Robotic positioning cart for surgical procedures

Abstract

A surgical positioning cart for supporting a robotic device for a surgical procedure is provided. [Solution] The surgical positioning cart comprises a base whose distal side faces the surgical entrance site of the patient and is movable along at least a horizontal reference plane; a head that is pivotable relative to the horizontal reference plane and defines, together with the horizontal reference plane, different tilt angles within a plane consisting of at least a vertical axis and a longitudinal axis; a slider that fixedly receives at least a portion of a surgical robot device and is attached to the head so as to be pivotable together with the head and movable relative to the head along at least the longitudinal axis; and a neck that connects the base and the head pivotally attached thereto and has an adjustable height determined by its vertical length.

Description

[Technical Field]

[0001] The subject matter of the present disclosure is in the field of positioning carts for cart-mountable surgical robotic tools, allowing a user to position such tools for desired manipulation immediately prior to a surgical procedure, more particularly immediately prior to a transvaginal procedure. [Background technology]

[0002] More particularly, the subject matter of the present disclosure relates to a positioning device for removably mounting a robotic surgical tool of the type disclosed in U.S. Patent No. 10,463,438, intended primarily for transvaginal procedures, where the tool is attachable to a support arm that is configured to be secured to a fixture in the operating room and that provides multiple degrees of freedom for the robotic surgical tool.

[0003] There are also surgical robots that have a base body and one or more surgical arms integrally attached to and operable by the body, with the base body having multiple additional features typical of robots such as the TransEnterix Sefance® and Medrobotics Flex® Robotic Systems. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] U.S. Patent No. 10,463,438 Summary of the Invention

[0005] According to one aspect of the presently disclosed subject matter, there is provided a mobile surgical positioning cart configured to support a surgical device, e.g., via a component of a surgical robotic device, and to linearly advance the surgical device into a patient's body at a selected angle and / or height. The surgical positioning cart has a proximal side, a distal side configured to face the patient's surgical entrance site and substantially opposite the proximal side, a central longitudinal axis between the two sides, a longitudinal axis passing through the two sides and intersecting the longitudinal axis, and a width axis perpendicular to the longitudinal axis, wherein the longitudinal axis and the width axis define a horizontal reference plane.

[0006] The surgical positioning cart includes a base, a neck, a head, and a slider. More specifically, the base can be movable at least along a horizontal reference plane. The head can be tiltable / pivotable relative to a horizontal plane to define different tilt angles with the horizontal plane at least within a plane consisting of the longitudinal axis and the vertical axis. The slider is configured to fixedly receive at least a portion of the robotic device thereon and can be attached to the head to tilt / pivot therewith and move relative thereto at least along the vertical axis. A neck connecting the base and the head (pivotally attached thereto) can have an adjustable height determined by the length of the neck in the vertical direction.

[0007] The surgical robotic device has a length l and a width w substantially less than the length l, such that a projection of the head with the slider on a horizontal reference plane has a width W along the width axis, and the ratio w:W can be less than 1:2. More specifically, the ratio w:W can be less than 1:1.8, more specifically less than 1:1.7, more specifically less than 1:1.6, and more specifically between 1:1.5 and 1:1.6. In some examples, the ratio w:W can be 1:1.57. The ratio w:W can be in any one of the following ranges: 1:1.2 to 1:2, 1:1.4 to 1:1.8, 1:1.4 to 1:1.6, or 1:1.5 to 1:1.6.

[0008] In some embodiments in which the robotic surgical device is fixedly housed and / or mounted to the slider, w can also be the projection of the robotic surgical device on a horizontal reference plane along a width axis. In this case, the robotic surgical device can have multiple motors arranged longitudinally, and the width w can be defined by the multiple motors and their sizes in a plan view of the robotic surgical device, for example, along the width axis.

[0009] Additionally or alternatively, the ratio of the width w of the surgical robotic device to the width Wh of the head can be in the range of 1:1 to 1:2, where Wh is the width of the projection of the head on a horizontal reference plane along the width axis. For example, the width W of the projection of the head with the slider on a horizontal reference plane along the width axis of the cart can be less than 26 cm.

[0010] The projection of the neck on the horizontal reference plane may be located within the boundaries of the projection of the head on the horizontal reference plane, at least in the width direction.

[0011] If the head and slider have different widths, the projection of the narrower of the two on the horizontal reference plane can fit within the boundaries of the wider projection along the width axis.

[0012] The slider may be attached to the head so as to be slidable along the longitudinal axis, and may be movable between a proximal position and a distal position.

[0013] The head can have a longitudinal extension L1 that can extend along the longitudinal axis, and the slider can have a longitudinal extension L2 that can extend along at least a majority of the longitudinal extension L1, for example, when the slider is positioned in the closest position. When the slider is positioned in the farthest position, at least a majority of the slider, for example, along the longitudinal extension L2, can protrude away from the head.

[0014] The surgical positioning cart further includes one or more controllers, which can be configured to control one or more of neck length adjustment, head tilt / pivot movement, or slider linear movement. The one or more controllers can be located at the proximal end of the slider. More specifically, the one or more controllers can be located at the proximal end of the cart. For example, one controller can be located at the proximal end of the cart handle. In another example, the controllers can be spaced apart from the proximal end of the cart in the proximal direction. In some embodiments, the controller can remotely control the cart via any communication means, such as, for example, a cable or wireless transmission.

[0015] The base can have a base projection on a horizontal reference plane with a base distal end a distance D1 from the longitudinal axis. The head can have a head projection on a horizontal reference plane with a head distal end a distance D2 from the longitudinal axis. The neck can have a neck projection on a horizontal reference plane with a neck distal end a distance D3 from the longitudinal axis. Optionally, distance D1 can be greater than or equal to D2 and D3.

[0016] In one embodiment, when the slider is in its closest position, e.g., in a compact configuration, the area of ​​the projection of the cart on the reference plane is 0.28 m 2 It can be made smaller.

[0017] The neck may have an elliptical shape such that the longitudinal extension L3 of the neck extends along the longitudinal axis of the cart. The neck may be a telescoping pole, for example a telescoping elliptical pole.

[0018] The surgical positioning cart may further include a tilt adjustment mechanism including a tilt adjustment actuator configured to adjust the tilt angle of the head, which may be within a range of ±30 degrees relative to a horizontal reference plane.

[0019] The slider may be further configured to lockingly engage a portion of a surgical robotic device. The slider may be further configured to allow relative movement of a moveable portion of the surgical robotic device with respect to the portion of the device configured to lockingly engage the slider.

[0020] The slider of the surgical positioning cart may further include a connector mechanism configured to place and lock a portion of the surgical robotic device.

[0021] The slider of the surgical positioning cart can further include at least two sockets on the top surface of the slider, disposed at a distal end and a proximal end of the slider, each socket configured to receive a protruding element of a surgical robotic device therein and to allow the protruding element to move linearly along the longitudinal axis relative to the slider.

[0022] The projection of the base on the horizontal reference plane may be less than 45 cm in width along the width axis. The projection of the head on the horizontal reference plane may be located within the boundaries of the projection of the base on the horizontal reference plane, at least in the width direction.

[0023] The base of the surgical positioning cart may have an interior formation configured to accommodate at least one weight therein.

[0024] The surgical positioning cart can further include wheels coupled to the base, thereby allowing the base to be moved along a horizontal reference plane. The surgical positioning cart can be manually or electronically movable.

