End effector and method for driving a tool guided by a surgical robotic system

Abstract

To provide end effectors for driving tools at surgical sites along trajectories maintained by surgical robots.SOLUTION: A tool has interface and working ends. An end effector has a mounting tool to attach to the surgical robot, and an actuator configured to generate torque. A drive assembly with a geartrain translates rotation from the actuator into rotation of a drive conduit supported about an axis. A rotational lock operatively attached to the drive conduit releasably secures the tool for concurrent rotation about the axis, and an axial lock releasably secures the tool for concurrent translation with the drive conduit along the trajectory maintained by the surgical robot. The axial lock is operable between a release configuration where relative movement between the drive assembly and the tool is permitted along the axis, and a lock configuration where relative movement between the drive assembly and the tool is restricted along the axis.SELECTED DRAWING: Figure 4

Description

[Technical Field]

[0001] [CROSS-REFERENCE TO RELATED APPLICATIONS] This patent application is filed on May 1, 2009, the disclosures of which are incorporated herein by reference in their entireties. No. 62 / 622,306, filed January 26, 2018, and U.S. Provisional Patent Application No. 62 / 622,306, filed January 26, 2018, This application claims priority to and benefit of U.S. Provisional Patent Application No. 62 / 744,878, filed October 12, 2014. Assert. [Background technology]

[0002] Surgical robotic systems are often used by medical professionals to perform various types of surgical procedures. For this purpose, the surgeon uses various tools, components, and To guide, position, move, actuate, or otherwise manipulate a device, prosthesis, etc. , a surgical robot can be used.

[0003] Surgical robots are being developed to assist surgeons in performing several different types of surgical procedures. It will be appreciated that surgical robots can be used to move patients. To help improve sexuality, reduce pain, reduce the risk of later injury or damage, etc. , a procedure that generally involves the correction, stabilization, removal, or replacement of one or more parts of a patient's body. Used for.

[0004] As an illustrative example, many types of spinal procedures (e.g., posterior lumbar interbody fusion "P" In a LIF (Large Intracranial Fracture) procedure, the robotic system advantageously performs a stent placement procedure at discrete locations within the vertebrae of the patient's spine. This helps facilitate proper placement of the pedicle screws. It acts as a device, typically working in conjunction with additional fixation hardware (e.g., stabilization rods). , limiting movement between the fused vertebrae, thereby preventing bone grafts placed between adjacent vertebrae This helps ensure that the components can be securely fastened together.

[0005] When a patient requires surgery involving pedicle screw placement, the patient's anatomy (e.g. Preoperative and / or intraoperative imaging may be used to aid in visualization of the vertebrae (e.g., the spine of the patient). It is often used by surgeons, who typically use a technique based on the patient's anatomy. Based on preoperative imaging, including captured images and 3D models created from the images, pedicle screw placement is performed. Planning can be done by visualizing the desired location in preoperative images and / or a 3D model. pedicle screws for the specific vertebrae where they should be placed, such as by identifying the position of the This involves determining the desired position and orientation (i.e., posture) of the pedicle screws. Once defined, the plan is communicated to the robotic system for execution.

[0006] Typically, the robotic system includes a surgical robot having a robotic arm. The pedicle arm is positioned on the desired trajectory, aligned with the desired orientation of the pedicle screw to be placed. The robotic system also positions the tool guide on the patient along the The arm can position the tool guide along the desired trajectory according to the surgeon's plan. A navigation system is provided to determine the location of the tool guide relative to the patient's anatomy so that the In some cases, the navigation system may include a surgical robot. and a tracking device attached to the patient's body, so that the robotic system , by dynamically moving the tool guide as needed to maintain the desired trajectory. Movements during a surgical procedure can be monitored and responded to.

[0007] In minimally invasive surgical techniques, once the tool guide is aligned with the desired trajectory, the surgeon generally The surgical site is then guided through an incision made in the patient's body adjacent to the vertebrae at the surgical site. The surgeon then inserts a drill bit into the hand-held drill. Insert the drill bit into the cannula and activate the drill to insert the pedicle screw. The surgeon then removes the drill bit and then The pedicle screw is driven into position in the pilot hole by the power transmission. The clew is placed into the vertebra.

[0008] Robotic arms are underutilized in the types of spinal surgery techniques mentioned above. However, there is little or no opportunity for pilot hole creation or actual pedicle screw placement. Furthermore, the ability of the surgical system to maintain trajectory Despite the advantages offered by the single pedicle screw, traditional minimally invasive techniques When installing the robot arm, it is often necessary to change its position several times. The frequency and extent of changes will depend, among other things, on the specific type of surgical technique being utilized, the surgeon's preferences, as well as pedicle screws, guide tools, drills, and the surgical robot itself. Depends on configuration.

[0009] Additionally, multiple pedicle screws are typically placed during a single surgery (e.g., two A total of four pedicle screws may be used in bilateral interbody fusion of adjacent vertebrae. This allows the robotic arm to move efficiently between different trajectories without interfering with the surgeon's technique. It can be difficult to articulate. In addition, in some situations, To achieve this across trajectories and / or provide surgeons with a consistent approach along each trajectory, When the robot arm is unable to perform the required articulation movements, the surgical robot itself may lose its position. The position may need to be changed relative to the patient's body.

[0010] Therefore, there remains a need in the art to address one or more of these problems. It is needed. Summary of the Invention

[0011] The present disclosure provides a method for driving a tool at a surgical site along a trajectory maintained by a surgical robot. The end effector is attached to a surgical robot. a fixture adapted to generate a rotational torque about a first axis; and a rotor coupled to the fixture. and a rotating device having an actuator configured to: A gear tray that converts rotation from a rotating device into rotation about a second axis different from the first axis. and configured to releasably secure the tool for rotation about a second axis. The end effector also includes a drive assembly having a connector for supporting the user's hand. and an operating tool assembly having an input operating tool that cooperates with the rotating device. The input manipulator, when engaged by a user, drives the rotating device to rotate the tool along the second axis. The end effector is also coupled to a drive assembly. The manual interface is configured to receive force from a user. and converting the received power into a rotational torque for rotating the tool about a second axis. It will be placed.

[0012] The present disclosure also provides a method for performing a surgical procedure along different trajectories selectively maintained by a surgical robot. The end effector is provided to drive the tool in a surgical robot position. a fixture adapted to be attached to the base; and a rotor coupled to the fixture and rotatable about a first axis. and a rotating machine including an actuator configured to generate a rotating torque. The effector also converts the rotation from the rotating device into a rotation about a second axis different from the first axis. A gear train that translates, and releasably secures, the tool to rotate about a second axis. The drive assembly includes a connector configured to couple the drive to the rotating device. The coupler is movably attached to the surgical robot, and the coupler is adapted to follow different trajectories maintained by the surgical robot. rotating the drive assembly along the second axis to selectively position the second axis relative to the rotating equipment; The device is configured to be releasably secured to the device in multiple orientations.

[0013] The present disclosure also provides a method for driving a tool at a surgical site along a trajectory maintained by a surgical robot. a moving end effector, the tool having an interface end and a working end. The end effector includes a mounting fixture adapted to be attached to a surgical robot and a mounting bracket. an actuator coupled to the attachment and configured to generate a rotational torque about a first axis; The end effector also includes a drive assembly, the drive assembly including an actuator. A gear tray that converts rotation around the first axis from the actuator into rotation around the second axis. a drive conduit supported for rotation about a second axis; and a drive conduit supported for rotation about the second axis. operatively attached to the drive conduit to releasably secure the tool for rotation The first rotating fixture and the drive conduit are simultaneously moved along a trajectory maintained by the surgical robot. and an axial stop that releasably secures the tool for translation. a released configuration in which relative motion between the drive assembly and the tool along a second axis is permitted; Between the locking configuration, relative motion between the drive assembly and the tool along two axes is limited. It can be operated with.

[0014] The present disclosure also provides a method for moving a tool relative to a surgical site along a trajectory maintained by a surgical robot. and an end effector for guiding the tool, the tool being a first tool and a second tool. and a second tool. The end effector is configured to be attached to a surgical robot. a fixture adapted to generate a rotational torque about a first axis; and a device coupled to the fixture and adapted to generate a rotational torque about a first axis. and a rotating device having an actuator configured as described above. The end effector also includes: A gear train that converts rotation about a first axis from a rotating device into rotation about a second axis; in rotational communication with the gear train for simultaneous rotation about a second axis at a first drive ratio; a first rotary locking device arranged to releasably secure the first tool, the first rotary locking device being connected to the gear train; and a second drive ratio different from the first drive ratio, so as to simultaneously rotate about a second axis. a second rotary locking device arranged to releasably secure a second tool; and a first actuator for simultaneous translation with the drive assembly along a trajectory maintained by the robot; a drive having an axial lock that releasably secures one of the tool and the second tool; The axial locking device includes a drive assembly and a fixed tool along a second axis. and a release configuration in which relative movement between the drive assembly and the fixed tool along a second axis is possible. and a locked configuration in which relative movement between the

[0015] The present disclosure also provides a method for driving a tool at a surgical site along a trajectory maintained by a surgical robot. a moving end effector, the tool being a first tool and a second tool being different from the first tool; and a second tool. The end effector is adapted to be attached to a surgical robot. a fixture coupled to the fixture and configured to generate a rotational torque about a first axis. and a rotating device having an actuator formed thereon. The end effector also includes a rotating device. a gear train that converts rotation from the rotor into rotation about a second axis different from the first axis; releasably rotating one of the first tool and the second tool about an axis of rotation; A connector configured to fix and rotate between the rotating device and the connector. The drive assembly includes a transmission interposed between the first gear set and the second gear set. a first gear set, a second gear set, and a transformation collar, the transformation collar being configured to transform the first gear set into a second gear set; a first drive ratio engaging the asset to convert rotation between the rotating device and the connector; a collar position and a conversion collar engaging a second gear set to provide a second drive ratio different from the first drive ratio; and a second collar position that translates rotation between the rotating device and the connector at a drive ratio of They are arranged as follows.

[0016] The present disclosure also provides a method for piloting a surgical robot to a surgical site along a trajectory maintained by a surgical robot. A method for forming a hole is provided, the method comprising: an actuator, a drive assembly, a manual input, and The interface and the end effector supporting the manipulation tool assembly are attached to the surgical robot. The method also includes attaching a rotary cutting tool to the drive assembly along a second axis. The rotary cutting tool is attached to the surgical site by aligning the second axis with the trajectory. and engaging the manipulator assembly to drive the first axis by the actuator. and a drive assembly drives the actuator to generate a rotational torque about the first axis. and converting the torque around the rotary cutting tool to rotate the rotary cutting tool around a second axis. The method also includes advancing a rotary cutting tool along a trajectory at the surgical site to a first depth. and then stopping the rotation around the first axis and presenting a manual interface. Positioning the manipulator assembly and applying force to the manual interface to rotate the rotating the cutting tool about a second axis; and rotating the cutting tool along a trajectory at the surgical site. and advancing the needle to a second depth greater than the first depth.

[0017] The present disclosure also provides a method for placing a fixture at a surgical site along a trajectory maintained by a surgical robot. The method includes: an actuator; a drive assembly; a manual interface; The surgical robot is attached with an end effector supporting the interface and the manipulation tool assembly. The method also includes mounting the tool to the drive assembly along a second axis. and attaching a fixture to the tool and aligning the second axis with the track to fix the fixture. and positioning the tool adjacent to the surgical site and engaging the manipulator assembly to actuate the actuator. A motor generates a rotational torque about a first axis, and a drive assembly drives the actuator. The torque from the motor about a first axis is converted to force the tool and fixture about a second axis. The method also includes rotating the tool and fastener along a trajectory at the surgical site. advancing the needle to a first depth, ceasing rotation about the first axis, and manually inserting the needle. positioning the manipulator assembly to present a manual interface; applying a force to the interface to rotate the tool and fixture about a second axis; and advancing the fixture along the trajectory at the site to a second depth greater than the first depth. nothing.

[0018] The present disclosure also provides a surgical robot along first and second trajectories, respectively, maintained by the surgical robot. The present invention provides a method for placing first and second fasteners at a surgical site by using an active Supports the actuator, drive assembly, manual interface, and operator assembly The method also includes attaching the end effector to the surgical robot. and attaching a first fixture to the tool. and aligning the second axis with the first trajectory to position the first fixator adjacent to the surgical site. and engaging the manipulator assembly to move the first axis by the actuator. and a drive assembly drives the actuator to generate a rotational torque about the first axis. converting the torque to rotate the tool and the first fixture about a second axis; The method also includes a first step of moving the tool and the first fixator along a first trajectory at the surgical site. and advancing the needle to a depth of 1, ceasing rotation about the first axis, and manually interfacing the needle. positioning the manipulator assembly to present a manual interface; applying a force to the tool to rotate the tool and the first fixture about a second axis; The tool and the first fixture are inserted along a first trajectory at the surgical site to a second depth greater than the first depth. and advancing the first fixture from the tool. , attaching a second fixture to the tool and aligning the second axis with the second orbit; Positioning a second fixture adjacent the surgical site and engaging the manipulator assembly; generating a rotational torque about a first axis by an actuator; and a drive assembly The torque around the first axis from the actuator is converted by and rotating the fixator about a second axis. advancing the tool and the second fixture to a third depth along the trajectory of the first axis; and assemble the manipulator assembly to present a manual interface. and applying a force to the manual interface to engage the tool and the second fixture. Rotating the fixture about a second axis and moving the tool and the fixture along a second trajectory at the surgical site. and advancing the second fastener to a fourth depth greater than the third depth.

[0019] Other features and advantages of the disclosed embodiments will become apparent from the following description taken in conjunction with the accompanying drawings. It is well understood and therefore easily evaluated. [Brief explanation of the drawings]

[0020] [Figure 1] FIG. 1 is a perspective view of a surgical system including a surgical robot having a robotic arm supporting an end effector with a tool secured along a trajectory adjacent a surgical site on a patient's body according to a first embodiment of the present disclosure. [Figure 2A] 2 is a perspective view of the end effector, tool, and portion of the patient's body of FIG. 1 showing the tool supported along a first trajectory. FIG. [Figure 2B] 2B is another perspective view of the end effector, tool, and portion of the patient's body of FIG. 2A showing the tool supported along a second trajectory. FIG. [Figure 2C] FIG. 2C is another perspective view of the end effector, tool, and portion of the patient's body of FIGS. 2A-2B, showing the tool supported along a third trajectory. [Figure 3] 1-2C, showing the end effector including: a mount supporting a rotating instrument to generate torque about a first axis and having a coupler; a drive assembly attached to the coupler of the rotating instrument and supporting a tool to rotate about a second axis; a manipulator assembly having a grip and an input manipulator, the input manipulator positioned to drive the rotating instrument when engaged by a user; a manual interface that receives force to rotate the tool about the second axis; and a handle assembly that engages the manual interface. [Figure 4] FIG. 4 is a partially exploded perspective view of the end effector of FIG. 3 showing the drive assembly spaced apart from the rotary instrument below the handle assembly and spaced apart from two tools configured to be releasably attached to the drive assembly, one of the tools shown as a rotary cutting tool having a drill bit and the other of the tools shown as a rotary drive tool supporting a fastener. [Figure 5A] FIG. 5 is an illustration of a surgical site in which a patient's vertebrae have been transversely cut in association with a minimally invasive spinal fixation technique performed by the surgical system of FIGS. 1-4, showing first and second trajectories positioned bilaterally relative to the spinous processes and extending into the vertebral body through the respective pedicles on either side of the vertebral foramen and spinal cord, with a fixator placed along the first trajectory and a drill bit guided along the second trajectory positioned adjacent to the vertebra. [Figure 5B] FIG. 5B is another illustration of the surgical site of FIG. 5A showing the drill bit penetrating the vertebra along a second trajectory to form a pilot hole of a first depth extending through the pedicle and into the vertebral body. [Figure 5C] FIG. 5C is another illustration of the surgical site of FIGS. 5A-5B showing the drill bit further advanced along the trajectory to create a pilot hole of a second depth further into the vertebral body. [Figure 5D] FIG. 5C is another illustration of the surgical site of FIGS. 5A-5C showing the drill bit removed from the pilot hole and the fastener supported by a rotary drive tool guided along a second track positioned adjacent to the vertebra. [Figure 5E] FIG. 5E is another illustration of the surgical site of FIGS. 5A-5D showing the fasteners placed into the vertebrae along a second trajectory to a third depth. [Figure 5F] FIG. 5C is another illustration of the surgical site of FIGS. 5A-5E showing the fasteners placed into the vertebrae along a second trajectory to a fourth depth. [Figure 5G] FIG. 5B is another illustration of the surgical site of FIGS. 5A-5F showing fasteners being placed within the vertebrae along their respective trajectories. [Figure 6] FIG. 5C is a perspective view of a tool supporting the fixture of FIGS. 1-5F. [Figure 7] FIG. 7 is a top view of a tool supporting the fixture of FIGS. 1 to 6. [Figure 8] FIG. 8 is a cross-sectional view taken along line 8-8 of FIG. 7. [Figure 9] FIG. 9 is an exploded perspective view of a tool shown spaced apart from the fixture of FIGS. 1-8. [Figure 10A] FIG. 5 is a perspective view of the end effector of FIGS. 1-4 showing the manipulator assembly positioned in a first manipulator assembly position, with the grip and input manipulator positioned on the manual interface adjacent to the drive assembly. [Figure 10B] FIG. 10B is another perspective view of the end effector of FIG. 10A showing the manipulator assembly disposed in a second manipulator assembly position with the grip and input manipulators moved to present a manual interface for engagement by the handle assembly. [Figure 11A]FIG. 10C is a front view of the end effector of FIGS. 10A-10B showing the manipulator assembly disposed in a first manipulator assembly position and the coupler supporting the drive assembly in a first orientation. [Figure 11B] FIG. 11B is another front view of the end effector of FIG. 11A showing the manipulator assembly positioned in a second manipulator assembly position, the coupler supporting the drive assembly in a first orientation, and the handle assembly positioned adjacent to the manual interface. [Figure 11C] 11A-11B, showing the manipulator assembly positioned in a second manipulator assembly position, the coupler supporting the drive assembly in a first orientation, and the handle assembly positioned to engage the manual interface. [Figure 11D] FIG. 11D is another front view of the end effector of FIGS. 11A-11C showing the manipulator assembly disposed in a first manipulator assembly position and the coupler supporting the drive assembly in a second orientation. [Figure 11E] FIG. 11B is another front view of the end effector of FIGS. 11A-11D showing the manipulator assembly disposed in a first manipulator assembly position and the coupler supporting the drive assembly in a third orientation. [Figure 11F] FIG. 11C is another front view of the end effector of FIGS. 11A-11E showing the manipulator assembly positioned in a third manipulator assembly position and the coupler supporting the drive assembly in a third orientation. [Figure 12] FIG. 5 is a top view of the fixture, rotating device, manipulator assembly, and coupler of the end effector of FIGS. [Figure 13] 13 is an offset cross-sectional view taken along line 13-13 of FIG. 12. [Figure 14] 14 is an enlarged cross-sectional view taken along mark 14 in FIG. 13. [Figure 15] FIG. 14 is an enlarged cross-sectional view taken along mark 15 in FIG. 13. [Figure 16]FIG. 13 is a perspective view of the fixture, rotating device, manipulator assembly, and coupler of the end effector of FIG. 12. [Figure 17] FIG. 17 is a partially exploded perspective view of the end effector of FIG. 16 showing the manipulator assembly, the fixture, and the retainer each spaced apart from the rotating instrument. [Figure 18] 17 is another partially exploded perspective view of the end effector of FIG. 16 showing portions of the retainer and manipulator assembly, respectively, spaced apart from the rotating instrument. [Figure 19A] 11A-18, with the manipulator assembly positioned in a first manipulator assembly position and the input manipulator shown in a first input position, with portions of the manipulator assembly shown in dashed lines. [Figure 19B] Another perspective view of the retainer and manipulator assembly portion of the end effector of Figure 19A, with the manipulator assembly positioned in a first manipulator assembly position and the manipulator shown positioned in a second input position, with portions of the manipulator assembly shown in dashed lines. [Figure 19C] Another perspective view of the holder and portion of the manipulator assembly of the end effector of Figures 19A-19B, with the manipulator assembly positioned in a third manipulator assembly position and the manipulator shown positioned in a first input position, with portions of the manipulator assembly shown in dashed lines. [Figure 20A] 18 is a perspective view of the retainer of FIG. 17 showing the plunger disposed in a locked position to limit movement of the actuator assembly relative to the rotating device between actuator assembly positions. [Figure 20B] 20B is another perspective view of the retainer of FIG. 20A showing the plunger disposed in an unlocked position to allow movement of the actuator assembly relative to the rotating device between actuator assembly positions. FIG. [Figure 21] FIG. 5 is a perspective view of the drive assembly of FIGS. 1-4 showing the manual interface and connector disposed along a second axis. [Figure 22] FIG. 22 is a top view of the drive assembly of FIG. 21. [Figure 23A] 23 is a cross-sectional view taken along line 23-23 of FIG. 22 showing the drive assembly including a gear train that converts torque from the rotating equipment to the connector to rotate the tool, and a clutch mechanism interposed between the manual interface and the gear train, the clutch mechanism operating in a first mode to cause rotation of the connector via torque from the rotating equipment without rotating the manual interface. [Figure 23B] FIG. 23B is another cross-sectional view of the gear train, clutch mechanism, and connector of the drive assembly of FIG. 23A, showing the clutch mechanism operating in a second mode to cause rotation of the connector from forces applied to the manual interface. [Figure 24] FIG. 24 is an exploded perspective view of the drive assembly of FIGS. 21-23B. [Figure 25A] FIG. 2 is a perspective view of an end effector according to a second embodiment of the present disclosure similarly configured for use with the surgical system of FIG. 1 , showing the end effector including a mount supporting a rotating instrument to generate torque about a first axis, a manipulator assembly positioned in a first manipulator assembly position, a drive assembly having a connector supporting a tool for rotation about a second axis, and a protective cover positioned in a first protective position. [Figure 25B] FIG. 25B is another perspective view of the end effector of FIG. 25A showing the manipulator assembly positioned in the second manipulator assembly position and the protective cover positioned in the second protective position to facilitate access to the manual interface. [Figure 26] FIG. 25C is an exploded perspective view of the end effector of FIGS. 25A-25B showing the manipulator assembly spaced between the drive assembly and the rotating instrument. [Figure 27A] 27 is a cross-sectional perspective view of the manipulator assembly of FIGS. 25A-26 shown in a generally longitudinal cross-section, with the input manipulator shown disposed in a first input position. FIG. [Figure 27B] 27B is another cross-sectional perspective view of the manipulator assembly of FIG. 27A, showing the input manipulator disposed in a second input position. [Figure 28] FIG. 27 is a cross-sectional perspective view of the drive assembly of FIGS. 25A-26 shown in a generally longitudinal cross-section. [Figure 29A] FIG. 11 is a perspective view of an end effector according to a third embodiment of the present disclosure similarly configured for use with the surgical system of FIG. 1 , showing the end effector including a mount supporting a rotating instrument to generate torque about a first axis, a drive assembly having a connector supporting a tool to rotate about a second axis, and a manipulator assembly shown positioned in a first manipulator assembly position and having first and second frame bodies, with the second frame body shown positioned in a first grip position to limit access to the manual interface. [Figure 29B] 29B is another perspective view of the end effector of FIG. 29A showing the second frame body positioned in the second grip position to facilitate access to the manual interface. FIG. [Figure 30] 29A-29B showing the drive assembly spaced apart from the rotary instrument and manipulator assemblies, and showing two tools configured to be releasably attached to the drive assembly, one of the tools shown as a rotary cutting tool having a drill bit and the other of the tools shown as a rotary drive tool supporting a fastener. [Figure 31A] A cross-sectional perspective view of a portion of the drive assembly and rotary drive tool of Figure 30 shown in approximately longitudinal section, showing the transmission having a conversion collar positioned in a first collar position to engage a first gear set of the transmission. [Figure 31B]A cross-sectional perspective view of a portion of the drive assembly and rotary cutting tool of Figure 30, shown in approximate longitudinal section, showing the transmission having a conversion collar positioned in a second collar position to engage with a second gear set of the transmission, and a portion of the rotary cutting tool positioned to engage with a diverter operably mounted to the conversion collar. [Figure 32] FIG. 10 is a perspective view of an end effector according to a fourth embodiment of the present disclosure similarly configured for use with the surgical system of FIG. 1 , showing the end effector including a mount supporting a rotating instrument to generate torque about a first axis, a drive assembly having a connector supporting a tool to rotate about a second axis, a differential assembly, a pair of pins, and a handle assembly supported within a dock. [Figure 33] FIG. 33 is an exploded perspective view of the end effector of FIG. 32 showing the drive assembly spaced apart from the rotary instrument, pin, and handle assembly, and showing two tools configured to be releasably attached to the drive assembly, one of the tools shown as a rotary cutting tool having a drill bit and the other of the tools shown as a rotary drive tool supporting a fastener. [Figure 34A] FIG. 34 is a cross-sectional perspective view of the drive assembly of FIG. 33 shown in a generally longitudinal cross-section, illustrating the differential assembly in communication with the first and second rotary locks of the drive assembly. [Figure 34B] 34B is another cross-sectional perspective view of the drive assembly of FIG. 34A showing a portion of the rotary cutting tool shown in FIG. 33 positioned to engage a first rotary lock of the drive assembly for rotation about a second axis, and showing one of the pins engaging a portion of the differential assembly. [Figure 34C]34A-34B is another cross-sectional perspective view of the drive assembly of FIGS. 34A-34B showing a portion of the rotary drive tool shown in FIG. 33 positioned to engage a second rotary lock of the drive assembly for rotation about a second axis, and showing the other of the pins engaging another portion of the differential assembly. [Figure 35] FIG. 10 is a perspective view of an end effector according to a fifth embodiment of the present disclosure similarly configured for use with the surgical system of FIG. 1 , showing the end effector including a mount that supports a rotary instrument to generate torque about a first axis and a drive assembly having a drive conduit that supports a tool to rotate about a second axis, the tool shown as a drill bit rotary cutting tool. [Figure 36] FIG. 36 is an exploded perspective view of the end effector of FIG. 35 showing the drive assembly spaced apart from the rotary instrument and rotary cutting tool, and spaced apart from another tool shown as a rotary drive tool that drives a fastener. [Figure 37A] FIG. 37 is a cross-sectional perspective view of the drive assembly of FIG. 36 shown in a generally longitudinal cross-section, illustrating a transmission having first and second gear sets disposed in rotational communication with the drive conduit. [Figure 37B] 37A is another cross-sectional perspective view of the drive assembly of FIG. 37A partially showing the portion of the rotary drive tool of FIG. 36 secured within the drive conduit and engaging with a diverter operably attached to a conversion collar of a transmission device, the conversion collar being positioned in a first collar position to engage with a first gear set. [Figure 37C] Another cross-sectional perspective view of the drive assembly of Figure 37A partially showing the portion of the rotary cutting tool of Figures 35-36 secured within the drive conduit and engaging a diverter operably attached to a conversion collar of a transmission, the conversion collar shown positioned in a second collar position to engage a second gear set. [Figure 38A] FIG. 37C is a perspective view of the drive assembly of FIGS. 35-37C, showing the transmission diverter positioned as shown in FIG. 37B. [Figure 38B] FIG. 37D is a perspective view of the drive assembly of FIGS. 35-37C, showing the transmission diverter positioned as shown in FIG. 37C. [Figure 39A] FIG. 11 is a perspective view of an end effector according to a sixth embodiment of the present disclosure similarly configured for use with the surgical system of FIG. 1 , showing the end effector including a mount supporting a rotating instrument to generate torque about a first axis, a drive assembly having a drive conduit supporting a tool to rotate about a second axis, and a manipulator assembly shown disposed in a first manipulator assembly position and having first and second frame bodies, the second frame body shown disposed in a first grip position to limit access to a manual interface defined by the tool. [Figure 39B] FIG. 39B is another perspective view of the end effector of FIG. 39A showing the second frame body positioned in a second gripping position to facilitate access to the manual interface defined by the tool. [Figure 39C] Another perspective view of the end effector of Figures 39A-39B, showing the manipulator assembly positioned in the second manipulator assembly position and the second frame body positioned in the second grip position. [Figure 40] 39A-39C are exploded perspective views of the end effector of FIGS. 39A-39C showing the manipulator assembly and drive assembly spaced apart from the rotating instrument, and two tools configured to be releasably attached to a drive conduit of the drive assembly, one of the tools shown as a rotary drive tool supporting a fixator to be driven by the rotating instrument along a trajectory maintained by the surgical robot, and the other of the tools shown as a dissection tool guided along a trajectory maintained by the surgical robot. [Figure 41] FIG. 41 is a partial cross-sectional perspective view of the manipulator assembly of FIGS. 39A-40, shown in a generally longitudinal cross-section. [Figure 42A]39A-40, showing a light source operably attached to a portion of the manipulator assembly, the manipulator assembly positioned as shown in FIG. 39A, and the light source emitting light along a second axis toward the surgical site. [Figure 42B] 39A-40, showing the tool including a light source supported within the drive conduit of the drive assembly, with the manipulator assembly positioned as shown in FIG. 39B, and with the light source emitting light along a second axis toward the surgical site. [Figure 43A] 41 is a partially exploded cross-sectional perspective view of the drive assembly of FIGS. 39A-40 shown in approximate longitudinal section, illustrating an axial lock for releasably securing the rotary drive tool of FIG. 40. FIG. [Figure 43B] 43B is a cross-sectional perspective view of the drive assembly of FIG. 43A showing the dissection tool of FIG. 40 positioned within the drive conduit. [Figure 43C] 43A-43B showing the rotary drive tool of FIG. 40 secured to the drive conduit by an axial lock and a rotary lock; FIG. [Figure 43D] FIG. 43D is another cross-sectional perspective view of the drive assembly, rotary drive tool, and rotary lock of FIG. 43C, shown in cross section along a plane (not shown) disposed about a second axis and at an acute angle to a longitudinal plane (not shown) disposed about the first axis. [Figure 44A] Another cross-sectional perspective view of the drive assembly, rotary drive tool, and rotary lock of Figures 43C-43D shown in cross section along a plane (not shown) disposed perpendicular to the second axis, with the axial lock shown disposed in a locked configuration. [Figure 44B] FIG. 44B is another cross-sectional perspective view of the drive assembly, rotary drive tool, and rotary lock of FIG. 44A, showing the axial lock positioned in the released configuration. [Figure 45]FIG. 10 is a perspective view of an end effector according to a seventh embodiment of the present disclosure similarly configured for use with the surgical system of FIG. 1 , showing the end effector including a mount supporting a rotating instrument to generate torque about a first axis, a drive assembly having a drive conduit supporting a tool to rotate about a second axis, and a manipulator assembly. [Figure 46] FIG. 46 is an exploded perspective view of the end effector of FIG. 45 showing the drive assembly spaced apart from the rotating instrument and manipulator assembly, and two tools configured to be releasably attached to a drive conduit of the drive assembly, one of the tools shown as a rotary cutting tool having a drill bit driven by the rotating instrument along a trajectory maintained by the surgical robot, and the other of the tools shown as a scalpel tool guided along a trajectory maintained by the surgical robot. [Figure 47A] FIG. 47 is a cross-sectional perspective view of the drive assembly of FIGS. 45-46 shown in a generally longitudinal cross-section showing the drive conduit equipped with a collet mechanism having a collet tensioner arranged in a locked configuration. [Figure 47B] FIG. 47B is another cross-sectional perspective view of the drive assembly of FIG. 47A showing the collet tensioner positioned in the released configuration. [Figure 47C] 47B is another cross-sectional perspective view of the drive assembly of FIG. 47A showing the collet tensioner positioned in a locked configuration to secure a portion of the rotary cutting tool of FIG. 46 for rotation about a second axis. [Figure 48A] FIG. 47B is a perspective view of the drive assembly of FIGS. 45-48, showing the collet tensioner positioned as shown in FIG. 47A. [Figure 48B] FIG. 47C is a perspective view of the drive assembly of FIGS. 45-48, showing the collet tensioner positioned as shown in FIG. 47B. [Figure 49A]FIG. 10 is a perspective view of an end effector according to an eighth embodiment of the present disclosure similarly configured for use with the surgical system of FIG. 1 , showing the end effector including a mount supporting a rotating instrument to generate torque about a first axis, a drive assembly having a drive conduit supporting a tool to rotate about a second axis coincident with the first axis, a manipulator assembly coupled to the drive assembly, and a retention mechanism having a protective cover positioned in a first protective position. [Figure 49B] FIG. 49B is another perspective view of the end effector of FIG. 49A showing the protective cover disposed in a second protective position and the end effector positioned adjacent to two tools configured to be releasably attached to the drive assembly, one of the tools shown as a rotary cutting tool having a drill bit and the other of the tools shown as a rotary drive tool supporting a fastener. [Figure 50] FIG. 49C is an exploded perspective view of the end effector of FIGS. 49A-49B showing portions of the retention mechanism and manipulator assembly spaced apart from the fixture and actuator subassembly. [Figure 51] FIG. 51 is an exploded perspective view of a portion of the actuator subassembly of FIG. 50. [Figure 52] FIG. 51 is an exploded perspective view of the manipulator assembly of FIG. 50 showing the first manipulating subassembly spaced apart from the second manipulating subassembly. [Figure 53A] FIG. 53 is an exploded perspective view of the second steering subassembly of FIG. 52. [Figure 53B] FIG. 53B is another exploded perspective view of the second steering subassembly of FIG. 53A. [Figure 54] 53A-53B, shown in a generally longitudinal cross-section. FIG. 53B is a partially cutaway perspective view of the second manipulation subassembly of FIGS. 53A-53B, shown in a generally longitudinal cross-section. [Figure 55] 53 is an exploded perspective view of the first operating subassembly of FIG. 52 showing a protective lock subassembly that secures the retention mechanism of FIGS. 49A-50. FIG. [Figure 56A]56 is a partial perspective view of the end effector of FIGS. 49A-50 showing the protective cover of the retention mechanism locked in the first protective position by the protective lock subassembly of FIG. 55. FIG. [Figure 56B] FIG. 56B is another partial perspective view of the end effector of FIG. 56A showing a portion of the retention mechanism engaging a portion of the protective lock subassembly. [Figure 56C] 56 is a partial perspective view of the end effector of FIGS. 49A-50 showing the protective cover of the retention mechanism disposed in the first protective position but disengaged from the protective lock subassembly of FIG. 55; [Figure 56D] FIG. 56D is another partial perspective view of the end effector of FIG. 56C showing a portion of the retention mechanism disengaged from, but adjacent to, a portion of the protective locking subassembly. [Figure 57] 51 is a partial cross-sectional perspective view of the end effector of FIGS. 49A-50 shown in a generally longitudinal cross-section, with the protective cover of the retention mechanism shown in the second protective position shown in FIG. 49B. [Figure 58A] 58 is an enlarged, partially cut-away perspective view taken along mark 58 of FIG. 57. FIG. [Figure 58B] 58A showing another enlarged, partial cross-sectional perspective view of the end effector of FIG. 58A, showing the portion of the rotary drive tool of FIG. 49B supported within a drive conduit of the drive assembly. [Figure 58C] FIG. 58C is another enlarged, partial cross-sectional perspective view of the end effector and rotary drive tool of FIG. 58B, showing the protective cover of the retention mechanism in position as shown in FIGS. 56C-56D. [Figure 58D] FIG. 58D is another enlarged, partial cross-sectional perspective view of the end effector and rotary drive tool of FIG. 58C, showing the protective cover of the retention mechanism disposed in the first, protective position shown in FIGS. 56A-56B. [Figure 59A] FIG. 58 is an enlarged, partially cut-away perspective view taken along mark 59 of FIG. 57. [Figure 59B]59B is another enlarged, partial cross-sectional perspective view of the end effector of FIG. 59A showing a portion of the rotary drive tool of FIG. 49B supported within a drive conduit of a drive assembly. [Figure 60] FIG. 49C is an exploded perspective view of the rotary drive tool and fastener of FIG. 49B, showing the rotary drive tool having a locking subassembly. [Figure 61A] 61 is a partial cross-sectional perspective view of the rotary drive tool of FIG. 60 shown in a generally longitudinal cross-section, illustrating the lock subassembly arranged in a power transmission lock configuration. [Figure 61B] FIG. 61B is another partial cross-sectional perspective view of the rotary drive tool of FIG. 61A showing the lock subassembly positioned in a power transfer unlocked configuration. [Figure 62A] 61 is a partial cross-sectional perspective view of the rotary drive tool of FIG. 60 showing the lock subassembly arranged in a power transmission lock configuration, shown in cross section along a plane (not shown) disposed about a second axis and perpendicular to a longitudinal plane (not shown) also disposed about the second axis. [Figure 62B] FIG. 61C is another partial cross-sectional perspective view of the rotary drive tool of FIG. 61B showing the lock subassembly positioned in a power transfer unlocked configuration. [Figure 63A] 49A-50 showing a partial perspective view of the end effector of FIGS. 49A-50 with the protective cover of the retention mechanism positioned in a first protective position and positioned adjacent to the rotary drive tool of FIGS. 61A-62B and the lock subassembly positioned in a power transfer lock configuration to drive the fastener. [Figure 63B] FIG. 63B is another partial perspective view of the end effector, rotary drive tool, and fastener of FIG. 63A , showing the rotary drive tool supported within the drive conduit of the drive assembly as shown in FIG. 58B and showing the fastener positioned along the track. [Figure 63C] 68B is another partial perspective view of the end effector, rotary drive tool, and fastener of FIG. 63B, showing the protective cover of the retention mechanism disposed in the second, protective position shown in FIG. 58D. [Figure 63D] Another partial perspective view of the end effector, rotary drive tool, and fastener of FIG. 63C showing the protective cover of the retention mechanism positioned in the first protective position, the locking subassembly of the rotary drive tool positioned in the power transfer lock configuration, and the fastener advanced along the track. [Figure 63E] FIG. 63E is another partial perspective view of the end effector, rotary drive tool, and fastener of FIG. 63D showing the locking subassembly of the rotary drive tool positioned in a power transfer locked configuration. [Figure 63F] FIG. 63D is another partial perspective view of the end effector, rotary drive tool, and fastener of FIG. 63E showing the rotary drive tool removed from the drive assembly of the end effector and released from the fastener, with the fastener positioned along a track spaced apart from the end effector and rotary drive tool. DETAILED DESCRIPTION OF THE INVENTION

