Surgical robotic system for control of suture-cutting needle-driver instrument

Abstract

A surgical robotic system includes a combination end effector for performing suturing operations. The end effector includes a pair of pivotable jaws each of which includes a distal gripping surface and a proximal cutting body having a straight and / or a curved blade that is occluded unless the jaws are sufficiently open. The opening angle and the aperture between the jaws as well as the corresponding gripping surfaces and blades is controlled by a paddle movable relative to a handle. The system includes a controller for implementing various control schemes for guiding, adjusting, and providing feedback to user inputs through the paddle for controlling the aperture between the jaws and operating the end effector in gripping and cutting modes.

Description

SURGICAL ROBOTIC SYSTEM FOR CONTROL OF SUTURE-CUTTING NEEDLE-DRIVER INSTRUMENTCROSS-REFERENCE TO RELATED APPLICATION

[0001] This application claims the benefit of U.S. Provisional Patent Application Serial No. 63 / 605,670, filed December 4, 2023, the entire content of which is incorporated herein by reference.BACKGROUND

[0002] Surgical robotic systems are currently being used in a variety of medical procedures, including minimally invasive surgical procedures. Some surgical robotic systems include a surgeon console controlling a surgical robotic arm and a surgical instrument having an end effector (e.g., forceps or grasping instrument) coupled to and actuated by the robotic arm. In operation, the robotic arm is moved to a position over a patient and then guides the surgical instrument into a small incision via a surgical port or a natural orifice of a patient to position the end effector at a work site within the patient’s body. A variety of different types of instruments are used with surgical robotic systems that are designed to perform specific functions, such as suturing during minimally invasive robotically assisted surgical procedures.SUMMARY

[0003] Laparoscopic and robotic surgical procedures utilize a gripping end effector for performing a suturing operation. As in conventional surgical procedures, laparoscopic and robotic suturing operations utilize a needle attached to a length of surgical suture for placing one or more sutures in a tissue. Laparoscopic and robotic suturing operations utilize a needledriver as the end effector for manipulating the needle when placing sutures. The needle-driver includes opposing jaws that articulate between closed and open positions when grasping and releasing the suturing needle. Upon completion of a suturing operation, the surgical thread is severed to remove the needle and excess surgical suture from the patient.

[0004] The present disclosure provides for cutting needle-drivers that are designed to combine the needle grasping functionality of a needle-driver with the cutting functionality of shears. The gripping surface of the instrument is located in close proximity to the cutting surface. A challenge related to locating the cutting surface in close proximity to the gripping surface is that, in operation of such a tool, suture or tissue may be cut or damaged inadvertently when attempting to grasp the suture or tissue. Cutting the suture inadvertently can result in procedural delays.

[0005] In various embodiments of the present disclosure, one or more cutting surfaces located adjacent to grasping surfaces on the same minimally invasive surgical tool or instrument are arranged on the instrument such that, during use of the instrument, the cutting surfaces are not exposed, or are not sufficiently exposed, for cutting unless a cutting functionality is selected actively or activated. The cutting functionality or mode can be effected by, for example, limiting an aperture (e.g., jaw angle) between the grasping surfaces to or below a threshold size. This feature would enable the instrument to grasp, maneuver, and release a suture needle or suture with a reduced risk of accidental suture cuts or tissue damage, thereby increasing procedural efficiency. The features further allow the instrument to be used to cut the suture when desired.

[0006] This disclosure describes mechanical designs and computer algorithms for blocking or otherwise inhibiting exposure to, one or more cutting surfaces of a suture-cutting needledriver to prevent inadvertent cutting or tissue damage.

[0007] According to one embodiment of the present disclosure, a surgical robotic system is disclosed. The system includes an end effector having a first jaw, which has a first gripping surface and a first cutting body disposed proximally of the first gripping surface, the first cutting body having a first blade. The end effector also includes a second jaw, which has a second gripping surface and a second cutting body disposed proximally of the second gripping surface, the second cutting body having a second blade. One of the first jaw or the second jaw is rotatable relative to the other of the first jaw or the second jaw such that the first and second jaws are relatively movable between a closed configuration, in which the first and second jaws are positioned adjacent one another, a first open configuration, in which the first and second jaws are separated and the first and second blades remain occluded, and a second open configuration, in which the first and second blades are exposed, and a gap is defined between the first and second blades. The system also includes a handle controller having a handle and a paddle pivotably movable relative to the handle from a closed position corresponding to the closed configuration of the first and second jaws, a first open position corresponding to the first open configuration of the first and second jaws, and a second open position corresponding to the second open configuration of the first and second jaws. The system further includes a feedback motor for applying force feedback and moving the paddle to return the paddle to the first open position.

[0008] Implementations of the above embodiment may include one or more of the following features. According to one aspect of the above embodiment, the feedback motor may maintain the input portion in the first open position. While the input portion is in the firstopen position, the feedback motor does not apply any force feedback. The input controller may further include a haptic feedback device for generating haptic feedback when the input portion is in at least one of the closed position, the first open position, or the second open position. The surgical robotic system may also include a surgeon console for generating an audio or a video indicator that the input portion is in the closed position, the first open position, or the second open position. In response to the input portion being moved from the first open position toward the second open position, opening of the first and second jaws from the first open configuration to the second open configuration may be delayed. In response to the input portion being disposed between the first open position and the second open position for a preset time period the input portion may resume real-time control of the first and second jaws. The first blade and the second blade may have at least one of a straight shape or curved shape.

[0009] According to another embodiment of the present disclosure, a surgical robotic system is disclosed. The system includes an end effector having a first jaw, which has a first gripping surface and a first cutting body disposed proximally of the first gripping surface, the first cutting body having a first blade. The end effector also includes a second jaw, which has a second gripping surface and a second cutting body disposed proximally of the second gripping surface, the second cutting body having a second blade. One of the first jaw or the second j aw is rotatable relative to the other of the first j aw or the second j aw such that the first and second jaws are relatively movable between a closed configuration, in which the first and second jaws are positioned adjacent one another, a first open configuration, in which the first and second jaws are separated and the first and second blades remain occluded, and a second open configuration, in which the first and second blades are exposed, and a gap is defined between the first and second blades. The system also includes an input controller having a stationary portion and an input portion movable relative to the stationary from a closed position corresponding to the closed configuration of the first and second jaws, a first open position corresponding to the first open configuration of the first and second jaws, and a second open position corresponding to the second open configuration of the first and second jaws. The input controller also includes a feedback motor for applying force feedback and moving the input portion to return the input portion to the first open position.

[0010] Implementations of the above embodiment may include one or more of the following features. According to one aspect of the above embodiment, the input controller may be a handle controller or a foot pedal. The feedback motor may maintain the paddle in the first open position. While the paddle is in the first open position, the feedback motor does not apply any force feedback. The handle controller may further include a haptic feedback devicefor generating haptic feedback when the paddle is in at least one of the closed position, the first open position, or the second open position. The surgeon console may generate an audio or video indicator that the paddle is in at least one of the closed position, the first open position, or the second open position. In response to the paddle being moved from the first open position toward the second open position, opening of the first and second jaws from the first open configuration to the second open configuration is delayed. In response to the paddle being disposed between the first open position and the second open position for a preset time period the paddle may resume real-time control of the first and second jaws. The first blade and the second blade may have at least one of a straight shape or curved shape.

[0011] According to a further embodiment of the present disclosure, a surgical robotic system is disclosed. The system includes an end effector having first jaw, which has a first gripping surface and a first cutting body disposed proximally of the first gripping surface. The first cutting body also includes a first curved blade and a first blade guard disposed distally of the first curved blade and extending past the first curved blade. The end effector also includes a second jaw, which has a second gripping surface and a second cutting disposed proximally of the second gripping surface. The second cutting body has a second curved blade and a second blade guard disposed distally of the second curved blade and extending past the second curved blade. One of the first jaw or the second jaw is rotatable relative to the other of the first jaw or the second jaw such that the first and second jaws are relatively movable between a closed configuration, in which the first and second jaws are positioned adjacent one another, a first open configuration, in which the first and second jaws are separated and the first and second curved blades define an aperture therebetween while the first and second blade guards occlude the aperture between the first and second curved blades, and a second open configuration, in which the first and second blade guards and the first and second curved blades are exposed and a first gap is defined between the first and second curved blades and a second gap is defined between the first and second blade guards that is larger than the first gap.

