Automated mechanical surgical instrument replacement

Abstract

A system and method for facilitating removal of a surgical instrument from an automated mechanical manipulator provides a surgical instrument having an instrument adapter mountable to an expandable receiver of an automated mechanical surgical system. With the instrument adapter positioned in the receiver, the user grasps the surgical instrument, pressing the one or more replacement members, changing the position of the replacement members relative to the receiver. The replacement member is configured such that its position will change relative to the receiver only if the user has firmly gripped the adapter. The receiver detects a change in position of the replacement member and, in response, moves the receiver from a closed position to an open position so that the instrument can be replaced by a user.

Description

Related applications

[0001] This application claims priority to U.S. Provisional Application No. 63 / 485,986, filed on February 20, 2023. Technical Field

[0002] This invention relates generally to the field of surgical devices and systems, and more specifically to the field of surgical instruments for robot-assisted surgery. Background Technology

[0003] Various types of automated mechanical surgical systems exist or are under development in the market. Some automated mechanical surgical systems use multiple automated mechanical manipulators or arms. Each arm carries surgical instruments or a camera for capturing images from inside the body for display on a monitor. Typical configurations allow for two or three instruments, along with a camera that will be supported and manipulated by the system. Input to the system is generated based on input from the surgeon located at the surgeon's console, typically using an input device such as an input handle. The system responds to the movement of the user's input device by controlling the automated mechanical manipulator arms associated with the input device to position, orient, and actuate the surgical instruments on that manipulator. Images captured by the camera are displayed on a monitor at the surgeon's console. The console can be located on the patient side, within a sterile area, or outside a sterile area.

[0004] An automated mechanical arm / manipulator includes a portion typically located at the distal end of the arm, designed to support and manipulate a surgical device assembly. The surgical device assembly includes a surgical instrument having a shaft and a distal end effector located on the shaft. The end effector is capable of being positioned within the patient's body. The end effector can be one of many different types of end effectors used in surgery, including but not limited to end effectors having one or more of the following characteristics: opening and closing jaws, a segment located at the distal end of the shaft that bends or hinges with one or more degrees of freedom, a tip that rolls axially relative to the shaft, and a shaft that rolls axially relative to the manipulator arm.

[0005] In many automated mechanical surgical systems, including those using rigid-axis instruments, surgical instruments are manipulated both automatonically via automated mechanical manipulator arms positioned outside the patient and electromechanically within the patient. In many systems, automated mechanical manipulation pivots the instrument axis relative to the patient and can alter the insertion depth and / or roll the instrument about its longitudinal axis. Furthermore, electromechanical actuation (or hydraulic / pneumatic actuation) can open and close the instrument jaws and / or actuate the hinges or bending of the distal end of the instrument axis, and / or roll the instrument axis or distal tip. Some systems may use only the latter form of instrument movement while using fixed supports or inactive automated mechanical manipulators to hold a more proximal portion of the instrument in a fixed position outside the body.

[0006] A proximal housing is typically located at the proximal end of the instrument shaft. This housing serves as an adapter or junction between the surgical instrument and the automated mechanical manipulator arm. The adapter may include a passive actuation mechanism that receives movement transferred from an active actuator in the automated mechanical manipulator or other support to the instrument end effector. Such functions may include jaw opening-closing, shaft hinge or bending, or other functions. As described above, the instrument actuator for driving the movement of the end effector is an electromechanical motor or other type of actuator that responds to user input to actuate the function of the instrument. The instrument actuator is typically located in the end portion of the automated mechanical manipulator. In some cases, the instrument actuator is located in the proximal housing of the surgical device assembly. In yet another configuration, some instrument actuators are located in the proximal housing, while others are located in the automated mechanical manipulator. In the latter example, some functions of the end effector may be driven by one or more motors in the end portion of the manipulator, while other movements may be driven by motors in the proximal housing. See, for example, US 2016 / 0058513, Surgical System with Sterile Wrappings, in which an electromechanical actuator in an automated mechanical manipulator is used to initiate a jaw opening-closing function, and in which an electromechanical actuator housed in the proximal housing of a surgical device assembly is used to initiate a rotation or turning function of the instrument.

[0007] In some systems, certain surgical instruments can be detachably connected to their respective adapters. This facilitates postoperative cleaning and sterilization of the instruments and adapters by allowing them to be separated.