[0021] In one or more of the embodiments shown throughout these figures, for purposes of illustration, a particular components, structural features, and / or assemblies are omitted and shown diagrammatically and / or It will be understood that the lines are shown in dashed or broken lines.

[0022] Referring now to the drawings, like numerals indicate like or corresponding parts throughout the several views. A surgical system 30 including a surgical robot 32 is shown in FIG. The surgical robot 32 has a base 34, a robotic arm 36, and a coupling 38. As will be explained in more detail below, the robot arm 36 is supported by the base 34. and the position and / or orientation of the coupling 38 relative to the base 34 during use. configured to drive, maintain, or otherwise control the The coupling 38 is adapted to releasably secure the end effector 40 so that , the end effector 40 is moved along one or more trajectories T to a surgical site ST on a patient's body B. and configured to drive a tool generally designated 42. Thus, the surgical robot 32 controls, among other things, the movement and positioning of the end effector 40 and tool 42. to assist medical personnel in performing various types of surgical procedures with the precise control , moves the end effector 40 via the robot arm 36. One exemplary arrangement is described in "Su rgical Robotic arm Capable of Controllin ga Surgical Instrument in Multiple Mode The robot arm is described in U.S. Patent No. 9,119,655 entitled "Robot Arms." 36 and other portions of the surgical robot 32 may also be arranged in alternative configurations. Let it be understood.

[0023] The surgical system 30 is operated by a user (e.g., a surgeon) who is maintained by a surgical robot 32. along the trajectory T held at and / or against the surgical site ST, or multiple types of tools 42. As will be understood from the following description of various embodiments of the present disclosure, In particular, the tool 42 is positioned in a high position relative to the trajectory T maintained by the surgical robot 32. The level of control allows the surgeon to access and manipulate the anatomical structures of the patient's body B at the surgical site ST. The end effector 40 can be supported to allow the workpiece to be moved. Each of the components of surgical system 30 introduced above is described in more detail below.

[0024] It is well known that conventional surgical procedures routinely involve the use of several different types of tools 42. As will be appreciated by those skilled in the art, the particular type of tool 42 is supported along a track T. However, when configured to be driven by the end effector 40, it is "active." can be characterized as (for example, but not limited to, drills and On the other hand, certain types of tools 42 move along a trajectory T. is guided by the end effector 40 while being at least partially supported by the When configured to be "passive" (i.e., not driven), (e.g., but not limited to, dissectors and scalpels). In addition, As will be understood from the following description, several types of tools 42 are available for various uses. They can be characterized as both "active" and "passive", depending on how they are used.

[0025] Although several different types of "active" tools 42 are contemplated by this disclosure, is a rotary cutting tool 44 (e.g., a cutting tool) that forms a pilot hole 46 at the surgical site ST along a trajectory T. For example, a rotary cutting instrument with a drill bit) and placed at the surgical site ST along the trajectory T. The device 50 is adapted to releasably secure a fastener 50 (e.g., a polyaxial screw) Two exemplary "rotary drive tools 48" (e.g., fixture drive devices) configured as follows are shown: The "active" tool 42 will now be described in connection with Figures 4-5F.

[0026] The end effectors described herein are shown in connection with a first embodiment of end effector 40. Representative embodiments of the actuator 40 and tool 42 generally involve the insertion of two or more vertebrae into the patient's body B. Surgeons who perform various types of minimally invasive spinal surgery procedures, including posterior interbody spinal fusion However, as will be understood from the following description, The system 30 includes an "active" tool 42 driven by an end effector 40 and and / or by a "passive" tool 42 guided by the end effector 40, etc. The movement of the roller 42 is restricted to rotation about the axial trajectory T and translation along the axial trajectory T. The present invention can be used in connection with a number of different types of surgical procedures in which it is advantageous to The term "driven" generally corresponds to the rotation of the tool 42 around the trajectory T. However, the surgical robot 32 is supported by an end effector 40 that is guided by the robot. The tool 42 is moved around the trajectory T and / or the surgical site ST and / or the trajectory T and and / or the surgical site ST, including but not limited to vibration, It can be driven in several different ways, including rotation, translation, or rotation, or a combination of these. It will be understood that

[0027] As mentioned above, the illustrated surgical system 30 advantageously performs posterior interbody spinal fusion procedures. In this illustrative example, a rotational The cutting tool 44 can be used to create pilot holes 46 in the different vertebrae. The rotary drive tool 48 drives the fixation devices 50, which are realized as pedicle screws, into the respective It can be used to place the needle into the pilot hole 46. Then, the two needles of the patient's body B Stabilizing rods (not shown) are attached between the fixtures 50 placed in the pedicles of the vertebrae. This limits the relative movement between these vertebrae, thereby promoting bone growth and holding the vertebrae together. The above examples are illustrative and other types of surgical procedures may also be contemplated. It will be understood that the drawings are merely illustrative.

[0028] In addition to forming pilot holes 46 for polyaxial pedicle screw type fixation devices 50 In some embodiments, the rotary cutting tool 44 may also be mounted on other types of fixed hardware. (e.g., pins, screws, brackets, plates, rods, etc.), prosthetic components (e.g., artificial joints, bone cages, implants, etc.), and / or medical devices (e.g., gas Holes can be formed for devices such as guide wires, instrumentation, sensors, trackers, etc. Additionally, in some embodiments, the rotary cutting tool 44 also serves to cut the vertebrae and / or adjacent structures. tissue (e.g., as a burr utilized during laminectomy or discectomy) or other bone (e.g., to help remove portions of the bone (e.g., to facilitate grafting of bone harvested from the iliac crest). Thus, tool 42 can be configured to cut, remove, manipulate, or otherwise manipulate tissue at a surgical site. or can be realized as several different types of surgical tools for performing treatments. The end effector 40 controls the movement of the tool 42, which is maintained by the surgical robot 32. Any suitable time period may be used in which it is advantageous to restrict the time period to rotations about and translations along the trajectory T. The present invention can be utilized in a variety of surgical procedures. As noted above, other configurations are contemplated.

[0029] The surgical system 30 may be configured with various types of trackers (e.g., optical with multiple degrees of freedom, inertial, and / or ultrasonic sensing devices), navigation systems (e.g., machine vision sensory systems, charge-coupled device cameras, tracker sensors, surface scanners, and / or rangefinder), anatomical computer models (e.g., magnetic resonance imaging of the lower lumbar region of the spine), resonance imaging scans), data from previous surgical procedures and / or previously performed surgical techniques ( For example, a pilot hole 46 may be formed which is subsequently used to facilitate installation of the fastener 50. By utilizing data recorded by a surgical robot while performing surgery, The surgical robot 32, the robot arm 36, and the end effector 40 in the same coordinate system. , and / or one or more portions of the tool 42 and various portions of the patient's body B. monitoring, tracking, and / or determining changes in the relative position and / or orientation of For these purposes, a surgical system 30, as shown diagrammatically in FIG. This allows the surgical robot 32 to maintain alignment of the tool 42 along the trajectory T. The vehicle includes a control system 52 and a navigation system 54 that cooperate to enable the vehicle to travel smoothly. The control system 52 includes an arm controller 56, and the navigation system 54 includes: The navigation controller 58 is provided. The controllers 56 and 58 are computers, processor, control unit, etc., and may be separate components. may be integrated and / or otherwise share hardware can be done.

[0030] Surgical system 30 includes, among other functions, articulation of robotic arm 36, actuation of tool 42, and The control system 52 is used to facilitate the operation. The controller 56 controls various actuators located at the joints of the robot arm 36 (not shown). The robot arm 36 is operated by driving a actuator, a motor, etc. The arm controller 56 is also configured to control the robot arm 36. Sensor data is collected from various sensors (not shown) such as encoders. The specific geometries of the components of the end effector 40 and tool 42 are known. Therefore, the arm controller 56 uses these sensor data to control the manipulator. The position and / or orientation of the tool 42 in the coordinate system MNPL (see FIG. 1) is reliably adjusted. The manipulator coordinate system MNPL has an origin, which is located at the center of the robot arm. 36. An example of this type of manipulator coordinate system MNPL is given in the referenced "Surgical Robotic arm Capable of Contr" olling a Surgical Instrument in Multiple No. 9,119,655 entitled "Modes."

[0031] The surgical system 30 includes, among other things, a tool 42 and a portion of a patient's body B (e.g., a surgical The navigation system is used to track the movement of various objects, such as the vertebrae located in the ST region. For this purpose, the navigation system 54 uses the localizer coordinate system to sense the position and / or orientation of a tracker 62 fixed to an object within the LCLZ. The navigation controller 58 includes a localizer 60 configured and is positioned to communicate with Localizer 60 within the localizer coordinate system LCLZ. Position and / or orientation data for each tracker 62 sensed thereby is collected.

[0032] The localizer 60 senses the position and / or orientation of a plurality of trackers 62 and It is understood that multiple objects can be tracked in the localizer coordinate system LCLZ. For example, as shown in FIG. 1, the tracker 62 may include a pointer tracker 62P, a pointer tracker 62B, a pointer tracker 62C, a pointer tracker 62D, a pointer tracker 62E, a pointer tracker 62F, a pointer tracker 62H ... the first patient tracker 62T, the first patient tracker 62A, and / or the second patient tracker 6 2B, as well as additional patient trackers, and tracks for additional medical and / or surgical tools. In FIG. 1, the tool tracker 62T may be an end effector. 40, and the first patient tracker 62A is attached to one vertebra ( For example, a second patient tracker 62B may be fixed to a different vertebra (e.g., the sacrum S1) and a second patient tracker 62C may be fixed to a different vertebra (e.g., the sacrum S2). (e.g., L5 of the lumbar spine). The end effector 40 may be integral with the end effector 40 or releasably attached thereto. The patient may also be secured to the end effector 40 in different ways, such as by clamping the patient. The patient trackers 62A, 62B may be attached to the patient's The various trackers 62 are fixed to different bones of body B in several different ways. It is possible to accurately track different types of tracked objects (e.g., individual bones, tools, pointers, etc.). It will be appreciated that it may be fixed.

[0033] The position of the tracker 62 relative to the anatomical structure to which it is attached is determined by a point-based This can be determined by known alignment techniques such as bone-on-bone alignment. Delineate points on landmarks or across bones for surface-based alignment A pointer tracker 62P (e.g., a navigation pointer) is used to Conventional registration techniques can be used to align the pose of the tracker 62 with the patient's anatomy (e.g., The mechanical clamps attached to the spinous processes of the vertebrae can be correlated to the spinous processes of the vertebrae. Other types of alignment are possible, such as by using a tracker 62 with a and such a mechanical clamp determines the shape of the spinous process to which the clamp is attached. Then, for alignment, the shape of the spinous process is measured. Three or more tactile sensors and trackers 62 can be fitted to a 3D model of the spinous process. The known relationship between the markers can be input into the navigation controller 58. or otherwise known by navigation controller 58. Based on the known relationship, the location of the marker relative to the patient's anatomy can be determined. .

[0034] Conventional registration / navigation techniques are used to determine the coordinate system of each Position and / or location information is provided by a navigation controller 58 that determines the coordinates of the tracker 62. Orientation data may be collected, determined, or otherwise manipulated. The coordinates facilitate articulation of the robotic arm 36, as described in more detail below. The information is communicated to the control system 52 for

[0035] In the exemplary embodiment shown in FIG. 1, the arm controller 56 controls the surgical robot 32. operatively attached, and the navigation controller 58 and localizer 60 Both are supported on a mobile cart 64 that is movable relative to the base 34 of the surgical robot 32. The mobile cart 64 may also be used to display information to a surgeon or other user and / or to provide surgical support. Receiving information from a physician or other user to facilitate operation of the surgical system 30 To do this, the user interface is generally designated 66. The base 66 is configured to communicate with the navigation system 54 and / or the control system 52. and information (e.g., images, video, data, graphics, navigation, one or more output devices 68 (e.g., a menu that can be displayed) for presenting the surgeon with monitor, indicator, display screen, etc.) and one or more input devices. device 70 (e.g., buttons, touch screen, keyboard, mouse, gestures or voice) One type of mobile cart 64 and and user interface 66, which are incorporated herein by reference in their entirety. No. 7,725,162 entitled "Surgery System" It is listed.

[0036] The mobile cart 64 and base 34 of the surgical robot 32 are movable relative to each other and to the patient. The surgical system 30 can be positioned relative to the body B so that the localizer coordinates The coordinates of each tracker 62 from the system LCLZ are transformed into the manipulator coordinate system MNPL, and vice versa, and therefore at least partly in a single common coordinate system (manipulator The relative position of each tracker 62 in the localizer coordinate system (MNPL or LCLZ) Based on the position and orientation, articulation of the robotic arm 36 can be performed. Using different conventional coordinate system transformation techniques, coordinates in the localizer coordinate system LCLZ are transformed into It is understood that coordinates in the MNPL coordinate system can be transformed into coordinates in the MNPL and vice versa. Let's do it.

[0037] In the illustrated embodiment, the localizer 60 is an optical localizer, and includes one or more The navigation system 54 includes a camera unit 72 having an optical position sensor 74. The optical position sensor 74 of the camera unit 72 is used to measure the track in the localizer coordinate system LCLZ. In the exemplary embodiment shown herein, Each tracker 62 receives light sensed by an optical position sensor 74 of a camera unit 72. This type uses an active marker 76 (e.g., a light emitting diode "LED") that emits An example of such a navigation system 54 is provided in the US Pat. No. 6,399,424, the disclosure of which is incorporated herein by reference in its entirety. "Navigation System Including Optic U.S. Patent No. 9,999,999 entitled "Al and Non-Optical Sensors" In another embodiment, the tracker 62 is a camera unit. The present invention may include a passive marker such as a reflector that reflects light emitted from the light source 72. Other suitable tracking systems and methods not specifically described herein (e.g., ultrasound, It should be understood that other techniques (electromagnetic, radio frequency, etc.) may also be used.

[0038] In some embodiments, the surgical system 30 provides images and and / or display the graphical representation on one or more output devices 68 (e.g., a display The surgeon is presented with a virtual representation of the relative position and orientation of the tracked object, such as on a display. or to other users of the surgical system 30. The controller 56 and / or navigation controller 58 may also be used by a surgeon or other user. may interact with the control system 52 to facilitate articulation of the robotic arm 36. A user interface 66 may be utilized to display command or request information so that the user can Other configurations are contemplated.

[0039] The control system 52 and navigation system 54 may position the tool 42 in different ways. It will be appreciated that the various components may also cooperate to facilitate position and / or orientation control. For example, in some embodiments, the arm controller 56 controls the robot arm 3 The robotic arm 36 is controlled to provide tactile feedback to the surgeon via the The haptic feedback is configured to be transmitted to the robot (for example, by driving a joint motor). The back allows the surgeon to move the end-effect beyond a predefined virtual boundary related to the surgical procedure. 40 and / or tool 42 from being manually moved ( For example, to maintain alignment of tool 42 along trajectory T). One type of haptic A feedback system and associated haptic objects that define a virtual boundary may be used, for example, as disclosed herein. "Haptic Guidance," which is incorporated herein by reference in its entirety. U.S. Patent No. 8,010,180 entitled "System and Method" In one embodiment, the surgical system 30 is located in Fort Lauderdale, FL. RIO (trade name) manufactured by MAKO Surgical Corp. of Brooklyn, NC Mark) Robotic Arm Interactive Orthopedic Sys It is tem.

[0040] 1-11F, as described above, the surgical system 30 includes a Precise control of the relative position and orientation of tool 42 with respect to B allows for various types of hand The end effector 40 is used to control the surgical robot to assist the surgeon in performing the surgical procedure. 3. Drive the tool 42 at the surgical site ST along a different trajectory T maintained by the tool 32. .

[0041] As best shown in FIGS. 3-4, the end effector 40 generally comprises a surgical robot. 32 is adapted to be attached to a coupling 38 of a robot arm 36 and to move simultaneously therewith. A rotating device, generally designated 80, is coupled to the fixture 78 (see FIG. 1). and selects a rotational torque about a first axis A1, as described in more detail below. A drive assembly 82 is configured to automatically generate a first axis A from the rotating equipment 80. A gear train converts rotation around axis A1 into rotation around a second axis A2 that is different from the first axis A1. The exemplary implementation shown in connection with the first embodiment of the end effector 40 is In this embodiment, the second axis A2 intersects the first axis A1 and is substantially perpendicular to the first axis A1. However, it will be understood that other arrangements of the axes A1, A2 are contemplated. 2 also includes a connector generally designated 86, which is connected to the second axis A2. The tool holder 40 is configured to releasably secure different types of tools 42 for rotation therebetween. A manipulator assembly, generally designated 88, supports the hand of a user (e.g., a surgeon). The input device 92 is provided with a lip 90 and an input operation tool 92 that is linked to the rotating device 80. The input operation tool 92 is provided with: When selectively engaged by a user, the rotating equipment 80 is driven to rotate the tool 42 along the second axis A. The end effector 40 is also arranged to rotate at different rotational speeds around the axis 2. , includes a manual interface generally designated 94, which is connected to a drive axis. In conjunction with the assembly 82, the tool 42 receives a force applied by a user and moves along the second axis A. 2. For this purpose, the torque shown in Figs. 3, 4, and 10B , and as shown in FIGS. 11B-11C, in the illustrated embodiment, a manual interface A manual handle assembly 96 is provided for releasably attaching to the manual insert 94. The interface 94 and handle assembly 96 allow manual operation (e.g., manual drilling). , screw drive, etc.) and power driven operation via torque from rotating equipment 80 (e.g., This gives the surgeon the ability to combine the power-driven drilling, screw driving, etc. Therefore, the specific procedure being performed, the type of tool 42 being utilized in that procedure, , via rotating instrument 80 during certain stages of the surgical procedure, depending on the surgeon's preferences, etc. The other steps can be performed manually via the handle assembly 96. The components of the end effector 40 and the end effector Each of the components for use with controller 40 is described in more detail below.

[0042] Minimally invasive spinal fixation techniques (as well as other types of surgical procedures) generally involve the surgical site ST. This involves placing multiple fasteners 50 in one or more vertebrae. For example, two adjacent vertebrae. In posterior lumbar interbody fusion (e.g., fusion of lumbar L5 to sacral S1), Typically, a fixture 50 is placed bilaterally into the pedicle on either side of the spinous process of each vertebra to be fixed. Correspondingly, it supports the left and right stabilization rods, thus fixing the two adjacent vertebrae. This generally involves installing at least four fasteners 50, with additional fasteners to be fastened. Each vertebra generally involves placing two additional left and right fixators 50 (e.g., lumbar Sacral S1 fusion to L5 vertebra combined with lumbar L5 fusion to L4 vertebra Furthermore, the entire pedicle of each vertebra can be inserted from the adjacent lamina into the vertebral body without passing through the vertebral foramen. The fixation device 50 is carefully attached to the vertebrae so as to extend over the spinal cord, nerve roots, etc. It will be understood by those skilled in the art that the ion implantation device must be installed in the same manner as in FIGS. As shown at C, each fixture 50 is positioned along a different trajectory T.

[0043] 5A-5G each show a vertebra (e.g., lumbar L5) in a transverse orientation. The rotation device 80 and, in some embodiments, the fixture 50 via a manual interface 94 To facilitate placement of the tool 42 supported by the end effector 40, In FIG. 5A, the first trajectory T1 and the second trajectory T2 are shown. T2 is shown to be positioned bilaterally relative to the spinous processes, and corresponds to the vertebral foramen and the spinous process. One fixation device 50 extends through each pedicle into the vertebral body on either side of the spinal cord. 1 and the rotary cutting tool 44 is already installed along the track T1. The distal cutting end 44D (e.g., the tip of the drill bit) is adjacent to the surgical site ST. Here, the rotary cutting tool 44 is rotated about a second axis A2. The surgical robot 32 is supported and adjusts the alignment of the second axis A2 with respect to the second trajectory T2. Maintain.

[0044] FIG. 5B shows positioning the distal cutting end 44D into the vertebrae at the surgical site ST at a first depth D1. 1 shows the rotary cutting tool 44 advanced through the pedicle along a second trajectory T2, as shown in FIG. 5C is configured to position the distal cutting end 44D at a second depth D2 greater than the first depth D1. 1 shows the rotary cutting tool 44 further advanced along a second trajectory T2.

[0045] FIG. 5D illustrates the rotary cutting tool extending along a second trajectory T2 into the vertebra to a second depth D2. 5D also shows the pilot hole 46 formed by 44. a distal tip 50 of another fixation device 50 positioned adjacent to the surgical site ST to be installed; D, where the fixture 50 is rotated by a rotary drive tool 40 for rotation about a second axis A2. 48 (see FIGS. 3-4), the surgical robot 32 is also supported by the second trajectory T Maintain alignment of second axis A2 relative to axis A2.

[0046] FIG. 5E illustrates the pilot hole 46 via rotation of the rotary drive tool 48 about the second axis A2. 5E shows the fastener 50 advanced along a second trajectory T2 after being "threaded" into the The distal tip 50D of the fastener 50 is positioned into the vertebra at a third depth D3, in this example: The third depth D3 is greater than the second depth D2 but may be equal to or less than the second depth D2. The depth can also be made smaller than D2.

[0047] In FIG. 5F, fastener 50 extends from distal tip 50D to a fourth depth D4 that is greater than third depth D3. The second trajectory T2 is shown to have been advanced further along to position the Here, the fourth depth D4 represents the intended final position FP of the installed fixture 50, and both the left and right The final position FP of the fixtures is shown in FIG. 5G, with each fixture 50 positioned along its respective trajectory T1. , aligned to T2.

[0048] With continued reference to FIGS. 5A-5G, the surgeon uses a rotary cutting tool 44 or rotary drive The tool 48 can be advanced along the second trajectory T2 in a number of different ways. It will be understood that the illustrated rotary cutting tool 44 and rotary driving tool 48 are configured as follows: Depending on the orientation of the tool 42, rotation of the tool 42 about the second axis A2 may result in a distal rotation of the tool 42 in response to engagement with the bone. A tendency to advance the cutting end 44D and / or distal tip 50D along a second trajectory T2 Despite this tendency, surgeons generally prefer the second orbit T2, which is normally inhibiting any movement or articulation of the robot arm 36 that may cause the axis A2 of the Thus, while the surgical robot 32 is operating in the haptic mode, the group of the manipulator assembly 88 Applying a force to the lip 90 advances the tool 42 along a second trajectory T2. do.

[0049] In some embodiments, the surgical system 30 may be configured to configured to behave differently upon approaching or reaching one or more of the For example, surgical system 30 may allow a surgeon to engage input manipulator 92 to drive rotary instrument 80. Then, the rotary cutting tool 44 is rotated about the second axis A2 until the first depth D1 is reached. The first depth D1 can be reached (see FIG. 5B). After this, the surgical system 30 will cease rotation and, among other things, the surgeon will be able to The handle assembly 96 is engaged with the base 94 to move from a first depth D1 to a second depth D2. D2 (see FIG. 5C) manually (e.g., without torque from the rotating equipment 80). It can be made possible.

[0050] The surgical system 30 begins to move when the distal tip 50D reaches a third depth D3 (see FIG. 5E). ) and similarly stops rotation when the fixation device 50 is installed, so the surgeon A third depth is achieved through engagement of the handle assembly 96 with the manual interface 94. Installation from D3 to the fourth depth D4 (see FIG. 5F) can be completed manually. In addition to stopping rotation at a depth, the surgical system 30 also provides a method for approaching a particular depth. As the rotational speed increases, the rotational speed may be slowed, the translational speed may be limited along the second trajectory T2, or the tool may be otherwise Variable control over the rotation and / or translation of the wheel 42 can be provided.

[0051] The installation sequence shown in Figures 5A-5G is intended to be exemplary and non-limiting. and the depths D1, D2, D3, and D4 are how the tool 42 can be used. It is intended to be an arbitrary reference point to help explain how It can also represent the actual depth into the bone (e.g., determined and set according to preoperative planning). Furthermore, the above-described depths D1, D2, D3, and D4 in connection with FIGS. 5A to 5G can be The discussion generally focuses on the rotation of the rotating device 80 until it reaches one depth (e.g., D1 or D3). Rotation of the tool 42 by manual interface to the final depth (e.g., D2 or D4) Although the rotation of tool 42 by interface 94 is distinguished from the rotation of tool 42 by interface 94, in some embodiments, 2 to the final depth (e.g., D2 or D4), a rotating device 80 or a hand It is contemplated that the dynamic interface 94 may be utilized alone. Then, the rotary device 80 is used to drive the rotary cutting tool 44 to cut the pipe to a second depth D2. A slot hole can be formed (by slowing the rotation from a first depth D1 to a second depth D2). At that point, the surgical system 30 stops the rotation of the rotating instrument 80 and The surgeon may be prompted to switch to the rotary drive tool 48 to install the fixation device 50. through the manual interface 94 without using torque from the rotating equipment 80. Thus, the rotary drive tool 48 can be manually rotated to a fourth depth D4. 10, the torque generated by the rotating equipment 80 is controlled exclusively by the manual interface. via manually applied torque to the face 94 or sequentially via the rotating device 80 and the manual input. It is possible to rotate a particular tool 42 from both the interface 94. Other configurations are contemplated.

