Robotic surgical system with interchangeable suturing tool modules

Abstract

A mounting system configured to operably couple a tool module to a component of a medical instrument. In some embodiments, the component to which the tool module is operably coupled is an elongate member passable through a natural orifice of a patient. The tool module may include a replaceable end cap having a needle holder for passing the needle through tissue and an actuator for controlling movement of the needle holder arm. A suture-equipped suturing needle may be removably coupled to the needle holder. The instrument is operably associated with a robotic system that controls the component of the instrument to which the tool module is operably coupled and / or the tool module.

Description

[Technical Field]

[0001] The present disclosure relates to systems, e.g., treatment systems, and more particularly, to systems, e.g., robotic treatment systems, that perform treatments on mammalian bodies (e.g., treatments of mammalian bodies). More particularly, the present disclosure relates to tools configured to couple to components of the treatment systems, as well as methods of coupling (and uncoupling) the tools to other components of the treatment systems. Various aspects of the present disclosure are particularly applicable to robotic treatment systems, facilitating the use of tools that share features with tools for non-robotic systems. [Background technology]

[0002] The condition of obesity means that an individual has excess body fat and weighs more than what is considered healthy for their height. While biology plays a large role in why some people become obese, not getting enough exercise, consuming more food than the body can utilize, and drinking too much alcohol also contribute to people becoming obese. Obesity is a major health threat, and excess weight puts more strain on every part of the body and puts people at risk for several health problems, such as diabetes, heart disease, and stroke.

[0003] For some people, lifestyle changes such as maintaining a healthy diet and regular exercise can reduce body fat and eliminate obesity. However, for others, losing body fat and maintaining consistent weight loss can be extremely difficult. Weight-loss medications are available on the market, but some have serious side effects and may not actually be effective. For obese people who are unable to reduce body fat through lifestyle changes or medications, a variety of surgical options are available.

[0004] Gastric bypass surgery was the first commonly performed procedure to reduce the size of the stomach. This procedure involves stapling a section of the stomach wall together and then transferring a portion of the small intestine into the newly formed gastric pouch. By reducing the size of the stomach, the amount of food the stomach can hold is reduced, leading to patients feeling fuller more quickly, consuming fewer calories, and absorbing fewer calories, resulting in weight loss. However, this procedure has drawbacks. It is an open surgery, which itself carries potential risks of complications and infection, and can result in a lengthy postoperative recovery period. The procedure is also relatively complex and requires restructuring of the small intestine. Furthermore, over time, the staples may become loose, causing the stomach to expand again, reducing the effectiveness of the procedure.

[0005] Another procedure is the "gastric banding" procedure, primarily performed with the LAP-BAND® system. In this procedure, an inflatable band is inserted through the abdomen and fitted around the stomach via laparoscopic surgery. The band surrounds the upper part of the stomach, forming a stoma (or ring). A thin tube is connected to the ring, which is guided to an access port implanted under the skin. A balloon attached to the band contacts the stomach and can be inflated (or deflated) by injecting (or withdrawing) saline through the access port using a needle. The addition of saline tightens the gastric stoma, causing a feeling of fullness sooner. If the band is too tight, the saline can be withdrawn. The advantages of gastric banding are that it can be performed as a minimally invasive procedure using a small laparoscopic incision in the abdomen, shortening recovery time and not requiring small bowel reconfiguration. Nevertheless, the procedure requires an incision, there is a risk of infection, and recovery can be uncomfortable. Additionally, the patient will be left with a permanent port under the skin, which may not be desirable for some people.

[0006] These types of procedures are effective if all goes well, but as mentioned above, they carry the risks associated with open or laparoscopic surgery, which is why they are only prescribed (or performed) in cases of severe obesity.

[0007] Fully endoscopic, incision-free methods for reducing gastric volume have been developed to surgically treat obesity. Broadly, these methods involve endoluminal approximation of tissue in a portion of the stomach, at least a portion of the greater curvature. The method involves creating an endoscopic stitch pattern that closes a large portion of the stomach. The resulting gastric reduction procedure can reduce available stomach volume by 70% to 75%. Because the procedure does not involve an incision, it is safer for the patient and allows for an easier recovery.

[0008] While this procedure has been shown to be an effective method of reducing gastric volume, producing faster satiety, and resulting in weight loss in obese patients, obstacles remain in its application. Weight loss surgery has traditionally been performed by weight loss surgeons accustomed to reducing the stomach from the outside, who are unfamiliar with operating on gastrointestinal structures from the inside of the digestive tract. Meanwhile, gastrointestinal surgeons, more accustomed to operating from the inside of the stomach, are unfamiliar with weight loss surgery and, as a result, have little proficiency in this type of surgery.

[0009] Although robotic systems have been used in a variety of surgical procedures, they have not been widely used in gastrointestinal surgery, an area that is challenging to operate in because the geometry changes significantly during the procedure, maintaining proper orientation of the robotic tools relative to the reconfigured surgical space is difficult, and the tools required are different from those currently available in the surgical robotics market. Summary of the Invention

[0010] In accordance with the present disclosure, a system is provided for securely coupling a tool module to a component of a medical instrument, e.g., a surgical instrument, for use on a patient's body. For convenience, and without limitation, reference may be made herein to a surgical tool or surgical tool module, although the tool or tool module may also be used in procedures on a patient that may be considered non-surgical. It will be understood, however, that references to tool or tool module may be made interchangeably herein, and without limitation. It will also be understood, without limitation, that reference may be made interchangeably herein to a surgical system, treatment system, robotic system, etc., in which the medical instrument and tool module are used. In some embodiments, the instrument is part of a system, such as a robotic system, e.g., a robotically controlled system (e.g., controlled by automation rather than manually by a human operator). It will also be understood that specific reference may be made herein to the coupling of a tool module to a robotic instrument and / or robotic system and components thereof. However, it will be understood that the various principles of the present disclosure are applicable to other systems, such as manually operated systems, e.g., manually operated surgical systems, manually operated endoscopic systems, etc.

[0011] In some embodiments, the component to which the tool module is coupled is an elongate member, e.g., a flexible elongate member insertable into a patient's body. For example, the component may have a distal end suitable for passage through a patient's natural orifice, e.g., the gastrointestinal tract, particularly the stomach. The tool module may be coupled to the distal end of the component. The tool module may include an end cap. In some embodiments, the end cap is removably positioned on and / or removably operably coupled to the component of the system (e.g., the elongate member) so that the tool module can be used during a procedure and removed for cleaning, disposal, modification, etc., and / or replacement with a different tool module. In some embodiments, the tool is a suturing tool. In some embodiments, the suturing tool has an end cap having a needle holder adapted to pass a needle through tissue. In some embodiments, an actuator is operably coupled to the needle holder and adapted to actuate the needle holder. For example, it may be adapted to move the needle holder. A suture needle with a suture may be removably coupled to the needle holder.