[0012] Implementations of the above embodiment may include one or more of the following features. According to one aspect of the above embodiment, the system may further include a surgeon console having a handle controller, which may include a handle and a paddle pivotably movable relative to the handle from a closed position corresponding to the closed configuration of the first and second jaws, a first open position corresponding to the first open configuration of the first and second jaws, and a second open position corresponding to the second open configuration of the first and second jaws; and a feedback motor for applying force feedback and moving the paddle to return the paddle to the first open position. Thesurgeon console may also generate an audio or video indicator that the paddle is in at least one of the closed position, the first open position, or the second open position.BRIEF DESCRIPTION OF THE DRAWINGS

[0013] Various embodiments of the present disclosure are described herein with reference to the drawings, wherein:

[0014] FIG. 1 is a perspective view of a surgical robotic system including a control tower, a console, and one or more surgical robotic arms, each disposed on a movable cart according to an embodiment of the present disclosure;

[0015] FIG. 2 is a perspective view of a surgical robotic arm of the surgical robotic system of FIG. 1 according to an embodiment of the present disclosure;

[0016] FIG. 3 is a perspective view of a movable cart having a setup arm with the surgical robotic arm of the surgical robotic system of FIG. 1 according to an embodiment of the present disclosure;

[0017] FIG. 4 is a schematic diagram of a computer architecture of the surgical robotic system of FIG. 1 according to an embodiment of the present disclosure;

[0018] FIG. 5 is a plan schematic view of movable carts of FIG. 1 positioned about a surgical table according to an aspect of the present disclosure;

[0019] FIG. 6 is a perspective view, with parts separated, of an instrument drive unit and a surgical instrument according to an embodiment of the present disclosure;

[0020] FIG. 7 is a perspective view of an end effector, according to an embodiment of the present disclosure, for use in the surgical robotic system of FIG. 1;

[0021] FIG. 8 shows the end effector in various configurations according to an embodiment of the present disclosure;

[0022] FIG. 9 is a side view of a suture-cutting needle-driver end effector in a closed, gripping, configuration according to an embodiment of the present disclosure;

[0023] FIG. 10 is a side view of the suture-cutting needle-driver end effector of FIG. 9 in a partially open, gripping, configuration according to an embodiment of the present disclosure;

[0024] FIG. 11 is a side view of the suture-cutting needle-driver end effector of FIG. 9 in a fully open, cutting, configuration according to an embodiment of the present disclosure;

[0025] FIG. 12 is a side view of a suture -cutting needle-driver end effector in a closed, gripping, configuration according to another embodiment of the present disclosure;

[0026] FIG. 13 is a side view of the suture -cutting needle-driver end effector of FIG. 12 in a partially open, gripping, configuration according to an embodiment of the present disclosure;

[0027] FIG. 14 is a side view of the suture -cutting needle-driver end effector of FIG. 12 in a fully open, cutting, configuration according to an embodiment of the present disclosure;

[0028] FIG. 15 is a perspective view of a handle controller according to one embodiment of the present disclosure;

[0029] FIG. 16 shows a schematic view of a paddle of the handle controller of FIG. 15 being moved into a closed position to control movement of the suture -cutting needle-driver end effector into the closed, gripping, configuration of FIG. 12 according to an embodiment of the present disclosure;

[0030] FIG. 17 shows a schematic view of the paddle of the handle controller of FIG. 15 being moved into a first open position to control movement of the suture-cutting needle-driver end effector into the partially open, gripping, configuration of FIG. 13 according to an embodiment of the present disclosure;

[0031] FIG. 18 shows a schematic view of the paddle of the handle controller of FIG. 15 being moved into a second open position to control movement of the suture-cutting needledriver end effector into the fully open, cutting, configuration of FIG. 14 according to an embodiment of the present disclosure; and

[0032] FIG. 19 is a schematic diagram of a system for determining phases of a surgical procedure according to an embodiment of the present disclosure.DETAILED DESCRIPTION

[0033] Embodiments of the presently disclosed surgical robotic system are described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views.

[0034] With reference to FIG. 1, a surgical robotic system 10 includes a control tower 20, which is communicatively coupled to all of the components of the surgical robotic system 10 including a surgeon console 30 and one or more movable carts 60. Each of the movable carts 60 includes a robotic arm 40 having a surgical instrument 50 coupled thereto. The robotic arms 40 also couple to the movable carts 60. The robotic system 10 may include any number of movable carts 60 and / or robotic arms 40.

[0035] The surgical instrument 50 is configured for use during minimally invasive surgical procedures. In embodiments, the surgical instrument 50 may be configured for open surgical procedures. One of the robotic arms 40 may include an endoscopic camera 51 configured to capture video of the surgical site. The endoscopic camera 51 may be a stereoscopic endoscope configured to capture two side-by-side (i.e., left and right) images of the surgical site to producea video stream of the surgical scene. The endoscopic camera 51 is coupled to a video processing device 56, which may be disposed within the control tower 20. The video processing device 56 may be any computing device as described below configured to receive the video feed from the endoscopic camera 51 and output the processed video stream.

[0036] The surgeon console 30 includes a first display 32, which displays a video feed of the surgical site provided by a camera 51 disposed on the robotic arm 40, and a second display 34, which displays a user interface for controlling the surgical robotic system 10. The first display 32 and the second display 34 may be touchscreens allowing for displaying various graphical user inputs selectable or movable by the user.

[0037] The surgeon console 30 also includes a plurality of user interface devices, such as foot pedals 36 and a pair of handle controllers 38a and 38b, which are used by a user to remotely control the robotic arms 40. The surgeon console further includes an armrest 33 used to support clinician’s arms while the clinician is operating the handle controllers 38a and 38b.

[0038] The control tower 20 can also include a display 23, which may be a touchscreen, and outputs on the graphical user interfaces (GUIs). The control tower 20 also acts as an interface between the surgeon console 30 and one or more of the robotic arms 40. In particular, the control tower 20 is configured to control the robotic arms 40, such as to move the robotic arms 40 and the corresponding surgical instrument 50, based on a set of programmable instructions and / or input commands from the surgeon console 30. In response to the instructions and / or input, the robotic arms 40 and the surgical instrument 50 execute a desired movement sequence in response to input from the foot pedals 36 and the handle controllers 38a and 38b. The system 10 can be configured so that the foot pedals 36 may be used to affect one or more of a wide variety of system functions, such as to enable and lock the hand controllers 38a and 38b, reposition camera movement, and activate / deactivate an electrosurgical instrument. In particular, the foot pedals 36 may be used to perform a clutching action on the hand controllers 38a and 38b. Clutching is initiated by pressing one of the foot pedals 36, which disconnects (i.e., prevents movement inputs from) the hand controllers 38a and / or 38b such that the robotic arm 40 and corresponding instrument 50 or camera 51 are not actuated. This allows the user to reposition the hand controllers 38a and 38b without moving the robotic arm(s) 40 and the instrument 50 and / or camera 51. This is useful when reaching control boundaries of the surgical space, for instance.

