Robotic surgical system for combined multi-channel and single port surgical techniques

Abstract

According to an aspect of this disclosure, a robotic surgical system includes a robotic arm cart, an endoscope, a surgical instrument, a videoscope, a surgeon console, and an overtube controller, wherein the endoscope is controllable by commands received from either the surgeon console or the overtube controller.

Description

ROBOTIC SURGICAL SYSTEM FOR COMBINED MULTICHANNEL AND SINGLE PORT SURGICAL TECHNIQUESCROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims the benefit of and priority to U.S. Provisional Application No. 63 / 669,722, filed July 11, 2024; U.S. Provisional Application No. 63 / 669,882, filed July 11, 2024; and U.S. Provisional Application No. 63 / 673,314, filed July 19, 2024. The entire disclosures of the foregoing applications are incorporated by reference herein.TECHNICAL FIELD

[0002] This disclosure relates to robotic surgical systems and procedures and, more particularly, to a robotic surgical system combining a multi-channel system and a single port system with one another, and related surgical procedures or techniques.BACKGROUND

[0003] Robotic surgical systems include control drive assemblies supporting surgical instruments used in endoluminal, laparoscopic and / or robotic surgery. These surgical instruments generally have a proximally located actuating mechanism that is operably coupled to a control drive unit of the control drive assembly for actuating distal end effectors of the surgical instruments. The control drive unit includes any number of motors operably associated with the actuating mechanisms of the surgical instruments. A clinician remotely controls these motors to enable the surgical instruments to robotically perform a surgical task within a body cavity of a patient, and often in remote locations within the body cavity that are not easily accessed without robotic surgical systems.

[0004] When clinicians arc looking for more organ sparing procedures and / or procedures which require no incisions, endoluminal robotic surgery plays a role as a potential solution. Some endoluminal robotic surgical procedures may be performed with a single lumen articulating catheter, while some endoluminal robotic surgical procedures require an application of forces on a target tissue at the same time as counter forces are applied to the target tissue, wherein an endoluminal robotic surgical system including multiple instruments and a camera,disposed within an overtube or the like, that can all be robotically controlled or actuated may be used.

[0005] A need exists for a robotic surgical system including a robotic arm that can do both single port procedures with a rigid tube and partially flexible instruments, and / or a multi-channel procedure with a fully flexible overtube and fully flexible instruments which uses or accesses the natural orifices of the body and / or beyond the lumens in a trans-lumen approach. A need further exists for a robotic surgical system that is configured for control by a clinician operating the robotic surgical system from a surgeon console or for control by a clinician operating the robotic surgical system from a controller located at the bedside and in close proximity to the patient lying on an operating table.SUMMARY

[0006] According to an aspect of this disclosure, a robotic surgical system includes a robotic arm cart, an endoscope, a surgical instrument, a videoscope, a surgeon console, and an overtube controller.

[0007] The robotic arm cart includes a setup arm assembly configured to translate relative to a tower of the robotic arm cart, and configured to rotate about a setup arm rotation axis which extends transverse to a longitudinal axis of the tower of the robotic arm cart; a central drive unit (CDU) defining a CDU longitudinal axis and being coupled to the setup arm assembly for rotation about the CDU longitudinal axis; and an endoscope drive unit arm extending from the chassis of the central drive unit, wherein the endoscope drive unit arm extends distally of the central drive unit to a position distal of the instrument drive unit and the videoscope drive unit, the endoscope drive unit arm being configured to transmit operational forces.

[0008] The central drive unit includes an instrument drive unit supported on a chassis of the central drive unit, wherein the instrument drive unit is configured to translate relative to the chassis between a retracted position and an advanced position, the instrument drive unit being configured to transmit operational forces; and a videoscope drive unit supported on the chassis of the central drive unit, wherein the videoscope drive unit is configured to translate relative to thechassis between a retracted position and an advanced position, the videoscope drive unit being configured to transmit operational forces.

[0009] The endoscope is selectively connected to the endoscope drive unit arm. The endoscope includes an endoscope housing and an elongate flexible overtube extending from the endoscope housing, wherein at least a distal end portion of the overtube is steerable to control a pitch and a yaw of the distal portion of the overtube. The endoscope housing includes at least one tool channel extending from a proximal face of the endoscope housing and into a respective overtube tool channel defined in the overtube; at least one fluid coupling in fluid communication with a corresponding fluid channel defined in the overtube; and at least one central drive unit coupling configured to receive the operational forces from the endoscope drive unit arm to control the pitch and / or yaw of the distal portion of the overtube.

[0010] The surgical instrument is selectively connected to the instrument drive unit. The surgical instrument includes an elongate flexible shaft extending from an instrument housing, wherein the elongate flexible shaft is configured to translate through a respective one of the at least one tool channel of the endoscope housing, wherein at least a distal end portion of the surgical instrument is steerable to control a pitch and a yaw of the distal portion of the elongate flexible shaft, and wherein the surgical instrument includes a tool supported at the distal end portion of the elongate flexible shaft.

[0011] The videoscope is selectively connected to the videoscope drive unit. The videoscope includes an elongate flexible shaft extending from a videoscope housing, wherein the elongate flexible shaft is configured to translate through a respective one of the at least one tool channel of the endoscope housing, wherein at least a distal end portion of the videoscope is steerable to control a pitch and a yaw of the distal portion of the elongate flexible shaft, and wherein the videoscope includes a camera supported at the distal end portion of the elongate flexible shaft.

[0012] The surgeon console includes input devices for controlling the central drive unit to transmit the operational forces from the endoscope drive unit arm to the endoscope; transmit the operational forces from the instrument drive unit to the surgical instrument; and transmit the operational forces from the videoscope drive unit to the videoscope.

[0013] The overtube controller is operatively connected to the surgeon console. The overtube controller includes inputs for controlling the transmission of the operational forces from the endoscope drive unit arm to the overtube of the endoscope.

[0014] Other aspects, features, and advantages will be apparent from the description, the drawings, and the claims that follow.BRIEF DESCRIPTION OF THE DRAWINGS

[0015] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate aspects of this disclosure and, together with a general description of this disclosure given above, and the detailed description given below, explain the principles of this disclosure, wherein:

[0016] FIG. 1 is an illustration of a robotic surgical system in accordance with the present disclosure which is configured for combined multi-channel and single port surgical techniques;

[0017] FIG. 2 is an illustration of the robotic surgical system of FIG. 1 depicting attachment of a videoscope to a central drive unit;

[0018] FIG. 3 is an illustration of the robotic surgical system of FIG. 1 depicting the vidcoscopc attached to the central drive unit and an endoscope attached to an endoscope drive unit of the central drive unit;

[0019] FIG. 4 is an enlarged view of the indicated area of detail of FIG. 3;

[0020] FIG. 5 is a perspective view of an endoscope of the present disclosure;

[0021] FIG. 6 is a rear, top perspective view of an endoscope housing of the endoscope of FIG. 5;

[0022] FIG. 7 is a rear, bottom perspective view of the endoscope housing of the endoscope of FIG. 5;

[0023] FIG. 8 is a distal end view of an overtube of the endoscope of FIG. 5;

[0024] FIG. 9 is an illustration of a distal end of the overtube including various tools and instruments deployed therefrom;

[0025] FIG. 10 is an illustration of a handle controller for operating the endoscope by a nurse located at the bedside;

[0026] FIG. 11 is a schematic illustration of the endoscope being attached to the endoscope drive unit via a sterile adapter;

[0027] FIG. 12 is an illustration of an endoscope overtube drive unit according to an embodiment of the present disclosure; and

[0028] FIG. 13 is an illustration of an endoscope overtube drive unit according to another embodiment of the present disclosure.DETAILED DESCRIPTION

[0029] Aspects of this disclosure 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. As used herein, the term “distal” refers to that portion of structure closer to a patient, while the term “proximal” refers to that portion of structure, farther from the patient. As used herein, the term “clinician” refers to a doctor, nurse, or other care provider and may include support personnel and / or equipment operators.

