A surgical device including a sterilization adapter having a mechanical lockout

Abstract

To provide a surgical apparatus.SOLUTION: A surgical apparatus includes a preload assembly in a surgical instrument manipulator that is under the control of a controller. The controller can automatically cause the preload assembly to engage and disengage a preload. The surgical apparatus includes a surgical instrument manipulator assembly and a sterile adapter assembly. The sterile adapter assembly is mounted in the distal face of the surgical instrument manipulator assembly. When the preload assembly configures the surgical instrument manipulator assembly to apply preload force on the sterile adapter assembly, the sterile adapter assembly is removable from the distal face of the surgical instrument manipulator. The sterile adapter assembly includes a mechanical sterile adapter assembly removal lockout and a mechanical surgical instrument removal lockout.SELECTED DRAWING: Figure 7A

Description

Technical Field

[0001] (Related Applications) This application claims the benefit of the filing date and the priority of U.S. Provisional Patent Application No. 62 / 362,183, entitled "A SURGICAL APPARATUS INCLUDING A STERILE ADAPTER HAVING MECHANICAL LOCKOUTS," filed on July 14, 2016, which is hereby incorporated by reference in its entirety.

[0002] The present invention generally relates to robotic instruments and systems, and more particularly to robotic instruments and systems that utilize preload forces.

Background Art

[0003] A robotic control system, such as used for minimally invasive medical procedures, can include a large and complex apparatus for accurately controlling and driving relatively small tools or instruments. (As used herein, the terms "robot" or "robotically," etc., include aspects of teleoperation or remote robotics.) FIG. 1A shows an example of a known robotic control system 100. For example, system 100, which can be part of the da Vinci® Surgical System commercially available from Intuitive Surgical, Inc., includes a patient-side system 110 having a plurality of arms 130. Each arm 130 generally includes a drive system 140 having a docking port with a mechanical interface for providing mechanical power for the attachment and operation of an instrument 150. The arms 130 can be used to move and position the respective instruments 150 during a medical procedure.

[0004] Figure 1B shows a bottom view of a known instrument 150. The instrument 150 generally includes a transmission mechanism or backend mechanism 152, a main tube 154 extending from the backend mechanism 152, and a functional tip 156 at the distal end of the main tube 154. The tip 156 generally includes medical tools such as scalpels, scissors, forceps, or cautery instruments that can be used during a medical procedure. A drive cable or tendon 155 is connected to the tip 156 and extends through the main tube 154 to the backend mechanism 152. The backend mechanism 152 typically provides a mechanical coupling between the drive tendon 155 of the instrument 150 and the electric shaft of the mechanical interface of the drive system 140. In particular, a gear or disk 153 is positioned, sized, and shaped to have features such as protrusions or holes that engage complementary features on the mechanical interface of the drive system 140. In a typical instrument, rotation of the disk 153 draws in the respective drive tendon 155 and actuates the corresponding mechanical link of the tip 156. Thus, the system 100 can control the movement and tension in the drive tendon 155 as needed to position, orient, and operate the tip 156. Further details of a known surgical system are described in Patent Document 1 filed on August 13, 2001, to Tierney et al., entitled "Surgical Robotic Tools, Data Architecture, and Use," which is hereby incorporated by reference in its entirety.

[0005] The instrument 150 of the system 100 can be exchanged by removing one instrument 150 from the drive system 140 and then attaching another instrument 150 in place of the removed instrument. Generally, the attachment process requires that the features on the disk 153 engage properly with the complementary features of the drive system 140. However, prior to attachment, the orientation of the disk 153 on the instrument 150 is generally not known to the patient-side system 110.

[0006] Furthermore, devices such as the patient-side system 110 are often covered with a sterilization barrier (e.g., a plastic sheet drape) for medical procedures because complex device cleaning and sterilization between medical procedures is difficult. This sterilization barrier may include a sterilization adapter placed between a docking port associated with the drive system 140 and the backend mechanism 152 of the instrument. For example, Patent Document 1 and Patent Document 2 to Anderson et al. (filed on March 31, 2006), each of which is hereby incorporated by reference in its entirety and describes some exemplary sterilization barriers and adapter systems, are described.

[0007] A typical mounting process for the instrument 150 may include attaching the backend mechanism 152, possibly with an intervening sterilization adapter, regardless of the orientation of the disk 153 on the drive system 140. Next, the drive motor of the drive system 140 can be rotated forward and backward multiple times during the mounting process to ensure that complementary features mesh with and securely engage each other for the operation of the newly mounted instrument 150. At some point during the mounting process, the drive motor will firmly engage to rotate each respective disk 153. However, since the drive motor engages the respective disks 153 of the instrument 150 at unexpected times different from each other, the mounted instrument 150 may move in an unexpected manner at points during the mounting process. In certain applications, such unexpected movement is unacceptable. Generally, an open or restricted space is required around the instrument 150 to accommodate random movement of the instrument tip during the mounting process.

Prior Art Documents

Patent Documents

[0008]

Patent Document 1

Patent Document 2

Patent Document 3

Patent Document 4

Summary of the Invention

[0009] The computer-assisted surgical device includes a preload assembly and a controller. The controller is coupled to the preload assembly. The preload assembly includes a preload engagement / disengagement mechanism. The controller is configured to move the preload assembly until it is fully retracted; to activate the preload engagement / disengagement mechanism when the preload assembly is fully retracted; and to move the preload assembly to the home position after activating the preload engagement / disengagement mechanism.

[0010] The device also includes a surgical instrument manipulator assembly including a preload assembly, a housing, and a motor pack movably mounted within the housing. The preload assembly includes a cam follower assembly including a wheel and a body. The wheel is configured to ride on a preload track. The body of the cam follower assembly is rotatably coupled to a first pivot pin. The body includes first and second ends. The second end of the body is coupled to the motor pack. The first end of the body is coupled to the wheel.

[0011] In one aspect, the preload engagement / disengagement mechanism also includes a preload engagement arm having first and second ends. The first end of the preload engagement arm is coupled to the first pivot pin. A rolling pin is attached to the second end of the preload engagement arm.

[0012] In this aspect, the preload engagement / disengagement mechanism further includes a second pivot pin and a preload engagement / disengagement arm rotatably coupled to the second pivot pin. The preload engagement / disengagement arm is connectable to and separable from the rolling pin. A torsion spring is attached to the second pivot pin and coupled to the preload engagement / disengagement arm. The torsion spring is configured to apply torque to the preload engagement / disengagement arm to hold the preload engagement / disengagement arm in a disengaged position from the rolling pin.

[0013] The preload engagement / disengagement mechanism further includes an electronic actuator coupled to the preload engagement / disengagement arm and a controller. When an engagement command from the controller is received by the electronic actuator, the electronic actuator applies torque to the preload engagement / disengagement arm to hold the preload engagement / disengagement arm in an engaged position relative to the rolling pin, which is referred to as having preload applied (engaged). The preload engagement / disengagement mechanism also includes an emergency tool release button coupled to the preload engagement / disengagement arm.

[0014] In another aspect, the apparatus includes a surgical instrument manipulator assembly, an insertion assembly, and a controller. The surgical instrument manipulator assembly includes a housing, a motor pack, and a preload assembly. The motor pack is movably mounted within the housing. The preload assembly includes a preload engagement / disengagement mechanism. The insertion assembly is coupled to the surgical instrument manipulator assembly. The insertion assembly includes a preload track. The controller is coupled to the surgical instrument manipulator assembly, the insertion assembly, and the preload assembly. The controller is configured to command the insertion assembly to move the preload assembly until the preload assembly is fully retracted; to command the preload engagement / disengagement mechanism to apply a preload when the preload assembly is fully retracted; and to command the insertion assembly to move the preload assembly to a home position after the preload is applied. In this apparatus, the preload engagement / disengagement mechanism is the same as described above.

[0015] The method includes the step of releasing a preload force on the motor pack of the surgical instrument manipulator assembly by moving the surgical instrument manipulator assembly to a fully retracted position.

[0016] Another method includes the step of the controller moving the surgical instrument manipulator assembly to a fully retracted position. This method also includes the step of the controller commanding the preload assembly of the surgical instrument manipulator assembly to apply a preload. The method further includes the step of the controller moving the surgical instrument manipulator assembly to a home position after the preload is applied. This method can also include the step of the controller moving the surgical instrument manipulator assembly to a fully retracted position to automatically release the preload.

[0017] The surgical device includes a surgical instrument manipulator assembly and a sterilization adapter assembly. The sterilization adapter assembly is attached to the distal surface of the surgical instrument manipulator assembly. When a preload assembly is set to apply a preloading force to the surgical instrument manipulator assembly onto the sterilization adapter assembly, the sterilization adapter assembly is removable from the distal surface of the surgical instrument manipulator.

[0018] In one aspect, the sterilization adapter assembly includes a mechanical sterilization adapter assembly removal lockout and a mechanical surgical instrument removal lockout. The surgical device also includes, in one aspect, a surgical instrument attached to the sterilization adapter assembly. Attaching the surgical instrument to the sterilization adapter assembly actuates the mechanical sterilization adapter assembly removal lockout.

[0019] In another aspect, the surgical device also includes an insertion assembly connected to the surgical instrument manipulator assembly. When the surgical instrument manipulator assembly is moved a predetermined distance in the distal direction, the surgical instrument manipulator assembly actuates a sterilization adapter removal lockout.

[0020] In this aspect, the surgical instrument manipulator assembly also includes a clutch button. The clutch button and an emergency release button are the only user-operated interfaces of the surgical instrument manipulator assembly.

[0021] In one aspect, the sterilization adapter assembly includes a frame. In this aspect, the mechanical surgical instrument removal lockout includes a movable body movably attached to the frame of the sterilization adapter assembly. In a first position of the movable body, the surgical instrument can be removed from the sterilization adapter assembly, while in a second position of the movable body, the surgical instrument is locked in a predetermined position of the sterilization adapter assembly.

[0022] In yet another aspect, the sterilization adapter assembly further includes a beam having a first end and a second end, the first end being opposite the second end. The beam is pivotally connected to the frame of the sterilization adapter assembly. A plurality of hook extensions extend from the second end of the beam. Each of the plurality of hook extensions includes a hook configured to engage a hook receiver of the surgical instrument manipulator assembly. A sterilization adapter assembly release button is coupled to the first end of the beam. Pushing the sterilization adapter assembly release button in a first direction moves the plurality of hook extensions in a second direction to disengage each hook from the hook receiver. A mechanical sterilization adapter assembly removal lockout has a first end of the beam that prevents movement of the surgical instrument in the first direction of the sterilization adapter assembly button and thus prevents removal of the surgical instrument from the surgical instrument manipulator assembly of the sterilization adapter assembly when the surgical instrument is attached to the sterilization adapter assembly.

[0023] In one aspect, the surgical instrument manipulator assembly includes a housing, a clutch button mounted within the housing, and a preload assembly including an emergency instrument release button. The clutch button and the emergency instrument release button are the only user-operated buttons of the surgical instrument manipulator assembly.

[0024] The method includes moving a combination of the surgical instrument manipulator assembly and the sterilization adapter assembly from a second position where the surgical instrument manipulator assembly applies a second preload force to the sterilization adapter assembly to a first position where the surgical instrument manipulator assembly applies a first preload force to the sterilization adapter assembly, where the second preload force is greater than the first preload force. The method also includes removing the sterilization adapter assembly from the surgical instrument manipulator assembly while the first preload force is applied to the sterilization adapter assembly.

[0025] In a further aspect, a computer-assisted surgical system includes a surgical instrument manipulator assembly and a controller. The surgical instrument manipulator assembly includes a preload assembly. The controller is coupled to the preload assembly. The controller directly controls the preload provided by a preload mechanism through commands to the preload assembly.

[0026] In this aspect, the surgical instrument manipulator assembly includes a housing and a motor pack movably mounted within the housing. The preload assembly is connected to the housing. The preload assembly is configured to move the motor pack relative to the housing under the control of the controller.

[0027] The preload assembly includes a motor and a nut. The motor is coupled to the controller. The nut is coupled to the motor such that the motor moves the nut in a first direction and a second direction. The preload assembly also includes an arm coupled to the motor pack and a preload release lever pivotally attached to the arm. The preload release lever is connectable to and disconnectable from the nut. When the preload release lever is coupled to the nut, movement of the nut is transmitted to the arm. The preload assembly also includes an emergency instrument release button coupled to the preload release lever.

[0028] In yet another aspect, a computer-assisted surgical system includes a surgical instrument manipulator assembly, an insertion assembly, and a controller. The surgical instrument manipulator assembly includes a housing, a motor pack, and a preload assembly. The motor pack is movably mounted within the housing. The insertion assembly is coupled to the surgical instrument manipulator assembly to move the surgical instrument manipulator assembly. The controller is coupled to the surgical instrument manipulator assembly, the insertion assembly, and the preload assembly. The controller is configured to command the preload assembly to change the position of the motor pack relative to the housing of the motor pack regardless of the position of the insertion assembly relative to the preload assembly and regardless of whether the insertion assembly is moving or stationary.

[0029] Another method includes the step of a controller that issues commands directly to the preload assembly controlling the preload force on the motor pack of the surgical instrument manipulator assembly.

[0030] Yet another method includes the step of the controller moving the motor pack of the surgical instrument manipulator assembly from a no-preload position to a low-preload position relative to the housing of the surgical instrument manipulator assembly while the surgical instrument manipulator assembly remains at a stop position such as a home position. This method further includes the step of the controller moving the motor pack of the surgical instrument manipulator assembly from a high-preload position to a low-preload position relative to the housing of the surgical instrument manipulator assembly independent of the control of the insertion assembly to which the surgical instrument manipulator is attached.

Brief Description of the Drawings

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[0032] In the drawings, for one - digit drawing numbers, the first digit of the reference number of an element is the drawing in which that element first appears. For two - digit drawing numbers, the first two digits of the reference number of an element are the drawing in which that element first appears.

DETAILED DESCRIPTION OF THE INVENTION

[0033] In one aspect, a computer-assisted remote operation system 200 (FIG. 2), sometimes referred to as system 200, for example, a minimally invasive computer-assisted remote operation system, includes a patient-side support system 210 having an arm 220. At the end of the arm 220, there is an entry guide manipulator assembly 230 (also referred to as the entry guide manipulator 230). Attached to the entry guide manipulator 230 is a master instrument manipulator 280 that supports a plurality of surgical device assemblies. In one aspect, the surgical device assembly includes an instrument manipulator assembly 240, an instrument sterilization adapter assembly 250, and an instrument 260. In one aspect, the instrument sterilization adapter assembly 250 is attached to a sterilization drape used for the drape entry guide manipulator 230 and each instrument manipulator assembly 240.

[0034] The instrument manipulator assembly 240 may sometimes be referred to as the instrument manipulator assembly 240. The instrument sterilization adapter assembly 250 may sometimes be referred to as the sterilization adapter assembly 250.

[0035] The entry guide manipulator 230 changes the pitch and yaw of the surgical device assembly as a group. The main tube of each instrument 260 extends through different channels within a single-port entry guide 270. In this aspect, the single-port entry guide 270 is attached within a cannula. The single port refers to a single access location (e.g., a single incision, a single natural opening, etc.) to the surgical site inside the patient.

[0036] As used herein, a cannula is a tube that penetrates a patient's body wall and is in direct contact with the patient. The cannula generally does not slide in and out relative to the patient, but the cannula can perform pitch and yaw motions about a point on its axis called the remote center of motion.

[0037] As used herein, the single-port entry guide 270 is a tube through which all surgical instruments and camera instruments must pass to reach a position inside the patient. The entry guide 270 has separate lumens for each instrument. The entry guide 270 passes through the cannula and can be twisted relative to the cannula.

[0038] The controller 290 is coupled to a surgeon's control console (not shown) and the patient-side support system 210. The controller 290 represents various controllers of the system 200. The controller 290 sends a second control command to the instrument 260 in response to a first control command. The first control command is based on the movement of the master of the surgeon's control console by the surgeon. The display control module of the system controller 290 also updates a stereoscopic image of the surgical site generated by the display device of the surgeon's control console when the slave instrument 260 moves in response to the second control command.

[0039] Although described as the controller 290, it should be understood that the controller 290 can actually be implemented by any combination of hardware, software executed on a processor, and firmware. Also, the functions described herein may be executed by one unit or may be divided into different components each implemented by any combination of hardware, software executed on a processor, and firmware. When divided among different components, the components may be centralized in one location for distributed processing purposes or distributed across the system 200. The processor should be understood to include at least a logic unit and memory associated with the logic unit.

[0040] As will be more fully described below, in one aspect, the controller 290 releases the preload force on the motor pack of the instrument manipulator assembly 240 by moving the instrument manipulator assembly 240 to the fully retracted position closest to the home position.

[0041] To apply the preload, the controller 290 moves the instrument manipulator assembly 240 to the fully retracted position and then the controller 290 commands the preload assembly of the instrument manipulator assembly 240 to apply the preload. After the preload is applied, the controller 290 moves the instrument manipulator assembly 240 to the home position. Here, when it is stated that the controller 290 executes an operation, it means that the controller issues a command or signal to the component that executes the operation.

[0042] In another aspect, the controller 290 can change the preload regardless of the position of the instrument manipulator assembly 240 and regardless of whether the instrument manipulator assembly 240 is moving or stationary. The controller 290 controls a motor within the preload assembly, which in turn determines the preload applied by the preload assembly. Commands from the controller 290 to the insertion assembly to move the instrument manipulator assembly 240 do not affect the preload in this aspect. The preload is under the direct control of the controller 290 and can be changed by the controller 290 as needed.