[0025] The surgical positioning cart can further include support legs, which can have an unfolding configuration to improve stability of the cart or to prevent the base from being movable along at least a horizontal reference plane. The support legs can also have a folding configuration to allow the base to be movable along at least a horizontal reference plane.

[0026] The surgical positioning cart may further include a height adjustment actuator that is configurable to manipulate the neck to adjust the height at which the head may be held above the base.

[0027] The surgical positioning cart may further include a slider actuator, which may be configured to set the movement of the slider.

[0028] The surgical positioning cart further includes an electrical safety feature that can be configured to enable or disable any one or more of the height adjustment actuator, the tilt adjustment actuator, the sliding movement of the slider, or the movement of the cart as a whole.

[0029] The slider of the surgical positioning cart can be movable relative to the head along at least the longitudinal axis, for example, via one or more rails positionable along the longitudinal axis of the head.

[0030] A further aspect of the presently disclosed subject matter is a method for aligning a patient's surgical entry site with a surgical positioning cart, such as those detailed above, supporting a robotic surgical device thereon, the method comprising the steps of: attaching and optionally locking the robotic surgical device to a slider; moving the base along at least a horizontal reference plane; adjusting the height of the neck vertically; tilting / pivoting the head relative to the horizontal plane to define different tilt angles in the plane of at least the vertical and longitudinal axes; and sliding the slider along the longitudinal axis.

[0031] According to a further aspect of the presently disclosed subject matter, there is provided a method of stabilizing and positioning a surgical robotic device relative to a patient's surgical entry site, the method comprising the steps of: providing a cart, e.g., as detailed above, comprising a slider, a base, a head carrying the slider, and a neck holding the head; attaching and optionally locking the surgical robotic device to the slider; moving the base along at least a horizontal reference plane to a position adjacent the surgical entry site; adjusting the vertical height of the neck connecting the base and the head; tilting / pivoting the head relative to the horizontal plane; and sliding the slider along a longitudinal axis.

[0032] According to another aspect of the presently disclosed subject matter, a surgical positioning cart supporting a robotic surgical device according to any of the aspects of the presently disclosed subject matter described above can be used to position and orient the robotic surgical device prior to a vaginal approach surgical procedure, an abdominal approach surgical procedure, or a cranial approach surgical procedure. In a cranial approach surgical procedure, the cart can be used to position the robotic surgical device relative to a treatment target location on the patient's head, e.g., a port, an incision made in the patient's head, and / or a natural body orifice, e.g., a mouth, in a manner that allows for optional introduction of one or more elements of the device through the treatment target location on the head.

[0033] In all of the above aspects, the surgical robotic device may be of a type having robotic arms that protrude from the remainder of the device, and the slider may be configured such that when the surgical device is mounted thereon, the robotic arms protrude distally from the remainder of the device, and optionally from the slider.

[0034] The alignment of the robotic surgical device may be established, at least in part, by the positioning of the cart and may be controlled by one or more actuators on the cart. For example, a method of positioning the robotic surgical device may include adjusting the position and / or orientation, e.g., height and / or tilt angle, of the robotic surgical device using the cart.

[0035] In some embodiments of each of the above-described aspects of the presently disclosed subject matter, the controlled movement of each one of the cart elements can be performed independently of one or more of the other elements. For example, the controlled movement may include adjusting the height and / or tilt angle of the head and slider, while the linear advancement of the slider can be performed separately from the head. The controlled movement may include linear advancement of the slider toward the location of the patient or target area on the patient. The linear advancement of the slider may be manually adjusted, thereby allowing for fine adjustment and precise movement of the slider toward the target area.

[0036] According to some exemplary embodiments, at least some of the controller(s) may comprise or be in the form of motion controllers, e.g., knobs and / or electronic switches, configured to control the activation of one or more actuators, e.g., electric motors, and operatively connected to elements of the cart, such as a movable part of the cart, e.g., a slider, head, neck, or base. In some embodiments, the one or more motion controllers may control the actuation of the one or more actuators according to motion parameter instructions, e.g., motion speed, motion duration, motion acceleration, motion distance, or any other motion-related parameter, which may be stored in a memory of the cart.

[0037] In some embodiments, the cart may include a user interface that may be configured to generate a human-detectable display based on signals received from the motion sensor(s), for example, to detect the location of the target area.

[0038] The cart can be used to position the robotic surgical device near a patient's treatment target location, such as a natural body orifice, a surgical port, an incision, or a target location on the exterior surface of the body or on the patient's skin. The cart can be configured to align the robotic surgical device or a component thereof, such as a robotic arm of the surgical device, with the treatment target location. The slider, configured to be advanced toward the target area location, can be configured, for example, to insert one or more robotic arms of the mounted robotic surgical device into the target area location or to bring the arms closer to the surgical target area location. For example, the slider can be configured to bring the robotic surgical device closer to a distance of less than 10 cm from the target area location.

[0039] According to some exemplary embodiments, the cart includes at least one motion sensor electrically connected to a control circuit configured to sense the position and / or orientation of the cart. The cart control circuit can control the movement of the cart and / or one or more elements, including the slider, so that the movement is maintained within a predetermined range of values. For example, by activating or deactivating at least one actuator and / or motor configured to move the cart elements based on the measured position and / or orientation, the cart control circuit can maintain the movement of the cart or its elements within a predetermined range related to a range of movement, a speed of movement, an acceleration, and / or a time of movement. According to some exemplary embodiments, the control circuit monitors the position and / or orientation of one or more of the cart components, such as the slider, head, neck, or base, during a surgical procedure, for example, when a robotic arm of a surgical robotic device is positioned within a treatment target location and / or in contact with body tissue. In some embodiments, a warning signal or instruction can be generated if the monitored position and / or orientation changes.

[0040] According to some exemplary embodiments, the cart may include one or more locks for securing the cart and / or one or more of its components, particularly the head and / or slider, in its desired position and / or orientation. For example, the locks may be used to secure the head and / or slider at any desired height. The locks may be of the same or different types, and may be in the form of, for example, electromagnetic locks.

[0041] According to some exemplary embodiments, the tilt adjustment actuator can be operatively connectable to a tilt adjustment user interface, which may be separate from or part of the cart's user interface, and can be configured to control operation of the tilt adjustment mechanism, for example, by being electrically connected to the interface. In some embodiments, the tilt adjustment user interface can include a switch configured to initiate a change in the user interface tilt angle relative to a reference plane, for example, to a zero-degree state when the slider is parallel to the support surface. Optionally, the tilt adjustment user interface can enable automatic tilt adjustment of the head and slider to the zero-degree state. In some embodiments, the user interface provides a human-detectable indication, for example, by vibration and / or sound, when the zero-degree state is reached.

[0042] According to some exemplary embodiments, the handle of the cart can include a tilt angle adjustment switch and a height adjustment switch that are adjacent to each other and, optionally, can be moved parallel to each other. In some embodiments, the handle can include one or more slider advancement switches, for example, two slider advancement switches. In some embodiments, a distance and / or angle difference between the position of one or more slider advancement switches and the position of other adjustment switches can reduce the risk of accidentally activating one or more slider advancement switches when adjusting the slider height and / or tilt angle. Optionally, the handle can have a lower handle portion positioned lower than at least one user interface. In some embodiments, the lower handle portion has a V-shaped configuration.

[0043] According to some exemplary embodiments, either of the motion adjusters (e.g., height adjusters or tilt adjusters) is operatively connected to a motion adjustment user interface. In some embodiments, the motion adjustment user interface allows for manually activating the motion adjuster and / or controlling the movement of a slider. In some embodiments, a user may activate and / or deactivate the motion adjuster by activating one or more locks, e.g., electromagnetic locks, using the user interface.