[0030] In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail.

[0031] Robotic surgical systems have been used in minimally invasive medical procedures. Such procedures may be referred to as what is commonly referred to as “Telesurgery.” These robotic surgical systems have one or more surgical instruments removably coupled thereto. Such surgical instruments include, for example, endoscopes, electrosurgical forceps, cutting instruments, staplers, graspers, electrocautery devices, or any other endoscopic, endoluminal or open surgical devices. Prior to or during use of the robotic surgical system, various surgical instruments can be selected and connected to the robotic surgical system for selectively operating end effectors of the connected surgical instruments.

[0032] According to the present disclosure, as depicted in FIGS. 1-3, a robotic surgical system 100 is provided which includes a robotic arm cart 200 configured to perform both single port procedures with a rigid tube including multiple tube passages for receipt of partially flexible instruments therein and / or therethrough, and natural orifice and / or endoluminal procedures (and even beyond the body lumens in trans-lumen approaches or procedures) with a fully flexible overtube including multiple tube passages (e.g., multi-channels) for receipt of fully flexible instruments therein and / or therethrough.

[0033] Such a robotic surgical system 100 will include a surgeon console 110 for controlling the robotic arm cart 200, surgical instruments 120 and the like that are connectable to the robotic arm cart 200 for control by the robotic arm cart 200; a control tower 130 (or a remote processing unit) or the like into which the surgeon console 110, the robotic arm cart 200, and any additional robotic surgical equipment may be connected for control thereof; and a robotic arm cart 200 capable of moving in multiple degrees of freedom and capable of driving components of an endoscope 300. As will be described in greater detail below, the endoscope 300 may include up to a 2 meter long flexible overtube and / or a rigid overtube 320 defining passages or channels therethrough that are configured to accommodate a plurality of rigid, semi-flexible, or fully- flexible surgical instruments (e.g., graspers, shears, hooks, and the like), a camera or videoscope, and / or an insufflation / suction / irrigation device.

[0034] The surgeon console 110 (i.e., surgeon user interface) is configured for use by a clinician to perform surgical tasks therefrom and view / control and / or operate various surgical instruments therefrom. The surgeon console 110 may be connected to a control tower and / or visualization tower 130 which is configured to process commands received from the surgeon console 110 and sent to the surgical instruments 120 and visualization devices (e.g., cameras, videoscope 122, the endoscope 300, etc.) and to relay feedback information and visualizations from the surgical instruments 120 and / or visualization devices back to the surgeon console 110.

[0035] The surgeon console 110 and / or the control tower 130 can include computing devices and / or controllers such as a master processor circuit in communication with the various input devices of the present disclosure (e.g., surgeon console input handles, handheld controller 400, etc.) for receiving input signals and generating control signals for controlling the robotic surgicalsystem 100, which can be transmitted to the robotic arm cart 200 for controlling surgical instruments 120, visualization devices 122 and endoscope 300.

[0036] The robotic arm cart 200 may be in the form of a cart including a mobile base 210, a setup arm assembly 220 supported on the mobile base 210, and a central drive unit or control drive assembly 230 supported by the setup arm assembly 220 and that is selectively movable relative to the mobile base 210 for translation vertically relative to the mobile base 210 (as indicated by arrow “A”), and for rotation about an axis “X” extending transverse to the axis of translation of setup arm assembly 220. The central drive unit 230 is movable relative to mobile base 210, and desirably rotatable about a central axis “Y” extending transverse to the axis of rotation “X”. The central drive unit 230 houses instrument / video drive assembly 232 for manipulating the surgical instruments 120 attached thereto with the assistance of, for example, one or more computing devices or controllers. The instrument / video drive assembly 232 can include an instrument drive unit 232a for operating surgical instruments 120 such as graspers coupled thereto and a video drive unit 232b for operating surgical devices such as an endoscope 300 coupled thereto.

[0037] The central drive unit or control drive assembly 230 is supported on the setup arm assembly 220 of the robotic arm cart 200 so as to be oriented in any number or orientations from completely vertical to completely horizontal. Further, the central drive unit 230 is supported on the robotic arm cart 200 such that the central drive unit 230 may be rotated about a central longitudinal axis thereof. A chassis 231 of the central drive unit 230 may support a plurality of instrument drive units 232 (four being shown, although fewer or more instrument drive units may be provided), which instrument drive units 232 may extend axially from and retract axially into a housing of the central drive unit 230, in a telescoping manner, such as, for example, the manner in which the instrument drive units of the central drive unit operate in International Patent Application No. PCT / US2023 / 015027, filed on March 10, 2023, the entire content of which is incorporated herein by reference.

[0038] Surgical instruments 120 can include any number and / or type of surgical instruments, for example, as seen in FIG. 9, graspers or forceps 120a, which may be electrosurgical, an endoscope or videoscope 122, an electrosurgical spatula or hook 120c, and / or an auxiliary tool in the form of a suction device, a suture delivery device or a biopsy device 120d. Additionalsurgical instruments include, and are not limited to, for example, dexterous tools, such as grippers, needle drivers, staplers, dissectors, cutters, scissors, coagulators, irrigators, which are used for performing a surgical procedure. It is contemplated that each surgical instrument 120 and each videoscope 122 may include an elongate shaft extending from a respective housing 121a wherein the elongate shaft includes a relatively short rigid proximal end portion 121b connected to the housing 121a, a relatively long flexible passive intermediate portion 121c extending distally of the rigid proximal end portion 121b, and an active distal tip portion 12 Id extending distally of the intermediate portion 121c. The active distal tip portion 12 Id of each surgical instrument 120 is capable of movement between a straight or substantially straight configuration and various gooseneck configurations, wherein a pitch of the active distal tip portion 121d may be actively controlled by the central drive unit 230.

[0039] The central drive unit 230 includes an endoscope drive unit 240 extending to a position distal of the instrument drive unit 232a and the video drive unit 232b. Specifically, the endoscope drive unit 240 includes an endoscope drive unit arm 242 extending from the chassis 231 of the central drive unit 203 and extending distally of the instrument drive unit 232a and the video drive unit 232b. The endoscope drive unit 240 further includes an endoscope mounting head 244 located at the distal end of the endoscope drive unit arm 242. The endoscope mounting head 244 is configured to selectively receiving and connect the endoscope 300 to the central drive unit 230. As depicted in FIG. 11, the endoscope mounting head 244 may include at least one actuator, drive member or motor 246 supported therein and actuatable by the central drive unit 230 as activated by the control inputs from the surgeon console 110 and / or by a handheld controller 400 controlled by a bedside clinician, as will be described in grater detail below.

