Cannula Assembly

Abstract

The trocar assembly can include a cannula, a sealing cartridge, and an obturator. The sealing cartridge is releasably coupled to the cannula and configured to be disposed at least partially within the cannula in the mated configuration of the sealing cartridge. The obturator is configured to latch directly to the cannula and extend through the cannula and the sealing cartridge in the mated configuration of the obturator.

Description

Technical Field

[0001] (Cross - Reference to Related Applications) This application claims the benefit and priority of U.S. Provisional Patent Application No. 63 / 008,652, filed Apr. 10, 2020, and U.S. Provisional Patent Application No. 63 / 086,013, filed Sep. 30, 2020, the entire contents of each of these applications are hereby incorporated by reference herein.

[0002] (Field of the Invention) The systems and methods disclosed herein relate to medical devices, and more specifically, to cannula assemblies for medical procedures.

Background Art

[0003] Minimally invasive procedures enable access to target sites within a patient with minimal trauma to the patient. For example, laparoscopic surgery can enable surgical access to a patient's cavity through a small incision in the patient's abdomen. A cannula can form a surgical corridor to enable tools to access the patient's cavity. In some procedures, it is possible to insufflate the patient's cavity to enable increased access to the patient's cavity and reduced trauma to the patient.

Brief Description of the Drawings

[0004] The disclosed embodiments will be described below in conjunction with the accompanying drawings, which illustrate, but do not limit, the disclosed embodiments, and like reference numerals refer to like elements.

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DETAILED DESCRIPTION OF THE INVENTION

[0005] 1. Overview Aspects of the present disclosure can be integrated into a robotic-enabled medical system capable of performing a variety of medical procedures, including both minimally invasive procedures such as laparoscopy and non-invasive procedures such as endoscopy. Among endoscopic procedures, the system can perform bronchoscopy, ureteroscopy, gastroscopy, etc.

[0006] In addition to performing a wide range of procedures, the system can provide additional benefits such as enhanced imaging and guidance to assist the physician. Additionally, the system can provide the physician with the ability to perform procedures from an ergonomic position without the need for awkward arm movements and postures. Still further, the system can provide the physician with the ability to perform procedures with improved ease of use such that one or more of the instruments of the system can be controlled by a single user.

[0007] For purposes of explanation, various embodiments will be described below in conjunction with the drawings. It is to be understood that many other implementations of the disclosed concepts are possible and that various advantages can be achieved with the disclosed implementations. Headings are included herein for reference and assist in identifying the locations of various sections. These headings are not intended to limit the scope of the concepts described therein. Such concepts can have applicability throughout this entire document.

[0008] A. Robot System - Cart A robot-compatible medical system can be configured in various ways depending on a particular procedure. FIG. 1 shows an embodiment of a cart-based robot-compatible system 10 arranged for a diagnostic and / or therapeutic bronchoscopy procedure. During bronchoscopy, the system 10 can include a cart 11 having one or more robotic arms 12 for delivering a medical instrument, such as a steerable endoscope 13 that can be a dedicated bronchoscope for the bronchoscopy procedure, to a natural orifice access point (i.e., the patient's mouth positioned on the table in this example) for delivering diagnostic and / or treatment tools. As shown, the cart 11 can be positioned proximate the upper torso of the patient to provide access to the access point. Similarly, the robotic arm 12 can be actuated to position the bronchoscope relative to the access point. The arrangement of FIG. 1 can also be utilized when performing a gastrointestinal (GI) procedure using a gastroscope, which is a special endoscope for GI procedures. FIG. 2 illustrates in more detail an exemplary embodiment of the cart.

[0009] Continuing to refer to FIG. 1, when the cart 11 is properly positioned, the robotic arm 12 can insert the steerable endoscope 13 into the patient either robotically, manually, or in combination thereof. As shown, the steerable endoscope 13 may include at least two nested components such as an inner leader portion and an outer sheath portion, each portion being coupled to a separate instrument driver from a set of instrument drivers 28, and each instrument driver being coupled to the distal end of an individual robotic arm. This linear arrangement of the instrument drivers 28, which facilitates aligning the leader portion coaxially with the sheath portion, forms a "virtual rail" 29 that can be repositioned in space by operating one or more robotic arms 12 at different angles and / or positions. The virtual rails described herein are illustrated in the figures using dashed lines, and thus the dashed lines do not illustrate the physical structure of any system. Translation of the instrument drivers 28 along the virtual rail 29 nests the inner leader portion within the outer sheath portion or advances or retracts the endoscope 13 from the patient. The angle of the virtual rail 29 may be adjusted, translated, and pivoted based on clinical use or the preference of the physician. For example, in bronchoscopy, the angle and position of the virtual rail 29 as shown represent a compromise that provides the physician access to the endoscope 13 while minimizing friction by bending the endoscope 13 into the patient's mouth.

[0010] The endoscope 13 may be directed downstream into the patient's trachea and lungs after insertion using precise commands from the robotic system until it reaches the target destination or surgical site. To facilitate navigation through the patient's pulmonary network and / or to reach the desired target, the endoscope 13 may be manipulated to extend the inner leader portion telescopically from the outer sheath portion to obtain enhanced articulation and a greater bend radius. The use of separate instrument drivers 28 also allows the leader portion and the sheath portion to be driven independently of each other.

[0011] For example, the endoscope 13 may be directed to deliver a biopsy needle to a target such as a lesion or nodule within a patient's lung. The needle may be deployed below the working channel over the length of the endoscope to obtain a tissue sample that is analyzed by a pathologist. Depending on the results of the pathology, additional tools may be deployed downstream of the working channel of the endoscope for additional biopsies. After identifying a nodule as malignant, the endoscope 13 may deliver tools endoscopically to excise potential cancerous tissue. In some cases, diagnostic and therapeutic procedures can be provided in separate procedures. In these situations, the endoscope 13 may also be used to deliver fiducials to "mark" the location of the target nodule. In other examples, diagnostic and therapeutic procedures may be delivered during the same procedure.

[0012] The system 10 may also include a movable tower 30 connected to the cart 11 via a support cable that can provide support for control, electronics, fluidics, optics, sensors, and / or power to the cart 11. Placing such functions within the tower 30 allows for a smaller form factor cart 11 that can be more easily adjusted and / or repositioned by the physician and their staff performing the procedure. Additionally, the separation of functions between the cart / table and the support tower 30 reduces clutter in the operating room and facilitates improved clinical workflows. The cart 11 may be positioned in close proximity to the patient, while the tower 30 may be housed in a remote location so as not to be obstructive during the procedure.

[0013] To support the above-described robotic system, the tower 30 may include components of a computer-based control system that stores computer program instructions in a non-transitory computer-readable storage medium such as, for example, a persistent magnetic storage drive, a solid-state drive, etc. Execution of these instructions may control the overall system or its subsystems, regardless of whether the execution occurs within the tower 30 or within the cart 11. For example, when executed by a processor of a computer system, the instructions may cause the components of the robotic system to operate the associated carriage and arm mounts, operate the robotic arm, and control the medical instrument. For example, in response to receiving a control signal, a motor within a joint of the robotic arm may position the arm in a particular posture.

[0014] The tower 30 may also include pumps, flow meters, valve control, and / or fluid access to provide controlled perfusion and suction functions to a system deployable through the endoscope 13. These components may also be controlled using the computer system of the tower 30. In some embodiments, the perfusion and suction capabilities may be delivered directly to the endoscope 13 via a separate cable.

[0015] The tower 30 may include voltage and surge protection devices designed to provide filtered and protected power to the cart 11, thereby avoiding the placement of a power transformer and other auxiliary power components within the cart 11, and making the cart 11 smaller and more mobile.

[0016] Tower 30 may also include support equipment for sensors deployed throughout the robot system 10. For example, tower 30 may include optoelectronic equipment for detecting, receiving, and processing data received from optical sensors or cameras through the robot system 10. In combination with the control system, such optoelectronic equipment may be used to generate real-time images for display within any number of consoles disposed throughout the system, including within tower 30. Similarly, tower 30 may also include an electronic subsystem for receiving signals from deployed electromagnetic (EM) sensors and processing the received signals. Tower 30 may also be used to house and position an EM field generator for detection by EM sensors within or on the medical device.

[0017] Tower 30 may also include console 31 in addition to other consoles available to the rest of the system, such as a console mounted on top of a cart. Console 31 may include a user interface for an operator, such as a physician, and a display screen, such as a touch screen. Consoles within system 10 are generally designed to provide both robot control and pre-operative and real-time information for a procedure, such as navigation information and location information for endoscope 13. If console 31 is not the only console available to the physician, console 31 may be used by a second operator, such as a nurse, to monitor the patient's health or life and the operation of the system and to provide procedure-specific data, such as navigation and location information. In other embodiments, console 30 is housed within a separate body from tower 30.

[0018] Tower 30 may be coupled to cart 11 and endoscope 13 via one or more cables or connections (not shown). In some embodiments, the support functions from tower 30 can be provided to cart 11 through a single cable, simplifying and organizing the operating room. In other embodiments, specific functions may be coupled with separate wiring and connections. For example, power may be supplied to the cart through a single power cable, while support for control, optics, fluidics, and / or navigation may be provided through separate cables.

[0019] FIG. 2 provides a detailed view of an embodiment of a cart from the cart-based robotic-enabled system shown in FIG. 1. Cart 11 generally includes an elongated support structure 14 (often referred to as a “column”), a cart base 15, and a console 16 at the top of column 14. Column 14 may include one or more carriages, such as a carriage 17 (alternatively an “arm support”) for supporting the deployment of one or more robotic arms 12 (three are shown in FIG. 2). Carriage 17 may include individually configurable arm mounts that rotate along a vertical axis to better position relative to the patient and adjust the base of robotic arm 12. Carriage 17 also includes a carriage interface 19 that allows carriage 17 to translate vertically along column 14.

[0020] The carriage interface 19 is connected to the column 14 through slots such as slot 20 positioned on both sides of the column 14 to guide the vertical translation of the carriage 17. Slot 20 includes a vertical translation interface for positioning and holding the carriage at various vertical heights relative to the cart base 15. Due to the vertical translation of the carriage 17, the cart 11 can adjust the reach of the robotic arm 12 to meet various table heights, patient sizes, and physician preferences. Similarly, with the individually configurable arm mounts on the carriage 17, the robotic arm base 21 of the robotic arm 12 can be angled in various configurations.

[0021] In some embodiments, to prevent dirt and fluid from entering the internal chamber of the column 14 and the vertical translation interface when the carriage 17 translates vertically, a slot cover that is coplanar and parallel to the slot surface may be added to the slot 20. The slot cover may be deployed through a pair of spring spools positioned near the vertical top and bottom of the slot 20. The cover is coiled in the spool until it is deployed to expand and contract from a coiled state as the carriage 17 translates vertically up and down. The spring load of the spool provides a force to retract the cover into the spool when the carriage 17 translates towards the spool, while maintaining the seal when the carriage 17 translates away from the spool. The cover may be connected to the carriage 17 using, for example, brackets within the carriage interface 19 to ensure that the cover extends and retracts properly as the carriage 17 translates.

[0022] The column 14 may include mechanisms such as gears and motors designed to use a lead screw aligned vertically to mechanically translate the carriage 17 in response to a control signal generated in response to a user input, such as an input from the console 16.

[0023] The robotic arm 12 may generally include a robotic arm base 21 and an end effector 22 separated by a series of links 23 connected by a series of joints 24. Each joint includes an independent actuator, and each actuator includes a separately controllable motor. The separately controllable joints represent the independent degrees of freedom available to the robotic arm. Each of the arms 12 has seven joints and thus provides seven degrees of freedom. A large number of joints result in a large number of degrees of freedom and enable "redundant" degrees of freedom. The redundant degrees of freedom enable the robotic arm 12 to position their respective end effectors 22 at specific positions, orientations, and trajectories in space using different joint positions and angles. This enables the system to position and orient a medical instrument from a desired point in space, while at the same time allowing the physician to move the arm joints to a clinically advantageous position away from the patient, creating better access while avoiding collisions of the arm.

[0024] The cart base 15 balances the weight of the column 14, the carriage 17, and the arm 12 on the floor. Thus, the cart base 15 houses heavier components such as electronics, motors, power supplies, and components that enable either movement and / or immobilization of the cart. For example, the cart base 15 includes rollable wheel-shaped casters 25 that enable the cart to be easily moved around the room before the procedure. After reaching an appropriate position, the casters 25 may be made immovable using wheel locks to hold the cart 11 in place during the procedure.

[0025] The console 16 positioned at the vertical end of column 14 enables both a user interface for receiving user input and a display screen (or a dual-purpose device such as, for example, touch screen 26), providing both preoperative data and intraoperative data to the user, who is a doctor. Potential preoperative data on touch screen 26 may include preoperative planning, navigation and mapping data derived from preoperative computerized tomography (CT) scans, and / or notes from preoperative patient interviews. Intraoperative data on the display may include optical information provided by the tool, sensor and coordinate information from sensors, and essential patient statistics such as respiration, heart rate, and / or pulse. The console 16 is positioned to enable the doctor to access the console from the column 14 side opposite the carriage 17 and may be inclined. From this position, the doctor can view the console 16, the robotic arm 12, and the patient while operating the console 16 from behind the cart 11. As shown, the console 16 also includes a handle 27 that assists in the operation and stabilization of the cart 11.

[0026] Figure 3 shows an embodiment of the robot-compatible system 10 arranged for ureteroscopy. In a ureteroscopy procedure, the cart 11 may be positioned to deliver a ureteroscope 32, a dedicated endoscope designed to traverse the patient's urethra and ureter, to the patient's lower abdominal region. In ureteroscopy, it may be desirable for the ureteroscope 32 to be directly aligned with the patient's urethra to reduce friction and force on sensitive anatomical structures within the region. As shown, the cart 11 may be aligned with the legs of the table such that the robotic arm 12 is positioned to enable direct linear access to the ureteroscope 32 into the patient's urethra. From the legs of the table, the robotic arm 12 may insert the ureteroscope 32 directly along the virtual rail 33 through the urethra into the patient's lower abdomen.