[0052] The workflow associated with placing the fixation device 50 depends, among other things, on the specific surgical procedure being performed, the fixation device 50 itself, and the associated workflow. The exemplary embodiments described herein may vary based on the configuration of fixture 50, etc. It will be understood that the fixings shown throughout the drawings are possible as non-limiting examples. To help facilitate installation of the tool 50, instead of forming a pilot hole 46, The fixture 50 is designed to be installed without the need for a pre-formed pilot hole 46. Fixtures 50, such as "self-tapping" or other configured fixtures, are not necessarily pilot Configured to facilitate a "single pass" workflow that does not require the formation of holes 46 It is contemplated that other configurations are possible.

[0053] 6-9, the rotary drive tool 48 and fixture 50 are shown in greater detail. As mentioned above, the illustrated fixation device 50 is placed into the vertebrae using minimally invasive surgical techniques. The pedicle screw implant is realized as a pedicle screw implant configured as follows, and the multiaxial head 100 The multi-axis head 100 has a screw body 98 supported by a screw, and the multi-axis head 100 has a removable blade 102. An exemplary embodiment of the construction of this type of fixture 50 is shown in the drawings, which are incorporated herein by reference in their entirety. "Percutaneous Poster ior Spinal Fusion Implant Construction a No. 9,408,716 entitled "Method for Producing and Producing a Highly Accurate and Highly Accurate Polyethylene Glyceride." In some embodiments, the surgical system 30 may be any of the surgical systems described herein, the disclosures of which are each incorporated by reference in their entirety. "Neural Monitor-Based Dyna U.S. Patent No. 9,801,686 entitled "Micro Haptics" and / or has filed a U.S. patent application entitled "Power Pedicle Screwdriver" This or other types of tamper-evident ... The present invention can facilitate the installation of other types and configurations of fasteners 50. It will be understood that, as well as related installations thereof, are also contemplated by this disclosure.

[0054] As best shown in FIG. 9, the rotary drive tool 48 is generally rotatably mounted within a support tube 106. The drive shaft 104 is supported by a contoured body. y) 108 are coupled to the support tube 106 for simultaneous rotation and are engaged by the surgeon. When combined, the rotary drive tool 48 is easily attached to the fixture 50, among other things. The profiles 108 are configured to rotate simultaneously via a splined engagement generally indicated at 112. The lock subassembly 110 selectively engages the lock subassembly 110 to rotate.

[0055] The lock subassembly 110 locks the drive shaft 104 axially relative to the support tube 106. To this end, the lock subassembly 11 is configured to selectively limit movement in either direction. 0 supports a slider 116 for movement transversely relative to the drive shaft 104. In the illustrated embodiment, the slider 116 is secured by a spring 118. The support tube 106 is biased and held against the locking body 114 via a pin 119. The external threads 120 are threaded to corresponding internal threads formed in the blades 102 of the fixture 50. The distal end of the drive shaft 104 is fitted with a drive key 124. 124 is formed adjacent to the polyaxial head 100 within the proximal end of the threaded body 98 of the fixture 50. The rotary drive tool 48 thus engages the drive key 126. 124 and the driven key 126, and the engagement between the male thread 120 and the female thread 122. This type of rotary drive tool 48 is releasably attachable to a fixture 50 via a and one exemplary embodiment of fixture 50 is described in detail in the accompanying drawings, the disclosure of which is incorporated herein by reference in its entirety. Incorporated, "System and Method for Spinal I No. 8,002,798 entitled "Plant Placement" It is listed.

[0056] A bit interface, generally designated 128, is adjacent to the lock subassembly 110. The bit interface 128 is coupled to the proximal end of the drive shaft 104. 40. The drive assembly 82 of the end effector 40 is releasably attached to the connector 86. 1 and 2, each of which has a rotational drive relative to connector 86, as will be explained in more detail below. An axial retainer 1 engages the connector 86 to limit translation and rotation of the moving tool 48. 30 and a rotary retainer 132. As best shown in FIG. 98, and the drive shaft 104 and bit interface of the rotary drive tool 48. The base 128 may be penetrated by, among other things, a guide wire GW (e.g., a "K-wire"). To enable this, a cannula is inserted (not shown in detail).

[0057] 1 to 24, as described above, the surgical robot 32 moves relative to the trajectory T. The grip of the manipulator assembly 88 is maintained by the surgeon while maintaining alignment of the second axis A2. 90, the end effector 40 and the tool 42 move along the second axis. A2, the end effector 40 is a rotary device. 80 or via torque from manual interface 94, the tool about second axis A2. 10A to 12, the rotation of the wheel 42 is facilitated. The fixture 78 supports various other components of the end effector 40 and advantageously supports the robot The second axis A2 is positioned relative to the coupling 38 of the arm 36 (see FIG. 1), and in particular, Promoting the hardness and rigidity of the do-effector 40 while also improving the usability of the surgical system 30, It is designed to provide advantages in terms of stability and accuracy.

[0058] A representative illustration of a manipulator assembly 88 shown in connection with a first embodiment of the end effector 40. In one embodiment, the grip 90 has a generally cylindrical shape and generally induces hand engagement in a pronated or rotated position. Therefore, the surgeon generates torque with the rotating instrument 80. When operating the manipulator assembly 88 in this manner, the surgeon's hand is positioned such that the second axis A2 is approximately 10A and 11A, so as to extend through the grip 90. 82, thereby advantageously allowing the operator assembly 88 to be engaged while This allows the surgeon to position his / her hand along the trajectory T, which allows the surgeon to Applying a force to the end effector 40 in a direction substantially aligned with the trajectory T to move the tool 4 2. Furthermore, this configuration can help drive assembly 8 2, the tool 42, or the surgeon's view of the surgical site ST without substantially obstructing the surgeon's view. However, the manipulator assembly 88 and / or Alternatively, the grip 90 may be configured such that the grip 90 is generally in a neutral (as opposed to pronated or supinated) position of the hand. They may also be configured in other ways, such as when molded and positioned for connection to rotating equipment8. When engaged to drive O, it is aligned with or offset from track T. It will be appreciated that other configurations are also contemplated.

[0059] In the above embodiment of the manipulator assembly 88 shown throughout the drawings, as described above, When the grip 90 is engaged to drive the rotating device 80 (FIGS. 10A and 11A ), advantageously the surgeon's hands are positioned along the trajectory T, but necessarily in this configuration The grip is configured to at least partially inhibit access to the manual interface 94. It will be appreciated that the pad 90 is positioned to provide access to the manual interface 94. To facilitate this, the manipulator assembly 88 includes a frame generally designated 134. The system 134 is configured such that the grip 90 and the input operation tool 92 drive the rotating device 80 to rotate the tool 4. 2 around the second axis A2 (FIGS. 10A, 11D, 11E, and 11F). 19A-19B), a first manipulator assembly positioned to be engaged by a surgeon. The assembly position P1, the grip 90 and the input operation tool 92 form a manual interface. 94, thereby facilitating access to the manual interface 9 4 receives a force applied by the user to rotate the tool 42 about the second axis A2. A second operating tool assembly position P2 (FIGS. 10B and 11B to 11C) is arranged so as to 1C) relative to the rotating device 80. 90 and input actuator 92. As will be explained in more detail below, other actuators may be used. Tool assembly locations are also contemplated.

[0060] As best shown in FIGS. 15, 17, and 19A-19C, the manipulator assembly 88 includes a retainer generally indicated at 136 which holds the floats together for simultaneous movement. In the illustrated embodiment, the retainer 136 is operably coupled to the endoscope frame 134. To facilitate assembly of the effector 40, the effector 40 is provided as a separate component from the frame 134. Although the frame 134 is formed integrally therewith, in other embodiments it may be formed integrally with the frame 134.

[0061] The retainer 136 prevents the grip 90 of the manipulator assembly 88 from inadvertently contacting the rotating equipment 80. To this end, the retainer 136 is configured to prevent movement in the locked position 13. 8L (see FIG. 20A, see also FIG. 15) and the unlocked position 138U (see FIG. 20B). ) and a catch, generally indicated at 140. is operably attached to the rotating equipment 80 (e.g., via fasteners) and has a plurality of receiving Each of the plurality of receiving portions 141 is adapted to receive the plunger 13 of the retainer 136. 8 is received in the lock position 138L to define one of the operating tool assembly positions P1, P2. As best shown in Figures 19A-19C, catch 140 is , each of the receiving portions 141 has a generally cylindrical shape, and the catches 14 The retainer 136 and catch 140 are radially spaced apart from one another around 0. The plunger may be interchangeable with the actuator assembly 88 so that it moves simultaneously. It will be appreciated that the rotating equipment 80 may remain stationary relative to the rotating equipment 80 rather than being rotated.

[0062] 15 and 20A-20B, the retainer 136 is attached to the plunger 13 8. The release lever 142 is operable by the surgeon or another user. 20A and 20B, the locking position 138L and the unlocking position 138R are engaged by the The plunger 138 is positioned to facilitate movement between the plunger 138 and the 38 is supported for movement along a plunger bore 144 formed in the retainer 136, It is connected to the release lever 142 via the lever guide pin 146, and the lever guide pin 14 6 is a retainer slot 148 (shown in dashed lines in FIGS. 20A-20B) formed in the retainer 136. The plunger 138 is supported for translation along the locking position 138L. To do this, a plunger biasing element 150 (see FIG. 15), such as a compression spring, biases the plunger 1 The plunger 138 is moved to the unlocked position 138U. To do this, the release lever 142 supports the clasp element 152, which 2 is selectively positioned within a correspondingly shaped clasp pocket 154 formed within the retainer 136. The clasp element 152 can be positioned by a release lever via a clasp pin 156. -It can be attached to 142.

[0063] To move plunger 138 to the unlocked position 138U, the surgeon or another user The clasp element 152 is generally pulled from the catch 140 until it enters the clasp pocket 154. Apply a force to the release lever 142 in the direction away from the retainer so that the lever guide pin 146 is in the retainer slot. As the plunger translates along the groove 148, the plunger biasing element 150 can be compressed. The corresponding shapes of the clasp element 152 and clasp pocket 154 allow the plunger 1 38 is maintained in the unlocked position 138U, and then the surgeon or another user generally A force is applied to the release lever 142 in a direction toward the clasp 140 to release the clasp element 152. 154 and then stored in the plunger biasing element 150. The stored energy returns the plunger 138 to the locked position 138L. It will be appreciated that other configurations of the plunger 138 and catch 140 are contemplated. cormorant.

[0064] As shown in FIG. 17, the rotating device 80 includes a journal generally designated 158, and an operating tool. The assembly 88 includes a bearing surface 160 operably attached to the frame 134. The bearing surface 160 is positioned to engage the journal 158 and thus the operator assembly. The bridge 88 rotates about the operating axis A3 (see FIGS. 19A-19C) to the operating tool assembly position P1. (see FIGS. 10A, 11A, and 19A to 19B), P2 (see FIGS. 10B and 11 11B to 11C), P3 (see FIG. 11F and FIG. 19C) for the rotating device 80. In other words, in the illustrated embodiment, the frame 134 is The manipulator assembly is rotated relative to the rotating device 80 between assembly positions P1, P2, and P3. As shown in FIG. 17, the bearing surface 160 is attached to the frame 13 via fasteners. 4, as well as the cap element 162 attached to the frame adjacent to the cap element 162. The flat surface between the rotating equipment 80 and the manipulator assembly 88 is defined by a portion of the frame 134. along the rotating device 80 and the manipulator assembly 88, respectively, to facilitate smooth rotational movement. Therefore, other journals and bearing surfaces can be provided at other locations (e.g., adjacent to the cage 136). The above embodiment can also be used with a first operating tool assembly position P1 and a second operating tool assembly position P2. The present invention is directed to the rotational movement of the manipulator assembly 88 between the assembly position P2 and the It will be understood that movement of the ball is also contemplated. , pivoting, sliding, translating, and / or combinations thereof may be utilized.

[0065] As mentioned above, in the illustrated embodiment, the grip 90 of the manipulator assembly 88 is When the surgeon engages the input manipulator 92 to drive the rotary instrument 80, the surgeon's hand moves along the trajectory T. In one embodiment, the second axis A2 is arranged to support the first manipulator assembly. At position P1, it intersects with at least a portion of the manipulator assembly 88 (see FIG. 10A). 11A, the manipulator assembly 88 is positioned at the first manipulator assembly position P1 , the grip 90 is substantially perpendicular to the second axis A2. Thus, when the manipulator assembly 88 is in the second manipulator assembly position P2, the grip 90 is substantially parallel to (offset from) the second axis A2. In the illustrated embodiment, the first manipulator assembly position P1 to the second manipulator assembly position P2 Movement to P2 rotates the manipulator assembly 88 approximately 90 degrees relative to the rotating device 80. 19A-19C, the first manipulator assembly position P The receiving portion 141 of the catch 140 that defines the first and second operating tool assembly positions P2 is The first operating tool assembly is arranged 90 degrees apart from each other with respect to the operating axis A3. A third manipulator assembly position P3 ( 11F and 19C) to define other manipulator assembly positions. Any suitable number of receiving portions 141 may be provided to accommodate multiple different receiving directions. A corresponding number of individual actuator assembly positions can be defined that are spaced apart from one another by a distance. It will be understood that

[0066] As shown generally in FIG. 16, in one embodiment, the end effector 40 is generally 16 4, the assembly sensor arrangement 164 is operable Position of the manipulator assembly 88 relative to the rotating equipment 80 between the tool assembly positions P1, P2, and P3 The rotating device 80 is interposed between the rotating device 80 and the manipulator assembly 88 (FIG. 11A) so as to determine the position of the rotating device 80. 11B and 11F). The assembly sensor arrangement 164 may be configured to The signal may be of any suitable configuration sufficient to distinguish between different devices (e.g., encoder, sensor / transmitter arrangement, etc.). , and communicates with the control system 52 to, among other things, control the operation of the manipulator assembly 88 on the rotating equipment 80. Controlling rotating equipment 80 differently depending on how it is positioned relative to Other configurations and arrangements are contemplated.

[0067] As described above, the input controls 92 of the control assembly 88 facilitate driving the rotating device 80. For ease of engagement by the surgeon, the device is positioned as shown diagrammatically in FIG. As shown, the rotating machine 80 includes an actuator 166 (e.g., a rotary actuator) supported within a machine housing 168. The equipment housing 168 defines and mounts the journal 158. The actuator 166 is rigidly attached to the fixture 78. The actuator 166 is generally designated 170. communicate with a motor driver (e.g., a motor controller carried on a printed circuit board) The actuator driver 170 is arranged to drive an actuator generally designated 172. via a data interface (e.g., a wiring harness connected to the arm controller 56) and arranged to communicate with the control system 52. The actuator driver 170 and / or actuator interface 172 to selectively generate a rotational torque about the first axis A1 in response to engagement of the operating tool 92. , powering, controlling, or otherwise enabling rotating equipment 80. Those skilled in the art will appreciate that the present invention may be arranged or configured in a number of different ways sufficient to achieve this. Furthermore, as will be understood from the following description, the end effector 40 The particular implementation of the end effector 40 described herein is shown in relation to the first embodiment of In some embodiments, the rotating equipment 80 is configured to have a generally modular configuration (e.g., a drive detachable from one or more portions of the assembly 82), other than the end effector 40 This embodiment is not modular (e.g., one or more of the drive assemblies 82 Therefore, unless otherwise indicated, "actuator 166" and and "rotating equipment 80" may be used interchangeably.

[0068] 13-19C, the input actuator 92 of the actuator assembly 88 is rotatable. To illustrate how torque is generated by the actuator 166, The input device 92 is arranged to communicate with the actuator driver 170. is used to control the rotational torque generated by the rotating device 80. (see FIG. 19A) and the second input position I2 (see FIG. 19B) with respect to the grip 90. In the illustrated embodiment, the first input position I1 is located at the input manipulation tool 92. The second input position I1 corresponds to the absence of engagement of the input actuator 92, and the second input position I2 corresponds to the full engagement of the input actuator 92. The input device 92 also facilitates variable speed control of the actuator 166, etc. , and is movable to another input position between the first input position I1 and the second input position I2. It will be understood that.

[0069] The physical position of the input operation tool 92 between the first input position I1 and the second input position I2 is determined by the To communicate with the actuator driver 170, the actuator assembly 88 includes an input actuator 9 17 to 19C) is provided in order to link with the operation transmitter 174. The actuator 80 communicates with the actuator driver 170 to determine the first input position I1 and the second input position I2. The position of the operation transmitter 174 corresponding to the movement of the input operation tool 92 between the input position I2 and the input position I3 is determined. The operation detector 176 (see FIGS. 17 and 18 for a schematic illustration) is arranged to detect the movement of the operation detector 176. In one embodiment, the operational transmitter 174 is further defined as a magnet and the operational detector 176 The relative position of the operating transmitter 174 responds to a predetermined change in the magnetic field generated by the magnet. In this illustrative example, the manipulation detector 176 senses a change in the magnetic field and determines the appropriate position. The operating transmitter may be of any suitable type sufficient to respond to the 174 can be made of a ferrous material, and the operation detector 176 is The sensor may be a Hall effect sensor that responds to changes in magnetic field due to interaction with ferrous materials. Therefore, the operating transmitter 174 may also be made of iron enamel, coating, paint, etc. It is contemplated that the present invention may also be implemented as, etc. Other configurations are contemplated.

[0070] Referring next to FIGS. 17 to 19C, between the first input position I1 and the second input position I2, The operation detector 176 can detect the movement of the input operation tool 92. between the input operation tool 92 and the operation transmitter 174 for converting the movement of the input operation tool 92 into a corresponding movement of the body 174. The link mechanism 178 is generally comprised of a cam member 180, a piston The fork includes a fork 182, a carrier 184, a fork-shaped body 186, and a fork guide 188. The input operation tool 92 includes an operation handle 190, a pair of guide shafts 192, and an extension The guide shaft 192 extends from the operating handle 190 and includes a grip member 194. 90. The extensions 196 are slidably supported within respective bushings 196 disposed within the extensions 190. The member 194 is similarly cut away from the operating handle 190 away from the guide shaft 192. The cam member 180 extends from the piston 182 to the notched end 198 of the input actuator 92. and pivots about a support shaft 200 connected to the frame 134. On either side of the support shaft 200, the cam member 180 has an engagement surface 202 that abuts the piston 182. and a slotted protrusion 204 within which an extension pin 206 moves. The extension pin 206 is attached to the notched end 198 of the extension member 194 so that the input actuator 92 Movement causes the cam member 180 to pivot about the support shaft 200 .

[0071] The piston 182 slides within a piston bushing 208 attached to the frame 134. In addition to contacting the engagement surface 202 of the cam member 180, the piston 182 also contacts the fork guide shaft 210 of the fork guide 188, The guide shaft 210 is provided with a pair of washers 214 and a keeper 216, which act as an operating biasing element. The keeper 216 is attached to the fork guide shaft 210 and supports the fork guide shaft 212 (see FIG. 18). and the washers 214 are attached to the actuator 212 so as to hold the operating biasing element 212 between the washers 214. The washer 214 engages one of the fork guards in response to the movement of the piston 182. The operating biasing element 212 helps to facilitate the translation of the guide shaft 210. When the input operation tool moves from the first input position I1 to the second input position I2, the washer 214 and the frame 134, and is disposed in a compressed state within the operating biasing element 212. The stored energy moves the input manipulator to the first input position I1.

[0072] The fork guide 188 moves simultaneously with the fork-shaped body 186 and, in the illustrated embodiment, The fork-shaped body 186 allows the input operation tool 92 to move between a first input position I1 and a second input position I2. 1. When moving between the first and second axes A1 and A2, the first and second axes A1 and A2 are disposed within the retainer 136 for translation along the first axis A1 (FIG. 1). 17A and 19B). As shown in FIG. 17, the retainer 136 is attached to the actuator assembly. A bridge 88 moves between the first operating tool assembly position P1 and the second operating tool assembly position P2. When moved, it is configured to rotate about the first axis A1 simultaneously with the fork-shaped body 186. .

[0073] Carrier 184 is operably attached to operating transmitter 174 for simultaneous movement. or otherwise supports the operating transmitter 174 and has an outer sliding contact surface 218 (see FIG. 18) and a pair of outer blocking surfaces 220. The fork-shaped body 186 defines an inner sliding contact surface 2 22 and a pair of inner blocking surfaces 224. The outer sliding contact surface 218 of the carrier 184 engages the inner sliding contact surface 222 of the fork-shaped body 186 to move the carrier 184. The fork-shaped body 186 can rotate about the first axis A1 without The outer blocking surface 220 of the rear 184 engages the inner blocking surface 224 of the fork-shaped body 186. The fork-shaped body 186 and the carrier 184 are simultaneously translated along the first axis A1. As shown in FIG. 18, the rotating equipment The instrument housing 168 of the 80 includes a slot 226 disposed adjacent to the operation detector 176. (shown diagrammatically in FIG. 18). The carrier 184 includes a boss 228. is generated by the movement of the input manipulation tool 92 between the first input position I1 and the second input position I2. 186 along the first axis A1. The linkage 178 and / or the operator assembly are supported along slots 226. Other configurations for the various components of the 88 are contemplated other than those shown in the drawings. It will be understood.

[0074] Referring again to FIGS. 1-24, the end effector 40 is operatively connected to a rotating device 80. The coupler 230 is maintained by the surgical robot 32. The second axis A2 is selectively positioned relative to the rotating device 80 along different trajectories that are supported. To this end, the drive assembly 82 is configured to be releasably secured to the rotating equipment 80 in multiple orientations. This function allows the second axis A2 to be aligned with the rotating device 80 and therefore with the end Regardless of how it is oriented relative to the fixture 78 of the effector 40, the grip Since the loops 90 can be positioned generally similarly, more space can be allocated along each individual track T. A consistent technique is provided to the surgeon (compare Figures 2A-2C).

[0075] The above-described function is shown throughout Figures 11A to 11F in relation to the orientation of the second axis A2 and the mounting fixture. This is further illustrated by comparing the orientation of the fixture 78 with that of the fixture 78, which is generally In this illustrative example, the reference portion 232 is a reference portion of the robot arm. The vertical line is defined by the approximate plane of the fixture 78 that abuts the coupling 38 of the frame 36. However, the reference portion 232 is attached to the endoscope, which remains fixed relative to the fixture 78. The distance may be defined by other components of the effector 40 or in other ways (e.g., It will be appreciated that the orientation may also be defined (perpendicular to the environment, such as by gravity).

[0076] 11A-11C, the drive assembly 82 is positioned in a reference orientation OR and is aligned with a second axis A 2 and the reference portion 232 of the fixture 78. Therefore, the second axis A2 is defined between the reference portion 232 of the fixture 78 and the reference portion 232 of the fixture 78. When in the quasi-orientation OR, it is parallel to the reference portion 232. However, in FIG. The bridge 82 is arranged in a different first orientation O1, and the first orientation O1 is a first rotation direction. Rotation of the drive assembly 82 relative to the rotating equipment 80 about a first axis A1 in a direction R1 Further, in FIGS. 11E and 11F, the drive assembly 82 is defined by a second The second orientation O2 is arranged in a second rotation direction R2 opposite to the first orientation O2. 1. The rotation of the drive assembly 82 relative to the rotating equipment 80 is defined by the rotation of the drive assembly 82 relative to the rotating equipment 80 about the axis A1.

[0077] From the perspective views shown in FIGS. 11A to 11F, the first rotation direction R1 is counterclockwise, and the second rotation direction R2 is counterclockwise. The rotation direction R2 of the arrow is clockwise. Therefore, when the arrow is in the first orientation O1 shown in FIG. The drive assembly 82 rotates +45 degrees counterclockwise about the first axis A1 relative to the reference portion 232. When the drive assembly is in the second orientation O2 shown in FIGS. 11E and 11F, The assembly 82 rotates -45 degrees clockwise about the first axis A1 relative to the reference portion 232. Therefore, there is a 90 degree difference between the first direction O1 and the second direction O2. However, the first orientation O1 and the second orientation O2 facilitate consistent positioning of the grip 90. It will be appreciated that the results may be defined in a number of different ways. It will be appreciated that the integrator 230 may support the drive assembly 82 in other orientations. cormorant.

[0078] Referring now to FIG. 13, in the exemplary embodiment shown herein, combiner 230 is A first axis A1 is aligned along each of the coupling pockets 236 formed in the carrier ring 238. A plurality of coupling elements 234 (e.g., ball bearings) supported for radial movement relative to the The coupler 230 also includes a locking collar 240. The locking collar 240 , has an inner angled surface 242 that contacts the coupling element 234. The locking collar 240 selectively rotate about a first axis A1 via a force applied to the locking collar 240 from the The carrier ring 238 is arranged so that the lock collar 240 and the carrier ring 238 are 38 (threaded engagement not shown in detail) axial translation relative to the rotating device 80 in response to rotation of the locking collar 240 relative to the rotating device 80 It is configured to:

[0079] When the locking collar 240 rotates about the first axis A1 in the second rotational direction R2, the carrier The bearing 238 moves the actuator 16 along the first axis A1 simultaneously with the coupling element 234. 6. Due to the shape of the inner inclined surface 242 that contacts the coupling element 234, the actuator Translation toward the eta 166 causes the coupling element 234 to move radially inward toward the first axis A1. 78. The drive assembly 82 moves to press against the fixture 78. Conversely, the locking collar 240 rotates in a first direction about the first axis A1. When rotating in the direction R1, the carrier ring 238 rotates simultaneously with the coupling element 234 along the first axis A. 1 and then the coupling element 234 is translated away from the actuator 166. The coupling pockets 236 are radially movable away from the first axis A1. It will be appreciated that other configurations of combiner 230 are contemplated. 0 can be set at any number of different orientations or just at a predefined orientation (e.g., lock or and a drive assembly (e.g., via a detent mechanism) configured to secure the drive assembly (e.g., via a detent mechanism) to the rotating equipment (e.g., It is possible.

[0080] The coupler 230 provides an additional interface between the base 34 of the surgical robot 32 and the tool 42. It will be appreciated that the orientation of the drive assembly 82 relative to the fixture 78 is To communicate, an orientation sensor arrangement, shown generally at 244 in FIG. 4, provides a The rotating equipment 80 and the drive assembly 82 are connected to each other so as to determine the orientation of the drive assembly 82. To this end, the orientation sensor arrangement 244 is operably connected to the drive assembly 82. an orientation emitter 246 attached to the Operable on the rotating device 80 to determine the position of the azimuth transmitter 246 relative to the rotating device 80 and an orientation detector 248 mounted on the sensor. Again, the orientation sensor arrangement 244 , may be of a number of different types, configurations, and / or arrangements. The selected direction is input via the input device 70 (see FIG. 1) of the user interface 66 or the like. The position may also be manually entered into the surgical system 30.

[0081] 21-24, as mentioned above, the drive assembly 82 is 80 or manual interface 94, through gear train 84, to connector 86. It is used to transmit rotation to the attached tool 42. For this purpose, the drive assembly Bridge 82 includes a generally L-shaped driver 250, which will be described in more detail below. The power input shaft 252 is supported along a first axis A1 (see FIG. 23A) so as to The manual input shaft 254, the holding shaft 255, and the intermediate shaft 256 are connected to the second shaft. A2. The power input shaft 252 includes a power coupler 258. The coupler 258 couples a corresponding actuator 166 to the actuator 166 for simultaneous rotation. shaped to engage with actuator coupler 260 (see FIG. 13) (e.g., interference type (as a "dog clutch" in the case of a power input shaft 252, a manual input shaft 254, a protection The support shaft 255 and intermediate shaft 256 each generally comprise one or more bearings. bearing 262 (e.g., a sealed ball bearing), washer 264, keeper 266, and and / or spring shims 268 are supported for rotation relative to the driver 250. (The arrangement is shown schematically in Figures 23A-23B and 24, but will not be described in detail. The drive assembly 82 includes a power input shaft 252, a manual input shaft 254, and and a seal 270 disposed adjacent the exposed end of each of the retaining shafts 255. can.

[0082] A gear tray is used to convert rotation about the first axis A1 into rotation about the second axis A2. The motor 84 includes at least one bevel gear set, generally designated 272. The slot 272 is interposed between the rotating device 80 and the connector 86 for rotational communication. The gear set 272 includes an input gear 274 and an output gear 276. is connected to the power input shaft 252 via a key and keyway arrangement generally indicated at 278. The input gear 274 rotates in unison with the output gear 276 (as will be described in more detail below). 23A). The output gear 276 is arranged to mesh with a shaft generally designated 280. Through a spline arrangement, it rotates simultaneously with the intermediate shaft 256. 56 includes an external spline 282, which will be described in more detail below. 276. The gear 276 engages corresponding internal splines 284 of the output gear 276 so as to

[0083] In the illustrated embodiment, the gear train 84 of the drive assembly 82 is generally designated 286 At least one reduction gear set is provided, and the reduction gear set 286 is connected to the rotating equipment 80. The actuator 86 is interposed in rotational communication with the rotating machine 80, and therefore The rotation of the connector 166 is different from the rotation of the tool 42 attached to the connector 86 (e.g. , faster or slower). More specifically, reduction gear set 286 The bevel gear set 272 and the connector 86 are interposed in rotational communication therebetween, and the intermediate Shaft 256 (which can be rotated via rotating equipment 80 or manual interface 94) The tool 42 is rotated about the second axis A2 by the retaining shaft 255. In a first embodiment of the end effector 40, , rotation of the actuator 166 about the first axis A1 rotates the tool 4 about the second axis A2. While the rotation of the rotor occurs at a speed faster than the rotation of the rotor, other configurations are contemplated and are referred to herein as "deceleration." The term "gear set" refers to a gear set that reduces rotational speed (increases torque) unless otherwise specified. This can refer to a reduction in torque (due to an increase in rotational speed) or a reduction in torque (due to an increase in rotational speed).

[0084] 23A-24, in the illustrated embodiment, the reduction gear set 286 includes: A compound planetary reduction gear set with a fixed ring gear 288 formed within the driver 250 23A-23B, the ring gear 288 is connected to the first set of planetary gears 29. 0A, second set of planetary gears 290B, and third set of planetary gears 290C. The first set of planetary gears 290A, the second set of planetary gears 290B, and the third set of planetary gears 290C are arranged as follows: The three sets of planetary gears 290C each include a first sun gear 292A, a second sun gear 292B, and a B, and third sun gear 292C. 94A, a second set of pins 294B, and a third set of pins 294C are connected to the first set of bushings. a first set of bushings 296A, a second set of bushings 296B, and a third set of bushings 296C; Cooperatively rotate the planet gears of each set of planet gears 290A, 290B, 290C. These pairs of pins 294A, 294B, and 294C are respectively The first carrier 298A, the second carrier 298B, and the third carrier 298C are The first carrier 298A is defined by a retaining shaft 255, or otherwise operably attached to the retaining shaft 255, a first set of planetary gears 290A The first set of planet gears 290A also meshes with the first sun gear 292A. The first sun gear 292A is arranged to rotate in unison with the second sun gear 292B. A second carrier 298B is coupled to the rear carrier 298B, which carries a second set of planetary gears 290B. The second set of planet gears 290B also meshingly engages a second sun gear 292B. The second sun gear 292B is arranged to rotate simultaneously with the third carrier. 298C, which holds a third set of planetary gears 290C. The third set of planet gears 290C is also arranged to meshingly engage a third sun gear 292C. The third sun gear 292C is arranged to rotate simultaneously with the intermediate shaft 256. The planetary gears 290A, 290B, and 290C are connected to each other to reduce friction between adjacent sets of planetary gears 290A, 290B, and 290C. To aid in this, one or more of the carriers 298A, 298B, 298C may be A washer 264 may be provided adjacent to the reduction gear set 286. or multiple types, such as those with four or more planetary reductions or those with no planetary reductions. Those skilled in the art will appreciate that the present invention may be arranged or configured in a number of different ways. Configurations of are also contemplated.