[0043] As described more fully below, the computer-assisted remote operation system 200 includes some features of conventional systems, which are: U.S. Patent Application Publication No. 2016 / 0184037 (“PRELOADED SURGICAL INTSTRUMENT INTERFACE” is disclosed); U.S. Patent Application Publication No. 2016 / 0184036 (“VARIABLE INSTRUMENT PRELOAD MECHANISM CONTROLLER” is disclosed); U.S. Patent Application Publication No. 2016 / 0184035 (“ACTUATOR INTERFACE TO INSTRUMENT STERILE ADAPTER” is disclosed); International Publication No. 2015 / 023834 (“INSTRUMENT STERILE ADAPTER DRIVE FEATURES” is disclosed); International Publication No. 2015 / 023840 (“INSTRUMENT STERILE ADAPTER DRIVE INTERFACE” is disclosed); and International Publication No. 2015 / 023853 (“ROBOTIC INSTRUMENT DRIVEN ELEMENT” is disclosed); are presented, each of which is hereby incorporated by reference in its entirety. Features common to both the conventional system and system 200 are not described in detail herein so as not to detract from aspects of the invention described herein.

[0044] In one aspect of the system described in the publications cited above, each instrument manipulator assembly included a sterilization adapter release latch, a clutch button, and a preload release button. As will be more fully described, the instrument manipulator assembly within system 200 does not include a sterilization adapter release latch or a preload-based sterilization adapter release lockout.

[0045] Instrument manipulator assembly 240 includes a clutch button and an emergency instrument release button mounted within the housing of instrument manipulator assembly 240. The clutch button and the emergency release button are the only user-operated buttons of instrument manipulator assembly 240. Thus, the clutch button and the emergency release button are the only user-operated interface of instrument manipulator assembly 240. The reduction in the number of buttons on instrument manipulator assembly 240 improves the user experience by minimizing the possibility that the user will accidentally press the wrong button or take time in a critical situation due to confusion about the functions of the various buttons on instrument manipulator assembly 240.

[0046] In one aspect of the system described in the above-cited publication, the preload release button had a dual function. The preload release button was pressed to disable the sterilization adapter removal lockout function so that the sterilization adapter could be removed. The preload release button was also used to release the preload in an emergency. In contrast, as more fully described below, the emergency instrument release button on each of the plurality of instrument manipulators of system 200 is used only to release the preload force to the disk stack. Additionally, to facilitate draping of system 200, the release of the preload and the actuation of the preload are under the control of controller 290 such that the preload can be released to facilitate the draping process and the preload can be actuated after draping is complete.

[0047] Figures 3A and 3B are views of four surgical device assemblies 300 attached to the entry guide manipulator 230. In Figure 3A, the surgical device assembly 300 is disposed in an initial position, e.g., a first position, also referred to as the "home position". The mechanical interface includes a disk stack between a motor within the instrument manipulator assembly 240 and a shaft within the transmission unit of the instrument 260. In the configuration of Figure 3A, following draping, a first preload force is applied to the disk stack, e.g., a first predetermined force is applied to the disk stack.

[0048] With this first preload force, the mechanical interface may have some backlash because the first preload force is not sufficient to tightly clamp the disks within the disk stack against each other to prevent relative movement between the disks within the mechanical interface. However, the design of the disks within the disk stack of the mechanical interface in combination with the first preload force ensures that the disks within the disk stack remain engaged, e.g., remain partially coupled, until the backlash is minimized.

[0049] At a first preload force that is a low preload force, the disk within the mechanical interface has zero backlash up to 1.17 in-lb (0.132 Nm), assuming a coefficient of friction of a first torque level, e.g., 0.1. Above the first torque level, there can be a known small backlash, e.g., 1.13 degrees. As more fully explained below, sufficient force is used to rotate the disk to overcome friction and quickly and dynamically engage the disk, so this force typically provides something greater than the first torque level. In this case, the disk within the mechanical interface has non-zero backlash. Thus, the mechanical interface is said to have non-zero backlash in this case.

[0050] In FIG. 3B, three of the four surgical device assemblies are being moved in the distal direction. Arrow 390 defines the distal and proximal directions. Here, the distal direction is the direction toward patient 201 and away from the master instrument manipulator 280. The proximal direction is the direction away from patient 201 and toward the master instrument manipulator 280. The distal direction is an example of a first direction, and the proximal direction is an example of a second direction that is opposite to the first direction.

[0051] When the surgical device assembly 300 moves distally on the insertion assembly 331, the preload force on the disk stack automatically increases from the first preload force to the second preload force. The second preload force is an example of a second predetermined force. The second preload force reduces the backlash of the mechanical interface, i.e., the backlash between the disks within the disk stack, to zero for the torque level used in the surgical procedure.

[0052] In one aspect, the second preload force is a high preload force, for example 2.3 pounds (1.0 kg). As just described, the disk within the mechanical interface, and thus the mechanical interface, has zero backlash at the torque levels used in the surgical procedure. In one example, assuming a coefficient of friction of 0.1, the mechanical interface has zero backlash for torque levels up to 4.9 in-lb (0.55 NM). In order for the instrument 260 to apply a surgically useful force at the end effector, a certain torque must be applied to the disk at the mechanical interface. This is considered to be the surgically useful torque. In one example, the surgically useful torque can be 4.425 in-lb (0.500 NM), so in this aspect the mechanical interface has zero backlash for the torque levels used in the surgical procedure.

[0053] Figures 4A through 4G are block diagrams showing the attachment of the sterilization adapter assembly and the instrument to the instrument manipulator assembly. Other aspects shown in Figures 4A through 4G include the operation of a preload engagement / disengagement mechanism for reducing backlash, an instrument removal lockout, a sterilization adapter assembly removal lockout, preload release, and automatic preload reset. These mechanical lockout mechanisms are used to ensure that the system 200 does not make prohibited transitions between different states of the system 200.

[0054] Figures 4A through 4G are not to scale. The arrows 390 in Figures 4A through 4G indicate the proximal and distal directions in each of Figures 4A through 4G.

[0055] Figure 4A shows an instrument manipulator assembly 440 attached to an insertion assembly 431. The instrument manipulator assembly 440 is an example of the instrument manipulator assembly 240. The insertion assembly 431 is an example of the insertion assembly 331.

[0056] The instrument manipulator assembly housing 448, also referred to as the housing 448, is fixedly attached to the distal end of the insertion assembly 431. Thus, the instrument manipulator assembly housing 448 moves with the movement of the insertion assembly 431. However, the motor pack 446 within the instrument manipulator assembly housing 448 can move along the rail 439. The motor pack 446 can move distally and proximally with respect to the instrument manipulator assembly housing 448. The motor pack 446 is coupled to the instrument manipulator assembly housing 448 by a motor pack return spring 447, also referred to as a return spring 447.

[0057] The motor pack 446 is movably coupled to the insertion assembly 431 by a preload assembly 480. In one aspect, the preload assembly 480 rides on a preload track within the insertion assembly 431. As described more fully below, when the preload assembly 480 moves distally, the preload assembly 480 applies a distal longitudinal force to the motor pack 446. The preload assembly 480 includes an emergency instrument release button 482.

[0058] The motor pack 446 includes a plurality of drive units 441. The plurality of drive units 441 includes a plurality of drive motors and a plurality of drive output assemblies. Each drive motor of the plurality of drive motors is coupled to a corresponding drive output assembly 443 of the plurality of drive output assemblies.

[0059] The drive output assembly 443 includes a preload spring assembly and a drive output disk 445. The drive output assembly 443 also includes a low backlash coupling positioned between the preload spring assembly and the drive output disk 445. The drive output disk 445 is coupled to the low backlash coupling by a set of input pins.

[0060] The drive output disk 445 is a cylindrical disk including a distal end face. The distal end of each drive output disk 445 has a drive interface. The drive interface includes a drive dog and an alignment element. The drive dog extends distally from the distal end face. Examples of a motor pack and a plurality of drive units suitable for use as a motor pack 446 including a plurality of drive units 441 are disclosed in U.S. Patent Application Publication No. 2016 / 0184037 (“PRELOADED SURGICAL INTSTRUMENT INTERFACE”), which is incorporated herein by reference previously.

[0061] The motor pack 446 includes a plurality of hard stops 437. Each of the plurality of hard stops 437 is configured to extend from the distal face of the motor pack 446 when there is a high preload in the motor pack 446.

[0062] FIG. 4A shows an instrument manipulator assembly 440 with the motor pack 446 in a no-preload position, i.e., a state where the preload mechanism is released. In this configuration, when the preload mechanism is not engaged, for example, when no preload is applied, since there is no preload in the motor pack 446, the plurality of drive output disks including the drive output disk 445 do not extend from the distal face of the instrument manipulator assembly housing 448, regardless of the position of the instrument manipulator assembly 440 relative to the home position. The distal face of the motor pack 446 is at the no-preload position 432. Conversely, when the preload mechanism is engaged and the instrument manipulator assembly 440 is in the home position, a first preload force is applied to the motor pack 446, so that the plurality of drive output disks including the drive output disk 445 extend from the distal face of the instrument manipulator assembly housing 448. This occurs when the motor pack is at the low preload position 433 relative to the instrument manipulator assembly housing 448.

[0063] Typically, prior to use, at least a portion of the patient-side support system 210 is draped with a sterile surgical drape prior to using the system 200. Since some of the control states of the instrument manipulator assembly 440 depend on signals provided during the draping process, it is useful to consider the aspects of the patient-side support system 210 and the sterile surgical drape prior to considering the mechanical lockout safety mechanism of the system 200, as presented in FIGS. 4B through 4G.

[0064] In one aspect, a sterile surgical drape 560, also referred to as the surgical drape 560 (FIG. 5), is used to drape a portion of the patient-side support system 210. In one aspect, the sterile surgical drape 560 includes a first portion 561 and a second portion 562.

[0065] The first portion 561 of the sterile surgical drape 560 is connected to the stationary portion of the rotatable seal 565, and the second portion 562 is connected to the movable portion of the rotatable seal 565. In one aspect, the rotatable seal 565 is a labyrinth seal, the stationary portion is the roll cover portion of the labyrinth seal, and the movable portion is the base comb portion of the labyrinth seal.

[0066] The second portion 562 of the sterile surgical drape 560 includes, in one aspect, a plurality of drape sleeves 562-1, 562-2, a plurality of boots 563-1, 563-2, and a plurality of mechanical interface elements 564-1, 564-2. Typically, the sterile surgical drape 560 includes one drape sleeve, one boot, and one mechanical interface element for each instrument manipulator assembly 240 of the system 200.

[0067] Each of the plurality of mechanical interface elements 564-1, 564-2 is coupled to a corresponding boot of the plurality of boots 563-1, 563-2. Each of the plurality of boots 563-1, 563-2 is coupled to a corresponding drape sleeve of the plurality of drape sleeves 562-1, 562-2. The opening of each drape sleeve of the plurality of drape sleeves 562-1, 562-2 is connected to the movable part of the rotatable seal 565, which in one aspect is a disk having ribs that form a plurality of wedge-shaped "frames" with openings, and each frame is sized to surround the instrument manipulator assembly. The open end of each of the plurality of drape sleeves 562-1, 562-2 is coupled to a different one of the plurality of wedge frames. Each of the plurality of boots 563-1, 563-2 fits around the instrument manipulator assembly that is coupled to the entry guide manipulator assembly by an insertion assembly.

[0068] Figure 6A is a view of one aspect of the patient-side support system 210 in a configuration for initiating draping. As shown in FIGS. 2 and 6A, the entry guide manipulator assembly 230, also referred to as the entry guide manipulator 230, includes four links 613, 615, 617, and 619 coupled by joints. As shown in FIG. 6A, a manipulator assembly yaw joint 611 is coupled between the end of the setup link 606 and the second end, e.g., the proximal end, of the first manipulator link 613. The yaw joint 611 allows the first manipulator link 613 to move in an arbitrarily defined movement about the manipulator assembly yaw axis relative to the link 606.

[0069] In one embodiment, the setup link 606 is rotatable in a horizontal plane or in the x, y plane, and the yaw joint 611 is configured to enable the first manipulator link 613 of the entry guide manipulator 230 to rotate about the yaw axis. The setup link 606, the yaw joint 611, and the first manipulator link 613 provide a yaw axis that is always perpendicular to the entry guide manipulator 230.

[0070] The first end of the first manipulator link 613 is coupled to the second end of the second manipulator link 615 by a first actively controlled rotary joint 614. The first end of the second manipulator link 615 is coupled to the second end of the third manipulator link by a second actively controlled rotary joint 616. The first end of the third manipulator link 617 is coupled to the distal portion of the fourth manipulator link 619 by a third actively controlled rotary joint.

[0071] In one embodiment, the links 615, 617, and 619 are coupled to each other to act as a coupled motion mechanism. Coupled motion mechanisms are well known (for example, such mechanisms are known as parallel motion linkages when the input and output link motions are kept parallel to each other). For example, when the rotary joint 614 rotates actively, the joints 616 and 618 also rotate actively so that the link 619 moves in a fixed relationship with respect to the link 615. Thus, it can be seen that the axes of rotation of the joints 614, 616, and 618 are parallel. When these axes are perpendicular to the axis of rotation of the joint 611, the links 615, 617, and 619 move with respect to the link 613 in a motion that can be arbitrarily defined as "pitch" about the pitch axis of the manipulator assembly. Since the links 615, 617, and 619 move as a single assembly, the first manipulator link 613 can be regarded as an active proximal manipulator link, and the second to fourth manipulator links 615, 617, and 619 can be regarded collectively as an active distal manipulator link.

[0072] In one aspect, the first manipulator link 613 includes a first end 613-1 (FIG. 6B) that includes an alignment receptacle 613C and a second end 613-2 (FIG. 6C) that includes two alignment receptacles 613A, 613B. In one aspect, each of the alignment receptacles 613A, 613B, 613C includes a magnet, and the attachment device fixed to the surgical drape 560 is shaped to fit the alignment receptacles 613A, 613B, 613C and is made of a metal that is attracted to and coupled with the magnet.

[0073] In one aspect, each of the alignment receptacles 613A, 613B, 613C includes or has an attachment sensor associated with the alignment receptacle. When the attachment sensor detects that the surgical drape 560 is attached to the patient-side support system 210, a drape attachment signal indicating the attachment of the surgical drape 560 is sent to the controller 290. Specifically, the attachment device attached to the surgical drape 560 engages the corresponding alignment receptacle to attach the surgical drape 560 to a part of the patient-side support system 210, and the attachment sensor detects the presence of the attachment device.

[0074] A sensor configured to detect the presence of the drape attachment device can be, for example, an inductive sensor. The inductive sensor emits a magnetic field sensed by the sensor, for example, via an inductive loop. When a metal member, i.e., the attachment device, is close to the sensor, the metal member changes the inductance, which is detected by the sensor to indicate the presence of the attachment device. The use of the inductive sensor is merely exemplary and is not intended to be limiting.

[0075] The sensor for detecting the attachment of the surgical drape 560 can be, for example, an optical sensor. The optical sensor can use, for example, light reflected from the drape attachment device or light reflected from the surgical drape 560 itself to detect when the surgical drape 560 is attached. In another example, the optical sensor can be a sensor that emits a light beam and receives the light beam, and senses the presence of the surgical drape 560 when the surgical drape 560 or the attachment device blocks the beam. The sensor can also be a capacitive sensor that senses a change in capacitance that occurs when the surgical drape 560 is attached. In another example, the sensor can be a switch that is mechanically depressed or otherwise switched by the drape attachment device or the surgical drape 560 when the surgical drape 560 is attached to the link 613 of the patient-side support system 210.

[0076] FIG. 7A shows a surgical drape mounting package 770 that is being moved to the home position for attachment to a platform 632 at one end of the link 619. The surgical drape mounting package 770 includes a surgical drape mounting aid to which the sterile surgical drape 560 is attached.

[0077] FIG. 7B shows the surgical drape mounting package 770 attached to the platform 632. In particular, each of the plurality of latches of the rotatable seal 565 is engaged with a corresponding latch receptacle of the platform 632. An example of a surgical drape mounting package is presented in U.S. Patent Application No. 62 / 362,190, a co-pending application by the same applicant, which is hereby incorporated by reference in its entirety and discloses "Surgical Drape Installation Aid" filed on July 14, 2016.

[0078] When the surgical drape mounting package 770 is attached to the platform 632, the drape attachment sensor transmits a drape attachment signal indicating the attachment of the surgical drape mounting package 770 to the controller 290. In one aspect, the drape attachment sensor includes a mechanical switch, such as a plunger, that is actuated by the attachment of the stationary portion of the rotatable seal 565. Alternatively, instead of a mechanical sensor, the drape attachment sensor can be an inductive sensor, a capacitance sensor, or an optical sensor similar to those described above.

[0079] Returning to the discussion of FIGS. 4B through 4G, these figures are described in combination with the state workflow diagram 800 (FIG. 8) of the instrument manipulator assemblies 240 and 440. In FIG. 8, the different states of the workflow diagram 800 are divided into a normal mode 891 and an illegal state mode 892. The normal path between states is shown by the thick solid line in FIG. 8.