[0012] According to various aspects of the present disclosure, prior to a surgical procedure, a tool module may be operably associated (e.g., securely attached) to a component of a robotic instrument, such as the distal end of the component. Then, during the procedure, the robotic system actively actuates the tool module to perform the surgical procedure. After the surgical procedure is completed, the module may be detached from the robotic instrument. The detached tool module may be cleaned and sterilized for later use or may be discarded. Another (e.g., the same or a different) tool module may be operably coupled to the component of the robotic instrument.

[0013] In accordance with various aspects of the present disclosure, various mounting systems are provided for securely attaching a tool module to a component of a system, such as a robotic system. These mounting systems include, but are not limited to, mechanical connections (e.g., engagement structures), magnetic and / or electromagnetic connections, and adhesive connections. All mounting systems similarly allow the tool module to be released from the component (e.g., its distal end) of the robotic system without causing damage to the system. Furthermore, the mounting system securely secures the tool module to the component, allowing the component and the robotic system to effectively actuate the tool module to perform a desired procedure.

[0014] Although aspects of the present disclosure may be described with particular reference to particular surgical devices and systems and procedures for treating the digestive system, it will be understood that such medical devices and methods may also be used to treat tissues of the abdominal cavity, digestive system, urinary tract, reproductive system, respiratory system, cardiovascular system, circulatory system, etc. [Brief explanation of the drawings]

[0015] [Figure 1] Schematic diagram of the robot system. [Figure 2] FIG. 1 is a perspective view of a distal end of one embodiment of a tool module attached to a robotic instrument component of a robotic system. [Figure 3] FIG. 3 is an assembled perspective view of the distal end of the tool module and robotic instrument of FIG. 2. [Figure 4] 1 is an assembly view of a first embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 5] 5 is a schematic diagram showing the locking system of the mounting system of FIG. 4. [Figure 6] 10 is an assembly view of a second embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 7]10 is an assembly view of a third embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 8] 10A-10C illustrate assembly of a fourth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 9] 10A-10C illustrate assembly of a fourth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 10] 10A-10C illustrate assembly of a fourth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 11] FIG. 10 is a cross-sectional view of a fifth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 12] FIG. 10 is a cross-sectional view of a sixth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 13] FIG. 10 illustrates a seventh embodiment mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 14] FIG. 10 illustrates a seventh embodiment mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 15] FIG. 10 illustrates a seventh embodiment mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 16] FIG. 13 illustrates an eighth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 17] FIG. 13 illustrates an eighth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 18] FIG. 13 illustrates an eighth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 19] FIG. 13 illustrates a ninth embodiment mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 20] FIG. 13 illustrates a ninth embodiment mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 21] FIG. 13 illustrates a ninth embodiment mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 22] FIG. 13 illustrates a tenth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 23] FIG. 13 illustrates a tenth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 24] FIG. 13 illustrates a tenth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 25] FIG. 16 is an assembly view of an eleventh embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 26] FIG. 23 illustrates a twelfth embodiment mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 27] FIG. 23 illustrates a twelfth embodiment mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 28] FIG. 20 illustrates a thirteenth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 29] FIG. 20 illustrates a fourteenth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 30] FIG. 20 illustrates a fifteenth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 31] FIG. 20 illustrates a sixteenth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 32]FIG. 20 illustrates a seventeenth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 33] FIG. 20 illustrates an eighteenth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 34] FIG. 20 illustrates an eighteenth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 35] FIG. 20 illustrates an eighteenth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 36] FIG. 20 illustrates a nineteenth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 37] FIG. 20 illustrates a nineteenth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 38] FIG. 20 illustrates a nineteenth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 39] FIG. 20 illustrates a twentieth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 40] FIG. 21 shows a mounting system according to a twenty-first embodiment for attaching a tool module to the distal end of a robotic instrument. [Figure 41] FIG. 21 shows a mounting system according to a twenty-first embodiment for attaching a tool module to the distal end of a robotic instrument. [Figure 42] FIG. 21 illustrates an alternative twenty-first embodiment mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 43] FIG. 21 illustrates an alternative twenty-first embodiment mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 44]FIG. 22 illustrates a twenty-second embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 45] FIG. 22 illustrates a twenty-second embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 46] FIG. 22 illustrates an alternative twenty-second embodiment mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 47] FIG. 22 illustrates an alternative twenty-second embodiment mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 48] FIG. 23 shows a twenty-third embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 49] FIG. 23 illustrates a mounting system according to a twenty-third embodiment for attaching a tool module to the distal end of a robotic instrument. [Figure 50] FIG. 24 illustrates a mounting system according to a twenty-fourth embodiment for attaching a tool module to the distal end of a robotic instrument. [Figure 51] FIG. 24 illustrates a mounting system according to a twenty-fourth embodiment for attaching a tool module to the distal end of a robotic instrument. [Figure 52] FIG. 25 illustrates a mounting system according to a twenty-fifth embodiment for attaching a tool module to the distal end of a robotic instrument. [Figure 53] FIG. 25 illustrates a mounting system according to a twenty-fifth embodiment for attaching a tool module to the distal end of a robotic instrument. [Figure 54] FIG. 26 illustrates a twenty-sixth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. [Figure 55] FIG. 26 illustrates a twenty-sixth embodiment of a mounting system for attaching a tool module to the distal end of a robotic instrument. DETAILED DESCRIPTION OF THE INVENTION

[0016] Referring to FIG. 1 , in one embodiment of a system 10 for performing a medical procedure, e.g., a robotic system 10, the system 10 includes an instrument 12, such as a robotic instrument 12, operatively associated with a tool module 14. In some embodiments, the instrument 12 is a medical instrument configured to perform a procedure, e.g., a surgical procedure, on a patient. In some embodiments, the instrument 12 is configured to be inserted into the patient. In some embodiments, the instrument 12 is an intraluminal instrument 12. In some embodiments, the instrument 12 includes an elongate member, such as an insertion tube 18, that can be advanced into a natural orifice of the patient. For convenience, the term insertion tube 18 is used herein, but this is not intended to limit the operative association of the system 10 and / or the instrument 12 with the tool module 14 to the insertion tube in particular. In some embodiments, the insertion tube 18 can be initially advanced and guided through a tortuous body passageway of the patient, e.g., through a natural orifice. In some embodiments, the insertion tube 18 can include a visualization device (e.g., a camera, fiber optics, etc.) and can be similar to the insertion tube of a medical scope, such as an endoscope. In some embodiments, the insertion tube 18 is flexible and / or deformable. In some embodiments, the system 10 and / or instrument 12 are aware of the shape of the insertion tube 18 and / or its location in space. In some embodiments, the tool module 14 is operatively associated with the distal end 16 of the instrument 12. In some embodiments, the tool module 14 is configured to be easily removable (e.g., uncoupled). The tool module 14 may be removed for cleaning, disposal, modification, etc., and / or replacement with an identical or different tool module 14.

