Robotic manipulation of surgical tool handles

Abstract

An adapter for coupling a proximal portion of an elongated surgical tool to a motor-driven robotic surgical device, the adapter including: a recess shaped and sized to receive the proximal portion of the elongated surgical tool; one or more moving bodies arranged to contact and move control components of the proximal portion; and a transmission coupling that couples the one or more moving bodies to the motor-driven transmission of the robotic surgical device.

Description

[Technical Field]

[0001] Related Applications This application claims the benefit of priority to U.S. Provisional Application No. 62 / 941,842, filed November 28, 2019, and U.S. Provisional Application No. 63 / 082,508, filed September 24, 2020, the contents of which are incorporated herein by reference in their entireties.

[0002] This application is also related to a co-filed, co-pending, and co-assigned PCT application entitled "DEVICE FOR AUTOMATICALLY INSERTING AND ADVANCING A MEDICAL TOOL INTO A BODILY LUMEN" (Attorney Docket No. 83976), and a PCT application entitled "MODULAR ROBOTIC SYSTEM FOR DRIVING MOVEMENT OF SURGICAL TOOLS" (Attorney Docket No. 84910), the contents of which are incorporated herein by reference in their entireties. [Background technology]

[0003] The present invention, in some embodiments thereof, relates to motorized actuation of surgical tools, and more particularly, but not exclusively, to motorized actuation of proximal handle portions of elongated endoluminal tools.

[0004] US Patent No. US10543047 discloses that "a robotic instrument driver for an elongated member includes a first elongated member, at least one manipulator mechanism configured to manipulate the first elongated member, and at least one articulating drive configured to articulate the first elongated member, and is positionable near a bed and a patient access location. The manipulator and articulating drive are positioned relative to each other at a distance less than the insertable length of the first elongated member and are fixed in position." Summary of the Invention

[0005] According to some embodiments there is provided an adapter for coupling a proximal portion of an elongated surgical tool to a motorized robotic surgical device, the adapter comprising: a recess shaped and sized to receive a proximal portion of an elongated surgical tool; one or more movers arranged to contact and move the control component of the proximal portion; a transmission coupling for coupling one or more moving bodies to a motor-driven transmission of the robotic surgical device; Includes:

[0006] In some embodiments, the contour of the recess matches at least a portion of the outer contour of the proximal portion of the tool, and the recess is sized to allow axial rotation of the proximal portion and to restrict lateral movement of the proximal portion when the proximal portion is within the recess.

[0007] In some embodiments, each of the one or more movers is independently actuated via a transmission coupling.

[0008] In some embodiments, the adapter includes a housing having a recess defined therein and including one or more movers and a transmission coupling.

[0009] In some embodiments, at least an inner portion of the adapter in which the recess is defined is configured to rotate with a proximal portion of the tool.

[0010] In some embodiments, the mover or movers include an indentation formed in the recess, the indentation shaped and sized to attach to a control component in a proximal portion of the tool.

[0011] In some embodiments, the transmission coupling is configured radially outwardly relative to the recess.

[0012] In some embodiments, the proximal portion comprises a handle and the control component affects at least a distal portion of the elongate surgical tool when moved.

[0013] In some embodiments, at least a portion of the housing is configured to slide linearly relative to the body of the handle along at least a portion of the length of the body.

[0014] In some embodiments, the control component is from the group of: axial slider, lock, rotatable knob.

[0015] In some embodiments, the transmission coupling comprises an attachment to a lead screw, pin, or rod that is driven by a motor-driven transmission of the robotic device.

[0016] In some embodiments, the housing contains one or more motors that actuate one or more moving bodies.

[0017] In some embodiments, the housing is configured to rotate as a single unit about the longitudinal axis of the recess.

[0018] In some embodiments, the recess and one or more movers are configured to rotate while the transmission coupling remains stationary.

[0019] In some embodiments, the housing includes a mechanical and / or electrical connection positioned and configured to attach to the housing of the robotic surgical device.

[0020] In some embodiments, the adapter includes a clutch that decouples one or more moving bodies from the transmission coupling.

[0021] In some embodiments, the adapter includes at least one sensor configured to indicate the relative position of the one or more moving bodies.

[0022] In some embodiments, the at least one sensor includes an optical encoder.

[0023] According to an aspect of some embodiments there is provided an assembly including an adapter, eg, as described herein, and an elongated surgical tool including a proximal portion engaged by the adapter.

[0024] In some embodiments, the proximal portion is removably received within a recess in the adapter.

[0025] In some embodiments, the elongate surgical tool comprises a guidewire.

[0026] In some embodiments, the elongated surgical tool comprises a microcatheter.

[0027] According to an aspect of some embodiments there is provided a method of operatively coupling a proximal manipulator of an elongated surgical tool to a motorized robotic surgical device, comprising: providing a robotic surgical device for controlling and navigating at least one elongated surgical tool; providing an adapter configured for coupling between a control component of a proximal manipulator of an elongated surgical tool and a motor-driven transmission of a robotic surgical device; Aligning a control component of the manipulator with respect to the adapter; and coupling the adapter to a motor-driven transmission of the robotic surgical device.

[0028] In some embodiments, the method includes using the adapter to actuate a motor-driven transmission of the robotic surgical device to move a control component of the proximal manipulator, the control component generating at least one of a roll of the elongate surgical tool, a deflection of a distal portion of the elongate surgical tool, and a change in stiffness and / or size characteristics of the distal portion of the elongate surgical tool.

[0029] In some embodiments, the moving includes one or more of sliding a slider component of the manipulator, rotating a rotation component of the manipulator, and rotating the handle as a single unit.

[0030] In some embodiments, the method includes selecting from among a plurality of available adapters an adapter that matches the geometry and functionality of a particular manipulator of a tool selected for use.

[0031] In some embodiments, the manipulator includes a proximal handle of the tool.

[0032] According to an aspect of some embodiments, a robotic device configured for manipulation of at least one surgical tool, the robotic device comprising one or more motors for actuating movement of the at least one elongated surgical tool; 1. An adapter configured for operative attachment to a robotic device, comprising: a first member shaped and configured to transmit movement actuated by one or more motors of a robotic device; a second member shaped and configured to receive or be attached to at least a portion of a proximal portion of an elongated surgical tool; Including, and an adapter, wherein movement of one or both of the first and second members driven by one or more motors of the robotic device produces movement of at least a portion of the proximal portion engaged by the adapter.

[0033] In some embodiments, the robotic device includes a controller configured to control movement of the first member and the second member of the adapter to affect at least a distal portion of the elongated surgical tool.

[0034] In some embodiments, the system further includes a remote interface for controlling the controller.

[0035] In some embodiments, the adapter includes multiple movers that move components of the proximal portion, the movers being driven by one or more motors of the robotic device.

[0036] In some embodiments, the mover includes a mount that is mounted on a slide component of the proximal portion of the tool, one of the gears arranged to rotate a rotatable component of the proximal portion of the tool.

[0037] According to some embodiments there is provided an adapter for coupling a proximal handle of an elongated surgical tool to a motorized robotic surgical device, the adapter comprising: a first geometry shaped and sized to engage a motor or motor transmission of a robotic surgical device; a second geometry shaped and sized to engage at least a portion of a proximal handle of an elongated surgical tool; The first geometry and the second geometry interact with one another such that movement of one of the geometries produces movement of the other geometry or at least a portion of the proximal handle engaged by the adapter.

[0038] In some embodiments, the first geometry and the second geometry are coaxial, and the first geometry is located around the second geometry.

[0039] In some embodiments, the second geometry defines at least one recess having a contour that matches at least a portion of an exterior contour of the proximal handle engaged by the adapter.

[0040] In some embodiments, the recess surrounds at least a portion of the body of the proximal handle and is sized to snugly engage at least one component of the proximal handle integrally attached to the body of the proximal handle.

[0041] In some embodiments, the recess is shaped and sized to slide linearly relative to the body of the handle along at least a portion of the length of the body.

[0042] In some embodiments, the second geometry includes at least one recess for receiving a motor transmission element of a surgical device, the motor transmission element including a lead screw, pin, or rod driven by a motor or motor transmission of the robotic device.

[0043] In some embodiments, at least one of the first geometry and the second geometry is configured to rotate about a common axis of the first geometry and the second geometry.

[0044] In some embodiments, at least one of the first geometry and the second geometry is configured to slide axially.

[0045] In some embodiments, the first geometry and the second geometry are coupled to one another such that movement of one of the geometries produces a similar movement of the other geometry.

[0046] In some embodiments, the connection between the geometries comprises an interference fit coupling.

[0047] In some embodiments, a connection between geometries includes at least partial inclusion of one of the geometries by the other geometry.

[0048] In some embodiments, the first geometry and the second geometry are formed as opposing surfaces of a single integral unit.

[0049] In some embodiments, the adapter includes a housing that includes the first geometry and the second geometry, the housing configured to rotate as a single unit about a longitudinal axis of the adapter housing.

[0050] In some embodiments, the housing includes a mechanical and / or electrical connection positioned and configured to attach to the housing of the robotic surgical device.

[0051] Unless otherwise defined, all technical and / or scientific terms used herein have the same meaning as commonly understood by those skilled in the art to which this invention belongs. Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of embodiments of the present invention, exemplary methods and materials are described below. In case of conflict, the patent specification, including definitions, will prevail. In addition, the materials, methods, and examples are illustrative only and are not intended to be necessarily limiting.

[0052] Implementation of the method and / or system of embodiments of the present invention may involve performing or completing selected tasks manually, automatically, or a combination thereof. Furthermore, depending on the actual equipment and implementation of the method and / or system embodiments of the present invention, some selected tasks may be implemented by hardware, software, firmware, or a combination thereof using an operating system.

