotic engagement feature 9723 has the same geometry as the robotic engagement feature 9727, and the robotic engagement feature 9724 has the same geometry as the robotic engagement feature 9728. Further, the robotic engagement features (9723, 9724) on the first robotic input drive member 9710 have a different geometry from the manual engagement feature (9722) of the first robotic input drive member 9710. Similarly, the robotic engagement features (9727, 9728) on the third robotic input drive member 9730 have a different geometry from the manual engagement feature (9725) on the third robotic input drive member 9710. As used herein, the geometry of the engagement features (robotic and manual) can include, for example, the shape, size, type, etc. of the engagement.

[0264] As described above, during a surgical procedure using a remote operating system (e.g., system 2000) and robotic instruments (e.g., 1400, 2400, 3400, 4400, 5400, 6400, 7400, 8400), it may be desirable to use a manually actuated medical device to perform a portion of the procedure. The manual drive adapter 9800 can be used for such procedures. The robotic instrument 9400 can be detached from the remote operating system (e.g., as shown for instrument 2400 in ​ ), and then releasably coupled to the manual drive adapter 9800. Thus, the same instrument (i.e., the robotic instrument) can be used with the remote operating system and manually with the manual drive adapter 9800. As described herein, the manual drive adapter 9800 is configured to couple to the same instrument drive members (e.g., 9710, 9730) of the robotic instrument when the instrument is detached from the remote operating system.

[0265] When the user attaches the robotic instrument to the manual drive adapter 9800, the user can apply less than full travel to the first manual actuator 9820 to slightly rotate the first adapter output drive member 9822, thereby causing engagement of the adapter output drive member 9822 with the robotic input drive member 9710. This allows the multiple splines 9855 of the first adapter output drive member 9822 and the multiple splines 9722 of the first robotic input drive member 9710 to align and engage with each other. In some embodiments, when moving to the engaged configuration, the first manual actuator 9820 can be actuated up to about no more than 9 degrees of its rotational travel, such that the maximum travel of the first actuator 9820 is available for initial use. In other words, the spline engagement allows alignment of the first adapter output drive member 9822 and the first robotic input drive member 9710 without having to exhaust most of the travel of the first manual actuator 9820 to set the robotic instrument in the ready-to-use position.

[0266] Similarly, the second manual actuator 9830 can be actuated in the same manner as described above to cause the second adapter output drive member 9832 to rotate slightly, and to allow the multiple splines 9855 of the second adapter output drive member 9832 and the multiple splines (not shown, but can be configured the same as the first robotic input drive member) of the second robotic input drive member to align and engage with each other in the same manner.

[0267] The user can also use a third actuator 9825 to manually rotate a third adapter output drive member 9852 to align a first brake portion 9853 with a cavity 9725 of a third robotic input drive member 9730. Similar to as described above for the first manual actuator 9820, the user can manually rotate the third manual actuator 9825 slightly to align the first brake portion 9853 and a second brake portion 9857 with the cavity 9725, and (as discussed above) a cantilever spring 9854 and a helical spring 9823 force the first brake portion 9853 into a first cavity 9725 and the second brake portion 9857 into a second cavity 9725. With both the first brake portion 9853 and the second brake portion 9857 within the cavity 9725 and the third adapter output drive member 9852 forced against the third robotic input drive member 9730, movement of the third robotic input drive member 9730 will be restricted. This will place the manual drive adapter 9800 in a ready-to-use position where the distal bending section (e.g., the wrist mechanism) is locked in a desired orientation.

[0268] Although various embodiments have been described above, it should be understood that they are presented by way of example and not limitation. In cases where the above methods and / or diagrams indicate certain events and / or flow patterns occurring in a certain order, 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.

[0269] For example, any instrument (and components thereof) described herein is optionally part of a surgical assembly for performing minimally invasive surgical procedures and may include a manipulator unit, a series of kinematic linkages, a series of cannulas, and the like. Thus, any instrument described herein can be used in any suitable surgical system, such as the MIRS system 1000 shown and described above. Additionally, any instrument shown and described herein can be used to manipulate target tissue during a surgical procedure. Such target tissue can be cancer cells, tumor cells, lesions, blood vessel blockages, thrombi, stones, uterine fibroids, bone metastases, adenomyosis, or any other body tissue. The examples of target tissue presented are not an exhaustive list. Additionally, the target structure can also include artificial substances (or non-tissue) inside or associated with the human body, such as, for example, stents, a portion of an artificial tube, fasteners inside the human body, etc.