[0017] In some embodiments, the robotic system 10, and in some cases the robotic instrument 12 in particular, includes a mechanization system 51 for controlling the movement of at least the components of the instrument 12 (e.g., the insertion tube 18) and / or devices coupled thereto (e.g., components of the tool module 14, such as the needle holder arm 22 and / or associated components shown in FIG. 2 ). The mechanization system 51 may control the insertion tube 18 via a mechanical actuator, including, but not limited to, a push-pull actuator and / or a rotary actuator and / or a gear drive mechanism such as a worm gear. Alternatively or additionally, the system 10 may include a control system 52 operatively associated with the mechanization system 51 for providing input to the mechanization system 51 based on various inputs to the system 10. In some embodiments, a human interface 54 is operatively associated with the robotic system 10, for example, translating manual input from a human into movement of the insertion tube 18. The interface 54 may include, for example, a joystick 55, a trackball, a keyboard, buttons, knobs, a haptic glove, and / or other suitable interface for enabling input from an operator. The robotic system 10, and in some cases the robotic instrument 12 in particular, may include a first sensor 56, including, but not limited to, a load cell and / or strain gauge coupled to an actuator operatively associated with the mechanization system 51. The sensor 56 may be configured to monitor forces applied by the mechanization system and actuator. The first sensor 56 may be disposed within the insertion tube 18 and may be coupled to a sensor external to the insertion tube 18 via mechanical, optical, and / or electrical components. A signal from the sensor 56 may be usable by the mechanization system 51 and / or the robotic system 10 to control one or more components of the system 10 and / or the instrument 12. For example, the signal from the sensor 56 may be used to control a component of the instrument 12, such as the insertion tube 18. That is, it may be used to control the operation of the instrument 12 and / or the insertion tube 18 and / or the tool module 14.The robotic system 10, and possibly the robotic instrument 12 in particular, also includes a light source and a camera 58, and a visual display 60 for displaying an image from the camera 58, which may be augmented by input from first and second sensors and / or patient data. Other sensors 59 may be provided to sense and identify the patient environment and possibly components of the instrument 12, such as the tool module 14 (e.g., a needle and / or suture operatively associated therewith). The robotic system 10 also includes a processor 62, including, for example, a microprocessor for executing software for the robotic system 10, memory for storing the software, an interface for accessing patient data, and integrates inputs to facilitate manipulating the insertion tube 18 and the tool module 14 to perform a surgical procedure.

[0018] While a variety of tool modules 14 are included within the scope of the present system, in one embodiment, the tool module 14 is adapted to advance a suture needle through tissue. With reference to FIGS. 2 and 3 , one embodiment of the suturing tool module 14 includes an end cap 20 adapted to be disposed on and connected to the distal end 16 of the insertion tube 18. The illustrated end cap 20 includes a needle holder arm 22 operably associated therewith. In some aspects, the needle holder arm 22 is rotatable to move a needle 26 carrying a suture through patient tissue. In some aspects, the needle holder arm 22 is oriented along the longitudinal axis A of the insertion tube 18. LThe tool module 14 is mounted to rotate in an arc about a rotation axis 24 extending transversely to the insertion tube 18. A needle 26 is connected to the needle holder arm 22 and adapted to penetrate tissue. In some aspects, the needle 26 is removably coupled to the needle holder arm 22. In the illustrated embodiment, one example of a mechanical coupling includes a flexible transmission member 30, a gear train 32 coupled to a distal end of the transmission member 30, and a connecting member 34 pivotally mounted to a mounting bracket 35 by a pivot pin 36 and extending to the needle holder arm 22, configured to rotate the needle holder arm 22. Other configurations are possible, including a transmission member operably associated with the needle holder arm 22 for actuating the needle holder arm 22 (e.g., by transmitting motion to the needle holder arm 22). The module optionally includes a tubular member 42 adapted to be inserted into a tubular opening 44, such as a working channel, defined in the insertion tube 18 to prevent relative rotation between the tool module 14 and the insertion tube 18. In some embodiments, the tubular member 42 is positioned off-axis from the module. In some embodiments, the tubular member 42 is in the form of a split spring having an outward force adapted to reinforce the engagement between the tool module 14 and the insertion tube 18. In some embodiments, the suturing system can operate as described in U.S. Pat. No. 9,867,610, which is incorporated herein by reference in its entirety. In other embodiments, the needle holder arm 22 and mechanical linkage can be configured to move the needle holder arm 22 and / or needle 26 in a different manner, such as a linear or circular motion.

[0019] As described above, the tool module 14 is operably associated with the instrument 12, e.g., attached to the distal end 16 of the insertion tube 18, but is removable therefrom, optionally allowing for replacement (with the same or a different type of tool module). The tool module 14 is operably associated with the instrument 12 via a mounting system that is shaped, configured, and adapted to facilitate operably associating the tool module 14, which is formed separately from the instrument 12, with the instrument 12. Such operable association is selected, configured, and adapted to transfer movement of the instrument 12 (e.g., the insertion tube 18) to the tool module 14, actuating the tool module 14, and performing a procedure on a patient. In some embodiments, the mounting system is shaped, configured, and adapted to facilitate removal of the tool module 14 from the instrument 12, e.g., for cleaning, disposal, modification, etc., and / or replacement with another tool module. In accordance with various principles of the present disclosure, the mounting system includes mounts that can generally be categorized as mechanical connections (e.g., engagement structures), magnetic and / or electromagnetic connections, friction fit connections, and / or temporary adhesive connections to the insertion tube 18. The various connections may include multiple types of connections and may be cross-categorized. Each mount may be configured to release the tool module 14 from the robotic system 10 (e.g., components thereof, such as the instrument 12, and more specifically the insertion tube 18) without damaging it.