[0085] With continued reference to FIGS. 23A-24, the bit interface 128 of the tool 42 To facilitate releasable attachment to the drive assembly 82, the connector 86 of the drive assembly 82 is Generally, a connector body 300, a flange member 302, a connector biasing element 304, and a pair of shafts The connector body 300 includes a directional connector element 306 and a rotational connector element 308. , operably attached to the driver 250 (e.g., via a threaded engagement), and a second It houses a bearing 262 which rotatably supports the retaining shaft 255 about axis A2. The retaining shaft 255 includes a connector element pocket 310. each inhibit relative axial movement between the tool 42 and the retaining shaft 255. axial retainer 130 of bit interface 128 of tool 42 to engage 306. As shown in FIG.

[0086] To release the tool 42, the flange member 302 translates along the second axis A2. and is positioned so that it moves along the connector body 300 in response to force applied by the surgeon. The flange member 302 can slide against the axial connector element 306. The connector biasing element 304 has an axially inclined surface 312 that biases the flange member 302 in the axial direction. The connector body 300 and the flange member 3 are moved in the direction away from the connector body 300. The flange member 302 is a seal member connected to the retaining shaft 255. Disengagement from the connector body is prevented via the stepped surface 314 of the axial connector 270. Due to the engagement between the rotor element 306 and the axially inclined surface 312 of the flange member 302, the connector The bias provided by the biasing element 304 causes the axial connector element 306 to rotate along the second axis A2. axial retainer 11 of bit interface 128 of tool 42 moves radially inward toward 30, providing axial retention of tool 42 relative to drive assembly 82. In the illustrated embodiment, the rotating connector element 308 of the connector 86 is attached to the distal end of the retaining shaft 255. a rotary retainer 132 formed at the distal end of the bit interface 128 of the tool 42; 42 and the retaining shaft 255. Other configurations of connector 86 are also contemplated.

[0087] With continued reference to FIGS. 23A-24, drive assembly 82 is generally designated 316. The clutch mechanism 316 is connected to the manual interface 94 and the gear train. 84. The clutch mechanism 316 operates in a first mode 316A (see FIG. 23A). and second mode 316B (see FIG. 23B). In A, the rotational torque generated by the actuator 166 of the rotating equipment 80 is The tool is rotated by the rotation of the manual interface 94. 42 about the second axis A2. In the second mode 316B, the manual interface The force applied to the tool 94 is transmitted as torque by the gear train 84 and drives the tool 42 As will be explained in more detail below, the clutch mechanism 3 16 responds to a force applied to the manual interface 94 to transition from the first mode 316A to the to the second mode 316B, and the clutch mechanism is switched from the second mode 316B to the first mode 3 16A.

[0088] As best shown in Figures 23A-23B, the clutch biasing element 318 is 256 adjacent to the outer spline 282. The clutch biasing element 318 also biases the bevel gear set 272 of the gear train 84. The output gear 276 is positioned to engage with the internal spline 284. 256. The intermediate shaft 256 is fitted with an outer spline 282. Since the clutch biasing element 318 is not axially fixed to the second axis A, the output gear 276 is 2 to meshingly engage the input gear 274, placing the clutch mechanism 316 in the first mode. 316A (see FIG. 23A).

[0089] To facilitate alignment with the second axis A2, the proximal end of the intermediate shaft 256 is A pilot shaft region 322 is provided adjacent the side spline 282, and the pilot The shaft region 322 is formed within the manual input shaft 254 of the manual interface 94. 23A-23B. The manual input shaft 254 also has an idle hole 326 at its distal end. Between the idle hole 326 and the pilot hole 324, a link spline arrangement 328 is provided. The outer surface of the manual input shaft 254 is rotatably supported by bearings 262. The bearing 262 is housed in a seat 330 attached to the driver 250. The manual input shaft 254 extends through the top cover 332. is also attached to the driver 250 and therefore, as will be explained in more detail below. Engage the proximal end of the manual input shaft 254 with the handle assembly 96, as shown. can be done.

[0090] When the clutch mechanism 316 is in the first mode 316A (see FIG. 23A), the manual input shaft The idle hole 326 of the shaft 254 contacts the outer spline 282 of the intermediate shaft 256. Furthermore, the idle hole 326 and the link spline arrangement Depending on how the positioning device 328 is positioned, the clutch mechanism 316 may be in the first mode 31. 6A, the rotation of the intermediate shaft 256 is not transmitted to the manual input shaft 254, and the The gears 274, 276 of the bell gear set 272 remain meshed, and therefore the power input The rotation of the power shaft 252 is transmitted to the intermediate shaft 256. When an axial force is applied to the interface 94, the manual input shaft 254 rotates against the output gear 276 At the same time, it translates along a second axis A2 toward connector 86. As shown in FIG. This causes the output gear 276 to be released from meshing engagement with the input gear 274, thereby rotating the shaft Stopping rotation between A1 and A2 and disengaging link spline arrangement 328 of manual input shaft 254 256. The manual input shaft 256 is then further engaged with the external splines 282 of the intermediate shaft 256. This facilitates simultaneous rotation of shaft 254 and intermediate shaft 256.

[0091] Thus, an axial force applied to the manual interface 94 causes the clutch mechanism 316 changes from a first mode 316A (see FIG. 23A) to a second mode 316B (see FIG. 23B). This configuration reduces the rotational torque between the rotating equipment 80 and the manual interface 94. In other words, the clutch mechanism 316 is in the first mode 316A. At one point, the manual interface 94 does not rotate even when the rotating device 80 is driven. When a force is applied to rotate the face 94, the rotating device 80 is not driven backward. In addition to those shown and described herein in connection with the first embodiment of the end effector 40, However, other configurations of the clutch mechanism 316 are also contemplated.

[0092] As shown in FIGS. 23A-23B, the drive assembly 82 and manual interface 9 The four above-described embodiments cooperate to define a guide hole, generally designated 334. 334 is a diagram of a manual interface 94 along a second axis A2 to the drive assembly 82. The cannula extends through the various components to a connector 86. 0 and rotary drive tool 48, as well as a guide wire GW (e.g., a "K-wire"), The guide hole 334 can extend through the guide hole 334 (not shown in detail, but generally known).

[0093] 11B-11C, as described above, the handle assembly 96 includes: Attached to the manual interface 94, the handle assembly is assembled by the surgeon, among other things. manually rotating the tool 42 about the second axis A2 in response to a force applied to the reel 96; It is used to translate the manual input shaft 254 along the second axis A2. The manual interface 94 is a head that is arranged to rotate about a second axis A2. 336, and the handle assembly 96 generally includes a power transmission 338 and a handle The head 336 is disposed at the proximal end of the manual input shaft 254 and includes a body 340. The force transmitting device 338 responds to a force applied to the handle body 340 by the surgeon. 3 and 4, and is shaped to receive the head 336 for simultaneous rotation about axis A2. As shown generally in FIGS. 11B-11C, the handle assembly 96 includes a ratchet mechanism 3 The ratchet mechanism 342 is connected between the handle body 340 and the power transmission tool 3 38, and the handle body 340 and the power transmission tool 338 are arranged around the second axis A2. and the handle 334 in a third rotation direction R3. The rotational direction R is opposite to the third rotational direction R3 about the second axis A2 relative to the body 340. 4. The ratchet mechanism 342 can be of several different types and configurations. (e.g., a ratchet and pawl arrangement, one or more resiliently flexible members, etc.) It will be appreciated that in the illustrated embodiment, the handle assembly The bridge 96 is releasably attachable to the manual interface 94, but is not part of the handle assembly. The assembly 96 can also be permanently secured to the manual interface 94 (e.g., by folding). It is contemplated that the handle body 340 may be attached to the casing 310 (eg, by a detachable or otherwise attachable handle body 340).

[0094] The present disclosure also provides a method for determining whether a surgical site ST is located along a trajectory T maintained by a surgical robot 32. The present invention is directed to a method of forming a pilot hole 46. The method includes: 82, manual interface 94, and end-effector supporting manipulator assembly 88. The method includes different steps, including attaching the effector 40 to the surgical robot 32. Also, the rotary cutting tool 44 is mounted to the drive assembly 82 along a second axis A2. and aligning the second axis A2 with the trajectory T to position the rotary cutting tool 44 at the surgical site. and engaging the manipulator assembly 88 to rotate the first axis A1 by the rotating device 80. and a drive assembly 82 drives the rotating equipment 80 along a first axis A The torque about axis A1 is converted to rotate the rotary cutting tool 44 about the second axis A2. The method includes rotating a rotary cutting tool 44 along a trajectory T at a surgical site ST to a first depth. and ceasing rotation about the first axis A1. The method also presents or otherwise prompts access to a manual interface 94. and positioning the manipulator assembly 88 to advance the manual interface 94. applying a force to rotate the rotary cutting tool 44 about a second axis A2; and The rotary cutting tool 44 is moved along the trajectory T at ST to a second depth D2 greater than the first depth D1. This includes advancing the

[0095] The present disclosure also provides a method for determining whether a surgical site ST is located along a trajectory T maintained by a surgical robot 32. The present invention is directed to a method of installing a fixture 50. The method includes: a rotating machine 80; a drive assembly 8 2, manual interface 94, and end effector supporting manipulator assembly 88. The method also includes different steps, including attaching the actuator 40 to the surgical robot 32. , mounting the tool 42 to the drive assembly 82 along the second axis A2; and 0 to the tool 42 and align the second axis A2 with the track to mount the fixture 50 and positioning the manipulator assembly 8 adjacent to the surgical site ST. 8 to generate a rotational torque about the first axis A1 by the rotating device 80, and the driving axis The assembly 82 converts torque from the rotating equipment 80 about the first axis A1 to The method further includes rotating the rod 42 and the fixture 50 about a second axis A2. also moves the tool 42 and fixture 50 along the trajectory at the surgical site ST to a first depth D1. Advancing and stopping rotation about the first axis A1 and manual interface 94. Positioning the operating tool assembly 88 to present or otherwise facilitate access to the The method includes applying a force to the manual interface 94 to cause the tool 42 and fixture 50 about a second axis A2 and in orbit at the surgical site ST. and advancing the fixture 50 along the groove 54 to a second depth D2 greater than the first depth D1. This includes:

[0096] The present disclosure also provides a first trajectory T1 and a second trajectory T2 maintained by the surgical robot 32. and a method for placing the first and second fixation devices 50 at the surgical site ST along the second trajectory T2. The method includes a rotating device 80, a drive assembly 82, a manual interface 9 4, and the end effector 40 supporting the manipulator assembly 88, to the surgical robot 32. The method also includes a different step of attaching a drive shaft along a second axis A2 to the drive shaft. Attaching the tool 42 to the assembly 82 and attaching the first fixture 50 to the tool 42 and aligning the second axis A2 with the first trajectory to place the first fixture 50 in the surgical field. and positioning the rotating device 80 adjacent to the position ST and engaging the manipulator assembly 88. and a drive assembly 82 drives the rotating machine. The torque about the first axis A1 from the tool 80 is converted to a torque between the tool 42 and the first fixture 5. and rotating the first surgical instrument at the surgical site ST about a second axis A2. advancing the tool 42 and the first fixture 50 along the trajectory to a first depth D1; , stopping rotation about the first axis A1 and accessing the manual interface 94 and positioning the manipulator assembly 88 to present or otherwise facilitate The method also includes applying a force to the manual interface 94 to move the tool 42 and and rotating the first fixture 50 about the second axis A2, and placing the first fixture 50 at the surgical site ST. The tool 42 and the first fixture 50 are moved along the trajectory to a second depth D1 that is greater than the first depth D1. D2 and releasing the first fixture 50 from the tool 42. The method includes attaching a second fixture 50 to the tool 42 and aligning a second axis A2 with a second positioning a second fixture 50 adjacent the surgical site ST in alignment with the trajectory; , engages with the manipulator assembly 88 and is rotated about the first axis A1 by the rotating device 80. The method also includes generating torque by the drive assembly 82. Torque about the first axis A1 from the equipment 80 is converted to torque between the tool 42 and the second fixture. 50 about a second axis A2 and moving the tool along a second trajectory at the surgical site ST. and advancing the first fastener 42 and the second fastener 50 to a third depth D3 and Stopping rotation around and providing access to the manual interface 94 or other and positioning the manipulator assembly 88 to facilitate the method. , a force is applied to the manual interface 94 to move the tool 42 and the second fixture 50 to the second and rotating the tool 42 and the surgical instrument 10 along a second trajectory at the surgical site ST. and advancing the second fastener 50 to a fourth depth D4 greater than the third depth D3. Further includes:

[0097] As mentioned above, a second embodiment of the end effector of surgical system 30 is shown in FIG. 28A to 28C. In the following description, the first embodiment of the end effector 40 The structures and components of the second embodiment are the same as or correspond in other ways to the structures and components of the second embodiment. Components have the same reference number incremented by 2000. End Effector 2040 Many of the components and features of the second embodiment of the end effector 40 described above are the same as those of the first embodiment of the end effector 40 described above. , which are substantially similar to those of the embodiments of , the second embodiment of the end effector 2040 and the first embodiment of the end effector 40 Only specific differences between the embodiments will be described below, and common features between the embodiments will be described. Only some of the elements and features are discussed herein and shown in the drawings. Without limitation, unless otherwise indicated below, the first The description of the embodiment is incorporated by reference for the second embodiment of the end effector 2040. You can put it in.

[0098] 25A-28, a fixture 2078, a rotating device 2080, and its accessories are shown. actuator 2166 (shown diagrammatically), and an engine with a drive assembly 2082. A second embodiment of the do-effector 2040 is shown schematically. In comparison to the first embodiment, the second embodiment of the end effector 2040 generally has a different configuration. The rotating equipment 2080, the drive assembly 2082, and the manipulator assembly 2088 are used. Each of these is described in more detail below.

[0099] As best shown in FIGS. 25A to 26, in the second embodiment, a rotating device 2080 and The drive assembly 2082 is configured such that the second axis A2 is fixed relative to the first axis A1. In other words, in this embodiment, the driver 2250 of the drive assembly 2082 is not arranged to move relative to the rotating device 2080. Here, the coupler 2230 is , releasably securing a drive subassembly, generally designated 2344, along a second axis A2. As best seen in FIG. As shown, drive subassembly 2344 includes reduction gear set 2286. 286 also has a planetary configuration, with a connector 2086 and a third sun gear 2292 C. When the actuator 2344 is operably attached to the coupler 2230, the drive subassembly couples The drive assembly 2082 includes an intermediate output coupling 2346 coupled to an intermediate shaft 2256 of the drive assembly 2082. In this embodiment, the intermediate shaft 2256 also engages the manual input shaft 2348. The second embodiment of the end effector 2040 is shown in the drawings. Although not shown, the connector 2086 of the drive subassembly 2344 is connected to the end effector 40 The connector 86 can be used to connect different types of tools in the same manner as the connector 86 described above in relation to the first embodiment. It will be appreciated that releasable fastening is also possible.

[0100] In this second embodiment, the intermediate shaft 2256 of the drive assembly 2082 is Bevel gear of gear train 2084 defining head 2336 of interface 2094 The head of the manual interface 2094 is coupled to the output gear 2276 of the gear set 2272. The blade 2336 similarly receives the force applied by the user and drives the tool (see FIGS. 25A-28). (not shown) into a rotational torque used to rotate the motor about a second axis A2. As will be described in more detail below, the second end effector 2040 In this embodiment, the operating tool assembly 2088 is positioned at either operating tool assembly position P1 or P2. is not configured to restrict access to the manual interface 2094. In this embodiment, the end effector 2040 further includes a protective cover generally designated 2350. The protective cover 2350 is operably attached to the drive assembly 2082. A second protection position U1 (see FIG. 25A) is provided between the first protection position U1 and the second protection position U2 (see FIG. 25B). The axis A2 is arranged to move.

[0101] In the first protective position U1, the second axis A2 intersects with at least a portion of the protective cover 2350. 2094 (see FIG. 25A). In the protective position U2, the protective cover 2350 is spaced from the second axis A2 and is facilitating access to face 2094 (see FIG. 25B). As best shown in FIG. 25B and FIG. 28, the protective cover 2350 is secured to the protective pocket 235. The protective body 2352 defines a first protective position U1, and the protective pocket 2354 is A device that houses at least a portion of the manual interface 2094 or otherwise provides a manual interface The protection is shaped to restrict access to at least a portion of the interface 2094. The body 2352 is provided with a protection hinge 2356, which is in a first protection position U1 ( 25A) and a second protection position U2 (see FIG. 25B) about a protection axis UA. In the illustrated embodiment, , the protection axis UA is arranged substantially perpendicular to both the first axis A1 and the second axis A2. .

[0102] By utilizing the protective cover 2350, the end effector 2040 can be attached to the manipulator assembly. access to the manual interface 2094 without necessarily relying on the movement of the It will be appreciated that this allows the process to be limited or otherwise inhibited. In the second embodiment, the operating tool assembly 2088 nevertheless has the same functions as the first operating tool. A first operating tool assembly position P1 (see FIG. 25A) and a second operating tool assembly position P2 (see FIG. 25B) The operating tool assembly 2 is arranged to move with the retainer 2136 between the Any part of the 088 may be used with the manual interface at either the operator assembly position P1 or P2. You will not restrict or otherwise inhibit access to Source 2094.

[0103] The grip 2090 of the operating tool assembly 2088 has a generally cylindrical shape. When in tool assembly position P1 (see FIG. 25A), the hand is generally neutrally engaged. When in the second manipulator assembly position P2 (see FIG. 25B), the hand is generally pronated or is configured to supinate and engage. Again, in this embodiment, the manipulator assembly 2 088 is arranged to move simultaneously with the retainer 2136, and thus the manipulator assembly 2088 is located at the first manipulator assembly position P1 (see FIG. 25A) or Regardless of whether the second manipulator assembly is positioned at position P2 (see FIG. 25B), 27A, the input operation tool 2092 is moved to a first input position I1 (see FIG. 27A) and a second input position I2 (see FIG. 27B).

[0104] Referring now to Figures 26-27B, in this embodiment, the manipulator assembly 2088 Similarly, movement of input implement 2092 causes corresponding movement of piston 2182. 27A to 28B, the piston 2182 is inserted into the retainer 2136. Engages with the fork guide 2188 to move the fork guide 2188 (see Figure 26). As shown in FIGS. 27A-27B, in this embodiment, the link mechanism 2178 is a slide member 2358 The sliding member 2358 is provided with an input operation between a first input position I1 and a second input position I2. The slide member 2092 is supported in the grip 2090 so as to move simultaneously with the slide member 2092. 358 defines two sliding ramps 2360, which are in contact with the piston 2182 and and respective bearings 226 supported on extension members 2194 of input operation implement 2092. 2 and transmits the motion from the input operating tool 2092 to the piston 2182 (FIG. 27A (Compare Figure 27B). Although not shown, the linkage 2178 may include additional components ( For example, biasing elements, bushings, fasteners, seals, etc. It will be appreciated that other configurations are contemplated.

[0105] As mentioned above, a third embodiment of the end effector of surgical system 30 is shown in FIG. 31A to 31B. In the following description, the first embodiment of the end effector 40 The structures and components of the third embodiment are the same as or correspond in other ways to the structures and components of the Components have the same reference number incremented by 3000. End effector 304 Many of the components and features of the third embodiment of the end effector 40 described above are the same as those of the first embodiment of the end effector 40 described above. 1 is substantially similar to that of the first embodiment, for purposes of clarity, consistency, and brevity. The third embodiment of the end effector 3040 and the first embodiment of the end effector 40 Only specific differences between the embodiments are described below, and common features between these embodiments are not included. Only some of the components and features are discussed herein and shown in the drawings. Unless otherwise indicated below, the first end effector 40 The description of this embodiment is incorporated by reference for the third embodiment of the end effector 3040. It can be incorporated.

[0106] 29A-31B, a fixture 3078, a rotating device 3080, and Actuator 3166 (shown diagrammatically), and actuator 3166 including drive assembly 3082. A third embodiment of the end effector 3040 is shown schematically. In comparison to the first embodiment, the third embodiment of the end effector 3040 generally has a different configuration. The actuator assembly 3088 and drive assembly 3082 are used to The tool 3042 is configured to be secured by a bit interface 3128 of the tool. , each of which is described in more detail below.

[0107] As best shown in FIGS. 29A-30, in the third embodiment, drive assembly 308 2 is similarly releasably attached to the rotating device 3080 via a coupler 3230. , so that the drive assembly 3082 can be rotated in different ways about the first axis A1. The positioning allows movement of the second axis A2 relative to the first axis A1. In the third embodiment, the manipulator assembly 3088 is similar to the manipulator assembly 2088 described above. The grip 3090 and the input operation tool 3092 are structurally similar to those of the second embodiment. However, in the third embodiment, the frame 3134 of the manipulator assembly 3088 is Generally, a plurality of manipulator assembly positions (first manipulator assembly position P1 as shown in FIGS. 29A-29C) are 29B)) and a first frame body 3136 connected to a retainer 3136 for simultaneous movement between the first frame body 3136 and the retainer 3136. 362, a first grip position G1 (see FIG. 29A) and a second grip position G2 (see FIG. 29B) relative to the first frame body 3362. A second frame body 3364 supports the grip 3090 and the input operation tool 3092. It is equipped with:

[0108] When the gripping portion 3362 is in the first grip position G1 shown in FIG. 29A, the second frame body 3364 At least a portion of the manual interface 3094 is restricted from accessing the input manipulator 3096. 092, when engaged by a user, rotates the rotating device 3, as described in more detail below. 080 is driven to move the tool 3042 fixed to the connector 3086 along the second axis A2. However, in the second grip position G2 shown in FIG. At some point, the second frame body 3364 receives a force applied by the user and moves to the tool. A manual interface is provided to facilitate rotation of the 3042 about the second axis A2. Although not shown in connection with the third embodiment, The second frame body 3364 also has a plurality of grip positions (e.g., a first grip position G a plurality of manipulator assemblies without depending on the movement between the first and second grip positions G1 and G2; 29A-29B) between the first frame and the second frame. The arm body 3362 is arranged to move simultaneously with the arm body 3362.

[0109] In the third embodiment of the end effector 3040, the second frame body 3364 is The gripping mechanism is arranged to translate between a first gripping position G1 and a second gripping position G2, The movement is substantially parallel to the first axis A1. To this end, the second frame body 3364 The first frame body 3362 is adapted to slide along a track 3368 defined in the first frame body 3362. This configuration is an example, and the first frame body 33 62 and the second frame body 3364 are configured such that the second frame body 3364 is a first interface 3094 to selectively inhibit and / or facilitate access to the first interface 3094; The frame body 3362 may be configured in a number of different ways sufficient to allow it to move relative to the frame body 3362. It will be understood that a first grip position G1 and a second grip position G2 can also be formed. The movement to and from the second grip position G2 can be any other type of translational movement (e.g., a curved path) (sliding along the axis A1 or sliding in a direction not parallel to the axis A1), rotational movement, or other types of movement. The movement of the loop can be defined by the movement of the loop. Other configurations are also contemplated.

[0110] 30-31B, as described above, the first The third embodiment provides different types of bit interfaces 31 through connector 3086. 28 to fix the tool 3042. a rotary cutting tool 3044 (e.g., a drill bit) supporting a cutting tool 3044 (e.g., a polyaxial screw) and a rotary drive tool 3048 (e.g., a multi-axis screwdriver). One representative tool 3042 is shown. Bit interface of rotary drive tool 3048 3128 is a bit interface used with the first embodiment of the end effector 40. It is constructed in the same manner as face 128, but with the bit-in of the rotary cutting tool 3044 shown. The interface 3128 is rotated away from the axial retainer 3130 and the rotational retainer 3132. As will be described in more detail below, in the third embodiment, The extension 3370 of the bit interface 3128 of the rotary cutting tool 3044 In cooperation with a transmission, generally designated 3372, of the drive assembly 3082, This makes it easy to operate the 082 gear train 3084 at different drive ratios.

[0111] As best shown in FIGS. 31A-31B, a third embodiment of the end effector 3040 In this drive assembly 3082, the power input shaft 3252 is connected to the driver 3250 ( a bearing located within input body 3374 operably attached thereto (e.g., via a fastener) The input gear 3262 of the bevel gear set 3272 is supported by the ring 3262. 274 is coupled to a power input shaft 3252 and adapted to rotate about a first axis A1. However, in this embodiment, the output gear 3276 of the bevel gear set 3272 is coupled to an idler shaft 3376. Here, the idler shaft 3376 is The bearing 3262 is supported by the main cover 3332 and the intermediate body 3378. The intermediate body 3378 is disposed between the upper cover 3332 and the driver 3250. The drive shaft 3376 is disposed substantially parallel to and spaced apart from the second axis A2. In this embodiment, the manual input shaft 3254 rotates around an idler axis IA. The intermediate shaft 3256 of the drive assembly 3082, which also serves as the upper cover 33, is similarly 32 and the intermediate body 3378 is supported by a bearing 3262 located in the second shaft A2 and is coupled to a third sun gear 3292C of the reduction gear set 3286. 3380 on the intermediate shaft 2256 and the idler shaft 3376, respectively. The pulley 3380 is supported by the intermediate shaft 3256 and the idler The shafts 3376 are connected to each other via an endless belt 3382 so that they rotate simultaneously. In the illustrated embodiment, the pulleys 3380 have the same configuration as each other, but some In this embodiment, a rotational speed or Different size pulleys may be used to provide increased torque or It will be appreciated that, although not shown herein, in some embodiments The drive assembly 3082 uses a tensioner to reduce the slack in the endless belt 3382. It will be appreciated that the ends shown may also be removed. Instead of the belt 3382 and pulley 3380 arrangement, a chain and sprocket It is contemplated that an arrangement of 10 15 20 25 30 35 40 45 50 55 60 65 6 70 75 80 85 10 15 20 25 30 35 40 45 50 55 60 65 10 other configurations are also contemplated.

[0112] The drive assembly 3082 of the third embodiment of the end effector 3040 also includes a decelerator. A planetary configuration is used for gear set 3286, but causes movement of transmission 3372 To this end, the various components are arranged differently. Rather than being arranged to engage, the first set of planetary gears 3290A, the second set of planetary gears The star gear 3290B, and the third set of planetary gears 3290C are each connected to a transmission 3372 3386 of the translating collar 3386. As will be described later, the internal teeth 3384 of the conversion collar 3386 also The conversion collar 3386 is arranged to selectively engage the shaft teeth 3388 in a splined engagement. 386 is an outer gear arranged to selectively engage with a ring gear 3288 by spline engagement. Further, in this embodiment, the ring gear 3288 is provided with a driver 3250 as a separate component supported between a pair of bushings 3196 .

[0113] With continued reference to FIGS. 31A-31B, the transmission 337 of the drive assembly 3082 2 generally between the rotating device 3080 (see FIGS. 29A to 30) and the connector 3086. The first gear set GS1, the second gear set GS2, and the third gear set GS3 are configured to be interposed in rotational communication with each other. GS2, and a conversion color 3386, where the conversion color 3386 is a first Between the collar position CP1 (see FIG. 31A) and the second collar position CP2 (see FIG. 31B) It is arranged to move along a second axis A2.

[0114] At the first collar position CP1, the conversion collar 3386 engages the first gear set GS1. and converts rotation between the rotating device 3080 and the connector 3086 at a first drive ratio DR1. In this embodiment, the first gear set GS1 includes a ring gear 3288 and a conversion collar 33 86 external teeth 3390 and is defined by a spline engagement, thus the conversion collar 3386 is effectively "fixed" to the driver 3250 (see FIG. 31A). At collar position CP1, torque generated via rotating equipment 3080 or manual interface The force applied to the head 3336 of the face 3094 of the intermediate shaft 3 256 rotations, planetary reduction gear set 3286, connector 3086 retaining shaft Transmitted to 3255.

[0115] In the second collar position CP2, the conversion collar 3386 engages the second gear set GS2. The rotating device 3080 and the connector 3081 are driven at a second drive ratio DR2 different from the first drive ratio DR1. 086. In this embodiment, the second gear set GS2 converts rotation between the conversion A spring is formed between the inner teeth 3384 of the roller 3386 and the shaft teeth 3388 of the intermediate shaft 3256. The line engagement defines the translation collar 3386 within the driver 3250. It rotates about the second axis A2 simultaneously with the intermediate shaft 3256 (see FIG. 31B). Therefore, at the second collar position CP2, the torque or hand generated through the rotating device 3080 The intermediate shaft 3094 is caused by a force applied to the head 3336 of the moving interface 3094. The rotation of the shaft 3256 effectively bypasses the planetary reduction gear set 3286 and 86 directly to the retaining shaft 3255 of the connector 3086. , at the second collar position CP2, the intermediate shaft 3256 is connected to the connector 3086 (and therefore , rotates at the same speed as the fixed tool 3042).

[0116] In the illustrated embodiment, the transmission 3372 includes a transmission linkage generally designated 3392. The transmission link mechanism 3392 is connected between the first collar position CP1 and the second collar position CP2. The actuators 3382 and 3384 are operably attached to a translation collar 3386 for simultaneous movement between the actuators 3382 and 3384. In an embodiment, the transmission linkage 3392 is driven by the retaining shaft 3255 of the connector 3086. A diverter 339 supported for movement by a movably attached brace 3396 In this embodiment, the diverter 3394 slides along the brace 3396. The braces 3396 are shaped and arranged so that the first and second braces 3396 are respectively Support pins of one set of pins 3294A.

[0117] As best shown in FIG. 31B, the diverter 3394 also includes a rotary cutting tool 3044. When secured to the connector 3086 of the rotating assembly 3082, the rotating cutting tool 3044 Engage the extension 3370 of the bit interface 3128 to move the conversion collar 3386 Conversely, as shown in FIG. 31A, the switching The device 3394 is connected to the bit interface 312 of the rotary cutting tool 3044 shown in FIG. 8 extension 3370 of the rotary drive tool 3048. 128 does not engage the diverter 3394, so that the rotary drive tool 3048 does not engage the drive axis. When secured to connector 3086 of assembly 3082, transition collar 3386 is In the illustrated embodiment, the transmission 3372 is also arranged to move the Also, the conversion collar 3386 is moved toward the first collar position CP1 (see FIG. 31A). A linkage biasing element 3398 (e.g., a compression spring, one or more spring washers) is disposed It is equipped with a safety lock (such as a safety lock).

[0118] The function provided by the transmission 3372 allows the drive assembly 3082 to 3370, the tool 3042 is driven at a first drive ratio DR1 or a second drive ratio DR2. It will be appreciated that the tool 3042 can be driven by In particular, it is designed with or without extension 3370 based on the intended rotational speed range in use. Furthermore, this configuration advantageously allows the transmission 3372 to 42 to the connector 3086. (to "manually" shift or otherwise select the tool) Automatically shifts between gear sets GS1 and GS2 based on the configuration of Rule 3042. It becomes possible to do this.