[0053] For example, hardware for performing selected tasks according to embodiments of the present invention may be implemented as a chip or circuit. As software, selected tasks according to embodiments of the present invention may be implemented as a plurality of software instructions executed by a computer using any suitable operating system. In exemplary embodiments of the present invention, one or more tasks according to exemplary embodiments of the methods and / or systems described herein are performed by a data processor, such as a computing platform for executing a plurality of instructions. Optionally, the data processor includes volatile memory for storing instructions and / or data, and / or non-volatile storage, e.g., a magnetic hard disk and / or removable media, for storing instructions and / or data. Optionally, a network connection is also provided. Optionally, a display and / or user input devices, such as a keyboard and / or mouse, are also provided.

[0054] Some embodiments of the invention are described herein, by way of example only, with reference to the accompanying drawings. Referring now in detail to the drawings, it is emphasized that the details shown are by way of example and are for the purpose of illustrating embodiments of the invention. In this regard, the description taken together with the drawings will make apparent to those skilled in the art how embodiments of the invention may be practiced. [Brief explanation of the drawings]

[0055] [Figure 1A] FIG. 10 is a schematic diagram of a mechanism for coupling a handle of an elongated surgical tool to a surgical robotic device and manipulating the handle via the robotic device to affect a distal portion of the elongated surgical tool, according to some embodiments. [Figure 1B] 1 is a schematic diagram of an adapter for coupling a handle of an elongated surgical tool to a motorized actuation, according to some embodiments. [Figure 2]1 is a flowchart of a general method for operably coupling a handle of an elongated surgical tool to a surgical robotic device, according to some embodiments. [Figure 3] FIG. 1 is a block diagram of a surgical robotic system configured to engage and control a proximal portion (e.g., a handle) of an elongated surgical tool, according to some embodiments. [Figure 4] 1A-B are isometric and side views of a robotic surgical system positioned relative to a patient, according to some embodiments. [Figure 5] 8A-8B are cross-sectional views of an adapter for coupling a proximal handle of an elongated surgical tool to a surgical robotic device, according to some embodiments. [Figure 6] 8A-8B are cross-sectional views of an adapter for coupling a proximal handle of an elongated surgical tool to a surgical robotic device, according to some embodiments. [Figure 7] 1A-C schematically illustrate examples of alternative configurations of an adapter into which the handle of an elongated surgical tool is received to couple the handle to a surgical robotic device, according to some embodiments. [Figure 8] 7A-7F schematically illustrate various positions of the handle of an elongated surgical tool within an adapter, such as that shown in FIG. 7B, and the corresponding resulting effect on the distal end of the elongated surgical tool, according to some embodiments. [Figure 9A] 9A and 9C are isometric views of an exemplary mechanism for engaging a proximal handle of an elongated surgical tool, according to some embodiments. [Figure 9B] 9B, 9D are cross-sectional views of an exemplary mechanism for engaging a proximal handle of an elongated surgical tool, according to some embodiments. [Figure 9C] 9A and 9C are isometric views of an exemplary mechanism for engaging a proximal handle of an elongated surgical tool, according to some embodiments. [Figure 9D] 9B, 9D are cross-sectional views of an exemplary mechanism for engaging a proximal handle of an elongated surgical tool, according to some embodiments. [Figure 10A] 10B shows a first example of a mechanism for engaging and actuating motorized movement of the guidewire handle shown in FIG. 10A, according to some embodiments. [Figure 10B] 10B shows a first example of a mechanism for engaging and actuating motorized movement of the guidewire handle shown in FIG. 10A, according to some embodiments. [Figure 10C] 10B shows a first example of a mechanism for engaging and actuating motorized movement of the guidewire handle shown in FIG. 10A, according to some embodiments. [Figure 10D] 10B shows a first example of a mechanism for engaging and actuating motorized movement of the guidewire handle shown in FIG. 10A, according to some embodiments. [Figure 10E] 10B shows a first example of a mechanism for engaging and actuating motorized movement of the guidewire handle shown in FIG. 10A, according to some embodiments. [Figure 11A] 11B illustrates a second example of a mechanism for engaging and actuating motorized movement of the guidewire handle shown in FIG. 11A, according to some embodiments. [Figure 11B] 11B illustrates a second example of a mechanism for engaging and actuating motorized movement of the guidewire handle shown in FIG. 11A, according to some embodiments. [Figure 11C] 11B illustrates a second example of a mechanism for engaging and actuating motorized movement of the guidewire handle shown in FIG. 11A, according to some embodiments. [Figure 11D] 11B illustrates a second example of a mechanism for engaging and actuating motorized movement of the guidewire handle shown in FIG. 11A, according to some embodiments. [Figure 11E] 11B illustrates a second example of a mechanism for engaging and actuating motorized movement of the guidewire handle shown in FIG. 11A, according to some embodiments. [Figure 12A]12B shows a third example of a mechanism for engaging and actuating motor-driven movement of the proximal portion of the guidewire shown in FIG. 12A (without the proximal handle), according to some embodiments. [Figure 12B] 12B shows a third example of a mechanism for engaging and actuating motor-driven movement of the proximal portion of the guidewire shown in FIG. 12A (without the proximal handle), according to some embodiments. [Figure 12C] 12B shows a third example of a mechanism for engaging and actuating motor-driven movement of the proximal portion of the guidewire shown in FIG. 12A (without the proximal handle), according to some embodiments. [Figure 12D] 12B shows a third example of a mechanism for engaging and actuating motor-driven movement of the proximal portion of the guidewire shown in FIG. 12A (without the proximal handle), according to some embodiments. [Figure 12E] 12B shows a third example of a mechanism for engaging and actuating motor-driven movement of the proximal portion of the guidewire shown in FIG. 12A (without the proximal handle), according to some embodiments. [Figure 13] 8A-8B show a housing of an adapter for engaging and actuating motor-driven movement of a handle of an elongated surgical tool, according to some embodiments. [Figure 14] 1A-1C schematically illustrate modules of a surgical robotic device configured to operably engage an adapter to couple a proximal handle of an elongated surgical tool, according to some embodiments. [Figure 15] 10A-10C illustrate schematic diagrams of motor engagement of the proximal portion of a "dual thread" according to some embodiments. DETAILED DESCRIPTION OF THE INVENTION

[0056] In some embodiments thereof, the present invention relates to motorized actuation of elongated surgical tools, and more particularly, but not exclusively, to motorized actuation of a proximal portion of an elongated surgical tool, such as, for example, a handle of the tool or other proximal manipulator of the tool.

[0057] A broad aspect of some embodiments relates to robotic manipulation of a proximal portion of an elongated surgical tool. In some embodiments, the proximal portion of the tool (typically a manipulator or handle configured for manual manipulation) is operably attached to a robotic system including one or more motors for driving movement of and / or selected components of the proximal portion of the tool.

[0058] Aspects of some embodiments relate to an interface between a proximal portion of an elongated surgical tool, such as a guidewire and / or a microcatheter, and a robotic system configured to actuate movement of the tool. In some embodiments, the interface takes the form of an adapter shaped and configured to operably couple the proximal portion to one or more motors or motor transmission elements of the robotic system.

[0059] In some embodiments, the adapter is configured to mechanically and / or electrically engage a proximal portion of a tool. In some embodiments, the adapter includes a first geometry (also referred to herein as a "first portion" or "first member") shaped and configured to interface with one or more elements of a robotic system (e.g., a screw gear, a rod, a gear, etc.) configured to transmit motorized actuation forces, and a second geometry (also referred to herein as a "second portion" or "second member") shaped and configured to interface with the proximal portion of the tool.

[0060] In some embodiments, the first geometry includes a transmission coupling, and the second geometry includes one or more movers actuated via the transmission coupling and positioned to contact a control portion of the proximal portion, e.g., a control component of the proximal portion that actuates the tool upon movement. In some embodiments, the mover comprises a recess or indentation (e.g., formed in an inner wall of the adapter), which contacts a control component of the tool proximal portion and moves the control component upon movement of at least a portion of the adapter in which the recess or indentation is defined. Exemplary control components of the handle may include a slider (e.g., which, upon movement, causes deflection of the tool tip) and / or a knob (e.g., which, upon rotation, causes roll of the tool about the tool axis).

[0061] In some embodiments, the second geometry is shaped to match the outer contour of the proximal portion, e.g., the outer contour of at least a portion of the graspable handle. For example, the second geometry includes a main recess in which the body of the proximal handle is received and at least one extension of the recess in which a handle component integral with the handle body, e.g., a slider, lock, rotatable knob, etc., may be received.

[0062] In some embodiments, the primary recess is defined by an inner wall of the adapter housing that is shaped and positioned to support at least a portion of the proximal portion received within the recess, hi some embodiments, the recess is sized to snugly engage the proximal portion, and optionally is shaped and sized according to the proximal portion of the particular tool being engaged.

[0063] In some embodiments, the inner walls of the adapter housing defining the recess are positioned to resist forces exerted on the proximal portion by the adapter mover. For example, the walls of the recess limit axial movement of the handle body when the handle slider is compressed and pushed by the adapter mover. In some embodiments, the recess is shaped and sized to provide rotation of the proximal portion about the longitudinal axis but prevent axial and / or lateral (diagonal) movement of the proximal portion within the recess. In some embodiments, the recess is shaped to allow only a predetermined number of handle positions and / or a predetermined range of movement of the handle control components and restrict other movement. In some embodiments, the adapter mover is optionally limited in its range of movement by the adapter housing. For example, it is limited in its axial pivot range and its degree of rotation.

[0064] In some embodiments, at least a portion of the adapter housing is configured to slide linearly relative to the body of the proximal portion received in the recess. Optionally, movement of the portion of the housing moves a proximal portion control component relative to the body of the proximal portion, e.g., pushes or retracts a slider of the handle relative to the handle body.