[0020] Additionally, the transmission member 30, which may be operably associated with an actuating portion of the tool module 14 (e.g., the needle holder arm 22), may also be operably associated with the system 10, particularly the mechanization system 51, and may be actuated to actuate one or more actuating portions of the tool module 14. The distal end of the transmission member 30 is operably associated with the actuating portion of the tool module 14, and the actuating portion is actuated by the transmission member 30. A portion of the transmission member 30 proximal to the distal end (e.g., including, but not limited to, the proximal end of the transmission member 30) is operably coupled to the system 10, e.g., the mechanization system 51, e.g., the tool 12. In some embodiments, the mechanization system 51, e.g., the tool 12, includes an actuator operably coupled to the transmission member 30 to transmit an actuation force from the system 10 to the transmission member 30 and actuate one or more components of the tool module 14. The transmission member 30 may be removed from the system 10 along with the tool module 14. For example, when the tool module 14 is decoupled from the robotic system 10, e.g., the instrument 12, the transmission member 30 may be removed along with the tool module 14. In some embodiments, the transmission member 30 is separable from the instrument 12 at a location adjacent the end cap 20 (usually, but not necessarily, a distal-most portion of the transmission member 30 remains with the tool module 14). In some embodiments, the transmission member 30 is separable from the instrument 12 at a location proximal to the end cap 20. In some embodiments, components of the transmission member 30 remain with the system 10 after the tool module 14 is removed from the system 10. The location at which the transmission member 30 is coupled to the system 10 (e.g., the instrument 12) is not critical to the present disclosure. Thus, the present disclosure is not limited by the particular configuration of coupling of the transmission member 30 to the system 10 or the particular configuration and manner in which the transmission member 30 is decoupled from the system 10.

[0021] 4 and 5, in an example of the mounting system 100 of the first embodiment, a surgical tool module 114 is mechanically attached to the distal end 16 of the insertion tube 18 via a bayonet fitting. The distal end 16 of the insertion tube 18 includes one or more pins 150 extending radially on a reduced diameter portion 152. The tool module 114 includes a proximal collar 154 having one or more L- or J-shaped internal grooves 156 that open to the proximal end. The collar 154 of the tool module 114 is fitted to the distal end 16 of the insertion tube 18, with the pins 150 guided into the respective grooves (not shown) of the collar 154. As the collar 154 is advanced longitudinally on the insertion tube 18, the shape of the groove 156 allows the collar 154 to rotate relative to the distal end 16 of the insertion tube 18, and the pin 150 is captured by the shape of the groove 156, longitudinally locking the tool module 114 relative to the insertion tube 18. The outer diameter of the distal end 16 of the insertion tube 18 and the inner diameter of the collar 154 may be adjusted to inhibit inadvertent reverse rotation that could allow unintended separation. Referring to FIG. 5 , alternatively or additionally, the groove 156 may be J-shaped so that when the tool module 114 is fully rotated onto the pin 150, the interior of the collar 154 may include a spring-biased element 158 ​​that presses the collar 154 against the pin 150, with the pin 150 partially seated in the groove 156 to prevent rotation of the tool module 114 relative to the insertion tube 18. The tool module 114 may remain in this configuration until the spring force is manually or actively overcome. The collar 154 is moved against the spring bias and rotated to release the bayonet connection.

[0022] 6, the second embodiment mounting system 200 is an example of another bayonet fitting, with a pin 250 provided in a reduced diameter portion 252 of the tool module 214 and a groove 256 formed in a collar 254 at the distal end 16 of the insertion tube 18, otherwise as described above with respect to mounting system 100.

[0023] 7, an example of a third embodiment mounting system 300 is shown. The tool module 314 includes a threaded male end 350, and the distal end 16 of the insertion tube 18 is provided with an internally threaded rotating collar 354. The collar 354 can be rotated in a first direction relative to the threaded male end 350 to secure the tool module 314. The tool module 314 can be removed by rotating the collar 354 in a second direction to loosen the threaded male end 350.

[0024] 8-10 , a fourth embodiment of the mounting system 400 is shown, depicting a surgical tool module 414. The surgical tool module 414 includes a generally cylindrical, protruding proximal end 450, which may be smooth or textured. The distal end 16 of the insertion tube 18 includes a split-shaft collet 452 having external threads 454 and a rotatable nut 464 that fits over the threads of the collet 452. The proximal end 450 of the module 414 is inserted into the collet 452 with the collet 452 in an open position (i.e., with the nut 464 positioned proximally along the external threads 454). The nut 464 is then advanced along the threads 454, reducing the diameter of the collet 452 and tightening the collet 452 around the proximal end 450 of the tool module 414, thereby securing the tool module 414 to the insertion tube 18. The tool module 414 can be released by loosening the nut 464 .

[0025] 11 , a fifth embodiment of the mounting system 500 is shown, including a tool module 514. The surgical tool module 514 is secured to the distal end 16 of the insertion tube 18 via a set screw 550. The set screw 550 passes through an end hole 552 in the end cap 520 of the tool module 514 and enters a set screw hole 554 in the end face 556 of the insertion tube 18. The set screw 550 locks and unlocks the tool module 514 relative to the insertion tube 18. Alternatively, the set screw 550 can be threaded through a hole in the side of the tool module 514 and into a corresponding hole in the side of the insertion tube 18.

[0026] 12, a sixth embodiment of the mounting system 500a is shown, including a tool module 514a. The tool module 514a includes a grub (set) screw 550a that is received through a hole 560a aligned with a screw boss 554a in the end cap 520a. The grub (set) screw 550a locks and unlocks the tool module 514a relative to the insertion tube 18.

[0027] 13-15, an example of a seventh embodiment of a mounting system 700 for a tool module 714 is shown. The end cap 720 of the tool module 714 defines a split ring having a sidewall 770 and a lower lip 772 (e.g., a radially inwardly extending lower lip 772). Two holes 774 are provided on either side of a split 776 in the end cap 720. The distal end 16 of the insertion tube 18 is provided with a tubular element 750 having a circumferential groove 752. A tool such as pliers can be inserted into and manipulated through the two holes 774 to expand the ring on either side of the split 776 in the end cap 720 (e.g., similar to the manipulation of a circlip) to position and secure the end cap 720 over the tubular element 750 with the lip 772 captured within the groove 752. The end cap 720 is adapted to be self-retaining relative to the tubular element 750, although a U-shaped retainer (not shown) can be placed within the two holes 774 to further secure the ends of the end cap 720 together during surgery. After the procedure, the retainer can be removed, and a tool can be used to expand the end cap 720 and remove the tool module 714 from the insertion tube 18. A trapezoidal shaped retainer (not shown) may also be permanently connected to the mounting holes. When pressed down, the mounting holes narrowly converge, securing the end cap 720 relative to the tubular element 750. After the procedure, to remove the end cap 720 from the endoscope, the retainer is pushed away from the endoscope / upward, widening the mounting holes 774 and releasing the end cap 720.