[0040] With reference to FIGS. 5-9, the endoscope 300 of the present disclosure is depicted and described in detail. Endoscope 300 includes an endoscope housing 310 configured and adapted to selectively engage the endoscope mounting head 244 of the endoscope drive unit 240, and an overtube 320 supported by and extending from the endoscope housing 310. The endoscope housing 310 includes a distal end 310a from which the overtube 320 extends, and a proximal end 310b.

[0041] The endoscope housing 310 defines or includes at least one, and desirably a plurality of tool channels 312 in the proximal end 310a and which tool channels 312 extend through theendoscope housing 310 and completely through to a distal end 320a of the overtube 320 (see FIG. 8).

[0042] The endoscope housing 310 further defines or includes at least one working channel 314 in the proximal end 310a and which working channel 314 extends through the endoscope housing 310 and completely through to the distal end 320a of the overtube 320 (see FIG. 8).

[0043] The tool channels 312 and the working channel 314 are provided to enable and permit the distal ends (or the working portions or tool portions) of the surgical instruments 120 to pass entirely through the endoscope 300, such that, during use of the robotic surgical system 100, as depicted in FIG. 9, the distal ends of the surgical instruments 120 extend, or are extendable, beyond the distal end 320a of the overtube 320.

[0044] The endoscope housing 310 further includes at least one fluid line coupling 316 for connection of insufflation, irrigation and / or suction to the endoscope 300 and for fluid communication with fluid channels 326 extending through the overtube 320 and to the distal end 320a thereof.

[0045] The endoscope housing 310 further includes at least one, desirably a plurality of drive coupling members 318 for the endoscope 300. Each drive coupling member 318 is configured to receive actuation forces from a respective actuator 246 of the endoscope mounting head 244 of the endoscope drive unit 240 and transmit the actuation forces to overtube control cables 330 (see FIGS. 7, 9 and 11) located within and extending at least partially through the overtube 320 in order to steer or flex a distal end portion or segment 322a of the overtube 320 and change a pitch / yaw thereof.

[0046] The overtube 320 of the endoscope 300 includes an elongate tubular body 322 formed of a flexible or pliable material along at least a portion of its length, and desirably along an entirety of its length. The body 322 of the overtube 320 defines a plurality of internal lumens or channels (e.g., the tool channels 312 and the working channel 314) extending from the endoscope housing 310 through to the distal end 320a of the overtube 320. The lumens or channels of the overtube 320 further include the fluid channels 326 described above. In embodiments, the body 322 of the overtube 320 may include tool channels 312, workingchannels 314 and fluid channels 326. However, it is contemplated, and in accordance with the present disclosure, that the body 322 of the overtube 320 may include only tool channels 312, only working channels 314, only fluid channels 326, or any combination and number of tool channels 312, working channels 314, and fluid channels 326. It is further contemplated, and in accordance with the present disclosure, that the tool channels 312 and / or working channels 314 may, in certain circumstances, be used as fluid channels or the like.

[0047] The overtube 320 additionally includes control cables 330 having proximal ends connected to the drive coupling members 318, and distal ends extending through the body 322 and terminating at various distal locations within the body 322 and within the distal end portion or segment 322a of the overtube 320. In use, as the drive coupling members 318 of the endoscope 320 are actuated, via respective actuators 246 of the endoscope mounting head 244 of the endoscope drive unit 240, the drive coupling members 318 act on the control cables to thereby pull (take in) or push (release or let out) the control cables to cause the distal end portion 322a to be flexed or steered (change in pitch and / or yaw) as needed or desired, to accommodate and navigate a tubular body lumen of a patient (e.g., colon, intestines, esophagus, etc.).

[0048] In use, actuation of the actuators 246 of the endoscope mounting head 244 of the endoscope drive unit 240 to effectuate steering of the distal end portion or segment 322a of the overtube 320 may be accomplished through actuation of hand controllers or input devices located at the surgeon console 1 10, through actuation of the handheld controller 400 controlled by a bedside clinician (as will be described in greater detail below), or through any other physically or remotely connected input device (e.g., wireless controller, wireless tablet, virtual reality or augmented reality headset or glasses, joysticks, control wheels or balls, etc.).

[0049] As depicted in FIGS. 7 and 11, the endoscope 300 includes electrical connectors 319 supported on the endoscope housing 310 for receiving data signals and power from the endoscope mounting head 244 of the endoscope drive unit 240 and for sending data signals, imaging signals, video signals and the like to the endoscope drive unit 240, the central drive unit 230, the robotic arm cart 200, the surgeon console 110, the control tower 130 and the like.

[0050] With reference to FIGS. 1 and 10, the robotic surgical system 100 further includes a handheld controller 400 connected to or otherwise tethered to the surgeon console 110, thecontrol tower 130, the robotic arm cart 200, the central drive unit 230 of the robotic arm cart 200, or to an inserter system 500 (as will be described in detail below). The handheld controller 400 may include a handle or grip 402 configured to be held by a hand of a clinician, a cable 404 extending from the handle 402 and configured to electrically connect to any one of the aforementioned systems or components of the robotic surgical system 100, and at least one input feature supported on the handle 402 (e.g., joystick or ball controller 406a, buttons 406b located at a top of the handle 402, buttons or triggers 406c located along a side of the handle 402, or the like). While handheld controller 400 is depicted as having a cable 404 for connecting handle 402 to any one of the aforementioned systems or components of the robotic surgical system 100, it is envisioned and within the scope of the present disclosure for handheld controller 400 to be connected to any one of the aforementioned systems or components of the robotic surgical system 100 via any know connection features or protocols, such as, for example, wireless communications and the like.

[0051] As depicted in FIG. 11, it is envisioned that a sterile adapter 450 may be provided for interconnecting the endoscope 300 to the endoscope mounting head 244 of the endoscope drive unit 240, wherein the sterile adapter 450 includes mechanical couplers 452 for transmitting forces from the actuators 246 of the endoscope mounting head 244 to the respective drive coupling member 318 of the endoscope 300. The sterile adapter 450 further includes electrical couplers 454 for transmitting electrical signals and power between electrical connectors 248 of the endoscope mounting head 244 and electrical connectors 319 of the endoscope 300.

[0052] Turning now to FIGS. 12-13, the robotic surgical system 100 further includes an inserter or bedside control module 500 which is selectively positionable on the patient bed in proximity to an entry point into the body orifice of the patient of the aforementioned overtube 320 of the endoscope 300. The bedside control module 500 may include a drive assembly 502, and an insertion / roll control assembly 504 operatively connected to the drive assembly 502. The bedside control module 500 is configured to facilitate insertion and extraction of the overtube 320 of the endoscope 300 into and out of the body orifice of the patient, and to facilitate rotation or roll of the overtube 320 relative to the body orifice of the patient.