[0027] After being inserted into the urethra using control techniques similar to those in bronchoscopy, the ureteroscope 32 may be navigated to the bladder, ureter, and / or kidney for diagnostic and / or therapeutic purposes. For example, the ureteroscope 32 can be directed towards the ureter and kidney and the formed kidney stones can be fragmented using a laser or ultrasonic lithotripsy device deployed below the working channel of the ureteroscope 32. After the lithotripsy is completed, the resulting stone fragments may be removed using a basket deployed below the ureteroscope 32.

[0028] FIG. 4 shows an embodiment of a robot-compatible system similarly arranged for vascular procedures. In a vascular procedure, the system 10 can be configured such that the cart 11 can deliver a medical instrument 34, such as a steerable catheter, to an access point within the femoral artery in the patient's leg. The femoral artery presents both a larger diameter for navigation and a relatively less circuitous path to the patient's heart, thereby simplifying navigation. As in a ureteroscopy procedure, the cart 11 may be positioned towards the patient's leg and lower abdomen to enable the robotic arm 12 to provide a virtual rail 35 with direct linear access to the femoral artery access point within the patient's thigh / lumbar region. After insertion into the artery, the medical instrument 34 may be directed and inserted by translating the instrument driver 28. Alternatively, the cart may be positioned around the patient's upper abdomen to reach alternative vascular access points, such as the carotid and brachial arteries near the shoulder and hand.

[0029] B. Robot System - Table Embodiments of the robotic-enabled medical system may also incorporate a patient table. Incorporating the table reduces the amount of capital equipment in the operating room by removing the cart and allows for greater access to the patient. FIG. 5 shows an embodiment of such a robotic-enabled system positioned for a bronchoscopy procedure. System 36 includes a support structure or column 37 for supporting a platform 38 (illustrated as a "table" or "bed") above the floor. Similar to the cart-based system, the end effector of the robotic arm 39 of system 36 includes an instrument driver 42 designed to manipulate an elongate medical instrument, such as the bronchoscope 40 of FIG. 5, through or along a virtual rail 41 formed from the linear alignment of the instrument driver 42. In practice, a C-arm for providing fluoroscopic imaging may be positioned above the upper abdominal region of the patient by placing the radiator and detector around the table 38.

[0030] FIG. 6 provides an alternative view of system 36 without a patient and medical instruments for illustrative purposes. As shown, column 37 may include one or more carriages 43 illustrated as ring-shaped within system 36 that can serve as the base of one or more robotic arms 39. The carriage 43 may translate along a vertical column interface 44 over the length of column 37 to provide different vantage points where the robotic arm 39 can be positioned to reach the patient. The carriage 43 may rotate around column 37 using a mechanical motor positioned within column 37 to enable the robotic arm 39 to have access to multiple sides of table 38, such as both sides of the patient, for example. In embodiments having multiple carriages, the carriages may be individually positioned on the column and may translate and / or rotate independently of other carriages. The carriage 43 need not surround column 37 or even be circular, but the ring shape as illustrated facilitates rotation of the carriage 43 around column 37 while maintaining structural balance. The rotation and translation of carriage 43 enables the system to align medical instruments, such as endoscopes and laparoscopes, to different access points on the patient. In other embodiments (not shown), system 36 may include a patient table or bed having an adjustable arm support in the form of parallel extending bars or rails. One or more robotic arms 39 can be attached to an adjustable arm support that can be adjusted vertically (e.g., via a shoulder having an elbow joint). By providing vertical adjustment, the robotic arm 39 can advantageously be compactly housed under the patient table or bed and then pulled up during the procedure.

[0031] The arm 39 may be mounted to the carriage via a set of arm mounts 45 that include a series of joints that can rotate individually and / or extend telescopically to provide additional configurability to the robotic arm 39. Further, the arm mounts 45 may be positioned on the carriage 43 such that when the carriage 43 is appropriately rotated, the arm mounts 45 can be positioned on the same side of the table 38 (as shown in FIG. 6), on both sides of the table 38 (as shown in FIG. 9), or on adjacent sides of the table 38 (not shown).

[0032] The column 37 structurally provides a path for the support of the table 38 and the vertical translation of the carriage. Internally, the column 37 may be provided with a lead screw for guiding the vertical translation of the carriage and a motor for mechanizing the translation of the carriage based on the lead screw. The column 37 may also transmit power and control signals to the carriage 43 and the robotic arm 39 mounted thereon.

[0033] The table base 46 serves a similar function as the cart base 15 of the cart 11 shown in FIG. 2 and houses heavier components to balance the table / bed 38, column 37, carriage 43, and robotic arm 39. The table base 46 may also incorporate rigid casters to provide stability during treatment. The casters deployed from the bottom of the table base 46 extend in opposite directions on both sides of the base 46 and may retract when it is necessary to move the system 36.

[0034] Continuing with reference to FIG. 6, system 36 may also include a tower (not shown) that divides the functionality of system 36 between the table and the tower to reduce the form factor and bulk of the table. As in the previously disclosed embodiments, the tower may provide various support functions such as processing, computing, and control capabilities, power, fluidics, and / or optics and sensor processing to the table. The tower may also be movable to be positioned away from the patient to improve physician access and to organize the operating room. Further, positioning components within the tower allows for more storage space within the table base for potential housing of robotic arms. The tower may also include a master controller or console that provides both a user interface for user input such as a keyboard and / or pendant, and a display screen (or touch screen) for preoperative and intraoperative information such as real-time imaging, navigation, and tracking information. In some embodiments, the tower may also include a holder for a gas tank used for insufflation.

[0035] In some embodiments, the table base may house and store the robotic arm when not in use. FIG. 7 shows a system 47 for housing a robotic arm in an embodiment of a table-based system. In system 47, carriage 48 may be translated vertically into base 49 to house robotic arm 50, arm mount 51, and carriage 48 within base 49. Base cover 52 may open and close in a translational and retracting manner to position carriage 48, arm mount 51, and arm 50 around column 53 and to house and protect them when not in use. Base cover 52 may be sealed with a membrane 54 along the edges of its opening to prevent dirt and fluid ingress when closed.

[0036] FIG. 8 shows an embodiment of a robotic-enabled table-based system configured for ureteroscopy procedures. In ureteroscopy, table 38 may include a swivel portion 55 for positioning the patient off-angle from column 37 and table base 46. The swivel portion 55 may rotate or pivot about a pivot point (e.g., located below the patient's head) to position the bottom of the swivel portion 55 away from column 37. For example, pivoting of the swivel portion 55 allows a C-arm (not shown) to be positioned above the lower abdomen of the patient without interfering with the space of a column (not shown) under table 38. By rotating a carriage 35 (not shown) around column 37, robotic arm 39 may directly insert ureteroscope 56 along virtual rail 57 into the patient's groin region to reach the urethra. In ureteroscopy, a bolster 58 may also be fixed to the swivel portion 55 of table 38 to support the position of the patient's legs during the procedure and allow clear access to the patient's groin region.

[0037] In laparoscopy procedures, minimally invasive instruments may be inserted through small incisions in the patient's abdominal wall into the patient's anatomical structures. In some embodiments, the minimally invasive instruments include elongated rigid members such as shafts used to access anatomical structures within the patient. After inflation of the patient's abdomen, the instruments may be instructed to perform surgical or medical tasks such as grasping, cutting, ablation, suturing, etc. In some embodiments, the instruments may include a scope such as a laparoscope. FIG. 9 shows an embodiment of a robotic-enabled table-based system configured for laparoscopy procedures. As shown in FIG. 9, carriage 43 of system 36 rotates and is adjusted vertically so that a pair of robotic arms 39 may be positioned on either side of table 38 using arm mount 45 such that instrument 59 can reach the patient's abdomen through minimal incisions on both sides of the patient.

[0038] To accommodate laparoscopic procedures, a robot-compatible table system may also tilt the platform to a desired angle. FIG. 10 shows an embodiment of a robot-compatible medical system having pitch or tilt adjustment. As shown in FIG. 10, system 36 can position one portion of the table at a distance from the floor greater than the other portion of the table, in adaptation to the tilt of table 38. Additionally, arm mount 45 may be rotated to conform to the tilt so that arm 39 maintains the same planar relationship with table 38. To accommodate steep angles, column 37 may also include a nested portion 60 that allows column 37 to extend vertically to prevent table 38 from contacting the floor or colliding with base 46.

[0039] FIG. 11 provides a detailed view of the interface between table 38 and column 37. Pitch rotation mechanism 61 may be configured to change the pitch angle of table 38 relative to column 37 with multiple degrees of freedom. Pitch rotation mechanism 61 may be enabled by the positioning of orthogonal axes 1, 2 at the column-table interface, with each axis actuated by a separate motor 3, 4 in response to an electrical pitch angle command. Rotation along one screw 5 enables tilt adjustment about one axis 1, and rotation along the other screw 6 enables tilt adjustment along the other axis 2. In some embodiments, a ball joint may be used to change the pitch angle of table 38 relative to column 37 with multiple degrees of freedom.

[0040] For example, pitch adjustment is particularly useful when attempting to position the table in the Trendelenburg position, i.e., when attempting to position the patient's lower abdomen at a higher position from the floor than the patient's upper abdomen for lower abdominal surgery. The Trendelenburg position slides the patient's internal organs towards the patient's upper abdomen by gravity, emptying the abdominal cavity for minimally invasive tools to perform lower abdominal surgeries or medical procedures such as laparoscopic prostatectomy.

[0041] Figures 12 and 13 show an isometric view and an end view of another embodiment of the table-based surgical robot system 100. The surgical robot system 100 includes one or more adjustable arm supports 105 (see, e.g., FIG. 14) that can be configured to support one or more robot arms relative to the table 101. In the illustrated embodiment, a single adjustable arm support 105 is shown, but additional arm supports can be provided on the opposite side of the table 101. The adjustable arm support 105 can be configured to move relative to the table 101 to adjust and / or change the position of the adjustable arm support 105 and / or any robot arm attached thereto relative to the table 101. For example, the adjustable arm support 105 can be adjusted relative to the table 101 with one or more degrees of freedom. The adjustable arm support 105 provides the system 100 with a high versatility that includes the ability to easily accommodate one or more adjustable arm supports 105 and any robot arms attached thereto under the table 101. The adjustable arm support 105 can be raised from the storage position to a position below the upper surface of the table 101. In other embodiments, the adjustable arm support 105 can be raised from the storage position to a position above the upper surface of the table 101.

[0042] The adjustable arm support 105 can provide several degrees of freedom, including lift, lateral translation, tilt, etc. In the illustrated embodiment of FIGS. 12 and 13, the arm support 105 is configured with four degrees of freedom, which are indicated by arrows in FIG. 12. The first degree of freedom enables adjustment of the adjustable arm support 105 in the z-direction ("Z lift"). For example, the adjustable arm support 105 can include a carriage 109 configured to move up and down along or relative to a column 102 that supports the table 101. The second degree of freedom enables the adjustable arm support 105 to tilt. For example, the adjustable arm support 105 can include a rotational joint, which may enable alignment of the adjustable arm support 105 with the Trendelenburg-positioned bed. The third degree of freedom can enable the adjustable arm support 105 to "pivot upward", which can be used to adjust the distance between the side of the table 101 and the adjustable arm support 105. The fourth degree of freedom enables the adjustable arm support 105 to translate along the longitudinal length of the table.

[0043] The surgical robot system 100 of FIGS. 12 and 13 can include a table supported by a column 102 mounted to a base 103. The base 103 and column 102 support the table 101 relative to a support surface. The floor axis 131 and support axis 133 are shown in FIG. 13.

[0044] The adjustable arm support 105 can be mounted to the column 102. In other embodiments, the arm support 105 can be mounted to the table 101 or the base 103. The adjustable arm support 105 can include a carriage 109, a bar or rail connector 111, and a bar or rail 107. In some embodiments, one or more robot arms mounted to the rail 107 can translate and move relative to each other.

[0045] The carriage 109 may be attached to the column 102 by a first joint 113, whereby the carriage 109 can move relative to the column 102 (e.g., move up and down the first or vertical axis 123). The first joint 113 can provide a first degree of freedom ("Z lift") to the adjustable arm support 105. The adjustable arm support 105 can include a second joint 115 that provides a second degree of freedom (tilt) to the adjustable arm support 105. The adjustable arm support 105 can include a third joint 117 that can provide a third degree of freedom ("upward pivot") to the adjustable arm support 105. An additional joint 119 (shown in FIG. 13) can be provided to mechanically constrain the third joint 117 to maintain the orientation of the rail 107 when rotating the rail connector 111 about the third axis 127. The adjustable arm support 105 can include a fourth joint 121 that can provide a fourth degree of freedom (translation) to the adjustable arm support 105 along a fourth axis 129.

[0046] FIG. 14 shows an end view of a surgical robot system 140A having two adjustable arm supports 105A, 105B mounted on both sides of a table 101. The first robot arm 142A is attached to a bar or rail 107A of the first adjustable arm support 105B. The first robot arm 142A includes a base 144A attached to the rail 107A. The distal end of the first robot arm 142A includes an instrument drive mechanism 146A that can be attached to one or more robotic medical instruments or tools. Similarly, the second robot arm 142B includes a base 144B attached to the rail 107B. The distal end of the second robot arm 142B includes an instrument drive mechanism 146B. The instrument drive mechanism 146B can be configured to be attached to one or more robotic medical instruments or tools.