[0065] In some embodiments, the first geometry and the second geometry are coaxial. In some embodiments, the first geometry is disposed radially outward relative to the second (inner) geometry. In some embodiments, one or more walls of the outer geometry extend to at least partially encase the inner geometry, or vice versa, such that movement of one of the geometries generates a respective movement of the second geometry.

[0066] In some embodiments, a control component in a proximal portion of the tool engaged by the adapter moves relative to the body of the proximal portion by generating relative movement between a first geometry and a second geometry. In some embodiments, the movement includes rotation (e.g., rotation of the second geometry while the first geometry is stationary, rotation of the first geometry while the second geometry is stationary, rotation of both geometries). In some embodiments, the movement includes axial advancement and / or retraction of one or both of the inner and outer geometries.

[0067] In some embodiments, the proximal portion (including one or more integral components) is moved as a single unit by the adapter, for example, rotated about the proximal portion longitudinal axis.

[0068] In one example, a proximal portion of an elongated surgical tool includes a body (e.g., a cylindrical body) and a handle having a slider attached to the body and configured to move axially along at least a portion of the handle body (e.g., to cause deflection of the distal tip of the tool, e.g., a guidewire). An adapter for operably coupling the handle to one or more motors of a robotic device can comprise a housing in which at least a portion of the handle is received, an inner geometry that matches at least a portion of the handle's outer contour and closely surrounds the slider, and an outer geometry that extends from the robotic device and is attached to a lead screw or pin that is driven (e.g., advanced or retracted) by one or more motors of the robotic device. During use, linear movement of the lead screw or pin carries the outer geometry together linearly. Because the adapter's outer geometry interfaces with the adapter's inner geometry (e.g., via at least a partial enclosure and / or an interference fit coupling), linear movement of the outer geometry also causes movement of the inner geometry, thereby sliding the slider relative to the body of the handle, which remains stationary. In another use case, the adapter rotates (either as a whole or only the inner geometry) to generate rotation of the handle as a whole, causing roll of the elongate tool about the long axis of the elongate tool. In another example, the handle includes a rotatable knob for fine adjustment of the roll of the elongate tool tip, the knob being engaged by a moving body (e.g., a gear) on the adapter which in turn rotates the knob.

[0069] Aspects of some embodiments relate to manipulation of a proximal portion of an elongated surgical tool via a robotic system. In some embodiments, the proximal portion is controlled by one or more controllers of the system. Optionally, the proximal portion is remotely controlled via a remote control device. In some embodiments, the robotic system is further configured for manipulation of a more distal portion of the tool extending from the proximal portion (e.g., to drive a less proximal portion of a guidewire located distal to the proximal portion), and optionally additional tools (e.g., a microcatheter, a guide catheter). In some embodiments, manipulation of the proximal portion of the tool (e.g., via an adapter) is coordinated with other manipulations performed by the robotic system on the tool, such as axial advancement and / or retraction of the tool, tool roll, etc. Potential benefits of controlling the proximal portion in coordination with manipulation of the more distal portion of the tool may include gaining or improving finer control over the most distal portion of the tool, e.g., gaining or improving finer control over tool tip movement. Potential advantages of controlling the proximal portion in coordination with manipulation of a more distal portion of the tool may include additional support for performing such manipulation, for example, by rotating both the proximal end and the tool itself at a more distal location, instead of rotating only the tool and passively rotating the proximal end with it, or even interfering with the rotational manipulation.

[0070] An aspect of some embodiments relates to the provision of various adapter configurations for engaging respective various tool proximal configurations. In some embodiments, the various adapter configurations are provided either in the form of various single-unit adapters or as various two-part adapters, each having a different inner adapter geometry that mates with the same outer adapter geometry (i.e., the outer adapter geometry that is common to the various adapter configurations). Whether provided as a single-unit or two-part adapter, each of the various configurations is configured to match the proximal end of the tool in both structure and function.

[0071] In some embodiments, the adapter includes multiple moving bodies, each shaped and configured to engage a proximal end component, such as a moving body configured as a slidable mount attached to a slider and a moving body configured as a rotary gear for rotating a knob located on the proximal portion. In some embodiments, the moving body is integral with a recess for retaining the proximal portion and has a size and shape compatible with the control component of the proximal end. For example, the moving body is formed as a recess extending radially outward from the recess in which the proximal portion is received. In one example, the recess within the recess is shaped and sized to mount to a slider of a handle. In some embodiments, the adapter directly or indirectly (e.g., via mechanical transmission) attaches the proximal portion to one or more motors of a robotic system that actuate movement of the moving bodies, the adapter portion, and / or the entire adapter. Additionally or alternatively, the adapter includes one or more integrated motors.

[0072] In some embodiments, manipulation of the proximal portion components by the adapter mover is configured to match the type and / or range and / or speed of movement inherent in the design of the proximal portion of the tool. Optionally, manipulation of the proximal portion components by the adapter mover (e.g., pressing a slider, turning a knob) is performed incrementally and / or to some extent selected to match the range and / or direction and / or degree of movement of the proximal portion components.

[0073] In some embodiments, movement of the proximal portion components is performed relative to a calibrated (home) position of these components, such as the position of the proximal portion component relative to the body of the proximal portion to which it is movably attached (e.g., a slider position along the longitudinal extent of the handle body). Optionally, the calibrated position is specific to the proximal portion, and the adapter mover is pre-configured accordingly. In some embodiments, the pre-configuration is by controlling one or more motors that actuate the mover of the adapter to place (and optionally return) the mover to a position where the proximal portion component is in its home position. Returning to the home position, in some embodiments, occurs automatically, such as when the system is turned on and / or off, upon engagement of the adapter and proximal portion, and / or other.

[0074] In some embodiments, a user (e.g., a physician, a technician) inputs into the system which type of proximal portion is being used, and the operating parameters of the adapter and / or its moving body are set accordingly. Additionally or alternatively, the system recognizes the type (e.g., configuration) of the proximal portion (e.g., handle, torque unit) being used, and the operating parameters are set accordingly. The system may recognize the presence of the proximal portion (e.g., recognize connection to the adapter) and / or identify the type and / or shape of the proximal portion using one or more sensors, such as a proximity sensor, a magnetic sensor, an encoder, etc. In some embodiments, the system recognizes the presence and / or type and / or shape of the proximal portion using imaging means. In some embodiments, the system recognizes the presence and / or type and / or shape of the proximal portion using identification means, such as an RFID tag.

[0075] In some embodiments, the adapter is structured to allow manual manipulation of the adapter traveler and / or to allow access to the proximal portion for direct manual manipulation of the proximal portion components.

[0076] In some embodiments, the adapter includes a removable cover through which a user can manually access the adapter's mover and / or directly access the proximal portion components. Optionally, when manual operation is performed, motor operation of the adapter mover is stopped, for example, by a clutch that decouples the motor from the mover and / or from one or more force transmission elements that transmit force from the motor to the adapter mover.

[0077] In some embodiments, the adapter includes a quick-eject mechanism for releasing the proximal portion, such as to provide for manual manipulation of the proximal portion.

[0078] It should be noted that while some examples are described herein with respect to guidewires, for example, the mechanisms and / or methods as described may be used with any elongated surgical tool, such as, for example, a microcatheter, a steerable catheter, a stent retriever, and / or any other elongated tool, whose movement and / or mechanical properties are affected by manipulation of a proximal portion of the tool, such as the handle of the tool.

[0079] As referred to herein, a tool "proximal portion" or "handle" may include, for example, a tool portion configured to affect and / or control the movement and / or mechanical properties (e.g., stiffness) of a tool portion, optionally distal to the distal tip of the tool. For example, a control component at the proximal portion of the tool (e.g., slider, knob) configured, when actuated, to cause deflection of the distal tip of the tool, rotation (e.g., roll) of the distal tip of the tool.

[0080] In some embodiments, the proximal portion (in some embodiments, the handle) comprises a graspable or otherwise manually engageable portion. Optionally, the proximal portion is generally manually manipulated (e.g., engaged by a user's hand and / or fingers). In some embodiments, the proximal portion is at the proximal-most end of the elongate surgical tool.

[0081] Before describing at least one embodiment of the invention in detail, it is to be understood that the invention is not necessarily limited in its application to the details of construction and arrangement of components and / or methods set forth in the following description and / or illustrated in the drawings and / or examples. The invention is capable of other embodiments or of being practiced or carried out in various ways.

[0082] Before describing at least one embodiment of the present invention in detail, it is to be understood that the invention is not necessarily limited in its application to the details set forth in the following description or illustrated by way of examples. The invention is capable of other embodiments or of being practiced or carried out in various ways.

[0083] Exemplary Adapter Binding and Operation Referring now to the drawings, FIG. 1A is a schematic illustration of a mechanism 101 for coupling an exemplary guidewire handle to a surgical robotic device and manipulating the handle via the robotic device, according to some embodiments.

[0084] In some embodiments, the guidewire handle is operably coupled to a robotic device, such as, for example, to one or more motors of the robotic device 103, via an adapter 105.

[0085] In some embodiments, the adapter 105 is shaped and configured to engage a guidewire handle to operably couple the handle to one or more motors (and / or to a motor transmission) of a robotic device. In some embodiments, the adapter includes a first motor engagement geometry 109 shaped to attach to one or more motors (or to a motor transmission) of a robotic device, and a second handle engagement geometry 107 shaped to attach to or receive a guidewire handle therein.

[0086] In some embodiments, the motor(s) 103 are controlled by a controller 111 of the surgical robotic device. In some embodiments, the controller is in communication with a user interface device (e.g., a remote control) and is programmed to receive commands from the user interface device and actuate the motor(s) accordingly.