[0053] As depicted in FIG. 12, the insertion / roll control assembly 504 of the bedside control module 500 includes a central lumen or passage 504a through which the overtube 320 passes, or,as depicted in FIG. 13, the insertion / roll control assembly 504 of the bedside control module 500 includes a radially extending slot 504b into which the overtube 320 is seated or placed.

[0054] The insertion / roll control assembly 504 of the bedside control module 500 includes mechanical features, actuatable by the drive assembly 502, for selectively gripping an outer surface of the overtube 320 so as to transmit forces to the overtube 320 to advance the overtube 320 into the body orifice of the patient, to withdrawn the overtube 320 from the body orifice of the patient, and to roll the overtube 320 relative to the body orifice of the patient.

[0055] In use, a bedside clinician may hold the handheld controller 400 in one hand (e.g., their left hand) and may hold a proximal end of the overtube 320 in their other hand (e.g., their right hand), whereby, and the bedside clinician manually manipulates the overtube 320 with one hand (e.g., advancing, withdrawing, rolling) the bedside clinician may steer the distal end portion 322a of the overtube 320 through the tortuous body orifice of the patient. Alternatively or additionally to the bedside clinician, a surgeon or clinician located at the surgeon console 110 may steer the distal end portion 322a of the overtube 320 through the tortuous body orifice of the patient.

[0056] Still further, alternatively or additionally to the bedside clinician manually manipulating the proximal end of the overtube 320, the bedside control module 500 may be employed to mechanically drive insertion, withdrawal and roll of the overtube 320. It is contemplated that the bedside control module 500 may function as a slack management system to accommodate and address the length of the overtube 320 of the endoscope 300 located external of the body of the patient.

[0057] The surgeon console 110 includes a display device, which is set up in particular to display three-dimensional images; and manual input devices by means of which a person, for example, a surgeon, is able to telemanipulate the central drive unit 230 in a first operating mode, as known in principle to a person skilled in the art, or the endoscope 300 in a second operating mode. The central drive unit 230 may be driven by electric drives that are connected to a control device (e.g., a computer) that is configured to activate the drives, in particular by means of a computer program, in such a way that the central drive unit 230, the endoscope 300, the attached instrument drive units, and thus the surgical instruments 120 execute a desired movementaccording to a movement defined by means of the manual input devices or controllers of the surgeon console 110 and / or the handheld controller 400.

[0058] The robotic surgical system is configured for use on a patient lying on a surgical table to be treated in a minimally invasive manner.

[0059] The surgeon console 110 may control a plurality of motors 233a, 233b of the instrument drive unit 232a or the endoscope drive unit 232b, respectively, (see FIG. 2), or motors 233 of the central drive unit 230, with each motor configured to drive movement of the in strument / endo scope drive units in a plurality of directions, and control the activation of the instrument / endoscope drive units to drive various operations of the surgical instruments 120.