[0047] In some embodiments, one or more of the robotic arms 142A, 142B include an arm having seven or more degrees of freedom. In some embodiments, one or more of the robotic arms 142A, 142B can include eight degrees of freedom, including an insertion axis (one degree of freedom including insertion), a wrist (three degrees of freedom including wrist pitch, yaw, and roll), an elbow (one degree of freedom including elbow pitch), a shoulder (two degrees of freedom including shoulder pitch and yaw), and a base 144A, 144B (one degree of freedom including translation). In some embodiments, the insertion degree of freedom can be provided by the robotic arms 142A, 142B, while in other embodiments, the instrument itself provides insertion via an instrument base insertion architecture.

[0048] C. Instrument Driver and Interface The end effector of the robotic arm of the system includes (i) an instrument driver (alternatively referred to as an “instrument drive mechanism” or “instrument device manipulator”) incorporating electromechanical means for actuating a medical instrument, and (ii) a removable or detachable medical instrument that may lack any electromechanical components such as motors. This dichotomy can be caused by the need to sterilize medical instruments used in medical procedures and the inability to properly sterilize expensive capital equipment due to the complexity of the mechanical assembly of medical instruments and the high sensitivity of electronic equipment. Thus, the medical instrument can be designed to be removed, detached, and replaced from the instrument driver (and thus the system) for individual sterilization or disposal by a physician or the physician's staff. In contrast, the instrument driver need not be replaced or sterilized and can be draped for protection.

[0049] FIG. 15 shows an exemplary instrument driver. The instrument driver 62 positioned at the distal end of the robotic arm comprises one or more drive units 63 arranged with parallel axes to provide controlled torque to a medical instrument via a drive shaft 64. Each drive unit 63 includes an individual drive shaft 64 for interacting with the instrument, a gear head 65 for converting the rotation of the motor shaft into a desired torque, a motor 66 for generating the drive torque, an encoder 67 for measuring the speed of the motor shaft and providing feedback to the control circuit, and a control circuit 68 for receiving control signals and operating the drive unit. Each drive unit 63 is independently controlled and motorized, and the instrument driver 62 can provide a plurality (four as shown in FIG. 15) of independent drive outputs to the medical instrument. During operation, the control circuit 68 receives control signals, transmits motor signals to the motor 66, compares the motor speed obtained as a result measured by the encoder 67 with a desired speed, and modulates the motor signals to generate a desired torque.

[0050] For procedures that require a sterile environment, the robotic system may incorporate a drive interface, such as a sterile adapter connected to a sterile drape, positioned between the instrument driver and the medical instrument. The main purpose of the sterile adapter is to transmit angular motion from the drive shaft of the instrument driver to the drive input of the instrument while maintaining physical separation, and thus sterility, between the drive shaft and the drive input. Accordingly, an exemplary sterile adapter can be composed of a series of rotational input and output portions intended to mate with the drive shaft of the instrument driver and a drive input for the instrument. The sterile drape connected to the sterile adapter is composed of a thin flexible material such as transparent or translucent plastic and is designed to cover capital equipment such as the instrument driver, robotic arm, and cart (in a cart-based system) or table (in a table-based system). The use of the drape allows the capital equipment to be positioned close to the patient while remaining in an area that does not require sterilization (i.e., the non-sterile field). On the opposite side of the sterile drape, the medical instrument may interface with the patient in an area that requires sterilization (i.e., the sterile field).

[0051] D. Medical Instrument FIG. 16 shows an exemplary medical instrument having a pair of instrument drivers. Similar to other instruments designed for use with a robotic system, medical instrument 70 includes an elongated shaft 71 (or elongated body) and an instrument base 72. Instrument base 72, also referred to as an “instrument handle” by virtue of its design intended for manual interaction by a physician, is generally designed to mate with a drive output portion 74 that extends through a drive interface on instrument driver 75 at the distal end of robotic arm 76, and may include a rotatable drive input portion 73, such as a receptacle, pulley, or spool. When physically connected, latched, and / or coupled, the mated drive input portion 73 of instrument base 72 can share a rotational axis with drive output portion 74 in instrument driver 75 and enable transmission of torque from drive output portion 74 to drive input portion 73. In some embodiments, drive output portion 74 may include splines designed to mate with a receptacle on drive input portion 73.

[0052] Elongated shaft 71 is designed to be delivered through either an anatomical opening or lumen, such as in an endoscope, or a minimally invasive incision, such as in laparoscopy. Elongated shaft 71 may be either flexible (e.g., having characteristics similar to an endoscope) or rigid (e.g., having characteristics similar to a laparoscope), or may include a customized combination of both flexible and rigid portions. When designed for laparoscopy, the distal end of the rigid elongated shaft extends from a joined list formed from a clevis having at least one degree of freedom, and can be connected to a surgical tool or medical instrument, such as a gripper or forceps, that can be actuated based on force from a tendon when rotating in response to torque received by the drive input portion from drive output portion 74 of instrument driver 75. When designed for endoscopy, the distal end of the flexible elongated shaft may include an articulatable or controllable bend that can be articulated and bent based on torque received from drive output portion 74 of instrument driver 75.

[0053] The torque from the instrument driver 75 is transmitted downstream of the elongate shaft 71 using tendons along the shaft 71. These individual tendons, such as pull wires, may be individually fixed to individual drive input portions 73 within the instrument handle 72. From the handle 72, the tendons are routed down one or more pull lumens along the elongate shaft 71 and are fixed to the distal portion of the elongate shaft 71, or to a list of the distal portions of the elongate shaft. During a surgical procedure, such as a laparoscopic, endoscopic, or hybrid procedure, these tendons may be coupled to a distally mounted end effector such as a list, grasper, or forceps. Under such a configuration, the torque applied to the drive input portion 73 transmits tension to the tendons, thereby actuating the end effector in some manner. In some embodiments, during a surgical procedure, the tendons can be rotated about an axis of a joint, thereby moving the end effector in one direction or another. Alternatively, the tendons may be connected to one or more jaws of a grasper at the distal end of the elongate shaft 71, and the grasper is closed by the tension from the tendons.

[0054] In an endoscopic examination, the tendon may be coupled to a flexion or articulation portion positioned along (e.g., at the distal end of) the elongated shaft 71 via an adhesive, a control ring, or other mechanical fixation. When fixedly attached to the distal end of the flexion portion, the torque exerted on the drive input portion 73 is transmitted downstream of the tendon to flex or articulate the softer flexion portion (which may be referred to as an articulable portion or region). Along the non-flexion portion, it may be advantageous to spiral or coil individual pull lumens that direct the individual tendons along (or inside) the wall of the endoscopic shaft to balance the radial forces resulting from the tension in the pull wires. The angle of the spiral and / or the spacing between these may be varied or designed for a particular purpose, where a narrower spiral exhibits less shaft compression under load forces while a lesser amount of spiral results in greater shaft compression under load forces but also exhibits flexion limitation. At the other end of the spectrum, the pull lumens may be oriented parallel to the longitudinal axis of the elongated shaft 71 to enable controlled articulation at the desired flexion or articulable portion.

[0055] In an endoscopic examination, the elongated shaft 71 houses several components that assist in robotic procedures. The shaft may constitute a working channel for positioning, perfusing, and / or aspirating a surgical tool (or medical instrument) with respect to the surgical area at the distal end of the shaft 71. The shaft 71 may also house wires and / or optical fibers to transmit signals between an optical assembly at a distal tip that may include an optical camera. The shaft 71 may also house an optical fiber to convey light from a proximally positioned light source, such as a light emitting diode, to the distal end of the shaft.

[0056] At the distal end of the instrument 70, the distal tip may include an opening of a working channel for delivering tools to the surgical site for diagnosis and / or treatment, irrigation, and aspiration. The distal tip may also include a port for a camera, such as a fiber optic scope or a digital camera, for capturing an image of the internal anatomical space. In connection therewith, the distal tip may also include a port for a light source for illuminating the anatomical space when using the camera.

[0057] In the embodiment of FIG. 16, the drive shaft axis, and thus the drive input axis, is orthogonal to the axis of the elongate shaft. However, this arrangement complicates the rolling ability of the elongate shaft 71. As a result of rolling the elongate shaft 71 along its axis while keeping the drive input portion 73 stationary, undesirable entanglement of the tendon occurs when the tendon extends from the drive input portion 73 and enters the pull lumen within the elongate shaft 71. Such resulting tendon entanglement may interfere with any control algorithm intended to predict the movement of the flexible elongate shaft during an endoscopic procedure.

[0058] Figure 17 shows an alternative design of an instrument driver and an instrument where the axis of the drive unit is parallel to the axis of the elongated shaft of the instrument. As shown, the circular instrument driver 80 includes four drive units with drive output portions 81 that are positioned parallel at the end of the robotic arm 82. The drive units and their respective drive output portions 81 are housed within the rotating assembly 83 of the instrument driver 80 that is driven by one of the drive units within the assembly 83. In response to the torque provided by the rotating drive unit, the rotating assembly 83 rotates along a circular bearing that connects the rotating assembly 83 to the non-rotating portion 84 of the instrument driver. Power and control signals may be transmitted from the non-rotating portion 84 of the instrument driver 80 to the rotating assembly 83 through electrical contacts and may be maintained through rotation by a brushed slip ring connection (not shown). In other embodiments, the rotating assembly 83 may be integrated with the non-rotatable portion 84 and thus may respond to a separate drive unit that is not parallel to the other drive units. The rotating mechanism 83 enables the instrument driver 80 to rotate the drive units and their respective drive output portions 81 as a single unit about the instrument driver axis 85.

[0059] Similar to the previously disclosed embodiments, the instrument 86 may include an elongated shaft portion 88 and an instrument base 87 (shown with a transparent outer skin for illustrative purposes) that includes a plurality of drive input portions 89 (such as receptacles, pulleys, and spools) configured to receive the drive output portions 81 within the instrument driver 80. Different from the previously disclosed embodiments, the instrument shaft 88 extends from the center of the instrument base 87 and the axis is not orthogonal as in the design of FIG. 16 but is substantially parallel to the axis of the drive input portions 89.

[0060] When coupled to the rotational assembly 83 of the instrument driver 80, the medical instrument 86, which includes the instrument base 87 and the instrument shaft 88, rotates with the rotational assembly 83 about the instrument driver shaft 85. Since the instrument shaft 88 is positioned at the center of the instrument base 87, the instrument shaft 88 is coaxial with the instrument driver shaft 85 when attached. Thus, due to the rotation of the rotational assembly 83, the instrument shaft 88 rotates about its own longitudinal axis. Further, when the instrument base 87 rotates with the instrument shaft 88, any tendons connected to the drive input portion 89 within the instrument base 87 are not entangled during rotation. Thus, the parallelism of the axes of the drive output portion 81, the drive input portion 89, and the instrument shaft 88 allows shaft rotation without entangling any control tendons.

[0061] FIG. 18 shows an instrument having an instrument base insertion architecture according to some embodiments. The instrument 150 can be coupled to any of the above-described instrument drivers. The instrument 150 includes an elongated shaft 152, an end effector 162 connected to the shaft 152, and a handle 170 coupled to the shaft 152. The elongated shaft 152 includes a tubular member having a proximal portion 154 and a distal portion 156. The elongated shaft 152 includes one or more channels or grooves 158 along its outer surface. The grooves 158 are configured to receive one or more wires or cables 180 therethrough. Thus, one or more cables 180 extend along the outer surface of the elongated shaft 152. In other embodiments, the cables 180 can also extend through the elongated shaft 152. Actuation of the end effector 162 is effected by operation of one or more of the cables 180 (e.g., via an instrument driver).

[0062] The instrument handle 170, which may also be referred to as the instrument base, can include an attachment interface 172 having one or more mechanical input portions 174, such as receptacles, pulleys, or spools, generally designed to reciprocally mate with one or more torque couplers on the attachment surface of the instrument driver.

[0063] In some embodiments, instrument 150 includes a series of pulleys or cables that allow the elongate shaft 152 to translate relative to the handle 170. In other words, the instrument 150 itself includes an instrument-based insertion architecture that adapts to the insertion of the instrument, thereby minimizing the reliance on a robotic arm to provide insertion of the instrument 150. In other embodiments, the robotic arm can be highly involved in the insertion of the instrument.

[0064] E. Controller Any of the robotic systems described herein can include an input device or controller for operating an instrument attached to a robotic arm. In some embodiments, the controller can be coupled (e.g., communicatively, electronically, electrically, wirelessly, and / or mechanically) to the instrument such that operation of the controller causes a corresponding operation of the instrument, e.g., via master-slave control.

[0065] FIG. 19 is a perspective view of an embodiment of a controller 182. In this embodiment, controller 182 includes a hybrid controller that can have both impedance control and admittance control. In other embodiments, controller 182 can utilize only impedance or passive control. In other embodiments, controller 182 can utilize only admittance control. By being a hybrid controller, controller 182 can advantageously have a lower perceived inertia during use.

[0066] In the illustrated embodiment, controller 182 is configured to enable the operation of two medical instruments and includes two handles 184. Each handle 184 is connected to a gimbal 186. Each gimbal 186 is connected to a positioning platform 188.

[0067] As shown in FIG. 19, each positioning platform 188 includes a SCARA arm (Selective Compliance Assembly Robot Arm) 198 coupled to the column 194 by a prism joint 196. The prism joint 196 is configured to translate along the column 194 (e.g., along the rail 197) such that each of the handles 184 is translated in the z-direction, providing a first degree of freedom. The SCARA arm 198 is configured to enable movement of the handle 184 in the x-y plane, providing two additional degrees of freedom.

[0068] In some embodiments, one or more load cells are positioned within the controller. For example, in some embodiments, a load cell (not shown) is positioned within each of the gimbals 186. By providing the load cells, a portion of the controller 182 can operate under admittance control, thereby advantageously reducing the perceived inertia of the controller during use. In some embodiments, the positioning platform 188 is configured for admittance control, while the gimbal 186 is configured for impedance control. In other embodiments, the gimbal 186 is configured for admittance control and the positioning platform 188 is configured for impedance control. Thus, in some embodiments, the translational or position degrees of freedom of the positioning platform 188 can depend on admittance control, while the rotational degrees of freedom of the gimbal 186 depend on impedance control.