[0087] In some embodiments, during use, manipulation of one or more components of the guidewire handle engaged with the adapter is performed by actuating a motor(s) or associated transmission of the surgical device. In some embodiments, the adapter is shaped to operatively contact one or more handle components, such as a slider element, a rotatable knob, a push button, a movable lock, etc. Upon actuation of the robotic device motor(s) by the controller, the motor engagement geometry moves, thereby generating movement of the handle engagement geometry, which in turn moves a component of the guidewire handle.

[0088] In some embodiments, movement of a handle component affects a more distal portion and / or the distal tip of the guidewire 113. For example, movement of a handle component can result in guidewire manipulation, such as roll of the guidewire (i.e., about the guidewire longitudinal axis), deflection of a distal portion of the guidewire, change in guidewire stiffness (e.g., by advancing or retracting threads in a multi-threaded guidewire, e.g., by displacing threads in a dual-threaded guidewire), expansion of tool diameter (e.g., by introducing fluid into the tool, optionally by injection), deployment of structures originally encapsulated within the tool, etc.

[0089] FIG. 1B is a schematic diagram of an adapter coupling a guidewire handle to a motorized actuation, according to some embodiments.

[0090] In some embodiments, the adapter 151 is configured to couple a proximal portion (e.g., a handle 160) of the guidewire 153 to a surgical robotic device 169.

[0091] In some embodiments, adapter 151 includes housing 150 defining a recess 159 in which at least a portion of a guidewire handle is received. In some embodiments, the housing contains at least one mover, such as movers 161, 163, positioned and configured to mechanically engage one or more control components of a guidewire handle received within the recess. In some embodiments, the movers are configured to rotate, slide, and / or otherwise move to generate movement of the handle component. In some embodiments, each mover is independently coupled to the transmission. Optionally, the movers operate independently of one another.

[0092] In the illustrated example, the moving body 161 is positioned in contact with a slider 164 of the handle, such that the moving body 161 moves the slider when actuated, and the moving body 163 is positioned in contact with a rotatable knob 166 of the handle, such that the moving body 163 rotates the knob when actuated.

[0093] In some embodiments, electrical and / or mechanical actuation of the vehicle(s) is by one or more motors 165 and / or via a motor transmission 167 of a surgical robotic device 169 .

[0094] In some embodiments, the motor transmission element includes a lead screw, a rod, a gear, and / or any other element suitable for mechanically transmitting the movement of the motor to one or more moving bodies of the adapter.

[0095] In some embodiments, the interior wall of housing 150 at recess 159 is shaped to match the contours of handle 160. Optionally, the handle is snugly received within the recess, for example, such that lateral movement of the handle within the recess is prevented. In some embodiments, the handle may rotate about its axis within the recess.

[0096] In some embodiments, the interior walls of the housing support the handle, e.g., the body of the handle, on at least two sides. In some embodiments, the handle is received within the recess such that the interior walls of the housing resist forces applied to the handle, e.g., forces applied by the movers 161, 163. In one example, the mover 161 is compressed onto the slider 164 to move the slider axially, while the body of the handle remains held and supported by the housing walls in the recess, so that the handle body does not move, only the slider. In some embodiments, the adapter 151 includes one or more sensors 170 configured to measure or otherwise indicate, for example, whether the handle is received within the recess, the position of the mover(s) relative to the handle, and the position of the handle components (e.g., the axial position of the slider, the angle of rotation of the knob). In some embodiments, the relative position of the mover is indicated by sensing the position of the motor and / or motor transmission, which then actuates the mover (e.g., via a counter that counts motor rotations). In some embodiments, the position of the mover and / or handle components is sensed using an encoder, such as, for example, an optical encoder. In one example, an encoder is configured along the axial path traveled by the mover pushing the handle slider, measuring the range of axial movement and, optionally, communicating that range of distance to a system controller. In some embodiments, one or more sensors are integrated and / or mounted on the mover's transmission, such as, for example, on a pin or rod that couples the mover to a machine motor.

[0097] In some embodiments, the adapter 151 includes an integrated power supply 162, such as a battery. Optionally, the power supply provides power to the adapter's mobile body and / or to one or more sensors. In one example, the battery is activated only when the adapter is in use. In a specific example, a zinc-air battery is activated when exposed to air; for example, insertion of the handle into the recess may move a slip covering the battery, exposing and activating the battery.

[0098] In some embodiments, at least a portion of guidewire 153 is operably received within robotic device 169. In some embodiments, a proximal-most portion of the guidewire (e.g., the handle) is received within adapter 151, an intermediate portion of the guidewire is received within robotic device 169, and a distal portion of the guidewire extends for insertion into the patient's body.

[0099] In some embodiments, the robotic device 169 is configured to manipulate the guidewire, for example, to roll the guidewire and / or to move the guidewire axially (ie, advance and / or retract).

[0100] In some embodiments, the robotic device 169 includes a tool movement element, such as a wheel, that engages the guidewire at a location distal to the handle to actuate movement of the guidewire.

[0101] In some embodiments, the robotic device 169 is configured to receive and actuate the movement of multiple elongated surgical tools, such as, for example, guidewires, microcatheters, guiding catheters, and the like.

[0102] In some embodiments, manipulation of the guidewire via the guidewire handle is coordinated (e.g., synchronized) with guidewire movement performed by a robotic device, e.g., as described herein. For example, when guidewire rolling is actuated via the guidewire handle, a tool movement element of the robotic device can be actuated to generate a similar roll of a more distal portion of the guidewire, potentially preventing kinking of the guidewire. In another example, deflection of the guidewire distal tip via the handle can be performed simultaneously with axial advancement and / or retraction of the guidewire and / or rolling of the guidewire by the robotic device. In another example, the stiffness of the guidewire (e.g., of a dual-threaded guidewire) can be altered during axial translation and / or rolling of the guidewire (e.g., by retracting one of the inner threads of the guidewire).

[0103] In some embodiments, manipulation of the guidewire handle is performed with consideration given to the positioning of the more distal portion of the guidewire held or received within the robotic device. For example, a guidewire held by the robotic device may be rotated one or more times (e.g., in a U-shaped bend). Optionally, when the guidewire is held by the robotic device at two positions, e.g., at the handle and at a more distal position along the guidewire length, the length of the guidewire between these two positions can be selectively modified according to the advancement or retraction of the distal portion of the guidewire within the patient. In some embodiments, the housing of the robotic device allows the guidewire to extend outside the housing between these two positions, allowing the segment in between to increase or decrease in length without being restricted by the confinement of the housing.

[0104] Manipulation of tools such as guidewires by robotic devices is as described, for example, in U.S. Provisional Application No. 62 / 941,842 (Attorney Specification 83238) and / or U.S. Provisional Application No. 63 / 082,508 (Attorney Specification 83116), which are incorporated herein by reference.

[0105] Exemplary Method for Operatively Coupling a Tool Handle to a Robotic System FIG. 2 is a flowchart of a general method for operably coupling, for example, a guidewire handle to a surgical robotic device, according to some embodiments.

[0106] In some embodiments, a robotic system for manipulating at least one elongated surgical tool is provided (201).

[0107] In some embodiments, an adapter is provided (203) for coupling a proximal portion of an elongated surgical tool to a surgical system. Optionally, the adapter is selected from a plurality of adapters having different shapes and / or sizes. In some embodiments, the adapter is selected according to the geometry and / or function of the proximal portion of the tool. For example, in the case of a tool handle including a rotatable knob, an adapter is selected that includes a mover suitable for rotating the knob. For example, in the case of a guidewire handle including a slider, an adapter is selected that includes a mover suitable for advancing and / or retracting the slider. In some embodiments, at least a portion of the adapter (e.g., only the motor-engagement portion of the adapter or the entire adapter) is provided as part of the robotic system in 201.

[0108] In some embodiments, the adapter is designed to engage with a handle having a particular design. Optionally, different adapters are designed to engage handles of different shapes and / or designs, such as handles for tools from different manufacturers. Because different handles may have different "neutral" (or calibrated) positions for the tool, in some embodiments, the adapter is designed to match the neutral position determined by the handle, for example, so that operation of the handle can be performed relative to a particular neutral position. In some embodiments, the adapter includes a portion shaped to match the outer contour of the handle.

[0109] Additionally or alternatively, the adapter may include at least one adjustable portion that may be moved, enlarged, reduced, and / or otherwise modified to engage multiple handle types or configurations.

[0110] In some embodiments, a proximal portion of the tool (e.g., a handle) is attached to the adapter (205). Optionally, the attachment is performed by a user (e.g., a doctor, nurse, and / or other clinical personnel). In some embodiments, the attachment includes inserting at least a portion of the handle into a designated recess in the adapter. Additionally or alternatively, the adapter is "trimmed" or attached to the handle.

[0111] In some embodiments, the adapter, along with the tool handle engaged thereby, is connected to the robotic system (207). Alternatively, in some embodiments, the adapter is constructed as an integral part of the robotic system and does not require separate attachment to the system. Alternatively, in some embodiments, the adapter is pre-assembled to the guidewire (e.g., to the guidewire handle) and provided with the guidewire. Optionally, the user then connects the adapter and guidewire assembly to the system. In some embodiments, the adapter and guidewire are provided pre-loaded on the robotic system.

[0112] In some embodiments, connecting the adapter to a robotic system establishes a mechanical coupling of the adapter to the motor(s) and / or motor transmission of the robotic system, hi some embodiments, connecting the adapter to a robotic system establishes an electrical coupling of the adapter to the robotic system, for example, to the system's power supply.