[0008] For surgical instruments actuated to perform jaw opening-closing, hinge, bending, or other functions, there is typically a mechanical engagement between the adapter and the automated mechanical manipulator. Movement generated by the instrument actuator within the automated mechanical manipulator is transmitted through this mechanical engagement to one or more mechanical inputs of the adapter to control any degree of freedom of the instrument and, where applicable, the jaw opening-closing function. This movement can be transmitted via a cover positioned between the sterile adapter and the non-sterile manipulator arm. In some commercially available automated mechanical systems, this movement is transmitted using a rotary connection, in which a rotary disk on the manipulator transmits movement to a rotary disk on the instrument adapter. See, for example, the configuration shown in US 6491701. In the embodiment shown in US 9358682, a lateral sliding pin extends laterally from one side of the housing portion mounted to the proximal end of the instrument. The lateral sliding pin is movable to open and close the jaws of the instrument (Figure 18 of the patent). When the instrument is mounted to the manipulator arm, the sliding pin is received by a corresponding component 430 in the manipulator arm (Figure 19). When it is necessary to open / close the instrument jaws, component 430 is translated on the carrier via a motor in the laparoscopic instrument actuator 400 of the manipulator arm. This advances the sliding pin 314 to actuate the jaws.

[0009] Instruments are interchangeable during surgery, allowing one instrument (and its corresponding adapter) to be removed from the manipulator and replaced with another. To minimize surgical time and make efficient use of operating room staff, the instrument changeover process must be made as efficient as possible.

[0010] For robust and safe instrument changes, both of the following are important: ensuring that the user reliably holds the instrument and that the user is also in a safe position relative to the moving automated mechanical manipulator arm.

[0011] The applicant’s co-pending publication, US 2021 / 169595, incorporated herein by reference, describes a compact actuation assembly, also referred to as an instrument assembly or “IDS,” which can be expanded to receive an adapter positioned at the proximal end of a surgical instrument and taken to a closed position to engage the instrument. Thus, the actuation assembly can be operated by an automated mechanical manipulator and can also be actuated as needed for jaw opening-closing, hinged or bent, or other functions. Instrument replacement using this configuration requires opening the IDS to allow removal of the existing instrument. The proximal end adapter of the replacement instrument is then positioned, and the IDS is moved to a closed position to engage and actuate.

[0012] When a user wishes to change one surgical instrument held by an automated mechanical manipulator to another, the instrument needs to be retracted from and moved away from the patient's body. This is typically done in a manual-guided operation, where the user uses his or her hand to retract the manipulator arm, thus moving the instrument out of and away from the body.

[0013] In existing systems, a distal linear guide is used to provide translation of surgical instruments along their longitudinal axis, which may be referred to as the z-axis. This linear guide provides predictable instrument movement during instrument changes.

[0014] This application provides linearly constrained motion during instrument changes without requiring a physical linear guide. Attached Figure Description

[0016] Figure 1 This is a three-dimensional diagram of a robot-assisted surgical system that can utilize the configuration described in this article;

[0017] Figure 2 It is a perspective view of an automated mechanical manipulator arm with a receiver / IDS and instrumentation assembly mounted thereto.

[0018] Figure 3 It shows Figure 2 A three-dimensional view of the receiver and the surgical instruments separated from the receiver;

[0019] Figure 4 This is a perspective view showing the device installed in the IDS;

[0020] Figure 5A and Figure 4 Similar, but shows a sterile cover between the device adapter and the IDS;

[0021] Figure 5B The IDS is shown in its expanded position, with the cover in place. The cover connector is shown detached from the cover, thus features within the IDS that receive the cover connector are visible;

[0022] Figure 6 This is a perspective view showing an instrument adapter equipped with a changing lever;

[0023] Figure 7A It is a 3D image of IDS, and Figure 7B This is a plan view of the far end of the IDS. Figure 7A and Figure 7B Each showed a detector;

[0024] Figure 8This is a 3D view of the IDS, where several features are omitted. The IDS housing is shown as a transparent view to allow internal features to be seen.

[0025] Figure 9 This is a cross-sectional view of the instrument adapter attached to the IDS, showing the components related to instrument replacement;

[0026] Figure 10A and Figure 10B This is a schematic diagram of the back of the instrument adapter, showing the movement of the detected target when the user presses the area of ​​the instrument changing lever.

[0027] Figure 11A and Figure 11B The diagram illustrates the device usage status and device replacement request status of the IDS, which are detected using optical sensors.

[0028] Figure 12 It can be used Figure 11A and Figure 11B A perspective view of an example of one type of sensor in the configuration shown;

[0029] Figure 13A and Figure 13B The diagram illustrates the device usage status and device replacement request status of the IDS, which are detected using optical sensors.

[0030] Figure 13C is similar to Figure 13B The diagram also illustrates the use of the replacement lever for the orientation sensor. Figure 13D is a partial exploded view of the replacement lever from Figure 13C.