[0028] 16, 17, and 18, an example of an eighth embodiment of a mounting system 800 for a tool module 814 is shown. The tool module 814 is provided with a proximal abutment surface 850, which defines one or more resilient retainers 852 facing radially outward. The distal end 16 of the insertion tube 18 is provided with a rigid tubular wall 854 having one or more openings or recesses 856 sized and positioned to receive the retainers 852. The tubular wall 854 may be a metal tube, and the openings 856 may be formed by laser cutting into the wall of the metal tube 854. During assembly, the module 814 is locked to the distal end 16 of the insertion tube 18 by inserting the proximal abutment surface 850 into the tubular wall 854 until the retainers 852 enter the recesses 856. The tool module 814 can be released by displacing the retainers 852 radially inward.

[0029] 19, 20, and 21, an example of a ninth embodiment of a mounting system 900 for a tool module 914 is shown. The tool module 914 includes one or more inwardly facing resilient retainers 952. The distal end 16 of the insertion tube 18 includes a collar 954 having a circumferential groove 956 defining a radially outwardly extending upper lip 958. The module 914 can be placed on the collar 954 such that the resilient retainers 952 are pressed over the lip 958 and seated within the groove 956, where they are retained by the lip 958. To further prevent rotation, the collar 954 may be provided with spaced openings, longitudinal rails, and / or other guides to ensure that the module 914 can only be mounted in a certain orientation relative to the distal end 16 of the insertion tube 18. The tool module 914 can be removed from the collar 954 by displacing the resilient retainers 952 radially inward to release them, which may require a specialized tool.

[0030] 22, 23, and 24, an example of a tenth embodiment of a mounting system 1000 for a tool module 1014 is shown. The tool module 1014 includes a relatively short hook 1050 and one or more relatively long snap retention arms 1052. The distal end 16 of the insertion tube 18 is provided with a collar 1054 defining first and second longitudinally spaced annular grooves 1056, 1058. The hook 1050 is adapted to initially engage the first (distal) groove 1056 (see FIG. 23). The end cap 1020 of the tool module 1014 is then rotated (in the direction of arrow 1060) to mount the tool module 1014 onto the distal end 16 of the insertion tube 18 until the retention arms 1052 engage the second (proximal) groove 1058 (see FIGS. 23 and 24). The tool module 1014 is released by using a tool to loosen the retaining arm 1052 from the second groove 1058 .

[0031] Referring to FIG. 25 , an example of an eleventh embodiment of a mounting system 1100 for a tool module 1114 is shown. The tool module 1114 includes a proximal retainer 1150. By way of example, the retainer 1150 may be provided in the form of a lip element extending (e.g., radially outward) to at least partially surround the end of the tubular member 1142 extending proximally from the end cap 1120. The distal end 16 of the insertion tube 18 includes a window 1152 in its sidewall 1154. A clip 1156 is provided for insertion into the window 1152 to engage the retainer 1150. The clip 1156 has a resilient arm 1160 insertable through the window to engage the retainer 1150. In some embodiments, the window 1152 may be shaped to correspond to the shape of the forked (wishbone-shaped) resilient arm 1160, as shown in FIG. 25 . The resilient arm 1160 may have a grip 1162 configured to surround and engage the retainer 1150. The clip 1156 may include a closure portion 1164 that engages the insertion tube 18 to hold the clip 1156 against the insertion tube 18. In some embodiments, the closure portion 1164 has a radius of curvature that matches the outer surface of the insertion tube 18. In some embodiments, the closure portion 1164 includes a recess 1166 that facilitates engagement with a tool to remove the clip 1156. When the proximal end of the module 1114 is inserted into the distal end 16 of the insertion tube 18, the clip 1156 is inserted into the window 1152 and holds the lip element 1150 against axial movement in the distal direction, thereby preventing the tool module 1114 from being released from the insertion tube 18. The clip 1156 can be removed by engaging a tool or the like with the recess 1166. The tool module 1114 is then released from the insertion tube 18.

[0032] 26 and 27, a twelfth exemplary embodiment of a mounting system 1200 for a tool module 1214 is shown. The tool module 1214 includes an end cap 1220 having proximally extending forks 1252 and 1254, each defining an annular groove portion 1256, 1258. The distal end 16 of the insertion tube 18 includes one or more longitudinal arrays (corresponding to the one or more forks 1252, 1254), one array 1260 of which is shown and the other hidden on the opposite side of the insertion tube 18. The forks 1252, 1254 are received within the array 1260. In the exemplary embodiment shown, the array 1260 is provided on the outer surface of the insertion tube 18. However, other configurations (e.g., notches) are within the scope of this disclosure, as will be understood by those skilled in the art. The distal end 16 of the insertion tube 18 also defines the remaining portions 1262, 1264 of the annular groove 1266. The groove 1256 may be formed as a recess or as a space between two longitudinally spaced walls. When the forks 1252, 1254 are fully inserted into the array 1260, the end cap 1220 abuts the distal end 16 of the insertion tube 18, forming the complete annular groove 1266. A band, tie wrap, adhesive tape, clamp, or other strap-like element 1268 is positioned in the annular groove 1266 and is shaped to fit over and / or within the annular groove 1266, locking the tool module 1214 to the insertion tube 18. After the procedure, the element 1268 is cut, opened, or otherwise removed, and the tool module 1214 is removed from the insertion tube 18.

[0033] 28 , a thirteenth exemplary embodiment of a mounting system 1300 for a tool module 1314 is shown. The tool module 1314 includes a proximal skirt 1350 defining a gripping ridge 1352 and an alignment slot 1354. The distal end 16 of the insertion tube 18 includes one or more tabs 1362 (e.g., laser-cut detent-like tabs 1362) adapted to abut the gripping ridges 1352 and the distal skirt 1360 having longitudinal deformations configured as ribs 1364. The tool module 1314 is rotationally positioned relative to the insertion tube 18 by guiding the ribs 1364 into the slots 1354. The gripping ridges 1352 are then pushed past the ends of the tabs 1362, and the tool module 1314 is advanced until it is fully seated relative to the insertion tube 18. Interference between the ridges 1352 and the tabs 1362 prevents inadvertent release of the tool module 1314. The tool module 1314 can then be released by a tool that deforms the tabs 1362 outward.