[0069] F. Navigation and Control Conventional endoscopies may involve the use of fluoroscopy (such as may be delivered through a C-arm) and other forms of radiation-based imaging modalities to provide intra-cavity guidance to the operator, a physician. In contrast, the robotic systems contemplated by the present disclosure can provide non-radiation-based navigation and localization means to reduce the physician's exposure to radiation and to reduce the amount of equipment in the operating room. As used herein, the term "localization" may refer to determining and / or monitoring the position of an object within a reference coordinate system. Techniques such as pre-operative mapping, computer vision, real-time EM tracking, and robotic command data may be used individually or in combination to achieve a radiation-free surgical environment. In other cases where radiation-based imaging modalities are still used, pre-operative mapping, computer vision, real-time EM tracking, and robotic command data may be used individually or in combination to improve the information obtained only by the radiation-based imaging modality.

[0070] FIG. 20 is a block diagram showing a localization system 90 that estimates the position of one or more elements of a robotic system, such as the location of an instrument, according to an exemplary embodiment. The localization system 90 may be a set of one or more computer devices configured to execute one or more instructions. The computer device may be embodied by a processor (or processors) and computer-readable memory within one or more of the components discussed above. By way of example, and not limitation, the computer device may be within the tower 30 shown in FIG. 1, within the cart shown in FIGS. 1-4, within the bed shown in FIGS. 5-14, and the like.

[0071] As shown in FIG. 20, the location system 90 may include a location module 95 that processes input data 91-94 to generate location data 96 for the distal tip of a medical instrument. The location data 96 may be data or logic representing the location and / or orientation of the distal end of the instrument relative to a reference system. The reference system can be a reference system for the patient's anatomical structure or a known object such as an EM field generator (see the following description of the EM field generator).

[0072] Here, the various input data 91-94 will be described in more detail. Preoperative mapping can be achieved using the collection of low-dose CT scans. The preoperative CT scans are reconstructed, for example, into a three-dimensional image that is visualized as a "slice" of a cutaway view of the patient's internal anatomical structure. When analyzed as a whole, an image-based model of the anatomical cavities, spaces, and structures of the patient's anatomical structure, such as the patient's pulmonary network, can be generated. Techniques such as center-line geometry can be determined and approximated from the CT images to create a three-dimensional volume of the patient's anatomical structure, referred to as model data 91 (also referred to as "preoperative model data" when generated using only the preoperative CT scan). The use of center-line geometry is discussed in U.S. Patent Application No. 14 / 523,760, the content of which is hereby incorporated by reference in its entirety. A network phase model may also be derived from the CT images and is particularly suitable for bronchoscopy.

[0073] In some embodiments, the instrument may be equipped with a camera to provide visual data 92. The localization module 95 may process the visual data to enable one or more vision-based location tracking. For example, preoperative model data may be used with the visual data 92 to enable computer vision-based tracking of a medical instrument (e.g., an endoscope, or an instrument advancing through the working channel of an endoscope). For example, using the preoperative model data 91, a robotic system can generate a library of predicted endoscope images from the model based on the predicted movement path of the endoscope, with each image linked to a position within the model. During the surgery, this library can be referenced by the robotic system to assist in localization by comparing real-time images captured by a camera (e.g., a camera at the distal end of the endoscope) with those in the image library.

[0074] Other computer vision-based tracking techniques use feature tracking to determine the operation of the camera and thus the endoscope. Some features of the localization module 95 may identify circular geometric shapes within the preoperative model data 91 corresponding to anatomical lumens and track changes in those geometric shapes to determine which anatomical lumen was selected and the relative rotational and / or translational movement of the camera. The use of phase maps may further improve vision-based algorithms or techniques.

[0075] Optical flow, another computer vision-based technique, may analyze the displacement and translation of image pixels within a video sequence in the visual data 92 to infer the movement of the camera. Examples of optical flow techniques can include motion detection, object segmentation calculation, luminance, motion-compensated coding, stereoscopic parallax measurement, etc. By comparing multiple frames over multiple iterations, the movement and location of the camera (and thus the endoscope) can be determined.

[0076] The position - specific module 95 can generate the real - time position of the endoscope within a global coordinate system that can be registered to the patient's anatomical structure represented by the preoperative model using real - time EM tracking. In EM tracking, an EM sensor (or tracker) that consists of one or more sensor coils embedded within a medical instrument (e.g., an endoscopic instrument) at one or more locations and orientations measures the variations in the EM field generated by one or more static EM field generators positioned at known locations. The position information detected by the EM sensor is stored as EM data 93. The EM field generator (or transmitter) can be placed in proximity to the patient to generate a low - intensity magnetic field that can be detected by the embedded sensors. The magnetic field induces a small current within the sensor coils of the EM sensor, and this current can be analyzed to determine the distance and angle between the EM sensor and the EM field generator. These distances and orientations can be "registered" intra - operatively to the patient's anatomical structure (e.g., the preoperative model) to determine the geometric transformation that aligns a single location within the coordinate system with a position within the preoperative model of the patient's anatomical structure. Once registered, the EM tracker embedded at one or more positions of the medical instrument (e.g., the distal tip of the endoscope) can provide a real - time display of the progress of the medical instrument through the patient's anatomical structure.

[0077] The robot commands and kinematic data 94 may also be used by the position - specific module 95 to provide position - specific data 96 for the robotic system. The device pitch and yaw resulting from the joint movement commands can be determined during preoperative calibration. During the operation, these calibration measurements can be used in combination with known insertion - depth information to estimate the position of the instrument. Alternatively, these calculations can be analyzed in combination with EM, visual, and / or phase modeling to estimate the position of the medical instrument within the network.

[0078] As shown in FIG. 20, some other input data can be used by the location determination module 95. For example, although not shown in FIG. 20, an instrument using shape sensing fibers can provide shape data that the location determination module 95 can use to determine the position and shape of the instrument.

[0079] The location determination module 95 can use the input data 91-94 in combination. In some cases, such a combination can use a probabilistic approach in which the location determination module 95 assigns a confidence weight to the locations determined from each of the input data 91-94. Thus, if the EM data may not be reliable (such as when there is EM interference), the reliability of the position determined by the EM data 93 can be reduced, and the location determination module 95 can rely more heavily on the visual data 92 and / or the robot command and kinematic data 94.

[0080] As discussed above, the robotic systems discussed herein can be designed to incorporate one or a combination of two or more of the techniques described above. The computer-based control system of a tower, bed, and / or cart-based robotic system may store computer program instructions, for example, in a non-transitory computer-readable storage medium such as a permanent magnetic storage drive, a solid-state drive, etc., which when executed cause the system to receive and analyze sensor data and user commands, generate control signals for the entire system, and display navigation and location determination data such as the position of the instrument in a global coordinate system, an anatomical map, etc.

[0081] 2. Trocar Assembly Embodiments of the present disclosure include systems and techniques related to trocar assemblies and cannulas, such as, for example, trocar assemblies for laparoscopic procedures.

[0082] The assemblies disclosed herein can overcome one or more problems discovered with certain conventional trocar assemblies. In certain trocar assemblies, it can be difficult for a clinician to engage and disengage a sealing cartridge from a cannula. Thus, during some procedures, the clinician may need additional time to insert or remove the sealing cartridge, or may not be able to fully engage the sealing cartridge, which can compromise insufflation within the patient's cavity. Further, in certain trocar assemblies, the sealing cartridge is disposed within the upper portion of the cannula. Thus, the configuration of certain trocar assemblies can interfere with a robust in-line latch of the cannula to a robotic arm of a robotic system or detection of the cannula. Advantageously, the disclosed trocar assemblies can enable easy engagement and disengagement of the sealing cartridge from the cannula while allowing for a secure engagement for the procedure. As can be appreciated, the disclosed trocar assembly configurations can reduce clinical errors, shorten procedure times, and simplify workflows.

[0083] Referring to FIGS. 21-22, an exemplary trocar assembly 200 including a closure 210, a sealing cartridge 240, and a cannula 260 is shown. FIG. 21 shows the trocar assembly 200 in an assembled state. FIG. 22 is an exploded view of the trocar assembly 200 of FIG. 23 in a non-assembled state. In the illustrated example, the trocar assembly 200 is capable of displacing or incising soft tissue to insert the cannula 260 into a patient's cavity to provide access to a surgical site. According to some embodiments, the trocar assembly 200 is configured to provide access to a surgical site for laparoscopic procedures. Additionally or alternatively, the trocar assembly 200 can be configured to provide access to a site for other medical or minimally invasive procedures where urological, endoscopic, percutaneous, orthopedic, and / or medical instruments are introduced to the site through the trocar assembly. In some applications, the trocar assembly 200 provides access to a surgical site for robotic laparoscopic procedures performed by the robotic system described herein. Additionally or alternatively, the trocar assembly 200 can be configured for use in manual laparoscopic procedures.

[0084] In the illustrated example, the closure 210 and the cannula 260 of the trocar assembly 200 can incise or puncture soft tissue to allow the trocar assembly 200 to access the surgical site. As shown, the proximal portion of the cannula 260 is configured as a funnel portion 262 that allows insertion of a tool including the closure 210. The cannula shaft 280 is configured as a tubular portion that extends distally from the funnel portion and provides a lumen through which the closure shaft 212 extends. In an assembled configuration, the closure shaft 212 extends through the cannula lumen 282 of the cannula shaft 280. The closure shaft 212 can be made longer than the cannula shaft 280 such that the closure shaft extends beyond the distal end portion 284 of the cannula shaft 280.

[0085] The closure shaft 212 can include an inclined or otherwise sharpened distal end 214 configured to incise or puncture soft tissue. During insertion, the distal end 214 of the closure shaft 212 can displace the soft tissue to enable insertion of the cannula shaft 280 into the patient's cavity. The closure 210 can be advanced by a clinician applying a force to the proximal portion 220 of the closure 210 or otherwise manipulating it. Optionally, the proximal portion 220 can be utilized by a clinician or other user as a handle for generally applying a force or otherwise advancing the closure 210 and / or the trocar assembly 200. As shown, the proximal portion 220 of the closure 210 can have a radius that is substantially larger than the shaft 212 to enable the user to more easily apply a greater force to the shaft 212. Further, the proximal portion 220 can include a gripping portion or planar surface to enable the clinician to advance the closure 210.

[0086] As shown, the closure 210 and cannula 260 of the trocar assembly 200 are coupled together to cooperatively incise or puncture soft tissue to permit access of the trocar assembly 200 to the surgical site. Thus, in an assembled configuration, the cannula 260 can be advanced together with the closure 210. As can be appreciated, the distal end portion 284 of the cannula shaft 280 can further displace the soft tissue to enable insertion of the cannula shaft 280 into the patient's cavity.

[0087] When the trocar assembly 200 is inserted into the patient's cavity, the closure 210 can be removed from the cannula 260. After removing the closure 210 from the cannula 260, the cannula lumen 282 can provide a working corridor or working channel through which other tools such as laparoscopic tools, surgical instruments, and / or scopes can be inserted, manipulated, and / or removed. Optionally, the movement of the cannula 260 and the tools can be operated or controlled by the robotic system described herein.

[0088] Optionally, the latch mechanism 230 of the closure 210 can be configured to couple the closure 210 to or release it from the cannula 260. In some embodiments, the latch mechanism 230 can extend from the proximal portion 220 of the closure 210 and releasably engage with other portions of the trocar assembly 200.

[0089] In some applications, the trocar assembly 200 can be configured to allow insufflation of a patient's cavity during a procedure to provide access to the patient's cavity while minimizing trauma to the patient. The sealing cartridge 240 can be configured to maintain insufflation within the patient's cavity after introduction of gas into the patient's cavity. The sealing cartridge 240 can be configured as, for example, a removable sub-assembly or a sealing pack that provides a gas-tight seal with the cannula 260. The sealing cartridge 240 can be coupled to the cannula 260 to seal isolate the cannula lumen 282 from the environment and maintain insufflation within the patient's cavity. During operation, the sealing cartridge 240 can maintain isolation of the patient's cavity while allowing tools, such as the closure 210, to pass through the passageway of the sealing cartridge 240. Further, the sealing cartridge 240 can sealingly engage the cannula funnel 262 to maintain insufflation of the patient's cavity. As shown, the sealing cartridge 240 can be disposed at the proximal portion of the cannula 260. For example, the sealing cartridge 240 can be at least partially disposed within the funnel portion 262 of the cannula.

[0090] In some applications, the sealing cartridge 240 can be removed from the cannula 260. Optionally, the sealing cartridge 240 and the cannula 260 can have different useful lifetimes, facilitated by the removable engagement of the sealing cartridge 240 with respect to the cannula 260. For example, the sealing cartridge 240 can be configured as a single-use disposable device (e.g., made of plastic), and the cannula 260 can be configured to be sterilized and reused (e.g., made of metal). As described herein, the latch mechanism 252 of the sealing cartridge 240 can be capable of coupling the sealing cartridge 240 to the cannula 260 or releasing it from the cannula 260. In some embodiments, the latch mechanism 252 can engage releasably with other parts of the trocar assembly 200.

[0091] According to some embodiments, the cannula 260 can be configured for use in robotic-assisted procedures. As described, the cannula 260 and the sealing cartridge 240 assembled therewith can be docked to a robotic manipulator. For example, the cannula 260 can be latched or otherwise attached to a robotic arm and / or instrument driver for coupling the cannula 260 to the robot after removal of the closure 210. Docking the cannula 260 to the robot can facilitate robotic manipulation of surgical tools through the cannula.

[0092] FIG. 23 shows an exemplary cannula docking arrangement within the robotic system 100. The arrangement shown in FIG. 23 utilizes a compact instrument driver architecture where the robotic driver is coupled to the cannula inline from the proximal end of the cannula.