[0113] In some embodiments, the proximal portion of the tool (e.g., a guidewire handle) is then manipulated via the robotic system to affect the movement and / or mechanical properties of the tool 209. In some embodiments, a user controlling the robotic system (such as via a user interface optionally configured as a remote control) manipulates the proximal handle of the tool.

[0114] In one example, a user instructs (e.g., via a remote control) to deflect the distal tip of a tool (e.g., a guidewire). One or more motors of the robotic system then actuate movement of a moving body(s) within the adapter, which then contacts a handle component, such as a slider, to move the slider and deflect the distal tip of the tool. In another example, a user instructs (e.g., via a remote control) to roll a tool (e.g., a guidewire or steerable catheter). One or more motors of the robotic system then actuate movement of a moving body(s) within the adapter, which then contacts a handle component, such as a rotatable tab, to rotate a knob and roll the tool (e.g., roll the guidewire around the guidewire long axis). In another example, a user instructs (e.g., via a remote control) to change a mechanical property of the tool, such as the stiffness of a distal portion of the tool. One or more motor(s) of the robotic system then actuate movement of the mover(s) within the adapter, which in turn contacts, for example, a puller / pusher configured to advance or retract the threads of a dual-threaded guidewire, thereby affecting the stiffness of the guidewire. Examples of dual-threaded guidewires include guidewires with an inner thread disposed within the lumen of an outer thread, or guidewires with two threads that are adjacent to each other or pass through the profile of the main thread. In some embodiments, deflection of a distal portion of the guidewire is achieved by moving (e.g., advancing or retracting) the threads.

[0115] In some embodiments, the range and / or speed of movement of a handle component (e.g., degree of rotation of a knob, distance traveled by a liner slider) is configured for each specific handle type engaged by the system. For example, motorized movement of a slider by the robotic system is controlled to advance and / or retract the slider within a distance range determined for the specific handle. For example, motorized movement of a rotatable knob by the robotic system is controlled to rotate the knob at a speed and / or degree of rotation appropriate for the specific knob. In some embodiments, an adapter configured to engage a specific handle type includes and / or is pre-configured with motor operating parameters for driving the adapter mover to match the specific movement of the handle component. The motor operating parameters are configured to control, for example, the speed of movement, the direction of movement, the degree or range of movement.

[0116] Exemplary Robotic System FIG. 3 is a block diagram of a surgical robotic system configured to, for example, engage and control a proximal portion (e.g., a handle) of a guidewire, according to some embodiments.

[0117] In some embodiments, the robotic system 301 is suitable for use in an operating room. Optionally, one or more system components (such as control components, imaging components, etc.) are physically separated from the rest of the system and may be used remotely.

[0118] In some embodiments, the system 301 is configured to receive one or more surgical tools (e.g., guidewires, microcatheters, guide catheters, intermediate catheters, and / or other elongated and / or intraluminal surgical tools) and actuate the movement of the tools.

[0119] In some embodiments, the actuator is configured to drive linear movement (e.g., advancement and / or retraction) of a tool received therein and / or to drive rotational movement (e.g., axial rotation) of a tool received therein, and in some embodiments, the linear and rotational movements are actuated simultaneously.

[0120] In some embodiments, the system 301 includes a robotic device 303 that includes one or more of the following components:

[0121] One or more actuators, such as one or more motors 305, and optionally associated motor transmissions

[0122] Tool movement elements 317, such as wheels, configured to operatively contact a tool received by the system to move the tool (e.g., advance, retract, rotate the tool).

[0123] A controller 307 configured to receive and / or send operational signals to and from a general control unit 309. The general control unit 309 may be configured as a remote control, a console, a control unit physically attached to a system base, or a combination thereof. In some embodiments, the controller 307 is configured to coordinate the manipulation (e.g., translation, rotation) of tools received and manipulated by the robotic system.

[0124] Power supply means 311, including batteries and / or connection means for mains power

[0125] Sensing means 315, such as one or more sensors configured to detect, for example, whether a tool is inserted, the relative position of the tool, the position of the tool moving element (e.g., a wheel), the actual movement of the tool moving element (e.g., by a counter counting the number of wheel revolutions), to communicate with other system sensors, and / or for other measurements and / or indications. In some embodiments, the sensors are configured to detect the state of the motor, e.g., the position of the motor, the rotational speed of the motor. Various types of sensors can be used, such as optical sensors, pressure sensors, force measurement sensors, speed sensors, sensors for detecting current, flow sensors, position sensors (e.g., optical, magnetic, electrical position sensors), etc.

[0126] A memory 313 that stores, for example, parameters related to tool movement such as movement speed, rotation, translation, angle, deflection angle, etc.; indications obtained by one or more system sensors such as measurements of forces acting on the tool, tool stiffness, etc.; parameters related to the patient's body and sensed by the inserted tool (e.g., heart rate, blood pressure, body temperature, oxygenation level, and / or other sensed parameters).

[0127] In some embodiments, the system 301 includes an integrated imaging modality 319. Alternatively, the system is configured to be operatively connected to (e.g., in communication with) an existing imaging modality, which may include, for example, fluoroscopy, CT, cone-beam CT, CT fluoroscopy, MRI, ultrasound, or any other suitable imaging modality.

[0128] In some embodiments, system 301 includes a mount 321 for positioning device 303 relative to the patient and / or relative to the operating table. In some embodiments, the mount includes or is configured to attach to an adjustable fixture. Optionally, the height and / or angle and / or distance of the system relative to the patient (e.g., relative to the body entry position) and / or relative to the bed is adjustable.

[0129] In some embodiments, system 301 optionally includes or is configured to engage as part of device 303 an adapter 323 for operatively engaging a proximal portion of a tool, such as a handle.

[0130] In some embodiments, the adapter defines a mechanical engagement between one or more motors 305 and one or more components of the handle that move the tool. For example, the adapter connects one or more motor(s) or associated transmissions to slider and / or knob components of the handle that deflect the tool tip when slid, to knob components of the handle that roll the tool when rotated, and / or to other handle components. Additionally or alternatively, the adapter itself includes one or more integrated motors to drive movement of the handle components.

[0131] In some embodiments, when attached to a system, the adapter can be actuated via a system controller, e.g., via a remote control controlled by a user. Additionally or alternatively, the adapter can be controlled directly, e.g., via manual engagement by a user. Additionally or alternatively, the handle can be detached from the adapter and optionally controlled manually.

[0132] In some embodiments, the adapter includes one or more sensors. Optionally, the sensors are configured to measure and / or indicate one or more of: whether a tool handle is engaged by the adapter; the relative position of a handle component such as a slider or rotation knob (e.g., relative to its calibrated or neutral position); the relative position of portions of the adapter such as the inner and outer geometries; the rate of movement of adapter portions and / or handle portions; the rate of movement (e.g., rotational rate) of the entire handle, such as by rotation of the entire adapter; and / or the rotation of the inner geometry of the adapter.

[0133] Exemplary Configurations of Robotic Systems 4A-B are isometric and side views of a robotic surgical system positioned relative to a patient, according to some embodiments.

[0134] In some embodiments, the robotic system 401 is positioned relative to the patient 403, optionally relative to a surgical body entry point of the patient. The entry point can be selected from, but is not limited to, the patient's groin (i.e., femoral artery), arm (i.e., radial artery), or neck (i.e., jugular vein).

[0135] In some embodiments, the system 401 is attached to a rigid fixture 405. In some embodiments, the fixture is placed on and / or restrained to the patient's body. Additionally or alternatively, the fixture is attached to the operating table.

[0136] In some embodiments, fixture 405 is adjustable to control one or more positioning parameters of system 401, such as height, angle (e.g., insertion angle into a body entry site), and distance from the patient (e.g., from the entry site). Optionally, fixture 405 includes rails along which system 401 can slide forward and / or backward toward and / or backward from the patient.

[0137] In some embodiments, the fasteners 405 are manually adjustable, for example, via a plurality of adjustable knobs 407 .

[0138] Potential advantages of a relatively small and compact system may include the ability to place the system relatively close to the patient (e.g., relative to the body entry point), e.g., less than 2 cm, 3 cm, 5 cm, 10 cm from the entry point, or at intermediate, longer, or shorter distances.

[0139] In some embodiments, the system 401 is compact and occupies a relatively small volume (e.g., 2000 cm 3 , 2500cm 3 , 3500cm 3, 5000cm 3 , 9000cm 3 The system may be small enough to accommodate a wide range of surgical procedures, such as a surgical instrument, a surgical instrument, a surgical instrumentation system ...

[0140] In some embodiments, attachment of the system to the surgical bed and / or patient may be accomplished using straps, bands, rigid attachments, and / or other attachment means. In some embodiments, attachment to the bed is accomplished using a stand stabilized to the mattress, to bed rails, and / or to the floor. The system can then be attached to the stand, e.g., via a snap-fit mechanism, magnetic means, straps (e.g., Velcro®), etc. In some embodiments, the stand is adjustable for use with patients of various sizes and / or different bed heights, etc. In some embodiments, when positioning the system, one or more of the height, body entry angle, and alignment of the system relative to the patient are selected. The positioning of the system can be determined relative to the patient's body or portions thereof (e.g., relative to the surgical entry site) and / or the surgical bed, and / or relative to other surgical room equipment, e.g., the imaging module.

[0141] Exemplary General Adapter Structure 5A-B are cross-sectional views of an adapter for coupling a proximal handle of a guidewire to a surgical robotic device, according to some embodiments: Figure 5A is a cross-sectional view along the minor axis (width) of the adapter, and Figure 5B is a cross-sectional view along the major axis (length) of the adapter.

[0142] In some embodiments, the adapter 501 defines an inner geometry 503 shaped and configured to interface with a proximal handle of a tool (e.g., a guidewire handle), and an outer geometry 505 shaped and configured to interface with a robotic device.