[0044] In some embodiments, the cart can be part of a surgical unit, which can include the cart, a robotic surgical device, and a control console configured to control the robotic surgical device. In some embodiments, when the position of the cart or any element thereof, such as a slider, is fixed, the control circuitry can deliver an indication to the control console that the cart and robotic surgical device are in place. According to some exemplary embodiments, the control console is configured to control at least some of the movements of the cart or any part thereof, for example, by wireless and / or wired signal transmission.

[0045] According to some exemplary embodiments, the surgical robotic device may include a linear unit at the bottom of the surgical device connectable to a slider, e.g., via a connector on the slider, which may be configured to lock a portion of the surgical robotic device in place when locked. The linear unit and connector may be configured such that engagable mating elements, e.g., male elements on the linear unit, are lockingly received within female elements on the connector. In particular, the connector on the slider may include openings corresponding in shape and / or size to protrusions formed on the linear unit of the surgical device.

[0046] According to some exemplary embodiments, an arm, e.g., a robotic arm, can be connected to the surgical robotic device, e.g., after the robotic device is securely attached to a cart. Alternatively, a robotic device having one or more robotic arms, e.g., two, four, six, eight, or any intermediate, smaller, or larger number of robotic arms, can be attached to the cart before loading onto the slider. In some embodiments, the one or more robotic arms can be operatively connected to the motor unit of the surgical robotic device through one or more top openings in the motor unit casing of the surgical robotic device. In some embodiments, the robotic arm is connected to the motor unit only after the linear unit is connected and locked to the slider of the cart.

[0047] In some embodiments, control over the cart and / or its elements can be remote, for example from a console or from a tablet, such as remotely controlling head height and / or tilt angle. In some embodiments, the remote control can be wirelessly connected to the cart and can be controlled from two separate locations: the remote location and the cart's user interface. In some embodiments, the controller can allow for fine adjustment of angle / height. Additionally, the controller can allow for automatic return to a "home" position and / or saving the last coordinate location in case the user wishes to repeat or return to a position.

[0048] In the presently disclosed subject matter, the term "width" with respect to any physical device or part thereof, or its projection on a plane, e.g., a reference and / or support surface, means its greatest width at least along its width axis.

[0049] The above general description is provided to enable a general understanding of the nature of the subject matter disclosed herein, without limiting it to specific embodiments and examples. While more specific descriptions are provided in the detailed description, the following are non-limiting examples of different embodiments of the subject matter disclosed herein.

[0050] First embodiment: 1. A surgical positioning cart configured to support a surgical robotic device, the surgical positioning cart comprising: a proximal side; a distal side configured to face a patient's surgical entrance site and substantially opposite the proximal side; a central longitudinal axis between the two sides; a longitudinal axis passing through the two sides and intersecting the central longitudinal axis; and a width axis perpendicular to the longitudinal axis and the central longitudinal axis, the longitudinal axis and the width axis defining a horizontal reference plane, the surgical positioning cart comprising: a base movable along at least the horizontal reference plane; and a base pivotable relative to the horizontal reference plane. a head defining different inclination angles with respect to the horizontal reference plane at least within a plane formed by the central vertical axis and the longitudinal axis; a slider configured to fixedly receive at least a portion of the robotic device, the slider attached to the head for pivotal movement therewith and for movement relative to the head along at least the longitudinal axis; and a neck connecting the base and the head pivotally attached to the base, the neck having an adjustable height determined by a longitudinal length.

[0051] Second embodiment: 10. The surgical positioning cart of claim 1, wherein the surgical robotic device has a length l and a width w that is essentially smaller than the length l, and a projection of the head with the slider on the horizontal reference plane has a width W along the width axis, and the ratio w:W is less than 1:2.

[0052] Third embodiment: 10. The surgical positioning cart of claim 2, wherein the surgical robotic device has multiple motors arranged in a longitudinal direction, and the width w is defined by the number of motors and the size of the motors in a plan view of the surgical robotic device.

[0053] Fourth embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, wherein the slider is movable between a closest position and a furthest position.

[0054] Fifth embodiment: 10. A surgical positioning cart according to a fourth embodiment, wherein the head has a longitudinal extension L1 along the longitudinal axis, and the slider has a longitudinal extension L2, the longitudinal extension L2 extending along at least a majority of the longitudinal extension L1 when the slider is positioned in the closest position.

[0055] Sixth embodiment: A surgical positioning cart according to a fifth embodiment, when directly or indirectly referring to the fourth embodiment, wherein when the slider is positioned in the farthest position, at least a majority of the longitudinal extension L2 of the slider protrudes away from the head.

[0056] Seventh embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, wherein a projected width of the head with the slider on the horizontal reference plane along the width axis of the surgical positioning cart is less than 26 cm.

[0057] Eighth embodiment: 10. The surgical placement cart of any one of the preceding embodiments, further comprising at least one controller configured to control at least one of the adjustment of the length of the neck, the pivotal movement of the head, or the linear movement of the slider.

[0058] Ninth embodiment: 10. The surgical placement cart of claim 8, wherein the at least one controller is located at a proximal end of the slider.

[0059] Tenth embodiment: 9. The surgical placement cart of claim 8, wherein the at least one controller is located at a proximal end of the surgical placement cart.

[0060] Eleventh embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, wherein when the width of the head and the width of the slider are different, the projection of the narrower width of the head and the slider on the horizontal reference plane falls within the boundaries of the projection of the wider width of the head and the slider on the horizontal reference plane along the width axis.

[0061] Twelfth embodiment: 1. The surgical positioning cart according to any one of the preceding embodiments, wherein, when directly or indirectly referring to the second embodiment, the projection of the head on the horizontal reference plane has a width W along the width axis, and the ratio w:W is in the range of 1:1 to 1:2.

[0062] Thirteenth embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, wherein the base has a base projection on the horizontal reference plane with a base distal end a distance D1 from the central longitudinal axis; the head has a head projection on the horizontal reference plane with a head distal end a distance D2 from the central longitudinal axis; and the neck has a neck projection on the horizontal reference plane with a neck distal end a distance D3 from the central longitudinal axis, wherein distance D1 is greater than or equal to each one of D2 and D3.

[0063] Fourteenth embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, wherein a projection of the neck on the horizontal reference plane is disposed within the boundaries of a projection of the head on the horizontal reference plane in at least the width direction.

[0064] Fifteenth embodiment: 10. The surgical placement cart of claim 9, wherein the projection area of ​​the surgical placement cart on the horizontal reference plane when the slider is in the closest position is 0.28 m 2 Smaller, surgical placement cart.

[0065] Sixteenth embodiment: 10. The surgical placement cart of any one of the preceding embodiments, wherein the neck has an elliptical shape in plan view, and a longitudinal extension L3 of the neck extends along the longitudinal axis of the surgical placement cart.

[0066] Seventeenth embodiment: 10. The surgical placement cart of any one of the preceding embodiments, wherein the head is pivotable in a plane formed by the longitudinal axis and the width axis.

[0067] Eighteenth embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, wherein the slider is further configured to lockingly engage a portion of the surgical robotic device.

[0068] Nineteenth embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, wherein the slider is further configured to allow a moveable portion of the surgical robotic device to move relative to the portion of the device configured to lockingly engage with the slider.

[0069] 20th embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, wherein the slider further comprises a connector mechanism configured to position and lock a portion of the surgical robotic device.