[0093] As shown, the instrument driver 110 can have an accessory or cannula attachment interface 140 on a first side of the instrument driver 110 configured to attach to the cannula 160. The opposite side of the instrument driver 110 can have an instrument attachment interface 120 configured to couple to the medical instrument 130. The passageway 112 extends through the instrument driver 110 and permits insertion or retraction of the instrument shaft 132 through the passageway 112. The passageway 112 can be configured as a lumen extending through the instrument driver 110 having a diameter larger than, for example, the outer diameter of the instrument shaft 132. The passageway 112 permits the instrument shaft 132 to extend or retract through the passageway 112.

[0094] According to some embodiments, the instrument driver 110 can be configured to operate a mechanism within the instrument 130 to insert or retract the instrument shaft 132 through the passageway 112. For example, one or more drive outputs at the instrument attachment interface 120 of the instrument driver 110 can operate one or more inputs on the instrument base 134 of the instrument 130. Such inputs can be coupled to a pull wire, gears, screws, and / or other mechanisms to convert the rotational movement of the input into a translational movement of the instrument shaft 132, thereby driving the axial translation of the instrument shaft through the instrument driver 110.

[0095] As described herein, the cannula 160 can be configured as an access port to provide access to a patient's cavity for a medical procedure such as a laparoscopic procedure. To facilitate insertion of the instrument 130 through the cannula, the proximal 161 of the cannula 160 can be attached to the instrument driver 110, and the axis or working channel 192 of the cannula 160 is aligned with the passageway 112 of the instrument driver 110. The cannula attachment interface 140 can hold the cannula 160 with a latching mechanism that engages the cannula 160 directly or through a sterile barrier such as a sterile drape and / or a sterile adapter.

[0096] Before inserting a tool or instrument into a patient, the cannula 160 can be inserted and / or positioned within the patient's cavity. The robotic arm can be moved or positioned to enable the instrument driver 110 and the robotic arm to dock and attach to the cannula 160. After docking to the cannula 160, the cannula attachment interface 140 of the robotic arm can hold the cannula 160 to the robotic arm or the instrument driver 110. In some embodiments, the instrument driver 110 is configured to detect the cannula to facilitate docking, presence determination, and / or identification of the cannula using any suitable sensing arrangement.

[0097] FIG. 24 shows a cannula assembly 300 including a cannula 360 with the closure removed and a sealing cartridge 340. The cannula assembly 300 can be utilized with the trocar assembly 200 as described with respect to the robotic docking arrangement shown in FIGS. 21-22 and / or FIG. 23. The cannula 360 includes features that can facilitate a removable attachment of the sealing cartridge 340 to the cannula 360 without interfering with the robotic capabilities of the assembly. The cannula assembly 300 can avoid interference of the sealing cartridge 340 with a cannula latch on the instrument driver that engages the cannula 360 in a mechanically robust manner, for example. Alternatively or in combination, the sealing cartridge 340 can avoid interfering with a cannula detection sensor or pulling the proximal end of the cannula away from sensors that can be used in the instrument driver. Alternatively or in combination, the cannula assembly can facilitate attachment and / or removal of the sealing cartridge in a user-friendly manner.

[0098] Referring to FIG. 24, upon insertion, cannula 360 provides access to the patient's lumen. As shown, cannula 360 includes a shaft 380 extending from an upper portion or funnel 362 of the cannula 360. Shaft 380 defines a shaft lumen that provides internal access between an end 384 and the cannula funnel 362. As described herein, the end 384 of shaft 380 can be advanced into the patient's lumen to enable access to the patient's lumen via funnel 362.

[0099] During a surgical procedure, the shaft lumen allows a tool to access the patient's lumen. The shaft lumen can have a generally circular inner cross-sectional profile to enable rotation of the tool within the shaft lumen. The shaft lumen can have an inner diameter suitable to allow a tool to pass therethrough. Shaft 380 can also have a generally circular outer cross-sectional profile to enable rotation of cannula 360 relative to the patient's lumen.

[0100] Funnel portion 362 has an enlarged inner diameter that results in a narrower inner diameter defined by the lumen of cannula shaft 380. The enlarged geometry facilitates insertion of a tool and / or a seal cartridge into the proximal portion of cannula 360. For example, during insertion of a tool such as closure 210 and / or instrument 130, the geometry of funnel 362 can direct the tool shaft towards the shaft lumen. In some embodiments, funnel 362 can include a stepped shape. As shown, funnel 362 can include an upper funnel portion 363a and a lower funnel portion 363b. Lower funnel portion 363b can have a reduced diameter relative to upper funnel portion 363a. Optionally, funnel 362 can include a transition portion 363c between upper tapered portion 363a and lower tapered portion 363b.

[0101] The sealing cartridge 340 can be coupled to the cannula 360 via the funnel portion 362. The geometry of the funnel 362 can enable a device such as the sealing cartridge 340 to be disposed within the funnel 362 of the cannula 360. For example, as seen in FIG. 24, the sealing cartridge 340 can seat within the funnel portion 362 of the cannula 360 such that the sealing cartridge does not protrude substantially beyond the proximal end of the cannula 360.

[0102] As shown in FIG. 24, the funnel wall of the funnel 362 can extend beyond the sealing cartridge 340 when the sealing cartridge 340 seats within the funnel 362 and allows the sealing cartridge 340 to be recessed within the funnel 362. As can be appreciated, by recessing the sealing cartridge 340 within the cannula 360, the sealing cartridge 340 allows the proximal end of the cannula 360 to be securely attached and docked with other components such as the closure 210 and / or the robotic arm. Although shown in a recessed configuration, it is also contemplated that when in an assembled or coupled configuration, the proximal end of the sealing cartridge 340 can be substantially coplanar with the proximal end of the cannula 360. Further, it is also contemplated that the particular principles of the present disclosure can apply to embodiments where the sealing cartridge 340 protrudes proximally beyond the proximal end of the cannula funnel portion 362 when assembled with the cannula 360.

[0103] Fluids such as gas for insufflation can be introduced into the patient's cavity via the fluid port 365 of the cannula assembly 300. Some examples of gases that can be introduced through the fluid port 365 and used to inflate the abdominal cavity via insufflation include carbon dioxide and air. Alternatively, or in combination, the fluid port 365 can be configured to introduce or transfer other fluids such as saline, liquids, or other fluid media for irrigation, expansion of orthopedic joints, or expansion of other patient cavities. In some embodiments, the fluid port can be formed in the cannula. In the illustrated example, the fluid port 365 is formed in the sealing cartridge 340. As shown, the fluid port 365 is attached to the body of the sealing cartridge and extends from the body of the sealing cartridge 340. In some embodiments, the fluid port 365 extends radially from the body of the sealing cartridge 340. The fluid port 365 can be in fluid communication with the cannula lumen when the sealing cartridge and cannula are joined together in an assembled configuration. The fluid port 365 can be configured as a valve such as a stopcock that allows the flow through the port to be opened, closed, or otherwise controlled. In the illustrated example, the fluid port 365 includes a lever 366 that can be manually controlled by the user to open and close the port. The fluid port 365 is also shown with a connector interface 369 such as a luer fitting that allows a gas line or other fluid conduit to be connected to or removed from the cannula assembly 300 as needed.

[0104] The funnel 362 can include features to allow the sealing cartridge 340 to be held or otherwise coupled to the funnel 362. As shown, the sealing cartridge 340 includes a latch mechanism 330 that can engage features of the funnel portion 362 to secure the sealing cartridge 340 to the cannula 360. The latch mechanism 330 includes one or more release buttons 338 that can be operated to release the latch mechanism 330 and disengage the sealing cartridge from the cannula 360.

[0105] The cannula 360 includes features along a sidewall 391 that permit access to portions of the sealed cartridge through the sidewall. In some applications, the engagement or latching mechanism of the sealed cartridge 340 can be made accessible through one or more windows or voids 370 formed through the funnel wall. For example, the void 370 can be configured as a latch window that enables a user to actuate a release button 338 through the sidewall 391. In some embodiments, the funnel 362 can include two opposing latch windows 370 disposed radially across from each other to permit access to two opposing release buttons 338 of the sealed cartridge 340. As shown, the latch window 370 can be formed through the funnel wall of the upper funnel portion 363a. Optionally, the funnel 362 can include additional latch windows or voids at various spaced-apart locations along the cannula, such as at various angular orientations along the sidewall 391. The latch window 370 can accommodate any shape that can correspond to and permit access to portions of the latching mechanism, such as the release button 338. In some embodiments, the latch window 370 is larger or wider than the release button 338. The wider window, for example, still enables access to the release button 338 through the latch window when the sealed cartridge 340 is assembled in different rotational or angular orientations about the longitudinal axis of the cannula, while providing an acceptable range of rotational orientations in which the sealed cartridge 340 can be assembled into the cannula 360.

[0106] Alternatively, or in combination with the voids of the latching mechanism, the cannula 360 can include one or more voids 371 that permit the fluid port 365 of the sealed cartridge 340 to extend through the funnel wall. Advantageously, by permitting the fluid port 365 of the sealed cartridge 340 to extend through the funnel wall, the sealed cartridge 340 can be recessed within the funnel 362 while permitting access to the fluid port 365 for air delivery.

[0107] Figures 25A - 25D show the cannula assembly 300 of FIG. 24 between various states. Referring to FIGS. 25A - 25D, while inserting the sealing cartridge 340 into the cannula 360, the sealing cartridge 340 can be pivoted or tilted to allow the fluid port 365 to enter the window 370 before latching or otherwise engaging the sealing cartridge 340 within the cannula. For example, the sealing cartridge 340 can be pivoted or tilted within the funnel portion 362 of the cannula 360 in the sequence shown in FIGS. 25A - 25D. During removal of the sealing cartridge 340, the sealing cartridge 340 is disengaged by the actuation release button 338 and then can be pivoted to allow the fluid port 365 to pass through the window after the portion of the sealing cartridge 340 opposite is removed. For example, the sealing cartridge 340 can be pivoted or tilted away from the funnel portion 362 of the cannula 360 in the reverse of the sequence shown in FIGS. 25A - 25D.

[0108] FIGS. 26 and 27 show cross - sectional views of the cannula assembly 300. FIG. 26 is a cross - sectional view through the sealing latch mechanism 330. FIG. 27 is a cross - sectional view through the fluid port 365.

[0109] Referring to FIGS. 26 and 27, the sealing cartridge 340 can engage with the cannula 360 in a latching or other manner. In the illustrated example, the sealing cartridge 340 includes a latching mechanism 330 for holding or otherwise coupling the sealing cartridge 340 to the cannula 360. As shown, the latching mechanism 330 extends from the sealing cartridge 340 and engages the cannula 360 to hold the sealing cartridge 340 to the cannula 760. In the illustrated example, the latching mechanism 330 includes a latch hook 354 that extends from the latching mechanism 330. The latch hook 354 can engage a feature of the funnel 362, such as a catch feature 364. The catch feature 364 can have, for example, an inner projecting lip that extends radially inward within the funnel portion 362, as seen in FIG. 26. As shown, the latch hook 354 can engage the funnel at the transition portion 363c. The latch hook 354 also includes a lead-in surface at its distal end to facilitate engagement of the sealing cartridge 340, for example, by moving the sealing cartridge 340 distally until the latching mechanism engages by snap.

[0110] As seen in FIG. 27, the cannula funnel portion 360 can further include a ledge, lip, or stop member 390 that prevents the sealing cartridge from being pushed distally too far when the sealing cartridge contacts the stop member 390. In the illustrated example, the stop member 390 is also disposed at the transition portion 363c.

[0111] The release button 338 is accessible through the cannula sidewall 391 via a void 370 that extends through the sidewall. As seen in the example of FIG. 26, the latch mechanism can include a pair of opposing release buttons 338 on radially opposing sides of the cannula funnel portion 362, and the cannula funnel portion 362 can include a corresponding pair of voids to permit access to the release buttons 338. As will be appreciated, a clinician can depress the release button 338 to disengage the latch mechanism 330 from the cannula 360 and remove the seal cartridge 340. Optionally, the release button 338 can include a raised or grooved portion to facilitate engagement of the release button 338 by the clinician.

[0112] In some embodiments, the latch mechanism 330 is biased outwardly to extend and engage the cannula 360. Optionally, for example as seen in FIG. 26, the biasing member can be configured as a compliant tab or flexure integrated into the latch mechanism to bias the hook feature 354 radially outwardly relative to the cannula funnel portion. In the illustrated example, depressing the release button 338 drives movement of the latch from an outer or engaged position to an inner or disengaged position.

[0113] Although a particular form of the latch mechanism is shown, it will be understood that various modifications can be made to the latch mechanism. For example, although hook and catch engagement features are shown on the seal cartridge and cannula respectively, these features can be reversed, or the engagement features for securing the latch can take other forms or geometries. Additionally or alternatively, although a compliant flexure-based biasing mechanism is shown, a coil spring, magnet, or other type of biasing member can be used. Additionally or alternatively, although latch release is shown configured as a push button, it is contemplated that a slider or other type of touch point can provide a release mechanism for disengaging the seal cartridge from the funnel portion.

[0114] Tools such as closures can be disposed on the upper or proximal surface of the sealing cartridge 340. In the illustrated embodiment, the sealing cartridge 340 can include one or more latch slots 356 to enable the closure to couple with the sealing cartridge 340. In some embodiments, the latch mechanism of the closure can extend into the latch slot 356 to couple the closure with the sealing cartridge 340.

[0115] In the illustrated example, the sealing cartridge 340 enables a tool to extend into the shaft lumen of the cannula 360 while maintaining insufflation within the patient's cavity. In the illustrated example, the sealing cartridge 340 defines a central lumen 342 that enables a tool to pass through the sealing cartridge 340 and into the shaft lumen of the cannula 360.