[0060] Further aspects and embodiments of the present disclosure are set out in the below numbered clauses:1. A robotic surgical system, comprising: a robotic arm cart including: a setup arm assembly; a central drive unit (CDU) coupled to the setup arm assembly, the CDU includes: an instrument drive unit supported on a chassis of the CDU, the instrument drive unit being configured to transmit operational forces; and a videoscope drive unit supported on the chassis of the CDU, the videoscope drive unit being configured to transmit operational forces; an endoscope drive unit arm extending from the chassis of the CDU, wherein the endoscope drive unit arm extends distally of the CDU to a position distal of the instrument drive unit and the videoscope drive unit, the endoscope drive unit arm being configured to transmit operational forces; an endoscope selectively connected to the endoscope drive unit arm, the endoscope including an endoscope housing and an elongate flexible overtube extending from the endoscopehousing, wherein at least a distal end portion of the overtube is steerable to control a pitch and a yaw of the distal portion of the overtube, the endoscope housing including: at least one tool channel extending from a proximal face of the endoscope housing and into a respective overtube tool channel defined in the overtube; at least one fluid coupling in fluid communication with a corresponding fluid channel defined in the overtube; and at least one central drive unit coupling configured to receive the operational forces from the endoscope drive unit arm to control the pitch and / or yaw of the distal portion of the overtube; a surgical instrument selectively connected to the instrument drive unit, the surgical instrument including an elongate flexible shaft extending from an instrument housing, wherein the elongate flexible shaft is configured to translate through a respective one of the at least one tool channel of the endoscope housing, wherein at least a distal end portion of the surgical instrument is steerable to control a pitch and a yaw of the distal portion of the elongate flexible shaft, and wherein the surgical instrument includes a tool supported at the distal end portion of the elongate flexible shaft; a videoscope selectively connected to the videoscope drive unit, the videoscope including an elongate flexible shaft extending from a videoscope housing, wherein the elongate flexible shaft is configured to translate through a respective one of the at least one tool channel of the endoscope housing, wherein at least a distal end portion of the videoscope is steerable to control a pitch and a yaw of the distal portion of the elongate flexible shaft, and wherein the videoscope includes a camera supported at the distal end portion of the elongate flexible shaft; a surgeon console including input devices for controlling the CDU to: transmit the operational forces from the endoscope drive unit arm to the endoscope; transmit the operational forces from the instrument drive unit to the surgical instrument; andtransmit the operational forces from the videoscope drive unit to the videoscope; and an overtube controller operatively connected to one of the surgeon console or the robotic arm cart, the overtube controller including inputs for controlling the transmission of the operational forces from the endoscope drive unit arm to the overtube of the endoscope.2. The robotic surgical system according to clause 1, wherein the setup arm assembly is translatable relative to a mobile base of the robotic arm cart, and is rotatable about a setup arm rotation axis which extends transverse to a vertical axis of the robotic arm cart.3. The robotic surgical system according to any of the preceding clauses, wherein the CDU defines a CDU longitudinal axis, and wherein the CDU is coupled to the setup arm assembly for rotation about the CDU longitudinal axis.4. The robotic surgical system according to any of the preceding clauses, wherein the instrument drive unit is translatable relative to the chassis between a retracted position and an advanced position.5. The robotic surgical system according to any of the preceding clauses, wherein the videoscope drive unit is translatable relative to the chassis between a retracted position and an advanced position.6. The robotic surgical system according to any of the preceding clauses, wherein the endoscope drive unit arm includes a head supporting a plurality of endoscope actuators, wherein the endoscope actuators are activatable by commands received from the surgeon console or by commands received by the overtube controller.7. The robotic surgical system according to any of the preceding clauses, wherein the at least one central drive unit coupling of the endoscope is configured to selectively engage a respective one of the plurality of endoscope actuators of the head of the endoscope drive unit arm.8. The robotic surgical system according to any of the preceding clauses, wherein the endoscope includes an actuation cable connected to each central drive unit coupling, wherein each cable extends distally through the overtube to at least a distal end portion of the overtube.9. The robotic surgical system according to any of the preceding clauses, wherein the overtube controller is a handheld controller.10. The robotic surgical system according to any of the preceding clauses, wherein the inputs of the overtube controller include at least one of a joystick or buttons.11. The robotic surgical system according to any of the preceding clauses, wherein the robotic arm cart is supported on a mobile base.12. A robotic surgical system, comprising: a robotic arm cart including: a setup arm assembly configured to translate relative to a tower of the robotic arm cart, and configured to rotate about a setup arm rotation axis which extends transverse to a longitudinal axis of the tower of the robotic arm cart; a central drive unit (CDU) defining a CDU longitudinal axis and being coupled to the setup arm assembly for rotation about the CDU longitudinal axis, the CDU includes: an instrument drive unit supported on a chassis of the CDU, wherein the instrument drive unit is configured to translate relative to the chassis between a retracted position and an advanced position, the instrument drive unit being configured to transmit operational forces; and a videoscope drive unit supported on the chassis of the CDU, wherein the videoscope drive unit is configured to translate relative to the chassis between a retracted position and an advanced position, the videoscope drive unit being configured to transmit operational forces; an endoscope drive unit arm extending from the chassis of the CDU, wherein the endoscope drive unit arm extends distally of the CDU to a position distal of the instrument driveunit and the videoscope drive unit, the endoscope drive unit arm being configured to transmit operational forces; an endoscope selectively connected to the endoscope drive unit arm, the endoscope including an endoscope housing and an elongate flexible overtube extending from the endoscope housing, wherein at least a distal end portion of the overtube is steerable to control a pitch and a yaw of the distal portion of the overtube, the endoscope housing including: at least one tool channel extending from a proximal face of the endoscope housing and into a respective overtube tool channel defined in the overtube; at least one fluid coupling in fluid communication with a corresponding fluid channel defined in the overtube; and at least one central drive unit coupling configured to receive the operational forces from the endoscope drive unit arm to control the pitch and / or yaw of the distal portion of the overtube; a surgical instrument selectively connected to the instrument drive unit, the surgical instrument including an elongate flexible shaft extending from an instrument housing, wherein the elongate flexible shaft is configured to translate through a respective one of the at least one tool channel of the endoscope housing, wherein at least a distal end portion of the surgical instrument is steerable to control a pitch and a yaw of the distal portion of the elongate flexible shaft, and wherein the surgical instrument includes a tool supported at the distal end portion of the elongate flexible shaft; a videoscope selectively connected to the videoscope drive unit, the videoscope including an elongate flexible shaft extending from a videoscope housing, wherein the elongate flexible shaft is configured to translate through a respective one of the at least one tool channel of the endoscope housing, wherein at least a distal end portion of the videoscope is steerable to control a pitch and a yaw of the distal portion of the elongate flexible shaft, and wherein the videoscope includes a camera supported at the distal end portion of the elongate flexible shaft; a surgeon console including input devices for controlling the CDU to:transmit the operational forces from the endoscope drive unit arm to the endoscope; transmit the operational forces from the instrument drive unit to the surgical instrument; and transmit the operational forces from the videoscope drive unit to the videoscope; and an overtube controller operatively connected to the surgeon console, the overtube controller including inputs for controlling the transmission of the operational forces from the endoscope drive unit arm to the overtube of the endoscope.13. The robotic surgical system according to clause 12, wherein the endoscope drive unit arm includes a head supporting a plurality of endoscope actuators, wherein the endoscope actuators are activatable by commands received from the surgeon console or by commands received by the overtube controller.14. The robotic surgical system according to clause 12 or 13, wherein the at least one central drive unit coupling of the endoscope is configured to selectively engage a respective one of the plurality of endoscope actuators of the head of the endoscope drive unit arm.15. The robotic surgical system according to any of clauses 12-14, wherein the endoscope includes an actuation cable connected to each central drive unit coupling, wherein each cable extends distally through the overtube to at least a distal end portion of the overtube.16. The robotic surgical system according to any of clauses 12-15, wherein the overtube controller is a handheld controller.17. The robotic surgical system according to any of clauses 12-16, wherein the inputs of the overtube controller include at least one of a joystick or buttons.18. The robotic surgical system according to any of clauses 12-13, wherein the robotic arm cart is supported on a mobile base.19. A robotic surgical system, comprising:a robotic arm cart supporting a central drive unit (CDU), the CDU including: a plurality of instrument drive units supported on a chassis of the CDU, each instrument drive unit including at least one motor for transmitting operational forces; and a videoscope drive unit supported on the chassis of the CDU, the videoscope drive unit including at least one motor for transmitting operational forces; an endoscope drive unit arm extending from the chassis of the CDU, wherein the endoscope drive unit arm supports a head including a plurality of endoscope actuators configured to transmit operational forces, wherein the head of the endoscope drive unit arm is located distal of the instrument drive unit and of the videoscope drive unit; an endoscope selectively connected to the head of the endoscope drive unit arm, the endoscope including an endoscope housing and an elongate flexible overtube extending from the endoscope housing, wherein at least a distal end portion of the overtube is steerable to control a pitch and a yaw of the distal portion of the overtube, the endoscope housing including: at least one tool channel extending from a proximal face of the endoscope housing and into a respective overtube tool channel defined in the overtube; at least one fluid coupling in fluid communication with a corresponding fluid channel defined in the overtube; and at least one central drive unit coupling configured to receive the operational forces from the plurality of endoscope actuators of the endoscope drive unit arm to control the pitch and / or yaw of the distal portion of the overtube; a surgical instrument selectively connected to the at least one motor of the instrument drive unit, the surgical instrument including an elongate flexible shaft extending from an instrument housing, wherein the elongate flexible shaft is configured to translate through a respective one of the at least one tool channel of the endoscope housing, wherein at least a distal end portion of the surgical instrument is steerable to control a pitch and a yaw of the distal portion of the elongate flexible shaft, and wherein the surgical instrument includes a tool supported at the distal end portion of the elongate flexible shaft;a videoscope selectively connected to the at least one motor of the videoscope drive unit, the videoscope including an elongate flexible shaft extending from a videoscope housing, wherein the elongate flexible shaft is configured to translate through a respective one of the at least one tool channel of the endoscope housing, wherein at least a distal end portion of the videoscope is steerable to control a pitch and a yaw of the distal portion of the elongate flexible shaft, and wherein the videoscope includes a camera supported at the distal end portion of the elongate flexible shaft; a surgeon console including input devices for controlling the CDU to: transmit the operational forces from the plurality of endoscope actuators of the endoscope drive unit arm to the endoscope; transmit the operational forces from the instrument drive unit to the surgical instrument; and transmit the operational forces from the videoscope drive unit to the videoscope; and a handheld overtube controller operatively connected to one of the surgeon console or the robotic arm cart, the overtube controller including inputs for controlling the transmission of the operational forces from the plurality of endoscope actuators of the endoscope drive unit arm to the overtube of the endoscope.20. The robotic surgical system according to clause 19, wherein the plurality of endoscope actuators are selectively activatable by commands received from the input devices of the surgeon console or by commands received by the handheld overtube controller.