[0031] Figure 14 The diagram illustrates the method of using the described features;

[0032] Figure 15A and Figure 15B An alternative embodiment incorporating a cam feature is schematically illustrated, which is used to move the instrument adapter away from the cover connector via cam action. Detailed Implementation

[0034] Although the concepts described in this article can be applied to various automated mechanical surgical systems, reference will be made to... Figure 1 The various embodiments are described using a system of the type shown. In the illustrated system, an automated mechanical manipulator 10 is positioned near the patient bed 2. Each manipulator 10 is configured to manipulate a surgical instrument 12 having a distal end effector capable of being positioned within the patient's body cavity. Figure 1 Four automatic mechanical actuators are shown; however, in other configurations, the number of actuators may vary.

[0035] The surgical console 14 has two input devices, such as handles 16 and 18. These input devices are configured for user manipulation to generate signals for commanding automated mechanical manipulators to move in multiple degrees of freedom, thereby manipulating instrument end effectors within a body cavity. The input devices can be mounted to linkages, universal joints, etc., equipped with sensors that generate signals corresponding to the position or movement of the input devices in a manner known to those skilled in the art. In other embodiments, the input devices may take the form of handles that are tracked using a tracking system, such as an optical or electromagnetic tracking system, which may be used alone or in combination with other sensors within the handle, such as an IMU.

[0036] In use, the user selectively assigns the two handles 16, 18 to the two automata in the automata 10, thereby allowing the surgeon to control two surgical instruments in the surgical instruments 12 at any given time. To control a third instrument in the instruments positioned at the work site, one of the two handles 16, 18 can be operatively disengaged from one of the initial two instruments and then operatively paired with the third instrument, or another form of input can control the third instrument as described in the next paragraph.

[0037] One of the instruments in instrument 12 is a camera that captures images of the surgical field of view within the body cavity. The camera can be moved using input from various types of input devices via its corresponding automated mechanical manipulator, including but not limited to one of handles 16, 18, additional controls on the console, foot pedals, eye-tracking device 21, voice controller, etc. The console may also include a display or monitor 24 configured to display images captured by the camera and optionally display system information, patient information, etc. An auxiliary display 26—which may be a touchscreen display—can further facilitate interaction with the system.

[0038] This surgical system allows operating room medical personnel to remove and replace surgical instruments 12 carried by an automated mechanical manipulator 10 as needed for the surgery. When an instrument needs to be replaced, the surgeon removes the instrument from the manipulator arm and replaces it with another instrument.

[0039] As discussed, manipulation of input devices 16, 18 generates signals processed by the system to produce commands for manipulating the movement of the manipulators, enabling the instruments to move in multiple degrees of freedom and appropriately controlling the operation of electromechanical actuators / motors that drive instrument functions, such as the articulation, bending, and / or actuation of the instrument end effectors. One or more control units 30 are operatively connected to the automated robotic arm and the user interface. The control unit receives user input resulting from the movement of the input devices and generates commands for the automated robotic arm to manipulate the surgical instruments, causing the instruments to be positioned and oriented according to the user-provided input.

[0040] Reference Figure 3 The receiver 104 is located at the distal end of each manipulator arm; the receiver 104 may also be referred to as an instrument drive assembly (IDS). Different surgical instruments 12 can be detachably mounted to each IDS. For example... Figure 3 As can be best seen from the image, each device 12 includes an elongated shaft 106, which is preferably rigid, but may be flexible or partially flexible in alternative systems. An end effector 108 is positioned at the distal end of the shaft 106, and a base assembly or adapter assembly 110 is positioned at the proximal end.

[0041] The following describes instrument and IDS configurations suitable for use with the disclosed invention; however, it should be understood that these instrument and IDS configurations are given by way of example only. The disclosed manipulator can be used with instruments and instrument drive systems of various configurations. More specifically, while the receiver / IDS described herein is configured to drive pitch and jaw movements of the articulated surgical instrument, in alternative embodiments, the receiver / IDS may have fewer functions. In some alternative configurations, the receiver / IDS may simply be used to receive the instrument and drive jaw opening / closing operations. In other configurations, the receiver / IDS may be configured, together with the instrument, to actuate a rolling function of the instrument tip relative to the axis of the instrument.

[0042] The device depicted in the accompanying figures is of the type described in a co-pending application jointly owned by the applicants, published in US 2020 / 0375680, entitled Articulating Surgical Instrument, which is incorporated herein by reference. The device uses four drive cables, two of which terminate at one jaw member, and the other two terminate at the other jaw member. This can be two cables looped around the end effector (thus, each of the two free ends of each cable loop is located at the proximal end), or it can be four separate cables. As described in the co-pending application, the tension on the cables varies in different combinations to affect the pitch and yaw motion of the jaw members and the jaw opening-closing function. Other devices used with this system will have a different number of cables, the specific number determined by the device function, the degrees of freedom of the device, and the particular configuration of the device's actuating components. Note that in this specification, the terms "tendon," "thread," and "cable" are used broadly to cover any type of tendon that can be used for the purposes described. The drive cable of the surgical instrument extends from the end effector 108 through the shaft 106 ( Figure 2 This extends into adapter assembly 110, where the drive cable is connected to the mechanical actuator. A more detailed description is given in the applicant’s co-pending application, US2021 / 169595, which is incorporated herein by reference, but this document will provide a general configuration of these actuators with respect to the adapter assembly.