[0116] As seen in FIGS. 26 and 27, the sealing cartridge 340 includes a sealing system for maintaining a gas seal within the lumen of the cannula. The sealing cartridge 340 includes an inner seal 343 disposed within the central lumen 342 to maintain insufflation into the patient's cavity. During operation, the inner seal 343 can prevent leakage of the gas flow through the central lumen 342. The inner seal 343 can conform around the shaft of a tool, such as a closure shaft, to prevent leakage of the gas flow when the tool passes through the sealing cartridge 340. As can be appreciated, the inner seal 343 can also seal the central lumen 342 in the absence of a tool passing through the central lumen 342. The inner seal 343 can be formed from an elastomer or other elastic material including, but not limited to, rubber, polymers, and the like. In some applications, the inner seal 343 can include an upper sealing portion 343a that seals the tool shaft when the tool is present, and a lower sealing portion 343b that provides a seal when the tool is absent. The lower sealing portion 343b can be implemented, for example, as a duckbill valve.

[0117] In some embodiments, the sealing cartridge 340 includes an outer sealing member 345 disposed around the outer surface of the sealing cartridge 340 to maintain air supply within the patient's cavity. During operation, the outer sealing member 345 can prevent leakage of the gas flow between the sealing cartridge 340 and the funnel 362 of the cannula 360. The outer sealing portion 345 can align with the funnel wall of the funnel 362 to prevent leakage of the gas flow. The outer sealing member 345 can be formed from an elastomer or other elastic material including, but not limited to, rubber, polymer, etc. In the illustrated example, the outer sealing member 345 is configured as an O-ring.

[0118] Figures 28-31 show various configurations of the voids that can be used in the cannula funnel portion to allow access to the features of the sealing cartridge.

[0119] Figure 28 shows a perspective view of a cannula 460 that can be utilized with the above-described sealing cartridge or trocar assembly. In the illustrated example, the fluid port window 471 includes features that further facilitate alignment of the sealing cartridge within the funnel.

[0120] As shown, the fluid port window 471 includes a notch 473 for receiving the fluid port of the sealing cartridge. Advantageously, the notch 473 can enable rotational alignment of the sealing cartridge with respect to the cannula 460. As shown, the notch 473 can be disposed at the lower edge of the fluid port window 471 to provide tactile feedback when the fluid port lands within the notch 473. In some embodiments, the sealing cartridge can further recess into the funnel 462 when the fluid port lands within the notch. During insertion, the notch 473 can prevent or resist rotation of the sealing cartridge out of alignment from the aligned position. The notch 473 can have a generally semi-circular profile for receiving the fluid port.

[0121] Additionally or alternatively, the notched fluid port window 471 can provide a visual indicator for a clinician to identify the fluid port window 471 relative to the other latch windows 470. Further, the clinician can orient the seal cartridge for insertion into the cannula 460 based on the position of the fluid port window 471. Advantageously, by enabling identification of the fluid port window 471, the seal cartridge can be installed rapidly.

[0122] FIG. 29 shows a perspective view of a cannula 560 that can be used with the seal cartridge or trocar assembly described above. In the illustrated example, the cannula 560 can be configured to receive the seal cartridge in a plurality of rotational orientations.

[0123] As shown, the funnel 562 includes a plurality of voids or windows 570 formed through the funnel wall to allow either the latch mechanism of the seal cartridge or a fluid port to extend through the funnel wall. In some embodiments, each window 570 can have the same dimensions and allow the latch mechanism or fluid port to extend through any of the windows. In some embodiments, the seal cartridge can be introduced and coupled to the cannula 560 in various rotational configurations. Optionally, the windows 570 are symmetrically disposed. In some embodiments, the windows 570 are larger than the latch mechanism of the seal cartridge and allow the seal cartridge to rotate within the funnel 562 while remaining engaged or otherwise axially retained.

[0124] In the illustrated example, each window 570 includes a notch 573 for receiving a fluid port of the sealing cartridge. As described herein, the notches 573 can enable rotational alignment of the sealing cartridge relative to the cannula 560 by aligning the fluid ports within their respective windows 570. Thus, the sealing cartridge can be inserted in various rotational orientations such that the fluid ports of the sealing cartridge extend through any of the windows 570, land within their respective notches 573, and allow alignment of the fluid ports, and thus the sealing cartridge, relative to the windows 570. In another example, each of the windows can be symmetrically arranged without a notch for each window. In the illustrated example, four windows are included to facilitate engagement with the sealing cartridge, and the sealing cartridge has fluid ports that are offset 90 degrees relative to a pair of opposing sealing latch buttons. Advantageously, by allowing various rotational orientations of the sealing cartridge relative to the cannula 560, the sealing cartridge can be installed more rapidly.

[0125] Figures 30 and 31 each show a perspective view of a cannula 660 that can be used with the above-described sealing cartridge or trocar assembly. FIG. 30 shows the cannula and sealing cartridge in an uncoupled configuration, and FIG. 31 shows the cannula 660 of FIG. 30 with the sealing cartridge coupled to the cannula. Referring to FIGS. 30 and 31, in some embodiments, the cannula 660 can include an axially extending slot 671 to allow the fluid port 665 of the sealing cartridge 640 to extend through the funnel wall. As shown, the slot 671 can extend from the proximal end of the funnel 662, distally from the brim 672, and through at least a portion of the funnel wall. The slot 671 can form a discontinuity in the circular profile of the brim 672 and the funnel wall. As can be appreciated, the slot 671 can index the sealing cartridge 640 in the rotational direction when the sealing cartridge 640 is inserted into the funnel 662 and rotated to align the sealing cartridge 640 with respect to the cannula 660. Advantageously, the sealing cartridge 640 can be inserted into the cannula 660 without pivoting or tilting.

[0126] Similar to the cannula 560, the cannula 660 can include a plurality of voids or windows 670 formed through the funnel wall, allowing the latch mechanism of the sealing cartridge 640 to extend through the funnel wall. As shown, the windows 670 can be disposed approximately 180 degrees apart from each other. Further, the windows 670 can be evenly spaced with respect to the slot 671 such that each window 670 is disposed approximately 90 degrees away from the slot 671. In some embodiments, the windows 670 can be arranged to allow various rotational arrangements of the sealing cartridge 640 with respect to the cannula 660.

[0127] From the foregoing examples, it will be appreciated that the present disclosure contemplates various features that can be used in a cannula assembly. In some embodiments, the cannula includes a funnel portion having a side wall, a tubular portion extending distally from the funnel portion, and one or more voids within the side wall of the funnel portion that permit access to a sealing cartridge through the side wall.

[0128] In some embodiments, the cannula includes a funnel portion having a side wall and a circumferential rim, a tubular portion extending distally from the funnel portion, and a cartridge slot formed in the funnel portion, the cartridge slot opening into a void in the side wall of the funnel portion and including a discontinuity in the rim of the funnel portion that permits access to a fluid port of a sealing cartridge through the side wall.

[0129] In some embodiments, a method of assembling a trocar assembly includes inserting a fluid port of a sealing cartridge through a void in a funnel portion of a cannula, the cannula funnel portion having a side wall and a tubular portion extending distally from the funnel portion, the void in the cannula funnel portion extending through the side wall of the funnel portion, and coupling the sealing cartridge to the cannula within the cannula funnel portion.

[0130] In some embodiments, the trocar assembly can be configured to enable a tool, such as a closure, to latch directly to the cannula. FIGS. 32-34 illustrate perspective views of a trocar 700 in an assembled state, a semi-assembled state, and a disassembled state, respectively. As can be appreciated, the trocar assembly 700 can include features similar to those of the trocar assembly 200. Thus, unless otherwise described, similar features can be referred to with similar reference numerals.

[0131] In the illustrated example, the latch mechanism 730 of the closure 710 can enable the closure 710 to be coupled to or released from the cannula 760. In some embodiments, the latch mechanism 730 can extend from an upper portion 720 of the closure 710 and releasably engage with other portions of the trocar assembly 700. In some embodiments, the latch mechanism 730 includes one or more release buttons 738 that can operate to release the latch mechanism 730 and disengage the closure from the cannula 760.

[0132] In the illustrated embodiment, the latch mechanism 730 can extend into a latch window 770 defined within the cannula 760 to couple the closure 710 to the cannula 760. The latch mechanism 730 of the closure 710 can be biased outwardly to hold the connection between the closure 710 and the cannula 760 or other portions of the trocar assembly 700.

[0133] In some applications, the trocar assembly 700 can enable insufflation of a patient's cavity during a procedure to provide access to the patient's cavity while minimizing trauma to the patient. In the illustrated example, gas can be introduced into the patient's cavity through a gas port 765 formed in the cannula 760, although the gas port 765 can alternatively be configured as part of a removable seal cartridge 740 as in the foregoing configurations of FIGS. 24-31. In some embodiments, the gas port 765 is in fluid communication with the cannula lumen 782.

[0134] The trocar assembly 700 can include a sealing cartridge 740 for maintaining insufflation within the patient's cavity after introduction of gas into the patient's cavity. The sealing cartridge 740 can be coupled to the cannula 760 to seal isolate the cannula lumen 782 from the environment and maintain insufflation within the patient's cavity. During operation, the sealing cartridge 740 can maintain isolation of the patient's cavity while allowing a tool, such as the closure 710, to pass through the passageway of the sealing cartridge 740. Further, the sealing cartridge 740 can sealingly engage the cannula funnel 762 to maintain insufflation of the patient's cavity. As shown, the sealing cartridge 740 can seat within the funnel portion 762 of the cannula 760. In some embodiments, the sealing cartridge 740 seats fully within the funnel portion 762 and does not extend beyond the funnel portion 762.

[0135] In some applications, the sealing cartridge 740 can be removed from the cannula 760. As described herein, the sealing cartridge 740 and the cannula 760 can have different useful lives facilitated by the removable engagement of the sealing cartridge 740 with respect to the cannula 760. For example, the sealing cartridge 740 can be configured as a single-use disposable device and the cannula 760 can be configured to be sterilized and reused. In some applications, when the sealing cartridge 740 is removed from the cannula 760, the insufflation gas is released from the patient's cavity. As can be appreciated, it is undesirable to unexpectedly or otherwise prematurely release the insufflation gas from the patient's cavity as loss of insufflation can increase patient trauma and reduce access within the patient's cavity.

[0136] As described herein, the latch mechanism 752 of the sealing cartridge 740 can be enabled to couple the sealing cartridge 740 to the cannula 760 or release it from the cannula 760. In some embodiments, the latch mechanism 752 can engage releasably with other parts of the trocar assembly 700. In the illustrated embodiment, the latch mechanism 752 extends from the body of the sealing cartridge 740 into a latch window 770 defined within the cannula 760 to couple the sealing cartridge 740 to the cannula 760. The latch mechanism 752 of the sealing cartridge 740 can be biased outwardly to hold the connection between the closure 710 and the sealing cartridge 740. In various embodiments, the closure 710 can be latched to the sealing cartridge 740.

[0137] In some embodiments, the latch mechanism 752 includes one or more release buttons 758 that can operate to release the latch mechanism 752 and disengage the sealing cartridge 740 from the cannula 760. Optionally, the release button 738 of the closure 710 can be rotationally aligned with the release button 758 of the sealing cartridge 740.

[0138] Advantageously, the trocar assembly 700 is configured to prevent inadvertent removal of the sealing cartridge 740 and prevent inadvertent loss of insufflation. In the illustrated example, when the closure 710 is coupled to the cannula 760, the sealing cartridge 740 is held between the upper portion of the closure 710 and the cannula funnel 762. Thus, the sealing cartridge 740 cannot be inadvertently removed from the cannula 760 prior to removal of the closure 710 from the cannula 760.

[0139] FIG. 35 is a perspective view of the cannula of the trocar assembly of FIG. 32. In the illustrated example, the geometry of the funnel 762 allows portions of tools such as the closure 710 and / or the sealing cartridge 740 to be disposed at least partially within the funnel 762 of the cannula 760. As can be appreciated, by disposing portions of the closure 710 and / or the sealing cartridge 740 within the funnel 762, the closure 710 and / or the sealing cartridge 740 can move with the cannula 760 and reduce the assembled size of the trocar assembly 700. In some embodiments, the closure 710 and / or the sealing cartridge 740 can be coupled to the cannula 760 via the funnel 762.

[0140] In some embodiments, the sealing cartridge 740 can be disposed within a portion of the lower tapered portion 763b and the upper tapered portion 763a of the funnel 762. As shown in FIG. 33, the funnel wall of the funnel 762 can extend beyond the sealing cartridge 740 when the sealing cartridge 740 seats within the funnel 762 and allows the sealing cartridge 740 to be recessed within the funnel 762. In some embodiments, the sealing cartridge 740 can extend beyond the funnel 762.

[0141] In some embodiments, the funnel 762 can include features to allow the sealing cartridge 740 to be held or otherwise coupled to the funnel 762. For example, in some applications, the engagement or latch mechanism of the sealing cartridge 740 can engage the transition portion 763c of the funnel 762 to axially hold the sealing cartridge 740 within the funnel 762. Optionally, the sealing cartridge 740 can engage a recess or protrusion of the transition portion 763c.

[0142] In some applications, the engagement or latching mechanism of the sealing cartridge 740 can engage with a latch window 770 formed through the funnel wall. For example, the latching mechanism of the sealing cartridge 740 can extend through the latch window 770 of the cannula 760 to hold the sealing cartridge 740 within the cannula 760. In some embodiments, the funnel 762 can include two latch windows 770 disposed radially across from each other. As shown, the latch window 770 can be formed through the funnel wall of the upper tapered portion 763a. Optionally, the funnel 762 can include additional latch windows 770 at various spacings. The latch window 770 can have a generally conical shape. As can be understood, the sealing cartridge 740 can engage with other portions of the cannula 760 and / or other components of the trocar assembly 700.