[0034] 29, an example of a fourteenth embodiment of a mounting system 1300a substantially similar to mounting system 1300 is shown in an inverted / flipped configuration. In this configuration, a proximal skirt 1350a of tool module 1314a includes tabs 1362a and alignment ridges (not shown), and a distal skirt 1360a of insertion tube 18 includes gripping ridges 1352a and alignment slots 13654a. The components can be assembled and disassembled in a similar manner.

[0035] 30 , an example of a fifteenth embodiment of a mounting system 1400 for a surgical tool module 1414 is shown. The tool module 1414 includes a proximal tubular portion 1450, e.g., in the form of a skirt 1450, with a first through-hole 1452 defined therein. The distal end 16 of the insertion tube 18 includes a corresponding second through-hole 1454. When the skirt 1450 of the tool module 1414 is fully inserted into the distal end 16 of the insertion tube 18, the first and second through-holes 1452, 1454 align. A split pin 1456 is advanced through the aligned first and second through-holes 1452, 1454 to secure the tool module 1414 relative to the insertion tube 18. The pin 1456 can be removed to remove the tool module 1414 from the insertion tube 18.

[0036] 31 , an example of a sixteenth embodiment of a mounting system 1500 for a tool module 1514 is shown. The tool module 1514 includes a proximally extending key member 1550, while the distal end 16 of the insertion tube 18 includes a recessed plate 1552 defining a keyway 1554. The key member 1550 of the tool module 1514 is positioned on and rotated against the plate 1552, thereby securing the tool module 1514 relative to the insertion tube 18. A tool (not shown) may be used to rotate the key member 1550. The tool module 1514 may then be released by rotating the key member 1550 into alignment with the keyway 1554.

[0037] Referring to FIG. 32 , an example of a seventeenth embodiment of a mounting system 1600 for a tool module 1614 is shown. The tool module 1614 includes a wire tether 1650 that extends from a base 1652 of the end cap 1620 and through the insertion tube 18 to a fixed location (not shown). The distal end of the tether 1650 may include a nipple 1654 that is pulled in tension against the base 1652 of the end cap 1620. Alternatively, the distal end of the tether 1650 may be a loop that is fixed through a hole in the end cap 1620. The proximal end of the tether 1650 may extend to a position adjacent the working end of the insertion tube 18. Alternatively, the proximal end of the tether 1650 may be fixed at an intermediate position along the length of the insertion tube 18. After a procedure, the tool module 1614 may be released by releasing or cutting the tether 1650.

[0038] 33, 34, and 35, an example of an eighteenth embodiment of a mounting system 1700 for a tool module 1714 is shown. The mounting system 1700 includes a flexible overcap 1750. The overcap 1750 has a circumferential portion 1752, an upper shoulder 1754, and a tab 1756. A collar 1760 is provided at the distal end 16 of the insertion tube 18. The collar 1760 has an annular groove 1762 that defines a distal lip 1764 (e.g., a distal lip 1764 that extends radially outward). The tool module 1714 is assembled to the distal end of the collar 1760. The overcap 1750 is positioned on the tool module 1714 such that the shoulder 1754 abuts the upper portion 1766 of the end cap 1720 of the tool module 1714. A crimping tool (not shown) is then used to crimp the circumferential portion 1752 of the overcap 1750 into the annular groove 1762 of the collar 1760, capturing the end cap 1720 of the tool module 1714 between the upper shoulder 1754 and the crimped circumferential portion 1752, thereby holding the tool module 1714 relative to the insertion tube 18. When the tool module 1714 is to be removed from the distal end 16 of the insertion tube 18, the tab 1756 can be peeled back to release and remove the overcap 1750. In some embodiments, the tab 1756 is breakable, or at least a portion of the overcap 1750 can be split to release the tool module 1714 from the insertion tube 18. A tool (not shown) may be used to pull the tab 1756.

[0039] 36, 37, and 38, an example nineteenth embodiment of a mounting system 1800 for a tool module 1814 is shown. The tool module 1814 can be positioned at the distal end 16 of the insertion tube 18. The mounting system 1800 includes a collar 1850 disposed at the distal end 16 of the insertion tube 18. In the example embodiment shown in FIGS. 36, 37, and 38, the collar 1850 includes one or more lugs 1852 (e.g., two diametrically opposed lugs 1852). A strap 1854, such as an elastic strap 1854, extends across the lugs 1852 and holds the tool module 1814 against the distal end 16 of the insertion tube 18. The tool module 1814 can be removed by releasing at least one end of the elastic strap 1854 from one of the lugs 1852.

[0040] 39 , a twentieth example embodiment of a mounting system 1900 for a tool module 1914 is shown. The mounting system 1900 includes a magnet 1952 attached to (e.g., attached or otherwise coupled to) at least one of the insertion tube 18 and the surgical module 1914. In the example embodiment shown, the mounting system 1900 includes the magnet 1952 at the distal end 16 of the insertion tube 18. The magnet 1952 is provided inside the insertion tube 18 and can be part of an alignment mechanism for rotationally aligning the tool module 1914 with the distal end 16 of the insertion tube 18. In some aspects, the magnet 1952 is provided as part of a tubular member 1944 at the distal end of a tool channel defined in the insertion tube 18. The tubular member 1944 is adapted to attract a tubular guide 1942 at the proximal end of the tool module 1914. Alternatively, the tool module 1914 and other components of the insertion tube 18 may have sufficient magnetic attraction with one another to hold the tool module 1914 in place relative to the insertion tube 18 and resist inadvertent release. In such cases, the magnetic force is strong enough to hold the tool module 1914 against inadvertent removal while still allowing active removal by pulling against the magnetic force with a force greater than that encountered during a surgical procedure. In yet another embodiment, the insertion tube 18 may include an electromagnetic system 1970 that, when activated, attracts the tool module 1914 and, when deactivated, releases the tool module 1914 relative to the insertion tube 18.

[0041] 40 and 41 , an example of a twenty-first embodiment of a mounting system 2000 for a tool module 2014 is shown. The tool module 2014 is mated to the distal end 16 of the insertion tube 18, such as by a press fit. The distal end 16 of the insertion tube 18 may include a reduced diameter collar 2050 to facilitate mating. A fixation element 2054 is then provided over the assembly. In some aspects, the fixation element includes tape 2054 or other structure configured to be secured onto the insertion tube 18 and tool module 2014.

[0042] 42 and 43, in another mounting configuration, the securing element includes heat shrink tubing 2054a that is placed around the interface of the tool module 2014 and the insertion tube 18 and then heated to shrink and form a strong bond. The tool module 2014 and insertion tube 18 can be separated by removing the tape 2054 or heat shrink tubing 2054a and applying sufficient force to separate the components.