[0039] Each of the control tower 20, the surgeon console 30, and the robotic arm 40 includes a respective computer 21, 31, 41. The computers 21 , 31 , 41 are interconnected to each other using any suitable communication network based on wired or wireless communicationprotocols. The term “network,” whether plural or singular, as used herein, denotes a data network, including, but not limited to, the Internet, Intranet, a wide area network, or a local area network. Suitable protocols include, but are not limited to, transmission control protocol / intemet protocol (TCP / IP), datagram protocol / intemet protocol (UDP / IP), and / or datagram congestion control protocol (DCCP). Wireless communication may be achieved via one or more wireless configurations, e.g., radio frequency (RF), optical, Wi-Fi, Bluetooth (an open wireless protocol for exchanging data over short distances, using short-length radio waves, from fixed and mobile devices, creating personal area networks (PANs), ZigBee® (a specification for a suite of high-level communication protocols using small, low-power digital radios based on the IEEE 122.15.4-1203 standard for wireless personal area networks (WPANs)).

[0040] The computers 21, 31, 41 may include any suitable processor (not shown) connected operably to a memory (not shown), which may include one or more of volatile, nonvolatile, magnetic, optical, or electrical media, such as read-only memory (ROM), random access memory (RAM), electrically erasable programmable ROM (EEPROM), non-volatile RAM (NVRAM), or flash memory. The processor may be any suitable processor (e.g., control circuit) adapted to perform the operations, calculations, and / or set of instructions described in the present disclosure, such as a hardware processor, a field programmable gate array (FPGA), a digital signal processor (DSP), a central processing unit (CPU), a microprocessor, and combinations thereof. Those skilled in the art will appreciate that the processor may be substituted for by using any logic processor (e.g., control circuit) adapted to execute algorithms, calculations, and / or set of instructions described herein.

[0041] With reference to FIG. 2, each of the robotic arms 40 may include a plurality of links 42a, 42b, 42c, which are interconnected at joints 44b and 44c, respectively. Other configurations of links and joints may be utilized as known by those skilled in the art. The joint 44a is configured to secure the robotic arm 40 to the movable cart 60 and defines a first longitudinal axis. With reference to FIG. 3, the movable cart 60 includes a lift 67 and a setup arm 61, which provides a base for mounting of the robotic arm 40. The lift 67 allows for vertical movement of the setup arm 61 and, thereby, of the robotic arms 40 mounted on the setup arm 61. The movable cart 60 also includes a display 69 for displaying information pertaining to the robotic arm 40. In embodiments, the robotic arms 40 may include any type and / or number of joints.

[0042] With further reference to FIG. 3, the setup arm 61 includes a first link 62a, a second link 62b, and a third link 62c, which provide for lateral maneuverability of the robotic arms 40.The links 62a, 62b, 62c are interconnected at joints 63a and 63b, each of which may include an actuator (not shown) for rotating the links 62b and 62b relative to each other and the link 62c. In particular, the links 62a, 62b, 62c are movable in corresponding lateral planes, which are parallel to each other, thereby allowing for extension of the robotic arm 40 relative to the patient (e.g., surgical table). In embodiments, the robotic arm 40 may be coupled to the surgical table (not shown). The setup arm 61 includes controls 65 for adjusting movement of the links 62a, 62b, 62c as well as the lift 67. In embodiments, the setup arm 61 may include any type and / or number of joints.

[0043] The third link 62c may include a rotatable base 64 having two degrees of freedom. In particular, the rotatable base 64 includes a first actuator 64a and a second actuator 64b. The first actuator 64a is rotatable about a first stationary arm axis, which is perpendicular to a plane defined by the third link 62c. And the second actuator 64b is rotatable about a second stationary arm axis which is transverse to the first stationary arm axis. The first and second actuators 64a and 64b along with the lift 67 allow for full three-dimensional orientation of the robotic arm 40.

[0044] Returning to FIG. 2, the actuator 48b of the joint 44b is coupled to the joint 44c via the belt 45a, and the joint 44c is in turn coupled to the joint 46b via the belt 45b. Joint 44c may include a transfer case coupling the belts 45a and 45b, such that the actuator 48b is configured to rotate each of the links 42b, 42c and a holder 46 relative to each other. More specifically, links 42b, 42c, and the holder 46 are passively coupled to the actuator 48b which enforces rotation about a pivot point “P” which lies at an intersection of the first axis defined by the link 42a and the second axis defined by the holder 46. In other words, the pivot point “P” is a remote center of motion (RCM) for the robotic arm 40. Thus, the actuator 48b controls the angle 0 between the first and second axes allowing for orientation of the surgical instrument 50. Due to the interlinking of the links 42a, 42b, 42c, and the holder 46 via the belts 45a and 45b, the angles between the links 42a, 42b, 42c, and the holder 46 are also adjusted in order to achieve the desired angle 0. In embodiments, some or all of the joints 44a, 44b, 44c may include an actuator to obviate the need for mechanical linkages.

[0045] The joints 44a and 44b include respective actuators 48a and 48b configured to drive the joints 44a, 44b, 44c relative to each other through a series of belts 45a and 45b or other mechanical linkages such as a drive rod, a cable, or a lever and the like. In particular, the actuator 48a is configured to rotate the robotic arm 40 about a longitudinal axis defined by the link 42a.

[0046] With reference to FIG. 2, the holder 46 defines a second longitudinal axis and configured to receive an instrument drive unit (IDU) 52 (FIG. 1). The IDU 52 is configured to couple to an actuation mechanism of the surgical instrument 50 and the camera 51 and is configured to move (e.g., rotate) and actuate the instrument 50 and / or the camera 51. IDU 52 transfers actuation forces from its actuators to the surgical instrument 50 to actuate components an end effector 49 of the surgical instrument 50. The holder 46 includes a sliding mechanism 46a, which is configured to move the IDU 52 along the second longitudinal axis defined by the holder 46. The holder 46 also includes a joint 46b, which rotates the holder 46 relative to the link 42c. During endoscopic procedures, the instrument 50 may be inserted through an endoscopic access port 55 (FIG. 3) held by the holder 46. The holder 46 also includes a port latch 46c for securing the access port 55 to the holder 46 (FIG. 2).

[0047] The IDU 52 is attached to the holder 46, followed by a sterile interface module (SIM) 43 being attached to a distal portion of the IDU 52. The SIM 43 is configured to secure a sterile drape (not shown) to the IDU 52. The instrument 50 is then attached to the SIM 43. The instrument 50 is then inserted through the access port 55 by moving the IDU 52 along the holder 46. The SIM 43 includes a plurality of drive shafts configured to transmit rotation of individual motors of the IDU 52 to the instrument 50 thereby actuating the instrument 50. In addition, the SIM 43 provides a sterile barrier between the instrument 50 and the other components of the robotic arm 40, including the IDU 52.

[0048] The robotic arm 40 also includes a plurality of manual override buttons 53 (FIG. 1) disposed on the IDU 52 and the setup arm 61, which may be used in a manual mode. The user may press one or more of the buttons 53 to move the component associated with the button 53.

[0049] With reference to FIG. 4, each of the computers 21, 31, 41 of the surgical robotic system 10 may include a plurality of controllers, which may be embodied in hardware and / or software. The computer 21 of the control tower 20 includes a controller 2 la and safety observer 21b. The controller 21a receives data from the computer 31 of the surgeon console 30 about the current position and / or orientation of the handle controllers 38a and 38b and the state of the foot pedals 36 and other buttons. The controller 21a processes these input positions to determine desired drive commands for each joint of the robotic arm 40 and / or the IDU 52 and communicates these to the computer 41 of the robotic arm 40. The controller 21a also receives the actual joint angles measured by encoders of the actuators 48a and 48b and uses this information to determine force feedback commands that are transmitted back to the computer 31 of the surgeon console 30 to provide haptic feedback through the handle controllers 38a and 38b. The safety observer 21b performs validity checks on the data going into and out of thecontroller 21a and notifies a system fault handler if errors in the data transmission are detected to place the computer 21 and / or the surgical robotic system 10 into a safe state.

