Robotic arm interface unit

Abstract

A robotic arm interface unit configured to interface, in use, between a robotic arm of a surgical robot and one or more surgical tools attached, in use, to the robotic arm interface unit, the robotic arm interface unit comprising: a housing having a connection portion for connecting to a plurality of different types of surgical tools; and a control system configured to control the operation of a surgical tool connected to the robotic arm interface unit; wherein: in a first mode of operation the control system is arranged to cause the surgical tool or one or more components of the surgical tool to move in one or more first degrees of freedom.

Description

[0001] ROBOTIC ARM INTERFACE UNIT

[0002] FIELD OF THE PRESENT INVENTION

[0003] The present invention relates to a robotic arm interface unit, a surgical robot, an arthroscopic surgical robot, a robot and a method.

[0004] BACKGROUND

[0005] Arthroscopy is a surgical procedure on a joint, such as an ankle, knee, hip, spine, shoulder, elbow or wrist where a small camera and surgical instruments are inserted into the joint through small incisions made in a patient’s skin. Arthroscopy is a type of “keyhole” surgery where the surgeon is able to view the joint area and perform surgery on soft tissue such as ligaments, the bony joint surface and other tissue from the outside of the joint. In contrast to traditional “open” surgery, recovery time and tissue trauma is greatly reduced.

[0006] However, a problem with arthroscopy is that it is a difficult medical procedure to perform, and it requires very high levels of skill. A large proportion of surgeons are not comfortable performing arthroscopy. Furthermore, current arthroscopic surgical procedures often result in observable damage being caused to the patient.

[0007] It is known for surgeons to perform arthroscopic surgery with the assistance of a specialised robotic surgical system which has been designed solely with arthroscopic surgery in mind.

[0008] Other surgical robotic systems are known. However, such other surgical robotic systems are not suitable for performing arthroscopy. In particular, laparoscopic robotic systems are known which assist a surgeon in performing keyhole surgery in the abdomen. For example, one known laparoscopic robot is the Da Vinci Surgical System of Intuitive Surgical, Inc. of California, United States. However, it will be understood that laparoscopic surgery is quite different to arthroscopy. In particular, a person skilled in the art will understand that laparoscopy involves surgery on a large single body cavity. With the known laparoscopic robot, a surgeon will generally operate robotic arms fully remotely via a console. The robotic arms include surgical instruments thereon to perform the laparoscopy. Typically, the laparoscopy is performed in a large single body cavity, such as an abdomen, whereby the surgeon obtains access from a common approach. As the cavity is vast and compliant, gas is used to distend the cavity, creating a large void between the entrance and the operative site. This improves surgical visibility and makes access relatively simple. It will be understood by those skilled in the art that laparoscopic robots are unsuitable to perform arthroscopy, and that the nature of the arthroscopic surgery is very different to laparoscopic surgery.

[0009] Arthroscopy involves surgery on joints, that are relatively small, resistant to distension and often have multiple compartments. Furthermore, they are often separated by anatomical structures which are difficult to access.

[0010] A person skilled in the art will appreciate that current laparoscopic devices and known laparoscopic robots are unsuitable to perform surgery on the knee. Furthermore, even if it were possible to reduce the size of a laparoscopic device then the problem remains that joints are mostly made of sensitive articular cartilage covering non- compliant bony surfaces, and as such, it is not possible to create a large void or cavity, analogous to that used in laparoscopy. Furthermore, even if a joint is distended, the joint space is still small and narrow, often curved and covered by cartilage that must be avoided, as bumping into, or scuffing along cartilage will wear and injure the cartilage.

[0011] As such, laparoscopic robots, such as the Da Vinci Surgical System, are not suited for use in performing arthroscopic surgery. In particular, the known robotic surgical systems relate to teleoperated surgical robots which are primarily designed to be fully controlled remotely via a user console. Known surgical robots only have very limited local control and are not suitable for use with applications which require high precision.

[0012] Another known surgical robot is the MAKO robot which unlike the Da Vinci Surgical System is used locally rather than being fully teleoperated. However, a problem with the MAKO robot is that its control is not designed for precise operation. The movement of the arm is controlled by the user’s movements and although the MAKO robot provides virtual guide rails to prevent using the robot in the wrong orientation, it is still limited to human accuracy. Furthermore, the MAKO robot is used for arthroplasty which is a fully invasive surgery in contrast to arthroscopy which is a minimally invasive and highly precise application.

[0013] It will be understood by those skilled in the art that both known robotic systems have a poor level of local control when it comes to robotically assisted surgery. In particular, both known robotic systems use human accuracy for local motion which will be understood is lower in terms of accuracy that robotically controlled methods.

[0014] It is desired to provide an improved surgical robot.

[0015] SUMMARY According to an aspect there is provided a robotic arm interface unit configured to interface, in use, between a robotic arm of a surgical robot and one or more surgical tools attached, in use, to the robotic arm interface unit, the robotic arm interface unit comprising: a housing having a connection portion for connecting to a plurality of different types of surgical tools; and a control system configured to control the operation of a surgical tool connected to the robotic arm interface unit; wherein: in a first mode of operation the control system is arranged to cause the surgical tool or one or more components of the surgical tool to move in one or more first degrees of freedom.

[0016] The robotic arm interface unit according to various embodiments is particularly advantageous in that it enables a robot such as a surgical robot to be operated with a plurality of different attachments (e.g. surgical tools) and operated by a user such that the movement of the attachment (e.g. surgical tool) can be precisely controlled in one or more degrees of freedom.