[0270] Any component of the surgical instrument described herein can be constructed of any material, such as medical grade stainless steel, nickel alloy, titanium alloy, etc. Additionally, any of the linkages, tool members, tension members, or components described herein can be constructed of multiple components that are subsequently joined together. For example, in some embodiments, a linkage can be constructed by joining separately constructed components together. However, in other embodiments, any of the linkages, tool members, tension members, or components described herein can be constructed integrally.

[0271] Although various embodiments have been described as having combinations of specific features and / or components, other embodiments can also have combinations of any features and / or components from any of the embodiments described above. While aspects have been described in the general context of medical devices, and more specifically surgical instruments, aspects of the invention need not be limited to use in medical devices. For example, although described for certain embodiments, any embodiment can include a splined engagement between an adapter output drive member and a robotic input drive member of a robotic instrument as described herein. Additionally, any embodiment of a manually driven adapter can include an adapter output drive member having a braking portion received within a cavity of a robotic input drive member of a robotic instrument.

Claims

1. A manual drive adapter for a robotic instrument, comprising: An adapter housing configured to be releasably coupled to a force transmission mechanism of the robotic instrument, wherein the force transmission mechanism of the robotic instrument includes a robotic input drive member configured to engage a robotic drive output of a remote surgical system; An adapter output drive member coupled to the adapter housing, wherein the adapter housing is configured to be releasably coupled to the force transmission mechanism of the robotic instrument such that the adapter output drive member is capable of engaging the robotic input drive member of the robotic instrument; The adapter output drive member includes a first plurality of splines configured to matingly engage a second plurality of splines on the robotic input drive member such that movement of the adapter output drive member causes the robotic input drive member to operate one or more degrees of freedom of the robotic instrument.

2. The manual drive adapter according to claim 1, wherein the adapter housing is capable of being releasably coupled to the force transmission mechanism of the robotic instrument when the robotic instrument is not coupled to the remote surgical system.

3. The manual drive adapter according to claim 1, wherein when the adapter output drive member is coupled to the robotic input drive member of the robotic instrument, engagement of the robotic input drive member of the robotic instrument with the robotic drive output of the remote surgical system is prevented.

4. The manual drive adapter according to claim 1, wherein: The first plurality of splines are located on an outer perimeter of the adapter output drive member, and the second plurality of splines are located on an inner wall of the robotic input drive member.

5. The manual drive adapter according to claim 1, wherein: The first plurality of splines are located on an inner wall of the adapter output drive member, and the second plurality of splines are located on an outer perimeter of the robotic input drive member.

6. The manual drive adapter according to claim 1, wherein the adapter output drive member is a first adapter output drive member, the robotic input drive member is a first robotic input drive member, and the robotic drive output is a first robotic drive output, wherein: The force transmission mechanism of the robotic instrument includes a second robotic input drive member configured to engage a second robotic drive output of the remote surgical system; The manual drive adapter includes a second adapter output drive member, the second adapter output drive member includes a braking portion, the second robotic input drive member includes a plurality of cavities, and The second adapter output drive member is configured to be coupled to the second robotic input drive member such that the braking portion is received in one of the plurality of cavities.

7. The manual drive adapter according to claim 6, wherein the braking portion of the second adapter output member is a first braking portion, the second adapter output member includes a second braking portion, and the second adapter output member has a center point, both the first braking portion and the second braking portion are positioned at an equal distance from the center point.

8. The manual drive adapter according to claim 7, wherein the first braking portion, the center point, and the second braking portion are non - collinear.

9. The manual drive adapter according to claim 6, wherein: the robotic instrument includes a wrist, the wrist is operably coupled to the instrument input drive member, and when the braking portion is received in one of the plurality of cavities, the movement of the wrist is restricted.

10. The manual drive adapter according to claim 6, wherein the braking portion is spring - biased into one of the plurality of cavities.

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