[0050] The computer 41 includes a plurality of controllers, namely, a main cart controller 41a, a setup arm controller 41b, a robotic arm controller 41c, and an instrument drive unit (IDU) controller 41d. The main cart controller 41a receives and processes joint commands from the controller 21a of the computer 21 and communicates them to the setup arm controller 41b, the robotic arm controller 41c, and the IDU controller 4 Id. The main cart controller 41a also manages instrument exchanges and the overall state of the movable cart 60, the robotic arm 40, and the IDU 52. The main cart controller 41a also communicates actual joint angles back to the controller 21a.

[0051] Each of joints 63a and 63b and the rotatable base 64 of the setup arm 61 are passive joints (i.e., no actuators are present therein) allowing for manual adjustment thereof by a user. The joints 63a and 63b and the rotatable base 64 include brakes that are disengaged by the user to configure the setup arm 61. The setup arm controller 41b monitors slippage of each of joints 63a and 63b and the rotatable base 64 of the setup arm 61, when brakes are engaged or can be freely moved by the operator when brakes are disengaged, but do not impact controls of other joints. The robotic arm controller 41c controls each joint 44a and 44b of the robotic arm 40 and calculates desired motor torques required for gravity compensation, friction compensation, and closed loop position control of the robotic arm 40. The robotic arm controller 41c calculates a movement command based on the calculated torque. The calculated motor commands are then communicated to one or more of the actuators 48a and 48b in the robotic arm 40. The actual joint positions are then transmitted by the actuators 48a and 48b back to the robotic arm controller 41c.

[0052] The IDU controller 4 Id receives desired joint angles for the surgical instrument 50, such as wrist and jaw angles, and computes desired currents for the motors in the IDU 52. The IDU controller 4 Id calculates actual angles based on the motor positions and transmits the actual angles back to the main cart controller 41a.

[0053] The robotic arm 40 is controlled in response to a pose of the handle controller controlling the robotic arm 40, e.g., the handle controller 38a, which is transformed into a desired pose of the robotic arm 40 through a hand eye transform function executed by the controller 21a. The hand eye function, as well as other functions described herein, is / are embodied in software executable by the controller 2 la or any other suitable controller described herein. The pose of one of the handle controllers 38a may be embodied as a coordinate position and roll-pitch-yaw (RPY) orientation relative to a coordinate reference frame, which is fixedto the surgeon console 30. The desired pose of the instrument 50 is relative to a fixed frame on the robotic arm 40. The pose of the handle controller 38a is then scaled by a scaling function executed by the controller 21a. In embodiments, the coordinate position may be scaled down and the orientation may be scaled up by the scaling function. In addition, the controller 21a may also execute a clutching function, which disengages the handle controller 38a from the robotic arm 40. In particular, the controller 21a stops transmitting movement commands from the handle controller 38a to the robotic arm 40 if certain movement limits or other thresholds are exceeded and in essence acts like a virtual clutch mechanism, e.g., limits mechanical input from effecting mechanical output.

[0054] The desired pose of the robotic arm 40 is based on the pose of the handle controller 38a and is then passed by an inverse kinematics function executed by the controller 21a. The inverse kinematics function calculates angles for the joints 44a, 44b, 44c of the robotic arm 40 that achieve the scaled and adjusted pose input by the handle controller 38a. The calculated angles are then passed to the robotic arm controller 41c, which includes a joint axis controller having a proportional-derivative (PD) controller, the friction estimator module, the gravity compensator module, and a two-sided saturation block, which is configured to limit the commanded torque of the motors of the joints 44a, 44b, 44c.

[0055] With reference to FIG. 5, the surgical robotic system 10 is setup around a surgical table 90. The system 10 includes movable carts 60a-d, which may be numbered “1” through “4.” During setup, each of the carts 60a-d are positioned around the surgical table 90. Position and orientation of the carts 60a-d depends on a plurality of factors, such as placement of a plurality of access ports 55a-d, which in turn, depends on the surgery being performed. Once the port placements are determined, the access ports 55a-d are inserted into the patient, and carts 60a-d are positioned to insert instruments 50 and the endoscopic camera 51 into corresponding ports 55a-d.

[0056] During use, each of the robotic arms 40a-d is attached to one of the access ports 55a-d that is inserted into the patient by attaching the latch 46c (FIG. 2) to the access port 55 (FIG. 3). The IDU 52 is attached to the holder 46, followed by the SIM 43 being attached to a distal portion of the IDU 52. Thereafter, the instrument 50 is attached to the SIM 43. The instrument 50 is then inserted through the access port 55 by moving the IDU 52 along the holder 46.

[0057] With reference to FIG. 6, the IDU 52 is shown in more detail and is configured to transfer power and actuation forces from its motors 152a-d to the instrument 50 to drive movement of components of the instrument 50, such as articulation, rotation, pitch, yaw,clamping, cutting, etc. The IDU 52 may also be configured for the activation or firing of an electrosurgical energy-based instrument or the like (e.g., cable drives, pulleys, friction wheels, rack and pinion arrangements, etc.).

[0058] The IDU 52 includes a motor pack 150 and a sterile barrier housing 130. Motor pack 150 includes motors 152a-d for controlling various operations of the instrument 50. The instrument 50 is removably couplable to IDU 52. As the motors 152a-d of the motor pack 150 are actuated, rotation of the drive transfer shafts 154a, 154b, 154c, 154d of the motors 152a-d, respectively, is transferred to drive assemblies of the instrument 50. The instrument 50 is configured to transfer rotational forces / movement supplied by the IDU 52 (e.g., via the motors 152a-d of the motor pack 150) into longitudinal movement or translation of the cables or drive shafts to effect various functions of an end effector 200 (FIG. 7).

[0059] Each of the motors 152a-d includes a current sensor 153, a torque sensor 155, and a position sensor 157, which may be an angular motor position sensor. For conciseness only, operation of the motor 152a is described below. The sensors 153, 155, 157 monitor performance of the motor 152a. The current sensor 153 is configured to measure current draw ofthe motor 152a and the torque sensor 155 is configured to measure motor torque. The torque sensor 155 may be any force or strain sensor including one or more strain gauges configured to convert mechanical forces and / or strain into a sensor signal indicative of the torque output by motor 152a. Position sensor 157 may be any device that provides a sensor signal indicative of the number of rotations of the motor 152a, such as a mechanical encoder or an optical encoder. Parameters which are measured and / or determined by position sensor 157 may include speed, distance, revolutions per minute, position, and the like. Sensor signals from sensors 153, 155, 157 are transmitted to the IDU controller 41d (FIG. 4), which then controls the motors 152a-d based on the sensor signals, via an actuator controller 159. In particular, the actuator controller 159 controls torque outputted and angular velocity of the motors 152a-d. In embodiments, additional position sensors may also be used, which include, but are not limited to, potentiometers coupled to movable components and configured to detect travel distances, Hall Effect sensors, accelerometers, and gyroscopes. In embodiments, a single controller can perform the functionality of the IDU controller 4 Id and the actuator controller 159.

[0060] With continued reference to FIGS. 6 and 7, instrument 50 includes an adapter 160 having a housing 162 at a proximal end portion thereof and an elongated shaft 164 that extends distally from housing 162. The instrument 50 also includes the end effector 200 as shown in FIG. 7. The housing 162 is configured to selectively couple to IDU 52, to enable the motors 152a-d of IDU 52 to operate the end effector 200 of the instrument 50 (FIG. 7). As shown inFIG. 6, the housing 162 supports a drive assembly (not shown) that mechanically and / or electrically cooperates with the motors 152a-d of the IDU 52. The drive assembly of instrument 50 may include any suitable electrical and / or mechanical component to effectuate driving force / movement.

[0061] The surgical instrument 50 also includes an end effector 200 coupled to the elongated shaft 164. The end effector 200 may include any number of degrees of freedom allowing the end effector 200 to articulate, pivot, etc., relative to the elongated shaft 164. The end effector 200 may be any suitable surgical end effector configured to treat tissue, such as a dissector, grasper, sealer, stapler, etc.