[0080] In the start state 801 of the instrument manipulator assembly 440 of the computer-assisted remote operation system 200, the preload engagement / disengagement mechanism of the preload assembly 480 is disengaged. Therefore, there is no preload force on the drive disk of the motor pack 446. For example, the motor pack 446 is in the preload-free position 432 relative to the instrument manipulator housing 448. Also, in the start state 801, the instrument manipulator assembly 440 (FIG. 4A) is moved so that the instrument manipulator assembly 440 is in the home position if the instrument manipulator assembly 440 is not yet in the home position. Therefore, in the start state 801, the preload engagement / disengagement release mechanism is not actuated, and thus no preload force is generated when the instrument manipulator assembly 440 is moved by the insertion assembly 431.

[0081] In response to a command from a user interface to deploy for draping, a drape attachment operation 815 is initiated. In the drape attachment operation 815, an entry guide manipulator 230 is moved by a controller 290 to the position shown in FIG. 6A, and a master instrument manipulator 280 moves a plurality of instrument manipulator assemblies as far as possible to facilitate draping. Next, a surgical drape attachment package 770 is attached to an entry guide manipulator assembly platform 632, and in response to the attachment of the package 770, a drape mount signal is sent to the controller 290.

[0082] A first portion 561 of the sterile surgical drape 560 extends over links 619, 617, and 615 of the entry guide manipulator 230. Finally, the first portion 561 is attached to alignment receptacles 613A, 613B, and 613C of the link 613. As described above, the attachment of the sterile drape 560 to the link 613 causes a drape attach signal to be sent to the controller 290. When the draping of the links of the entry guide manipulator 230 is complete, the user typically moves the entry guide manipulator 230 back to a vertical position from the inclined positions shown in FIGS. 7A and 7B.

[0083] When the controller 290 receives a drape attach signal after receiving a drape mount signal, the state of the instrument manipulator assembly 440 transitions from a start state 801 to a state 811 where the drape is mounted, also called a state 811 of the draping process 810 (state 811). Upon entering state 811, the instrument manipulator assembly 440 is configured to automatically move in the direction of the force applied by the user when the user presses on the instrument manipulator assembly 440. This helps the user position the sleeve of the sterile drape 560 around the insertion assembly 431 and the instrument manipulator assembly 440.

[0084] Accordingly, during the insertion expansion operation 816, the user pushes the instrument manipulator assembly 440 in the distal direction. In response to the force supplied by the user, the controller 290 moves the instrument manipulator assembly 440 in the distal direction relative to the insertion assembly 430. An example of a controller that moves the instrument manipulator in response to a user tap is described in U.S. Patent Application No. 62 / 362,192, filed Jul. 14, 2016, by the same applicant and entitled “Automatic Manipulator Assembly Deployment for Draping,” which is hereby incorporated by reference in its entirety. After the insertion assembly 431 is extended, the mounted drape state 811 transitions to the insertion expansion state 812. Even though the insertion assembly 431 is extended, there is no preload operation because the preload engagement / disengagement mechanism of the preload assembly 480 is disengaged.

[0085] With the instrument expansion manipulator 440 in the insertion expansion state 812, during the sterile adapter attachment operation 817, a surgical device interface element 450, e.g., a sterile adapter assembly, is attached to the instrument manipulator assembly 440 to obtain the configuration shown in FIG. 4B. The surgical device interface element 450 is an example of the sterile adapter assembly 250. Since the preload engagement / disengagement mechanism is not engaged, the motor pack 446 does not displace distally relative to the housing 448, and thus attaching the surgical device interface element 450 in this configuration does not require compressing a plurality of preload spring assemblies, including the preload spring assembly within the drive output assembly 443, during attachment of the surgical device interface element 450.

[0086] In a state where there is no preload force on the motor pack 446, the surgical device interface element 450 is attached by moving the surgical device interface element 450 in the proximal direction until the hook on the surgical device interface element 450 engages with the hook receiving portion of the instrument manipulator assembly 440. Different from the prior art surgical device interface element where one end of the surgical instrument interface element needs to be placed inside the instrument manipulator assembly and rotated until the opposite end of the surgical instrument interface element is latched, the surgical device interface element 450 is moved in a direction perpendicular to the distal surface of the instrument manipulator assembly 440. The attachment of the surgical device interface element 450 causes the sensor to send a signal for attaching the sterilization adapter to the controller 290, resulting in a transition to the sterilization adapter attached state 813. In one aspect, the sensor is a mechanical switch that changes state when the surgical device interface element 450 is attached. Alternatively, the sensor can be an optical sensor, an inductive sensor, or a capacitive sensor as described above.

[0087] Accordingly, when the user performs the sterilization adapter attachment operation 817, the state of the instrument manipulator assembly 440 progresses from the insertion and extension state 812 to the sterilization adapter attached state 813 shown in FIG. 4B. In the sterilization adapter attached state 813, the insertion assembly 431 is extended and the preload engagement / engagement release mechanism is not engaged.

[0088] When the surgical device interface element 450 is attached to each of the instrument manipulator assemblies, the draping process 810 is completed. Following the completion of the draping process 810, the user uses the clutch button on the instrument manipulator assembly 440 to manually move the instrument manipulator assembly 440 to the home position.

[0089] In the insertion / retraction operation 818, each of the instrument manipulator assemblies is retracted and returned to the home position. When the insertion / retraction operation 818 is completed, each of the instrument manipulator assemblies is in a state 820, also called the sterilization adapter mounted and inserted / retracted state 820. In state 820, since the preload engagement / disengagement mechanism is still disengaged, there is no preload force on the surgical device interface element 450.

[0090] Before considering further operations of the instrument manipulator assembly 440, the structure of the surgical device interface element 450 is first described. In this aspect, the surgical device interface element 450 includes a frame 451 and a movable manipulator-instrument interface plate 451C. The movable manipulator-instrument interface plate 451C, also called the movable body 451C, is attached to the frame 451 such that the movable body 451C can move in the proximal and distal directions within the frame 451. A plurality of intermediate disks are attached to the manipulator-instrument interface plate 451C such that each of the plurality of intermediate disks can rotate relative to the frame 451.

[0091] In this aspect, since each intermediate disk of the plurality of disks is the same, intermediate disk 453 represents each of the plurality of intermediate disks. Each intermediate disk 453 of the plurality of intermediate disks includes an intermediate driven interface 455, also referred to as a first intermediate disk interface, and an intermediate drive interface 456, also referred to as a second intermediate disk interface. The intermediate driven interface 455 is on the opposite side of the intermediate drive interface 456 and is removed from the intermediate drive interface 456. In one aspect, the intermediate driven interface 455 includes a first alignment receptacle and a drive dog receptacle. The intermediate drive interface 456 includes a drive dog and an engagement structure. Examples of a movable manipulator - instrument interface plate 451C and a movable manipulator - instrument interface plate and a plurality of intermediate disks suitable for use as the plurality of intermediate disks in FIGS. 4A - 4G are presented in U.S. Patent Application Publication No. US2016 / 0184035, International Publication No. WO2015 / 023834, and International Publication No. WO2015 / 023840, each of which is incorporated herein by reference.

[0092] The movable body 451C also includes a plurality of hard stop receptacles 457. The plurality of hard stop receptacles 457 extend into the movable body 451C in a distal direction from the proximal surface of the movable body 451C.

[0093] When the instrument manipulator assembly 440 is retracted to the home position such that the instrument manipulator assembly 440 is in state 820, the controller 290 initiates a sterilization adapter engagement sequence operation 821. In the sterilization adapter engagement sequence operation 821, the controller 290, in one aspect, moves the instrument manipulator assembly 440 to a first predetermined position proximal to the home position, i.e., a fully retracted position, in the insertion assembly 431.

[0094] When the instrument manipulator assembly 440 is in the fully retracted position, in one aspect, the controller 290 sends a preload activation signal 486 to the preload engagement / disengagement mechanism 485 within the preload assembly 480. In response to the preload activation signal 486, the preload engagement / disengagement mechanism 485 applies a preload, and then the controller 290 returns the insertion assembly 431 to the home position (FIG. 4C). As the insertion assembly 431 moves the instrument manipulator assembly 440 from the fully retracted position to the home position, the motor pack 446 displaces distally relative to the housing 448 of the instrument manipulator assembly 440 from the no-preload position 432 to the low-preload position 433. This displacement stretches the motor pack return spring 447. Engagement of the preload engagement / disengagement mechanism holds the motor pack 446 in a position displaced distally relative to the housing 448 such that there is a preload force on the motor pack 446 in the distal direction.

[0095] Accordingly, when the instrument manipulator assembly 440 moves to the home position, the displacement of the motor pack 446 from the no-preload position 432 to the low-preload position 433 relative to the housing 448 causes the drive interface of each drive output disk 445 of the plurality of drive output disks to contact the corresponding intermediate driven interface 455 among the plurality of intermediate driven interfaces of the plurality of intermediate disks. Accordingly, the movement of the instrument manipulator assembly 440 causes each intermediate disk 453 to contact the movable body 451C and moves the movable body 451C distally. When the movable body 451C moves as distally as possible within the frame 451, further distal movement of the drive output disk 445 is blocked.

[0096] As a result, as the instrument manipulator assembly 440 continues to move to the home position, the preload spring assembly of each drive output assembly 443 of the plurality of drive output assemblies is compressed such that a preload force is applied to each drive output disk 445 of the plurality of drive output disks. This preload force is also referred to as a first preload force or a low preload force. Since the preload force presses on the drive output disk 445 and the corresponding intermediate driven interface 455, the preload force is transmitted to each intermediate disk 453 of the plurality of intermediate disks of the surgical device interface element 450. This configuration is shown in FIG. 4C.

[0097] When the surgical device interface element 450, also referred to as the surgical device interface, is first attached to the instrument manipulator assembly 440, the elements of the intermediate driven interface 455 may not be aligned (not in register) with the corresponding elements of the drive interface on the drive output disk. If the elements of disks 453 and 445 are not aligned, the two disks are partially coupled to each other by features within the drive and intermediate driven interfaces, but the two disks are not coupled to each other, e.g., not meshed.

[0098] Next, in the sterilization adapter engagement sequence operation 821, the controller 290 sends a signal to the instrument manipulator assembly 440 to rotate the drive output disk 445. Rotation of the intermediate disk 453 is prohibited, and the drive output disk 445 is rotated until the drive interface of the drive output disk 445 engages with the intermediate driven disk 455 of the intermediate disk 453. The partial coupling of the elements of the drive interface on the drive disk 445 with the corresponding elements of the intermediate driven interface 455 on the intermediate disk 453 ensures that the two disks remain partially coupled under a preload force when the two disks rotate. In one aspect, when the two disks are coupled, another sensor detects a change in the height of the disk stack and sends a signal to the controller 290 to stop the rotation of the drive output disk 445. When the two disks engage, a first preload force is on the disks. The engagement of the drive output disk 445 and the intermediate disk 453 is the same as the engagement of the corresponding disks as described in U.S. Patent Application Publication No. 2016 / 0184035.

[0099] When each drive output disk of the instrument manipulator assembly 440 engages with the corresponding intermediate disk of the surgical device interface element 450, the sterilization adapter engagement operation 821 is completed. The instrument manipulator assembly 440 is set to a low preload in the normal use process 830 and is in a disk engagement state 831.

[0100] When the instrument manipulator assembly 440 is set to a low preload and is in the disk engagement state 831, several operations are possible. For example, the user can wear the instrument and continue the surgical procedure. As more fully described below, when the surgical procedure is completed, the normal use process 830 returns to a low preload and the disk engagement state 831, and then the user removes the drape from the patient side support system 210. Accordingly, each of these operations is considered in order.

[0101] When the instrument manipulator assembly 440 is in the low preload setting and the disk engagement state 831, the user can press the emergency instrument release (EIR) button 482 in the emergency instrument release button operation 822. Activating the emergency instrument release button 482, for example pressing the button 482, releases the preload engagement / disengagement mechanism of the preload assembly 480 to the preload engagement / disengagement mechanism 485, so that the low preload force on the disk stack is released. This returns the instrument manipulator assembly 440 to the state 820 where the sterilization adapter is attached and the insertion is retracted.

[0102] Alternatively, when the instrument manipulator assembly 440 is in the low preload setting and the disk engagement state 831, the user can attach the instrument to the surgical device interface element 450. Thus, in the instrument attachment operation 835, the first end of the instrument 460 slides along the inclined path of the frame 451 of the surgical device interface element 450 until the instrument 460 is held in place as shown in Figure 4E. In this state of the low preload instrument manipulator assembly 440, the movable manipulator-instrument interface plate 451C is not fixed in position and can move proximally. Thus, when the instrument 460 slides along the inclined path, the movable manipulator-instrument interface plate 451C is displaced proximally, which further compresses the first preload spring assembly, and thus the preload force on the disk stack consisting of disks 445, 453, and 463 is said to be approximately the first preload.

[0103] When the instrument attachment operation 835 is completed, the instrument manipulator assembly 440 is in the instrument-attached state 832, also called state 832. In state 832, the preload force on the disk stack consisting of disks 445, 453, and 463 is approximately the first preload, and the driven interface of the driven disk 464 is probably not engaged with the intermediate drive interface 456 of the intermediate disk 453.

[0104] Before considering the instrument engagement sequence operation 836 that changes the state of the instrument manipulator assembly 440 from the instrument mounted state 832 to the instrument engaged state 833, a brief discussion of the characteristics of the instrument 460 will be given. In one aspect, the instrument 460 is the same as the surgical instrument described in U.S. Patent Application Publication No. 2016 / 0184037.

[0105] In this aspect, the instrument 460 (FIG. 4E) includes a body 465 and a main tube 467. The main tube 467 extends distally from the body 465. The body 465 includes a driven disk receptacle 463, a shaft 466, and a driven disk 464. The shaft 466 and the driven disk 464 are part of a transmission unit that transmits the received torque through the instrument to one or more components of the instrument.

[0106] The proximal end of the shaft 466 extends into the driven disk receptacle 463, and the driven disk 464 is attached to the proximal end of the shaft 466 such that the driven disk 464 is positioned within the driven disk receptacle 463. The driven disk 464 includes a driven interface that interacts with an intermediate drive interface 456 of an intermediate disk 453.

[0107] The driven interface of the driven disk 464 includes an engagement receptacle, a drive dog receptacle, and an anti-rotation element. The anti-rotation element includes a rotation locking mechanism. Upon engagement of the anti-rotation element, the rotation locking mechanism engages the driven disk receptacle 464 and prevents rotation of the driven disk 464.

[0108] When the instrument 460 is coupled to the instrument manipulator assembly 440, each driven disk 464 proximally presses against a corresponding intermediate disk 453 of the surgical device interface element 450, so that the intermediate disk 453 can rotate freely. This increases the preload force on the disk stack. However, when the instrument 460 is first attached to the surgical device interface element 450, the elements of the intermediate drive interface 456 may not be aligned with the corresponding elements of the driven interface on the driven disk 464. If the elements of the two disks 453 and 464 are not aligned, the two disks are partially coupled together by the features of the intermediate drive interface 456 and the driven interface, but the two disks do not mesh with each other.

[0109] When the intermediate drive interface 456 of the intermediate disk 453 is not aligned with the corresponding driven interface of the driven disk 464, the engagement structure on the intermediate drive interface 456 of the intermediate disk 453 engages with the immobilizing element on the driven disk 464 of the instrument 460. The immobilizing element includes a rotation lock mechanism. When the immobilizing element engages, the rotation lock mechanism engages with the driven disk receptacle 464 to prevent rotation of the driven disk 464.

[0110] When the instrument 460 is coupled to the instrument manipulator assembly 440, the instrument manipulator assembly 440 detects the presence of the instrument 460 and transmits a signal to the controller 290. In response to the signal, the controller 290 transmits the signal to the instrument manipulator assembly 440 and executes an instrument engagement sequence operation 836, which may also be referred to as operation 836.

[0111] In response to a signal from the controller 290, the instrument manipulator assembly 440 rotates the drive output disk 445, which in turn rotates the intermediate disk 453. As the intermediate drive interface 456 of the intermediate disk 453 rotates with the driven disk 464 fixed in place, each element on the intermediate drive interface 456 rotates and aligns with the corresponding element of the driven interface of the driven disk 464 and meshes with the corresponding element. The coupling of the intermediate drive interface 456 and the driven interface on the driven disk 464 releases the rotational lock on the driven disk 464. Thus, the stack of disks, disks 445, 453, and 464 rotate as a unit. When disks 453 and 464 are coupled, the sensor again detects a change in the height of the disk stack and sends a signal to the controller 290 to stop the rotation of the drive output disk 445. When the stack of disks is meshed, the preload force applied to the disk stack is called a first longitudinal force, i.e., a first preload force.

[0112] When the intermediate disk of the surgical device interface element 450 meshes with the disk of the instrument 460, the instrument manipulator assembly 440 is in an instrument engagement state 833, also called state 833 of the normal use process 830. In state 833, the instrument 460 is attached, the preload is a low preload, and the instrument 460 can be removed from the surgical device interface element 450. At low preload, the movable manipulator-instrument interface plate 451C is not locked in place and can be displaced in the proximal direction, so the instrument 460 can be removed.

[0113] In the configuration of FIG. 4E, the surgical device interface element 450 cannot be removed without removing the instrument 460. The attachment of the instrument 460 prevents the use of the release button on the side of the surgical device interface element 450. Thus, since the surgical device interface element 450 includes a mechanical sterilization adapter assembly removal lockout, when the instrument 460 is attached to the surgical device interface element 450, the instrument 460 activates the mechanical sterilization adapter assembly removal lockout.