[0043] 44 and 45 , a twenty-second exemplary embodiment of a mounting system 2100 for a tool module 2114 is shown. In the mounting system 2100, the proximal end of the tool module 2114 is formed as a male connector 2150. The male connector 2150 has one or more circumferential grooves 2152 and, optionally, one or more O-rings 2154 mounted in each groove 2152. The male connector 2150 is inserted into a female connector 2160 formed on the distal end 16 of the insertion tube 18. The O-rings 2154 provide a strong, temporary assembly between the connectors 2150, 2160.

[0044] Alternatively, as shown in FIGS. 46 and 47, the distal end 16 of the insertion tube 18 can include a male connector 2150a with a groove 2152a and an associated O-ring 2154a, while the tool module 2114a can include a female connector 2160a into which the male connector 2150a is inserted to form a temporary, rigid assembly 2100a.

[0045] 48 and 49, a twenty-third exemplary embodiment of a mounting system 2200 for a tool module 2214 is shown. The mounting system 2200 includes an adhesive 2280. The adhesive 2280 is applied between a portion of the tool module 2214 and a portion of the insertion tube 18 or a portion connected to the insertion tube 18. To increase the surface area over which the adhesive 2280 is applied and / or acts on, the tool module 2214 may include a skirt 2250 and / or the insertion tube 18 may include a collar 2260. The adhesive 2280 may be, for example, a fast-curing adhesive, such as a cyanoacrylate, a fast-curing epoxy, or an adhesive with a cure accelerator to speed curing. The adhesive 2280 may be, for example, a UV-curable adhesive, such as Loctite® light-curable adhesive or Dymax® UV-curable epoxy. The tool module 2214 can be released from the distal end 16 of the insertion tube 18 by using an agent to deactivate the adhesive, mechanical release, and / or steam cleaning.

[0046] 50 and 51 , an example twenty-fourth embodiment of a mounting system 2300 for a tool module 2314 is shown. The mounting system 2300 includes a coil spring 2350 attached to and extending from the proximal end of the tool module 2314. In its natural state, the coil spring 2350 has an inner diameter smaller than the outer diameter of the insertion tube 18 (or at least its distal portion 16). However, the coil spring 2350 can be compressed in length to expand its inner diameter to a dimension larger than the outer diameter of the distal portion 16 of the insertion tube 18. In this compressed state, the distal portion 16 of the insertion tube 18 is advanced until it contacts the tool module 2314. The coil spring 2350 is then released and naturally biased back to its pre-compressed length and diameter, automatically reducing the inner diameter of the coil spring 2350 to grip the outer surface of the insertion tube 18. The components are held together by compression and friction. The components can be released by recompressing the length of the coil spring 2350. A tool (not shown) for compressing the coil spring 2350 can be provided on or off the insertion tube 18.

[0047] 52 and 53 , an example twenty-fifth embodiment of a mounting system 2400 for a tool module 2414 is shown. The mounting system 2400 includes an elastomeric roll sock member 2450 attached to the tool module 2414. The tool module 2414 is placed at the distal end 16 of the insertion tube 18, and the sock 2450 is unwound (deployed) onto the distal end 16 of the insertion tube 18, holding the tool module 2414 in place through compression and friction. After the procedure, the tool module 2414 can be released by rewinding the sock 2450 or by tearing or cutting the sock 2450 from the insertion tube 18.

[0048] 54 and 55 , an example twenty-sixth embodiment of a mounting system 2500 for a tool module 2514 is shown. The mounting system 2500 includes a flexible crimp band 2550 formed on a proximal portion of the tool module 2514. For example, the crimp band 2550 may extend from the end cap 2520. The crimp band 2550 may include one or more deformable arms 2552 adapted to extend around the distal end 16 of the insertion tube 18 and deform to overlap. The ends of the arms 2552 may define an interference shape, such as a recess 2554 and an arrow shape 2556 that fits within the recess 2554 and prevents unintended release after the arms 2552 have been deformed to a desired position. The tool module 2514 is coupled to the distal end 16 of the insertion tube 18, and the arms 2552 of the crimp band 2550 are deformed around the distal end 16 of the insertion tube 18. A sacrificial sleeve (not shown) may be placed on the insertion tube 18 under or over the crimp band 2550 to prevent damage to the insertion tube 18, the patient, and / or other tools from being caused by the crimp band 2550. Tools (not shown) may be provided for assembly and disassembly of the mounting system 2500.

[0049] In any of the above-described embodiments, and in further embodiments according to various principles of the present disclosure, it will be understood that the distal end 16 of the insertion tube 18 itself may be modified, or a separate element having various structures and features for coupling to a tool module may be operably coupled to the insertion tube 18. Furthermore, while the above-described embodiments are particularly suited for use with and operative association with a robotic instrument of a robotic system, it will be understood that the principles of the present disclosure are also applicable to manually operated (e.g., conventional human-controlled, not primarily computer-controlled) devices and systems.

[0050] In any embodiments in which a needle instrument may be exposed at or near the temporary connection between the tool module and the distal end of the insertion tube 18, the temporary joint of such components may be covered with a removable sleeve, tape, or the like to prevent injury or damage to the patient or other instruments. Similarly, in any embodiments having elements that could potentially be unintentionally released, the elements may be secured with tape, sleeve, or the like to secure the components together. By way of example only, the joint, components, and nearby areas may be covered with polyether block amide polymer (e.g., PEBAX®) tubing, heat shrink tubing, adhesive tape, or other material that covers the joint, holds the components in place, and / or maintains a smooth, fluid-tight interface between the components.