[0062] As shown in FIGS. 7 and 8, the end effector 200 may include a pair of opposing jaws 120 and 122 that are movable relative to each other. The jaws 120 and 122 may be grippers as shown or any other suitable type of jaws, e.g., shears, sealers, etc. In embodiments, the end effector 200 may include a proximal portion 112 having a first axle 113 and a distal portion 114 (i.e., wrist portion). The end effector 200 may be actuated using a plurality of cables 201a-d routed through proximal and distal portions 112 and 114 around their respective pulleys 112a, 112b, 114a, 114b, which are integrally formed as arms of the proximal and distal portions 112 and 114. Each of the cables 201a-d is actuated by a respective motor 152a-d via corresponding couplers disposed in adapter 160. In embodiments, the end effector 200, namely, the distal portion 114 and the jaws 120 and 122, may be articulated about the axis “A- A” to control a yaw angle of the end effector with respect to a longitudinal axis “X-X”. The distal portion 114 includes a second axle 115 with first jaw 120 and a second jaw 122 pivotably coupled to the second axle 115. The jaws 120 and 122 are configured to pivot about an axis “B-B” defined by the second axle 115 allowing for controlling a pitch angle of the jaws 120 and 122 as well as opening and closing the jaws 120 and 122. The yaw, pitch, and jaw angles between the jaws 120 and 122 as they are moved between open and closed positions are controlled by adjusting the tension and / or length and direction (e.g., proximal or distal) of the cables 201a-d as shown in FIG. 8. The end effector 200 may also include a cable displacement sensor 116 configured to measure position of the cables 201a-d. Thus, the end effector 200 may have three degrees of freedom, yaw, pitch, and jaw angle between jaws 120 and 122. Control algorithms for a cable actuated instrument 50 are also described in International Patent Application No. PCT / US2022 / 019703, “Surgical Robotic System for Realignment of Wristed Instruments,” filed on March 10, 2022.

[0063] FIGS. 9-14 show additional embodiments of end effectors 400 and 500, which are combinations of a suture cutter and a needle-driver. The end effectors described hereinincorporate both needle-driving and suture-severing capabilities within the footprint of a single end effector. The end effectors described herein include opposing jaws capable of opening and closing to grasp and release tissue, surgical sutures, needles, and the like.

[0064] In various embodiments, the opposing jaws can be manipulated to open beyond a predetermined angle to expose blades for cutting surgical suture when desired, such as upon the completion of suturing. Specifically, the opposing jaws can be opened beyond a predetermined angle sufficient to expose blades located proximal to a pivot joint of the opposing jaws of the needle-driver. The blades are then ready to sever surgical suture upon at least partially closing the jaws. As such, the end effectors of the present disclosure can facilitate multiple aspects of a suturing operation, particularly needle grasping and releasing as well as surgical suture severance.

[0065] The end effectors described herein are configured such that cutting surfaces of the blades are not engaged against one another or with another surface until severance of surgical suture is desired. More specifically, in various embodiments, from a fully closed jaw position up to a predetermined angle, the blades overlap and there is no aperture into which surgical suture can be received. As such, the blades are effectively occluded, except when severing of surgical suture is desired. By keeping the blades non-engaged until severing of the surgical suture is desired and the risk of accidental cutting considerably decreases.

[0066] The end effector 400 is substantially similar to the end effector 200 in operation and the primary differences are in the shape of jaws 420 and 422 and further includes cutting surfaces for cutting suture. FIG. 9 shows jaws 420 and 422 in a fully closed configuration and FIG. 10 shows jaws 420 and 422 in a partially open configuration. Jaws 420 and 422 are capable of pivoting between the fully closed and the fully open configurations, as well as to any degree in between. Consequently, the depicted configurations are not limiting.

[0067] Each of the jaws 420 and 422 includes a grasping surface 421 and 423, respectively.End effector 400 is configured to grasp a needle (or possibly tissue) via the grasping surfaces 421 and 423 during a suturing operation when jaws 420 and 422 are closed and to release the needle (or possibly tissue) when jaws 420 and 422 are at least partially open. The extent of opening needed to release a needle during suturing need not necessarily be as wide as that depicted in FIGS. 10 and 11. The closed configuration of FIG. 9 and the partially open configuration of FIG. 10 represent examples of pivoting extremes of jaws 420 and 422 when severing of surgical suture is not desired (i.e., when grasping and releasing a needle). In practice, a much more limited opening of jaws 420 and 422 than that depicted in FIG. 10 canbe employed when releasing a needle during a suturing operation, and it can be advantageous to limit the range of opening, as discussed hereinafter.

[0068] The end effector 400 further includes cutting bodies 430 and 432, respectively, which are disposed on inner surfaces of the jaws 420 and 422. The cutting bodies 430 and 432 contact each during opening and closing of the jaws 420 and 422. The cutting body 430 includes a blade 434 and cutting body 432 includes a blade 436.

[0069] FIGS. 9 and 10 show an embodiment of the end effector 400 having curved or arcuate blades 434 and 436 with a distal blade guard 434a and 436a extending distally from the blades 434 and 436, respectively. The blade guards 434a and 436a extend toward the opposing jaw beyond the blades 434 and 436, such that the blades 434 and 436 are accessible through distal aperture only when the jaws 420 and 422 are sufficiently open so that the blade guards 434a and 436 are apart as shown in FIG. 11.

[0070] As described hereinafter, blades 434 and 436 are exposed only when jaws 420 and 422 are opened beyond a predetermined threshold angle (a) at which the blade guards 434a and 436a are open and permit the blades 434 and 436 to receive a suture. When jaws 420 and 422 are opened further, an aperture is formed between the blade guards 434a and 436a to receive surgical suture between the blades 434 and 436. The aperture between the blade guards 434a and 436a is larger than the aperture between the blades 434 and 436. When jaws 420 and 422 are positioned at an angle less than the predetermined angle (a), aperture between the blade guards 434a and 436a is closed and blades 434 and 436 can no longer accept surgical suture for cutting. As such, the risk of premature suture severance by the blades 434m 436 is reduced significantly if not completely.

[0071] As shown in FIG. 10, the jaws 420 and 422 of the end effector 400 may pivot through a first range of angles (a) without opening the blade guards 434a and 436a such that the blades 434 and 436 are not distally accessible. First range of angles (a) represents the angular positions through which jaws 420 and 422 may pivot between a closed configuration and a partially opened configuration. The end effector 400 can be designed to have any of a variety of first angle ranges (a). For instance, in various embodiments, the end effector 400 may be configured such that the first range of angles (a) is between 0 degrees and about 40 degrees, or between about 0 degrees and about 30 degrees, or between 0 degrees and about 25 degrees. As such, in some embodiments, jaws 420 and 422 may each be articulated through an angular range of a / 2 without exposing aperture between blade guards 434a and 436a.

[0072] Cutting bodies 430 and 432 and come into slidable engagement with one another at an angle smaller than that at which blades 434 and 436 come into slidable adjacent contactwith each other as shown in FIG. 10. For example, in some embodiments, cutting bodies 430 and 432 may come into slidable engagement at the angle (a) ranging between about 10 and about 15 degrees, or between about 15 and about 20 degrees, or between about 20 degrees and about 25 degrees, at which blades 434 and 436 remain non-engaged with one another as shown in FIG. 10. When partially open, the blades 434 and 436 define a circumscribed (i.e., by the blades 434 and 436) cutting aperture allowing for passage of a suturing needle through the cutting aperture.

[0073] In further illustrative embodiments, jaws 420 and 422 may be articulated through a second range of angles (P) to open aperture between blades 434 and 436 (see FIG. 11). Angle (P) is larger than angle alpha (a) and angle (P) starts only after angle alpha (a) is reached. That is, second range of angles (P) corresponds to the additional angular translation required to move from sliding engagement between the blade guards 434a and 436a to form an aperture in between.