[0119] The transmission 3372 drives different tools 3042 with different drive ratios DR1, DR2. To make things easier, we have implemented "automatic" shifting between the gear sets GS1 and GS2. As described in more detail below in connection with other embodiments, the drive assembly 3082 includes: Drive with different drive ratios DR1 and DR2 without necessarily using the transmission 3372 It will be appreciated that the above-mentioned transmission method may also be configured to facilitate this. The actuator 3372 adjusts the engagement between the diverter 3394 and the extension 3370 of the tool 3042. The switch 3394 is configured to facilitate movement of the conversion collar 3386 through the In addition to the extension portion 3370 shown in FIGS. 30 and 31B, there are other extension portions 3370 associated with different portions of the tool 3042. It will be appreciated that other configurations are also contemplated.

[0120] As mentioned above, a fourth embodiment of the end effector of surgical system 30 is shown in FIG. 34C. In the following description, the first embodiment of the end effector 40 The structures and components of the fourth embodiment are the same as or correspond in other ways to the structures and components of the fourth embodiment. Components have the same reference number incremented by 4000. End effector 4040 Many of the components and features of the fourth embodiment of the end effector 40 described above are the same as those of the first embodiment of the end effector 40 described above. , which are substantially similar to those of the embodiments of , the fourth embodiment of the end effector 4040 and the first embodiment of the end effector 40 Only specific differences between the embodiments will be described below, and common features between the embodiments will be described. Only some of the elements and features are discussed herein and shown in the drawings.

[0121] Therefore, without limitation, unless otherwise indicated below, The description of the first embodiment of the end effector 40 is now given in conjunction with the description of the fourth embodiment of the end effector 4040. Similarly, the corresponding components of the previous embodiments may be incorporated by reference. Specific components of the fourth embodiment of the end effector 4040 are similar in design and features. Elements and features will be further illustrated by the same reference numerals 1000 and 1100 for all intervening embodiments. If reference is made to a drawing or otherwise as having a number incremented by 1000, (For example, in the case of the fourth embodiment, the same method as described in relation to the third embodiment can be used.) The number of components added would be increased by 1000, and the configuration described in relation to the second embodiment would be The element should increase by 2000.

[0122] 32-34C, the fixture 4078, rotating equipment 4080, and its accessories are shown. actuator 4166 (shown diagrammatically), and an engine with a drive assembly 4082. A fourth embodiment of the do-effector 4040 is shown schematically. In comparison to the configuration, the fourth embodiment of the end effector 4040 generally has a different configuration. The actuator assembly 4088 and the drive assembly 4082 are used to Interacting with the handle assembly 4096 and different types of bit interfaces 41 28 to fix the tool 4042, each of which is as follows: This will be explained in more detail.

[0123] As best shown in FIGS. 32-33, in the fourth embodiment, the drive assembly 4082 is similarly releasably attached to the rotating device 4080 via a coupler 4230. configured to position the drive assembly 4082 in different ways about the first axis A1. By positioning the second axis A2, it is possible to move the second axis A2 relative to the first axis A1. In a third embodiment, the manipulator assembly 4088 includes a contoured grip 4090. , an input operation tool that is structurally similar to the second embodiment of the operation tool assembly 2088 described above. As will be understood from the following description, in the fourth embodiment, The operating tool assembly 4088 shown in FIGS. 32-33 is an example, and the drive assembly 4082 may be configured to restrict and / or facilitate access to the manual interface 4094. a plurality of different types of manipulator assemblies 4088 that can be configured to operate; Both can be used (this action is not shown in the fourth embodiment).

[0124] With continued reference to FIGS. 32-33, in the fourth embodiment, the handle assembly 40 96 has a different configuration than the handle assembly 96 described in connection with the first embodiment. Specifically, the handle assembly 4096 has a more symmetrical shape and is generally easier to operate manually. selectively locks rotatably and axially to head 4336 of interface 4094 In this embodiment, the drive assembly 4082 is configured to , between the rotating device 4080, the connector 4086, and the manual interface 4094. As will be described in more detail below, the differential assembly 4400 Assembly 4400 is in haptic torque mode 4400H (see FIG. 34A, not shown in detail). ), and a user can engage the handle assembly 4096, The torque wheel assembly 4096 is adapted to provide tactile torque feedback to the user. When not in use (e.g., For example, when the end effector 4040 is being repositioned, the handle assembly 4 096 is located in a dock 4402 formed on the driver 4250 of the drive assembly 4082. It can be stored (see Figure 32).

[0125] In haptic torque mode 4400H, the user can manually operate the handle assembly of the 4094 In addition to enabling haptic torque feedback via the assembly 4096, Additionally, the differential assembly 4400 also relates to the first embodiment of the end effector 40. This provides a function similar to the clutch mechanism 316 described above. The library 4400 also has a first abort mode 4400A (see FIG. 34B, not shown in detail) and , and a second suspended mode 4400B (see FIG. 34C, not shown in detail). In the first abort mode 4400A, the rotational torque generated by the rotating equipment 4080 is transmitted to connector 4086 by differential assembly 4400, connecting tool 4042 to the first 2 around the axis A2, but the rotation torque is applied to the head of the manual interface 4094 In the second abort mode 4400B, the manual interface 409 The rotational torque generated when a force is applied to the head 4336 of the differential assembly 4 400 to the connector 4086 to rotate the tool 4042, The torque is not transmitted to the rotating equipment 4080.

[0126] The operation of the differential assembly 4400 in the first abort mode 4400A is 404 through the manual input shaft 4254 of the drive assembly 4082 and the top cover 433 This is achieved by selectively locking the ignition to 2 (see FIG. 34B, not shown in detail). Similarly, operation of the differential assembly 4400 in the second abort mode 4400B is Drive assembly 4082 top cover 4 through differential assembly 4400 via pin 4406 332 (see FIG. 34C, not shown in detail). ). Furthermore, the operation of the differential assembly 4400 in the haptic torque mode 4400H is When the rotation device 4080 is driven to rotate the tool 4042 about the second axis A2, To prevent rotation of the head 4336 about the second axis A2, the drive assembly 40 82 from the top cover 4332 to selectively remove the first pin 4404 and the second pin 4406. (See FIG. 34A, not shown in detail) and manually insert the handle assembly 4096. This is achieved by connecting to head 4336 of interface 4094.

[0127] 34A-34C, the differential assembly 44 of the drive assembly 4082 00 generally comprises an interface arranged in rotational communication with the manual interface 4094. A face side gear 4408 and a connector 4086 arranged to rotate in tandem therewith. A differential case 44 is arranged to rotate in conjunction with the rotor gear 4410 and the rotating device 4080. 12 and a pinion shaft operably attached to the differential case 4412 for simultaneous movement. and the pinion shaft 4414, respectively, are supported by the interface. a pair of gears arranged to mesh with the drive gear 4408 and the connector gear 4410; and a pinion gear 4416. Operatively attached to the drive assembly 4082. The differential housing 4418 is at least one of the differential case 4412 of the differential assembly 4400. The differential chamber 4420 is shaped to accommodate a portion of the differential Each of the components of the moving assembly 4400 is described in more detail below.

[0128] Again, in the fourth embodiment of the end effector 4040, the drive assembly 4082 The gear train 4084 is also available with the planetary reduction gear set 4286 and the bevel gear set However, in this embodiment, the reduction gear set 4286 is 080 (see Figures 32 and 33) and bevel gear set 4272 so as to rotate together. More specifically, the components of the planetary reduction gear set 4286 are connected to the input body 4374. and is supported within a power input shaft 4252 and a carrier shaft 4253, which are generally rotatable about a first axis A1. Here, the input gear 4274 of the bevel gear set 4272 is disposed between the input gear 4274 and the output gear 4422. are coupled to the carrier shaft 4422 for simultaneous rotation about a first axis A1, The output gear 4276 of the bevel gear set 4272 simultaneously rotates about a second axis A2. 4412.

[0129] The differential case 4412 includes a driver 4250, a differential housing 4418, and a top cover. 4332, and is rotatably supported by bearings 4262 disposed within the ribs (detailed The annular hub 4424 is supported by a second A casing 4400B is formed in the top cover 4332 to facilitate operation in the abort mode 4400B. 4406. When aligned with the radial cover opening 4428, the second pin 4406 is received. The manual input shaft 4254 also has a plurality of hub openings 4426 shaped as follows: The bearings 4262 located in the top cover 4332 and the differential case 4412 and coupled to an interface side gear 4408, and Transverse covers formed in top cover 4332 to facilitate operation in 00A. - shaped to receive the first pin 4404 when aligned with opening 4432 The pinion shaft 4414 is connected to the differential case 4 412, which rotatably supports pinion gear 4416, and pinion gear 44 16, as described above, the interface side gear 4408 and the connector side gear 441 0. Here, the connector side gear 4410 is arranged to mesh with the intermediate shaft 4256, and in this embodiment, the intermediate shaft 4256 is coupled to the differential case 4412 It is rotatably supported by a bearing 4262 disposed therein.

[0130] The differential housing 4418 of the differential assembly 4400 defines a differential axis DA and, in the illustrated embodiment, In this embodiment, the differential axis DA coincides with the second axis A2. When in 00A, the differential case 4412 is allowed to rotate relative to the differential housing 4418. Conversely, when in the second abort mode 4400B, the differential housing 4418 The rotation of the differential case 4412 is inhibited. Furthermore, in the second abort mode 4400B, The differential shafts DA of both the interface side gear 4408 and the connector side gear 4410 are However, when in the first abort mode 4400A, the connector Although rotation of the side gear 4410 about the differential axis DA is possible, the interface side gear 44 Rotation of the pinion shaft 4414 around the differential shaft DA of the pinion shaft 4414 is restricted. The pinion gear 4416 defines a pinion axis PA, and the pinion gear 4416 is in a first stop mode 4400A, a second stop mode 4400B, and a third stop mode 4400C. In the abort mode 4400B and the haptic torque mode 4400H, the pinion shaft PA In the illustrated embodiment, the pinion shaft PA is rotatable about the differential shaft DA is substantially perpendicular to

[0131] As described above, in haptic torque mode 4400H, handle assembly 4096 When operating with the head 4336 of the manual interface 4094 connected The user may then rotate the tool 4042 around the second axis A2 by causing the rotating device 4080 to rotate the tool 4042 around the second axis A2. When driven, the hand is rotated to prevent rotation of the head 4336 about the second axis A2. The actuator 4166 can grasp the clamp assembly 4096. When the manual input shaft 4254 and the intermediate shaft 4256 are rotated, the manual input shaft 4254 and the intermediate shaft 4256 are rotated by the same amount. They are subjected to torque but can rotate at different speeds.

[0132] Thus, the differential assembly 4400 provides a torque between the rotating equipment 4080 and the tool 4042. As part of the gear train 4084, the handle assembly 4096 By gripping the manual input shaft 4254, the manual input shaft 4254 can be rotated about the second axis A2. When this occurs, haptic (or "tactile") torque feedback is transmitted to the user's hand. The handle assembly 4096 does not rotate when gripped, but may also rotate. Regardless, the user must apply a torque substantially equal to the amount of torque being applied to the tool 4042. Therefore, the driven tool 4042 moves the fixture 4050 When equipped with a rotary drive tool 4048 having a torque You should "feel" the torque in the handle assembly 4096. The drive advantageously utilizes a rotating device 4080 to drive the fixture 4050. The fixture 4050 provides the user with a relative resistance to the rotation being experienced.

[0133] With continued reference to FIGS. 34A-34C, a fourth embodiment of the end effector 4040 is shown. In this embodiment, the gear train 4084 further comprises an auxiliary gear set, generally designated 4434, The auxiliary gear set 4434 is interposed between the intermediate shaft 4256 and the connector 4086. The auxiliary gear set 4434 is mounted in an auxiliary housing secured to the driver 4250 by fasteners. and a gear set 4434 and an auxiliary housing 4436. A total of four auxiliary planetary gears 4440 are arranged on the auxiliary ring gear 4438. gear 4438, which is in meshing engagement with auxiliary sun gear 4442. The auxiliary planetary gear 4440 is fastened to the auxiliary carrier 4444 via a fastener. and fixed to the first interface body 4446, 6 are bearings disposed within the driver 4250 and auxiliary housing 4436, respectively. Supported by 4262.

[0134] The first interface body 4446 is shown in FIG. 33, as described in more detail below. 4128 of the rotary drive tool 4048. The auxiliary sun gear 4442 has a cross hole 4448 that defines a rotation stop. The interface body 4450 is coupled to the auxiliary carrier 4444 and the first interface The second interface is supported by a bearing 4262 disposed within the body 4446. Peg 4452 is operably attached to base body 4450 and is configured to be mounted on a base 4450 as described in more detail below. 33. As shown in FIG. 33, the rotary cutting tool 4044 is engaged with the bit interface 4128. The rotary lock defines another rotary lock shaped to fit the rotary lock.

[0135] In the exemplary embodiment shown herein, the peg 4452 defines the first rotary lock RL1. and cross hole 4448 defines second rotary lock RL2 (see FIG. 34B). , the peg 4452 of the first rotary lock RL1 is inserted into the cross hole 4448 of the second rotary lock RL2. This arrangement is similar to the rotation shown in FIG. of the bit interface 4128 of the driving tool 4048 and rotary cutting tool 4044 The bit interfaces 4128 shown in FIG. In connection with the bit interface 128 utilized with the first embodiment of the processor 40, The fourth embodiment uses an axial retainer 4130 similar to that previously described. In the second embodiment, the rotating retainer 4132 differs from each other and from the first embodiment. In the fourth embodiment, the bit interface 4128 of the rotary cutting tool 4044 is 34B. ), the bit interface 4128 of the rotary drive tool 4048 is connected to the second rotary lock R A key element 4456 is provided that is configured to engage with L2 (see FIG. 34C). 4456 has a curved, generally rectangular shape shaped to fit within cross-shaped hole 4448. Therefore, when the rotary drive tool 4048 is secured to the connector 4086, the auxiliary gear The first interface body 4446 of the asset 4434 is rotated about the second axis A2. (See FIG. 34C.) The notched elements 4454 are 4448 through the cross hole 4448, and thus the rotary cutting tool 4044, when fixed to the connector 4086, forms a second interface body 4450. Both rotate simultaneously about a second axis A2 (see Figure 34B).

[0136] In the fourth embodiment, the drive assembly 4082 includes a first rotary lock RL1 and a second rotary lock RL2. However, in other embodiments described herein, the first rotary lock RL2 It will be understood that only the tool RL1 may be used. The connectors of the drive assembly 82 described above in connection with the first embodiment of the end effector 40 Similar to the rotary connector element 308 formed in the retaining shaft 255 of the rotor 86. Several different configurations are possible, including: Other configurations are also contemplated.

[0137] In the fourth embodiment, the axial direction of the tool 4042 fixed to the connector 4086 The holding of the drive assembly is performed along a trajectory T maintained by the surgical robot 32 (see FIG. 1). The rotary cutting tool 4044 and the rotary driving tool 4042 are arranged to move in parallel with the assembly 4082. 48, or another tool 4042. This is achieved by the axial locking element AL. For this purpose, the axial locking element AL is in the release configuration ACR (see FIG. 34A) and lock type ACL (see FIGS. 34B-34C). When the axial lock AL operates in the release configuration ACR shown in FIG. 4082 and a first rotary locking member RL1 or a second rotary locking member RL2. The relative motion between the tool 4042 (tool 4042 is not shown in FIG. 34A ) The axial locking device AL is capable of locking the locking mechanism 100 along the second axis A2. When operating with the ACL, the drive assembly 4082 and the first rotary lock RL1 (FIG. 3 4B) or a tool 4042 fixed to the second rotary lock RL2 (see FIG. 34C). Relative movement between is restricted along a second axis A2.

[0138] In the fourth embodiment, the axial locking device AL is secured by a generally spherical axial connector element 4306. The axial connector element 4306 forms part of the connector 4086 and The first embodiment of the effector 40 operates in substantially the same manner, but now the connector The retaining shaft 4255 of the connector 4086 is connected to the connector body 4300 and the rider body 4458. The rider body 4458 is supported by bearings 4262 arranged in the frame. When in the locked configuration, the axial connector element 430 moves simultaneously with the locking member 4302. 6 is supported by bearings 4262 and is connected to the rotary cutting tool 4044 and the rotary cutting tool 4046. Engage the axial retainer 4130 of the bit interface 4128 of the driving tool 4048 along the second axis A2 between the axial connector element 4306 and the axial retainer 4130. The flange member 4302 of the connector 4086 is engaged by the user to limit relative movement. When the flange member 4302 is moved to the release configuration ACR, the flange member 4302 moves along the second axis A2. axial connector element 4306 disengages from axial retainer 4130 and This arrangement allows the axial locking element 4262 to be released from the locked configuration ACL. When fixed to the AL, the retaining shaft 4255 and the bit interface of the tool 4042 This allows the interface 4128 to rotate simultaneously, and the tool 4042 connects to the connector 4086. When the rotary locking device RL1 is removed from the This allows the retaining shaft 4255 to rotate without any need for a clamp.

[0139] Again, the axial lock is, for example, associated with the first embodiment of the end effector 40. The connector formed in the retaining shaft 255 of the connector 86 of the drive assembly 82 described above axial connector element 306 disposed within connector element pocket 310. It will be appreciated that the present invention may be implemented in a number of different configurations, and other configurations are contemplated.

[0140] In the fourth embodiment of the end effector 4040, the auxiliary gear set 4434 effectively Acting as a speed increaser between the intermediate shaft 4256 and the second interface body 4450 , and therefore the peg 4452 of the first rotary lock RL1 is driven at a first drive ratio DR1. On the other hand, the cross hole 4448 of the second rotary locking device RL2 is driven at a second drive ratio DR2. The intermediate shaft 4256 is rotated simultaneously with the intermediate shaft 4256. is transmitted to the auxiliary carrier 4444 via the intermediate coupling 4460. As 44 rotates, the auxiliary planet gear 4440 rotates in conjunction with the auxiliary ring gear 4438 and the auxiliary sun gear While being meshed with the wheel 4442, it orbits about the second axis A2 and rotates about a specific axis. , and therefore the auxiliary sun gear 4442 rotates about the second axis A2 more rapidly than the auxiliary carrier 4444. Therefore, as mentioned above, the transmission is "shifted" between the different gear sets. drive assembly 4082 without necessarily requiring a "drive" Different tools 4042 can be driven with a fixed drive ratio.

[0141] As mentioned above, a fifth embodiment of the end effector of surgical system 30 is shown in FIG. 38B. In the following description, the first embodiment of the end effector 40 The structures and components of the fifth embodiment are the same as or correspond in other ways to the structures and components of the fifth embodiment. Components have the same reference number incremented by 5000. End effector 5040 Many of the components and features of the fifth embodiment of the end effector 40 described above are the same as those of the first embodiment of the end effector 40 described above. , which are substantially similar to those of the embodiments of , the fifth embodiment of the end effector 5040 and the first embodiment of the end effector 40 Only specific differences between the embodiments will be described below, and common features between the embodiments will be described. Only some of the elements and features are discussed herein and shown in the drawings.

[0142] Therefore, without limitation, unless otherwise indicated below, The description of the first embodiment of the end effector 40 is now given in conjunction with the description of the fifth embodiment of the end effector 5040. Similarly, the corresponding components of the previous embodiments may be incorporated by reference. Specific components of the fifth embodiment of the end effector 5040 are similar in design and features. Elements and features will be further illustrated by the same reference numerals 1000 and 1100 for all intervening embodiments. If reference is made to a drawing or otherwise as having a number incremented by 1000, (For example, in the case of the fifth embodiment, the same method as described in relation to the fourth embodiment can be used.) The number of components added would be increased by 1000, and the configuration described in relation to the third embodiment would be The elements should be increased by 2000, and the components described in relation to the second embodiment should be: (It should increase by 3000.)

[0143] Referring now to Figures 35-38B, the fixture 5078, rotating equipment 5080 and its accessories are actuator 5166 (shown diagrammatically), and an engine with a drive assembly 5082. A fifth embodiment of the effector 5040 is shown schematically. In comparison to the configuration, the fifth embodiment of the end effector 5040 generally has a different configuration. and a gear train. Tool 5042 is driven via drive conduit 5462 forming part of 5084. For each of these components, This will be explained in more detail.

[0144] As best shown in FIGS. 35-36, a fifth embodiment of an end effector 5040 includes , the same manipulator assembly as described above in connection with the second embodiment of the end effector 2040. The input device 5092 includes an assembly 5088, a grip 5090, and an input operation tool 5092. Similar to the second embodiment, the fifth embodiment of the end effector 5040 includes a rotating device. 5080 and the drive assembly 5082 are arranged such that the second axis A2 is fixed relative to the first axis A1. In other words, again in this embodiment, the drive assembly 50 The driver 5250 of 82 is not arranged to move relative to the rotating device 5080. However, as will be appreciated from the following description, drive assembly 5082 and / or The rotating device 5080 rotates about a first axis A in a manner similar to the first embodiment of the end effector 40. It may be configured in different shapes, for example to allow for relative positioning around one Other configurations are also contemplated.

[0145] The drive assembly 5082 of the fifth embodiment of the end effector 5040 is as described above and As explained in more detail below, different types of Tool 5042 "top loading" The manual interface of the fifth embodiment is improved by including a drive conduit 5462 to facilitate manual operation. The interface 5094 is attached to the drive assembly 5082 rather than being part of the drive assembly 5082 itself. The bit interface 5128 of the tool 5042 is fixed to the bridge 5082. However, this configuration is merely an example, and as will be understood from the following description, Additionally, the end effector 5040 forms part of the drive assembly 5082. However, drive conduit 5462 still allows for "top loading" of tool 5042 A separate manual interface 5094 may also be provided for controlling the movement of the control panel. Other configurations are contemplated. .

[0146] Referring now to FIGS. 36-38B, a fifth embodiment of an end effector 5040 includes: , the drive conduit 5462 of the drive assembly 5082 is rotated about a second axis A2. bevel gear set 5272. Therefore, again in this embodiment, the first axis A1 is different from the second axis A2. (See also FIG. 35.) More specifically, in this embodiment, the first axis A1 is However, as will be understood from the eighth embodiment described later, The first axis A1 is arranged to be parallel to the second axis A2 or even coincident with the second axis A2. It is contemplated that the components may be arranged differently, for example, to accommodate different configurations. In the fifth embodiment, the bevel gear set 5272 also includes an output gear 5276 The input gear 5274 is different in construction from the input gear 5274, and therefore provides a reduction in speed. In this embodiment, in addition to converting a rotation about the first axis A1 into a rotation about the second axis A2, The bevel gear set 5272 also generates a rotational torque between the first axis A1 and the second axis A2. Adjust.

[0147] Similar to the fourth embodiment of the end effector 4040 described above, in the fifth embodiment: The gear train 5084 also includes a planetary reduction gear set 52 disposed along a first axis A1. 86 is used. Here, the reduction gear set 5286 is used to reduce the actuator of the rotating equipment 5080. (See FIG. 35, actuator not shown in detail) and the drive of the drive assembly 5082 The conduit 5462 is interposed in rotational communication with the conduit 5462, and therefore rotates about the first axis A1. The rotation of the first rotary locking device RL1 around the second axis A2 is different (e.g., faster). Furthermore, similar to the third embodiment of the end effector 3040 described above, to facilitate "shifting" between the first gear set GS1 and the second gear set GS2, Correspondingly, different drive ratios DR1 and DR2 are used to drive different types of tools 5042. For this purpose, a transmission 5372 is provided. These are described in more detail below.

[0148] The drive assembly 5082 of the fifth embodiment of the end effector 5040 is Using the locking device RL1 and the axial locking device AL, the tool 5042 is rotated about the second axis A2. The first rotary locking member RL1 is rotated around the second axis A2 at the same time. The axial stop AL is operably attached to the drive conduit 5462 so as to rotate. The drive conduit 5462 is moved along a trajectory T maintained by the surgical robot 32 (see FIG. 1). a drive assembly for releasably securing a tool 5042 thereto for translational movement therethrough; A release mechanism is provided in which relative movement between the bridge 5082 and the tool 5042 is possible along a second axis A2. Form ACR (see FIG. 37A, tool 5042 not shown), drive assembly 5082, and The locking configuration ACL ( 37B to 37C). The configuration of is described in more detail below.

[0149] In the fifth embodiment, the first rotary lock RL1 is provided with a key hole, and the key hole is tool body 54 disposed between interface end 5468 and working end 5470 of tool body 54 66. It has a "square" shape (see FIG. 36). As will be understood from the following description, The tool body 5466 may include any suitable interposer between the interface end 5468 and the working end 5470. Similarly, the interface ends 5468 and 5469 may be defined by any number of components. and / or working end 5470 may be part of the tool body 5466 itself, or may be actuated by the tool body 5466. separate components releasably attached to the tool 5042 and / or releasably attachable to the tool 5042. It may also be defined as an attached component (e.g., fixture, handle assembly, etc.). It will be appreciated that other configurations are also contemplated. 6 includes a conduit axially disposed between an interface end 5468 and a working end 5470. A retainer 5472 is also formed, and the conduit axial retainer 5472 is axially engaged in a locking configuration ACL. The locking mechanism is engaged by a stopper AL (see FIGS. 37B to 37C). The working end 5470 of the tool 5044 generally corresponds to the distal cutting end 5044D and is a rotary drive tool. The working end 5470 of the bolt 5048 generally includes a fastener 5050 secured to the working end 5470. 36, corresponding to distal tip 5050D (not shown in locked state). In this embodiment, the interface end 5468 generally rotates about a second axis A2. a rotary cutting tool 5044 secured to a drive assembly 5082 for driving the rotary cutting tool; Compatible with 5048 or other type of tool 5042 bit interface 5128 do.

[0150] Although similar in construction, the conduit rotating holder 5464 of the tool body 5466 and the conduit axial The retainer 5472 is axially connected to the rotational retainer 5132 of the bit interface 5128. It will be understood that the retainer 5130 is different from the retainer 5130. Specifically, in the fifth embodiment, The rotational retainer 5132 and the axial retainer 5130 of the interface 5128 manual interface for releasably securing to the control assembly (not shown in this embodiment) The tool body 5466 includes a conduit rotary retainer 546 that forms part of the face 5094. 4 and conduit axial retainer 5472 are first, which in this embodiment effectively act as a connector. The tool 5042 is driven through engagement by the rotary lock RL1 and the axial lock AL. This facilitates releasable attachment to the assembly 5082. Furthermore, the fifth embodiment , the tools 5042 each have the same first rotary lock RL1 and the same axial lock RL2. The AL is configured to engage the AL.

[0151] As mentioned above and described in more detail below, the first gear in cooperation with the transmission 5372 To facilitate "shifting" between set GS1 and second gear set GS2 , the tool body 5466 of the rotary drive tool 5048 includes a first shaft portion 5474; The tool body 5466 of the rotary cutting tool 5044 includes a second shaft portion 5476 . Both the first shaft portion 5474 and the second shaft portion 5476 are Between the interface end 5468 of 466 and the working end 5470 (more specifically, In this embodiment, the conduit axial retainer 5472 is disposed between the conduit rotary retainer 5464. Both the first shaft portion 5474 and the second shaft portion 5476 are geared 5372 abuts against, engages with, or engages with at least a portion of the switch 5394 of the transmission link mechanism 5392 or otherwise shaped and positioned to contact, as described in more detail below. The diverter 5394 has a stepped outer shape and a cylindrical outer shape disposed along a second axis A2. The second shaft portion 5476 has a generally tubular shape including an inner shape of the first shaft. 37B-37C. (compare .), as explained in more detail below, the switch 539 of the transmission 5372 The abutment between gear set 4 and first shaft portion 5474 facilitates engagement of first gear set GS1. 37B), whereas the diverter 5394 and the second shaft portion 5476 The abutment therebetween facilitates engagement of the second gear set GS2 (see FIG. 37C).

[0152] 35-37C, the drive conduit 5462 of the drive assembly 5082 is A drive hole, generally indicated at 5478, is defined through which a second 5470 of the tool 5042 along the axis A2 of the tool 5042. In other words, the drive hole 5478 is adapted to receive the drive key 5124 or rotary cutting tool 5048. 5044D of the drive assembly 5044. 082 generally defines a proximal inlet 5480 and an opposite distal outlet 5482, 5462 is interposed between the proximal inlet 5480 and the distal outlet 5482 in a manner that allows for axial movement. When the locking member AL is in the release configuration ACR, the working end 5470 of the tool 5042 is connected to the second shaft A2 into the proximal entrance 5480 and through the drive hole 5478 to the distal exit 5482. This allows the catheter to be advanced from the surgical site ST (see Figure 1) towards the surgical site ST. As shown, in this embodiment, the drive conduit 5462 is connected to the distal exit 5482 of the drive bore 5478. , while the proximal inlet 5480 defines a drive assembly 5490, as described in more detail below. 5082. However, other configurations are contemplated, and in some implementations In this configuration, the drive conduit 5462 may alternatively be connected to the proximal inlet 5480 or even the drive hole 4 It will be understood that this defines the entirety of 478.

[0153] In the fifth embodiment, at least one of the drive holes 5478 disposed adjacent the distal exit 5482 Both portions define a first rotary lock RL1, and the first rotary lock RL1 is an axial lock. When stop AL is in lock configuration ACL, interface end 5468 and working end 5470 At least a portion of the tool 5042 (here, the conduit rotary holder 5464) between the The working end 5470 of the tool 5042 is shaped to fit within the drive hole 547. 8. Again, the interface of the tool 5042 The end 5468 is adjacent to the drive hole 5478 when the axial lock AL is in the locked configuration ACL. The catheter is positioned proximal to the surgical inlet 5480.

[0154] As mentioned above, in the fifth embodiment of the end effector 5040, the drive assembly 5 The gear train 5084 of the rotating equipment 5080 is connected to the actuator (see FIG. 35). The actuator (not shown in detail) is interposed in rotational communication with the drive conduit 5462. Here again, the transmission 5372 includes a first gear set GS 1, a second gear set GS2, and a conversion collar 5386, Similarly, the first collar position CP1 (see FIG. 37B) and the second collar position CP2 (see FIG. 37C) At the first color position CP1 shown in FIG. 37B, the transformation The collar 5386 engages the first gear set GS1 to drive the rotating equipment at a first drive ratio DR1. 5080 actuator (see FIG. 35, the actuator is not shown in detail) and drive guide At a second collar position CP2 shown in FIG. 37C, the translation collar The rotor 5386 engages the second gear set GS2 to drive the rotating equipment 5 at a second drive ratio DR2. 080 actuator (see FIG. 35, actuator not shown in detail) and drive conduit Converts rotation between 5462 and 5463.

[0155] As best shown in Figures 37A-37C, similar to the third embodiment described above, In the fifth embodiment of the end effector 5040, the gear 5288 is meshingly engaged with the ring gear 5288. Instead of being arranged in this manner, the first set of planetary gears 5290A and the second set of planetary gears 52 90B, and the third set of planetary gears 5290C are respectively the conversion collars of the transmission 5372. 5386. However, in this embodiment, , the inner teeth 5384 of the conversion collar 5386 also rotate when the conversion collar 5386 is in the second collar position C When the power input shaft 5252 is at P2 (see FIG. 37C), the shaft teeth 5388 of the power input shaft 5252 are engaged. In the third embodiment, the shaft is arranged to selectively engage with the splined engagement. The shaft teeth 3388 are formed on the intermediate shaft 3256. Rotation of the power input shaft 5252, facilitated by the attached bearing 5262, Again, in this embodiment, the rotation of the translation collar 5386 occurs simultaneously with the rotation of the sun gear 5292C. The outer teeth 5390 are similarly configured such that the conversion collar 5386 is in the first collar position CP1 (FIGS. 37A-37C). 7B), the gear 5288 is selectively engaged by a spline engagement. It will be placed.