[0070] 21st embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, wherein the slider further comprises at least two sockets, the at least two sockets being disposed at a distal end and a proximal end of the slider, respectively, and disposed on an upper surface of the slider, each socket configured to receive a protruding element of the surgical robotic device therein and configured to allow linear movement of the protruding element relative to the slider along the longitudinal axis.

[0071] Twenty-second embodiment: 13. A surgical positioning cart as described in any one of the preceding embodiments that directly or indirectly cites a thirteenth embodiment, wherein the projection of the base on the horizontal reference plane has a width along the width axis, the width being less than 45 cm.

[0072] Twenty-third embodiment: 13. A surgical positioning cart according to any one of the preceding embodiments that directly or indirectly cites the thirteenth embodiment, wherein a projection of the head on the horizontal reference plane is disposed within the boundaries of a projection of the base on the horizontal reference plane in at least the width direction.

[0073] Twenty-fourth embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, wherein the base has an internal configuration configured to accommodate at least one weight.

[0074] Twenty-fifth embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, further comprising wheels coupled to the base, the wheels enabling movement of the base along the horizontal reference plane.

[0075] Twenty-sixth embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, further comprising support legs, the support legs having an unfolded configuration configured to promote stability of the cart and a folded configuration, the support legs preventing the base from being movable along at least the horizontal reference plane when the support legs are in the unfolded configuration.

[0076] Twenty-seventh embodiment: 26. A surgical positioning cart as described in a 26th embodiment, wherein the base is movable along at least the horizontal reference plane when the support legs are in the folded configuration.

[0077] Twenty-eighth embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, wherein the tilt angle is within a range of ±30 degrees relative to the horizontal reference plane.

[0078] Twenty-ninth embodiment: 10. The surgical placement cart of any one of the preceding embodiments, further comprising a height adjustment actuator configured to manipulate the neck to adjust the height at which the head is held above the base.

[0079] Thirty embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, further comprising a tilt adjustment actuator, the tilt adjustment actuator configured to adjust the tilt angle of the head.

[0080] Thirty-first embodiment: 10. The surgical placement cart of any one of the preceding embodiments, further comprising a slider actuator configured to set the movement of the slider.

[0081] Thirty-second embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, wherein the surgical positioning cart is manually movable.

[0082] Thirty-third embodiment: 32. A surgical positioning cart as described in any one of the thirtieth to thirty-second embodiments, further comprising an electrical safety feature configured to enable or disable operation of at least one, and optionally all, of the height adjustment actuator, the tilt adjustment actuator, the sliding movement of the slider, or the movement of the entire surgical positioning cart.

[0083] Thirty-fourth embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, wherein the slider is movable relative to the head at least along the longitudinal axis via one or more rails extending along the longitudinal axis of the head.

[0084] Thirty-fifth embodiment: 10. The surgical placement cart of any one of the preceding embodiments, wherein the neck is a telescoping pole.

[0085] Thirty-sixth embodiment: 10. The surgical positioning cart of any one of the preceding embodiments, directly or indirectly citing the second embodiment, wherein the ratio w:W is less than 1:1.8, optionally less than 1:1.7, optionally less than 1:1.6.

[0086] Thirty-seventh embodiment: A surgical positioning cart according to any one of the preceding embodiments, including the second embodiment, wherein the ratio w:W is within any of the following ranges: 1:1.2 to 1:2, 1:1.4 to 1:1.8, 1:1.4 to 1:1.6, and 1:1.5 to 1:1.6.

[0087] Thirty-eighth embodiment: 10. The surgical positioning cart according to any one of the preceding embodiments, which directly or indirectly relies on the second embodiment, wherein the ratio w:W is 1:1.57.

[0088] Thirty-ninth embodiment: 10. The surgical placement cart of claim 8, wherein the at least one controller is spaced proximally from a proximal end of the surgical placement cart.

[0089] Fortieth embodiment: 1. A method for aligning a surgical positioning cart supporting a surgical robotic device with respect to a surgical entrance site of a patient, the surgical positioning cart comprising: a proximal side; a distal side configured to face the surgical entrance site and substantially opposite the proximal side; a central longitudinal axis between the two sides; a longitudinal axis passing through the two sides and intersecting the central longitudinal axis; and a width axis perpendicular to the longitudinal axis and the central longitudinal axis, the longitudinal axis and the width axis defining a horizontal reference plane; the surgical positioning cart comprising: a base; a neck; a head; and a slider attached to the head. wherein the neck is connected between the base and the head, the method comprising: mounting and optionally locking the surgical robot device to the slider; moving the base at least along the horizontal reference plane; adjusting the height of the neck in a vertical direction; pivoting the head relative to the horizontal reference plane to define, together with the horizontal reference plane, different tilt angles in a plane consisting of at least the central vertical axis and the longitudinal axis; and sliding the slider along the longitudinal axis.

[0090] Forty-first embodiment: 1. A method for stably positioning a robotic surgical device relative to a patient's surgical entry site, the method comprising: providing a cart comprising a slider, a base, a head carrying the slider, and a neck holding the head; mounting and optionally locking the robotic surgical device to the slider; moving the base along at least a horizontal reference plane to a position near a surgical entry site; vertically adjusting the height of the neck connecting the base and the head; pivoting the head relative to the horizontal reference plane; and sliding the slider along the longitudinal axis.

[0091] Forty-second embodiment: A method according to the fortieth or forty-first embodiment, wherein the surgical positioning cart is a surgical positioning cart according to any one of the first to thirty-ninth embodiments.

[0092] In order to better understand the subject matter disclosed herein and to illustrate how it may be carried out in practice, embodiments will now be described, by way of non-limiting example only, with reference to the accompanying drawings in which: [Brief explanation of the drawings]

[0093] [Figure 1A] FIG. 1A is a schematic side view of a surgical placement cart in accordance with an embodiment of the presently disclosed subject matter, the cart being in its initial state. [Figure 1B] FIG. 1B is a perspective view of the surgical positioning cart shown in FIG. 1A. [Figure 1C] FIG. 1C is a side view of the surgical placement cart shown in FIGS. 1A and 1B with the neck extended. [Figure 1D] FIG. 1D is a side view of the surgical positioning cart shown in FIGS. 1A and 1B with the head tilted relative to its base. [Figure 2]FIG. 2 is a perspective view of the surgical positioning cart shown in FIGS. 1A and 1B with the slider displaced. [Figure 3A] FIG. 3A is a diagram schematically showing the projection of the head and slider of the cart shown in FIGS. 1A and 1B onto a horizontal plane. [Figure 3B] FIG. 3B is a diagram schematically showing the projection of the base, head, and slider of the cart shown in FIGS. 1A and 1B onto a horizontal plane. [Figure 3C] FIG. 3C is a diagram showing a schematic view of the base, neck, head, and slider of the cart shown in FIGS. 1A and 1B projected onto a horizontal plane. [Figure 4A] FIG. 4A is a side view of a mobile cart according to another embodiment of the presently disclosed subject matter. [Figure 4B] 4B is a diagram illustrating an example of the internal configuration of the head of the cart shown in FIG. 4A, according to an embodiment of the disclosed subject matter. [Figure 4C] 4C is a diagram illustrating an example of the internal configuration of the head of the cart shown in FIG. 4A, according to an embodiment of the disclosed subject matter. [Figure 4D] FIG. 4D illustrates an example of a top perspective view that the slider of the cart shown in FIGS. 4A and 4B may have, according to an embodiment of the disclosed subject matter. [Figure 5A] FIG. 5A shows the cart shown in FIG. 4A with a surgical robotic device attached for treatment at the target area location, with its slider in the initial position. [Figure 5B] FIG. 5B shows the cart shown in FIG. 4A with a surgical robotic device attached for treatment at the target area location, with its slider in the extended position. DETAILED DESCRIPTION OF THE INVENTION

[0094] Described below is a mobile surgical positioning cart configured to support a surgical device / tool, such as a surgical robotic device, in accordance with the presently disclosed subject matter to allow the surgical device to be advanced linearly into a patient at a selected angle and / or height. For example, the positioning cart may be movable along a horizontal plane to position the surgical device so that it is aligned with or near a selected treatment target location on the patient.