[0143] Furthermore, the upper portion or head portion 720 of the closure 710 can be disposed at least partially within the upper tapered portion 763a of the funnel 762. In some embodiments, the funnel 762 can include features to enable the closure 710 to be held or otherwise coupled to the funnel 762. For example, in some applications, the engagement or latching mechanism of the closure 710 can releasably engage with the brim 772 of the funnel 762 to axially hold the closure 710 relative to the cannula 760. The closure 710 can engage with the protruding portion of the brim 772. Optionally, the brim 772 can accommodate a recess 773 for corresponding to the features of the engagement or latching mechanism of the closure 710.

[0144] In some applications, the engagement or latching mechanism of the closure 710 can also engage a latch window 770 formed through the funnel wall. For example, the latching mechanism of the closure 710 can extend through the latch window 770 of the cannula 760 to hold the closure 710 against the cannula 760. Optionally, the brim 772 of the cannula 760 can define the edge or boundary of the latch window 770. As can be understood, the closure 710 can engage other portions of the cannula 760 and / or other components of the trocar assembly 700.

[0145] As described herein, the cannula 760 can enable insufflation of a patient's cavity. In the illustrated example, the cannula 760 includes a gas port 765 formed in the lower portion of the funnel 762 that allows gas to flow into the shaft lumen 782. In some embodiments, the gas port 765 is in fluid communication with the shaft lumen 782. The gas port 765 can be sealed or isolated from the upper portion of the funnel 762 by a sealing cartridge 740.

[0146] FIG. 36 shows a perspective view of another embodiment of a cannula for use with the trocar assembly of FIG. 32. Similar to the cannula 760, the cannula 760' allows the engagement or latching mechanism of the closure 710 to releasably engage the brim 772' of the funnel 762 to axially hold the closure 710 against the cannula 760'. In the illustrated example, the brim 772' can maintain a constant thickness or inner diameter across the circumference of the brim 772'.

[0147] FIG. 37 shows a perspective view of the sealing cartridge of the trocar assembly of FIG. 32. In the illustrated example, the sealing cartridge 740 allows a tool to pass through the shaft lumen 782 of the cannula 760 while maintaining insufflation within the patient's cavity.

[0148] In the illustrated example, the sealing cartridge 740 defines a central lumen 742 that allows a tool, such as the closure 710, to pass through the sealing cartridge 740 and into the shuttle lumen 782 of the cannula 760.

[0149] In some embodiments, the sealing cartridge 740 includes an inner sealing member 743 disposed within the central lumen 742 to maintain insufflation within the patient's cavity. During operation, the inner sealing member 743 can prevent leakage of the gas flow through the central lumen 742. The inner sealing member 743 can conform around the shaft of a tool, such as the closure shaft 712, to prevent leakage of the gas flow when the tool passes through the sealing cartridge 740. As can be appreciated, the inner sealing member 743 can also expand to seal the central lumen 742 in the absence of a tool passing through the central lumen 742. The inner sealing member 743 can be formed from an elastomer or other elastic material including, but not limited to, rubber, polymers, etc. In some applications, the inner sealing member 743 can be implemented as a duckbill valve.

[0150] In some embodiments, the sealing cartridge 740 includes an outer sealing member 745 disposed around the outer surface of the sealing cartridge 740 to maintain insufflation within the patient's cavity. During operation, the outer sealing member 745 can prevent leakage of the gas flow between the sealing cartridge 740 and the funnel 762 of the cannula 760. The outer sealing member 745 can conform to the funnel wall of the funnel 762 to prevent leakage of the gas flow. The outer sealing member 745 can be formed from an elastomer or other elastic material including, but not limited to, rubber, polymers, etc.

[0151] FIG. 38 shows a perspective view of the closure of the trocar assembly of FIG. 32.

[0152] In the illustrated example, the closure 710 can displace tissue to enable insertion of the trocar assembly 700 into the patient's body cavity. As shown, the closure 710 includes a shaft 712 that extends from an upper portion 720 of the closure 710. In some applications, the shaft 712 can extend beyond the end 784 of the cannula 760 when the closure 710 is coupled to the cannula 760. The shaft 712 can have a generally cylindrical shape that enables the closure 710 to rotate within the patient's body cavity.

[0153] The shaft 712 can include a tapered, angled, or otherwise pointed end or tip 714. During operation, by advancing the closure 710, the shaft 712 can pierce, displace, or otherwise incise the patient tissue to enable the closure 710 and the coupled cannula 760 to access the patient's body cavity.

[0154] Optionally, the upper portion 720 can be utilized by a clinician as a handle to generally apply force or otherwise advance the closure 710 and / or the trocar assembly 700. As shown, the upper portion 720 of the closure 710 can have a generally larger radius than the shaft 712 to enable the clinician to more easily apply force to the shaft 712. Further, the upper portion 720 can include a gripping portion or a planar surface to enable the clinician to advance the closure 710. In some embodiments, as described herein, the enlarged geometry of the upper portion 720 can hold the seal cartridge 740 within the cannula 760 when the closure 710 is also coupled to the cannula 760.

[0155] FIG. 39 shows a perspective view of the latch mechanism of the closure of the trocar assembly of FIG. 32 and the latch mechanism of the sealing cartridge. FIG. 40 shows a cross-sectional view of the trocar assembly of FIG. 32 with the latch mechanism of the closure shown in the engaged position. Referring to FIGS. 39 and 40, the sealing cartridge 740 and the closure 710 can be latched or otherwise engaged with the cannula 760.

[0156] In the illustrated example, the sealing cartridge 740 includes a latch mechanism 752 for holding or otherwise coupling the sealing cartridge 740 to the cannula 760. As shown, the latch mechanism 752 extends from the sealing cartridge 740 and engages the cannula 760 to hold the sealing cartridge 740 to the cannula 760. In some embodiments, the latch mechanism 752 includes a latch hook 754 that extends from the latch mechanism 752. The latch hook 754 can engage features of the funnel 762, such as a transition portion 763c, to engage the cannula 760.

[0157] The latch mechanism 750 can further include an extension portion 753. The extension portion 753 can engage features of the funnel 762. For example, the extension portion 753 can extend through a latch window 770 of the cannula 760. In some embodiments, the latch mechanism 752 includes a biasing member that biases the latch mechanism 752 outwardly to extend and engage the cannula 760. Optionally, the biasing member can be integrated with the latch mechanism.

[0158] As can be appreciated, the clinician can push down on the extension portion 753 to disengage the latch mechanism 752 from the cannula 760 and remove the sealing cartridge 740. Optionally, the extension portion 753 can include a raised portion or a grooved portion to enable the clinician to engage the latch mechanism 752. In some embodiments, a portion of the sealing cartridge 740 extends over the cannula funnel 762 and can engage or otherwise latch to the outer edge of the cannula brim 772 or other features of the cannula 760.

[0159] In the illustrated example, the closure 710 includes a latch mechanism 730 for holding or otherwise coupling the closure 710 to the cannula 760. As shown, the latch mechanism 730 extends from the closure 710 and engages the cannula 760 to hold the closure 710 to the cannula 760. In some embodiments, the latch mechanism 730 includes a latch hook 734 that extends from the latch mechanism 730. The latch hook 734 can engage a feature of the funnel 762, such as a brim 772, to engage the cannula 760.

[0160] The latch mechanism 730 can further include an extension portion 732. The extension portion 732 can engage a feature of the funnel 762. For example, the extension portion 732 can extend through a latch window 770 of the cannula 760. In some embodiments, the latch mechanism 730 includes a biasing member that biases the latch mechanism 730 outwardly to extend and engage the cannula 760. Optionally, the biasing member can be integrated with the latch mechanism.

[0161] As shown, the latch mechanism 730 of the closure 710 and the latch mechanism 752 of the seal cartridge 740 can be rotationally aligned. Here, the rotational alignment allows the window 770 to serve a dual purpose of not only providing access to the seal cartridge release button but also functioning as a feature of the cannula funnel 762 that can engage the latch hook 734 of the latch mechanism 730 of the closure 710. Thus, this avoids the need to manufacture additional latch features on the cannula funnel 762 for engagement of the latch mechanism 730 of the closure 710. In some embodiments, the latch mechanism 730 of the closure 710 and the latch mechanism 752 of the seal cartridge 740 can be rotationally spaced apart.

[0162] In some applications, since the closure 710 is latched directly to the cannula 760, the trocar assembly 700 can be configured to prevent inadvertent removal of the sealing cartridge 740 and prevent inadvertent loss of insufflation. In the illustrated example, when the closure 710 is coupled to the cannula 760, the upper portion 720 of the closure 710 holds the sealing cartridge 740 within the funnel 762 and prevents the sealing cartridge 740 from being removed from the cannula 760 before the closure 710 is removed from the cannula 760. As can be appreciated, the closure 710 can hold the sealing cartridge 740 within the funnel 762 if the latch mechanism 752 of the sealing cartridge 740 is inadvertently released. In some embodiments, portions of the closure 710 can extend over the cannula funnel 762 and engage or otherwise latch to the outer edge of the cannula brim 772 or other features of the cannula 760.

[0163] FIG. 41 shows a cross-sectional view of the trocar assembly of FIG. 32 with the latch mechanism of the closure shown in the disengaged position. Referring to FIG. 41, a clinician can depress the extension portion 732 of the latch mechanism 730 to disengage the latch mechanism 730 from the cannula 760 and remove the closure 710. Optionally, the extension portion 732 can include a raised portion or a grooved portion to enable a clinician to engage the latch mechanism 730. When the closure 710 is released from the cannula 760, the clinician can depress the extension portion 753 to disengage the latch mechanism 752 from the cannula 760 and remove the sealing cartridge 740. Optionally, the sealing cartridge 740 and the closure 710 are removed from the cannula 760.

[0164] Figure 42 shows a perspective view of the trocar assembly 800. Figure 43 is a cross-sectional view of the trocar assembly 800 of Figure 42. The trocar assemblies of Figures 42 and 43 can include features similar to those of the trocar assembly 200. Similar features of the trocar assembly 800 are referenced with similar reference numbers. As described herein, the latch mechanism 852 of the sealing cartridge 840 can be capable of coupling the sealing cartridge 840 to the cannula 860 or releasing it from the cannula 860. In some embodiments, the latch mechanism 852 can engage releasably with other parts of the trocar assembly 800. In the illustrated embodiment, the latch mechanism 852 extends from the body of the sealing cartridge 840 into a latch window 870 defined within the cannula 860 to couple the sealing cartridge 840 to the cannula 860. In some embodiments, the latch mechanism 852 includes a latch hook 854 extending from the latch mechanism 852. The latch hook 854 can engage with features of the funnel 862, such as a transition portion 863c, to engage with the cannula 860.

[0165] The latch mechanism 852 can further include an extension portion 853. The extension portion 853 can engage with features of the funnel 862. In the illustrated example, the extension portion 853 is movable between an extended or engaged position and a retracted or disengaged position.

[0166] Figure 44 is a detailed cross-sectional view of the trocar assembly 800 of Figure 42 with the latch mechanism 852 in a free state. Figure 45 is a detailed cross-sectional view of the trocar assembly 800 of Figure 42 with the latch mechanism 852 in a depressed state. In the free or extended position, the extension portion 853 can extend through the latch window 870 of the cannula 860. In some embodiments, the latch mechanism 852 includes a biasing member that biases the latch mechanism 852 outwardly to extend and engage with the cannula 860. Optionally, the biasing member can be integrated with the latch mechanism.

[0167] In the retracted position or the depressed position, the extension portion 853 can be retracted or spaced apart from the latch window 870 of the cannula 860. As can be understood, the clinician can depress the extension portion 853 to disengage the latching mechanism 852 from the cannula 860 and remove the sealing cartridge 840. Optionally, the extension portion 853 can include a raised portion or a grooved portion to enable the clinician to engage the latching mechanism 852.

[0168] As shown, during operation, the extension portion 853 of the latching mechanism 852 can be constrained to rotate or pivot between an extended position and a retracted position. In some embodiments, the extension portion 853 can rotate inwardly or upwardly from the extended position to the retracted position. As shown, the upper portion 855 of the extension portion 853 can rotate upwardly as the extension portion 853 moves from the extended position to the retracted position.

[0169] Similar to other embodiments, a tool such as a closure can be disposed on the upper or proximal surface of the sealing cartridge 840. In the illustrated embodiment, the sealing cartridge 840 can include one or more latch slots 856 to enable the closure to couple with the sealing cartridge 840. In some embodiments, the latching mechanism of the closure can extend into the latch slot 856 to couple the closure or other tool with the sealing cartridge 840.

[0170] Advantageously, the sealing cartridge 840 is configured to prevent inadvertent removal of the sealing cartridge 840 during removal of the closure or other tool and to prevent inadvertent loss of air supply. In the illustrated example, when the closure or another tool is coupled to the sealing cartridge 840, the latching mechanism 852 of the sealing cartridge 840 can prevent the sealing cartridge 840 from being removed from the cannula 860. Thus, the sealing cartridge 840 cannot be inadvertently removed from the cannula 860 prior to removal of the closure from the cannula 860.

[0171] In the illustrated example, the sealing cartridge 860 can prevent the latch mechanism 852 from being depressed or otherwise actuated before removing the closure or other tool from the sealing cartridge 840. As shown, when the closure is coupled to the sealing cartridge 840, the inner surface of the closure prevents the extension 853 of the latch mechanism 852 from rotating upward, impedes the extension 853 from moving to the retracted position, and prevents the latch mechanism 852 from releasing the sealing cartridge 840.

[0172] As can be appreciated, when the closure is released from the sealing cartridge 840, the clinician can depress the extension 853 to disengage the latch mechanism 852 from the cannula 860 and remove the sealing cartridge 840.

[0173] 3. Implementation System and Terms The implementations disclosed herein provide a system, method, and apparatus for operably coupling a closure and a cannula.