[0074] In illustrative embodiments, an aperture may be defined between blade guards 434a and 436a when jaws 420 and 422 are articulated within a second range of angles (P) residing between about 25 degrees and about 45 degrees, or between about 30 degrees and about 45 degrees, or between about 25 degrees and about 40 degrees, or between 30 degrees and about 40 degrees, where 0 degrees represents a configuration in which jaws 420 and 422 are fully closed against one another. As will be appreciated, the second range of angles (P) includes angles greater than those in the first range of angles (a).

[0075] In various embodiments, the first range of angles (a) represents the extent of jaw articulation over which end effector 400 is typically utilized for performing a suturing operation, with an angle of substantially 0 degrees being employed when grasping a suturing needle and an angle up to about 25 degrees, or up to about 30 degrees, or up to about 40 degrees being employed when the suturing needle is released. In more particular operational embodiments, the suturing needle may be released from jaws 420 and 422 at an angle much less than that at which aperture becomes defined, such as any angle above 0 degrees and up to about 20 degrees, or any angle above 0 degrees and up to about 15 degrees. In still more specific embodiments, jaws 420 and 422 may be articulated through a range of angles such that the suturing needle is released before cutting bodies 430 and 432 come into slidable engagement with one another. Releasing the suturing needle without cutting bodies 430 and 432 coming into slidable engagement with one another can be desirable for minimizing friction during operation of end effector 400. Likewise, the second range of angles (P) corresponds to the extent of jaw articulation over which end effector 400 is capable of receiving surgical threadfor severing by placing the surgical thread in aperture defined between blades 434 and 436 and then decreasing the angular separation until blades 434 and 436 slidingly engage one another once again.

[0076] When jaws 420 and 422 are closed, cutting bodies 430 and 432 are not engaged with one another and blades 434 and 436 are occluded, as described in more detail below. At some point between the closed configuration of FIG. 9 and the partially opened configuration of FIG. 10, cutting bodies 430 and 432 come into sliding engagement with one another, and in the configuration of FIG. 9, blades 434 and 436 slidingly engage one another. A portion of cutting bodies 430 and 432 remain in sliding engagement with one another upon further pivoting to the fully opened configuration of FIG. 10.

[0077] In some embodiments, cutting body(ies) 430 and / or 432 may be fabricated integrally as a one-piece construct with a jaw body rotatably coupling corresponding jaw(s) 420 and / or 422 to end effector axle 115, thereby allowing articulation to take place. In other embodiments, cutting body(ies) 430 and / or 432 and a corresponding jaw body may be fabricated as separate components that are configured to mate together so that they can pivot in tandem with one another.

[0078] FIGS. 12-14 show another embodiment of the end effector 500 having jaws 520 and 522 with grasping surfaces 521 and 523. In addition, the jaws 520 and 522 also include cutting bodies 530 and 532 with straight blades 534 and 536, respectively, without blade guards. The end effector 500 is otherwise substantially similar to the end effector 400 of FIGS. 9-11. The end effector 500 also includes a pair of jaws 520 and 522 having grasping surfaces 521 and 523, respectively. The main difference in operation between the end effector 400 and the end effector 500 is that the jaw angle ( ) is sufficient to open the straight blades 534 and 536 rather than the blade guards 434a and 436a.

[0079] The end effectors 400 and 500 of FIGS. 9-13 are operated using the handle controllers 38a and 38b. FIG. 15 shows the right-handle controller 38b, which is a mirror copy of the left-handle controller 38a. Each of the handle controllers 38a and 38b includes a handle 701 and a paddle 708 that is pivotally coupled to the handle 701 at one end (e.g., proximal) of the paddle 708. The paddle 708 is configured to control actuation, namely, opening and closing jaws 520 and 522 of the end effector 500. Operation of the paddle 708 and the operation is described with respect to the end effector 500 but applies to the end effector 400 as well. The paddle 708 may include a finger sensor 704 configured to detect presence or movement of a finger, such as touch sensors, capacitive sensors, optical sensors, and the like. In embodiments, the finger sensor 704 may be disposed on any portion of the handle controllers 38a and 38b.Each of the handle controllers 38a and 38b may also include a trigger 705a and one or more buttons 705b for activating various functions of the instrument 50. In addition, each of the handle controllers 38a and 38b may include a gimbal assembly 706 allowing for movement and rotation of the handle controllers 38a and 38b about three axes (x, y, z). The handle controllers 38a and 38b may also include an infrared proximity sensor 707 configured to detect hand contact with a grip of the handle controllers 38a and 38b. The controller 31a of the surgeon console 30 monitors operator interactions with the handle controllers 38a and 38b and controls the instrument(s) 50 in response to operator inputs.

[0080] The paddle 708 is maintained, i.e., biased, in an open position by a feedback motor 712, which receives operator mechanical input, i.e., as the motor 712 is back driven during movement of the paddle 708 in the opposite direction, e.g., if the paddle 708 is being moved to close, the motor 712 drives to open and vice versa. The paddle 708 may include a finger catch to allow for movement of the paddle 708 away from the handle 701.

[0081] The motor 712 also provides force feedback to the paddle 708 by counteracting operator’s input, i.e., the motor 712 is forward driven. In addition, the motor 712 also measures the force, angle relative to the handle 701, and / or velocity of the paddle 708. The angle of the paddle 708 relative to the handle 701 is proportional to the angle between jaws 520 and 522. Thus, the paddle 708 and the jaws 520 and 522 may be fully aligned when in fully open and fully closed position and the jaw angle in between those position corresponds the paddle angle during the travel of the paddle 708.

[0082] In addition, the controller 31a also monitors individual or a new velocity of each joint of the gimbal assembly 706 as well as displacement of each of the joint of the gimbal assembly 706 and / or net displacement of the gimbal assembly 706. Details of the handle controllers 38a and 38b are provided in U.S. Patent Application Publication No. 2020 / 0315729, titled “Control arm assemblies for robotic surgical systems”.

[0083] A haptic feedback device 710 is disposed in the handle controller 38b to provide vibratory or haptic feedback to the operator. As shown, the feedback device 710 is configured to provide vibrational feedback at set frequencies and intervals to provide a sensation of touching. The feedback device 710 may include eccentric rotating mass (ERM) actuator, a linear resonant actuator (LRA), a piezoelectric actuator, or any other suitable tactile actuator configured to impart information to the operator through their sense of touch. Details of the haptic feedback mechanism are provided in U.S. Patent No. 10,517,686, titled “Haptic feedback controls for a robotic surgical system interface”.

[0084] The paddle 708 is used to actuate various components of the instrument 50, e.g., open and close jaws 520, 522. Thus, during use, the operator applies a constant force to close the jaws 520, 522 from fully open to fully closed configuration. To maintain full jaw closure, the operator maintains force on the paddle 708 to ensure the jaws 520, 522 are fully closed.

[0085] The opening angle or aperture of the jaws 420 and 422 and jaws 520 and 522 may be limited mechanically (e.g., a peg of one jaw traveling inside a slot of another jaw) and / or in software, which may be stored in memory as instructions executable by a processor, e.g., controller 21a. With reference to FIGS. 16-18, operation of the end effectors 400 and 500 is described with respect to the handle controller 38b in which the handle 701 and the paddle 708 are shown schematically as bars.

[0086] The system 10 may operate in a needle driving, e.g., grasping, mode and a cutting mode. In the needle driving mode, the paddle 708 is movable between closed and intermediate position 715 as shown in FIGS. 15 and 16. The jaws 520 and 522 are correspondingly (i.e., in relation to the position of the paddle 708) movable between a closed position and a partially open position as shown in FIGS. 12 and 13, in which the blades 534 and 536 are occluded. In the cutting mode, the paddle 708 is movable from the intermediate position 715 to a fully open position as shown in FIGS. 17 and 18. The jaws 520 and 522 are correspondingly movable between the partially open position to a fully open position as shown in FIGS. 13 and 14. Accordingly, the blades 534 and 536 are movable from an occluded position to an open position for receiving a suture. Switching between grasping and cutting modes may be performed manually, which may be selected or enable by a user, or automatically, where the controller 21a switches between the modes based on a detected phase as described in further detail with respect to FIG. 19.