[0095] In accordance with the subject matter of the present disclosure, the cart has a compact design and / or a relatively small footprint, at least along its width axis, at least of the components thereof that hold the surgical robotic device, thereby allowing a user, e.g., a doctor, nurse, and / or technician, to move the system close to the treatment target location without obstructing the user's field of view (FOV).

[0096] The treatment target location may be any one of a body entry site, such as a port formed in the patient, an incision in the patient, an anatomical opening in the patient's body, or other opening in the patient's body. Alternatively, or additionally, the target location comprises a treatment target site located on an external surface of the body, such as on the skin of the body. In accordance with the presently disclosed subject matter, the cart is shaped and sized to allow easy vaginal access to the treatment target location, for example, by placing the cart between the patient's legs.

[0097] 1A and 1B, which are schematic side and perspective views, respectively, of a mobile surgical positioning cart 100 in accordance with an embodiment of the presently disclosed subject matter, the surgical positioning cart 100 configured to carry and support a surgical robotic device (not shown) having a length l and a width w that is substantially less than the length l, e.g., a ratio of length l to width w of at least 3.5:1. Such a system can have, for example, multiple motors arranged in at least two rows along the length of the system, the size of which defines the width w of the system in plan view. An example of such a system is disclosed in commonly owned U.S. Pat. No. 10,463,438.

[0098] Cart 100 has a proximal side 102, a distal side 104 substantially opposite proximal side 102 and configured to face a patient, e.g., a surgical entrance site of the patient, a central longitudinal axis VA between the two sides, a longitudinal axis LA passing through the two sides and intersecting the longitudinal axis VA, a width axis WA perpendicular to the longitudinal axis LA and the longitudinal axis VA, and a horizontal reference plane RP (shown in FIG. 1B) defined by the longitudinal axis LA, the width axis WA, and the horizontal reference plane RP. The longitudinal axis LA, the width axis WA, and the horizontal reference plane RP can be considered to be at any position along the longitudinal axis VA, and their different positions can be shown on the drawings depending on the positions of the associated described components.

[0099] The cart 100 includes a base 110 , a neck 120 , a head 130 , and a slider 140 .

[0100] Base 110 provides structural support to the other components of cart 100 and is configured to be movable therewith parallel to a support surface, such as an operating room floor. For purposes of this specification, the support surface is considered to be parallel to or defined by horizontal reference plane RP. Base 110 may have a projection on horizontal reference plane RP that is larger than that of the other components of cart 100 and / or may have an interior configuration configured to accommodate at least one weight therein and / or thereon to ensure stability of the cart.

[0101] Neck 120 is attached to base 110, and its height H is adjustable along a central longitudinal axis VA, as shown in FIG. 1C. For example, neck 120 can be in the form of a telescoping pole, and either neck 120 or base 110 can include an actuator configured to manipulate the height H of neck 120. Neck height H can vary between 34 cm in the compact configuration and 115 cm in the extended configuration, thereby allowing for variations in overall cart height from 0.86 meters in the compact configuration to 1.7 meters in the extended configuration. Neck 120 can have an elliptical shape such that a longitudinal extension L3 of the neck is disposed along the longitudinal axis.

[0102] The head 130 is pivotally mounted on the neck 120, allowing the head to be tilted at different tilt angles relative to a horizontal plane RP. The head 130 has a longitudinal extension L1 along a longitudinal axis LAh. As shown in FIG. 1D , the head 130 may be pivotable about its width axis WA such that the longitudinal axis LAh forms a variation angle α with a reference plane RP in the plane formed by the longitudinal axis VA and the longitudinal axis LA. The tilt angle α may be within a range of ±30 degrees relative to the reference plane RP when the reference plane RP passes through the center of the head 130, which is located at the intersection of the longitudinal and width axes. This range may be narrower, for example, ±25 degrees, ±15 degrees, or more specifically ±5 degrees, for pre-treatment of intravaginal procedures. Optionally, the head 130 may also be pivotable about its longitudinal axis LAh and / or the longitudinal axis VA.

[0103] The slider 140 is slidably mounted to the head 130 such that the slider 140 is movable along a longitudinal axis LAh between its closest position, shown in Figures 1A-1D, and its farthest position, designated 220 in Figure 2. When positioned in the closest position, the slider 140, having a longitudinal extension L2, extends along at least a majority of the longitudinal extension L1 of the head 130, i.e., its distal end 142 does not or does not substantially protrude distally from the head 130. In the farthest position 220, the slider's distal end 142 essentially protrudes distally from the head 130, bringing the surgical device closer to the selected treatment target location. Thus, when positioned at the farthest position 220, the far end 142 of the slider is moved a distance D relative to the nearest position, the distance D being at least 30%, more particularly at least 40%, and even more particularly at least 50%, e.g., 58%, of the length of the slider, and may be as long as 31 cm for a slider length of 54 cm.

[0104] Referring now to FIG. 3A, this figure shows a plan view of the horizontal reference plane RP, with the projections of the head 130 and the slider 140 thereon labeled HP and SP, respectively. FIG. 3B shows a plan view of the horizontal reference plane RP with the head and slider projected onto the surgical robotic device, labeled H&SP and SRSP, respectively. In this embodiment, the width Ws of the slider projection can be smaller, equal to, or larger than the width Wh of the head projection along the width axis WA. However, in either case, the narrower projection fits within the boundary of the wider projection, at least along the width axis WA. Note that the width of the slider and head projections H&SP on the horizontal reference plane RP is smaller than 26 cm, e.g., 22 cm. As shown in FIG. 3C, the neck projection NP on the horizontal reference plane RP of the cart 100 in this embodiment has an area substantially smaller than the projection of the head 130 and is located within the boundary of the head projection HP, at least along the width direction, e.g., along the width axis WA. As can be seen in FIG. 3C, the head and slider projections H&SP on the horizontal reference plane RP are contained within the boundaries of the base projection BP at least along the width axis WA; and the neck projection NP on the horizontal reference plane RP is contained within the boundaries of the head and slider projections H&SP on the horizontal reference plane RP at least in the width direction, e.g., in the width axis WA.

[0105] When the cart 100 of this embodiment is configured for use with a surgical robotic device having a width w of the type described above, the width of the head 130 and the width of the slider 140 can be greater than or substantially equal to the width w of the surgical robotic device. Accordingly, in this embodiment, the width W of the projection of the head 130 with the slider 140 on the horizontal reference plane RP exceeds the width w of the robotic device. For example, the ratio w:W can be less than 1:2, more specifically less than 1:1.8, more specifically less than 1:1.7, more specifically less than 1:1.6, and even more specifically between 1:1.5 and 1:1.6. A specific example of the ratio w:W is 1:1.57.