[0114] Unlike conventional systems that prohibit operation of the mechanical release button for the surgical device interface element whenever a preload force is present, there is no interlock for the surgical device interface element 450 based on the preload state. The only interlock on the surgical device interface element 450 is a mechanical interlock based on whether the instrument 460 is attached to the surgical device interface element 450.

[0115] However, in the configuration of FIG. 4E, the instrument 460 can still be removed. As more fully described in U.S. Patent Application Publication No. 2016 / 0184036, in one aspect, there are release buttons on each side of the instrument 460. Engaging the release buttons causes the movable body 451C of the surgical device interface element 450 to be pushed proximally into the mechanism of the instrument 460 so that the intermediate disk 453 and the driven disk 464 are disengaged and the instrument 460 can be removed.

[0116] Thus, in the instrument removal operation 838, the user operates the release buttons on each side of the instrument 460 that disengage the intermediate disk 453 and the driven disk 464, and then the user slides the instrument 460 from the surgical device interface element 450. Removal of the instrument 460 changes the state of the instrument manipulator assembly 440 to set the low preload of the normal use process 830 from the instrument engagement state 833 and returns to the disk engagement state 831.

[0117] The extended insertion operation 837 changes the state of the instrument manipulator assembly 440 from the instrument engagement state 833 to an instrument state 834 that uses a high preload, also referred to as state 834. State 834 is in both the normal use process 830 and the instrument tip state 850 beyond the cannula.

[0118] In the extended insertion operation 837, the distal end of the instrument 460 is moved into and through the cannula by an insertion assembly 431 that moves the instrument manipulator assembly 440 in the distal direction. When the distal end of the instrument 460 is inserted into the cannula by the insertion assembly 431 that moves the instrument manipulator assembly 440, a second preload force is applied by the preload assembly 480 to the stack of disks 445, 453, and 464 before the end component coupled to the main tube 467 protrudes from the distal end of the cannula.

[0119] Specifically, as the instrument 460 moves distally, the preload assembly 480 moves distally along the preload track. In one aspect, when the instrument manipulator assembly 440 moves distally a predetermined distance Zload, the preload assembly 480 moves the motor pack 446 a distance of the predetermined distance Zload plus an additional distance Δ. In another aspect, the motor controller moves the motor pack 446 a distance Δ relative to the housing 448 independent of or in cooperation with the movement of the instrument manipulator assembly 440 by the insertion assembly 431.

[0120] In both of these aspects, the additional movement of the motor pack 446 relative to the housing 448 compresses the preload spring assemblies within each of the plurality of drive output assemblies 443 of the plurality of drive output assemblies, so that a second preload force is applied to each of the drive output disks 545 of the plurality of drive output disks. The second preload force reduces any backlash between the rotation of the motor shaft of the drive unit 441 and the rotation of the shaft 466 of the instrument 460 to less than 0.7 degrees before the distal end of the instrument 260 exits the cannula.

[0121] The movement of the additional distance Δ of the motor pack 446 also further stretches the return spring 447 and further inserts each of the plurality of hard stops 437 into the corresponding hard stop receptacle of the plurality of hard stop receptacles 457. The plurality of hard stops 437 prevent any proximal movement of the movable body 451C of the surgical device interface element 450. The combination of the plurality of hard stops 437 and the plurality of hard stop receptacles 457 forms an instrument removal interlock and prevents removal of the instrument 460. When attempting to press the release button of the instrument 460, since the plurality of hard stops 437 prevent proximal movement of the movable body 451C, the mechanism of the instrument 460 cannot push the movable body 451C of the surgical device interface element 450 proximally, and the intermediate disk 453 and the driven disk 464 cannot be disengaged.

[0122] The use of the plurality of hard stop receptacles 457 is merely exemplary and is not intended to be limiting. In another aspect, the plurality of hard stop receptacles 457 are not used. Instead, the plurality of hard stops 437 contact the proximal surface of the movable body 451C and prevent movement of the movable body 451C in the proximal direction. When the extended insertion operation 837 is complete, the instrument manipulator assembly 440 is in the instrument state 834 that uses a high preload. In state 834, all the disks in the disk stack of disks 445, 453, and 464 are engaged, and the disk stack has a second preload. Neither the surgical device interface element 450 nor the instrument 460 can be removed in state 834.

[0123] The insertion operation 839 changes the state of the instrument manipulator assembly 440 from the instrument state 834 using high preload to the instrument engagement state 833. In the insertion operation 839, the instrument manipulator assembly 440 is moved by the user along the insertion assembly 431 to the home position. When the instrument manipulator assembly 440 is moved to the home position, the distal end of the instrument 460 no longer extends through the cannula, and the second preload force is changed to the first preload force by the preload engagement / disengagement mechanism 485 of the preload assembly 480. That is, when the instrument manipulator assembly 440 is retracted, the motor pack 446 moves from the high preload position 434 to the low preload position 433 relative to the housing 448.

[0124] If for some reason it is necessary to remove the instrument 460 while the distal tip of the instrument 460 extends beyond the distal end of the cannula in the state 834, the person presses the emergency instrument release button 482 to perform the emergency instrument release button operation 851. The emergency instrument release (EIR) button operation 851 changes the state of the instrument manipulator assembly 440 from the instrument state 834 using high preload to the no preload state 861 of the user interface (UI) guided recovery process 860. The state of the user interface guided recovery process 860 is an illegal instrument state.

[0125] In the emergency instrument release button operation 851, actuating the emergency instrument release button 482 releases the longitudinal force applied to the motor pack 446. As a result, the return spring 447 pulls the motor pack 446 back to the fully retracted position within the housing 448.

[0126] When the motor pack 446 is fully retracted, the plurality of hard stops 437 are withdrawn from the plurality of hard stop receptacles 457 of the movable body 451C of the surgical device interface element 450, and the disks 453 and 464 no longer receive any preload force. Accordingly, the release button of the instrument 460 can be used to remove the instrument 460 from the surgical device interface element 450 at any position of the insertion assembly 431.

[0127] However, to remove the instrument 460 from the cannula, an insertion retraction operation 865 is performed. The insertion retraction operation 865 changes the state of the instrument manipulator assembly 440 from the no-preload state 861 to the no-preload insertion home state 862 of the user interface guided recovery process 860. In the insertion retraction operation 865, the user engages the clutch button of the instrument manipulator assembly 440 and moves the instrument manipulator assembly 440 to the home position along the insertion assembly 431.

[0128] When the instrument manipulator assembly 440 is in the instrument engagement state 833 where the instrument 460 is attached and has a low preload, an emergency instrument release button operation 867 can be performed. In the emergency instrument release button operation 867, actuating the emergency instrument release button 482 releases the longitudinal force on the motor pack 446. As a result, the return spring 447 pulls the motor pack 446 back to the fully retracted position within the housing 448 so that there is no preload. Performing the emergency instrument release button operation 867 changes the state of the instrument manipulator assembly 440 from the instrument engagement state 833 to the no-preload, insertion home state 862.

[0129] In the no-preload, insertion home state 862, the instrument 460 is withdrawn from the cannula and there is no preload force on the disk stack. Accordingly, it is safe and possible to remove the instrument 460 from the surgical device interface element 450.

[0130] In the instrument removal operation 866, the user operates the release buttons on each side of the instrument 460 that disengages the intermediate disk 453 and the driven disk 464, and then the user slides the instrument 460 from the surgical device interface element 450. Completion of the instrument removal operation 866 changes the state of the instrument manipulator assembly 440 from the no preload, insertion home state 862 to the sterilization adapter attachment, insertion retracted state 820.

[0131] During normal surgical procedures, the instrument retraction operation 839 is performed to change the state of the instrument manipulator assembly 440 from the instrument state 834 using high preload to the instrument engagement state 833. Next, the instrument removal operation 838 is performed to change the state of the instrument manipulator assembly 440 from the instrument engagement state 833 to the disk engagement state 831 where low preload is set.

[0132] Since the surgical procedure is complete, the drape needs to be removed from the patient side support system 210. To facilitate the drape removal (UNDRAPING) process 840, in the extended insertion operation 841, the user uses the clutch button on the instrument manipulator assembly 440 to move the instrument manipulator distally. When the instrument manipulator assembly 440 moves distally, the preload assembly 480 moves distally along the preload track. In one aspect, when the instrument manipulator assembly 440 moves distally by a predetermined distance Zload, the preload assembly 480 moves the motor pack 446 to the high preload position 434 relative to the housing 448 by the predetermined distance Zload plus an additional distance Δ. The movement of the motor pack 446 by the additional distance Δ compresses the preload spring assembly of each drive output assembly 443 of the plurality of drive output assemblies such that a second preload force is applied to each drive output disk 545 of the plurality of drive output disks. This second preload force is also referred to as the high preload force relative to the low preload force as described above.

[0133] The additional movement of distance Δ of the motor pack 446 also further stretches the return spring 447 and, in addition, inserts each of the plurality of hard stops 437 into the corresponding hard stop receptacles of the plurality of hard stop receptacles 457. The plurality of hard stops 437 prevent any proximal movement of the movable body 451C of the surgical device interface element 450. This configuration is shown in FIG. 4D. Thus, the extended insertion operation 841 changes the state of the instrument manipulator assembly 440 from the low preload setting sterilization adapter engagement state of the normal use process 830 to the sterilization adapter mounted high preload state 842 of the drape removal process 840. In the sterilization adapter mounted high preload state 842, a second preload is applied to the engaged disks (drive output disk 445 and intermediate disk 453) using the surgical device interface element 450 attached to the instrument manipulator assembly 440.

[0134] In a conventional system for either the first preload state or the second preload state, removal of the sterilization adapter required first pressing the preload release button of the instrument manipulator assembly to release the preload state and also disabling the lock of the sterilization adapter release button of the instrument manipulator assembly. The sterilization adapter release button of the instrument manipulator assembly was then used to remove the sterilization adapter. For details of the conventional system, see U.S. Patent Application Publication No. 2016 / 0184037.

[0135] In contrast, in the sterilization adapter / drape removal operation 843, the user presses the release button on the side of the surgical device interface element 450 to move the surgical device interface element 450 distally away from the distal face of the instrument manipulator assembly 440, regardless of whether the second preload condition is active. There is no need to operate a button on the instrument manipulator assembly 440 to remove the surgical device interface element 450 under the second preload condition. Since only the feature of the surgical device interface element 450 is used to remove the surgical device interface element 450, this makes the removal of the surgical device interface element 450 more intuitive. The emergency instrument release button 482 is not used or required for the removal of the surgical device interface element 450 under any preload condition, so it reduces confusion. After removing the surgical device interface element 450, the user removes the surgical drape from the patient-side support system 210.

[0136] When the sterilization adapter removal operation 843 is completed, the instrument manipulator assembly 440 is in the insertion expansion state 844. The user performs an insertion retraction operation 845 to change the state of the instrument manipulator assembly 440 from the insertion expansion state 844 to the insertion home state 846.

[0137] In the insertion retraction operation 845, each of the instrument manipulator assemblies is retracted and returned to the home position by the user using the clutch button on that instrument manipulator assembly 440 to move the instrument manipulator assembly 440 to the home position.

[0138] With the instrument manipulator assembly 440 in the home position, the controller 290 executes a preload release operation 847 to change the state of the instrument manipulator assembly 440 to the start state 801. In one aspect, the controller commands the instrument manipulator assembly 440 to move proximally to the home position, which automatically releases the preload, as will be more fully described below. In another aspect, the controller 290 commands the motor to move the motor pack 446 to the preload - free position.

[0139] FIG. 9A shows an example of an insertion manipulator assembly 940 fixed to an insertion assembly 931, which insertion assembly is attached to an insertion shaft base assembly 932. The insertion shaft base assembly 932 includes a motor and power electronics for moving the insertion assembly 931. The instrument manipulator assembly 940 is an example of the instrument manipulator assembly 240 and the instrument manipulator assembly 440. The insertion assembly 931 is an example of the insertion assembly 331 and the insertion assembly 431.

[0140] The instrument manipulator assembly 940 includes two buttons, namely a clutch button 944 and an emergency instrument release button, which are not visible. The emergency instrument release button is an example of the emergency instrument release button 482. When the user presses, i.e., actuates, the clutch button 944, the user can manually move the instrument manipulator assembly 940 in both the proximal and distal directions along the insertion assembly 931. The emergency instrument release button is used to release the preload, as described with respect to FIG. 8.

[0141] The instrument manipulator assembly 940 also includes a drive unit assembly 941 and a drive output unit 942. In this aspect, the drive output unit 942 includes a plurality of drive output assemblies, for example, eight drive output assemblies. In this specification, the drive output assembly 943 refers to any one of the eight drive output assemblies. In one aspect, only six of the eight drive output assemblies are used. The drive output assembly 943 includes a low backlash coupling and a drive output disk. The drive unit assembly, the drive output unit 942, and the drive output assembly 943 are equivalent to those described in U.S. Patent Application Publication No. 2016 / 0184035.

[0142] The sterilization adapter assembly 250 (FIGS. 9B through 9G) includes a sterilization adapter frame 951 and a sterilization drape (not shown). The sterilization drape is fixedly attached to the sterilization adapter frame 951. The sterilization adapter assembly 250 is an example of a surgical device interface element. The sterilization adapter frame 951 is an example of a surgical device interface element body. More generally, a surgical device interface element is a structure that includes a mechanical interface between a drive interface of a drive system and a driven interface of an instrument such as a surgical instrument or a camera instrument.

[0143] The frame 951 of the sterilization adapter assembly 250 has a front end portion 951FE, i.e., a first end portion, a rear end portion 951RE, i.e., a second end portion, a first side portion 951S1, and a second side portion 951S2. The second end portion 951RE is the end portion into which the instrument is inserted and is thus open to receive the instrument. Therefore, the second end portion 951RE is also referred to as the open end of the sterilization adapter assembly 250 and the sterilization adapter frame 951.

[0144] The first beam 955, also referred to as beam 955, is movably attached inside the first side portion 951S1 of the sterilization adapter frame 951. Thus, the distal end portion (the first end portion) of beam 955 moves in the first direction (inward), and the proximal end portion (the second end portion) of beam 955 moves in the second direction (outward), which is opposite to the first direction. The second beam 956, also referred to as beam 956, is movably attached inside the second side portion 951S2 of the sterilization adapter frame 951. Thus, the distal end portion (the first end portion) of beam 956 moves in the first direction (inward), and the proximal end portion (the second end portion) of beam 956 moves in the second direction (outward), which is opposite to the first direction. The configurations of beams 955 and 956 are the same, and each beam has the same characteristics.

[0145] In one aspect, Beam 955 is attached inside the first side portion 951S1 by a first flexure such that when the distal end portion of beam 955 moves inward, the proximal end portion of beam 955 moves outward. Beam 956 is attached inside the second side portion 951S2 by a second flexure such that when the first end portion of beam 956 moves inward, the proximal end portion of beam 956 moves outward.

[0146] In another aspect, beam 955 is pivotally attached inside the first side portion 951S1 and includes a spring that maintains the proximal end portion of beam 955 in an engaged position. When a force is applied to the distal end portion of beam 955, the proximal end portion of beam 955 pivots to a disengaged position. Similarly, beam 956 is pivotally attached inside the second side portion 951S3 and includes a spring that maintains the proximal end portion of beam 956 in an engaged position. When a force is applied to the distal end portion of beam 956, the proximal end portion of beam 955 pivots to a disengaged position.

[0147] The first hook extension 955HE1 extends proximally from the beam 955. The first hook extension 955HE1 is adjacent to the third end of the beam 955. The second hook extension 955HE2 extends proximally from the beam 955. The second hook extension 955HE2 is adjacent to the fourth end of the beam 955, where the third end of the beam 955 is removed from and does not intersect the fourth end of the beam 955.

[0148] The first hook extension 956HE1 extends proximally from the beam 956. The first hook extension 956HE1 is adjacent to the third end of the beam 956. The second hook extension 956HE2 extends proximally from the beam 956. The second hook extension 956HE2 is adjacent to the fourth end of the beam 956, where the third end of the beam 956 is removed from and does not intersect the fourth end of the beam 956.

[0149] The side portion 951S1 includes a through-opening 959 (Figs. 9B, 9C, and 9D) extending from the proximal edge of the side portion 951S1. A sterilization adapter release button 961, also referred to as a release button 961, is disposed within the through-opening 959. The sterilization adapter release button 961 is fixed to the outer surface of the beam 955.

[0150] The second side portion 951S2 includes a through-opening 960 (Figs. 9E and 9F) extending from the proximal edge of the second side portion 951S2. A sterilization adapter release button 962, also referred to as a release button 962, is disposed within the through-opening 960. The sterilization adapter release button 962 is fixed to the outer surface of the beam 956.

[0151] The inner sides of the beams 955 and 956 each include instrument insertion skid plates 963 and 964 that terminate in parking slots. The instrument insertion skid plate 963 is formed on the inner side of the beam 955. The instrument insertion skid plate 963 extends from the fourth end of the beam 955 to the parking slot 965 adjacent to the third end of the beam 955. The instrument insertion skid plate 964 is formed on the inner side of the beam 956. The instrument insertion skid plate 964 extends from the fourth end of the beam 956 to the parking slot 966 adjacent to the third end of the beam 956.

[0152] The sterilization adapter frame 951 includes a movable manipulator-instrument interface plate 951C, called the movable body 951C. The movable manipulator-instrument interface plate 951C can move distally and proximally, for example, in the first and second directions, within the sterilization adapter frame 951.

[0153] The movable manipulator-instrument interface plate 951C includes receptacles for each of the plurality of intermediate disks 953P. The movable body 951C also includes a plurality of optional hard stop receptacles 957 (Figure 9C).