[0143] In some embodiments, inner geometry 503 defines a main recess 507 into which a handle (i.e., the body of the handle, not shown) is received. Optionally, one or more lateral recesses, such as recess 509, are provided to accommodate handles of particular configurations. For example, recess 509 is shaped and sized to snugly accommodate a slider of a guidewire handle. In this example, main recess 507 defines a circular cross-sectional profile along its width (forming a cylindrical lumen as shown in FIG. 5B ), although other recess profiles are contemplated, such as, for example, a square cross-sectional profile, a rectangular profile, a triangular profile, an oval profile, any profile, and / or other profile shaped to match the exterior profile of a tool handle engaged by the adapter. In some embodiments, main recess 507 is shaped and / or sized to allow axial sliding of the adapter relative to the handle body received therein. Optionally, the primary recess is sized to provide a radial distance between the outermost wall of the handle body and the innermost wall of the primary recess, such as at least 0.1 mm, 1 mm, 5 mm, 10 mm, or an intermediate, longer or shorter distance.

[0144] In some embodiments, the outer geometry 505 defines one or more features for coupling to a robotic device. For example, the outer geometry includes a recess 511 in which a lead screw 513 (or pin, and / or any other elongated element) protruding from the robotic device (from the housing of the robotic device) is received.

[0145] In some embodiments, the inner geometry is configured to move relative to the outer geometry, or vice versa, or both geometries move together as a single unit.

[0146] In some embodiments, the movement includes rotation (e.g., rotation of the inner geometry while the outer geometry is stationary, rotation of the outer geometry while the inner geometry is stationary, rotation of both geometries). In some embodiments, the movement includes axial advancement and / or retraction of one or both of the inner and outer geometries.

[0147] In the examples shown herein, only the inner geometry 503 is configured to rotate with rotation of the handle, such as to cause roll of the guidewire, while the outer geometry 505 remains stationary. In some embodiments, the handle (not shown) rotates (e.g., by a pin or lead screw extending from the robotic device and rotating at least the inner geometry) and rotates with a slider that is part of the handle. The slider is snugly received within a recess 509 in the inner geometry, so that rotation of the handle causes rotation of the inner geometry with it, or vice versa. In some embodiments, more distal rotation of the tool causes the handle to rotate within or with the adapter.

[0148] In some embodiments, the outer geometry 505 moves axially (e.g., by axial movement of a rod or pin received in the recess 511). As the outer geometry moves axially, it carries the inner geometry axially with it. The slider is then advanced or retracted relative to the body of the handle, which is received in the main recess 507.

[0149] In some embodiments, the inner geometry is at least partially enveloped within the outer geometry, as shown, for example, in FIG. 5B . The sidewalls 517 of the outer geometry extend to at least partially cover the inner geometry. Additionally or alternatively, portions of the inner geometry extend to cover portions of the outer geometry. Additionally or alternatively, an interference fit coupling (e.g., respective protrusions and recesses) couples between the two geometries. In some embodiments, the coupling between the two geometries provides one or more of: rotation of the inner geometry simultaneously rotates the outer geometry; rotation of the outer geometry simultaneously rotates the inner geometry; and axial movement of the outer geometry simultaneously moves the inner geometries axially together.

[0150] In some embodiments, the handle is inserted into the adapter by sliding (e.g., threading) the handle body into a main recess of the adapter. Optionally, the handle is manually placed into the recess of the adapter. Additionally or alternatively, the adapter includes movable and / or separable parts (e.g., separate parts that can be connected to each other) and is configured to mount over or on the handle. Additionally or alternatively, the adapter includes a cover (e.g., a lid) that can be moved to allow insertion of the tool handle into its designated recess.

[0151] 6A-B are cross-sectional views of an adapter for coupling, for example, the proximal handle of a guidewire to a surgical robotic device, according to some embodiments.

[0152] In this example, the entire adapter 601 (including both the inner geometry 603 and the outer geometry 605) is configured to rotate with the guidewire handle received therein as the adapter rotates.

[0153] In the adapter structure shown, outer geometry 605 is attached to the robotic device via pin 607. A circumferential slot 609 is defined along the outer geometry to accommodate pin 607 regardless of the current rotational orientation of the adapter. In use, this coupling ensures that the pin maintains attachment of the adapter to the robotic device at all rotational positions of the adapter.

[0154] 7A-C schematically illustrate examples of alternative configurations of an adapter into which a handle of a guidewire is received to couple the handle to a surgical robotic device, according to some embodiments.

[0155] 7A, an adapter housing 701 rotates with a handle 703 held therein, according to some embodiments. A slider 705 of the handle is received within a designated recess 707 in the adapter housing. In some embodiments, a mover 709 of the adapter is configured to move the adapter housing axially relative to the handle, producing axial movement of the slider relative to the handle (i.e., relative to the body of the handle 706).

[0156] 7B, only the handle 703 rotates while the adapter housing 711 remains stationary. The handle's slider 705 may rotate with the handle within a designated circumferential slot 713.

[0157] In Figure 7C, the adapter 715 includes an integrated motor 717. In use, the motor drives the axial translation of a mover 719, which in turn axially moves the slider 705. As further shown, the adapter 715 (together with the motor 717 and mover 719) rotates to rotate the entire handle 703 (i.e., including the body of the handle and slider).

[0158] Generally, the slider will rotate with the handle body as the handle body rotates. In some embodiments, the rotating slider will push against the walls of the adapter's inner geometry, causing the inner geometry to rotate with the handle. Alternatively, the inner geometry will push against the walls of the slider, causing the handle to rotate with it.

[0159] In some embodiments, rotation of the inner geometry will also lead to rotation of the outer geometry (e.g., due to interference and / or inclusion of the inner geometry within the outer geometry, or vice versa), and both geometries will rotate together.

[0160] 8A-F schematically illustrate various positions of a guidewire handle within an adapter, such as that shown in FIG. 7B, and the corresponding resulting effect on the distal end of the guidewire, according to some embodiments.

[0161] The adapters shown in these figures are, for example, as described in Figure 7B.

[0162] In Figure 8A, handle 703 may rotate while slider 705 rotates within designated circumferential slot 713. Rotation of the handle causes a roll of the more distal portion 801 of the guidewire (or the entire guidewire) as shown in Figure 8B.

[0163] In Figure 8C, the adapter housing 711 is moved (e.g., pushed) in a proximal direction (see arrow 712) relative to the handle 703, pushing the slider 705 proximally. Axial movement of the slider causes deflection of the more distal portion 801 of the guidewire, e.g., deflection of the distal tip of the guidewire, as shown in Figure 8D. In some embodiments, when the adapter housing is moved in the opposite direction (distally), the slider is pushed distally, causing deflection of the guidewire tip to the opposite side.

[0164] In FIG. 8E, rotation of handle 703 (pushing slider 705 proximally) after pushing adapter housing 711 proximally causes the guidewire to roll, while the guidewire tip deflects, as shown in FIG. 8F.

[0165] 9A-B are isometric (FIG. 9A) and cross-sectional (FIG. 9B) views of an exemplary mechanism for engaging the proximal handle of a guidewire, according to some embodiments.

[0166] In some embodiments, the robotic device 901 is configured to operatively engage a proximal handle 903 of a tool, for example, a guidewire, that is manipulated by the robotic device.

[0167] In some embodiments, one or more extensions of the device, such as a lead screw 905 or pin 907, protrude outward to engage a tool handle, optionally via an adapter 909. In the example shown, the lead screw 905 is received within a recess 910 defined in the outer geometry 911 of the adapter. In some embodiments, as shown, the inner geometry defines a recess 913 into which a slider 915 of the handle is snugly received. In use, the lead screw 905 is configured to move axially toward and / or away from the device (optionally, the screw is rotated to cause its advancement / retraction), pulling the outer geometry 911 with it. Moving the outer geometry 911 axially will, in turn, carry the inner geometry with it, thereby moving the slider 915 axially relative to the body 917 of the handle 903.

[0168] In some embodiments, the pin 907 is coupled to the handle body 917 to rotate the handle body. In some embodiments, the pin 907 is an integral part of the handle. In such embodiments, the pin may be coupled to a motor that drives its rotation by a mechanical attachment such as a snap fit, press fit, or interference fit. Alternatively, the pin 907 is an integral part of the adapter. Alternatively, the pin 907 is an integral part of the robotic device. During use, rotation of the pin causes the handle body and attached slider to rotate together, which in turn causes rotation of the inner geometry 919 of the adapter.

[0169] In some embodiments, movement of the lead screw and / or pin and / or other elements for transmitting axial and / or rotational movement to the adapter and / or directly to the handle is actuated by one or more motors (not shown) housed within the robotic device 901.

[0170] 9C-D are isometric (FIG. 9C) and cross-sectional (FIG. 9D) views of another exemplary mechanism for engaging the proximal handle of a guidewire, according to some embodiments.

[0171] In this exemplary configuration, the adapter outer geometry 931 consists of separable parts 933, 935 which can be attached to the adapter inner geometry 939 and then to the tool handle 936 and then connected to each other, for example via a snap connection 937.

[0172] As further shown in this example, in some embodiments, portions of the adapter's inner geometry 939 (e.g., the proximal and distal faces of the inner geometry as shown) extend to at least partially cover or encase portions of the outer geometry 941, as shown, for example, in FIG. 9C.

[0173] As further shown in this example, in some embodiments, a guidewire 938 extending from handle 936 is received by a robotic device 943. Optionally, at least a portion of the guidewire extends through the robotic device and is inserted into a lumen of a microcatheter 945 that is manipulated by the robotic device.

[0174] Exemplary Adapter Structures for Different Types of Tool Handles In the following description of Figures 10-12, the components being described are numbered in the figure in which they are most easily seen.