[0106] More specifically, if the cart 100 of this embodiment is intended to support the surgical robotic device described in the applicant's US Pat. No. 10,463,438, in this particular application, the shape and size of the cart 100 can be such that the width W of the head 130 and slider 140 does not exceed a predetermined dimension, for example, 26 cm, so that the cart 100, and more specifically its head 130 with slider 140, can be positioned between any anticipated patient leg opening, thereby allowing direct and uninterrupted access to the vaginal target location within the patient's body.

[0107] The width of the base 110 does not necessarily have to be as narrow as the width of the head 130 with the slider 140, but only needs to be wide enough to stably and reliably support the head attached to the neck. Thus, in the cart 100 of this embodiment, the projection of the base 110 onto the horizontal reference plane RP has a width WB along the width axis WA, which is equal to or greater than the width W of the head with slider. However, at least for the specific application described above, the base 110 can still be relatively narrow, for example, having a width WB of less than 45 cm.

[0108] In general, it is desirable to select the length and weight of the base 110 so that the base can stably and reliably support the slider 140 together with the head 130 even when the slider 140 is in the extended state 220 as shown in FIG. 2. Therefore, in the cart 100 of this embodiment, the base 110 can have a length Lb along the longitudinal axis LA so that it is at least not shorter than the head 130.

[0109] The elements of the cart 100 may have different longitudinal dimensions, i.e., different distances between their distal and proximal ends, more specifically, different distances between their distal ends and the central longitudinal axis VA of the cart. In this embodiment, the base 110 has a base projection BP on the horizontal reference plane RP, with the base distal end at a distance D1 from the longitudinal axis VA. The head 130 with the slider 140, at its closest position, has a head and slider projection H&SP on the horizontal reference plane RP, with the head and slider distal end at a distance D2 from the longitudinal axis VA. The neck 120 has a neck projection NP on the horizontal reference plane RP, with the neck distal end at a distance D3 from the longitudinal axis VA. In this embodiment, the distance D1 is greater than or equal to each one of the distances D2 and D3. Furthermore, the distal end of the head 130 protrudes farther from the distal end of the neck 120, i.e., D2 is greater than or equal to D3. The distal end of neck 120 can be shorter than the distal ends of head 130 and base 110 in the distal direction, i.e., D2 can be smaller than D1 and D3, i.e., cart 100 can have an overall "C" shape in side view.

[0110] The overall "C" shape of the cart 100 and the aforementioned ratios between the dimensions of its different elements may allow a user to position the cart 100 in close proximity to a treatment target while still maintaining a very compact cart. For example, the base 110 may fit under a patient reconfiguration surface, such as a bed or chair, while the head 130, slider 140, and surgical robotic device may be positioned above the patient reconfiguration surface and thus in close proximity to the treatment target. For example, at least for the specific application described above, the lengths may be in the following ranges: the length Lb of the base 110 is 52 cm to 62 cm, D1 is 28 cm to 34 cm, the neck longitudinal extension L3 is 14 cm to 20 cm, D3 is 7 cm to 10 cm, the head longitudinal extension L1 is 52 cm to 60 cm, and similarly, the slider longitudinal extension L2 is 52 cm to 60 cm, and D2 is 24 cm to 29 cm.

[0111] With the dimensions described above, the cart 100 is extremely compact and can occupy a relatively small total footprint, i.e., a projection area onto the reference plane RP of 0.28 m 2 can be made smaller than

[0112] 4A illustrates another embodiment of a mobile cart in accordance with the subject matter of this disclosure. In this example, the cart, designated 400, has proximal and distal sides 102 and 104, respectively, and includes all of the components described above with respect to cart 100, including base 110, neck 120, head 130 having housing 132 with an interior space, and slider 140, all of which are movable and have the parameters described above. With this in mind, the following discussion will primarily focus on features of cart 400 that are not present or described in detail in the description of cart 100.

[0113] Additionally, cart 400 has wheels 412 attached to base 110 so that cart 400 can roll along a supporting surface, such as a floor. The wheels are attached to base 110 with dimensions that allow them to protrude downward, thereby forming a space 415 below the base, i.e., between the base and a horizontal plane passing through the lowest point of the wheels.

[0114] Although not shown, the base 110 may further include one or more wheel brakes configured to prevent the wheels 412 from rolling, thereby providing stability to the cart 400 after it has been placed in its designated position, for example, to prevent the cart 400 from continuing to roll across a surface.

[0115] The wheel brakes can be activated and / or deactivated manually and / or electronically by hand and / or foot switches. In the example shown in Figure 4, the cart 400 has foot levers 414 for this purpose.

[0116] Cart 400 further includes a height adjustment actuator 416 for actuating extension of neck 120 along longitudinal axis VA of the cart. Actuator 416 is mounted to base 110, thereby acting as a weight on base 110 to reduce the center of gravity of cart 400 and improve overall stability and / or balance. Height adjustment actuator 416 may include a drive unit in the form of, for example, an electric motor, a pneumatic actuator, and / or a hydraulic actuator. In this embodiment, actuator 416 is mounted to base 110 such that it projects downwardly from base 110 into space 415, thereby further facilitating compactness of cart 400.

[0117] The cart 400 further includes a tilt mechanism (not shown in FIG. 4A ) that is internal to the housing of the head 130 and configured to tilt / pivot the head to change the angle between the head's longitudinal axis LAh and the horizontal reference plane RP. This mechanism may include a manually operable tilt adjustment actuator, or may include a drive device in the form of, for example, an electric motor, a pneumatic actuator, and / or a hydraulic actuator. The head 130 may be mounted to the neck 120 by such a tilt mechanism.

[0118] The cart further includes an elongated slide assembly disposed within the housing of the head 130 and configured to move the slider 140 along the longitudinal axis of the cart. The elongated slide assembly may be manually operable or may include a drive in the form of, for example, an electric motor, a pneumatic actuator, and / or a hydraulic actuator.

[0119] The slide assembly is connectable on one side to the tilt mechanism and on the other side to the housing so that the slide assembly, together with the housing, is tiltable relative to the tilt mechanism.

[0120] The cart 400 further includes a handle assembly that projects proximally beyond all other components of the cart 400 and is mounted to allow a user to move the cart 400 along a support surface. In this embodiment, the handle assembly, designated 442, projects proximally beyond all other components of the cart 400 and is attached at its proximal end 144 to the slider 140, thereby allowing, on the one hand, a user to move the cart 400 along a support surface when the slider 140 is locked in place, and, on the other hand, allowing the slider 140 to move along the cart's longitudinal axis LA when the cart 400 is locked in place.

[0121] The cart 400 can include at least one controller 446 configured to control, or at least enable or disable, the extension of the neck 120 and / or the tilt / pivot movement of the head 130 and / or the movement of the slider 140. In this embodiment, the controller can be configured to control the height adjustment actuator 416, the tilt adjustment actuator, the brakes on the wheels 412, or the locking mechanism of the slider. Optionally, the controller can also control the movement of the wheels 412. The controller can be mounted anywhere within the cart, for example, the at least one controller 446 can be located at the proximal end of the cart 400, or the cart 400 can be operated remotely via any communication means, for example, via cable or wireless transmission.

[0122] The cart 400 can include various means of user interface options connected to the controller 446, such as mechanical knobs and / or electronic switches, to allow a user to operate the controller. The user interface can be remote, or rather, can be located on the proximal side of the cart, or at least closer to the proximal side than the distal side of the cart. The controller and associated user interface can be in the form of an assembly, which can be mounted, for example, on the handle assembly 442, the head 130, or the slider 140 (near its proximal end). In this embodiment, the controller, designated 446, is mounted to the handle assembly in its most proximal region.