[0043] Adapter assembly 110 (also referred to as the "adapter") may include a closed or partially closed structure, such as a housing or shell, or adapter assembly 110 may be a frame or plate. The exemplary adapter 110 shown in the figures includes a mechanical input actuator 112 exposed to the outside of the surgical instrument 102. Figure 3 In the middle, two mechanical input actuators 112 are exposed at the first lateral surface of the adapter 110. Two second mechanical input actuators 112 (in Figure 3 (Not visible in the middle) may be exposed on the opposite second side surface of the adapter 110, preferably but optionally, to be in contact with Figure 3 The same or similar configurations shown are exposed on the opposite second lateral surface of adapter 110.

[0044] Each mechanical input actuator in the mechanical input actuator 112 is movable relative to the adapter 110 between a first position and a second position. In the specific configuration shown in the figures, the actuator is capable of moving relative to the housing as follows: Figure 3The movement is longitudinal between the first (more distal) position and the second (more proximal) position. However, the direction of movement is not required to be longitudinal and can extend in any direction.

[0045] In this configuration, the adapter thus has four drive inputs exposed to the outside, one drive input corresponding to each of the input actuators 112. The illustrated adapter has two parallel flat surfaces, and two of these inputs are positioned on each of the flat surfaces. While it is preferable to include the inputs on opposite sides of the proximal body, other arrangements of the inputs on multiple surfaces of the proximal body can also be used alternatively. Each of these configurations advantageously arranges the drive inputs to maximize the distance between the control inputs, thereby minimizing stress in the sterile cover positioned between the proximal body and receiver 104 during use. Co-pending US2021 / 169595 contains Figure 3 Further description of the adapter shown.

[0046] The IDS 104 located at the end of each manipulator 10 has an open position (e.g., Figure 3 As shown), in the open position, IDS 104 detachably receives the adapter 110 of the corresponding device 12 to form assembly 100. After the adapter 110 is placed inside the IDS, the IDS moves to... Figure 4 The adapter 110 is thus captured in the closed position shown. In this position, the drive input 112 of the adapter can engage with the corresponding drive output 114 of the IDS. As described in detail in co-pending US 2021 / 169595, user inputs at input devices 16, 18 commanding the instrument to perform jaw opening and closing, pitching or yaw hinge, etc., cause the electromechanical actuator in the IDS to move the drive output 114. The movement of those drive outputs moves the corresponding one of the drive inputs 112 of the adapter, thereby changing the tension on the drive cable of the instrument in a manner that results in the desired movement being performed at the end effector of the instrument.

[0047] It is important to understand that the IDS described in this application and in US 2021 / 169595 are examples of various instrument drive systems to which the inventive concepts described below can be applied. However, these concepts are equally applicable to any system in which instrument replacement requires the adapter of the instrument to be released from the support in such a way that the system receives confirmation that the user is supporting the instrument before the instrument will be released.

[0048] IDS and automated mechanical manipulators are typically unsterilized components, which are covered by a sterile cover before being attached to a sterile surgical instrument. Figure 5 illustrates the engagement of the IDS and the instrument, with a cover 154 or barrier between them. As previously described, at the interface between the driving element of the IDS and the driven element of the adapter, the end effector movements described above are transmitted through the cover to control the degrees of freedom of the instrument. This cover may include an embedded plastic "cover connector" 156, which is adhered such that the connector has a geometry extending to both sides of the cover. For example, the cover connector includes mating pins, posts, conical elements, etc., 152 in the proximal direction that mate with a recessed portion 150a (e.g., recess, conical notch, hole, or similar alignment feature) in the seat of the IDS 104, and the cover connector includes the same or similar elements on the distal direction that mate with a recessed portion 150b on the instrument adapter. See also Figure 5B and Figure 10A .

[0049] The automated mechanical manipulator can be a manipulator that automatically and mechanically manipulates the instrument 102 with one or more degrees of freedom during surgery (e.g., as shown in the image). Figure 1 (As shown in the image), or a support that remains stationary during the surgical procedure of a surgical instrument used in an automated mechanical surgical system. As detailed in co-pending US 2021 / 169595, user input at input devices 17, 18 commands the instrument to perform jaw opening and closing, pitching, or tilting articulation, etc., causing an electromechanical actuator in receiver 104 of arm 14 to move a drive element in receiver 104. The movement of those drive elements causes a corresponding actuator in actuator 112 of the adapter to move, thereby changing the tension on the instrument's drive cable in a manner that causes the end effector of the instrument to perform the desired movement.