[0154] Each intermediate disk has a cylindrical body. Each of the plurality of intermediate disks 953P is attached to a corresponding intermediate disk receptacle of the plurality of intermediate disk receptacles of the movable body 951C such that each intermediate disk can rotate with respect to the sterilization adapter frame 951 and with respect to the movable body 951C. Thus, the plurality of intermediate disks 953P are rotatably attached to the sterilization adapter frame 951. Also, each intermediate disk can move distally and proximally within the intermediate disk receptacle.

[0155] Each intermediate disk includes an intermediate driven interface on a first side of the intermediate disk and an intermediate drive interface on a second side of the intermediate disk. The intermediate driven interface is configured to engage with a drive interface on a drive output disk of the drive output unit 942. The movable body 951C and the plurality of intermediate disks 953P are equivalent to the movable body and the plurality of intermediate disks of the sterilization adapter described in International Publication No. WO 2015 / 023840, which was previously incorporated by reference.

[0156] Figures 10A and 10B show the movements and forces necessary to attach the sterilization adapter assembly 250 to the instrument manipulator assembly 1040 connected to the insertion assembly 1031 (Figure 10A) and to remove the sterilization adapter assembly 250 from the instrument manipulator assembly 1040 (Figure 10B). The instrument manipulator assembly 1040 also includes a drive unit assembly and a drive output unit. In this aspect, the drive output unit includes a plurality of drive output assemblies, for example, eight drive output assemblies. Each drive output assembly includes a low backlash coupling and a drive output disk. The drive unit assembly, the drive output unit, and the drive output assemblies are equivalent to those described in U.S. Patent Application Publication No. 2016 / 0184035.

[0157] The instrument manipulator assembly 1040 is another example of the instrument manipulator assembly 240 and the instrument manipulator assembly 440. The insertion assembly 1031 is another example of the insertion assembly 331 and the insertion assembly 431. The instrument manipulator assembly 1040 includes two buttons - namely, a clutch button 1044 and an emergency instrument release button 1082. The emergency instrument release button 1082 is an example of the emergency release button 482.

[0158] The clutch button 1044 is attached to the housing of the instrument manipulator assembly 1040. When the user presses, i.e., actuates, the clutch button 1044, the user can manually move the instrument manipulator assembly 1040 both proximally and distally along the insertion assembly 1031.

[0159] The emergency instrument release button 1082 is attached to the preload assembly 1080 of the instrument manipulator assembly 1040. The emergency instrument release button is used to release the preload as described with respect to FIG. 8.

[0160] To attach the sterilization adapter assembly 250 to the instrument manipulator assembly 1040, the user moves the sterilization adapter assembly 250 in the proximal direction, direction 1091, and pushes the sterilization adapter assembly 250 into the distal face of the instrument manipulator assembly 1040. The hook extensions of the sterilization adapter assembly 250 are movable such that each hook of the hook extensions snap into the distal face of the instrument manipulator assembly 1040 to securely attach the sterilization adapter assembly 250 to the instrument manipulator assembly 1040.

[0161] As shown in FIG. 10A, when the sterilization adapter assembly 250 is attached to the instrument manipulator assembly 1040, the plunger of the instrument manipulator assembly 1040 is depressed to block a light beam, which in turn generates a signal indicating the presence of the sterilization adapter assembly 250 to the controller 290. Alternatively, one of the other sensors described above can be used to detect the presence or absence of the sterilization adapter assembly 250.

[0162] To remove the sterilization adapter assembly 250, the user presses the sterilization adapter release buttons 961 and 962 inwardly using forces 1092A and 1092B respectively, regardless of whether there is a preload on the sterilization adapter assembly 250. The inward forces on buttons 961 and 962 swivel the beams, which releases the hooks including hooks 1071 and 1072 (Figure 10C), holds the sterilization adapter assembly 250 to the instrument manipulator assembly 1040, and thus allows for easy removal of the sterilization adapter assembly 250. When the sterilization adapter assembly 250 is removed from the instrument manipulator assembly 1040, the plunger of the instrument manipulator assembly 240 is no longer depressed, which in turn generates a signal indicating to the controller 290 the absence of the sterilization adapter assembly 250.

[0163] Figure 10C is a view of the sterilization adapter assembly 250 attached to the instrument manipulator assembly 1040 with the parts of the sterilization adapter assembly 250 and the instrument manipulator assembly 1040 removed to show the hook and hook receiver latch mechanism used to attach and hold the sterilization adapter assembly 250 to the distal face of the sterilization adapter assembly 250. In the following description of the sterilization adapter assembly 250 and the instrument manipulator assembly 1040, with respect to Figure 10C, the left and right configurations of the sterilization adapter assembly 250 and the instrument manipulator assembly 1040 are the same. Thus, the left side of Figure 10C is described, and each reference number is followed by the reference number for the corresponding feature on the right side of Figure 10C to avoid duplicate descriptions of different reference numbers for the left and right sides of the sterilization adapter assembly 250 and the instrument manipulator assembly 1040.

[0164] The instrument manipulator assembly 1040 includes a first side member 1073 and a second side member 1074. The side member 1073 (1074) includes an inclined side surface 1075 (1076) that forms part of the hook receiver 1077 (1078) of the side member 1073 (1074). The hook receiver 1077 (1078) is shaped to engage a hook 1071 (1072) formed on the hook extension 955HE2 (956HE2) of the beam 955 (956). For example, the hook receiver fits into the hook of the hook extension.

[0165] In the sterilization adapter assembly 250, the beam 955 (956) is movably connected to the side wall of the sterilization adapter assembly 250 by a flexure 1083 (1084). In this aspect, the beam 955 (956) and the flexure 1083 (1084) are formed as a single piece. More generally, the first end of the flexure 1083 (1084) is connected to the beam portion 955 at a position between the distal end and the proximal end of the beam portion 955. The position is selected such that the flexure enables the hook 1071 (1072) formed on the hook extension 955HE2 (956HE2) of the beam 955 (956) to engage and disengage from the hook receiver 1077 (1078) of the side beam 1073 (1074). The second end of the flexure 1083 (1084) is connected to the side wall of the sterilization adapter assembly 250. More generally, the beam 955 (956) is pivotally connected to the side wall at a position between the distal end and the proximal end of the beam 955 (956).

[0166] To remove the sterilization adapter assembly 250 from the instrument manipulator assembly 1040, the user presses each of the release buttons 961, 962 inwardly into the sterilization adapter assembly, i.e., applies a force 1092A to the release button 961 and a force 1092B to the release button 962. The forces 1092A and 1092B on the release buttons 961 and 962 are applied to the distal ends of the beams 955 and 956.

[0167] The forces on the distal ends of beams 955 and 956 cause bends 1083 and 1084 to bend such that the hooks of hook extensions 955HE1 and 956HE2 bisect instrument manipulator assembly 1040 and rotate outwardly away from the plane including the longitudinal axis of instrument manipulator assembly 1040. The outward rotation of the hooks disengages the hooks from the hook receivers, which enables sterilization adapter assembly 250 to move distally from instrument manipulator assembly 1040.

[0168] FIG. 11A is a more detailed view of a prior art surgical instrument that can be attached to sterilization adapter assembly 250. Instrument 260, in this aspect, includes a driven interface assembly 1161, a transmission unit 1165, a main tube 1167, a parallel motion mechanism 1168, a wrist joint 1169, and an end effector 1170. Wrist joint 1169 is described, for example, in U.S. Patent Application Publication No. 2003 / 0036748, “Surgical Tool Having Positively Positionable Tendon-Activated Multi-Disk Wrist Joint,” which is incorporated herein by reference. Parallel motion mechanism 1168 is described, for example, in U.S. Patent No. 7,942,868, filed Jun. 13, 2007, “Surgical Instrument With Parallel Motion Mechanism.”

[0169] As shown in FIG. 11B, driven interface assembly 1161 includes a plurality of driven disks 1164P. The plurality of driven disks 1164P is an example of a passive interface element. Driven disk 1164 represents each driven disk of the plurality of driven disks 1164P. Driven disk 1164 is attached to the shaft of transmission unit 1165. Also, each driven disk 1164 is attached to a receptacle within the body of driven interface assembly 1161.

[0170] The mechanical components of the transmission unit 1165 (e.g., gears, levers, gimbals, cables, etc.) transmit the torque from the plurality of driven disks 1164P to cables, wires, and / or combinations of cables, wires, and hypochutes extending through the main tube 1167 to control the movement of the parallel motion mechanism 1168, the wrist joint 1169, and the end effector 1170. The main tube 1167 is substantially rigid but can bend slightly between the transmission unit 1165 and the entry guide 270. This bending allows the holes of the instrument body tubes within the entry guide 270 to be spaced closer to each other than the size of the transmission unit otherwise allowed. The bending is elastic such that the main tube 1167 assumes its straight shape when the instrument 260 is withdrawn from the entry guide 270 (the main tube may be formed with a permanent bend, which would interfere with the rotation of the instrument body).

[0171] The driven interface assembly 1161 has a pair of mounting wings (1162A1, 1162B1) and (1162A2, 1162B2) on both sides. Also, there are release buttons 1163A, 1163B on both sides of the transmission unit 1165. The mounting wing 1162B2 and the release button 1163B are shown in FIG. 10.

[0172] To attach the instrument 260 to the sterilization adapter frame 951, first, the mounting wings 1162A1, 1162A2 are placed on the skid plates 963, 964 (FIGS. 9E, 9F, and 12 to 14) at the open end 951RE of the sterilization adapter frame 951. FIGS. 12 to 14 are cross-sectional views with the outer surfaces of the sterilization adapter frame 951 and the beam 956 removed.

[0173] The mounting wing 1162A1 is placed on a skid plate 964 extending from the inner wall of the beam 956. As the instrument 260 slides on the skid plate 964 towards a parking slot 966 at the opposite end of the skid plate 964 (FIG. 12), the upper surfaces of the first mounting wings 1162A1, 1162A2 contact the bottom edge of the lip 1251A of the movable body 951C, which moves the movable body 951C in the proximal direction (FIGS. 12 and 13). The proximal movement of the movable body 951C pushes down the plunger 1246 of the instrument manipulator assembly 1040, thereby generating a signal for the controller 290 that the instrument 260 is loaded into the sterilization adapter assembly 250.

[0174] When the mounting wing 1162A1 reaches the parking slot 966 (FIG. 14), the upper surfaces of the first mounting wings 1162A1, 1162A2 no longer contact the bottom edge of the lip 1251A of the movable body 951C. As a result, the preload force on the movable body 951C moves the body 951C in the distal direction (FIG. 13) and locks the first mounting wing 1162A1 in place. When the first mounting wing 1162A1 reaches the end of the sterilization adapter frame 951, the second mounting wing 1162B1 rests on a flat portion of the skid plate 964 near the open end of the sterilization adapter frame 951 (FIG. 14).

[0175] Each intermediate disk 953 of the sterilization adapter frame 951 is axially pushed in the distal direction by a preload force to a plurality of drive output disks of the instrument manipulator assembly. Thus, when the instrument 260 is attached to the sterilization adapter frame 951, the plurality of intermediate disks 953P transmit a first preload force to the movable body 951C, whereby the preload force is applied to the mounting wing 1162A1. This preload force is selected such that the instrument 260 can be easily slid into the sterilization adapter frame 951 and a small preload force is maintained on all the disks.

[0176] When the instrument 260 is attached to the sterilization adapter assembly 250, the instrument manipulator assembly 1040 detects the presence of the instrument 260 and transmits a signal indicating the presence of the instrument 260 to the controller 290. In response to the signal, the controller 290 of the system 200 sends a signal to the instrument manipulator assembly 1040 to rotate each of the plurality of drive output disks of the instrument manipulator assembly 1040.

[0177] As fully described in U.S. Patent Application Publication No. 2016 / 0184037, each drive output assembly 943 of the drive output unit 942 is spring-loaded and automatically positioned such that a preload force is applied to each drive output disk after the sterilization adapter assembly 250 is attached to the instrument manipulator assembly 1040. The preload force presses the drive output disk against the corresponding intermediate driven interface of the intermediate disk 953 of the sterilization adapter frame 951.

[0178] However, when the instrument 260 is first attached to the sterilization adapter assembly 250, the elements of the intermediate drive interface of the intermediate disk 953 may not be aligned with the corresponding elements of the driven interface 1180 on the driven disk 1164. If the elements of the two disks 953 and 1164 are not aligned, the two disks are partially coupled but do not mesh with each other. Thus, the disk stack including the drive disk, the intermediate disk, and the driven disk is partially coupled. To mesh the disks, an instrument engagement sequence operation 836 is performed.

[0179] In one aspect, each of the sterilization adapter frame 951, the movable body 951C, and the plurality of intermediate disks 653P is made by injection molding. Materials suitable for the sterilization adapter frame 951, the movable body 951C, and the plurality of intermediate disks 953P include polycarbonate, polyphenylene sulfone (PPSU), polyethyleneimine (PEI), and the like.

[0180] The beams 955 and 956 of the sterilization adapter assembly 250 are included in a mechanical instrument removal lockout actuated by the attachment instrument 260 of the sterilization adapter assembly 250. Specifically, if the proximal ends of the beams 955 and 956 cannot be moved inward by pressing the release buttons 961 and 962, the hook of the sterilization adapter assembly 250 cannot be disengaged from the hook receiver of the instrument manipulator assembly 1040. When the instrument 260 is attached to the sterilization adapter assembly 250, the body of the instrument prevents the inward movement of the beams 955 and 956, and thus the instrument 260 is said to actuate the mechanical instrument lockout that is the beams 955 and 956.

[0181] More specifically, as shown in FIG. 15, the distance 1501 between the beams 955 and 956 is selected based on the size of the body of the instrument 260. When the instrument 150 is attached to the sterilization adapter assembly 250, the distance 1501 is selected such that any movement of the proximal ends of the beams 955 and 956 is not sufficient to disengage the hook of the sterilization adapter assembly 250 from the hook receiver of the instrument manipulator assembly 1040. Thus, to prevent accidental release of the sterilization adapter assembly 250, the body of the instrument 260 physically blocks the movement of the beams 955 and 946, thereby preventing removal of the sterilization adapter assembly 250 when the instrument 260 is present. This lockout is independent of any preload force that may be present.

[0182] FIG. 16 is a more detailed view of one aspect of the insertion assembly 331. The insertion assembly 331 includes a frame 1610, an intermediate carriage 1620, and a distal carriage 1630. The intermediate carriage 1620 rides on the ball screw 1611 of the frame 1610. In one aspect, the ball screw 1611 has a 6 mm pitch, and thus the intermediate carriage 1620 is back drivable. The intermediate carriage 1620 includes a metal belt 1621 that drives the distal carriage 1630. The distal carriage 1630 is attached to the instrument manipulator assembly housing of the instrument manipulator assembly 240. In one aspect, the distal carriage 1630 moves twice as far as the intermediate carriage 1620.

[0183] FIGS. 17A and 17B show the preload assembly 1080 and the operation of the preload assembly 1080. The configuration and operation of the preload assemblies 480 and 980 are, in one aspect, the same as those shown in FIGS. 17A and 17B. For simplicity of explanation, the instrument 260, the sterilization adapter assembly 250, the housing of the instrument manipulator assembly 1040, and the insertion assembly 331 are not shown in FIGS. 17A and 17B. When the preload assembly 1080 is in the configuration shown in FIG. 17A, the distal end of the instrument 260 is positioned, for example, at the entrance to the channel of the entry guide 270. Similarly, in FIGS. 18A-18E and 19A-19C, only the elements necessary to understand the preload assembly are shown. The actual configuration related to FIGS. 17A, 17B, 18A-18E, and 19A-19C includes all of the elements illustrated and described with respect to FIGS. 9A-9E, 10A-10C, 11A, and 11B.

[0184] Before considering the operation of the preload assembly 1080, the elements within the preload assembly 1080 will be described. Unlike the preload assembly described in U.S. Patent Application Publication No. 2016 / 0184036, the preload supplied by the preload assembly 980 can be automatically released by the controller 290 and can also be manually released by the user. The preload supplied by the preload assembly described in U.S. Patent Application Publication No. 2016 / 0184036 can only be manually released by the user.

[0185] In FIGS. 17A, 17B, 18A - 18E, and 19A - 19C, a preload track 1725 is attached to the intermediate carriage 1620. A valley portion is disposed at the proximal end of the preload track 1725. The ramp 1725R of the preload track 1725 connects the valley portion to the flat portion of the preload track 1725. A preload engagement ridge 1726 extends distally from the preload track 1725 beyond the ramp 1725R. A description of a preload track suitable for use as the preload track 1725 is presented in U.S. Patent Application Publication No. 2016 / 0184036, which is hereby incorporated by reference in its entirety.

[0186] A wheel 1783W is rotatably attached to the first end of a cam follower assembly 1783. The wheel 1783W rides on the preload track 1725 (in some of FIGS. 17A, 17B, 18A - 18E, and 19A - 19C, the wheel 1783W may appear to be displaced from the preload track 1725. In all of the examples shown in FIGS. 17A, 17B, 18A - 18E, and 19A - 19C, the wheel 1783W contacts and rides on the preload track 1725.).

[0187] The cam follower assembly 1783 pivots about a pivot pin 1784 which is the first pivot pin. The cam follower assembly 1783 is rotatably connected to a first end of an arm 1782 of the preload assembly 1080. The first end of the arm 1782, for example the distal end, is connected to a motor pack bracket 1781. A description of a cam follower assembly suitable for use as the cam follower assembly 1783 is presented in U.S. Patent Application Publication No. 2016 / 0184036.