[0123] To prevent unintended movement of any one of the elements of the cart 400, such as the wheels 412, neck 120, head 130, and / or slider 140, several safety mechanisms are installed in the controller 446, such as requiring the user to sequentially manipulate certain element(s) of the controller's 446 user interface to enable movement of the associated component on the cart. For example, to move the slider 140, the user may be required to press one or two slide knobs while physically pushing and / or pulling the slider 140; only then will the slider 140 slide in a distal or proximal direction. Other safety mechanisms may further include manipulating two user interface elements simultaneously, requiring the use of an electronic key such as an employee badge, a "dead man's switch," an emergency stop button to cut off general power or power to a specific element of the cart, and / or any combination thereof.

[0124] To provide proper control of the cart 400 and minimize human error, elements of the user interface configured to cause the controller to operate the tilt adjuster and height adjustment actuators may be spaced apart from one another and / or positioned at opposite locations on the user interface.

[0125] Although not shown, to further enhance patient safety, the cart 400 can optionally include a control circuit electrically connected to the memory, configured to limit the tilt angle of the head 130 with the slider 140 according to the designated and stored memory, for example, to prevent tilting at an angle greater than a selected angle (the same applies to height adjustment). In addition, the cart 400 can also include an orientation sensor connectable to the controller. The orientation sensor can include a gyroscope and / or an accelerometer. The orientation sensor can be configured to sense changes in the orientation of the head 130 and / or the slider 140. For example, the orientation sensor can sense changes in the rotation, e.g., tilt angle, of the head 130, slider 140, and / or cart 400 as a whole relative to each component of the cart 400 and / or relative to the vertical axis VA and / or horizontal reference plane RP.

[0126] To avoid malfunctions due to power supply shorts and to enhance mobility options within the operating room with minimal footprint interference, the cart 400 can include an internal power source, such as a rechargeable battery. In other embodiments, the cart can further include a power distribution circuit electrically connected to an external power source.

[0127] Although not shown, the cart 400 may further include support legs that have a folded state in which the cart can move on its wheels and an unfolded state in which the cart cannot move, thereby improving the stability of the cart when the surgical robotic device is operating.

[0128] FIG. 4B shows an example of the internal configuration of head 130 of cart 400, which includes housing 132, a tilting mechanism generally designated by the reference numeral 131, and an elongated slide assembly carrying slider 140 and generally designated by the reference numeral 141.

[0129] The tilt mechanism 131 can be mounted on top of the neck 120 to pivot the head 130 about a pivot mounting point 133. The tilt mechanism can include a tilt adjustment actuator (not shown), which can be in the form of, for example, a piston that is at least partially movable or extendable along the longitudinal axis LAh of the head to pivot the head 130 about the pivot mounting point 133. Alternatively, the tilt adjustment actuator can be configured to pivot about the pivot mounting point 133 and be fixedly connected to the head 130. In any event, the overall design of the tilt mechanism is such that it does not have a large footprint, at least in the width direction, thereby enabling the shape and size of the head 130 to have the dimensions described above, for example, a maximum combined width W of 26 cm.

[0130] If the tilt adjustment actuator (not shown in FIG. 4B) is in the form of a piston, the latter may be disposed between the distal side of the upper portion of the neck 122 and the bottom of the slide assembly 141, so that at least half of its footprint extends along the longitudinal axis LAh. Accordingly, the head 130 may further comprise a spring designed to provide resistance to the tilt adjustment actuator when adjusting the tilt angle, thereby facilitating smooth tilting of the head 130. FIG. 4C shows an embodiment of a head in which such a structure is implemented.

[0131] The elongated slide assembly 131 can include one or more slider support elements movable with the slider and a slider locking mechanism that can lock the slider 140 or slider support element(s) in any desired fixed position relative to the slide actuator. In this embodiment, shown in FIG. 4B or 4C , the slide assembly includes a runner 143 movable along one or more rails (not shown) mounted and fixedly held in the housing 132, with the slider locking mechanism 137 configured to prevent the runner from moving along the rail(s). To this end, the slider locking mechanism in this embodiment includes a strap 138 extending between and movable with rollers 136 fixedly connected to the runner 143, thereby rotating the rollers 136, and means for disabling the roller rotation, thereby preventing linear movement of the slider 140. The slider locking mechanism 137 may be controlled by a user via the user interface and controller 446. In some embodiments, roller 136 may include a slide actuator and / or roller motor to facilitate electromechanical rotational movement of the roller and thus electromechanical linear movement of slider 140. The actuator and / or motor may be controlled by a user via user interface and controller 446, thereby allowing the user to electromechanically control the linear movement of slider 140.

[0132] The head may further comprise one or more longitudinal support elements, via which the above-mentioned components may be attached to the head housing or neck 120. In this embodiment, the head comprises an elongated support plate 122 that carries the tilt mechanism 131 and extends along the longitudinal axis of the head. The plate 122 may be used to directly or indirectly mount any desired components that facilitate movement of the head and / or cart, such as sensors, processors, actuators, gyroscopes, accelerometers, springs, or any other electronic and / or mechanical elements, at different positions along the head longitudinal axis LAh, thereby reducing the footprint of the head, such as the projected width Wh of the head along the width axis WA.

[0133] As noted above, U.S. Patent No. 10,463,438 describes a surgical robotic device that can use cart 400. Among other elements, the surgical robotic device includes a linear unit that is removably attached to a support and configured to linearly advance the surgical robotic device relative to the support. The description of the arrangement that allows such linear advancement in U.S. Patent No. 10,463,438 is incorporated herein by reference.

[0134] For the slider 140 to allow for the fixation of such a linear unit, the latter must have a mounting portion configured to engage with a corresponding mounting portion on the slider, which can have a number of engageable protrusions and corresponding recesses configured to provide a stable and secure attachment of the surgical robotic device to the slider while still allowing movement of the linear unit.

[0135] In this embodiment, as shown in FIG. 4D , the mounting portion of slider 140 includes a recessed connector arrangement 146 and two recessed sockets 145 and 147 disposed on the top surface of the slider at the distal and proximal ends, respectively. Connector arrangement 146 is configured to receive and lock a corresponding lockable protrusion of a linear unit of a surgical robotic device, and defines an opening 148 corresponding in shape and / or size to the lockable protrusion. To releasably lock the surgical robotic device to slider 140, connector 146 includes a movable lever and / or latch 149 configured to secure the lockable protrusion of the surgical device once positioned within opening 148. To better establish stabilization of the surgical robotic device on slider 140, the surgical robotic device can further include two stabilizing protrusions configured to be inserted into sockets 145 and 147. To allow the linear unit to advance the surgical robot within a desired longitudinal range, sockets 145 and 147 have a greater longitudinal extent along the longitudinal axis of slider 140 than the stabilizing protrusions, as shown.

[0136] 5A and 5B illustrate an example of the use of the cart 400 to position a robotic surgical device 500 relative to a patient, who may be lying in Trendelenburg or lithotomy positions (both of which allow for a vaginal approach), and a target area location. A user can control the movement of the cart 400 and / or its components via at least one controller 446, thereby positioning the surgical device 500 in an XYZ Cartesian coordinate system. The at least one controller 446 allows the user to align the surgical device 500 relative to a patient 550 and / or a target area location 552, for example, by positioning the cart 400 and / or parts thereof in a required position, for example, by setting at least the length of the neck 120, the horizontal movement of the cart 400 along the reference plane RP, the pivot movement, i.e., tilt angle α, of the head 130, and / or the longitudinal movement of the slider 140 along the longitudinal axis LA. Some of the elements of the cart 400, such as the positioning of the cart 400 along the support surface and reference plane RP and / or the longitudinal movement of the slider 140 along the longitudinal axis LA, can be adjusted manually, while defining the longitudinal height H and / or tilt angle α of the neck 120 can be achieved by using mechanical actuators. It should be noted that in other embodiments, the movement of the cart 400 or parts thereof can be manual or at least partially motorized, for example by using mechanical actuators.