[0050] Transmit user intent and device safety during device removal.

[0051] This section describes features that improve the usability of the IDS and adapters described in US 2021 / 169595. In general, these features perform one or any combination of the following functions:

[0052] (a) A mechanism is provided in which the system will only allow or initiate opening of the IDS or release of the device from the IDS upon receiving signals that confirm whether the user has engaged the device with sufficient force with his or her hand, thereby preventing the device from falling when the IDS is opened or when the device is released.

[0053] (b) A mechanism is provided through which a user can give input instructing the system to open the IDS, release the instrument from the IDS, or initiate another action related to removing the instrument from the IDS. This input can also trigger other responses, such as retracting the IDS away from the adapter (along the z-axis) using a connection of an automatic mechanical manipulator.

[0054] (c) Preferably, the functions described in (a) and (b) are performed by a single action of the user's body. In this implementation, the user may simply grasp the adapter with one hand, and this single action will cause the system to generate signals that both confirm the user is grasping the adapter and initiate the opening or release of the IDS from the system. However, in other implementations, the user actions that result in the performance of functions (a) and (b) may be separate actions (e.g., grasping the adapter to generate a signal confirming the user is grasping the adapter, and simultaneously taking another action, such as pressing a button, turning a lever, etc., while maintaining the grasp of the device, to command the opening or release of the IDS from the system).

[0055] structure

[0056] Reference Figure 6 In an exemplary embodiment of the invention, a replacement input assembly is provided on the device adapter. The replacement input assembly is a mechanical feature engaged by the user to generate an electronic signal indicating that the user wishes to remove the device and that the user is gripping the adapter. The replacement input assembly shown in the figures is a pair of replacement members or levers 200 located on the device adapter. Each replacement lever 200 includes a distal portion 202 configured to be pressed by the user and to advance inward toward the longitudinal axis of the adapter upon pressing. The distal portion 202 may be shaped to receive the user's finger, thereby forming a defined pressing area or button as shown.

[0057] The replacement lever 200 also includes a proximal portion 204 that is displaced when the user presses the distal portion. In the embodiment shown in the figures, the replacement lever pivots about a pivot point or hinge provided between the proximal and distal portions, such that when the distal portion 202 is pressed down, the proximal portion 204 pivots away from the longitudinal axis of the adapter. Figure 8 With optimal visibility, the detection target 206 is positioned on the proximal portion of the replacement rod 200.

[0058] It should be noted that the specific mechanical features of the input replacement assembly can vary between embodiments, and this description should not be construed as limiting the invention to any particular configuration of the input replacement assembly or the replacement lever. Alternatively, any structure or component configured to produce an action similar to the replacement lever described herein—that is, to mechanically displace one or more detection targets relative to the corresponding detector in response to a user gripping the device adapter—discussed below—can be used. In some variations, the input replacement assembly may include one or more links, flexible elements, or other components operatively associated with the physical displacement of the detection target in response to a user gripping the device. Mechanisms pivoting around a pivot or articulation (or a set of articulations / pivots) may be used; these mechanisms may be flexible elements or groups of flexible elements. When using flexible elements, the flexible elements may be incorporated as part of the corresponding replacement lever, or the flexible elements may be multi-part components. In other embodiments, the device replacement assembly may include a pair of mechanical switches or buttons not connected to a pivoting or traversing linkage or lever. In this implementation, detecting that two buttons / switches have been pressed simultaneously sends a signal to the system, indicating that the user is gripping the adapter and wishes to remove the device from the IDS replacement unit.

[0059] Electronic detectors 208 are positioned within the IDS. Each electronic detector is positioned and intended to detect whether its corresponding detection target 206 has been displaced due to the user pressing the proximal portion 204 of the replacement lever 200. The type of detector used for this purpose can vary. In some implementations, for example... Figure 11A and 11B In the implementations shown, optical switches, such as Onsemi / Fairchild's QRE1113 miniature reflective object sensor, are used as detectors to detect the movement of the target and / or when the target aligns with the detector. See also Figure 12 For these configurations, the optical target of the detector can be a simple geometric feature that blocks the optical sensor, or the optical target of the detector can have a reflective element (bright material, reflective strip, marking, reflective paint, light color, etc.) that increases the light intensity difference between the first position and the second position (which corresponds to the instrument replacement requested by the user). Detector 208 is connected via a cover connector ( Figure 5B ) and IDS housing ( Figure 7B The window or opening 207 in the detector is exposed, thus allowing light to pass between the detector and the target.