[0087] FIG. 16 shows the paddle 708 in a fully closed position which commands the jaws 520 and 522 to close as shown in FIG. 12. The feedback motor 712 applies force feedback through the paddle 708 and when the paddle 708 is fully closed no force feedback is applied. However, when the paddle 708 is not fully closed, feedback forces are applied to open input paddle 708 to an intermediate position 715 as shown in FIG. 17. Conversely, force feedback may be consistently applied to the paddle 708, even while the paddle 708 is fully closed. In addition, other feedback may be provided by the handle 701 such as haptic feedback, audio feedback, GUI message, etc. on the surgeon console 30 to indicate the paddle 708 and the jaws 520 and 522 are fully closed.

[0088] With reference to FIG 16, when the paddle 708 is in the intermediate position 715, the feedback motor 712 may not apply any feedback, such that the paddle 708 is at rest.Enabling cutting mode may also be done by moving the paddle 708 away from the handle 701 past a preset angle threshold as shown in FIG. 17. Upon moving the paddle 708 past the threshold where the cutting bodies 530 and 532 are exposed, various feedback may be provided, e.g., haptic, audio, GUI, etc. on the surgeon console 30.

[0089] Opening the jaws 520 and 522 may be delayed in response to opening the paddle 708 beyond intermediate position 715, such that the blades 534 and 536 are not immediately exposed when the paddle 708 reaches a preset angle threshold. Instead, the jaws 520 and 522 may be paused for a preset time period (e.g., 500 ms) with the blades 534 and 536 still being occluded. Thus, if the paddle 708 is closed again within this time period, the jaws 520 and 522 remain in the intermediate position 715.

[0090] With reference to FIG. 18, when the paddle 708 is fully opened, the blades 534 and 536 are fully exposed as shown in FIG. 14. In embodiments, when the paddle 708 is moved beyond the intermediate position 715 but is not fully open, feedback forces may be applied to move the input paddle 708 to the intermediate position 715 as shown in FIG. 18. This automatic movement prevents the blades 534 and 536 from being inadvertently exposed and requires that the user fully open the paddle 708 to cut the suture. Once the paddle is 708 fully open, force feedback may be applied by the feedback motor 712 to maintain the paddle 708 in the fully open position as well as the jaws 520 and 522 and their corresponding blades 534 and 536.

[0091] In further embodiments, prolonged opening of the paddle 708 beyond intermediate position 715 for a preset time period (e.g., 500 ms or more) removes the movement pause, i.e., delay. In addition, any safety delays described above with respect to FIG. 18 may be disabled, allowing for instantaneous control over movement of the jaws 520 and 522. The delay may be re-enabled once the paddle 708 is moved toward the closed position beyond the intermediate position 715 threshold. Thus, returning to paddle 708 to less than intermediate position 715 threshold resets time lag and returns to the end effector 500 to needle driving mode.

[0092] The control scheme described above in FIGS. 16-18 may also be applied to other types of input controllers besides the handle controllers 38a and 38b, such as foot pedals 36, or any other control device that operates between open and closed positions.

[0093] With reference to FIG. 19, the surgical robotic system 10 may include a machine learning (ME) processing system 310 that processes the surgical data using one or more ML models to identify one or more features, such as surgical phase, instrument, anatomical structure, etc., in the surgical data. The ML processing system 310 includes a ML training system 325, which may be a separate device (e.g., server) that stores its output as one or moretrained ML models 330. The ML models 330 are accessible by a ML execution system 340. The ML execution system 340 may be separate from the ML training system 325, namely, devices that “train” the models are separate from devices that “infer,” i.e., perform real-time processing of surgical data using the trained ML models 330.

[0094] System 10 includes a data reception system 305 that collects surgical data, including the video data and surgical instrumentation data. The data reception system 305 can include one or more devices (e.g., one or more user devices and / or servers) located within and / or associated with a surgical operating room and / or control center. The data reception system 305 can receive surgical data in real-time, i.e., as the surgical procedure is being performed.

[0095] The ML processing system 310, in some examples, may further include a data generator 315 to generate simulated surgical data, such as a set of virtual or masked images, or record the video data from the image processing device 56, to train the ML models 330 as well as other sources of data, e.g., user input, arm movement, etc. Data generator 315 can access (read / write) a data store 320 to record data, including multiple images and / or multiple videos.

[0096] The ML processing system 310 also includes a phase detector 350 that uses the ML models to identify a phase within the surgical procedure. Phase detector 350 uses a particular procedural tracking data structure 355 from a list of procedural tracking data structures. Phase detector 350 selects the procedural tracking data structure 355 based on the type of surgical procedure that is being performed. In one or more examples, the type of surgical procedure is predetermined or input by user. The procedural tracking data structure 355 identifies a set of potential phases that may correspond to a part of the specific type of surgical procedure.

[0097] In some examples, the procedural tracking data structure 355 may be a graph that includes a set of nodes and a set of edges, with each node corresponding to a potential phase. The edges may provide directional connections between nodes that indicate (via the direction) an expected order during which the phases will be encountered throughout an iteration of the surgical procedure. The procedural tracking data structure 355 may include one or more branching nodes that feed to multiple next nodes and / or may include one or more points of divergence and / or convergence between the nodes. In some instances, a phase indicates a procedural action (e.g., surgical action) that is being performed or has been performed and / or indicates a combination of actions that have been performed. In some instances, a phase relates to a biological state of a patient undergoing a surgical procedure. For example, the biological state may indicate a complication (e.g., blood clots, clogged arteries / veins, etc.), pre-condition (e.g., lesions, polyps, etc.). In some examples, the ML models 330 are trained to detect an “abnormal condition,” such as hemorrhaging, arrhythmias, blood vessel abnormality, etc.

[0098] The phase detector 350 outputs the phase prediction associated with a portion of the video data that is analyzed by the ML processing system 310. The phase prediction is associated with the portion of the video data by identifying a start time and an end time of the portion of the video that is analyzed by the ML execution system 340. The phase prediction that is output may include an identity of a surgical phase as detected by the phase detector 350 based on the output of the ML execution system 340. Further, the phase prediction, in one or more examples, may include identities of the structures (e.g., instrument, anatomy, etc.) that are identified by the ML execution system 340 in the portion of the video that is analyzed. The phase prediction may also include a confidence score of the prediction. Other examples may include various other types of information in the phase prediction that is output. The predicted phase may be used by the controller 21a to determine when to enable gripping or cutting mode.

[0099] It will be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be construed as limiting, but merely as exemplifications of various embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended thereto.

[0100] The following examples are illustrative of the techniques described herein.

[0101] Example 1. A surgical robotic system comprising: an end effector including: a first jaw having a first gripping surface and a first cutting body disposed proximally of the first gripping surface, the first cutting body having a first blade; and a second jaw having a second gripping surface and a second cutting body disposed proximally of the second gripping surface, the second cutting body having a second blade, wherein at least one of the first jaw or the second jaw is rotatable relative to the other of the first jaw or the second jaw such that the first and second jaws are relatively movable between a closed configuration, in which the first and second gripping surfaces contact or are directly adjacent one another and the first and second blades are occluded, a first open configuration, in which the first and second gripping surfaces are separated and the first and second blades are occluded, and a second open configuration, in which the first and second gripping surfaces are separated and the first and second blades are exposed; and a handle controller including: a handle; a paddle pivotably movable relative to the handle from a closed position corresponding to the closed configuration of the first and second jaws, a first open position corresponding to the first open configuration of the first and second jaws, and a second open position corresponding to the second open configuration of the first and second jaws; and a feedback motor for applying force feedback and moving the paddle to return the paddle to the first open position.