[0061] The disclosed structure can include any suitable mechanical, electrical, and / or chemical components for operating the disclosed system or components thereof. For instance, such electrical components can include, for example, any suitable electrical and / or electromechanical, and / or electrochemical circuitry, which may include or be coupled to one or more printed circuit boards. As appreciated, the disclosed computing devices (and / or servers) can include, for example, a “controller,” “processor,” “digital processing device” and like terms, andwhich are used to indicate a microprocessor or central processing unit (CPU). The CPU is the electronic circuitry within a computer that carries out the instructions of a computer program by performing the basic arithmetic, logical, control and input / output (VO) operations specified by the instructions, and by way of non-limiting examples, include server computers. In some aspects, the controller includes an operating system configured to perform executable instructions. The operating system is, for example, software, including programs and data, which manages hardware of the disclosed apparatus and provides services for execution of applications for use with the disclosed apparatus. Those of skill in the art will recognize that suitable server operating systems include, by way of non-limiting examples, FreeBSD, OpenBSD, NetBSD®, Linux, Apple® Mac OS X Server®, Oracle® Solaris®, Windows Server®, and Novell® NetWare®. In some aspects, the operating system is provided by cloud computing.

[0062] In some aspects, the term “controller” may be used to indicate a device that controls the transfer of data from a computer or computing device to a peripheral or separate device and vice versa, and / or a mechanical and / or electromechanical device (e.g., a lever, knob, etc.) that mechanically operates and / or actuates a peripheral or separate device.

[0063] In aspects, the controller includes a storage and / or memory device. The storage and / or memory device is one or more physical apparatus used to store data or programs on a temporary or permanent basis. In some aspects, the controller includes volatile memory and requires power to maintain stored information. In various aspects, the controller includes non-volatile memory and retains stored information when it is not powered. In some aspects, the non-volatile memory includes flash memory. In certain aspects, the non-volatile memory includes dynamic randomaccess memory (DRAM). In some aspects, the non-volatile memory includes ferroelectric random-access memory (FRAM). In various aspects, the non-volatile memory includes phasechange random access memory (PRAM). In certain aspects, the controller is a storage device including, by way of non-limiting examples, CD-ROMs, DVDs, flash memory devices, magnetic disk drives, magnetic tapes drives, optical disk drives, and cloud-computing- based storage. In various aspects, the storage and / or memory device is a combination of devices such as those disclosed herein.

[0064] In various aspects, the memory can be random access memory, read-only memory, magnetic disk memory, solid state memory, optical disc memory, and / or another type ofmemory. In various aspects, the memory can be separate from the controller and can communicate with the processor through communication buses of a circuit board and / or through communication cables such as serial ATA cables or other types of cables. The memory includes computer-readable instructions that are executable by the processor to operate the controller. In various aspects, the controller may include a wireless network interface to communicate with other computers or a server. In aspects, a storage device may be used for storing data. In various aspects, the processor may be, for example, without limitation, a digital signal processor, a microprocessor, an ASIC, a graphics processing unit (“GPU”), field-programmable gate array (“FPGA”), or a central processing unit (“CPU”).

[0065] The memory stores suitable instructions and / or applications, to be executed by the processor, for receiving the sensed data (e g., sensed data from camera), accessing storage device of the controller, generating a raw image based on the sensed data, comparing the raw image to a calibration data set, identifying an object based on the raw image compared to the calibration data set, transmitting object data to a post-processing unit, and displaying the object data to a graphic user interface. Although illustrated as part of the disclosed structure, it is also contemplated that a controller may be remote from the disclosed structure (e.g., on a remote server), and accessible by the disclosed structure via a wired or wireless connection. In aspects where the controller is remote, it is contemplated that the controller may be accessible by, and connected to, multiple structures and / or components of the disclosed system.

[0066] The term “application” may include a computer program designed to perform functions, tasks, or activities for the benefit of a user. Application may refer to, for example, software running locally or remotely, as a standalone program or in a web browser, or other software which would be understood by one skilled in the art to be an application. An application may run on the disclosed controllers or on a user device, including for example, on a mobile device, an IOT device, or a server system.

[0081] In some aspects, the controller includes a display to send visual information to a user. In various aspects, the display is a cathode ray tube (CRT). In various aspects, the display is a liquid crystal display (LCD). In certain aspects, the display is a thin film transistor liquid crystal display (TFT-LCD). In aspects, the display is an organic light emitting diode (OLED) display. In certain aspects, on OLED display is a passivematrix OLED (PMOLED) or active-matrix OLED (AMOLED) display. In aspects, the display isa plasma display. In certain aspects, the display is a video projector. In various aspects, the display is interactive (e.g., having a touch screen) that can detect user interactions / gestures / responses and the like. In some aspects, the display is a combination of devices such as those disclosed herein.

[0067] The controller may include or be coupled to a server and / or a network. As used herein, the term “server” includes “computer server,” “central server,” “main server,” and like terms to indicate a computer or device on a network that manages the disclosed apparatus, components thereof, and / or resources thereof. As used herein, the term “network” can include any network technology including, for instance, a cellular data network, a wired network, a fiberoptic network, a satellite network, and / or an IEEE 802.1 la / b / g / n / ac wireless network, among others.

[0068] In various aspects, the controller can be coupled to a mesh network. As used herein, a “mesh network” is a network topology in which each node relays data for the network. All mesh nodes cooperate in the distribution of data in the network. It can be applied to both wired and wireless networks. Wireless mesh networks can be considered a type of “Wireless ad hoc” network. Thus, wireless mesh networks are closely related to Mobile ad hoc networks (MANETs). Although MANETs are not restricted to a specific mesh network topology, Wireless ad hoc networks or MANETs can take any form of network topology. Mesh networks can relay messages using either a flooding technique or a routing technique. With routing, the message is propagated along a path by hopping from node to node until it reaches its destination. To ensure that all its paths are available, the network must allow for continuous connections and must reconfigure itself around broken paths, using self-healing algorithms such as Shortest Path Bridging. Self-healing allows a routing-based network to operate when a node breaks down or when a connection becomes unreliable. As a result, the network is typically quite reliable, as there is often more than one path between a source and a destination in the network. This concept can also apply to wired networks and to software interaction. A mesh network whose nodes a e all connected to each other is a fully connected network.

[0069] In some aspects, the controller may include one or more modules. As used herein, the term “module” and like terms are used to indicate a self-contained hardware component of the central server, which in turn includes software modules. In software, a module is a part of aprogram. Programs are composed of one or more independently developed modules that are not combined until the program is linked. A single module can contain one or several routines, or sections of programs that perform a particular task.

[0070] As used herein, the controller includes software modules for managing various aspects and functions of the disclosed system or components thereof.

[0071] The disclosed structure may also utilize one or more controllers to receive various information and transform the received information to generate an output. The controller may include any type of computing device, computational circuit, or any type of processor or processing circuit capable of executing a series of instructions that are stored in memory. The controller may include multiple processors and / or multicore central processing units (CPUs) and may include any type of processor, such as a microprocessor, digital signal processor, microcontroller, programmable logic device (PLD), field programmable gate array (FPGA), or the like. The controller may also include a memory to store data and / or instructions that, when executed by the one or more processors, cause the one or more processors to perform one or more methods and / or algorithms.