[0175] 10A-E show a first example of a mechanism for engaging and actuating motorized movement of the guidewire handle shown in FIG. 10A, according to some embodiments.

[0176] FIG. 10A shows a tool handle (e.g., guidewire handle) 1001 having a generally rectangular (e.g., box-shaped) body 1003, a slider 1005 that moves linearly along at least a portion of the length of the handle body (e.g., to deflect the distal tip of the guidewire 1009), and a vertically oriented rotatable knob 1010 that rotates (e.g., to generate fine adjustments to the roll of the tip portion of the guidewire 1009).

[0177] In some embodiments, an adapter 1011 is provided to operably couple the handle to the robotic device. In some embodiments, the adapter includes an outer housing 1013 and a plurality of trucks configured to engage and move handle components, such as a slider and a rotatable knob. In some embodiments, the trucks are mounted directly over the slider 1005 and are configured to move (e.g., advance or retract) the slider therewith upon movement. In some embodiments, the trucks include a knob-engaging gear 1017 positioned and configured to rotate the knob 1010 upon rotation.

[0178] In some embodiments, movement of slider-engagement truck 1015 is actuated by motor 1019. In some embodiments, rotation of knob-engagement gear 1017 is actuated by motor gear 1021. In some embodiments, rotation of the entire adapter to generate a roll of the guidewire by rotating the handle as a single part is actuated by gear 1023 driven by motor 1025. Optionally, gear 1023 is externally coupled to adapter housing 1013.

[0179] In some embodiments, a moving body such as 1015 is configured for direct manual engagement by a user. Manual engagement may be performed, for example, in the event of an equipment malfunction, a medical emergency, and / or when specific manual manipulation is desired (e.g., to fine-tune a tool tip). Optionally, the moving body in the adapter is coupled to a clutch mechanism that, upon manual actuation, disengages the moving body from an associated transmission. In the example shown, a push button 1020 on the moving body 1015, when pressed, disengages the moving body 1015 from its transmission (slide pin 1022), for example, by releasing a set of fastener legs 1024 that couple the moving body 1015 to the pin 1022. Once the moving body is disengaged from its transmission, the moving body can be manually moved (e.g., slid) to move the handle slider 1005.

[0180] 11A-E show a second example of a mechanism for engaging and actuating motorized movement of the guidewire handle shown in FIG. 11A, according to some embodiments.

[0181] FIG. 11A shows a tool handle (e.g., a guidewire handle) 1101 having a body 1103, a horizontally oriented rotatable knob 1110 that rotates (e.g., to generate deflection of the tip portion of the guidewire 1109), and a lock 1105 that locks the guidewire tip in a desired deflected position, e.g., by obstructing rotation of the knob 1110.

[0182] In some embodiments, an adapter 1111 is provided to operably couple the handle to the robotic device. In some embodiments, the adapter includes an outer housing 1113 and a plurality of trucks configured to engage handle components such as a lock and a rotatable knob. In some embodiments, the truck includes a lock-engagement truck 1115 mounted directly on the lock and configured to move (e.g., advance or retract, push downward) the lock 1105 when moved.

[0183] In some embodiments, the mover includes a knob engagement gear 1117 positioned and configured to rotate the knob 1110 when rotated.

[0184] In some embodiments, the movement of the lock engagement traveler 1115 is actuated by a motor 1119. In some embodiments, the rotation of the knob engagement gear 1117 is actuated by a motor gear 1121.

[0185] In some embodiments, rotation of the entire adapter to generate a roll of the guidewire by rotating the handle as a single piece is actuated by a gear 1123 driven by a motor 1125. Optionally, gear 1123 is externally coupled to the adapter housing 1113.

[0186] 12A-E show a third example of a mechanism for engaging and actuating motor-driven movement of the proximal portion of the guidewire shown in FIG. 12A (without the proximal handle), according to some embodiments.

[0187] 12A shows a proximal portion of a guidewire including two graspers 1201, 1203. In some embodiments, each grasper holds the proximal end of a thread making up dual-threaded guidewire 1204. For example, grasper 1201 holds a first thread and grasper 1203 holds a second thread. In use, translation of the graspers relative to each other pulls one thread against the other, creating a deflection in the distal portion of the guidewire.

[0188] In some embodiments, an adapter 1205 is provided to operably couple a dual-threaded guidewire to a robotic device. In this example, the adapter includes a truck 1207 configured to cover at least the gripper 1201 and to move (e.g., slide axially) the gripper 1201 relative to the gripper 1203, such as to generate deflection of the distal tip of the guidewire. Optionally, the movement of the truck 1207 is driven by a motor 1209.

[0189] In some embodiments, rotation of the entire adapter to generate a roll of the guidewire by rotating the handle as a single piece is actuated by a gear 1223 driven by a motor 1225. Optionally, gear 1223 is externally coupled to the adapter housing 1213.

[0190] 13A-B show a housing of an adapter for engaging and actuating motorized movement of a guidewire handle, according to some embodiments.

[0191] In some embodiments, the adapter constitutes a stand-alone unit that can be attached to and / or located adjacent to a robotic device. In some embodiments, the adapter itself houses one or more motor(s) and / or controller(s) for effecting manipulation of the tool handle via one or more moving bodies of the adapter. Additionally or alternatively, the adapter is mechanically and / or electrically connected to a robotic system, with actuation of one or more moving bodies of the adapter being via one or more motor(s) of the robotic device.

[0192] In the example shown, adapter housing 1301 includes one or more electrical connectors, such as connectors 1303, 1305. Optionally, the electrical connectors are positioned and arranged according to the location of corresponding electrical connections on the robotic device (not shown).

[0193] In some embodiments, the adapter housing defines one or more mechanical connectors. For example, as shown, mounting legs 1307 extend from the housing and are attached to and / or received within the housing of the robotic device.

[0194] In some embodiments, the adapter housing includes a conduit or opening 1309 through which a tool (eg, a guidewire) extending from the handle passes.

[0195] In some embodiments, the dimensions of the adapter housing are determined according to the size of the handle to be engaged by the adapter. For example, the length 1311 of the housing may range, for example, between 2 cm and 20 cm, the width 1313 of the housing may range, for example, between 0.5 cm and 10 cm, and the height (thickness) 1315 of the housing may range, for example, between 0.5 cm and 10 cm. The example dimensions listed may be suitable for an adapter that accommodates a handle with a length of approximately 1.5 to 20 cm, a width of 0.4 cm to 10 cm, and a height of 0.4 cm to 10 cm.

[0196] FIG. 14 schematically illustrates a module 1400 of a surgical robotic device configured to operably engage an adapter for coupling a proximal handle of a guidewire, according to some embodiments.

[0197] In some embodiments, the robotic device includes a mechanical and / or electrical coupling for connecting to the adapter. For example, one or more protrusions, such as gear 1401 and / or at least a portion of knob 1403, extend outwardly relative to housing 1407 of the robotic device for engaging the adapter. In some embodiments, electrical connection 1405 is provided for electrically connecting the adapter to the robotic device.

[0198] FIG. 15 shows a schematic of motor engagement of the proximal portion of a "dual-threaded" guidewire 1501 according to some embodiments.

[0199] In some embodiments, multiple threads (e.g., two, three, four, six threads, or an intermediate, greater, or lesser number) (see 1503, 1505) of the guidewire can be engaged at their proximal ends to motor(s), and / or to a motor transmission, and / or to mover(s), such as gear 1507, actuated by the motor. During use, rotation of gear 1507 connected to the threads may pull on the threads, e.g., shortening the effective length of the threads. Optionally, shortening the threads of a pair of threads pulls on the guidewire, deflecting a distal portion of the guidewire in the direction of the pulled threads.

[0200] In some embodiments, a multi-threaded guidewire may include threads arranged adjacent to one another (e.g., side-by-side, optionally connected at the proximal and / or distal ends of the guidewire) and / or coaxially arranged, e.g., an inner thread within the lumen of an outer thread.

[0201] Manipulation of the threads (e.g., by pulling and / or advancing the threads of a dual-threaded device) may deflect the guidewire and / or affect the stiffness of the distal portion of the guidewire, for example, if the inner thread is pulled proximally from the lumen of the outer thread, thereby potentially affecting the stiffness of the guidewire.

[0202] The words "comprises," "comprising," "includes," "including," "having," and their combinations mean "including but not limited to."

[0203] The term "consisting of" means "including and limited to."

[0204] The term "consisting essentially of" means that a composition, method, or structure may include additional ingredients, steps, and / or components, but only if the additional ingredients, steps, and / or components do not materially alter the basic and novel characteristics of the claimed composition, method, or structure.

[0205] As used herein, the singular forms "a," "an," and "the" include plural references unless the context clearly dictates otherwise. For example, the terms "a compound" or "at least one compound" can include multiple compounds, including mixtures thereof. Throughout this application, various embodiments of the invention may be presented in a range format. It should be understood that this range format is merely for convenience and brevity and should not be construed as an inflexible limitation on the scope of the invention. Accordingly, the description of a range should be considered to have specifically disclosed all possible subranges and individual numerical values within that range. For example, recitation of a range such as 1 to 6 should be considered to have specifically disclosed subranges such as 1 to 3, 1 to 4, 1 to 5, 2 to 4, 2 to 6, 3 to 6, etc., as well as individual numbers within that range, e.g., 1, 2, 3, 4, 5, and 6. This applies regardless of the breadth of the range.

[0206] Whenever a numerical range is given herein, it is meant to include any recited number (fractional or integer) within the stated range. The phrases "ranging between" a first designator number and a second designator number, and the phrase "ranging from" a first designator number "to" a second designator number, are used interchangeably herein and are meant to include the first and second designators and all fractional and integer numbers therebetween.