[0060] like Figure 13A and Figure 13BAs shown, an alternative configuration can be used, in which detector 308 is a Hall effect sensor, and the detected target includes magnet 306 located at the distal end 202 of the replacement rod. In this case, the detector detects the presence and strength of the magnet's magnetic field. This is in Figure 13A and Figure 13B The figure below illustrates this configuration. This configuration is particularly advantageous because it can be used to inform the system of the orientation of the adapter. This is important for the control of the IDS, as the system must know the required orientation of the surgical instruments within the adapter so that the control algorithm for the IDS can map the IDS actuators to their corresponding drive inputs on the instrument adapter. In this configuration, one of the replacement levers is the North Pole lever 300a, where the north pole polarity of the magnet is positioned so that it can be detected by a Hall sensor within the receiving adapter area of ​​the IDS. The other replacement lever is the South Pole lever 300b, where the south pole polarity of the magnet is positioned so that it can be detected by a Hall sensor within the receiving adapter area of ​​the IDS. To set the orientation, these levers are assembled relative to specific features on the drive carriage / drive input and / or adapter housing within the IDS, such as flush end caps. Figure 13D shows that the magnets can be enclosed within the proximal end of the replacement lever using a cap. When the adapter is sufficiently close to the IDS, the two Hall sensors detect the polarities of the two replacement levers. Therefore, the orientation of the instrument adapter is determined using the readings of the corresponding Hall sensors. For example, the north polarity reading of Hall sensor 308a and the south polarity reading of sensor 308 can be recorded by the system as the 0-degree orientation of the adapter, while the south polarity reading of Hall sensor 308a and the north polarity reading of sensor 308 can be recorded by the system as the 0-degree orientation of the adapter.

[0061] Each replacement lever preferably has at least a first position and a second position. Figure 8 , Figure 9 , Figure 10A , Figure 11A and Figure 12 In the first position shown in A, the distal portion 202 is at its outermost position relative to the longitudinal axis of the adapter, while the proximal portion 204 is at its innermost position relative to the longitudinal axis of the adapter. In the illustrated embodiment, in the first position, the detection target 206 is aligned with the detector 208. Figure 10B , Figure 11B and Figure 12In the second position shown in B, due to the force of the user's finger pressing against the pressing area of ​​the distal portion 202, the distal portion 202 shifts inward, while the proximal portion 204 shifts outward, thereby displacing the detection target 206 away from the detector 208 and out of alignment with the detector 208. It should be noted that the term "alignment" in this context does not necessarily require direct alignment; it means that the position of the detection target relative to the detector is sufficient for the detector to generate a signal that the system recognizes as indicating that the user is gripping the adapter. In some cases, such as with some optical sensors, this could be the absence or presence of the detection target, for example, when the optical sensor is obscured or unobscured by the detection target, or when the Hall sensor detects the presence or absence of a magnetic field. In other cases, the response is threshold-based. For example, a threshold is set such that moving the detection target to disalign with the detector causes the sensed standard to drop below a predetermined threshold, indicating that the user is gripping the adapter. Examples of thresholds include, but are not limited to: the amount of visible / infrared / electromagnetic radiation reflected by the detection target and detected by the optical sensor; the magnetic field strength sensed by the Hall sensor; and the distance between the detection target and the detector determined based on the signal received by the detector.

[0062] exist Figure 8 In this implementation, the return spring biases the replacement lever in a first position such that the replacement lever returns to the first position when the user stops applying force to the pressing area. Figure 9 In this implementation, the pivot geometry of the replacement lever is formed by a flexible element that combines both pivoting motion and a return spring force. When the pressure applied to the pressing area is released, this return spring force returns the replacement lever to the first position.

[0063] In some embodiments, the replacement input assembly also serves to facilitate the mechanical disengagement of the proximal end of the adapter from the cover connector as the IDS begins to open. More specifically, the replacement input assembly may be configured to include a cam portion that presses against the cover connector as the replacement input assembly pivots to a second position, thereby disengaging the mating feature 152 of the cover connector from the concave portion 150b located on the proximal face of the adapter. See Figure 15A and... Figure 15BThis also has another advantage: pushing the cover connector against the IDS ensures that the cover connector and cover remain in place on the IDS as the instrument is removed. This can be configured as a single-stage process in which the pressure applied by the user to the replacement input assembly performs a single action: moving the probe target sufficiently to provide the system with the required input, thus confirming that the user is grasping the instrument while simultaneously signaling their intention to remove it, and simultaneously moving the adapter body away from the cover connector via a cam action. For example, after the user moves the probe target, causing a signal to the system (and, for example, the IDS begins to open), further pressure on the distal portion of the replacement input assembly will cause the proximal portion to move further, pushing the adapter away from the fixed feature of the cover connector. This movement can be a smooth advance without jamming, or a jam or other feature that produces a tactile click, bump, or increase in tension to let the user know that the first “half-press” operation has been completed. Full advance can then produce another tactile sensation using this jamming or the naturally greater force felt as the replacement assembly continues to move as it reaches the fully advanced state. In a variation of this implementation, the replacement component performs the same function not through multi-stage advancement, but through multiple identical advancement stages. In an alternative implementation, the cam function can be performed using a mechanism independent of the input component replacement mechanism.