[0072] The phrases “in an aspect,” “in aspects,” “in various aspects,” “in some aspects,” “in other aspects” or the like may each refer to one or more of the same or different aspects in accordance with the present disclosure. A phrase in the form “A or B” means “(A), (B), or (A and B).” A phrase in the form “at least one of A, B, or C” means “(A); (B); (C); (A and B); (A and C); (B and C); or (A, B, and C) ”

[0073] Various aspects disclosed herein may be combined in different combinations than the combinations specifically presented in the description and accompanying drawings. It should also be understood that, depending on the example, certain acts or events of any of the processes or methods described herein may be performed in a different sequence, may be added, merged, or left out altogether (e.g., all described acts or events may not be necessary to carry out the techniques).

[0074] Certain aspects of the present disclosure may include some, all, or none of the above advantages and / or one or more other advantages readily apparent to those skilled in the art fromthe drawings, descriptions, and claims included herein. Moreover, while specific advantages have been enumerated above, the various aspects of the present disclosure may include all, some, or none of the enumerated advantages and / or other advantages not specifically enumerated above.

[0075] The aspects disclosed herein are examples of the disclosure and may be embodied in various forms. For instance, although certain aspects herein are described as separate, each of the aspects herein may be combined with one or more of the other aspects herein. Specific structural and functional details disclosed herein are not to be interpreted as limiting, but as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present disclosure in virtually any appropriately detailed structure. Like reference numerals may refer to similar or identical elements throughout the description of the figures.

[0076] Any of the herein described methods, programs, algorithms, or codes may be converted to, or expressed in, a programming language or computer program. The terms “programming language” and “computer program,” as used herein, each include any language used to specify instructions to a computer, and include (but is not limited to) the following languages and their derivatives: Assembler, Basic, Batch files, BCPL, C, C+, C++, Delphi, Fortran, Java, JavaScript, machine code, operating system command languages, Pascal, Perl, PL1, scripting languages, Visual Basic, metalanguages which themselves specify programs, and all first, second, third, fourth, fifth, or further generation computer languages. Also included are database and other data schemas, and any other meta-languages. No distinction is made between languages which are interpreted, compiled, or use both compiled and interpreted approaches. No distinction is made between compiled and source versions of a program. Thus, reference to a program, where the programming language could exist in more than one state (such as source, compiled, object, or linked) is a reference to all such states. Reference to a program may encompass the actual instructions and / or the intent of those instructions.

[0092] Securement of any of the components of the disclosed devices may be effectuated using known securement techniques such welding, crimping, gluing, fastening, etc.

[0077] Persons skilled in the ail will understand that the structures and methods specifically described herein and shown in the accompanying figures are non-limiting exemplary aspects, and that the description, disclosure, and figures should be construed merely as exemplary ofaspects. It is to be understood, therefore, that this disclosure is not limited to the precise aspects described, and that various other changes and modifications may be effectuated by one skilled in the art without departing from the scope or spirit of the disclosure. Additionally, the elements and features shown or described in connection with certain aspects may be combined with the elements and features of certain other aspects without departing from the scope of this disclosure, and that such modifications and variations are also included within the scope of this disclosure. Accordingly, the subject matter of this disclosure is not limited by what has been particularly shown and described.

Claims

WHAT IS CLAIMED IS:

1. A robotic surgical system, comprising: a robotic arm cart including: a setup arm assembly; a central drive unit (CDU) coupled to the setup arm assembly, the CDU includes: an instrument drive unit supported on a chassis of the CDU, the instrument drive unit being configured to transmit operational forces; and a videoscope drive unit supported on the chassis of the CDU, the videoscope drive unit being configured to transmit operational forces; an endoscope drive unit arm extending from the chassis of the CDU, wherein the endoscope drive unit arm extends distally of the CDU to a position distal of the instrument drive unit and the videoscope drive unit, the endoscope drive unit arm being configured to transmit operational forces; an endoscope selectively connected to the endoscope drive unit arm, the endoscope including an endoscope housing and an elongate flexible overtube extending from the endoscope housing, wherein at least a distal end portion of the overtube is steerable to control a pitch and a yaw of the distal portion of the overtube, the endoscope housing including: at least one tool channel extending from a proximal face of the endoscope housing and into a respective overtube tool channel defined in the overtube; at least one fluid coupling in fluid communication with a corresponding fluid channel defined in the overtube; and at least one central drive unit coupling configured to receive the operational forces from the endoscope drive unit arm to control the pitch and / or yaw of the distal portion of the overtube;a surgical instrument selectively connected to the instrument drive unit, the surgical instrument including an elongate flexible shaft extending from an instrument housing, wherein the elongate flexible shaft is configured to translate through a respective one of the at least one tool channel of the endoscope housing, wherein at least a distal end portion of the surgical instrument is steerable to control a pitch and a yaw of the distal portion of the elongate flexible shaft, and wherein the surgical instrument includes a tool supported at the distal end portion of the elongate flexible shaft; a videoscope selectively connected to the videoscope drive unit, the videoscope including an elongate flexible shaft extending from a videoscope housing, wherein the elongate flexible shaft is configured to translate through a respective one of the at least one tool channel of the endoscope housing, wherein at least a distal end portion of the videoscope is steerable to control a pitch and a yaw of the distal portion of the elongate flexible shaft, and wherein the videoscope includes a camera supported at the distal end portion of the elongate flexible shaft; a surgeon console including input devices for controlling the CDU to: transmit the operational forces from the endoscope drive unit arm to the endoscope; transmit the operational forces from the instrument drive unit to the surgical instrument; and transmit the operational forces from the videoscope drive unit to the videoscope; and an overtube controller operatively connected to one of the surgeon console or the robotic arm cart, the overtube controller including inputs for controlling the transmission of the operational forces from the endoscope drive unit arm to the overtube of the endoscope.

2. The robotic surgical system according to claim 1, wherein the setup arm assembly is translatable relative to a mobile base of the robotic arm cart, and is rotatable about a setup arm rotation axis which extends transverse to a vertical axis of the robotic arm cart.

3. The robotic surgical system according to claim 2, wherein the CDU defines a CDU longitudinal axis, and wherein the CDU is coupled to the setup arm assembly for rotation about the CDU longitudinal axis.

4. The robotic surgical system according to claim 1, wherein the instrument drive unit is translatable relative to the chassis between a retracted position and an advanced position.

5. The robotic surgical system according to claim 4, wherein the videoscope drive unit is translatable relative to the chassis between a retracted position and an advanced position.

6. The robotic surgical system according to claim 5, wherein the endoscope drive unit arm includes a head supporting a plurality of endoscope actuators, wherein the endoscope actuators are activatable by commands received from the surgeon console or by commands received by the overtube controller.

7. The robotic surgical system according to claim 6, wherein the at least one central drive unit coupling of the endoscope is configured to selectively engage a respective one of the plurality of endoscope actuators of the head of the endoscope drive unit arm.

8. The robotic surgical system according to claim 7, wherein the endoscope includes an actuation cable connected to each central drive unit coupling, wherein each cable extends distally through the overtube to at least a distal end portion of the overtube.