[0156] In this embodiment, the ring gear 5288 is formed on the intermediate body 5378 and the conversion collar 5 The movement of 386 occurs substantially along a first axis A1 within intermediate body 5378 (FIGS. 37B- (Compare FIG. 37C.) For this purpose, a diverter guide 5484 is provided to guide the diverter collar 5386 and moves simultaneously with the conversion collar 5386, and the changeover guide 5484 also moves in the same manner as the brace 5396 passes through the diverter guide 5484 to provide support for the first set of pins 5294A. In this embodiment, the first set of pins 5294A are supported by The brace 5396 is similar to that described in connection with the third embodiment of the end effector 3040. 3255 as shown in FIG. 10. In this embodiment, a linkage biasing element 5398 is disposed within the intermediate body 5378, and the linkage biasing element 5398 The lock mechanism biasing element 5398 is configured to lock the axial lock AL in the release configuration ACL (see FIG. 37A). or when the tool 5042 is not otherwise positioned within the drive conduit 5462. abutting the converting collar 5386 and rotating the converting collar 5386 along the first axis A1 relative to the first collar - Move towards position CP1.

[0157] The input gear 5274 of the bevel gear set 5272 is coupled to the carrier shaft 5422. The carrier shaft 5422 is operably attached to the driver 5250 and the intermediate body 5378. The rotation is controlled by bearings 5262 disposed within the carrier support 5486 attached to the The carrier shaft 5422 defines a carrier bore 5488 and is supported to A portion of the interchanger guide 5484 is disposed within the carrier bore 5488 and is connected to the piston element 549 0 extends along the first axis A1 through the carrier bore 5488. In this embodiment, Stone element 5490, as well as diverter guide 5484, are part of transmission linkage 5392. The piston element 5490 is inserted into the carrier bore 5488 and the diverter guide 5484. The first collar position CP1 and the second collar position CP2 are supported by bearings 5262 disposed within the first collar position CP1 and the second collar position CP2. and collar position CP2 simultaneously with the diverter guide 5484 and the diverter collar 5386. .

[0158] 37A-38B, the corresponding positions along the second axis A2 of the diverter 5394 are In response to the movement of the piston element 5490, the piston element 5490 and the diverter guide 5484 are rotated along the first axis A1. To facilitate simultaneous movement of the pistons along the Piston link member 5490 pivotally coupled to piston element 5490 by pin 5494 492. The piston link member 5492 is generally disposed within the driver 5250. , extends around the diverter 5394 in a "wishbone" arrangement. 92 are pivotally connected to respective cam link members 5496 by link pins 5498 The cam link member 5496 is pivoted to the pivot mount 5500 by the cam pin 5502. The pivot mount 5500 is coupled to the driver 5250 by fasteners. The cam pin 5502 is generally located closer to the output gear 5276 than the link pin 5498. Each cam link member 5496 is shaped to engage with a respective cam link surface 550. 38A-38B), and the cam link surface 5504 defines a bearing seat 5 508. The bearing seat 5508 slides along the bearing seat surface 5506. supports a bearing 5262 about a second axis A2, and the bearing 5262 is I support 5394.

[0159] As mentioned above, in the fifth embodiment, the diverter 5394 has a stepped outer shape and a generally More specifically, the diverter 5394 has a proximal diverter end 5512 and a diverter bore 5510 extending between a proximal diverter end 5512 and a distal diverter end 5514. a first outer portion 5516 extending from the first outer portion 5516 to a diverter step 5518; and a second outer portion 5520 extending from the distal diverter end 5514 to the distal diverter end 5514. The side portion 5520 passes through a bearing 5262 disposed on a bearing seat 5508. The diverter step 5518 extends in a direction perpendicular to the axis of the shaft 5262, and is positioned to abut against the bearing 5262.

[0160] The second outer portion 5520 of the diverter 5394 has a generally cylindrical shape and includes a first rotational lock. The drive hole 5478 is disposed above the tool RL1 and is received within the second cylindrical region 5522 of the drive hole 5478. As described above, in this embodiment, the drive hole 5478 and the first circuit Both rotation stops RL1 are defined by the output gear 5276. The output gear 5276 is A bearing disposed within a bottom cover 5524 operably attached to the driver 5250 The translation collar 5386 is rotatably supported by the ring 5262. CP2 (see FIGS. 38A to 38C), the second outer At least a portion of portion 5520 is within a cylindrical region 5522 defined by output gear 5276. In the illustrated embodiment, the diverter 5394 remains disposed within the output gear 522. Although not specifically positioned to rotate simultaneously with 276, diverter hole 5510 is Similarly, the tool 5042 is moved along the second axis A2 in a "loading" manner. Therefore, it can be considered to be an extension of the drive hole 5478. It will be appreciated that, again, in the fifth embodiment of the end effector 5040, the diverter 53 It will be appreciated that 94 can be considered to be, in effect, an extension of drive conduit 5462. .

[0161] The first outer portion 5516 of the diverter 5394 also has a generally cylindrical shape and 5255. The first cylindrical region 5526 of the housing 5255 is shaped to be received within the first cylindrical region 5526 of the housing 5255, and in this embodiment In this case, the retaining shaft 5255 is supported by a bearing 5262 disposed within the driver 5250. 5042. The tool 5042 is rotatably supported by a conduit formed in the tool body 5466. It acts as a part of the axial locking device AL so as to engage with the axial retainer 5472. In this embodiment, the first cylindrical region 5526 of the retaining shaft 5255 is 5082, as well as a diverter hole 5510. is similarly shaped to receive a portion of tool 5042 along second axis A2 in a "grip" fashion. Therefore, it can be considered to be an extension of the drive hole 5478. In the fifth embodiment of the do-effector 5040, the retaining shaft 5255 is effectively a drive conduit. It will be appreciated that this can be considered an extension of 5462.

[0162] As shown in FIGS. 37A-37C, in this embodiment, a proximal A connector element pocket 5310 is formed adjacent the entrance 5480 to accommodate the axial connector element 5306 is molded to receive it in the connector element pocket 5310. The rotor element 5306 has a substantially spherical configuration, and the flange member 5302 is oriented along the second axis A2. In response to movement along the axis A2, the second axis A2 moves radially (see FIGS. 37A-37C ). (Compare Fig. 10B and Fig. 10C). Here, in this embodiment, the axially inclined surface 5312 is 302. The ramp portion 5528 is defined by a ramp member 5528 formed as a separate component from the ramp portion 5528. The member 5528 is rotatable relative to the flange member 5302 by means of bearings 5262. The angled member 5528 moves simultaneously with the flange member 5302, and therefore As the axial ramp surface 5312 moves relative to the retaining shaft 5255, the axial connector element 53 06 moves radially relative to the second axis A2. Fifth embodiment of end effector 5040 , the flange member 5302, the inclined member 5528, the retaining shaft 5255, and the axial The connector elements 5306 cooperate to define an axial stop AL, thereby When the forward connector element 5306 is in the locked configuration ACL (see FIGS. 37B-37C), Engage the conduit axial retainer 5472 of the tool 5042 and release the ACR (see FIG. 37A). When the tool 5042 is in position (not shown), the conduit axial retainer 54 is moved away from the second axis A2. 72.

[0163] Referring now to Figures 36-38B, as described above, the conduit rotary retainer 5464 and The conduit axial retainer 5472 is attached to the tool 5042 (here, the rotary cutting tool 5044 and and rotary drive tool 5048) in the same manner. The tool body 54 is rotated in accordance with the relative distance between the first rotary locking member AL and the first rotary locking member RL1. 66. However, the first shaft of the rotary drive tool 5048 The first shaft portion 5474 and the second shaft portion 5476 of the rotary cutting tool 5044 are The tool 5042 has a tool body 5466 and a conduit rotating holder 5464 and a conduit axial direction. 5472, so that engagement with the proximal diverter end 5512 The switch 5394 switches the tool 5042 depending on which tool 5042 is fixed to the axial locking device AL. Accordingly (compare FIGS. 37A-37C), it moves to different positions along the second axis A2. In the illustrated embodiment, the second shaft portion 5476 is longer than the first shaft portion 5474. Because it is located near the conduit rotating cage 5464 (see FIG. 36), the diverter 5394 When the rotary driving tool 5048 is fixed to the axial locking member AL, the rotary cutting tool 5 When the axial locking member AL is fixed to the first rotary locking member RL1, the axial locking member AL moves to the vicinity of the first rotary locking member RL1 ( Compare Figure 37C with Figure 37B).

[0164] The changer 5394 moves along the second axis A2, causing the changer collar 5386 to move correspondingly. moves along the first axis A1 via the transmission link mechanism 5392. , the transmission 5372 also allows the user to "manually shift" the transmission 5372. Based on the configuration of tool 5042, the gear sets GS1 and GS2 can be connected without the need for It will be understood that the "automatic shift" occurs when the switch 5394 is moved along the second axis A2. This movement also moves bearing seat 5508, which in turn moves cam link member 5496 When the cam link surface 5504 slides on the bearing seat surface 5506, the pivot mount 55 38A-38B. This movement of the cam link member 5496 causes the piston link member 5492 to The link member 5496 pivots about a link pin 5498 connected to the link member 5496, thereby Piston element 5490 is connected to the carrier shaft via a connection provided by piston pin 5494. The piston element 5490 moves within the carrier bore 5488 of the shaft 5422. A changeover guide 5484 and a changeover switch 5485 are provided between the first color position CP1 and the second color position CP2. It moves simultaneously with the interchangeable collar 5386 (compare Figures 38B-38C).

[0165] As discussed above, the drive conduit 5462 of the drive assembly 5082 can accommodate different types of tools. The structure is configured to releasably secure the cable 5042 in a "top-loading" manner. 3. The robotic arm 36 may be configured to, among other things, connect the base 34 and / or the surgical site ST. Based on the amount of joint motion available for the specific type of surgical procedure and and / or provides significant advantages for certain types of tools 5042. More specifically, "Top loading" refers to the removal of one tool and / or the next of another. The end effector is positioned to provide sufficient clearance to the surgical site ST for attachment of the It is desirable to substantially move or otherwise change the position of the end effector. in unlikely or impractical scenarios or as a result of techniques utilized by surgeons, What is sufficient for one type of tool but desirable for a different type of tool The robot arm 36 is articulated relative to the base 34 in a manner that is not possible or feasible. In other words, it is advantageous to be able to use a specific type The tool is designed to facilitate "top-loading" installation. It is intended that the robot arm 36 does not need to be moved as a whole as in the "top The "bottom loading" type is different from what is normally available in the "bottom loading" type. This utilizes the range of articulation of the robot arm 36 relative to the base 34 and the surgical site ST. It is contemplated that this may provide improved opportunities for

[0166] The above examples are illustrative rather than limiting and relate to the first, second, third, and fourth embodiments. The "bottom loading" method described above can be applied to different tools used sequentially during a surgical procedure. and may be preferred over "top loading" in certain situations. Similarly, it will be appreciated that the tool may be secured in a "bottom loading" fashion. and a "top-loading" tool clamping mechanism. The tool-to-tool transitions are observed in specific scenarios for both the end effector and the The movement of the end effector along the trajectory T can be performed to facilitate, or further It will be appreciated that it may be desirable to have one tool 504 2 can be completely removed and another tool, 5042, can be installed in a "bottom loading" fashion. To provide sufficient clearance, an undesirable amount of movement along the trajectory T would normally be necessary. If the lengths of the different tools 5042 used in sequence are different, the end effector The "top loading" approach provided by the fifth embodiment of the Kuta 5040 is particularly advantageous. is.

[0167] As mentioned above, a sixth embodiment of the end effector of the surgical system 30 is shown in FIG. 44A to 44B. In the following description, the first embodiment of the end effector 40 The structures and components of the sixth embodiment are the same as or correspond in other ways to the structures and components of the sixth embodiment. Components have the same reference number incremented by 6000. End effector 604 Many of the components and features of the sixth embodiment of the end effector 40 described above are the same as those of the sixth embodiment of the end effector 40 described above. 1 is substantially similar to that of the first embodiment, for purposes of clarity, consistency, and brevity. The sixth embodiment of the end effector 6040 and the first embodiment of the end effector 40 Only specific differences between the embodiments are described below, and common features between these embodiments are not included. Only some of the components and features are discussed herein and shown in the drawings.

[0168] Therefore, without limitation, unless otherwise indicated below, The description of the first embodiment of the end effector 40 is now given in conjunction with the sixth embodiment of the end effector 6040. Similarly, the corresponding components of the previous embodiments may be incorporated by reference. Specific components of the sixth embodiment of the end effector 6040 are similar in design and features. Elements and features will be further illustrated by the same reference numerals 1000 and 1100 for all intervening embodiments. If reference is made to a drawing or otherwise as having a number incremented by 1000, (For example, in the case of the sixth embodiment, the same method as described in relation to the fifth embodiment can be used.) The number of components added would be increased by 1000, and the configuration described in relation to the fourth embodiment would be The elements should be increased by 2000, and the components described in relation to the third embodiment should be: The components described in relation to the second embodiment should be increased by 4000. should increase).

[0169] 39A-44B, a fixture 6078, a rotating device 6080, and Actuator 6166 (shown diagrammatically), and actuator 6166 including drive assembly 6082. A sixth embodiment of the end effector 6040 is shown schematically. In comparison to the first embodiment, the sixth embodiment of the end effector 6040 generally has a different configuration. The fifth embodiment uses a manipulator assembly 6088 and a drive assembly 6082. In a manner similar to that shown in FIG. 1, tool 6042 is driven via drive conduit 6462 in a "top loading" manner. For each of these components, Explain in detail.

[0170] As best shown in FIGS. 39A-40, in the sixth embodiment, the drive assembly 608 2 is similarly releasably attached to the rotating device 6080 via a coupler 6230. , so that the drive assembly 6082 can be rotated in different ways about the first axis A1. The positioning allows movement of the second axis A2 relative to the first axis A1. In the sixth embodiment, the manipulator assembly 6088 is the manipulator assembly 3088 described above. The third embodiment uses a grip 6090 and an input operation tool 6092 that are structurally similar to those of the third embodiment. Again, the frame 6134 of the operating tool assembly 6088 is a first frame body. The first frame body 6362 and the second frame body 6364 are Similarly, the first operating tool assembly position P1 (see FIGS. 39A-39B) and the second operating tool Simultaneous movement between multiple manipulator assembly positions, including assembly position P2 (see FIG. 39C) The second frame body 6364 is also coupled to the retainer 6136. The first grip position G1 (see FIG. 39A) and the second grip position G2 (see FIG. 39B) are 39C) relative to the first frame body 6362. 6090 and the input operation tool 6092. However, in this embodiment, The second frame body 6364 has the same translational structure as described and illustrated in connection with the third embodiment. In contrast to the exercise, the first grip position G1 is moved between the first grip position G2 and the second grip position G3. It is arranged to pivot relative to the frame body 6362.

[0171] When the gripping portion 6362 is in the first grip position G1 shown in FIG. 39A, the second frame body 6364 At least in part, by restricting access to the manual interface 6094, this embodiment In this case, the manual interface 6094 is the "Top Lo" as in the fifth embodiment described above. The bit interface of the tool 6042 is secured to the drive conduit 6462 in a "loading" manner. 6128. Furthermore, as will be explained in more detail below, the first grid When in the snap position G1, the input manipulation implement 6092 similarly acts as a The rotating device 6080 is driven to rotate the tool 6042 secured to the drive conduit 6462 in a second direction. However, the second grip shown in FIG. When in position G2, the second frame body 6364 receives the force applied by the user. A manual override is provided to facilitate rotation of the tool 6042 about the second axis A2. The second frame body 6364 is disposed in a spaced apart relationship with the interface 6094. Furthermore, the multiple operating tool assemblies can be moved independently of the movement between the multiple grip positions G1 and G2. The first frame body 6362 is arranged to move simultaneously with the first frame body 6362 between the bridge positions P1 and P2 (see FIG. (Compare Figures 39A-39C).

[0172] In the sixth embodiment of the end effector 6040, the second frame body 6364 is A first grip position G1 (see FIG. 39A) and a second grip position G2 (see FIG. 39B) The pivoting motion is performed on both the first axis A1 and the second axis A2. The rotation of the rotor 1 occurs along a pivot axis VA arranged substantially perpendicular to the rotor 1. For this purpose, the best representation of the rotor 1 shown in FIG. As shown, a pivot pin 6530 connects the first frame body 6362 and the second frame The first frame body 6362 is pivotally coupled to the first frame body 6364 and operably attached to the first frame body 6362. The tensioner 6532 attached to the second frame body 6362 is A tension member formed within the second frame body 6364 is provided to limit the movement of the body 6364. The tensioner slot 6534 extends into the first gear. and a second grip position G2. To provide an adjustable amount of resistance to rotation about the pivot axis VA, or in any other manner , at the first grip position G1 and the second grip position G2, or at the first grip Between the position G1 and the second grip position G2, the second frame body 6362 is It can also be used to "lock" the frame body 6364.

[0173] As shown in FIG. 41, in the sixth embodiment, the link mechanism 6088 of the operating tool assembly 6088 178 connects a first input location I1 to a second input location I2 using a cable arrangement generally designated 6536. In response to corresponding movement of the input actuator 6092 between the force position I2, the piston 6182 (The first input position I1 is shown in Figure 41). The positioning member 6536 is attached to the first frame body 6362 and the second frame body 6364, respectively. A flexible conduit 6538 extends between a pair of coupled tensioner assemblies 6540. A wire 6542 (shown diagrammatically in FIG. 41) connects the input actuator 6092 and the piston 61. 82 and extending through the tensioner assembly 6540 and the flexible conduit 6538; Therefore, movement of the input manipulation implement 6092 results in a corresponding movement of the piston 6182, The piston 6182 engages with a fork guide 6188 of the rotating device 6080 to rotate the fork guide. This configuration allows the second frame body 6364 to move. The first grip position can be easily rotated relative to the first frame body 6362. position G1 (see Figure 39A), the second grip position G2 (see Figure 39B), or the first grip position G3 (see Figure 39C). At any other grip position between the first grip position G1 and the second grip position G2 However, the input operation tool 6092 can be moved between the first input position I1 and the second input position I2. This will ensure that you can do this.

[0174] 40 and 42B, a sixth embodiment of an end effector 6040 A total of three different exemplary types of tools 6042 are shown in association with tool 6 042 are respectively a second end effector 5040 as in the fifth embodiment of the end effector 5040 described above. into the drive conduit 6462 of the drive assembly 6082 along the axis A2 of the More specifically, FIG. 40 illustrates a dissection tool 6544 and a fixation tool 6546. 42B shows a type of rotary drive tool 6048 for use in driving the . 65A shows a schematic representation of an alignment tool 6546. As will be explained in more detail below, the rotation The driving tool 6048 has structural differences compared to the previous embodiments, but Regardless, the drive conduit 6462 extends through the drive conduit 6462 and rotates around the second axis A2 via the rotating device 6080. The first rotary lock RL1 of the drive assembly 6082 and the axial It is configured for releasable attachment to the fastener AL in a "top loading" manner. In the illustrated embodiment, the dissection tool 6544 and alignment tool 6546 are also The first drive conduit 6462 is configured to be received within the drive conduit 6462 along the second axis A2, while the second drive conduit 6462 is configured to be received within the drive conduit 6462 along the second axis A3. It is not designed to be attached to the rotary lock RL1 or the axial lock AL. Here, the dissection tool 6544 and the alignment tool 6546 are driven along a second axis A2. The surgical robot 32 (see FIG. 1) can be used for the surgical operation. Since it can be positioned relative to the site ST, it is implemented as a "passive" tool 6042. Although the rotating equipment 6042 is depicted as an "active" tool 6042, such as a rotary driven tool 6048, It is not driven by the 080. Other types of "active" " and / or "passive" tools 6042 are also contemplated by the present disclosure.

[0175] In a representative example shown in connection with the sixth embodiment, the dissection tool 6544 and alignment A "passive" tool 6042, such as tool 6546, operates independently of the drive conduit 6462. , which is freely rotatable about a second axis A2 and along which a drive guide In other words, in this embodiment, The "passive" tool 6042 does not engage the first rotary lock RL1 or the axial lock AL. However, it can nevertheless be inserted into the drive conduit 6462 along the second axis A2. axial lock AL. 62. In contrast to the "passive" tool 6042, the "active" tool 6042 engages both the first rotary lock RL1 and the axial lock AL, and the second axial A2 simultaneously with the drive conduit 6462, allowing for easy removal from the drive conduit 6462. This requires the user to interact with the axial lock AL to activate it.

[0176] The "passive" tool 6042 shown in connection with the sixth embodiment is a tool that is into drive conduit 6462 along second axis A2 without engaging axial stop AL. Although the tool is configured to receive a particular type of "passive" tool 6042, It may also be configured so that it does not engage with the rotational locking device RL1 but engages with the axial locking device AL. and thus allows free rotation about the second axis A2, but along the second axis A2 It is contemplated that translation should be inhibited.

[0177] As best shown in FIGS. 40 and 43B, the dissection tool 6544 generally comprises a dissection shaft. The dissection shaft 6548 includes an interbody suction cannula 6550. a knob 6552 disposed at the face end 6468 and a tip 6553 disposed at the working end 6470. 554, and is shaped to extend through a dissecting cannula 6550. The rail 6550 includes a guide body 6556 extending from a stop element 6558 to a toothed end 6560. The guide body 6556 has a first tapered step 6562 adjacent to the stop element 6558 and A generally cylindrical shape is indicated by a second tapered step 6564 adjacent to the toothed end 6560. Here, the guide body 6556 of the dissection cannula 6550 is connected to the tool body 6466. and the abutment between the stop element 6558 and the drive assembly 6082 is along the second axis A2. Insert the drive conduit 6462 along the second axis A2 until it limits further translational movement. The dissecting cannula 6550 is free to rotate within the drive conduit 6462. The dissection shaft 6548 has a tip 6554 that is connected to a guide body. 6556 along the second axis A2 until it extends beyond the toothed end 6560 of the dissecting cannula 6556. 550. Again, the dissection shaft 6548 can be inserted into the dissection cannula 550. The anatomy shaft 6548 is free to rotate about a second axis A2 within the anatomy shaft 6548. The knob 6552 advances or advances the dissecting shaft 6548 through the dissecting cannula 6550. shaped and configured to be grasped by a user, such as to facilitate retraction and positioned in response to an applied force acting on the end effector 6040. Various types of "haptic" or "freedom" modes that allow articulation of the bot arm 36 The end effector 604 is attached to the base 34 of the surgical robot 32 (see FIG. 1). To facilitate moving or otherwise positioning the 0, use knob 6552. This can be used to measure movements relative to the surgical site ST during the course of a particular surgical procedure. (e.g., along a trajectory T or based on various types of virtual boundaries) Therefore, the user can control the surgical robot 32 (see FIG. 1). When operating in one or more of the "tactile" or "free" modes, the knob 6552 is grasped. A force can be applied in a particular direction to move the end effector 6040.

[0178] Referring next to FIG. 42B, the alignment tool 6546 aligns the drive assembly 6082 10. The drive conduit 6462 is shown schematically as being disposed within the drive conduit 6462. In this embodiment, the guide body 6556 of the alignment tool 6546 is similar to the tool body 6466. When the stop element 6558 abuts against the drive assembly 6082, along a second axis A2 to a distally disposed modular end 6566 of the drive conduit 6462. However, as will be understood from the following description, the module end 6566 Without departing from the scope of the present disclosure, They can also be arranged in different ways.

[0179] In the illustrated embodiment, a light source, generally designated 6568, is provided on the alignment tool 6546. The light source 6568 is coupled to the guide body 6556 adjacent the module end 6566. The mounting tool 6546 is positioned within the drive conduit 6462 of the drive assembly 6082 along a second axis A2. When inserted into the The light source 100 is configured to emit light L along a path LP toward the surgical site ST. An activation button 6570 coupled to element 6558 illuminates light L when activated by a user. and disposed in electrical communication with the light source 6568 to facilitate selective emission. A battery or other device may be installed within the guide body 6556 to power the light source 6568. In some embodiments, the light source 6 568 can be configured as a laser diode. Depending on the particular configuration of the source 6568, the emitted light L is projected onto the surgical site ST along a trajectory. can be visualized as "dots" aligned along the T and the light path LP ( Therefore, it can also be visualized as a "beam" aligned along a trajectory T Light source 6568 emits light L at any suitable wavelength sufficient for visualization in any suitable manner. It will be appreciated that the light L may be configured to emit , which can be visualized directly (e.g., in the visible spectrum) and / or indirectly to visualize the image (e.g., by a camera feed presented on a display screen) can be done.

[0180] Additionally, in addition to or in addition to the light sources 6568 shown throughout the figures and described herein It will be appreciated that a variety of different types of light sources 6568 may alternatively be utilized. As a non-limiting example, the light source may be configured to generally direct light L toward the surgical site S, such as for general illumination purposes. The T may be directed or otherwise radiated. In the present specification, the light source 6568 is a light source according to the present invention, the disclosure of which is incorporated herein by reference in its entirety. surgical tool for Selectively Illuminatin U.S. Patent Application Publication No. 2013 / 0130304 entitled "Ga Surgical Volume" It can be constructed in a similar manner to that described in Patent No. 0053648(A1). Various types and configurations of fixtures 50 and their associated installations are also contemplated by this disclosure. It will be appreciated that in some embodiments, other types of optical devices (e.g., It will be appreciated that a camera (e.g., a camera) may also be used. Other configurations are contemplated.

[0181] The alignment tool 6546 is attached to the drive conduit 6462 of the drive assembly 6082. 6568 and / or alignment tool. The entire box 6546 is a "disposable" box that is disposed of for recycling or reprocessing after the surgical procedure. Alternatively, the light source 6568 and / or The alignment tool 6546 is a "reusable" component that is sterilized after the surgical procedure. Other configurations are also contemplated.

[0182] In the exemplary embodiment shown in FIG. 42A, the light source 6568 is The device is not configured to be removably attached to the moving conduit 6462. In this embodiment, the light source 6568 and the activation button 6570 are mounted on the first frame body 6362. 6088. The manipulator assembly 6088 is connected to the second frame body 6364 for simultaneous movement relative to the first frame body 6364. Here, the second frame body 6364 is in the first grip position shown in FIG. When positioned at G1, light L is guided through conduit 6462 driven by light source 6568 to a second along the optical path LP aligned with the axis A2 (and therefore the trajectory T) of the surgical site ST. This configuration allows the tool 6042 to be removed from the drive conduit 6462. When removed, the tool 6042 (e.g., a cannulated tool) along the second axis A2 remains. For example, a drive conduit 646 (not shown in this embodiment) may be provided to receive a guidewire GW. 2, the light source 6568 can also be utilized. Similar to those described above in connection with the light source 6568, the light source 6568 may be of other types, configurations, etc. It can be equipped with a variety of different optical devices (e.g., cameras, lights for general illumination, etc.). Other configurations are contemplated.

[0183] As shown in FIGS. 43A to 43C, in the sixth embodiment, the gear of the drive assembly 6082 The axle train 6084 is similarly rotated about a first axis A1 using a bevel gear set 6272. To this end, the input gear 6274 converts the rotation of the first and an output gear coupled to the carrier shaft 6422 for simultaneous rotation about the axis A1 of the output gear. 6276 are coupled to drive conduit 6462 for simultaneous rotation about a second axis A2, The drive conduit 6462 rotates via a bearing 6262 disposed within the driver 6250. As in the fifth embodiment of the end effector 5040 described above, The bell gear set 6272 also provides a reduction between the input gear 6274 and the output gear 6276. and utilizes a planetary type reduction gear set 6286 arranged along a first axis A1. Here, the power facilitated by the bearing 6262 located within the input body 6374 The rotation of the input shaft 6252 occurs simultaneously with the third sun gear 6292C. The shaft 6422 is supported on the first axis by a bearing 6262 disposed in the intermediate body 6378. A1 and operably attached to a first set of pins 6294A. A first set of planetary gears 6290A, a second set of planetary gears 6290B, and a third set of planetary gears 6290C are Each of the set of planet gears 6290C is positioned in meshing engagement with the ring gear 6288. In this embodiment, the ring gear 6288 is formed within the input body 6374 .

[0184] 40 and 43A-44B, the sixth end effector 6040 In this embodiment, first rotary lock RL1 is positioned within drive conduit 6462 near drive bore 6478. The spline 6572 is formed adjacent to the drive spline 6572. The drive spline 6572 is implemented as a bore, as described in more detail below. , releasably attached to the axial lock AL to facilitate retention of the "active" tool 6042. to a corresponding outer transition spline 6574 of a transition gear 6576 configured to The transition gear 6576 also releasably engages the tool body 64 of the "active" tool 6042. 66. The inner transition spline 6580 releasably engages a corresponding tool spline 6580 formed in the inner transition spline 6580. The drive splines 6572 formed in the drive conduit 6462 include The distal end 6482 has a generally frustoconical shape tapering inwardly relative to the second axis A2 toward the distal outlet 6482. The outer transition spline 6574 of the transition gear 6576 meshes with the drive spline 6572. The drive spline 6572 is complementary shaped to the drive spline 6572 so that it is positioned to engage the drive spline 6572. (See Figures 43C-43D.) The internal transition spline 6578 also has a generally frustoconical shape. 6572, but not at the distal exit 6482 as in the drive spline 6572, but at the second axis A2 The "active" tool 6042 tapers inwardly toward the proximal entrance 6480. The tool spline 6580 formed in the tool body 6466 of the inner transition spline 6 578. The internal transition spline of the transition gear 6576 is disposed in meshing engagement with the internal transition spline of the transition gear 6578. It is shaped to be complementary to 6578 (see Figures 43C to 43D).

[0185] The drive spline 6572 is formed in the drive conduit 6462 by a drive shelf 6582 . The drive shelf 6582 is located proximally, as described in more detail below. The axial locking device AL has a flat ring-shaped configuration facing away from the opening 6482. The abutment surface 65 formed on the tool body 6466 of the "active" tool 6042 is fixed via 84. This configuration allows the tool body 6466 to be fitted into the drive bore 6 axial stop A by limiting how far it can be advanced into 478 When L is in the locked configuration ACL, the tool body 6466 rotates along the second axis A2 to the drive conduit. This helps ensure that the sensor is properly positioned relative to the 6462.

[0186] As best shown in FIGS. 43C-43D, in the sixth embodiment, an "active" tool 60 The tool body 6466 of 42 is also disposed between the abutment surface 6584 and the tool spline 6580. The engagement flange 6586 is disposed between the abutment surface 6584 and the defines a flange surface 6588 facing away from the flange surface 6588, wherein the flange surface 6588 is Shaped and positioned to engage the transition surface 6590 of the transition gear 6576. 576 also includes a handling portion 6592 that extends away from the transition surface 6590 to a handling surface 6594. a transition hole extending between the handling surface 6594 and the transition surface 6590 along the second axis A2 6596, an internal transition spline 6578 is formed within the transition bore 6596, and is otherwise defined by a transition hole 6596. The handling portion 6592 and the transition gear 657 A transition notch 6598 is disposed between the outer transition spline 6574 of the 6 and the transition notch 659 8, the axial locking element AL is in locking configuration ACL and is configured to lock the drive conduit 6462 about the second axis A2. When the tool 6042 is secured to rotate simultaneously with the drive conduit 6462, the The relative movement of the tool 6042 with respect to both the tool body 6466 and the drive conduit 6462 and the tool body 6466 of the "active" tool 6042. It is designed to do so.