[0064] Orientation of transmission equipment

[0065] method

[0066] The following will refer to Figure 14 A method is described for informing a user of an automated mechanical system that they wish to remove an instrument, for example, for instrument replacement. Control of the electronic functions associated with this method can be performed using a processor 30.

[0067] In the initial step, the user grasps the adapter, with the user's thumb placed on the distal portion 202 of a replacement lever 200, while one or more of the user's opposite fingers are placed on the distal portion of the opposite replacement lever. The user presses the distal portions toward the adapter body, thereby pivoting the proximal portion 204 of the replacement lever outward.

[0068] The system receives signals from the detector. When these signals indicate that the target has become out of alignment with the detector (as described above), the system recognizes that the user is gripping the adapter. Therefore, the system undertakes the subsequent steps required to remove or replace the device. These steps may include: activating the motor in the IDS to open it, or electronically releasing the locking mechanism in the IDS to allow it to be manually opened. A non-limiting example of manually opening the IDS is discussed in US2021 / 169595 regarding lever / knob 138 (see this application). Figure 4 This was discovered in [the document]. Other actions may include: moving the jaws of the surgical instrument to the open position when the jaws are closed; straightening the surgical instrument when it is articulated; or activating the motor of the manipulator arm to retract the manipulator arm along the z-axis (where the z-axis coincides with the longitudinal axis of the instrument mounted to the IDS), so that the automated mechanical manipulator retracts away from the adapter after the IDS has been opened.

[0069] A specific sequence of events for replacing the instrument can be shown below:

[0070] The user begins the replacement sequence by gripping the device and pressing down on the distal part of the replacement component as described above, and the system recognizes that the user intends to remove the device and that the user's hand is firmly gripping the device.

[0071] Open the instrument jaws before they are fully open.

[0072] The system retracts the manipulator arm (along the machine axis).

[0073] The IDS arm moves to the open position.

[0074] The user removes the device, separating the cover from the cover connector before the cover connector is separated by the actuation of the cam feature.

[0075] The user inserts the new instrument into the IDS and presses it proximally to engage the fixing features with those features of the cover connector.

[0076] The IDS arm can be closed by pressing a button, thereby locking the instrument in place. Alternatively, locking can be initiated by the detector detecting the presence of a new instrument target, or by the sensing characteristics of an alternative instrument.

[0077] The user manually guides the instrument (attached to the IDS) to the position where a previously used instrument was placed. For safety, the system can be configured to stop this movement before approaching the previously used instrument's previous working position in the body cavity. In some implementations, the system can also provide an automatic insertion function initiated by pressing a button.

[0078] in conclusion

[0079] The concept described in this application includes an instrument adapter for attaching an instrument to an automated mechanical surgical system. The instrument adapter also includes a region or button that a user can press down to indicate a desire to initiate an instrument change. This button or region is located in a proximal position on the instrument axis, thereby passively limiting the user's ability to maintain a fixed position on the instrument's weight. This proximal position allows the user to request an instrument change without changing their hand position.

[0080] The concept described herein offers several advantages, including ensuring the user is holding the instrument axis in a stable position before releasing the instrument from the IDS; and in some cases, utilizing mechanical advantages to further assist in pushing the instrument away from the cover connector and pushing the cover connector into the IDS, thereby ensuring fixation. In the described implementation, the user can both express their intention to change instruments to the automated mechanical surgical system and remove instruments from the system without changing hand position.

[0081] While some embodiments have been described above, it should be understood that these embodiments are presented by way of example only and are not intended to be limiting. It will be apparent to those skilled in the art that various changes in form and detail can be made to the invention without departing from the scope characterized by the claims. This is especially true given the techniques and terminology that may subsequently be developed in the relevant art. Furthermore, the features of the various disclosed embodiments can be combined in various ways to produce a variety of other embodiments.