[0188] The motor pack bracket 1781 is fixed to the motor pack 1746. Thus, the arm 1782 is coupled to the motor pack 1746. As described above, the instrument manipulator assembly housing is fixed to the distal carriage 1630. An example of the motor pack 1746 is presented in U.S. Patent Application Publication No. 2016 / 0184036.

[0189] A second end, the proximal end, of the preload engagement arm 1786 is rotatably coupled to the pivot pin 1784. The pivot pin 1784 is slidably coupled to the housing of the instrument manipulator assembly 1040.

[0190] A rolling pin 1786P is attached to a first end, the distal end, of the preload engagement arm 1786. Proximate to the rolling pin 1786P at the first end of the preload engagement arm 1786 is a preload engagement surface 1786S, also referred to as surface 1786S. In this aspect, the preload engagement surface 1786S is perpendicular to the flat portion of the preload track 1725. The preload engagement arm 1786 is coupled to a linear rail 1787. A description of a preload engagement arm and a linear rail suitable for use as the preload engagement arm 1786 and the linear rail 1787 is presented in U.S. Patent Application Publication No. 2016 / 0184036.

[0191] In this aspect, the preload engagement / disengagement arm 1785, also referred to as the arm 1785, has a T-shaped structure with a crossbar and legs. The T-shaped structure is rotated 90 degrees clockwise with respect to the vertical so that the legs of the T-shaped structure are horizontal, or more generally perpendicular to the crossbar. The use of the T-shaped structure is optional. Any shape of the preload engagement / disengagement arm 1785 that can perform the following operations can be used.

[0192] The crossbar of the preload engagement / disengagement arm 1785 functions as a lever and is thus referred to as the lever or lever portion of the preload engagement / disengagement arm 1785. The hook at the second end, the proximal end, of the crossbar of the preload engagement / disengagement arm 1785 engages with the rolling pin 1786P at the second end of the arm 1785 when the preload becomes effective and disengages from the rolling pin 1786P when the preload becomes ineffective. The emergency device release button 1082 is connected to, for example, in contact with, the first end, the distal end, of the crossbar of the preload engagement / disengagement arm 1785. The emergency device release button 1082 is an example of the emergency device release button 482 and the emergency device release button 982.

[0193] Between the first end and the second end of the crossbar of the preload engagement / disengagement arm 1785, the preload engagement / disengagement arm 1785 is rotatably attached to another pivot pin 1788, the second pivot pin, which functions as a fulcrum for the lever action of the preload engagement / disengagement arm. Since the legs of the T-shaped structure extend from the lever portion of the arm 1785, the pivot pin 1788 is centered with respect to the legs of the T-shaped structure. Thus, the legs of the preload engagement / disengagement arm 1785 have a first end and a second end, and the first end is connected to the crossbar of the preload engagement / disengagement arm 1785.

[0194] A torsion spring 1789 (FIG. 17C) concentric with pivot pin 1788 exerts a counterclockwise torque (counterclockwise with respect to FIGS. 17A, 17B, 18A-18E, and 19A-19C) on the preload engagement / disengagement arm 1785. The torsion spring 1789 applies a force to the preload engagement / disengagement arm 1785, which moves the hook of the preload engagement / disengagement arm 1785 away from an axis extending through pivot pins 1784 and 1788. The axis extending through pivot pins 1784 and 1788 is perpendicular to the longitudinal axes of pivot pin 1784 and pivot pin 1788. The torsion spring 1789 rotates the preload engagement / disengagement arm 1785 in the preload release direction, which is necessary to maintain the preload engagement / disengagement arm 1785 in the released position shown in FIGS. 18A, 18B, 18C, 19B, and 19C.

[0195] In one aspect, with respect to the emergency device release button 1082, since the fulcrum is between the effort (the force supplied by the emergency device release button 1082) and the load (the connection between the hook and the rolling pin 1786P), the lever portion of the preload engagement / disengagement arm 1785 is a Class 1 lever. In this example, the preload engagement / disengagement arm 1785 is implemented as a Class 1 lever, but this is merely exemplary and not intended to be limiting. In other aspects, a Class 2 lever or a Class 3 lever can be used. In the case of a Class 2 lever, the load is between the fulcrum and the effort, and in the case of a Class 3 lever, the effort is between the fulcrum and the load.

[0196] The second end of the leg of the preload engagement / disengagement arm 1785 is connected to the second end of the link 1723. The first end of the link 1723 is connected to an electric actuator, which is realized as a solenoid 1720 having a plunger 1721 in this example. In this aspect, the first end of the link 1723 is connected to the plunger 1721. The electric actuator is connected to the controller 290. In response to a command from the controller 290, the electric actuator is enabled and disabled.

[0197] The emergency appliance release button 1082, the preload engagement / disengagement arm 1785, the preload engagement arm 1786, the torsion spring 1789, the electric actuator, and the link 1723 form the preload engagement / disengagement mechanism of the preload assembly 1080. Accordingly, both the preload engagement / disengagement mechanism and the preload assembly 1080 are mechanical structures coupled to the controller.

[0198] The preload engagement / disengagement arm 1785 is rotatably coupled to the second pivot pin 1788. The preload engagement / disengagement arm 1785 is separable from and connectable to the rolling pin 1786P of the preload engagement arm 1786. The torsion spring 1789 is attached to the second pivot pin 1788 and is coupled to the preload engagement / disengagement arm 1785. The torsion spring 1789 is configured to apply torque to the preload engagement / disengagement arm 1785 so as to hold the preload engagement / disengagement arm 1785 in the disengaged position from the rolling pin 1786P. See FIGS. 18A and 18B.

[0199] First, as shown in FIG. 17A, the cam follower assembly 1783 of the preload assembly 1080 is positioned in the valley of the preload track 1725 on the intermediate carriage 1620, e.g., at a first position - the home position - of the preload track 1725. At the first position, the light preload springs within each drive output assembly of the motor pack 1746 are compressed, and a first preload force is applied to each disk of the disk stack (see FIG. 4E). When the surgical device assembly 300 is moved distally by a distance Zload from the first position to the second position by the insertion assembly 331, the instrument manipulator assembly housing is moved by the distance Zload.

[0200] The pivot pin 1784 to which the cam follower assembly 1783 is rotatably attached is coupled to the instrument manipulator assembly housing of the instrument manipulator assembly 1040. Thus, when the insertion assembly 331 moves the instrument manipulator assembly housing distally by a distance Zload, the pivot pin 1784 moves the cam follower assembly 1783 by the same distance Zload. In one aspect, the distance Zload is 3.85 inches (9.80 cm).

[0201] As described above, the wheel 1783W is rotatably attached to the first end of the cam follower assembly 1783, and the wheel 1783W rides on the preload track 1725. Thus, as the cam follower assembly 1783 moves distally, the wheel 1783W follows the contour of the preload track 1725. However, the distance between the preload track 1725 and the pivot pin 1784 decreases as the cam follower assembly 1783 moves distally. As a result, when the cam follower assembly 1783 rides onto the ramp 1725R within the preload track 1725, the cam follower assembly 1783 rotates from the first position shown in FIG. 17A to the second position shown in FIG. 17B, moving the motor pack 1746 a distance greater than the distance by which the instrument manipulator assembly housing has moved. Thus, the rotation of the cam follower assembly 1783 displaces the motor pack 1746 a predetermined distance Δ in the distal direction relative to the instrument manipulator assembly housing.

[0202] When the cam follower assembly 1783 moves along the preload track 1725, two operations are performed by the cam follower assembly 1783. As the cam follower assembly 1783 moves up and rotates along the ramp 1725R, the rotation of the cam follower assembly 1783 pushes the motor pack a distance greater than the distance Zload in the distal direction; for example, the motor pack 1746 moves a distance (Zload + Δ). In addition, as the cam follower assembly 1783 moves up the ramp 1725R, the cam follower assembly 1783 transmits a force to the motor pack 1746, which compresses both the light preload spring and the high preload spring within each drive output assembly, so that a second preload force - a high preload force - is asserted on each drive output disk of the instrument manipulator assembly 1040. Of course, the springs are not compressed otherwise, and this only applies when the instrument is attached.

[0203] Figures 18A through 18E are diagrams of one implementation of the operations performed in the automatic setting of the preload by the preload assembly 1080. The operations of the preload assemblies 480 and 980 are, in one aspect, the same as those shown in Figures 18A through 18E.

[0204] When the sterilization adapter assembly 250 is attached to the instrument manipulator assembly 1040 in the sterilization adapter attachment operation 817, the instrument manipulator assembly 1040 transmits a signal indicating the presence of the sterilization adapter assembly 250 to the controller 290.

[0205] When the user presses the clutch button 1044 to move the instrument manipulator assembly 1040 proximally, the instrument manipulator assembly housing moves proximally at twice the speed of the preload engagement ridge 1726 on the preload track 1725. This is because the distal carriage 1630 to which the instrument manipulator assembly 1040 is attached moves twice as far as the intermediate carriage 1620 to which the preload track 1725 is attached. In this aspect, the preload engagement ridge 1726 extends from the distal portion of the preload track 1725.

[0206] First, when the instrument manipulator assembly 1040 is in the home position, there is a gap 1801 between the preload engagement ridge 1726 on the preload track 1725 and the preload engagement surface 1786S of the preload engagement arm 1786. The controller 290 commands the insertion assembly to move the instrument manipulator assembly proximally from the home position. As the instrument manipulator assembly housing moves proximally, the preload engagement ridge 1726 moves proximally at half the speed of the preload engagement arm 1786, and the instrument manipulator assembly housing and the insertion assembly 331 shorten. Accordingly, the intermediate carriage 1620 and the distal carriage 1630 move closer to each other to close the gap 1801 between the preload engagement ridge 1726 on the preload track 1725 and the preload engagement surface 1786S of the preload engagement arm 1786.

[0207] When the gap 1801 closes (FIG. 18B), the surface 1786S of the preload engagement arm 1786 engages the preload engagement ridge 1726 on the preload track 1725. The proximal movement of the preload engagement arm 1786 is constrained to move proximally with the preload track 1725, but the instrument manipulator assembly 1040 continues to move proximally with the distal carriage 1630, and the linear rail 1787 slides relative to the rail within the instrument manipulator housing. As the instrument manipulator housing continues to move proximally, which extends the motor pack return spring, the arm 1782 holds the motor pack 1746 in place.

[0208] When the instrument manipulator assembly 1040 is at a predetermined distance, for example 2 mm, close to the home position, the hook at the second end of the lever included in the preload engagement / disengagement arm 1785 is close to the rolling pin 1786P at the first end of the preload engagement arm 1786 (FIG. 18C). However, the torsion spring 1789 around the pivot pin 1788 prevents the preload engagement / disengagement arm 1785 from rotating clockwise to engage the rolling pin 1786P.

[0209] When the instrument manipulator assembly reaches the fully retracted position (third position), the controller 290 fires the solenoid 1720, which moves the plunger 1721 in the proximal direction. The proximal movement of the plunger 1721 moves the link 1723 in the proximal direction, which rotates the hook of the preload engagement / disengagement arm 1785 clockwise until the hook of the preload engagement / disengagement arm 1785 engages the rolling pin 1786P (FIG. 18D).

[0210] After the hook of the preload engagement / disengagement arm 1785 engages the rolling pin 1786P, the controller 290 moves the instrument manipulator assembly 1040 distally to the home position, so that there is a gap between the preload engagement ridge 1726 on the preload track 1725 and the preload engagement surface 1786S of the preload engagement arm 1786 (FIG. 18E). At this position, the motor pack return spring of the instrument manipulator assembly pulls the motor pack 1746 distally. The force supplied by the motor pack return spring is sufficient to keep the hook of the preload engagement / disengagement arm 1785 engaged with the rolling pin 1786P. This places the hook under tension, so that the torsion spring 1789 cannot rotate the preload engagement / disengagement arm 1785 counterclockwise. As a result, the controller 290 cancels the firing command to the solenoid 1720. As shown in FIGS. 18A-18E, the instrument manipulator assembly 1040 is automatically configured to set a first preload on the motor pack 1746 under the control of the controller 290.

[0211] FIGS. 19A-19C are diagrams of one implementation of the operations performed in the automatic release of preload by the preload assembly 1080 in one aspect. The operations of the preload assemblies 480 and 980 are the same as those shown in FIGS. 19A-19C.

[0212] When the instrument manipulator assembly 1040 and the preload assembly 1080 are moved proximally, the cam follower assembly 1783 (FIG. 17B) moves proximally and the wheel 1783W follows the contour of the preload track 1725. However, as the cam follower assembly 1783 moves in the proximal direction, the distance between the preload track 1725 and the pivot pin 1784 increases. As a result, as the cam follower assembly 1783 descends the ramp 1725R of the preload track 1725, the cam follower assembly 1783 rotates from the second position shown in FIG. 17B to the position shown in FIG. 17A. This releases the second preload so that only the first preload force acts when the preload assembly 1080 is in the home position, as shown in FIG. 19A. This also allows the hard stop to be retracted from the sterilization adapter assembly 250 so that the instrument 260 can be removed, since the movable manipulator-instrument interface plate can be moved proximally when the hard stop is retracted.

[0213] With respect to FIG. 19A, the controller 290 actuates a motor that moves the instrument manipulator assembly 1040 proximally. The instrument manipulator assembly housing moves proximally at twice the speed of the preload engagement ridge 1726 of the preload track 1725. This is because the distal carriage 1630 to which the instrument manipulator assembly 1040 is attached moves twice as far as the intermediate carriage 1620 to which the preload track 1725 is attached.

[0214] Initially, there is a gap between the preload engagement ridge 1726 of the preload track 1725 and the preload engagement surface 1786S of the preload engagement arm 1786 (FIG. 19A). As the instrument manipulator assembly housing moves proximally, the preload engagement ridge 1726 moves proximally at half the speed of the preload engagement arm 1786, and the instrument manipulator assembly housing and the insertion assembly 331 shorten. Accordingly, the intermediate carriage 1620 and the distal carriage 1630 move closer relative to each other to close the gap between the preload engagement ridge 1726 of the preload track 1725 and the preload engagement surface 1786S of the preload engagement arm 1786.

[0215] When the gap closes (FIG. 19B), the surface 1786S of the preload engagement arm 1786 engages the preload engagement ridge 1726 of the preload track 1725. The proximal movement of the preload engagement arm 1786 is constrained to move proximally with the preload track 1725, but the instrument manipulator assembly 1040 continues to move proximally with the distal carriage 1630, and the linear rail 1787 slides relative to the rail of the instrument manipulator housing.

[0216] When the instrument manipulator assembly 1040 is at a predetermined distance, for example 2 mm, close to the home position, the hook at the second end of the lever included in the preload engagement / disengagement arm 1785 is close to the rolling pin 1786P at the first end of the preload engagement arm 1786 (FIG. 18C). Since the solenoid 1720 is not actuated, the torsion spring 1789 around the pivot pin 1788 rotates the preload engagement / disengagement arm 1785 counterclockwise to disengage the hook from the rolling pin 1786P.

[0217] After the hook of the preload engagement / disengagement arm 1785 disengages from the rolling pin 1786P, the controller 290 moves the instrument manipulator assembly 1040 distally to the home position. Since the hook of the preload engagement / disengagement arm 1785 is disengaged from the preload engagement arm 1786, there is no force in the distal direction on the motor pack 1746. The motor pack does not displace distally relative to the instrument manipulator housing, and thus there is no preload force when the instrument manipulator assembly 1040 is moved distally. In this way, as shown in FIGS. 19A - 19C, the instrument manipulator assembly 1040 automatically configures to reset the first preload on the motor pack 1746 and prevent the application of a preload force when the instrument manipulator assembly 1040 moves distally beyond home from the fully retracted position under the control of the controller 290.

[0218] If the insertion assembly 331 jams in the extended position, a high preload force must be released so that the instrument 260 can be removed. To remove the instrument 260, the user presses the emergency instrument release button 1082 (FIG. 10A). In response to the force provided by the user, the emergency instrument release button 1082 applies a force to the first end of the preload engagement / disengagement arm 1785. The force on the first end of the preload engagement / disengagement arm 1785 rotates the preload engagement / disengagement arm 1785 about the pivot pin 1788, disengaging the hook at the second end of the preload engagement / disengagement arm 1785 from the rolling pin 1786P attached to the second end of the preload engagement arm 1786.

[0219] Recall that the motor pack return spring is attached between the instrument manipulator assembly housing and the motor pack 1746 and is stretched when a high preload force is applied. As a result, when the preload engagement / disengagement arm 1785 is disengaged from the preload engagement arm 1786, the motor pack return spring retracts the motor pack 1746 to the fully retracted position.

[0220] In the fully retracted position, since there is no preload force, the drive output disk is disengaged from the intermediate disk. In addition, a plurality of hard stops are engaged so that both the instrument sterilization adapter assembly 250 and the instrument 260 can be removed. If the distal end of the instrument 260 is not straight, when a person pulls out the instrument, since the disk stack without preload force and with the drive output disk disengaged is back-drivable, the cannula forces the distal end of the instrument 260 to be straight.