9. The robotic surgical system according to claim 8, wherein the overtube controller is a handheld controller.

10. The robotic surgical system according to claim 9, wherein the inputs of the overtube controller include at least one of a joystick or buttons.

11. The robotic surgical system according to claim 1, wherein the robotic arm cart is supported on a mobile base.

12. A robotic surgical system, comprising: a robotic arm cart including:a setup arm assembly configured to translate relative to a tower of the robotic arm cart, and configured to rotate about a setup arm rotation axis which extends transverse to a longitudinal axis of the tower of the robotic arm cart; a central drive unit (CDU) defining a CDU longitudinal axis and being coupled to the setup arm assembly for rotation about the CDU longitudinal axis, the CDU includes: an instrument drive unit supported on a chassis of the CDU, wherein the instrument drive unit is configured to translate relative to the chassis between a retracted position and an advanced position, the instrument drive unit being configured to transmit operational forces; and a videoscope drive unit supported on the chassis of the CDU, wherein the videoscope drive unit is configured to translate relative to the chassis between a retracted position and an advanced position, the videoscope drive unit being configured to transmit operational forces; an endoscope drive unit arm extending from the chassis of the CDU, wherein the endoscope drive unit arm extends distally of the CDU to a position distal of the instrument drive unit and the videoscope drive unit, the endoscope drive unit arm being configured to transmit operational forces; an endoscope selectively connected to the endoscope drive unit arm, the endoscope including an endoscope housing and an elongate flexible overtube extending from the endoscope housing, wherein at least a distal end portion of the overtube is steerable to control a pitch and a yaw of the distal portion of the overtube, the endoscope housing including: at least one tool channel extending from a proximal face of the endoscope housing and into a respective overtube tool channel defined in the overtube; at least one fluid coupling in fluid communication with a corresponding fluid channel defined in the overtube; andat least one central drive unit coupling configured to receive the operational forces from the endoscope drive unit arm to control the pitch and / or yaw of the distal portion of the overtube; a surgical instrument selectively connected to the instrument drive unit, the surgical instrument including an elongate flexible shaft extending from an instrument housing, wherein the elongate flexible shaft is configured to translate through a respective one of the at least one tool channel of the endoscope housing, wherein at least a distal end portion of the surgical instrument is steerable to control a pitch and a yaw of the distal portion of the elongate flexible shaft, and wherein the surgical instrument includes a tool supported at the distal end portion of the elongate flexible shaft; a videoscope selectively connected to the videoscope drive unit, the videoscope including an elongate flexible shaft extending from a videoscope housing, wherein the elongate flexible shaft is configured to translate through a respective one of the at least one tool channel of the endoscope housing, wherein at least a distal end portion of the videoscope is steerable to control a pitch and a yaw of the distal portion of the elongate flexible shaft, and wherein the videoscope includes a camera supported at the distal end portion of the elongate flexible shaft; a surgeon console including input devices for controlling the CDU to: transmit the operational forces from the endoscope drive unit arm to the endoscope; transmit the operational forces from the instrument drive unit to the surgical instrument; and transmit the operational forces from the videoscope drive unit to the videoscope; and an overtube controller operatively connected to the surgeon console, the overtube controller including inputs for controlling the transmission of the operational forces from the endoscope drive unit arm to the overtube of the endoscope.

13. The robotic surgical system according to claim 12, wherein the endoscope drive unit arm includes a head supporting a plurality of endoscope actuators, wherein the endoscope actuators are activatable by commands received from the surgeon console or by commands received by the overtube controller.

14. The robotic surgical system according to claim 13, wherein the at least one central drive unit coupling of the endoscope is configured to selectively engage a respective one of the plurality of endoscope actuators of the head of the endoscope drive unit arm.

15. The robotic surgical system according to claim 14, wherein the endoscope includes an actuation cable connected to each central drive unit coupling, wherein each cable extends distally through the overtube to at least a distal end portion of the overtube.

16. The robotic surgical system according to claim 15, wherein the overtube controller is a handheld controller.

17. The robotic surgical system according to claim 16, wherein the inputs of the overtube controller include at least one of a joystick or buttons.

18. The robotic surgical system according to claim 13, wherein the robotic arm cart is supported on a mobile base.

19. A robotic surgical system, comprising: a robotic arm cart supporting a central drive unit (CDU), the CDU including: a plurality of instrument drive units supported on a chassis of the CDU, each instrument drive unit including at least one motor for transmitting operational forces; and a videoscope drive unit supported on the chassis of the CDU, the videoscope drive unit including at least one motor for transmitting operational forces; an endoscope drive unit arm extending from the chassis of the CDU, wherein the endoscope drive unit arm supports a head including a plurality of endoscope actuators configured to transmit operational forces, wherein the head of the endoscope drive unit arm is located distal of the instrument drive unit and of the videoscope drive unit;an endoscope selectively connected to the head of the endoscope drive unit aim, the endoscope including an endoscope housing and an elongate flexible overtube extending from the endoscope housing, wherein at least a distal end portion of the overtube is steerable to control a pitch and a yaw of the distal portion of the overtube, the endoscope housing including: at least one tool channel extending from a proximal face of the endoscope housing and into a respective overtube tool channel defined in the overtube; at least one fluid coupling in fluid communication with a corresponding fluid channel defined in the overtube; and at least one central drive unit coupling configured to receive the operational forces from the plurality of endoscope actuators of the endoscope drive unit arm to control the pitch and / or yaw of the distal portion of the overtube; a surgical instrument selectively connected to the at least one motor of the instrument drive unit, the surgical instrument including an elongate flexible shaft extending from an instrument housing, wherein the elongate flexible shaft is configured to translate through a respective one of the at least one tool channel of the endoscope housing, wherein at least a distal end portion of the surgical instrument is steerable to control a pitch and a yaw of the distal portion of the elongate flexible shaft, and wherein the surgical instrument includes a tool supported at the distal end portion of the elongate flexible shaft; a videoscope selectively connected to the at least one motor of the videoscope drive unit, the videoscope including an elongate flexible shaft extending from a videoscope housing, wherein the elongate flexible shaft is configured to translate through a respective one of the at least one tool channel of the endoscope housing, wherein at least a distal end portion of the videoscope is steerable to control a pitch and a yaw of the distal portion of the elongate flexible shaft, and wherein the videoscope includes a camera supported at the distal end portion of the elongate flexible shaft; a surgeon console including input devices for controlling the CDU to:transmit the operational forces from the plurality of endoscope actuators of the endoscope drive unit arm to the endoscope; transmit the operational forces from the instrument drive unit to the surgical instrument; and transmit the operational forces from the videoscope drive unit to the videoscope; and a handheld overtube controller operatively connected to one of the surgeon console or the robotic arm cart, the overtube controller including inputs for controlling the transmission of the operational forces from the plurality of endoscope actuators of the endoscope drive unit arm to the overtube of the endoscope.

20. The robotic surgical system according to claim 19, wherein the plurality of endoscope actuators are selectively activatable by commands received from the input devices of the surgeon console or by commands received by the handheld overtube controller.

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