[0082] All patents, patent applications and print publications mentioned above, including those for priority purposes, are incorporated herein by reference. Claims (as amended under Article 19 of the Treaty) 1. A method for removing surgical instruments from an automated mechanical manipulator, the method comprising: An automated mechanical manipulator is provided having an expandable receiver for receiving the proximal end of a surgical instrument, the receiver having an open position and a closed position, wherein in the open position the base of the surgical instrument can be introduced into an actuator assembly, and in the closed position the receiver releasably engages the base. With the receiver in the closed position, the surgical instrument is gripped by the user's hand; In response to a grasp of the surgical instrument, the receiver is moved from the closed position to the open position; and With the receiver in the open position, the surgical instrument is removed from the receiver. 2. The method of claim 1, wherein the grasping step of the instrument is performed using a single hand. 3. The method of claim 1, wherein the method includes, during the grasping step, using a detector located on the receiver to detect displacement of the probe target on the instrument. 4. The method of claim 3, wherein detecting displacement includes detecting displacement of a first detection target capable of moving in response to pressure from a first portion of the surgical instrument by a user's thumb, and detecting displacement of a second detection target capable of moving in response to pressure from a second portion of the surgical instrument by at least one user's finger, wherein the user's thumb and the user's finger are located on the same hand of the user. 5. The method of claim 3, wherein when the user grasps the device, the detection target is movable from a first position to a second position, and wherein, in the second position, the detector generates a signal indicating that the detection target is not aligned with a corresponding detector. 6. The method of claim 5, wherein, at the second position, the detector generates a signal indicating at least one of the following: the presence of the target being absent or reduced relative to the detector. 7. The method of claim 1, wherein moving the receiver from the closed position to the open position comprises actuating a motor, the actuation of the motor moving the receiver from the closed position to the open position. 8. The method of claim 1, wherein moving the receiver from the closed position to the open position comprises electronically releasing a locking element, and then, after releasing the locking element, manually moving the receiver from the closed position to the open position. 9. An automated mechanical system component, comprising: A surgical instrument having an elongated shaft, an end effector located at the distal end of the elongated shaft, and a proximal body located at the proximal end of the elongated shaft; An actuator assembly including a first arm and a second arm having opposing first and second surfaces defining an instrument receiving portion located between the first and second arms, the actuator assembly having an open position and a closed position, wherein in the open position, the proximal body of the surgical instrument can be introduced into the instrument receiving portion of the actuator assembly, and in the closed position, the proximal body is releasably engaged by engaging the actuator assembly; At least one detection target is arranged on the proximal body such that manual gripping of the proximal body by a user causes the detection target to shift relative to the proximal body. At least one sensor, located on the actuator assembly, configured to detect displacement of the probe target relative to the proximal body when the proximal body is engaged by the actuator assembly in a closed position; and At least one motor, the at least one motor being configured to move the actuator assembly from the closed position to the open position in response to a detected displacement of the probe target relative to the proximal body. 10. The automated mechanical system component of claim 9, wherein the at least one detection target includes a first detection target movable in response to pressure from a user's thumb against a first portion of the proximal body and a second detection target movable in response to pressure from at least one user's finger against a second portion of the proximal body, wherein the user's thumb and the user's finger are located on the same hand of the user. 11. The automated mechanical system assembly of claim 9, wherein the proximal body comprises at least one member having a distal end and a proximal end, wherein the at least one detection target is disposed on the proximal end of the member, and wherein the proximal end is displaced relative to the proximal body in response to manual pressure of the distal end by a user's finger. 12. The automated mechanical system component according to claim 10, wherein: The proximal body includes a first component, wherein the first portion of the proximal body is the distal end of the first component, and wherein the first detector is located on the proximal end of the first component; The proximal body includes a second component, wherein the second portion of the proximal body is the distal end of the second component, and wherein the second detector is located on the proximal end of the first component. 13. The robot system component of claim 9, wherein the sensor is an optical sensor. 14. The robot system component of claim 9, wherein the sensor is a magnetic sensor.

Claims

1. A method for removing surgical instruments from an automated mechanical manipulator, the method comprising: An automated mechanical manipulator is provided having an expandable receiver for receiving the proximal end of a surgical instrument, the receiver having an open position and a closed position, wherein in the open position the base of the surgical instrument can be introduced into an actuator assembly, and in the closed position the receiver releasably engages the base. With the receiver in the closed position, the surgical instrument is gripped by the user's hand; In response to a gripping of the surgical instrument, the receiver is moved from the closed position to the open position; as well as With the receiver in the open position, the surgical instrument is removed from the receiver.

2. The method according to claim 1, wherein, The grasping step of the device is performed using a single hand.

3. The method according to claim 1, wherein, The method includes using a detector located on the receiver to detect displacement of the probe target on the instrument during the gripping step.

4. The method according to claim 3, wherein, The displacement detection includes detecting displacement of a first probe target that is movable in response to pressure from a first portion of the surgical instrument by a user's thumb, and detecting displacement of a second probe target that is movable in response to pressure from a second portion of the surgical instrument by at least one user's finger, wherein the user's thumb and the user's finger are located on the same hand of the user.

5. The method according to claim 3, wherein, When the user grips the device, the detection target can move from a first position to a second position, wherein, in the second position, the detector generates a signal indicating that the detection target is not aligned with the corresponding detector.

6. The method according to claim 5, wherein, In the second position, the detector generates a signal indicating at least one of the following: the presence of the target being detected is absent or reduced relative to the detector.

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