[0051] Embodiments of tool modules, such as a robotic suturing system for bariatric treatment, and methods of coupling devices and systems to a robotic system are described and illustrated herein. While specific embodiments are described, the disclosure is not intended to be limited to those specific embodiments, and the disclosure should be interpreted as broadly as permitted by those skilled in the art. Accordingly, those skilled in the art will understand that various additions, modifications, and substitutions can be made to the embodiments disclosed herein without departing from the concept, spirit, and scope of the disclosure. In particular, it will be apparent to those skilled in the art that the principles of the disclosure can be embodied in other forms, structures, arrangements, proportions, and with other elements, materials, and components. For example, each feature of the disclosure may be described together in one or more aspects, embodiments, or configurations for the sake of brevity of the disclosure. However, it should be understood that each feature of a particular aspect, embodiment, or configuration of the disclosure may be combined into alternative aspects, embodiments, or configurations. While the disclosure is presented in terms of embodiments, each individual feature herein need not necessarily be present in its entirety to achieve at least some of the desired properties and / or advantages of the disclosure. Those skilled in the art will understand that the present disclosure may be used with modifications and variations in structure, arrangement, proportions, materials, components, and the like, particularly to adapt to particular environments and operating requirements, without departing from the principle, spirit, or scope of the present disclosure. For example, an integrally formed element may be comprised of multiple pieces, and an element shown as multiple pieces may be integrally formed. The operations of elements may be reversed or otherwise changed, and the sizes and dimensions of elements may be changed. Similarly, although operations, actions, or steps may be described in a particular order, this does not require that particular order, nor does it imply that all operations, actions, or steps must be performed to achieve the desired results. Furthermore, other embodiments are within the scope of the following claims. In some cases, the operations recited in the claims may be performed in a different order and still achieve the desired results. The embodiments disclosed herein are, therefore, intended in all respects to be illustrative and not restrictive.The scope of the claimed subject matter is indicated by the appended claims, and is not limited to the above description or to the particular embodiments or configurations. In view of the foregoing, individual features of any embodiment may be used and claimed alone or in combination with features of that embodiment or any other embodiment. The scope of the claimed subject matter is indicated by the appended claims, and is not limited to the above description or to the particular embodiments or configurations.

[0052] In the foregoing description and in the claims that follow, it will be understood that the terms "at least one," "one or more," and "and / or," as used herein, are open phrases and operate conjunctively and disjunctively. The use of singular terms such as "a," "an," "the," "first," "second," etc., does not exclude a plurality. For example, the term "a" or "an" entity herein refers to one or more of that entity. Thus, the terms "a" (or "an"), "one or more," and "at least one" can be used interchangeably herein. As used in this specification and the appended claims, the term "or" is generally used in its sense including "and / or" unless the context clearly dictates otherwise. As used herein, the conjunction "and" includes each and every structure, component, feature, etc. so connected, unless the context clearly dictates otherwise, and the conjunction "or" includes one or more of the structures, components, features, etc. so connected, alone or in any combination and number, unless the context clearly dictates otherwise. All directional references (e.g., proximal, distal, superior, inferior, above, below, left, right, lateral, longitudinal, front, rear, upper, lower, upper, bottom, upper, lower, vertical, horizontal, radial, axial, clockwise, counterclockwise, etc.) are used for identification purposes only to assist the reader in understanding this disclosure and to distinguish regions of related elements from one another, but are not intended to limit the related elements, particularly with respect to the position, orientation, or application of this disclosure. Connection references (e.g., attached, coupled, connected, engaged, joined, etc.) should be interpreted broadly and may include intermediate members between elements and relative movement between elements, unless otherwise indicated. Thus, conjunctive references do not necessarily imply that two elements are directly connected or in a fixed relationship. Distinguishing references (e.g., first, second, third, fourth, etc.) do not imply importance or priority, but are used to distinguish one feature from another.

[0053] The following claims are incorporated by reference into the detailed description herein, with each claim standing on its own as a separate embodiment of the present disclosure. In the claims, the terms "comprises," "comprising," "includes," and "including" do not exclude the presence of other elements, components, features, groups, regions, integers, steps, operations, etc. Furthermore, although individual features are included in different claims, they may be advantageously combined, and their inclusion in different claims does not imply that the combination of features is impossible or disadvantageous. In addition, reference in the singular does not exclude a plurality. Reference signs in the claims are provided merely as a clarifying example and shall not be construed as limiting the scope of the claims in any way.

Claims

1. 1. A system for performing a procedure on a patient, comprising: the system includes a robotic instrument, the robotic instrument having an elongate member operatively connected to a robotic system for operating and controlling the robotic instrument and configured to be inserted through a natural orifice of a patient; the system includes a tool module operably coupleable with the elongate member of the robotic instrument and configured to perform a procedure on a patient; The robotic instrument is operably coupled to the robot system to control movement of the robotic instrument and the tool module.

2. The system of claim 1 , wherein the tool module is coupled to the distal end of the elongate member via a mechanical connection.

3. The system of claim 2 , wherein the mechanical connection comprises interengaging elements on the elongate member and the tool module.

4. 4. The system of claim 3, wherein the mechanical connection is selected from the group consisting of a bayonet lock, a threaded connection, a collet on one of the elongate member and the tool module and a compressible portion on the other of the elongate member and the tool module, the collet adapted to compress the compressible portion, a set screw configured to secure the tool module to the elongate member, a split ring, at least one resilient retainer, at least one hook and at least one resilient retaining arm, at least one clip, a band element, at least one deformable tab and at least one ridge with which the at least one deformable tab interferes, a pin insertable into a hole through the distal end and the tool module, or a key and keyway.

5. The surgical system of claim 1 , wherein the tool module is coupled to the elongate member by a separate structure positioned over the tool module and the elongate member to hold the tool module relative to the elongate member.

6. 6. The system of claim 5, wherein the separate structure is selected from the group consisting of a crimpable collar, an elastic retaining strap, a heat shrinkable element, at least one O-ring, an elastic radially contractible member, or a deployable sock.

7. The system of claim 1 , wherein the tool module is coupled to the elongate member via a magnetic coupling.

8. The system of claim 1 , wherein the tool module is coupled to the elongate member via electromagnetic coupling.

9. The system of claim 1 , wherein the tool module is coupled to the elongate member via an adhesive bond.

10. 10. The system of claim 1, further comprising a mechanization system operatively associated with the elongated member and the robotic system for controlling movement of the elongated member or the tool module, or the elongated member and the tool module, based on input from the robotic system.

11. The system of claim 10 , further comprising a sensor operatively associated with the robotic instrument and the mechanized system and usable to control operation of the robotic instrument.

12. 1. A system for performing a procedure on a patient, comprising: The system includes an instrument having an elongate member with a distal end; The system includes a tool module configured to perform a procedure on a patient; The system includes a mounting system, the mounting system including at least one of a mechanical connection, a magnetic or electromagnetic connection, a friction fit connection, an adhesive connection, or a separate element that overlies a portion of the distal end of the elongate member and a portion of the tool module to operably couple and hold the tool module to the elongate member, and that is configured to transfer motion from the instrument to the tool module to actuate the tool module to perform a procedure on a patient.

13. The system of claim 12 , wherein the tool module comprises a suturing tool.

14. The system of claim 13 , wherein the suturing tool comprises a fastener holder arm adapted to rotate a releasable tissue fastener along a path.

15. The system of claim 14 , wherein the releasable tissue fastener is a suture needle coupled with a length of suture.

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