[0137] Once the cart 400 is positioned relative to the patient 550, for example by being manually pushed along a support surface, the user can electromechanically position the surgical device 500 via the controller 446 via movement of the head 130 and / or neck 120 relative to the treatment target location 552, for example by using height and / or tilt adjustment actuators to set the height H and tilt angle α of the head 130 and slider 140. The head 130 and slider 140 are positioned to set the mounted or connected surgical robotic device 500 to a position from which the surgical robotic device 500 can be linearly advanced to the treatment target location 552 at a selected angle and / or height. After aligning the surgical device 500 with the treatment target location 552, a user can adjust the distance between the two, for example, by manually sliding the slider 140 longitudinally along the longitudinal axis LA, thereby linearly advancing the distal end 242 of the slider 140 in a distal direction while the remaining elements of the cart 400 remain stationary. In some embodiments, for example, a slide actuator may be added to improve control of the linear advancement of the slider 140, allowing a user to electromechanically control the sliding movement of the slider 140 via the controller 446. One or more movable elements of the cart 400, such as the slider 140 and / or the base 110, are configured to move the handle assembly, for example, by physically pushing the handle assembly and / or using one or more motion controllers.

[0138] Note that the area surrounding the patient 550, or at least the treatment target location 552, is considered a sterile zone 560; therefore, any element entering that zone should be sterile or at least covered by a sterile covering, such as a surgical drape. As shown in FIG. 5B , the slider 140, along with the surgical robotic device 500, can enter the sterile zone 560 at least at its distal-most position 220. Thus, even when the slider 140 is positioned at its distal-most position 220, the cart 400, along with the surgical robotic device 500, can be configured to be covered with a sterile covering (not shown) configured to cover at least the distal portion 104 of the cart 400. If at least one controller 446 is located at the proximal end of the cart, such as the proximal end of the slider 244 or the handle assembly 442, the handle assembly 442 can be shaped and sized, for example, to allow at least one user interface and controller 446 to be located outside the sterile zone 560 and / or outside the surgical drape. This allows the handle assembly 442 or at least the controller 446 to be spaced from the sterile zone 560 in the proximal direction and be usable by a user even when the cart 400 or portions thereof and the surgical robotic device are covered by the surgical drape. In other embodiments, the controller 446 can be at least partially remote, for example, using a cable or wireless transmission, whereby the controller 446 can be located in a remote location and even further away from the sterile zone 560.

Claims

1. 1. A surgical positioning cart configured to support a surgical robotic device, comprising: The surgical positioning cart comprises: The proximal side and a distal side configured to face a surgical entrance site of a patient and substantially opposite the proximal side; a central longitudinal axis between these two sides; a longitudinal axis passing through the two sides and intersecting the central longitudinal axis; a width axis perpendicular to the longitudinal axis and the central longitudinal axis; wherein the longitudinal axis and the width axis define a horizontal reference plane; The surgical positioning cart comprises: a base movable along at least the horizontal reference plane; a head having a longitudinal extension along said longitudinal axis, pivotable relative to said horizontal reference plane and defining, with said horizontal reference plane, different tilt angles at least in a plane formed by said central longitudinal axis and said longitudinal axis; a slider configured to fixedly receive at least a portion of the surgical robotic device and attached to the head for pivotal movement therewith and for movement relative to the head along at least the longitudinal axis; a neck connecting the base and the head pivotally mounted to the base, the neck having an adjustable height determined by a longitudinal length; Equipped with The slider includes: When the height of the neck is adjusted, it is displaced vertically, pivoting about a pitch axis with the head when the head pivots relative to the neck; A surgical positioning cart configured to slide longitudinally relative to the head to extend the length of a projection of the head with the slider on the horizontal reference plane.

2. 10. The surgical positioning cart of claim 1, The surgical positioning cart further comprising at least one controller configured to control at least the length adjustment of the neck, the pivotal movement of the head, and the linear movement of the slider.

3. 3. The surgical positioning cart of claim 1 or claim 2, A surgical positioning cart, wherein the head is pivotable in a plane defined by the longitudinal axis and the width axis.

4. 4. A surgical positioning cart according to any one of claims 1 to 3, the slider is further configured to allow a moveable portion of the surgical robotic device to move relative to the portion of the surgical robotic device configured to lockingly engage with the slider.

5. 5. A surgical positioning cart according to any one of claims 1 to 4, comprising: The surgical positioning cart, wherein the tilt angle is within a range of ±30 degrees relative to the horizontal reference plane.

6. 6. A surgical positioning cart according to any one of claims 1 to 5, a height adjustment actuator; The height adjustment actuator is configured to manipulate the neck to adjust the height at which the head is held above the base.

7. 7. A surgical positioning cart according to any one of claims 1 to 6, comprising: further comprising a tilt adjustment actuator; The tilt adjustment actuator is configured to adjust the tilt angle of the head.

8. 8. A surgical positioning cart according to any one of claims 1 to 7, comprising: The surgical positioning cart further comprising a slider actuator configured to set the movement of the slider.

9. 9. A surgical positioning cart according to any one of claims 1 to 8, comprising: The slider is movable relative to the head at least along the longitudinal axis via one or more rails extending along the longitudinal axis of the head.

10. 10. A method of operating a surgical positioning cart according to any one of claims 1 to 9, comprising: The method may be performed in any order. a) adjusting the height of the neck to vertically displace the slider; b) pivoting the head relative to the neck to pivot the slider about the pitch axis; c) extending a projection of the head with the slider on the horizontal reference plane by sliding the slider longitudinally relative to the head; A method for providing the above.

11. 1. A method of deploying a robotic surgical device, comprising: The method includes providing a surgical placement cart; The surgical positioning cart comprises: (i) a base movable along at least a horizontal reference plane; (ii) a head having a longitudinal extension along a longitudinal axis, pivotable relative to said horizontal reference plane and defining, with said horizontal reference plane, different tilt angles at least in the plane of the central longitudinal axis and the longitudinal axis; (iii) a slider attached to the head and configured to fixedly receive at least a portion of the surgical robotic device; (iv) a neck connecting the base and the head pivotally mounted to the base, the neck having an adjustable height defined by a longitudinal length; Equipped with The method may be performed in any order. a) mounting and optionally locking the robotic surgical device to the slider; b) adjusting the height of the neck to vertically displace the slider; c) pivoting the slider relative to the neck about a pitch axis; d) extending a projection of the head with the slider on the horizontal reference plane by sliding the slider longitudinally relative to the head; A method comprising:

12. 12. The method of claim 10 or 11, wherein at least one of the vertically displacing, pivoting about the pitch axis, and longitudinally sliding is performed when a surgical robot device is mounted to the slider, and optionally when one or more surgical arms are proximally attached to an arm mount of the surgical robot.

13. 13. The method of claim 11 or claim 12, The method, wherein extending the length of the upper section by sliding the slider longitudinally comprises sliding the slider toward a treatment target position.

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