[0221]

[0222]

[0223] The instrument manipulator assembly housing 2048, also referred to as the housing 2048, is fixedly attached to the distal end of the insertion assembly 2031, so the instrument manipulator assembly housing 2048 moves from the home position to the fully extended position along with the movement of the insertion assembly 2031. The motor pack 2046 within the instrument manipulator assembly housing 2048 can move along the rail 2039. The motor pack 2046 can move in a distal direction and a proximal direction with respect to the instrument manipulator assembly housing 2048. The motor pack 2046 is coupled to the instrument manipulator assembly housing 2048 by a motor pack return spring 2047, also referred to as a return spring 2047. The elements included in the motor pack 2046 are, in one aspect, the same as the elements described above with respect to the motor pack 446. The motor pack return spring 2047 is equivalent to the motor pack return spring 447.

[0224] Since the preload assembly 2080 is attached to the instrument manipulator assembly housing 2048, it moves with the housing 2048. The preload assembly 2080 is connected to the motor pack 2046 by an arm 2088. The preload assembly 2080 includes an emergency instrument release button 2082.

[0225] Unlike the motor pack 446 that is movably coupled to the insertion assembly 431 by the preload assembly 480, the motor pack 2046 is not movably coupled to the insertion assembly 2031 by the preload assembly 2080. However, the preload assembly 2080 has the ability to move the motor pack 2046 relative to the housing 2048 regardless of the position of the instrument manipulator assembly 2040 relative to the home position. Thus, as the instrument manipulator assembly moves away from the home position, the preload assembly moves along the track and the preload is increased from a first preload to a second preload, in contrast to the aspects of FIGS. 18A-18E and 19A-19C. Here, the preload assembly 2080 is under the direct control of the controller 290, e.g., the motor controller of the controller 290, and thus the preload can be increased or decreased regardless of the position of the instrument manipulator assembly 2040 relative to the home position and regardless of whether the instrument manipulator assembly 2040 is being moved by the insertion assembly 2031 or is stationary.

[0226] When no preload is desired and the motor pack 2046 is not displaced distally relative to the instrument manipulator assembly housing 2048, the controller 290 does not perform any operation. (Note that in one aspect, as described above with respect to FIG. 8, the desired preload is determined by the state of the instrument manipulator assembly 2040.) In this case, the motor pack 2046 is in the zero preload position 2032 relative to the instrument manipulator housing 2048 regardless of where the instrument manipulator assembly is located between the home position and the fully extended position.

[0227] The movement of the instrument manipulator assembly 2040 alone from the home position to the fully extended position or from the fully retracted position to the home position does not change the preload. The preload changes only if the controller 290 sends a command directly to the preload assembly 2080 to effect a change or if the emergency instrument release button 2082 is actuated. When the motor pack 2046 is in the no-preload position 2032 and the sterilization adapter assembly is attached to the distal face of the instrument manipulator assembly 2040, no preload force will be exerted on the intermediate disk of the sterilization adapter assembly.

[0228] If a low preload is desired and the motor pack 2046 does not displace distally relative to the instrument manipulator assembly housing 2048, i.e., the motor pack is in the no-preload position 2032, the controller 290 commands the preload assembly 2080 to move the arm 2088 distally to move the motor pack 2046 to the low-preload position 2033. As the motor pack 2046 moves distally relative to the instrument manipulator housing 2048, the motor pack return spring 2047 stretches.

[0229] When the sterilization adapter assembly is attached to the distal face of the instrument manipulator assembly 2040 with the motor pack 2046 in the low preload position 2033, there will be a low preload force, e.g., a first preload force, on the intermediate disk of the sterilization adapter assembly. In the example of FIGS. 20A and 20B, the preload force was increased by the controller 290, but the instrument manipulator assembly 2040 was not moved by the insertion assembly 2031. Alternatively, when the instrument manipulator assembly is moved by the insertion assembly 290, the preload force can be increased by the controller 290. If the emergency instrument release button 2082 is actuated when the motor pack 2046 is in the low preload position 2033, the preload mechanism of the preload assembly 2080 is disengaged and the motor pack return spring 2047 retracts the motor pack 2046 proximally to the preload - free position 2032.

[0230] When a low preload is desired and the motor pack 2046 is in the high preload position 2034 relative to the instrument manipulator assembly housing 2048, i.e., when the motor pack is in the high preload position 2034, the controller 290 commands the preload assembly 2080 to move the arm 2088 in the proximal direction to move the motor pack 2046 to the low preload position. When the motor pack 2046 is moved proximally relative to the instrument manipulator housing 2048, the motor pack return spring 2047 contracts. Similarly in this case, this can be done without the insertion mechanism moving the instrument manipulator assembly 2040 or while the insertion mechanism is moving the instrument manipulator assembly 2040. Because the preload force supplied by the preload assembly 2080 can be changed regardless of the position of the preload assembly relative to the home position and regardless of whether the insertion assembly 2031 is moving the instrument manipulator assembly 2040. The change in preload does not depend on a command from the controller 290 to the insertion assembly 2031 to change the position of the instrument manipulator assembly 2040, which is different from the embodiments described with respect to FIGS. 19A - 19C.

[0231] The control of the preload by the controller 290 is independent of the control of the insertion assembly 2031 to which the instrument manipulator assembly 2040 is attached. This means that, unlike in the foregoing aspect, commands from the controller 290 to the insertion mechanism 2031 to change the position of the instrument manipulator assembly 2040 cannot change the preload. Rather, the controller 290 directly commands the preload assembly 2080 to change the preload. It should be appreciated that the controller 290 can command the preload assembly 2080 to change the preload based on the position of the instrument manipulator assembly 2040. Thus, commands to the preload assembly 2080 can be coupled with commands to the insertion assembly 2031, but the commands to the insertion assembly 2031, in this aspect, cannot change the preload in 2031, so the control of the preload by the controller 290 is said to be independent of the control of the insertion assembly 2031 to which the instrument manipulator assembly 2040 is attached.

[0232] When no preload is desired and the motor pack 2046 is in the low preload position 2033 relative to the instrument manipulator assembly housing 2048, i.e., when the motor pack 2046 is in the low preload position 2033, the controller 290 commands the preload assembly 2080 to move the arm 2088 in the proximal direction to move the motor pack 2046 to the no-preload position 2032. When the motor pack 2046 is moved proximally relative to the instrument manipulator housing 2048, the motor pack return spring 2047 is compressed. Again, this can be done with the insertion mechanism 2031 not moving the instrument manipulator assembly 2040 or while the insertion mechanism 2031 is moving the instrument manipulator assembly 2040. This is because the preload force supplied by the preload assembly 2080 can be varied by the controller 290 independent of the position of the preload assembly 2080 relative to the insertion assembly 2031 and independent of the position of the instrument manipulator assembly 2040 relative to the home position. Of course, this can also be done when the insertion assembly 2031 is moving the instrument manipulator assembly 2040.

[0233] When high preload is desired, the controller 290 commands the preload assembly 2080 to move the arm 2088 in the distal direction to move the motor pack 2046 to the high preload position 2034. When the motor pack 2046 is moved distally relative to the instrument manipulator housing 2048, the motor pack return spring 2047 is extended.

[0234] When the sterilization adapter assembly is attached to the distal surface of the instrument manipulator assembly 2040 with the motor pack 2046 in the high preload position 2034, there is a high preload force, e.g., a second preload force, on the intermediate disk of the sterilization adapter assembly. When the emergency instrument release button 2082 is actuated while the motor pack 2046 is in the high preload position 2034, the preload mechanism of the preload assembly 2080 is disengaged and the motor pack return spring 2047 pulls the motor pack 2046 proximally to the no-preload position 2032, which removes the high preload force.

[0235] When the motor pack 2046 is in the high preload position 2033 relative to the instrument manipulator assembly housing 2048, the controller 290 can command the preload assembly 2080 to move the motor pack 2046 proximally to either the low preload position 2033 or the no-preload position 2032. In the examples of FIGS. 20A, 20B, and 20C, the preload force was increased by the controller 290, but the insertion assembly 2031 did not move the instrument manipulator assembly 2040. When the insertion assembly 2031 moves the instrument manipulator assembly 2040, the preload force can also be varied by the controller 290 in each of these examples.

[0236] In the examples described below with respect to FIGS. 21A through 21C and the examples shown in FIGS. 4A through 4G, a mechanical instrument removal lockout (which prevents the movable body of the sterilization adapter assembly from moving proximally) is actuated by moving the motor pack of the instrument manipulator assembly. In another aspect shown in FIGS. 21D and 21E, the mechanical instrument removal lockout is independent of the movement of any part of the instrument manipulator assembly 2040. In this aspect, the mechanical instrument removal lockout assembly 2090 is attached to the housing 2048 of the instrument manipulator assembly 2040. The mechanical instrument removal lockout assembly 2090 is connected to a lockout arm 2091, also referred to as arm 2091, which includes a plurality of stops at its proximal end. The plurality of stops are optional and are used as an example for interfacing with the aforementioned sterilization adapter assembly. More generally, for example, the distal face of the arm 2091 can interact with the proximal face of the movable body of the sterilization adapter assembly. In this aspect, an emergency instrument release button 2082A is shared between the preload assembly 2080 and the mechanical instrument removal lockout assembly 2090. In one aspect, a lockout return spring 2047A is connected between the proximal end of the lockout arm 2091 and the housing 2048.

[0237] The sterilization adapter assembly 2050 (FIG. 20D) is attached to the distal face of the instrument manipulator assembly 2040. The sterilization adapter assembly 2050 includes a movable manipulator-instrument interface plate 2051C, also referred to as movable body 2051C, which can move in the proximal and distal directions relative to the frame of the sterilization adapter assembly 2050. The sterilization adapter assembly 250 is an example of the sterilization adapter assembly 2050, and the sterilization adapter assembly 2050 will not be described in further detail.

[0238] As described above, when the instrument is attached to or removed from the sterilization adapter assembly 2050, the movable body 2051C moves in the proximal direction. To prevent removal of the instrument, the movable body 2051C is locked in place by a mechanical instrument removal lockout assembly 2090 to prevent the movable body 2051C from moving proximally.

[0239] An optional mechanical instrument removal lockout assembly 2090 (FIG. 20D) is under the direct control of the controller 290, e.g., the motor controller of the controller 290. The mechanical instrument removal lockout can be actuated or deactivated regardless of the position of the manipulator assembly 2040 relative to the home position, whether the instrument manipulator assembly 2040 is being moved or stationary by the insertion assembly 2031, and regardless of the position of the motor pack 2046 relative to the housing 2048. The movement of the arm 2091 is independent of the movement of the instrument manipulator assembly 2040 and independent of the movement of the motor pack 2046. The arm 2091 moves only when the controller 290 commands the mechanical instrument removal lockout assembly 2090 to move the arm 2091, or when the arm 2091 is in the extended position and the emergency instrument release button 2082A is actuated by the user.

[0240] In this aspect, the arm 2091 has a proximal position shown in FIG. 20D and a distal position shown in FIG. 20E. In the proximal position, the second position, no portion of the arm 2091 is in contact with the movable body 2051C of the sterilization adapter assembly 2050. When the mechanical instrument removal lockout assembly 2090 receives an engagement lockout command from the controller 290, the mechanical instrument removal lockout assembly 2090 moves the arm 2091 to the distal position (FIG. 20E), which locks the movable body 2051C in the distal position of the sterilization adapter assembly 2050. With the movable body 2051C locked in the distal position, the instrument attached to the sterilization adapter assembly cannot be removed.

[0241] When the arm 2091 moves to the distal position, the return spring 2047A is stretched. When the emergency device release button 2082A is actuated, the arm 2091 is disengaged from the mechanical device removal lockout assembly 2090, and the return spring 2047A pulls the arm 2091 to its proximal position (Figure 20D). As a result, the movable body 2051C can be moved in the proximal direction, and the device can be removed.

[0242] Alternatively, the controller 290 can send a disengagement lockout command to the mechanical device removal lockout assembly 2090. When the mechanical device removal lockout assembly 2090 receives the disengagement lockout command from the controller 290, the mechanical device removal lockout assembly 2090 moves the arm 2091 from the distal position 20E to the proximal position 20D, which unlocks the movable body 2051C of the sterilization adapter assembly 2050 and enables movement of the movable body 2051C.

[0243] Figures 21A through 21C are examples of one aspect of the instrument manipulator assembly 2040 and preload assembly 2080 of Figures 20A through 20C. Elements within the instrument manipulator assembly 2040 of Figures 21A through 21C that have the same reference numbers as those in Figure 4A are equivalent elements to those in Figure 4A, and thus the description of the elements with respect to Figure 4A is not repeated here.

[0244] In this aspect, the preload assembly 2080 includes a motor 2181, such as a servo motor, connected to the controller 290. The motor 2181 is attached to the housing 2048. The motor 2181 drives a screw 2183. A nut 2184 is attached to the screw 2183 and moves proximally or distally when the motor 2181 rotates the screw 2183. In one aspect, the screw 2183 is the threaded shaft of the motor 2181. The rotation of the shaft of the motor 2181, and thus the distal or proximal movement of the nut 2184, is controlled by the controller 290. The combination of the motor, screw, and nut is an example of a movable assembly whose position along the axis is directly controlled by the controller 290.

[0245] A preload tab 2184T extends from the outer surface of the nut 2184 adjacent to the distal end of the nut 2184. The preload tab 2184T has a first plane on the distal surface and a second plane on the proximal surface. The first plane extends further from the outer surface of the nut 2184 than the second plane. Thus, the surface joining the first plane to the second plane is an inclined surface.

[0246] A preload release lever 2186 is attached to a pivot pin 2187. A torsion spring is attached around the pivot pin and is attached to the preload release lever 2186 to maintain the preload release lever 2186 in a preload engagement position when the emergency device release button 2082 is not pressed. The pivot pin 2187 is attached to an arm 2088 connected to the motor pack 2046. In this example, the arm 2088 moves proximally and distally relative to the housing 2048 on a rail 2139. The rail 2139 is optional.

[0247] The distal end, i.e., the first end, of the preload release lever 2186 includes a hook 2186A that engages and disengages with the preload tab 2184T. In this example, the hook 2186A has a flat plane that extends from the side surface of the preload release lever 2186. The flat plane of the hook 2186A is configured to contact the first plane of the preload tab 2084T such that distal movement of the preload tab 2184T moves the preload release lever 2186 distally together with the preload tab 2184T.

[0248] The inclined surface extends from the end of the flat plane of the preload release lever 2186 removed from the side surface of the preload release lever 2186 to the distal end of the preload release lever 2186. The inclination of the inclined surface at the distal end of the preload release lever 2186 is opposite to the inclination of the inclined surface on the tab 2184T, so that when the preload is released, the hook 2186A and the tab 2184T can move proximally relative to each other.

[0249] The emergency device release button 2082 is attached to apply a force to the proximal end, the second end, of the preload release lever 2186. In the examples of FIGS. 21B and 21C, when the emergency device release button 2082 is actuated, the emergency device release button 2082 applies a preload release force to the proximal end of the preload release lever 2186, which pivots the preload release lever 2186 in the preload release direction, clockwise in FIGS. 20B and 20C, about the pivot pin 2187.

[0250] The pivoting of the preload release lever 2186 about the pivot pin 2187 in the preload release direction disengages the hook 2186A from the tab 2184T of the nut 2184. As a result, the motor pack return spring 2047 moves the motor pack 2046 proximally to the preload-free position 2032 relative to the instrument manipulator assembly housing 2048.

[0251] To engage the preload, the controller 290 commands the motor 2181 to proximally move the nut 2184 from either the position of FIG. 21B or the position of FIG. 20C to the position of FIG. 20A. Since the tab 2184T is distal to the hook 2186A, when the nut 2184 moves proximally and moves the tab 2184T, the inclined surface of the tab 2184T contacts the inclined surface of the hook 2186A of the preload release lever 2186. As the tab 2184T continues to move proximally, the inclined surface of the tab 2184T pivots the preload release lever 2186 until the first plane (distal flat surface) clears the first plane of the hook 2186A, and then the torsion spring around the pivot pin 2187 rotates the hook 2186A in the preload engagement direction so that the first flat plane of the hook 2186A contacts the first flat plane of the tab 2184T. Now when the tab 2184T moves, the hook 2186A moves, and this in turn moves the motor pack 2046, which engages the preload mechanism.

[0252] Specifically, as shown in FIGS. 21A and 21B, when the preload mechanism is engaged, the motor pack 2046 is not in the preload position 2032 and the controller 290 commands the preload assembly 2080 to move the motor pack 2046 to the low preload position 2033, the motor 2181 moves the nut 2184 distally. The distal movement of the nut 2184 causes a distal force to be applied to the tab 2184T towards the hook 2186A. The force on the hook 2186A moves the arm 2088 distally, which moves the motor pack 2046 distally to the low preload position 2033 relative to the instrument manipulator housing 2048.

[0253] As shown in FIGS. 21B and 21C, when the preload mechanism is engaged, the motor pack 2046 is in the low preload position 2033, and the controller 290 commands the preload assembly 2080 to move the motor pack 2046 to the high preload position 2034, the motor 2181 moves the nut 2184 in the distal direction. The movement of the nut 2184 in the distal direction causes a force on the tab 2184T to be applied in the distal direction to the hook 2186A. The force on the hook 2186A moves the arm 2088 in the distal direction, which moves the motor pack 2046 in the distal direction to the high preload position 2034 relative to the instrument manipulator housing 2048.