[0102] Example 2. The surgical robotic system according to Example 1, wherein the feedback motor maintains the paddle in the first open position.

[0103] Example 3. The surgical robotic system according to Example 1, wherein while the paddle is in the first open position, the feedback motor applies no force feedback.

[0104] Example 4. The surgical robotic system according to Example 1, wherein the handle controller further includes a haptic feedback device for generating haptic feedback when the paddle is in at least one of the closed position, the first open position, or the second open position.

[0105] Example 5. The surgical robotic system according to Example 1, further comprising a surgeon console for generating an audio or a video indicator that the paddle is in at least one of the closed position, the first open position, or the second open position.

[0106] Example 6. The surgical robotic system according to Example 1, wherein in response to the paddle being moved from the first open position toward the second open position, opening of the first and second jaws from the first open configuration to the second open configuration is delayed.

[0107] Example 7. The surgical robotic system according to Example 6, wherein in response to the paddle being disposed between the first open position and the second open position for a preset time period the paddle resumes real-time control of the first and second jaws.

[0108] Example 8. The surgical robotic system according to Example 1, wherein the first blade and the second blade have at least one of a straight shape or a curved shape.

[0109] Example 9. A surgical robotic system comprising: an end effector including: a first jaw having a first gripping surface and a first cutting body disposed proximally of the first gripping surface, the first cutting body having a first blade; and a second jaw having a second gripping surface and a second cutting body disposed proximally of the second gripping surface, the second cutting body having a second blade, wherein at least one of the first jaw or the second jaw is rotatable relative to the other of the first jaw or the second jaw such that the first and second jaws are relatively movable between a closed configuration, in which the first and second gripping surfaces contact or are directly adjacent one another and the first and second blades are occluded, a first open configuration, in which the first and second gripping surfaces are separated and the first and second blades are occluded, and a second open configuration, in which the first and second gripping surfaces are separated and the first and second blades are exposed; an input controller having: a stationary portion; an input portion movable relative to the stationary from a closed position corresponding to the closedconfiguration of the first and second jaws, a first open position corresponding to the first open configuration of the first and second jaws, and a second open position corresponding to the second open configuration of the first and second jaws; and a feedback motor for applying force feedback and moving the input portion to return the input portion to the first open position.

[0110] Example 10. The surgical robotic system according to Example 9, wherein the input controller is at least one of a foot pedal or a handle controller.

[0111] 11. The surgical robotic system according to Example 9, wherein the feedback motor maintains the input portion in the first open position.

[0112] Example 12. The surgical robotic system according to Example 9, wherein while the input portion is in the first open position, the feedback motor applies no force feedback.

[0113] Example 13. The surgical robotic system according to Example 9, wherein the input controller further includes a haptic feedback device for generating haptic feedback when the input portion is in at least one of the closed position, the first open position, or the second open position.

[0114] Example 14. The surgical robotic system according to Example 9, further comprising a surgeon console generates an audio or video indicator that the input portion is in at least one of the closed position, the first open position, or the second open position.

[0115] Example 15. The surgical robotic system according to Example 9, wherein in response to the input portion being moved from the first open position toward the second open position, opening of the first and second jaws from the first open configuration to the second open configuration is delayed.

[0116] Example 16. The surgical robotic system according to Example 15, wherein in response to the input portion being disposed between the first open position and the second open position for a preset time period the input portion resumes real-time control of the first and second jaws.

[0117] Example 17. The surgical robotic system according to Example 1, wherein the first blade and the second blade have at least one of a straight shape or a curved shape.

[0118] Example 18. A surgical robotic system comprising: an end effector including: a first jaw having a first gripping surface and a first cutting body disposed proximally of the first gripping surface, the first cutting body having a first curved blade and a first blade guard disposed distally of the first curved blade and extending past the first curved blade; and a second jaw having a second gripping surface and a second cutting body disposed proximallyof the second gripping surface, the second cutting body having a second curved blade and a second blade guard disposed distally of the second curved blade and extending past the second curved blade, wherein at least one of the first jaw or the second jaw is rotatable relative to the other of the first j aw or the second j aw such that the first and second j aws are relatively movable between a closed configuration, in which the first and second gripping surfaces contact or are directly adjacent one another and the first and second curved blades are occluded, a first open configuration, in which the first and second gripping surfaces are separated and the first and second curved blades define an aperture therebetween while the first and second blade guards occlude the aperture between the first and second curved blades, and a second open configuration, in which the first and second gripping surfaces are separated and the first and second blade guards and the first and second curved blades are exposed and a first gap is defined between the first and second curved blades and a second gap is defined between the first and second blade guards that is larger than the first gap.

[0119] Example 19. The surgical robotic system according to Example 18, further comprising a surgeon console including: a handle controller having: a handle; a paddle pivotably movable relative to the handle from a closed position corresponding to the closed configuration of the first and second jaws, a first open position corresponding to the first open configuration of the first and second jaws, and a second open position corresponding to the second open configuration of the first and second jaws; and a feedback motor for applying force feedback and moving the paddle to return the paddle to the first open position.

[0120] Example 20. The surgical robotic system according to Example 19, wherein the surgeon console generates an audio or video indicator that the paddle is in at least one of the closed position, the first open position, or the second open position.

Claims

WHAT IS CLAIMED IS:

1. A surgical robotic system (10) comprising: an end effector (400, 500) including: a first jaw (420, 520) having a first gripping surface (421, 521) and a first cutting body (430, 530) disposed proximally of the first gripping surface, the first cutting body having a first blade (434, 534); and a second jaw (422, 522) having a second gripping surface (423, 523) and a second cutting body (432, 532) disposed proximally of the second gripping surface, the second cutting body having a second blade (436, 536), wherein at least one of the first jaw or the second jaw is rotatable relative to the other of the first jaw or the second jaw such that the first and second jaws are relatively movable between a closed configuration, in which the first and second gripping surfaces contact or are directly adjacent one another and the first and second blades are occluded, a first open configuration, in which the first and second gripping surfaces are separated and the first and second blades are occluded, and a second open configuration, in which the first and second gripping surfaces are separated and the first and second blades are exposed; and a handle controller (38a, 38b) including: a stationary portion (701); an input portion (708) movable relative to the stationary from a closed position corresponding to the closed configuration of the first and second jaws, a first open position corresponding to the first open configuration of the first and second jaws, and a second open position corresponding to the second open configuration of the first and second jaws; and a feedback motor for applying force feedback and moving the input portion to return the input portion to the first open position2. The surgical robotic system according to claim 1 , wherein the feedback motor maintains the input portion in the first open position.

3. The surgical robotic system according to any preceding claim, wherein while the input portion is in the first open position, the feedback motor applies no force feedback.

4. The surgical robotic system according to claim 1, wherein the handle controller further includes a haptic feedback device (710) for generating haptic feedback when the input portion is in at least one of the closed position, the first open position, or the second open position.

5. The surgical robotic system according to any preceding claim, further comprising a surgeon console (30) for generating an audio or a video indicator that the input portion is in at least one of the closed position, the first open position, or the second open position.

6. The surgical robotic system according to any preceding claim, wherein in response to the input portion being moved from the first open position toward the second open position, opening of the first and second jaws from the first open configuration to the second open configuration is delayed.

7. The surgical robotic system according to claim 6, wherein in response to the input portion being disposed between the first open position and the second open position for a preset time period the input portion resumes real-time control of the first and second jaws.

8. The surgical robotic system according to any preceding claim, wherein the first blade and the second blade have at least one of a straight shape or a curved shape.

9. The surgical robotic system according to any preceding claim, wherein the stationary portion is a handle (701).

10. The surgical robotic system according to any preceding claim, wherein the input portion is a paddle (708).

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