[0207] As used herein, the term "method" refers to methods, means, techniques, and procedures for accomplishing a given task, including, but not limited to, methods, means, techniques, and procedures that are known or that can be readily developed from known methods, means, techniques, and procedures by those skilled in chemistry, pharmacology, biology, biochemistry, and medicine.

[0208] As used herein, the term "treating" includes negating, substantially inhibiting, slowing, or reversing the progression of a condition, substantially ameliorating the clinical or cosmetic symptoms of a condition, or substantially preventing the appearance of clinical or cosmetic symptoms of a condition.

[0209] It is understood that certain features of the invention that are, for clarity, described in the context of separate embodiments, can also be provided in combination in a single embodiment. Conversely, various features of the invention that are, for brevity, described in the context of a single embodiment, can also be provided separately or in any suitable subcombination, or as preferred in any other described embodiment of the invention. Particular features described in the context of various embodiments should not be considered essential features of those embodiments, unless the embodiment cannot function without those elements.

[0210] While the present invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications, and variations will be apparent to those skilled in the art. Accordingly, it is intended to embrace all such alternatives, modifications, and variations that fall within the spirit and broad scope of the appended claims.

[0211] It is the intention of the applicants (applicants) that all publications, patents, and patent applications mentioned herein be incorporated by reference in their entireties, as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference herein. Furthermore, citation or identification of any reference in this application should not be construed as an admission that the reference is available as prior art to the present application. Section headings, if used, should not be construed as necessarily limiting. Additionally, any priority document(s) of this application are incorporated by reference herein in their entireties.

Claims

1. 1. An adapter (105, 151, 323, 501, 601, 909, 1011, 1111, 1205) for coupling a proximal portion (160, 703, 903, 936, 1001, 1101) of an elongated surgical tool (113, 153, 938, 1009, 1109, 1204) to a motorized robotic surgical device (103, 169, 303, 901, 943), comprising: 109, 1204) comprises a distal end (801) and said proximal portion (160, 703, 903, 936, 1001, 1101), said proximal portion (160, 703, 903, 936, 1001, 1101) comprising one or more control components (164, 166, 705, 915, 1005, 1010, 1105, 1110), said adapter (105, 151, 323, 501, 601, 909, 1011, 1111, 1205) a housing (701, 711, 1013, 1113, 1213, 1301) shaped and sized to receive the proximal portion of the elongated surgical tool (113, 153, 938, 1009, 1109, 1204), the housing (701, 711, 1013, 1113, 1213, 1301) comprising: i. a primary recess (159, 507) defined by an interior wall of the housing (701, 711, 1013, 1113, 1213, 1301) and configured to permit rotation of the proximal portion (160, 703, 903, 936, 1001, 1101) received therein about a longitudinal axis of the proximal portion (160, 703, 903, 936, 1001, 1101) relative to the adapter (105, 151, 323, 501, 601, 909, 1011, 1111, 1205); ii. said main recess (507) further comprises a recess (509, 609, 707, 913) shaped and sized to snugly receive at least one of said one or more control components (164, 166, 705, 915, 1005, 1010, 1105, 1110); The housing (701, 711, 1013, 1113, 1213, 1301), b. one or more movers (161, 163, 719, 1015, 1017, 1115, 1207) located within the main recess of the housing and arranged to contact and move the one or more control components (164, 166, 705, 915, 1005, 1010, 1105, 1110) to affect the distal end (801) of the elongate surgical tool (113, 153, 938, 1009, 1109, 1204); a transmission coupling (1020, 1022, 1024, 1119, 1121) within said housing (701, 711, 1013, 1113, 1213, 1301) that couples said one or more mobile bodies (161, 163, 719, 1015, 1017, 1115, 1207) to a motor-driven transmission (167) of said motor-driven robotic surgical device (103, 169, 303, 901, 943); d. a first motor configured to actuate the one or more movers (161, 163, 719, 1015, 1017, 1115, 1207); e. a second motor configured to drive a gear that rotates the adapter to rotate the proximal portion of the elongate surgical tool, thereby generating a roll of the elongate surgical tool; The adapter.

2. 2. The adapter of claim 1, wherein the contour of the main recess (507) matches at least a portion of the outer contour of the proximal portion (160, 703, 903, 936, 1001, 1101) of the elongated surgical tool (113, 153, 938, 1009, 1109, 1204), and the main recess (507) is sized to limit lateral movement of the proximal portion when the proximal portion is within the main recess (507).

3. 3. The adapter of claim 1 or 2, wherein each of the one or more movers (161, 163, 719, 1015, 1017, 1115, 1207) is independently actuated via the transmission coupling (1020, 1022, 1024, 1119, 1121).

4. The adapter of any one of claims 1 to 3, further comprising at least one motor (1025, 1125, 1225) configured to drive a gear (1023, 1123, 1223), the gear configured to rotate together with the proximal portion (160, 703, 903, 936, 1001, 1101) of the elongated surgical tool (113, 153, 938, 1009, 1109, 1204) upon rotation of the adapter (105, 151, 323, 501, 601, 909, 1011, 1111, 1205).

5. The adapter of any one of claims 1 to 4, wherein the one or more movers (161, 163, 719, 1015, 1017, 1115, 1207) include a recess formed in the recess (509, 609, 707, 913), the recess being shaped and sized to attach to a control component of the proximal portion (160, 703, 903, 936, 1001, 1101) of the elongated surgical tool (113, 153, 938, 1009, 1109, 1204).

6. The adapter of any one of claims 1 to 5, wherein the transmission coupling (1020, 1022, 1024, 1119, 1121) is configured radially outwardly relative to the recess (509, 609, 707, 913).

7. An adapter according to any one of claims 1 to 6, wherein the proximal portion (160, 703, 903, 936, 1001, 1101) comprises a handle and the control component, when moved, influences the movement and / or mechanical properties of at least the distal end (801) of the elongated surgical tool (113, 153, 938, 1009, 1109, 1204).

8. The adapter of claim 7, wherein at least a portion of the housing (701, 711, 1013, 1113, 1213, 1301) is configured to slide linearly relative to a body of a handle along at least a portion of the length of the body.

9. The adapter of claim 1 , wherein the control component is selected from the group consisting of an axial slider, a lock, and a rotatable knob.

10. The adapter of any one of claims 1 to 9, wherein the transmission coupling (1020, 1022, 1024, 1119, 1121) comprises an attachment to a lead screw, pin, or rod driven by the motor-driven transmission (167) of the motor-driven robotic surgical device (103, 169, 303, 901, 943).

11. The adapter of claim 1 , wherein the housing (701, 711, 1013, 1113, 1213, 1301) is configured to rotate as a single unit about the longitudinal axis of the primary recess (507).

12. 2. The adapter of claim 1, wherein the recess (509, 609, 707, 913) and the one or more movers (161, 163, 719, 1015, 1017, 1115, 1207) are configured to rotate while the transmission coupling (1020, 1022, 1024, 1119, 1121) remains stationary.

13. 10. The adapter of claim 1, wherein the housing (701, 711, 1013, 1113, 1213, 1301) comprises a mechanical and / or electrical connection arranged and configured to attach to a housing of the motorized robotic surgical device (103, 169, 303, 901, 943).

14. The adapter of claim 1 , comprising a clutch that disengages the one or more moving bodies (161, 163, 719, 1015, 1017, 1115, 1207) from the transmission coupling (1020, 1022, 1024, 1119, 1121).

15. An adapter according to any one of the preceding claims, comprising at least one sensor configured to indicate the relative position of said one or more mobile objects (161, 163, 719, 1015, 1017, 1115, 1207).

16. The adapter of claim 15 , wherein the at least one sensor comprises an optical encoder.

17. 1. An assembly comprising: An adapter (105, 151, 323, 501, 601, 909, 1011, 1111, 1205) according to claim 1; an elongated surgical tool (113, 153, 938, 1009, 1109, 1204) having a proximal portion (160, 703, 903, 936, 1001, 1101) engaged by said adapter (105, 151, 323, 501, 601, 909, 1011, 1111, 1205); The assembly comprising:

18. 18. The assembly of claim 17, wherein the proximal portion (160, 703, 903, 936, 1001, 1101) is removably received within the main recess (507) of the adapter (105, 151, 323, 501, 601, 909, 1011, 1111, 1205).

19. The assembly of claim 17, wherein the elongated surgical tool (113, 153, 938, 1009, 1109, 1204) comprises a guidewire.

20. 18. The assembly of claim 17, wherein the elongated surgical tool (113, 153, 938, 1009, 1109, 1204) comprises a microcatheter.

21. 1. A system comprising: a. a robotic device configured for manipulation of at least one elongated surgical tool (113, 153, 938, 1009, 1109, 1204), said robotic device comprising one or more motors for actuating movement of said at least one elongated surgical tool (113, 153, 938, 1009, 1109, 1204); b. The adapter of claim 1 configured for operative attachment to the robotic device; The system comprising:

22. 22. The system of claim 21, wherein the robotic device comprises a controller configured to control movement of the one or more movers of the adapter to affect the proximal portion of the elongated surgical tool and the distal portion of the elongated surgical tool.

23. 23. The system of claim 22, further comprising a remote interface for controlling the controller.

24. 22. The system of claim 21, wherein a mover of the one or more movers (161, 163, 719, 1015, 1017, 1115, 1207) comprises one of a mounting portion mounted on a slide component of the proximal portion (160, 703, 903, 936, 1001, 1101) of the elongated surgical tool (113, 153, 938, 1009, 1109, 1204), a gear arranged to rotate a rotatable component of the proximal portion of the elongated surgical tool (113, 153, 938, 1009, 1109, 1204).

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