[0254] In the embodiment shown in FIGS. 21A - 21C, with respect to the emergency instrument release button 2082, since the fulcrum (pivot pin 2187) is between the force (the force supplied by the preload release button 3082) and the load (the connection between the hook 2186A and the tab 2184T), the preload release lever 2186 is a class 1 lever. In this example, the preload release lever 2186 is implemented as a class 1 lever, but this is merely illustrative and not intended to be limiting. In other embodiments, a class 2 lever or a class 3 lever can be used. In the case of a class 2 lever, the load is between the fulcrum and the force, and in the case of a class 3 lever, the force is between the fulcrum and the load.

[0255] All of the states and all of the operations of FIG. 8 can be achieved using the instrument manipulator assembly 2040 that includes the preload assembly 2080. Therefore, the description of FIG. 8 is not repeated for the embodiment of the instrument manipulator assembly 2040 that includes the preload assembly 2080. Here, the controller 290 directly controls the preload, and the preload does not depend on the movement of the instrument manipulator assembly 2040 by the insertion mechanism 2031. Therefore, the operations of FIG. 8 where the controller 290 moves the instrument manipulator assembly to set or reset the preload mechanism are not required when the instrument manipulator assembly 2040 that includes the preload assembly 2080 is used.

[0256] Thus, in one aspect, when the sterilization adapter assembly 2050 is not attached to the instrument manipulator assembly 2040, the controller 290 maintains no preload force on the motor pack 2046 of the instrument manipulator assembly 2040. After the sterilization adapter assembly 2050 is attached to the instrument manipulator assembly 2040, the controller issues a direct command to the preload assembly 2080 to increase the preload force on the motor pack 2046 of the instrument manipulator assembly 240 from no preload force to a first preload force. After the instrument is attached to the sterilization adapter assembly 2050, the controller issues another direct command to the preload assembly 2080 to increase the preload force on the motor pack 2046 of the instrument manipulator assembly 240 from the first preload force to a second preload force.

[0257] In one aspect, the mechanical instrument removal lockout assembly 2090 is implemented with elements equivalent to those shown for the preload assembly 2080 in FIG. 21A, and thus the description of the mechanical instrument removal lockout assembly 2090 will not be repeated. In other aspects, assemblies 2080 and 2090 are combined into a single assembly that performs both the preload function and the mechanical instrument removal lock function with the two functions being independent of each other.

[0258] In some of the above examples, the terms "proximal" or "proximally" are used in a general way to describe an object or element that is closer to the manipulator arm base along the kinematic chain of the system movement or farther from the remote center (or surgical site) of the movement along the kinematic chain of the system movement. Similarly, the terms "distal" or "distally" are used in a general way to describe an object or element that is farther from the manipulator arm base along the kinematic chain of the system movement or closer to the remote center (or surgical site) of the movement along the kinematic chain of the system movement.

[0259] As used herein, "first," "second," "third," "fourth," etc. are adjectives used to distinguish different components or elements. Thus, "first," "second," "third," "fourth," etc. are not intended to imply an order of components or elements.

[0260] The foregoing description and the accompanying drawings showing embodiments and implementations of the invention are not to be construed as limiting, but rather define the invention as protected by the claims. Various mechanical, compositional, structural, electrical, and operational changes may be made without departing from the spirit and scope of this description and the claims. In some instances, well-known circuits, structures, and techniques are not shown or described in detail to avoid obscuring the invention.

[0261] Furthermore, the terms of this description are not intended to limit the invention. For example, spatially relative terms such as "beneath," "below," "lower," "above," "upper," "proximal," "distal," etc. may be used to describe the relationship of one element or feature to another as shown in the drawings. These spatially relative terms are intended to encompass different positions (i.e., locations) and orientations (i.e., rotational arrangements) of the device in use or operation in addition to the position and orientation shown in the figures. For example, if the device in the figures is turned over, an element described as "below" or "beneath" another element or feature would then be "above" or "over" the other element or feature. Thus, the exemplary term "below" can encompass both an upper and a lower position and orientation. The device may be oriented in other directions (rotated 90 degrees or otherwise), and the spatially relative descriptors used herein are to be interpreted accordingly. Similarly, descriptions of movement along and around various axes include various particular device positions and orientations.

[0262] The singular forms "a", "an", and "the" are intended to include the plural forms as well, unless the context indicates otherwise. Terms such as "having", "comprising", "including", etc. specify the presence of the stated features, steps, operations, elements, and / or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and / or groups. Components described as being coupled may be directly coupled electrically or mechanically, or may be indirectly coupled through one or more intermediate components.

[0263] All examples and exemplary references are non-limiting and should not be used to limit the claims to the specific implementations and embodiments described herein and their equivalents. The text under one heading may cross-reference or be applicable to the text under one or more headings, so the headings are for formatting purposes only and should not be used to limit the subject matter in any way. Finally, in view of the present disclosure, specific features described with respect to one aspect or embodiment may be applicable to other disclosed aspects or embodiments of the invention, even if not specifically shown in the drawings or described in the text. The following appendix is noted.

[0264] (Appendix 1) A surgical instrument manipulator assembly comprising: A preload assembly; and A distal surface; having, A surgical instrument manipulator assembly; and A sterilization adapter assembly attached to the distal surface of the surgical instrument manipulator assembly, wherein when the preload assembly sets the surgical instrument manipulator assembly to apply a first preload force to the sterilization adapter assembly, the sterilization adapter assembly is removable from the distal surface of the surgical instrument manipulator assembly, the sterilization adapter assembly; having, A surgical device. (Appendix 2) The sterilization adapter assembly is: provided with a mechanical sterilization adapter assembly removal lockout, the surgical device according to Appendix 1. (Appendix 3) The sterilization adapter assembly is: further provided with a mechanical surgical instrument removal lockout, the surgical device according to Appendix 2. (Appendix 4) A surgical instrument attached to the sterilization adapter assembly, further comprising a surgical instrument that activates the mechanical sterilization adapter assembly removal lockout, the surgical device according to Appendix 3. (Appendix 5) Further comprising an insertion assembly connected to the surgical instrument manipulator assembly, when the motor pack of the surgical instrument manipulator assembly is moved distally by a predetermined distance, the motor pack activates the mechanical sterilization adapter assembly removal lockout, the surgical device according to Appendix 2, or any one of Appendices 3 or 4. (Appendix 6) The sterilization adapter assembly is: further provided with a mechanical surgical instrument removal lockout, the surgical device according to Appendix 1, or any one of Appendices 2 to 4. (Appendix 7) The surgical instrument manipulator assembly further comprises a clutch button, and the clutch button and the emergency release button are the only user operation interfaces of the surgical instrument manipulator assembly, the surgical device according to Appendix 1, or any one of Appendices 2 to 4. (Appendix 8) A sterilization adapter assembly comprising: a mechanical surgical instrument removal lockout; and a mechanical sterilization adapter assembly removal lockout; and when a surgical instrument is attached to the sterilization adapter assembly, the mechanical sterilization adapter assembly removal lockout is activated; ​When the surgical instrument is attached to the sterilization adapter assembly and the surgical instrument manipulator assembly is moved in the distal direction by a predetermined distance, the mechanical surgical instrument removal lockout is actuated by the surgical instrument manipulator assembly; having a sterilization adapter assembly; A surgical device. (Appendix 9) The sterilization adapter assembly has a frame; The mechanical surgical instrument removal lockout has a movable body movably attached to the frame of the sterilization adapter assembly; In a first position of the movable body, the surgical instrument can be removed from the sterilization adapter assembly; In a second position of the movable body, the surgical instrument is locked in a predetermined position of the sterilization adapter assembly, The surgical device according to Appendix 8. (Appendix 10) The sterilization adapter assembly is: A beam having a first end and a second end, the first end being on the opposite side of the second end, and being pivotally connected to the frame between the first end and the second end of the beam, a beam; A plurality of hook extensions extending from the second end of the beam, each of the plurality of hook extensions including a hook configured to engage a hook receiver of the surgical instrument manipulator assembly, a plurality of hook extensions; A sterilization adapter assembly release button coupled to the first end of the beam, pressing the sterilization adapter assembly release button in a first direction moves the plurality of hook extensions in a second direction to disengage each hook from the hook receiver, a sterilization adapter assembly release button; and further having, The mechanical sterilization adapter assembly removal lockout includes the first end of the beam; When the surgical instrument is attached to the sterilization adapter assembly, the surgical instrument prevents the movement of the sterilization adapter assembly release button in the first direction so as to prevent the removal of the surgical instrument from the surgical instrument manipulator assembly of the sterilization adapter assembly. The surgical device according to appendix 9. (Appendix 11) The mechanical sterilization adapter assembly removal lockout is: A beam having a first end and a second end, the first end being on the opposite side of the second end, and being pivotally connected to the frame between the first end and the second end of the beam. A plurality of hook extensions extending from the second end of the beam, each of the plurality of hook extensions including a hook configured to engage a hook receiver of the surgical instrument manipulator assembly. A sterilization adapter assembly release button coupled to the first end of the beam, pressing the sterilization adapter assembly release button in a first direction moves the plurality of hook extensions in a second direction to disengage each hook from the hook receiver. When the surgical instrument is attached to the sterilization adapter assembly, the surgical instrument prevents the movement of the sterilization adapter assembly release button in the first direction so as to prevent the removal of the surgical instrument from the surgical instrument manipulator assembly of the sterilization adapter assembly. The surgical device according to appendix 8, or any one of appendices 9 or 10. (Appendix 12) Further comprising the surgical instrument manipulator assembly, the surgical instrument manipulator assembly comprising: A distal surface; and A preload assembly including an emergency instrument release button. The sterilization adapter assembly is configured to be attached to the distal surface of the surgical instrument manipulator assembly. Removal of the sterilization adapter assembly from the distal surface of the surgical instrument manipulator assembly does not require use of the emergency instrument release button. A surgical device according to any one of appended claim 8, or appended claim 9 or 10. (Appended claim 13) A sterilization adapter assembly comprising: A frame; A beam having a first end and a second end, the first end being on the opposite side of the second end and pivotally connected to the frame; A plurality of hook extensions extending from the second end of the beam, each of the plurality of hook extensions including a hook configured to engage a hook receiver of a surgical instrument manipulator assembly; and A sterilization adapter assembly release button coupled to the first end of the beam, pressing the sterilization adapter assembly release button in a first direction moves the plurality of hook extensions in a second direction to disengage each hook from the hook receiver; A sterilization adapter assembly; and A surgical instrument attached to the sterilization adapter assembly, the surgical instrument preventing movement of the sterilization adapter assembly release button in the first direction so as to prevent removal of the surgical instrument from the surgical instrument manipulator assembly of the sterilization adapter assembly; A surgical device. (Appended claim 14) The sterilization adapter assembly further comprises: A movable body movably attached to the frame of the sterilization adapter assembly; In a first position of the movable body, the surgical instrument can be removed from the sterilization adapter assembly; In a second position of the movable body, the surgical instrument is locked in a predetermined position of the sterilization adapter assembly. A surgical device according to appended claim 13. (Appended claim 15) A surgical instrument manipulator assembly comprising: a housing and; a clutch button attached to the housing and; a preload assembly including an emergency instrument release button, wherein the clutch button and the emergency instrument release button are the only user-operated buttons of the surgical instrument manipulator assembly, the preload assembly; having, a surgical instrument manipulator assembly; having, a surgical device. (Appendix 16) A sterilization adapter assembly having a frame and a mechanical surgical instrument removal lockout; having, the mechanical surgical instrument removal lockout having a movable body movably attached to the frame of the sterilization adapter assembly, the movable body having a first position and a second position, the first position and the second position being independent of the position of any part of the surgical instrument manipulator assembly to which the sterilization adapter assembly is attached, in the first position of the movable body, a surgical instrument attached to the sterilization adapter assembly can be removed from the sterilization adapter assembly; in the second position of the movable body, the surgical instrument is locked in a predetermined position of the sterilization adapter assembly, a surgical device. (Appendix 17) A step of moving a combination of a surgical instrument manipulator assembly and a sterilization adapter assembly from a second position in which the surgical instrument manipulator assembly applies a second preload force to the sterilization adapter assembly to a first position in which the surgical instrument manipulator assembly applies a first preload force to the sterilization adapter assembly, the second preload force being greater than the first preload force, the step; and; a step of removing the sterilization adapter assembly from the surgical instrument manipulator assembly while the first preload force is applied to the sterilization adapter assembly; and; including, a method.

Claims

1. A sterilization adapter assembly comprising: a mechanical surgical instrument removal lockout; and a mechanical sterilization adapter assembly removal lockout; and having wherein the mechanical sterilization adapter assembly removal lockout is actuated when a surgical instrument is attached to the sterilization adapter assembly; the mechanical surgical instrument removal lockout is actuated by the surgical instrument manipulator assembly under the condition that the surgical instrument is attached to the sterilization adapter assembly and the surgical instrument manipulator assembly moves a predetermined distance; a sterilization adapter assembly; a surgical device.

2. The sterilization adapter assembly has a frame: The mechanical surgical instrument removal lockout has a body movably attached within the frame of the sterilization adapter assembly, and in a first position of the body, the surgical instrument is removable from the sterilization adapter assembly, In a second position of the body, the surgical instrument is locked in a predetermined position in the sterilization adapter assembly. The surgical device according to claim 1.

3. The sterilization adapter assembly further comprises: a beam having a first end and a second end opposite the first end, the beam being pivotally connected to the frame between the first end and the second end of the beam; a plurality of hook extensions extending from the second end of the beam, each of the plurality of hook extensions including a hook configured to engage a hook receiver of the surgical instrument manipulator assembly; a sterilization adapter assembly release button coupled to the first end of the beam, pressing the sterilization adapter assembly release button in a first direction moves the plurality of hook extensions in a second direction to disengage each hook from the hook receiver; The surgical device according to claim 2.

4. The first end of the beam has the mechanical sterilization adapter assembly removal lockout. The surgical device according to claim 3.

5. With the surgical instrument attached to the sterilization adapter assembly, the surgical instrument prevents movement of the sterilization adapter release button in the first direction so as to prevent removal of the surgical instrument from the surgical instrument manipulator assembly of the sterilization adapter assembly. The surgical device according to claim 3.

6. Further comprising the surgical instrument manipulator assembly, the surgical instrument manipulator assembly comprising: A distal surface; A preload assembly having an emergency release button; The sterilization adapter assembly is configured to be removably attached to the distal surface of the surgical instrument manipulator assembly. The sterilization adapter assembly is removable from the distal surface of the surgical instrument manipulator assembly regardless of the actuation of the emergency release button. The surgical device according to claim 1.

7. The sterilization adapter assembly has a frame: The mechanical surgical instrument removal lockout has a body movably attached within the frame of the sterilization adapter assembly, the body having a first position and a second position, the first position and the second position being independent of the position of any part of the surgical instrument manipulator assembly to which the sterilization adapter assembly is attached. In the first position of the body, the surgical instrument attached to the sterilization adapter assembly is removable from the sterilization adapter assembly. In the second position of the body, the surgical instrument is locked in a predetermined position in the sterilization adapter assembly. The surgical device according to claim 1.

8. A sterilization adapter assembly comprising: A first mechanical lockout configured to prevent removal of a medical instrument from a state of being attached to the sterilization adapter assembly when actuated; A second mechanical lockout configured to prevent removal of the sterilization adapter assembly from a state of being attached to a manipulator assembly when actuated; The second mechanical lockout is actuated by the presence of the medical instrument in the state attached to the sterilization adapter assembly. The first mechanical lockout is actuated by movement of a portion of the manipulator assembly from a first position to a second position in the state where the sterilization adapter assembly is attached to the manipulator assembly. A sterilization adapter assembly. A medical device.

9. The portion of the manipulator assembly has a preload assembly; The first position corresponds to the position of the preload assembly configured to supply a first preload force to the sterilization adapter assembly; The second position corresponds to the position of the preload assembly configured to supply a second preload force to the sterilization adapter assembly, and the second preload force is greater than the first preload force. The medical device according to claim 8.

10. The sterilization adapter assembly has a manipulator latch mechanism engageable with the manipulator assembly, and in the engaged state with the manipulator assembly, the manipulator latch mechanism holds the sterilization adapter assembly in the attached state to the manipulator assembly; The second mechanical lockout is configured to prevent disengagement of the manipulator latch mechanism from the manipulator assembly in the state where the medical instrument is attached to the sterilization adapter assembly. The medical device according to claim 8.

11. The sterilization adapter assembly has a release element operable to disengage the manipulator latch mechanism from the engaged state; The second mechanical lockout prevents operation of the release element under operating conditions. The medical device according to claim 10.

12. The release element is operable in response to movement of the second mechanical lockout in a first direction; Under the condition that the second mechanical lockout is actuated by the attached medical instrument, the medical instrument engages with the second mechanical lockout and prevents movement of the second mechanical lockout in the first direction. The medical device according to claim 11.

13. The sterilization adapter assembly has an instrument latching mechanism engageable with the medical instrument, and in an engaged state with the medical instrument, the instrument latching mechanism holds the medical instrument in the state attached to the sterilization adapter assembly; Under conditions where the first mechanical lockout is activated, the first mechanical lockout prevents disengagement of the instrument latching mechanism from the medical instrument. The medical device according to claim 8.

14. The sterilization adapter assembly has a frame: The instrument latching mechanism has a body attached to the frame and movable between a first position and a second position; In the first position of the body, the medical instrument is removable from the sterilization adapter assembly, In the second position of the body, the medical instrument is locked in a predetermined position in the sterilization adapter assembly. The medical device according to claim 13.

15. The first mechanical lockout, when activated, has a portion of the body configured to engage the manipulator assembly to prevent movement of the body from the second position to the first position. The medical device according to claim 14.

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