[0187] In the sixth embodiment, the transition notch is not formed as part of the tool 6042. 6598 is a pair of axial connectors forming part of a lock assembly generally designated 6600. Through engagement with the connector element 6306, it acts as a conduit axial retainer 6472. 43D-44B, the lock assembly 6600 includes a second axis. A lock operably attached to the drive conduit 6462 for simultaneous rotation about A2. The lock housing 6602 includes a proximal entrance to the drive bore 6478. 6480, and the tool 604 is inserted through the proximal entrance 6480 along a second axis A2. The lock housing 6602 is similarly shaped to receive the working end 6470 of the locking mechanism 6602. A slider slot 6604 is provided within the slider element 66 06 is supported for movement in a direction substantially perpendicular to the second axis A2. The element 6306 is coupled to the slider element 6602 for simultaneous movement relative to the lock housing 6602. 06 and axial locking device AL through engagement with transition notch 6598. Work together to define it.

[0188] As best shown in FIGS. 44A-44B, the slider element 6606 is guided by a guide slot 6606. Define 608, and within the guide slot 6608, a guide pin 6610 operably attached to the lock housing 6602 is disposed. Here, through the cooperation between the guide slot 6608 and the guide pin 6610, the slider element position SL1 (see FIG. 44B) related to the release form ACR and the second slider element position SL2 (see FIG. 44A) related to the lock form ACL are moved relative to the second axis A2, and the slider element 6606 is held within the slider slot 6604. The axial connector element 6306 coupled to the slider element 6606 is disposed closer to the second axis A2 when at the second slider element position SL2 than when at the first slider element position SL1. A slider biasing element 6612 disposed within the slider slot 6604 and intervening between the slider element 6606 and the lock housing 6602 moves the slider element 6606 towards the second slider element position SL2. The slider engagement button 6614 is provided integrally with the slider element 6606 and is arranged to move from the second slider element position SL2 to the first slider element position SL1 when engaged by the user. The slider engagement button 6614 is arranged generally perpendicular to the stop surface 6616 defined by the lock housing 6602, and the stop surface 6616 serves as a portion that abuts against the stop element 6558 of the "passive" tool 6042 in the drive assembly 6082 (see FIG. 43B). Here, through the cooperation between the guide slot 6608 and the guide pin 6610, the slider element position SL1 (see FIG. 44B) related to the release form ACR and the second slider element position SL2 (see FIG. 44A) related to the lock form ACL are moved relative to the second axis A2, and the slider element 6606 is held within the slider slot 6604. The axial connector element 6306 coupled to the slider element 6606 is disposed closer to the second axis A2 when at the second slider element position SL2 than when at the first slider element position SL1. A slider biasing element 6612 disposed within the slider slot 6604 and intervening between the slider element 6606 and the lock housing 6602 moves the slider element 6606 towards the second slider element position SL2. The slider engagement button 6614 is provided integrally with the slider element 6606 and is arranged to move from the second slider element position SL2 to the first slider element position SL1 when engaged by the user. The slider engagement button 6614 is arranged generally perpendicular to the stop surface 6616 defined by the lock housing 6602, and the stop surface 6616 serves as a portion that abuts against the stop element 6558 of the "passive" tool 6042 in the drive assembly 6082 (see FIG. 43B). Here, through the cooperation between the guide slot 6608 and the guide pin 6610, the slider element position SL1 (see FIG. 44B) related to the release form ACR and the second slider element position SL2 (see FIG. 44A) related to the lock form ACL are moved relative to the second axis A2, and the slider element 6606 is held within the slider slot 6604. The axial connector element 6306 coupled to the slider element 6606 is disposed closer to the second axis A2 when at the second slider element position SL2 than when at the first slider element position SL1. A slider biasing element 6612 disposed within the slider slot 6604 and intervening between the slider element 6606 and the lock housing 6602 moves the slider element 6606 towards the second slider element position SL2. The slider engagement button 6614 is provided integrally with the slider element 6606 and is arranged to move from the second slider element position SL2 to the first slider element position SL1 when engaged by the user. The slider engagement button 6614 is arranged generally perpendicular to the stop surface 6616 defined by the lock housing 6602, and the stop surface 6616 serves as a portion that abuts against the stop element 6558 of the "passive" tool 6042 in the drive assembly 6082 (see FIG. 43B). Here, through the cooperation between the guide slot 6608 and the guide pin 6610, the slider element position SL1 (see FIG. 44B) related to the release form ACR and the second slider element position SL2 (see FIG. 44A) related to the lock form ACL are moved relative to the second axis A2, and the slider element 6606 is held within the slider slot 6604. The axial connector element 6306 coupled to the slider element 6606 is disposed closer to the second axis A2 when at the second slider element position SL2 than when at the first slider element position SL1. A slider biasing element 6612 disposed within the slider slot 6604 and intervening between the slider element 6606 and the lock housing 6602 moves the slider element 6606 towards the second slider element position SL2. The slider engagement button 6614 is provided integrally with the slider element 6606 and is arranged to move from the second slider element position SL2 to the first slider element position SL1 when engaged by the user. The slider engagement button 6614 is arranged generally perpendicular to the stop surface 6616 defined by the lock housing 6602, and the stop surface 6616 serves as a portion that abuts against the stop element 6558 of the "passive" tool 6042 in the drive assembly 6082 (see FIG. 43B). Here, through the cooperation between the guide slot 6608 and the guide pin 6610, the slider element position SL1 (see FIG. 44B) related to the release form ACR and the second slider element position SL2 (see FIG. 44A) related to the lock form ACL are moved relative to the second axis A2, and the slider element 6606 is held within the slider slot 6604. The axial connector element 6306 coupled to the slider element 6606 is disposed closer to the second axis A2 when at the second slider element position SL2 than when at the first slider element position SL1. A slider biasing element 6612 disposed within the slider slot 6604 and intervening between the slider element 6606 and the lock housing 6602 moves the slider element 6606 towards the second slider element position SL2. The slider engagement button 6614 is provided integrally with the slider element 6606 and is arranged to move from the second slider element position SL2 to the first slider element position SL1 when engaged by the user. The slider engagement button 6614 is arranged generally perpendicular to the stop surface 6616 defined by the lock housing 6602, and the stop surface 6616 serves as a portion that abuts against the stop element 6558 of the "passive" tool 6042 in the drive assembly 6082 (see FIG. 43B). Here, through the cooperation between the guide slot 6608 and the guide pin 6610, the slider element position SL1 (see FIG. 44B) related to the release form ACR and the second slider element position SL2 (see FIG. 44A) related to the lock form ACL are moved relative to the second axis A2, and the slider element 6606 is held within the slider slot 6604. The axial connector element 6306 coupled to the slider element 6606 is disposed closer to the second axis A2 when at the second slider element position SL2 than when at the first slider element position SL1. A slider biasing element 6612 disposed within the slider slot 6604 and intervening between the slider element 6606 and the lock housing 6602 moves the slider element 6606 towards the second slider element position SL2. The slider engagement button 6614 is provided integrally with the slider element 6606 and is arranged to move from the second slider element position SL2 to the first slider element position SL1 when engaged by the user. The slider engagement button 6614 is arranged generally perpendicular to the stop surface 6616 defined by the lock housing 6602, and the stop surface 6616 serves as a portion that abuts against the stop element 6558 of the "passive" tool 6042 in the drive assembly 6082 (see FIG. 43B). Here, through the cooperation between the guide slot 6608 and the guide pin 6610, the slider element position SL1 (see FIG. 44B) related to the release form ACR and the second slider element position SL2 (see FIG. 44A) related to the lock form ACL are moved relative to the second axis A2, and the slider element 6606 is held within the slider slot 6604. The axial connector element 6306 coupled to the slider element 6606 is disposed closer to the second axis A2 when at the second slider element position SL2 than when at the first slider element position SL1. A slider biasing element 6612 disposed within the slider slot 6604 and intervening between the slider element 6606 and the lock housing 6602 moves the slider element 6606 towards the second slider element position SL2. The slider engagement button 6614 is provided integrally with the slider element 6606 and is arranged to move from the second slider element position SL2 to the first slider element position SL1 when engaged by the user. The slider engagement button 6614 is arranged generally perpendicular to the stop surface 6616 defined by the lock housing 6602, and the stop surface 6616 serves as a portion that abuts against the stop element 6558 of the "passive" tool 6042 in the drive assembly 6082 (see FIG. 43B). Here, through the cooperation between the guide slot 6608 and the guide pin 6610, the slider element position SL1 (see FIG. 44B) related to the release form ACR and the second slider element position SL2 (see FIG. 44A) related to the lock form ACL are moved relative to the second axis A2, and the slider element 6606 is held within the slider slot 6604. The axial connector element 6306 coupled to the slider element 6606 is disposed closer to the second axis A2 when at the second slider element position SL2 than when at the first slider element position SL1. A slider biasing element 6612 disposed within the slider slot 6604 and intervening between the slider element 6606 and the lock housing 6602 moves the slider element 6606 towards the second slider element position SL2. The slider engagement button 6614 is provided integrally with the slider element 6606 and is arranged to move from the second slider element position SL2 to the first slider element position SL1 when engaged by the user. The slider engagement button 6614 is arranged generally perpendicular to the stop surface 6616 defined by the lock housing 6602, and the stop surface 6616 serves as a portion that abuts against the stop element 6558 of the "passive" tool 6042 in the drive assembly 6082 (see FIG. 43B). Here, through the cooperation between the guide slot 6608 and the guide pin 6610, the slider element position SL1 (see FIG. 44B) related to the release form ACR and the second slider element position SL2 (see FIG. 44A) related to the lock form ACL are moved relative to the second axis A2, and the slider element 6606 is held within the slider slot 6604. The axial connector element 6306 coupled to the slider element 6606 is disposed closer to the second axis A2 when at the second slider element position SL2 than when at the first slider element position SL1. A slider biasing element 6612 disposed within the slider slot 6604 and intervening between the slider element 6606 and the lock housing 6602 moves the slider element 6606 towards the second slider element position SL2. The slider engagement button 6614 is provided integrally with the slider element 6606 and is arranged to move from the second slider element position SL2 to the first slider element position SL1 when engaged by the user. The slider engagement button 6614 is arranged generally perpendicular to the stop surface 6616 defined by the lock housing 6602, and the stop surface 6616 serves as a portion that abuts against the stop element 6558 of the "passive" tool 6042 in the drive assembly 6082 (see FIG. 43B). Here, through the cooperation between the guide slot 6608 and the guide pin 6610, the slider element position SL1 (see FIG. 44B) related to the release form ACR and the second slider element position SL2 (see FIG. 44A) related to the lock form ACL are moved relative to the second axis A2, and the slider element 6606 is held within the slider slot 6604. The axial connector element 6306 coupled to the slider element 6606 is disposed closer to the second axis A2 when at the second slider element position SL2 than when at the first slider element position SL1. A slider biasing element 6612 disposed within the slider slot 6604 and intervening between the slider element 6606 and the lock housing 6602 moves the slider element 6606 towards the second slider element position SL2. The slider engagement button 6614 is provided integrally with the slider element 6606 and is arranged to move from the second slider element position SL2 to the first slider element position SL1 when engaged by the user. The slider engagement button 6614 is arranged generally perpendicular to the stop surface 6616 defined by the lock housing 6602, and the stop surface 6616 serves as a portion that abuts against the stop element 6558 of the "passive" tool 6042 in the drive assembly 6082 (see FIG. 43B). Here, through the cooperation between the guide slot 6608 and the guide pin 6610, the slider element position SL1 (see FIG. 44B) related to the release form ACR and the second slider element position SL2 (see FIG. 44A) related to the lock form ACL are moved relative to the second axis A2, and the slider element 6606 is held within the slider slot 6604. The axial connector element 6306 coupled to the slider element 6606 is disposed closer to the second axis A2 when at the second slider element position SL2 than when at the first slider element position SL1. A slider biasing element 6612 disposed within the slider slot 6604 and intervening between the slider element 6606 and the lock housing 6602 moves the slider element 6606 towards the second slider element position SL2. The slider engagement button 6614 is provided integrally with the slider element 6606 and is arranged to move from the second slider element position SL2 to the first slider element position SL1 when engaged by the user. The slider engagement button 6614 is arranged generally perpendicular to the stop surface 6616 defined by the lock housing 6602, and the stop surface 6616 serves as a portion that abuts against the stop element 6558 of the "passive" tool 6042 in the drive assembly 6082 (see FIG.​​​​​​​​​​​​​​​​​6478 into the proximal entrance 6480 and advance along the second axis A2 to the distal exit 64 82, and in the sixth embodiment, the distal outlet 6482 is located at the bottom cover 652 4 by a bottom cap 6618 operably attached to the drive conduit 6462 adjacent Here, the tool body 6466 is defined such that the abutment surface 6584 of the tool 6042 is a driving guide. advancing the drive bore 6478 until it engages the drive shelf 6582 of the tube 6462; Next, the user grasps the handling portion 6592 of the transition gear 6576 and 042 through the transition hole 6596, and the transition gear 6576 is 6466 along axis A2 to align transition surface 6590 with flange surface 6588 of tool body 6466. to abut flange surface 6588. Alternatively, the user may The transition gear 6576 is "placed" onto the tool 6042 and the internal transition spline 6578 is attached to the tool. 6470 into meshing engagement with the drive spline 6580 and then inserting the working end 6470 into the proximal position of the drive bore 6478. The drive spline 6572 can be inserted into the inlet 6480. The inner transition spline 6578 engages and meshes with the tool spline 65 80 to define a first rotary lock RL1 and thus drive conduit 6 462, transition gear 6576, and tool 6042 rotate simultaneously about second axis A2. Furthermore, the transition surface 6590 of the transition gear 6576 engages the engagement flange 65 of the tool 6042. When the axial lock AL abuts against the slider element 6606, the axial lock AL is held by the slider element 6606. Between the directional connector element 6306 and the transition notch 6598 formed in the transition gear 6576 6042 and the transition gear 65. 76 and the drive conduit 6462 along the second axis A2.

[0190] As mentioned above, a seventh embodiment of the end effector of surgical system 30 is shown in FIG. 48B. In the following description, the first embodiment of the end effector 40 The structures and components of the seventh embodiment are the same as or correspond in other ways to the structures and components of the seventh embodiment. Components have the same reference number incremented by 7000. End effector 7040 Many of the components and features of the seventh embodiment are the same as those of the first embodiment of the end effector 40 described above. , which are substantially similar to those of the embodiments of , the seventh embodiment of the end effector 7040 and the first embodiment of the end effector 40 Only specific differences between the embodiments will be described below, and common features between the embodiments will be described. Only some of the elements and features are discussed herein and shown in the drawings.

[0191] Therefore, without limitation, unless otherwise indicated below, The description of the first embodiment of the end effector 40 is now given in conjunction with the seventh embodiment of the end effector 7040. Similarly, the corresponding components of the previous embodiments may be incorporated by reference. Specific components of the seventh embodiment of the end effector 7040 are similar in design and features. Elements and features will be further illustrated by the same reference numerals 1000 and 1100 for all intervening embodiments. If reference is made to a drawing or otherwise as having a number incremented by 1000, (For example, in the case of the seventh embodiment, the same method as described in relation to the sixth embodiment can be used.) The number of components added would be increased by 1000, and the configuration described in relation to the fifth embodiment would be The elements should be increased by 2000, and the components described in relation to the fourth embodiment should be: The components described in connection with the third embodiment should be increased by 4000. The components described in relation to the second embodiment will increase by 5000. (It should be).

[0192] Referring now to Figures 45-48B, a fixture 7078, a rotating device 7080, and its accessories are shown. actuator 7166 (shown diagrammatically), and an engine with drive assembly 7082. A seventh embodiment of the do-effector 7040 is shown schematically. In comparison to the configuration, the seventh embodiment of the end effector 7040 generally has the same type The actuator assembly 7088 is driven by the following drive assembly 7082: As will be described in detail, in a manner similar to the fifth and sixth embodiments, drive conduit 7462 7042 in a "top loading" manner.

[0193] In the seventh embodiment, different configurations of the rotary cutting tool 7044 and scalpel tool 7620 are used. Two exemplary types of tools 7042 are shown in FIG. 46, including: The cutting tool 7044 is rotated simultaneously with the drive conduit 7462 about a second axis A2. The scalpel tool 7620 is realized as an adapted "active" tool 7042, and the scalpel tool 7620 is realized as a "passive" tool. In relation to the sixth embodiment of the end effector 6040, As with the dissection tool 6544 described above, the illustrated scalpel tool 7620 and rotary cutting tool 7044 is similarly associated with a knob 7046 disposed on an interface end 7468 of the tool body 7466. However, as shown in FIG. 47C, the knob 755 of the rotary cutting tool 7044 2 is connected to the interface end 7468 via a bearing 7262 operably mounted thereon. 7466 and are arranged to rotate independently of the tool body 7466. In this embodiment, the illustrated rotary cutting tool 7044 is not equipped with any type of manual interface. The first rotary stop RL1 and the axial stop AL of the drive assembly 7082 are used to lock the drive assembly 7082 in place. While held in place, the drive conduit 7462 rotates about a second axis A2 through engagement with the drive conduit 7462, Each of these is described in more detail below. In other words, in this embodiment: The rotary cutting tool 7044 is "manually" rotated by a user about a second axis A2. Instead, the knob can be held by the user. The rotation is transmitted back to the user's hand using the rotary device 7080. The working end 7470 rotates about the second axis A2 without any rotation. However, other configurations are contemplated. The one or more tools 7042 may be any of the tools shown and described in connection with the previous embodiments. It will be appreciated that a manual interface similar to that of the present invention may also be provided.

[0194] Referring now to FIGS. 47A-48B, a seventh embodiment of an end effector 7040 is shown. The drive assembly 7082 similarly utilizes a drive conduit 7462 to drive the rotating device 7080. The "top row" of tool 7042 rotates about a second axis A2 via the torque generated by the Again, the gear train 7084 facilitates the power input A planetary type reduction gear set is interposed between the shaft 7252 and the carrier shaft 7422. The input gear 7274 and the output gear 7276 have different structures. Further reduction in speed is provided by bevel gear set 7272. In this embodiment, the input gear 7274 is coupled to the carrier shaft 7422, whereas The output gear 7276 is then guided to a tapered conduit 7622 that forms part of the collet mechanism 7624. Combined, the collet mechanism 7624 controls the axial and rotational movement of the “active” tool 7042. The first rotational lock RL1 and the axial lock AL are configured to facilitate retention. Here, tapered conduit 7622 is inserted into driver 7250 of drive assembly 7082. and supported for rotation about a second axis A2 via a bearing 7262 disposed thereon, The bottom cap 7618 and the top cap 7626 rotate simultaneously about a second axis A2. (See Figures 47A to 47C.) The tapered conduit 7622 has a tapered hole 7628. The bore 7628 extends along a second axis A in a direction away from the proximal inlet 7480 and toward the distal outlet 7482. The tapered hole 7628 has a generally frustoconical shape with a radius increasing relative to the diameter of the tapered hole 7628. In this embodiment, the collet 7630 is generally The collet defines a vascular conduit 7462 extending from the proximal collet end 7634 to the distal collet end 7636. It has an elastic collet body 7632.

[0195] As best shown in FIG. 47A, the elastic collet body 7632 has an "ER collet" configuration. The collet hole 763 is realized as a single, integral component having a generally cylindrical shape. 8, and collet bore 7638 defines drive bore 7478. As described in more detail below 7466. The resilient collet body 7632 engages the tool body 7466 to engage the tool 70. 42, the second axis A2 is at least partially radially inwardly deflectable to facilitate retention of the second axis A2. Collet 7630 is also configured to fit into tapered bore 7628 of tapered conduit 7622. a proximal collet portion 7640 shaped to be received within the proximal inlet 7480; A generally frustoconical shape with a decreasing radius relative to the second axis A2 in a direction away from and toward the distal outlet 7482 The proximal collet portion 7640 and the distal collet portion 7642 have a similar shape. Collet notch 7644 disposed between collet portion 7642 and collet notch 7644.

[0196] Collet notch 7644 is positioned to be engaged by a user. 648, where the collet knob 7648 is Collet tensioner 7650 of collet mechanism 7624 coupled to collet 7630. 47B and 48B) and the second tensioner Position TP1 and position TP2 (see Figures 47A and 48A). The collet position TP1 allows relative movement between the tool 7042 and the collet 7630. The second tensioner position TP2 is associated with the release configuration ACR of the axial locking element AL and is Axial locking mechanism AL restricts relative movement between 042 and collet 7630 Related to ACLs.

[0197] As best shown in FIGS. 47A and 48A-48B, collet tensioner 765 Collet knob 7648 of 0 is inserted into knob slot 765 formed in collet knob 7648. 4, via a pair of knob guides 7652 (e.g., fasteners) extending through the drive assembly. Operatively attached to bottom cap 7618 of bridge 7082. Knob slot 765 4 is a generally threaded knob having a first knob slot end 7656 and a second knob slot end 7658. A first knob slot end 7656 and a second knob slot end 7658 have a helical shape. holds the knob guide 7652, thereby supporting the collet tensioner 7650. The tensioner is shaped to define a first tensioner position TP1 and a second tensioner position TP2. A knob biasing element 7660 is disposed between the collet knob 7648 and the bottom cap 7618. 47B and 47C, and collet tensioner 7650 is positioned at first tensioner position TP1 (FIG. 47B and FIG. 48B). This configuration allows the knob guide 7652 to Rotate the knob 7648 relative to the bottom cap 7618 until the first knob slot end 7648 engages the 656 and second knob slot end 7658 to act as a "detent" to The second knob slot end 7656 and the second knob slot end 7658 can be retained within the In other words, the user rotates the collet knob 7648 to release the ACR (FIG. 4 7B and 48B) and the locking form ACL (see FIGS. 47A and 48A). The axial stop AL can be moved.

[0198] Due to the configuration of the knob slot 7654 described above, the control is controlled via force applied by the user. As a result of the rotation of collet knob 7648, collet knob 7648 also translates along second axis A2. In addition, the collet retainer 7646 of the collet knob 7648 and the collet 7630 Collet knob 7648 rotates due to engagement between collet knob 7648 and collet notch 7644. The nozzle 7630 also translates along a second axis A2 within the tapered bore 7628 of the tapered conduit 7622. Now, the user can engage the collet knob 7648 to tighten the collet tensioner 7650. From the first tensioner position TP1 (see Figures 47B and 48B) to the second tensioner position When moved to TP2 (see Figures 47A, 47C, and 48A), collet 7630 moves toward the proximal inlet 7480 and between the proximal collet portion 7640 and the tapered bore 7628. The "active" tool 7042 is compressed radially inward toward the second axis A2 through engagement of the In this case, the tool body 7466 of the tool 7042 is inserted into the drive shaft defined by the collet hole 7638. When placed within bore 7478, this compression causes at least The other portion of the tool 7042 is pressed against the tool body 7466, clamping the tool 7042 to the drive conduit 7462. "locking" the first rotary locking member RL1 and the axial locking member AL, thereby preventing the movement of both the first rotary locking member RL1 and the axial locking member AL. For "passive" tools such as the female tool 7620, the collet tensioner 76 50 is utilized in a first tensioner position TP1 and is moved to a second tensioner position TP2. It will never be possible.

[0199] The seventh embodiment of the end effector 7040 includes both "active" and "passive" tools. The drive conduit 7462 is also "top-loading" along a second axis A2. and can be removed from the drive conduit 7462. When the tensioner 7650 is in the first tensioner position TP1 (see FIG. 47B), The working end 7470 is inserted into the proximal entrance 7480 and aligned along the second axis A2 with the collet bore 7638 ( In this embodiment, the drive hole 7478 is advanced into the distal exit 7482 (which defines the drive hole 7478). In an embodiment, the collet 7648 may extend from the collet 7648. As shown in FIG. 8C, certain types of tools 7042 may be attached to interface ends 7468. The stop fixture 7662 may include a stop surface 7616 ( In this embodiment, the tool abuts against the upper cap 7626 (defined by the upper cap 7626). 7042 from further advancement along second axis A2 into drive bore 7478. However, other configurations are contemplated, and the drive conduit along the second axis A2 It is understood that the position of tool 7042 relative to 7462 may be constrained in other ways. When the tool 7042 is in the "active" configuration, the tool To facilitate driving the 7042 about the second axis A2, a collet tensioner The 7650 can be moved from a first tensioner position TP1 to a second tensioner position TP2. However, if the tool is in a "passive" configuration, the collet tensioner 7650 As mentioned, the first tensioner position TP1 can remain.

[0200] As mentioned above, an eighth embodiment of the end effector of the surgical system 30 is shown in FIG. 63A to 63F. In the following description, the first embodiment of the end effector 40 The structure and components of the eighth embodiment are the same as or correspond in other ways to the structure and components of Components have the same reference number incremented by 8000. End effector 804 Many of the components and features of the eighth embodiment of the end effector 40 described above are the same as those of the first embodiment of the end effector 40 described above. 1 is substantially similar to that of the first embodiment, for purposes of clarity, consistency, and brevity. The eighth embodiment of the end effector 8040 and the first embodiment of the end effector 40 Only specific differences between the embodiments are described below, and common features between these embodiments are not included. Only some of the components and features are discussed herein and shown in the drawings.

[0201] Therefore, without limitation, unless otherwise indicated below, The description of the first embodiment of the end effector 40 is now given in conjunction with the eighth embodiment of the end effector 8040. Similarly, the corresponding components of the previous embodiments may be incorporated by reference. Specific components of the eighth embodiment of the end effector 8040 are similar in design and features. Elements and features will be further illustrated by the same reference numerals 1000 and 1100 for all intervening embodiments. If reference is made to a drawing or otherwise as having a number incremented by 1000, (For example, in the case of the eighth embodiment, the same method as described in relation to the seventh embodiment can be used.) The number of components added would be increased by 1000, and the configuration described in relation to the sixth embodiment would be The elements should be increased by 2000, and the components described in relation to the fifth embodiment should be: The components described in connection with the fourth embodiment should be increased by 4000. The components described in relation to the third embodiment will increase by 5000. The components described in relation to the second embodiment would be increased by 6000. (This is the case.)

[0202] 49A-63F, the fixture 8078, the rotating equipment 8080, and The end effector 808 includes an actuator 8166 and a drive assembly 8082. An eighth embodiment of the present invention is shown in schematic form in comparison with the other embodiments described above. The eighth embodiment of the end effector 8040 includes a rotating machine 8080 and a drive assembly. In other words, in the eighth embodiment, The drive assembly 8082 is arranged to move relative to the actuator 8166. Additionally, as described in more detail below, an eighth embodiment of the end effector 8040 The configuration may also be such that the first axis A1 is different from the second axis A2 as in the embodiments previously described herein. The first axis A1 is configured to coincide with the second axis A2, rather than being perpendicular (e.g., perpendicular). More specifically, in the eighth embodiment, the first axis A1 is also an actuator 816 6, and the second axis A2 is also defined by the rotational torque generated by the drive assembly. The rotation of the tool 8042 fixed to the rib 8082 determines the rotation of the tool 8042. 1. This embodiment is similar to the embodiment of FIG. 1, except that the axes A1 and A2 are the same in this embodiment. When compared to the other embodiments described above, the eighth embodiment of the end effector 8040: As will be explained in more detail below, as with the fifth, sixth and seventh embodiments, the drive conductor cooperate to secure tool 8042 in a "top loading" fashion via tube 8462 The actuator assembly 8088, the drive assembly 8082, and the first rotary locking device RL1 and a second rotary stop RL2, and an axial stop AL are used.

[0203] 49A-49B, as described above, the end effector 8040 In the eighth embodiment, the drive assembly 8082 and the actuator of the rotating device 8080 8166 is integrally formed, so that the device housing 8168 and the driver 8250 are The fixture 8078 is realized by a component (hereinafter referred to as the driver 8250). operatively attached to the body 8250 or otherwise formed as part of the driver body 8250. and releasable to a coupling 38 of a robot arm 36 of a surgical robot 32 (see FIG. 1). In addition to the mounting fixture 8078, the manipulator assembly 8088 and retention mechanism 8664 are also operably attached to driver 8250 . Furthermore, in the eighth embodiment of the end effector 8040, the driver 8250 is Contains the eta subassembly 8666, reduction gear set 8286, and drive conduit 8462. 50, the actuator subassembly 8666 is and its actuator 8166, or otherwise actuating the rotating equipment 8080 and its 56A-59B, which define an actuator 8166. As illustrated, the retention mechanism 8664 includes a protective cover 8350 and is configured to extend along a second axis A2. The drive conduit 8462 is configured to facilitate retention of the tool 8042 in the drive conduit 8462.

[0204] As best seen in FIG. 50, the actuator subassembly 8666 generally comprises a rotor subassembly 8668 and stator subassembly 8670. The assembly 8668 is adapted to be received distally within the stator subassembly 8670. The stator subassembly is held in the driver 8250 via the lower cover 8524. The assembly 8670 is received proximally within the driver 8250 and includes an actuator end plate 867 2, and the actuator end plate 8672 is threadably engaged with the driver 8250. (See also FIG. 57.) The stator subassembly 8670 is 8674 (shown schematically) and a motor sensor 8676. is used, inter alia, to cause the commutation of the actuator 8166, In the exemplary embodiment shown herein, the actuator 8166 is In-runner brushless DC electric motor with rotor 8678 formed as part of 668 It is realized as data.

[0205] More specifically, as best shown in FIG. 51, rotor assembly 8668 includes a rotor 8678, reduction gear set 8286, and drive conduit 8462. 8678 has a generally tubular shape and is formed in a perch 86 80, and thus in this embodiment also has a generally tubular shape. The shaft 8422 extends through the rotor 8678. 82 secures the rotor 8678 to the carrier shaft 8422 via a threaded engagement, The shaft 8422 is supported by a bearing 8262 disposed within the driver 8250. Therefore, the rotor 8678 and the carrier shaft 8 of the reduction gear set 8286 422 rotates simultaneously around the second axis A2 (and in this embodiment, the first axis A1). In the eighth embodiment, the carrier shaft 8422 also includes a reduction gear set 8286. A second carrier 8298B defines a second rotational lock, as described in more detail below. 8082. The drive bore 8478 of the drive assembly 8082 is provided with a proximal entrance 8480. Determine.

[0206] 51 and 57, the drive conduit 8462 extends approximately along a second axis A2. and a proximal conduit end 8684 extending between the proximal conduit end 8684 and the distal conduit end 8686. 8686 forms a part of the drive bore 8478 of the drive assembly 8082. The locking element RL1 is inserted into a first notch 86 formed in the proximal conduit end 8684 of the drive conduit 8462. 88 and rotates about a second axis A2, as described in more detail below. The reduction gear set is configured to rotatably fix a particular tool 8042 so that the reduction gear set The first sun gear 8292A of 8286 is rotated simultaneously with the drive conduit 8462. The distal conduit end 868 is secured to the distal conduit end 868 via one or more retaining pins 8690 (see FIGS. 59A-59B). 6. The first sun gear 8292A is meshed with the first set of planetary gears 8290A. The first set of planetary gears 8290A are also arranged to mesh with the ring gear 8288. The first set of planetary gears 8290A are arranged to engage with the first carrier 829 8A, and the first carrier 8298A is supported by a carrier shaft 8422. The second carrier 8298B is coupled to the second sun gear 8292B, as defined by the second carrier 8298B. The second sun gear 8292B has a generally tubular shape, and the drive conduit 8462 extends through the second sun gear 8292B. Here, the first set of planetary gears 8290A is supported by bearings 8262 and The bearing 8262 is connected to a first set of pins 8294A coupled to a first carrier 8298A. Supported by

[0207] The second sun gear 8292B is secured to the sun gear 8292A via one or more retaining pins 8690 (see FIG. 57). and fixed to the first carrier 8298A and meshingly engaged with the second set of planetary gears 8290B. The second set of planet gears 8290B are also arranged to mesh with the ring gear 8288. a second carrier 8422 defined by a carrier shaft 8422 and arranged to mate with the first carrier 8422; 298B. More specifically, in this embodiment, the carrier shaft 8 422 extends between a distal carrier end 8692 and a proximal carrier end 8694 and is connected to a reduction gear set. A second carrier 8298B of the mat 8286 is disposed adjacent to the distal carrier end 8692. Here, the second set of planetary gears 8290B is supported by bearings 8262. , bearing 8262 is connected to a second set of pins 829 coupled to a second carrier 8298B. As will be explained in more detail below, the second rotary lock RL2 is supported by , unlike the first rotary lock RL1, the proximal carrier end 86 of the carrier shaft 8422 94, and is realized as a second notch 8696 formed in the first rotary locking device RL1. Rotate the particular tool 8042 so that it rotates about the second axis A2 without depending on The device is configured to be possibly fixed.