[0174] Note that as used herein, the terms "coupling," "coupled," "coupled to," or other variations of the word "coupling" may indicate either an indirect connection or a direct connection. For example, if a first component is "coupled to" a second component, the first component may be indirectly connected to the second component via another component or directly connected to the second component.

[0175] The methods disclosed herein include one or more steps or acts for achieving the described methods. The method steps and / or acts may be exchanged without departing from the scope of the claims. In other words, the order and / or use of specific steps and / or acts may be modified without departing from the scope of the claims, provided that a particular order of steps or acts is not required for the proper operation of the described method.

[0176] As used herein, the term "plurality" means two or more. For example, a plurality of components means two or more components. The term "determine" encompasses a wide variety of acts, and thus "determine" can include calculate, compute, process, calculate, investigate, look up (e.g., look at a table, database, or other data structure), confirm, etc. Also, "determine" can include receive (e.g., receive information), access (e.g., access data in a memory), etc. Also, "determine" can include solve, select, pick out, establish, etc.

[0177] The phrase "based on" does not mean "based only on" unless explicitly specified otherwise. In other words, the phrase "based on" encompasses both "based only on" and "based at least on".

[0178] The foregoing description of the disclosed implementations is provided to enable any person skilled in the art to make or use the present invention. Various modifications to these implementations will be readily apparent to those skilled in the art, and the general principles defined herein may be applied to other implementations without departing from the scope of the present invention. For example, those skilled in the art will understand that many corresponding alternative and equivalent structural details, such as equivalent ways of fastening, attaching, coupling, or engaging tool components, equivalent mechanisms for producing a particular operating motion, and equivalent mechanisms for delivering electrical energy, can be employed. Accordingly, the present invention is not intended to be limited to the implementations shown herein, but rather is to be accorded the widest scope consistent with the principles and novel features disclosed herein.

[0179] 〔Embodiments〕 (1) A trocar assembly, a cannula, A sealing cartridge, releasably coupled to the cannula, configured to be disposed at least partially within the cannula in the coupling configuration of the sealing cartridge, and a sealing cartridge. A closure, directly latched to the cannula in the coupling configuration of the closure, and configured to extend through the cannula and the sealing cartridge, and a trocar assembly including the closure. (2) The trocar assembly according to Embodiment 1, wherein the closure is configured to directly latch to the brim of the cannula in the coupling configuration of the closure. (3) The trocar assembly according to Embodiment 1 or 2, wherein the closure is configured to directly latch to the inner surface of the cannula in the coupling configuration of the closure. (4) The trocar assembly according to Embodiment 1 or 2, wherein the closure is configured to directly latch to the outer surface of the cannula in the coupling configuration of the closure. (5) The trocar assembly according to any one of Embodiments 1 to 4, wherein the sealing cartridge is configured to directly latch to the cannula in the coupling configuration of the sealing cartridge and form a seal with the cannula.

[0180] (6) The trocar assembly according to any one of Embodiments 1 to 5, wherein the closure obstructs removal of the sealing cartridge from the cannula in the coupling configuration of the closure. (7) The trocar assembly according to any one of Embodiments 1 to 6, wherein the closure includes a release button that is rotationally aligned with the release button of the sealing cartridge in the coupling configuration of the closure. (8) The trocar assembly according to any one of Embodiments 1 to 6, wherein the closure includes a release button that is rotationally offset from the release button of the sealing cartridge in the coupling configuration of the closure. (9) The trocar assembly according to any one of embodiments 1 to 8, wherein the cannula includes a first window in the coupling configuration of the sealing cartridge that permits access to a release button of the sealing cartridge through a sidewall of the cannula. (10) The trocar assembly according to embodiment 9, wherein the closure is configured to latch to the first window in the coupling configuration of the closure.

[0181] (11) The trocar assembly according to embodiment 9, wherein the cannula includes a second window disposed approximately 180 degrees away from the first window. (12) The trocar assembly according to embodiment 11, wherein the cannula includes a slot in the coupling configuration of the sealing cartridge that permits access to a fluid port of the sealing cartridge through the sidewall of the cannula. (13) The trocar assembly according to embodiment 12, wherein the first window and the second window are each disposed approximately 90 degrees from the slot. (14) The cannula includes a funnel portion and a tubular portion extending distally from the funnel portion, the closure includes a head portion, a shaft portion extending distally from the head portion, and a tip at a distal end of the shaft portion, the head portion of the closure engages the funnel portion of the cannula in the coupling configuration of the closure, the shaft portion of the closure extends through the tubular portion of the cannula in the coupling configuration of the closure, the tip at the distal end of the shaft portion extends distally beyond a distal end of the cannula in the coupling configuration of the closure, the trocar assembly according to any one of embodiments 1 to 13. (15) A trocar assembly, a cannula, a funnel portion, A cannula including a lower cannula portion extending from the funnel portion and defining a cannula lumen. A sealing cartridge configured to releasably engage the funnel portion of the cannula. A closure, In a coupled configuration, an upper closure portion configured to couple to the funnel portion of the cannula. A shaft portion extending from the upper closure portion, the shaft portion being configured to extend through the cannula lumen and the sealing cartridge in the coupled configuration. A closure including a latch member movable to engage the funnel portion to hold the cannula and the closure in the coupled configuration. A trocar assembly comprising the closure.

[0182] (16) The trocar assembly according to embodiment 15, wherein the funnel portion includes a side wall and a brim disposed at an upper edge of the side wall, and the latch member of the closure is movable to engage the brim of the cannula in the coupled configuration. (17) The trocar assembly according to embodiment 15 or 16, wherein the funnel portion defines a latch window through the side wall, and the latch member of the closure is movable to engage an edge of the latch window in the coupled configuration. (18) The trocar assembly according to any one of embodiments 15 to 17, further comprising a gas port configured to be in fluid communication with the cannula lumen. (19) The trocar assembly according to any one of embodiments 15 to 18, wherein the latch member includes a biasing member configured to bias the latch member through at least one latch window of the funnel portion of the cannula. (20) The seal cartridge includes an outer seal portion configured to seal against the funnel portion of the cannula and an inner seal portion configured to seal against the shaft portion of the closure, the trocar assembly according to any one of embodiments 15-19.

[0183] (21) The seal cartridge includes a seal cartridge latch member that extends through the at least one latch window and is movable to hold the seal cartridge and the cannula in a sealed configuration separated from the closure, the trocar assembly according to embodiment 15. (22) The seal cartridge latch member includes a biasing member configured to bias the seal cartridge latch member through the at least one latch window, the trocar assembly according to embodiment 21. (23) The seal cartridge latch member and the latch member of the closure are rotationally aligned, the trocar assembly according to embodiment 21. (24) A method of operating a surgical device, disengaging the closure from the funnel portion of the cannula, removing the shaft portion of the closure from the cannula lumen of the cannula, disengaging the seal cartridge from the funnel portion of the cannula, removing the seal cartridge from the funnel portion after removing the shaft portion of the closure from the cannula lumen, the method comprising. (25) inserting the shaft portion of the closure into the cannula lumen of the cannula, further comprising engaging at least one latch window defined in the funnel portion of the cannula with a closure latch member of the closure, the method according to embodiment 24.

[0184] The method according to embodiment 24 or 25, further comprising engaging a closure latch member with the brim of the cannula. (27) The method according to any one of embodiments 24 to 26, further comprising providing a positive pressure into the cannula lumen via a gas port. (28) The method according to any one of embodiments 24 to 27, further comprising maintaining a positive pressure within the cannula lumen via a sealing portion of a sealing cartridge. (29) The method according to any one of embodiments 24 to 28, further comprising preventing removal of the sealing cartridge prior to disengaging the closure. (30) A cannula, comprising: a funnel portion having a sidewall and configured to receive a removable sealing cartridge; a tubular portion extending distally from the funnel portion; a first void allowing access to a fluid port of the sealing cartridge through the sidewall; a second void allowing access to a latch release button of the sealing cartridge through the sidewall.

[0185] (31) The cannula according to embodiment 30, wherein the first void includes a slot extending through a proximal end of the sidewall. (32) The cannula according to embodiment 30, wherein the first void includes a hole surrounded by the sidewall. (33) The cannula according to embodiment 32, wherein the hole includes a notch that guides alignment of the sealing cartridge relative to the cannula funnel portion by rotation about a longitudinal axis of the cannula. (34) The cannula according to any one of embodiments 30 to 33, wherein the first void and the second void are spaced apart at different angular positions along the sidewall. (35) The cannula according to embodiment 34, further comprising a third void spaced apart from the first void and the second void at different angular positions along the sidewall.

[0186] (36) The first gap and the third gap are opposing gaps spaced at an angular position along the side wall, and the opposing gaps allow access to opposing latch release buttons of the sealing cartridge, the cannula according to embodiment 35. (37) The cannula according to embodiment 35, further comprising a fourth gap spaced at a different angular position along the side wall from the first gap, the second gap, and the third gap. (38) The cannula according to any one of embodiments 30 - 37, wherein the funnel portion includes a stop that impedes distal movement of the sealing cartridge received within the cannula. (39) The cannula according to any one of embodiments 30 - 38, wherein the funnel portion includes a catch that engages a latch of the sealing cartridge. (40) The cannula according to any one of embodiments 30 - 39, wherein when the sealing cartridge is received within the funnel portion, a proximal end of the sealing cartridge does not extend proximally beyond a proximal end of the funnel portion.

[0187] (41) A cannula, a funnel portion having a side wall and a circumferential rim, a cannula shaft extending distally from the funnel portion and defining a lumen for inserting a surgical tool, a cartridge slot formed in the funnel portion, including a discontinuity in the rim of the funnel portion, opening to a gap in the side wall of the funnel portion and allowing access to a fluid port of a sealing cartridge through the side wall, a latch window formed in the funnel portion, allowing access to release a latch of the sealing cartridge through the side wall, the cannula comprising the latch window. (42) The cannula according to embodiment 41, wherein the cartridge slot extends longitudinally from the rim adjacent to the latch window. (43) The cannula according to embodiment 41 or 42, wherein the latch window is a first latch window, and the cannula further includes a second latch window facing the first latch window. (44) The cannula according to any one of embodiments 41 to 43, wherein the funnel portion includes an inner stop member that obstructs distal movement of the sealing cartridge when the sealing cartridge is received within the funnel portion. (45) The cannula according to any one of embodiments 41 to 44, further including an inner protruding lip formed on the funnel portion, the inner protruding lip being configured to engage a hook.

[0188] (46) The cannula according to any one of embodiments 41 to 45, wherein the funnel portion is sized and shaped to hold the sealing cartridge such that the sealing cartridge does not extend proximally beyond the proximal end of the funnel portion. (47) A method of assembling a trocar assembly, inserting a fluid port of a sealing cartridge through a void in a sidewall of a funnel portion of a cannula, coupling the sealing cartridge to the cannula within the funnel portion, actuating a latch through the sidewall of the funnel portion to disengage the sealing cartridge from the funnel portion. (48) The method according to embodiment 47, wherein the inserting includes tilting a longitudinal axis of the sealing cartridge relative to a longitudinal axis of the cannula to pass the fluid port through the void. (49) The method according to embodiment 48, wherein the cannula funnel portion includes a continuous circumferential rim extending around an entirety of the cannula funnel portion. (50) The cannula funnel portion includes a circumferential rim and a cartridge slot formed in the funnel portion as a discontinuity of the rim of the funnel portion, the cartridge slot opening into the void in the side wall of the funnel portion to enable insertion of the fluid port into the void, the inserting including aligning the longitudinal axis of the sealing cartridge with the longitudinal axis of the cannula while inserting the fluid port into the void, the method according to embodiment 47.

[0189] (51) The method according to embodiment 47, wherein the coupling includes rotationally aligning the sealing cartridge with the cannula funnel portion. (52) The method according to embodiment 51, wherein the cannula funnel portion includes a notch for guiding the rotational alignment of the sealing cartridge. (53) The cannula funnel portion includes two opposing voids spaced at opposing angular positions along the side wall, the coupling including aligning two opposing latch release buttons of the sealing cartridge with the two opposing voids, the method according to embodiment 47.

Claims

1. A trocar assembly comprising: a cannula; a sealing cartridge releasably coupled to the cannula and configured to be at least partially disposed within the cannula in the coupling configuration of the sealing cartridge; a closure member configured to directly latch to the cannula in the coupling configuration of the closure member and extend through the cannula and the sealing cartridge; The trocar assembly, wherein the cannula includes a first window in the coupling configuration of the sealing cartridge that permits access to a release button of the sealing cartridge through a sidewall of the cannula.

2. The trocar assembly according to claim 1, wherein the closure member is configured to directly latch to a brim of the cannula in the coupling configuration of the closure member.

3. The trocar assembly according to claim 1 or 2, wherein the sealing cartridge is configured to directly latch to the cannula in the coupling configuration of the sealing cartridge and form a seal with the cannula.

4. The trocar assembly according to claim 1, wherein the closure member is configured to latch to the first window in the coupling configuration of the closure member.

5. The cannula includes a second window disposed approximately 180 degrees away from the first window, and optionally, the cannula includes a slot that permits access to a fluid port of the sealing cartridge through the sidewall of the cannula in the coupling configuration of the sealing cartridge, and further optionally, the first window and the second window are each disposed approximately 90 degrees from the slot. The trocar assembly according to claim 1.

6. The cannula includes a funnel portion and a tubular portion extending distally from the funnel portion. The closure member includes a head portion, a shaft portion extending distally from the head portion, and a tip at a distal end of the shaft portion. The head portion of the closure member engages the funnel portion of the cannula in the coupling configuration of the closure member. The shaft portion of the closure member extends through the tubular portion of the cannula in the coupling configuration of the closure member. ​ The trocar assembly according to claim 1, wherein the tip at the distal end of the shaft portion extends distally beyond the distal end of the cannula in the coupling configuration of the closure.

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