[0208] In the eighth embodiment of the end effector 8040, the reduction gear set 8286 shaft 8422 (as described above) is connected to rotor 8678 of actuator 8166 A second rotation lock R defined by a second notch 8696 formed in the L2 and a first notch 8688 formed in the drive conduit 8462 of the drive assembly 8082. A torque reduction (and speed increase) occurs between the first rotary lock RL1 defined by In other words, the eighth embodiment uses a two-stage planetary configuration that provides a drive conduit 84 62 (and the first rotary lock RL1) is connected to the actuator 8166 (and the second rotary lock In the eighth embodiment, the second rotation lock (RL2) rotates at a faster speed than the first rotation lock (RL3). The rotation of the tool RL2 about the second axis A2 is parallel to the first axis A1 of the actuator 8166 (this In the embodiment, this occurs in a 1:1 ratio with respect to rotation about the second axis A2. Relative rotation between the drive conduit 8462 and the carrier shaft 8422 drives the first carrier 82 98A and via bearing 8262 supported within carrier shaft 8422. As will be explained in more detail below, the tool 8042 Rotation stop RL1 engages and rotates simultaneously with drive conduit 8462, or a second rotation stop Whether the tool engages with the locking device RL2 and rotates simultaneously with the actuator 8166, When the tool 8042 is fixed to the end effector 8040, the tool body 8466 At least a portion extends through drive conduit 8462 along second axis A2.

[0209] As described above, the eighth embodiment of the end effector 8040 may be implemented using a different configuration of manipulation tool. The input operation tool 8092 is provided to a user. When engaged, the tool rotates via the rotational torque generated by the actuator 8166. 50. As best seen in FIG. The operating tool assembly 8088 generally includes a first operating subassembly 8698 and a or a plurality of fasteners or the like, and is operably attached to the first operating subassembly 8698. and a second operating subassembly 8700 attached thereto (see FIG. 57). The first operating subassembly 8698 includes an upper mounting plate 8702 and a gripping fixture 8 704, with a second operating subassembly 8698 attached to the grip fixture 8704. As will be described in more detail below, the retention mechanism 8664 is attached to the upper mounting plate 8702. Operatively mounted adjacent to the upper mounting plate 8702 is also a Additionally, the grip fixture 8704 supports a pair of indicator housings. As will be described in more detail below, the protective cover 8350 of the retention mechanism 8664 may be releasably secured. The protective lock subassembly 8708 is configured to:

[0210] In addition to the actuator end plate 8672, a circuit board 8710 and an intermediate mounting plate 8712 are also included. Also, the upper mounting of the stator subassembly 8670 and the first operating subassembly 8698 plate 8702, where the actuator end plate 8672 is attached via a threaded engagement. and the circuit board 8710 is secured to the driver 8250 via one or more fasteners. The intermediate mounting plate 8712 is secured to one or more of the actuator end plates 8672. The upper mounting plate 8702 is secured to the driver 8250 via a plurality of fasteners. The intermediate mounting plate 8712 is secured to the intermediate mounting plate 8712 via a number of fasteners. Supports seals 8270 and fasteners (e.g., bolts, circlips, etc.) and generally This facilitates ease of assembly of the end effector 8040.

[0211] In the illustrated embodiment, the stator subassembly 8670 includes an indexing tab 8714. , the indexing tab 8714 is spaced from the bottom cover 8524 and the actuator end plate 8672 and a board opening 8718 formed in the circuit board 8710. This configuration extends through both the driver 8250 and the facilitates alignment of the stator assembly 8670 with respect to the motor sensor 8676 In the illustrated embodiment, the motor sensor 8676 is mounted on the circuit board 8710. In electrical communication with the attached board controller 8720 (shown schematically, electrical connections not shown) Here, the board controller 8720 is arranged to and, inter alia, communicates with other components of the surgical system 30, such as the actuator 8166. and facilitates the commutation and / or movement of various end effectors 8040. Controlling inputs (e.g., additional sensors) and / or outputs (e.g., indicators) It can be used for this purpose.

[0212] 52-54, the second manipulation subassembly 8700 includes one or The grip fitting 87 of the first manipulation subassembly 8698 is secured by a plurality of fasteners or the like. 04. The second manipulation subassembly 8700 generally comprises a A cap 8090, an input operation tool 8092, and an operation biasing element located within the input operation tool 8092. 8212 (see FIG. 54). Here, an eighth embodiment of the end effector 8040 Then, the movement of the input manipulation tool 8092 between the first input position I1 and the second input position I2 is as follows: The operation sensor 87 is supported in an operation sensor keeper 8724 fixed to the grip 8090. 22 (see FIGS. 53A and 53B), and the input operation tool 8092 is a pin and It is held against the grip 8090 via a slot arrangement (not shown in detail).

[0213] The operation sensor 8722 is connected to the board controller 872 mounted on the circuit board 8710. 50, electrical connections not shown), and the input manipulation device 80 Movement of the first operating transmitter 8726 and the second operating transmitter 8728 coupled to 92 , the input position I1 and the input position I2 move simultaneously (see FIG. 54). For this purpose, when the input operation tool 8092 is in the first input position I1, the first operation tool When the transmitter 8726 is disposed adjacent to the operation sensor 8722 and is at the second input position I2, The second operation sensor 8728 is configured to be positioned adjacent to the operation sensor 8722. The operation sensor keeper 8724 also supports an input button 8730, which Similarly, it is in electrical communication with the board controller 8720 (see FIG. 50, electrical connections not shown). and is positioned to be engaged by a user. The grip cover 8734 is secured to the grip 8090 via a fastener. When positioned within cover opening 8732 and engaged by a user, The input buttons 8730 are positioned to facilitate control of the end effector 80. 40. The device is configured to facilitate control of multiple different aspects of the device (e.g., switching to haptic mode). It will be appreciated that other configurations are also contemplated.

[0214] In addition to the input operation device 8092 and the input button 8730, a second operation subassembly 8 700 also includes a switch between left and right switch positions (not shown in detail) via engagement by the user. supported by switch shaft 8738 to pivot relative to grip 8090 An input switch 8736 is provided, which is in electrical communication with the board controller 8720. A switch sensor 8740 disposed at is located within the grip 8090 (see FIG. 50 ). (Electrical connections not shown). The switch sensor 8740 is coupled to the input switch 8736. In response to the movement of the switch transmitter 8742, it simultaneously moves relative to the grip 8090. In the embodiment shown, the input switch 8736 is moved to the left or right switch position during disengagement from the user. A switch detent arrangement, generally designated 8744, is provided to maintain one of the positions. Although not shown in detail, the switch transmitter 8742 is connected to the switch detent arrangement 87 44 is adjacent to the switch sensor 8740 in one of the left and right switch positions maintained by the and spaced apart from the switch sensor 8740 at the other of the left and right switch positions. Thus, the board controller 8720 can distinguish between the left and right switch positions. Like the input button 8730 described above, the input switch 8736 can be used to , can facilitate additional control of the surgical system 30. As a non-limiting example, Movement of input switch 8736 between the described left and right switch positions may be achieved by, for example, tool 8042 in a clockwise and counterclockwise direction about the second axis A2, respectively. This allows for the actuator 8166 to operate in both the "forward" and "reverse" directions. Other configurations are contemplated.

[0215] Referring now to FIGS. 55-57, the first operating subassembly 8698 includes a first protective To facilitate releasably securing the protective cover 8350 of the retention mechanism 8664 at position U1. In the eighth embodiment, the first protection position U1 is configured so that the tool 8042 is and the second rotary locking member RL2, The axial locking device AL also ensures that the bearing is held axially. As will be understood from the description of the retention mechanism 8664, the first protection position U1 also corresponds to the locked configuration. The axial lock AL is configured to operate at the ACL, and the end effector 2040 is configured as described above. Unlike the second embodiment, access to the manual interface 8094 is facilitated.

[0216] In order to maintain the operation of the axial locking device AL in the locked configuration ACL, the first operating sub-device The protective lock subassembly 8708 of assembly 8698 is attached to grip fixture 8704. To this end, the protective cover 8350 of the retention mechanism 8664 is selectively restricted from moving relative to the retention mechanism 8664. As best shown in FIG. 55, the protective lock subassembly 8708 is attached to the keeper fixture 87 50 to the grip fixture 8704. A support supported to pivot relative to the grip fixture 8704 via a support 8748 The protective lever 8746 is provided on the lever fastener shank 8748. and a lever pawl 8752 is provided between a pair of washers 8214 supported by the lever pawl 8752. Lever pawl 8752 is actuated by lever biasing element 8756, as described in more detail below. and positioned to engage pawl stop member 8754 of retention mechanism 8664. The tool 8750 also includes a protection lever for simultaneous movement between a locked configuration ACL and a released configuration ACR. Lever sensor 875 responsive to movement of lever transmitter 8760 coupled to bar 8746 8. The protective lock subassembly 8708 also couples to a keeper fixture 8750. and upper vertical stops 8762, each coupled to a grip fixture 8704. As will be explained in more detail below, In the lock-type ACL, the pawl stop member 8754 is comprised of a lever pawl 8752 and a side stop 8766. The upper vertical stop 8762 and the lower vertical stop 8764 are arranged to engage between the Each of the upper and lower vertical members 8768 and 8769 is connected to the retention mechanism 8664. 56C.

[0217] Continuing to refer to Figure 55, the protective lock subassembly of the first operating subassembly 8698 Assembly 8708 also includes a lower vertical stop 8764 within grip fixture 8704. The protective sensor 8772 is connected to the retention mechanism 8664. Responds to changes in the position of the integrated protective transmitter 8774 (see Figures 56B and 56D) Both the protection sensor 8772 and the lever sensor 8758 are connected to the board controller 872. 0 (see FIG. 50, electrical connections not shown), and As will be explained in more detail below, the axial locking element AL between the locked configuration ACL and the released configuration ACR Furthermore, the upper handle of the first operating subassembly 8698 cooperates to determine the operation of the Indicator housings 8706 coupled to mounting plates 8702 each contain a pair of indicators. a data module 8776 (e.g., a light emitting diode), and an indicator module 8 776 is similarly arranged in electrical communication with the board controller 8720 (FIG. 5 0, electrical connections not shown), various corresponding structures associated with the end effector 8040. In response to configuration or operating parameters or otherwise predetermined configuration or operating parameters Provides visual feedback to the user by changing color, state, brightness, etc. As a non-limiting example, indicator module 8776 The axial locking device AL can emit red light when the axial locking device AL is in the release configuration ACR, and the axial locking device AL can emit red light when the axial locking device AL is in the release configuration ACR. When the locking element AL is in the locked configuration ACL, a green light can be emitted. is also contemplated.

[0218] Operable to the first operating subassembly 8698 and the second operating subassembly 8700 Various electrical components mounted on the board and the circuit board 8710 Electrical communication between the Controller 8720 and / or other components is limited to Although not intended to be a standard, it may be facilitated in several different ways, including wired connections, wireless communications, etc. It will be appreciated that the eighth embodiment of the end effector 8040 may further include The manipulator assembly 8088 is generally disposed for movement relative to the driver 8250. However, in some embodiments, all or a portion of the manipulator assembly 8088 may include: be configured to move or otherwise be selectively positioned by a user. As a non-limiting example, all or part of the grip 8090 may be One or more sensors, buttons, etc. may be connected to the circuit board 8710 and / or the driver. The grip 8090 is movable (e.g., rotatable) so that it moves simultaneously with the body 8250. In such embodiments, the disclosure of which is incorporated herein by reference in its entirety. The Rotating Switch Sensor for a U.S. Provisional Patent Application No. 2018 / 05 / 31, filed May 31, 2018, entitled "Botic System" As described in US Pat. No. 62 / 678,838, electronic communications can be facilitated. Other configurations are also contemplated.

[0219] Referring now to FIG. 49B, a rotary cutting tool 8044 and a fixture 8050 are shown. The rotary drive tool 8048 is attached to the drive conduit 8462 of the end effector 8040. Two types of tool 8042 are shown, configured for "loading" installation. Here, each of the tools 8042 is interfaced on the tool body 8466. The bearing element 8778 is formed between the base end 8468 and the working end 8470. The driving element 8778 is a portion of the drive hole 8478 defined adjacent the distal exit 8482. shaped and positioned to engage bearing 8262 that defines the axial length (see FIG. 59B). ). This configuration allows alignment of tool 8042 to rotate about second axis A2. Each tool 8042 also has an interface with the tool body 8466. The tool includes a proximal key body 8780 disposed at the end 8468 of the tool. The proximal key bodies 8780 for each of the 8042 are different from each other, but each has a second axis A The proximal key has a cylindrical outer shape. The proximal key surface 8784 is urged in a direction away from the working end 8470 of the tool body 8466. 782. As described in more detail below, the proximal key surface 8782 and the proximal key The element 8784 cooperates with the retention mechanism 8664 to facilitate the operation of the axial lock AL. .

[0220] In the eighth embodiment, each tool 8042 of the type shown includes a proximal key element 878 4 and bearing element 8778. More specifically, the rotary cutting tool 8044 includes a first notch element 8788 and a first a first seating element having a first seating flange 8790 defining a seating surface 8792; 8786, and the rotary drive tool 8048 includes a second cutout element 8796 and a second sheet a second seat element 879 having a second seat flange 8798 defining a surface 8800; 4. The first sheet element 8786 is shaped to be disposed within the drive conduit 8462. and arranged, and the first notch element 8788 is arranged within the first notch 8688, and the first The seating surface 8792 abuts the proximal conduit end 8684 of the drive conduit 8462 to form a first rotary engagement. The second sheet element 8794 defines a stop RL1 (see Figures 58A-58D). A second notched element 879 is shaped and positioned to be disposed within the rear shaft 8422. 6 is disposed within the second notch 8696, and the second seat surface 8800 is disposed within the carrier shaft 8422 abuts the proximal carrier end 8694 of the carrier 8422 to define a second rotary lock RL2 (FIG. 63A-63E, not shown in detail).

[0221] 56A-57, as described above, the first In the eighth embodiment, the retention feature 8664 defines an axial stop AL and is secured to the protective cover 835. 0. Here, the protective cover 8350 also provides a tool 8 042 "top loading" for easy insertion and removal, first protection It is movable from a position U1 (see FIGS. 56A to 56D) to a second protection position U2 (see FIG. 57). Furthermore, the axial locking device AL can be configured in a locked state ACL (see Figs. 56A and 56B) and a released state. ACR (see Figures 56C-56D) and the protection lock subassembly 8708 The end effector 80 can be moved to engage and disengage with the In an eighth embodiment of the present invention, the protective cover is attached to the axial locking element AL before the axial locking element AL is moved to the locked configuration ACL. The bar 8350 must be placed in the first protective position U1, which simultaneously 8664 restricts relative motion between the fixed tool 8042 and the drive conduit 8462 and the protective cover 8350 and the driver 8250 are connected via the protective lock subassembly 8708. For this purpose, as best shown in Figures 56B and 57, The protective body 8352 of the protective cover 8350 includes a knob guide slot 8802. A knob retainer 8804 coupled to a protective knob 8806 is positioned along the knob guide slot 8802. Knob retainer 8804 supports bearing 8262, which is described in more detail below. As will be explained in detail, a protective knob 8806 is provided to facilitate operation of the axial locking device AL. As it rotates, it follows the knob guide slot 8802 .

[0222] One or more fasteners (e.g., rings, circlips, etc.) and knob keepers 8 808, the protective knob 8806 is prevented from being removed from the protective body 8352, The knob keeper 8808 engages with the protective knob 8806 to secure the protective knob 8806 to the protective body 8352. 88. The protective knob supports a protective knob biasing element 8810 arranged to move the protective knob away from the 56A to 56C, the axial locking device AL is engaged with the protective knob 8806 and placed in the locking configuration ACL (FIG. 56A to 56C). 56B and 58D) to the release form ACR (see FIGS. 56C to 56D and 5 8C), haptic feedback is provided to the user, and as a result, the user rotates the protective knob 8806, and the knob retainer 8804 slides along the knob guide slot 8802. When moving from the release mode ACR to the lock mode ACL, the protective knob The momentum element 8810 is compressed.

[0223] 56A-58D, the retention mechanism 8664 also includes a protective knob 8806. It includes a key hub 8812 and a key collar 8814 operably attached thereto. The key hub 8812 can be rotated so that the ring 8262 rotates relative to the protective knob 8806. When the axial locking device AL moves between the release configuration ACR and the locking configuration ACL, A thrust bearing 8816 secures the connection between the key hub 8812 and the protection knob 8806. Key collar 8814 includes key collar slot 8818. and a key pin 8820 coupled to the key hub 8812 within the key collar slot 8818. This configuration allows the key collar 881 to move relative to the key hub 8812. The key collar 8814 is held in place while facilitating the restriction of movement of the 4. Key hub 8812 and the key collar 8814, a key collar biasing element 8822 is interposed between the key collar 88 14 generally away from the key hub 8812. One of the tools 8042 58C. The protective cover 8350 is inserted through the drive conduit 8462 and is in the form of a first protective When moved to position U1, both the key hub 8812 and the key collar 8814 8042. Here, the key collar 8814 is located near the key element 8784 proximal to the key hub 8812 and then axially When the forward locking device AL moves towards the locking configuration ACL, the protection knob 8806 rotates, Collar 8814 abuts proximal key surface 8782 of tool body 8466, locking configuration ACL As shown in FIG. 58D, the key collar biasing element 8822 is compressed. 2 receives the proximal key element 8784 of the tool 8042 when in lock configuration ACL Both the key hub 8812 and the key collar 8814 are molded to fit the proximal key. This configuration allows the proximal key element 8784 to be positioned against the key surface 8782. The key hub 8812 helps guide the tool around the second axis A2. This helps to make the alignment of the 8042 easier.

[0224] The key collar 8814 and the key hub 8812 each have a protective cover 8350 attached to a first When in the protection position U1, the drive hole 8478 is adjacent to the proximal entrance 8480. Furthermore, the protective cover 8350 has a generally cylindrical inner shape. A generally cylindrical knob opening is arranged to cooperate with the inner shape of the key hub 8812 and the key hub 8814. This configuration allows for manual interface access through knob opening 8824. 8094, the user is provided with the ability to access the eighth embodiment of the end effector 8040. In an embodiment, the knob opening 8824 is configured as a knob with a recessed portion 8826, as described in more detail below in connection with FIGS. 60-62B. 8048.

[0225] As best shown in FIG. 56C, the lower vertical member 8770 is coupled to the protector 8352. When the protective cover 8350 is in the first protective position U1, the grip attachment 870 4. Upper vertical member 8768, pawl stop member 8754 and protective transmitter 8774 (see FIG. 56D) are respectively attached to the protector 8352. The protective knob 8806 is coupled to the shaft 8806 for simultaneous movement relative to the shaft 8806. The direction locking device AL is changed from the release state ACR shown in Figs. 56C to 56D to the state shown in Figs. 56A to 56B. When moved to the locking configuration ACL, the pawl stop member 8754 first engages the protective lever 8746. 8752, thereby pivoting the protection lever 8746, and then Continued rotation of the protection knob 8806 causes the pawl stop member 8754 to abut the side stop 8766. Here, in the locked state ACL shown in FIGS. 56A and 56B, the lever biasing element 87 56 presses the protective lever 8746 against the pawl stop member 8754, The upper vertical member 876 is also positioned to abut against the side stops 8766. 8 abuts against the upper vertical stop 8762. Therefore, in the locked configuration ACL, The guard 835 remains in place until the user engages the guard lever 8746 to release the pawl stop member 8754. 2 and the movement of the protective knob 8806 relative to the grip fixture 8704. As shown, the protection sensor 8772 coupled to the grip fixture 8704 is connected to the protection knob 880. 6, and thus the board controller 8 720 determines the movement of the axial lock AL between the locked configuration ACL and the released configuration ACR. Similarly, a lever sensor 8758 coupled to the grip fixture 8704 can , in response to movement of a lever transmitter 8760 coupled to the protection lever 8746, and thus , the board controller 8720 can determine the movement of the protection lever 8746 .

[0226] Referring now to FIGS. 60-62B, as discussed above, the illustrated rotary drive tool 8048 is releasable in a "top loading" manner to an eighth embodiment of the end effector 8040 An eighth embodiment of the end effector 8040 is adapted to be attached to an In comparison with the rotary drive tool 48 described above in connection with the first embodiment of the effector 40, different configurations of lock subassembly 8810 can be used to release fixture 8050. In the eighth embodiment, as best shown in FIG. Thus, the support tube 8106 generally defines a tool body 8466 and is adjacent to a working end 8470. and a profile 8108 adjacent the interface end 8468. The bearing element 8778 is disposed between the male thread 8120 and the profile 8108 . The drive shaft 8104 is similarly disposed so as to be rotatably supported within the support tube 8106. The drive key 8124 is positioned adjacent the working end 8470 and the interface end 84 68 and the adjacent hexagonal portion 8826. The locking element detent 8828 may lock the drive shaft under certain conditions, as described in more detail below. To facilitate si...

Claims

1. an end effector that drives a tool at a surgical site along a trajectory maintained by a surgical robot, a mounting fixture adapted to be attached to the surgical robot; a rotating device comprising an actuator coupled to the fixture and configured to generate a rotational torque about a first axis; a drive assembly including a gear train that converts rotation from the rotating equipment into rotation about a second axis different from the first axis, and a connector configured to releasably secure the tool for rotation about the second axis; a manipulator assembly including a grip for supporting a user's hand and an input manipulator associated with the rotating device, the input manipulator being arranged to be operated by the user, and the user manipulating the input manipulator to drive the rotating device and rotate the tool about the second axis; and a manual interface in communication with the drive assembly and arranged to receive and convert a force applied by the user into a rotational torque for rotating the tool about the second axis; a handle assembly separate from the tool and releasably attachable to the manual interface, wherein a force applied to the handle assembly rotates the tool about the second axis; and An end effector comprising:

2. The end effector of claim 1 , wherein the manipulator assembly comprises a frame that supports the grip and the input manipulator for movement relative to the rotating device between a plurality of manipulator assembly positions.

3. the manipulator assembly further comprising a retainer coupled to the frame; one of the retainer and the rotating device includes a plunger selectively movable between a locked position where relative movement between the operating tool assembly and the rotating device is restricted and an unlocked position where the relative movement is permitted; the other of the retainer and the rotating device includes a catch having a plurality of receiving portions; The end effector of claim 2 , wherein each of the plurality of receivers is shaped to receive the plunger in the locked position to define one of the plurality of manipulator assembly positions.

4. the plurality of manipulator assembly positions: a first manipulator assembly position arranged to drive the rotating device to rotate the tool about the second axis when the manipulator assembly is engaged by the user; a second manipulator assembly position where the manual interface is positioned to receive a force applied by the user to rotate the tool about the second axis; The end effector of claim 2 , comprising:

5. 5. The end effector of claim 4, further comprising an assembly sensor arrangement interposed between the rotating device and the manipulator assembly to determine a position of the manipulator assembly relative to the rotating device between the first and second manipulator assembly positions.

6. The end effector of any one of claims 1 to 5, wherein the manual interface comprises a head arranged to rotate about the second axis to receive a rotational force applied by the user.

7. a protective cover operably attached to the drive assembly; The protective cover is a first protective position in which the second axis intersects at least a portion of the protective cover to restrict access to the manual interface; a second, protective position in which the protective cover is spaced from the second axis to facilitate access to the manual interface; The end effector of claim 6 , wherein the end effector is arranged to move relative to the second axis between

8. the manipulator assembly further comprises a frame that supports the grip and the input manipulator for rotation relative to the rotating device between a plurality of manipulator assembly positions; 2. The end effector of claim 1, wherein the input manipulator of the manipulator assembly is arranged to move relative to the grip between a first input position and a second input position to control rotational torque generated by the rotating device.

9. the operation tool assembly further includes an operation transmitter associated with the input operation tool; The end effector of claim 8 , wherein the rotating device further comprises a manipulation detector that determines a position of the manipulation transmitter corresponding to movement of the input manipulator between the first and second input positions.

10. the manual interface includes a head arranged to rotate about the second axis; 10. The end effector of claim 1, wherein the handle assembly comprises a power transmission shaped to receive the head of the manual interface for simultaneous rotation in response to force applied to the handle assembly by the user.

11. the handle assembly a handle body for receiving a force applied by the user; a ratchet mechanism interposed between the handle body and the power transmission device to allow the handle body and the power transmission device to simultaneously rotate about the second axis in a third rotational direction and to prevent the power transmission device from rotating relative to the handle body in a fourth rotational direction opposite to the third rotational direction; The end effector of claim 10 further comprising:

12. the drive assembly further comprising a clutch mechanism interposed between the manual interface and the gear train; The clutch mechanism is a first mode in which rotational torque generated by the rotating equipment is transmitted by the gear train to rotate the tool about the second axis but not the head of the manual interface; and a second mode in which a force applied to the handle assembly simultaneously rotates the head and the power transmission, transmitting torque through the gear train and rotating the tool about the second axis; and The end effector of claim 10 or 11, wherein the end effector is operable between

13. a differential assembly interposed between the rotating device, the connector, and the manual interface; the differential assembly: a haptic mode in which rotational torque generated by the rotating instrument is transmitted by the differential assembly to the connector, causing the tool to rotate about the second axis, and transmitted to the head of the manual interface, providing haptic torque feedback at the manual interface; and a first abort mode in which rotational torque generated by the rotating device is transmitted by the differential assembly to the connector, causing the tool to rotate about the second axis, but not transmitting rotational torque to the head of the manual interface; a second abort mode in which rotational torque applied to the head of the manual interface is transmitted by the differential assembly to the connector to rotate the tool about the second axis, but does not transmit rotational torque to the rotating instrument; and The end effector according to any one of claims 10 to 12, wherein the end effector is operable between

14. 14. The end effector of claim 1, wherein the gear train of the drive assembly comprises at least one reduction gear set interposed in rotational communication between the rotating device and the connector, whereby rotation of the rotating device occurs at a different speed than rotation of the tool.

15. 2. The end effector of claim 1, wherein the gear train of the drive assembly comprises at least one bevel gear set interposed in rotational communication between the rotating instrument and the connector to convert rotation about the first axis to rotation about the second axis.

16. The end effector of claim 15 , wherein the bevel gear set comprises a reduction gear set configured such that rotation of the rotating equipment occurs at a different speed than rotation of the tool.

17. 16. The end effector of claim 15, wherein the gear train of the drive assembly further comprises at least one reduction gear set interposed in rotational communication between (1) the rotating device and the bevel gear set or (2) the bevel gear set and the connector, whereby rotation of the rotating device occurs at a different speed than rotation of the tool.

18. The end effector of any one of claims 1 to 17, further comprising a guide hole defined through the manual interface and the connector of the drive assembly for receiving a guide wire.

19. The end effector of any one of claims 1 to 18, further comprising a coupler operably attached to the rotating device and configured to releasably secure the drive assembly to the rotating device.

20. 20. The end effector of claim 19, wherein the coupler is configured to fix the drive assembly in multiple orientations relative to the rotating instrument to facilitate selective positioning of the second axis relative to the rotating instrument along different trajectories selectively maintained by the surgical robot.

21. The end effector of claim 20, further comprising an orientation sensor arrangement interposed between the rotating device and the drive assembly to determine the orientation of the drive assembly relative to the rotating device.

22. the second axis intersects the first axis, The second axis is perpendicular to the first axis. An end effector according to any one of claims 1 to 21.

23. 1. A surgical system comprising: A surgical robot, an end effector attached to the surgical robot and configured to drive a tool at a surgical site along a trajectory maintained by the surgical robot, a rotating instrument attached to the surgical robot and comprising an actuator configured to generate a rotational torque about a first axis; a gear train that converts rotation from the rotating equipment into rotation about a second axis different from the first axis; and a drive assembly including a connector configured to releasably secure the tool for rotation about the second axis; a manipulator assembly including a grip for supporting a user's hand and an input manipulator associated with the rotating device, the input manipulator being arranged to be manipulated by the user, such that the user's manipulation of the input manipulator drives the rotating device to rotate the tool about the second axis; a manual interface in communication with the drive assembly and arranged to receive and convert a force applied by the user into a rotational torque for rotating the tool about the second axis; and a handle assembly separate from the tool and releasably attachable to the manual interface, wherein a force applied to the handle assembly rotates the tool about the second axis; an end effector including: A surgical system comprising:

24. 1. A surgical system comprising: A surgical robot, an end effector attached to the surgical robot and configured to drive a tool at a surgical site along a trajectory maintained by the surgical robot, a rotating device comprising an actuator configured to generate a rotational torque about a first axis; a gear train that converts rotation from the rotating equipment into rotation about a second axis different from the first axis; and a drive assembly including a connector configured to releasably secure the tool for rotation about the second axis; a manipulator assembly including a grip for supporting a user's hand and an input manipulator associated with the rotating device, the input manipulator being arranged to be manipulated by the user, such that the user's manipulation of the input manipulator drives the rotating device to rotate the tool about the second axis; a manual interface in communication with the drive assembly and arranged to receive and convert a force applied by the user into a rotational torque for rotating the tool about the second axis; and a coupler operably attached to the rotating instrument, the coupler configured to releasably secure the drive assembly relative to the rotating instrument in a plurality of orientations to facilitate selective positioning of the second axis relative to the rotating instrument along different trajectories selectively maintained by the surgical robot; an end effector including: A surgical system comprising:

25. 1. A surgical system comprising: A surgical robot, an end effector attached to the surgical robot and configured to drive a tool at a surgical site along a trajectory maintained by the surgical robot, a rotating device comprising an actuator configured to generate a rotational torque about a first axis; a drive assembly including a gear train that converts rotation from the rotating equipment into rotation about a second axis different from the first axis, and a connector configured to releasably secure the tool for rotation about the second axis; a manual interface in communication with the drive assembly and arranged to receive and convert a force applied by a user into a rotational torque for rotating the tool about the second axis; A manipulator assembly comprising: a grip for supporting the user's hand; an input device associated with the rotating device, the input device being arranged to be operated by the user, and the user operating the input device to drive the rotating device and rotate the tool around the second axis; and a frame supporting the grip and the input manipulator for movement relative to the rotating device between a plurality of manipulator assembly positions, the plurality of manipulator assembly positions including: a first manipulator assembly position arranged to drive the rotating device to rotate the tool about the second axis when the manipulator assembly is engaged by the user; a second manipulator assembly position, the manual interface positioned to receive a force applied by the user to rotate the tool about the second axis; Includes frame, a manipulator assembly including: an end effector including: A surgical system comprising:

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