[0017] The one or more first degree of freedoms may be selected from the group consisting of: (i) forward or back (surge); (ii) up or down (heave); (iii) left or right (sway); (iv) rotation forward and backward about a lateral axis (pitch); (v) rotation left and right around the vertical axis (yaw); and (vi) rotation side to side about a longitudinal axis (roll).

[0018] In the first mode of operation the control system may be arranged to cause the surgical tool or one or more components of the surgical tool to move in a single first degree of freedom. In particular, simultaneous movement in the other degrees of freedom may be restricted or substantially prevented.

[0019] The control system may be configured either: (i) to control and / or operate and / or move the robotic arm or one or more portions of the robotic arm; (ii) to control and / or operate and / or move an attached surgical tool or one or more components of an attached surgical tool; or (iii) to control and / or operate and / or move both the robotic arm or one or more portions of the robotic arm and an attached surgical tool or one or more components of an attached surgical tool.

[0020] According to various embodiments an attached surgical tool may comprise a first portion and a second portion, wherein in a mode of operation the control system is configured to control and / or operate and / or move either: (i) the first portion of the attached surgical tool in an independent manner relative to the second portion of the attached surgical tool; (ii) the second portion of the attached surgical tool in an independent manner relative to the first portion of the attached surgical tool; or (iii) both the first portion and the second portion of the attached surgical tool in an independent manner relative to each other.

[0021] The first portion of the attached surgical tool may comprise: (i) a camera or a portion of a camera; (ii) a sensor or a portion of a sensor; (iii) a tool or a portion of tool; (iv) an instrument or a portion of an instrument; (v) a detector or a portion of a detector; (vi) a proximal or distal end of the surgical tool; or (vii) a furthermost point, end point or instrument tip of the surgical tool.

[0022] The second portion may comprise: (i) a body or housing of the surgical tool; or (ii) a connection or attachment portion for connecting or attaching to the robotic arm interface unit.

[0023] The control system may be configured either: (i) to control the position and / or orientation and / or pose and / or configuration of the robotic arm or one or more portions of the robotic arm; (ii) to control the position and / or orientation and / or pose and / or configuration of an attached surgical tool or one or more components of an attached surgical tool; (iii) to control the position and / or orientation and / or pose and / or configuration of both the robotic arm or one or more portions of the robotic arm and an attached surgical tool or one or more components of an attached surgical tool.

[0024] The control system may be configured to operate an attached surgical tool.

[0025] The control system may be configured to cause an attached surgical tool to perform: (i) aspiration; (ii) electro-surgery; (iii) clamping; (iv) suturing; (v) drilling; (vi) cutting; (vii) diagnosing; (viii) debridement; (ix) menisectomy; (x) synovectomy; (xi) repairing; (xii) reconstruction; (xiii) joint lavage; (xiv) microfracture surgery; (xv) osteochondral autograft transfer; or (xvi) rotator cuff repair.

[0026] The robotic arm interface unit may comprise a sterile single use or disposable controller.

[0027] The robotic arm interface unit may comprise a sterile single use or disposable unit.

[0028] The robotic arm interface unit may further comprise a user interface.

[0029] The user interface may further comprise one or more buttons or user interface portions configured to send a signal to the control system so as either: (i) to cause the surgical tool to operate in the first mode of operation; (ii) to control the operation of the surgical tool whilst operating in the first mode of operation; or (iii) to cause the surgical tool to operate in a second different mode of operation.

[0030] The user interface may be configured to cause the surgical tool to operate in a mode of operation wherein the surgical tool can be physically positioned or repositioned by a user.

[0031] The robotic arm interface unit may further comprise a reader for reading a readable identifier attached to or forming part of a surgical tool.

[0032] According to another aspect there is provided a surgical robot configured to perform arthroscopic surgery comprising: one or more robotic arms; a robotic arm interface unit as described above, wherein the robotic arm interface unit is connected to one of the robotic arms; and one or more surgical tools attached to the robotic arm interface unit.

[0033] The surgical robot may further comprise: a controller having a user interface.

[0034] The user interface may further comprise one or more buttons or user interface portions configured to send a signal to the control system so as either: (i) to cause the surgical tool to operate in the first mode of operation; (ii) to control the operation of the surgical tool whilst operating in the first mode of operation; or (iii) to cause the surgical tool to operate in a second different mode of operation.

[0035] The controller may comprise a sterile single-use or disposable unit.

[0036] The surgical robot may further comprise a gimbal mounted between the controller and the robotic arm interface unit.

[0037] The gimbal may comprise a pivoted support which is configured to stabilise any movement of the controller relative to any movement of the robot arm interface unit and / or a surgical tool attached to the robotic arm interface unit.

[0038] The surgical robot may further comprise a motorised U-shaped bracket mounted between the controller and the robotic arm interface unit, wherein the motorised U- shaped bracket enables independent rotation or movement of: (i) a surgical tool attached to the robotic arm interface unit; (ii) the robotic arm interface unit; or (iii) the controller.

[0039] Preferably, at least one of the surgical tools comprises a surgical camera. According to another aspect there is provided an arthroscopic surgical robot comprising: a surgical robot as described above; wherein the one or more surgical tools are configured for assisting in performing arthroscopic surgery.

[0040] According to another aspect there is provided a robotic arm interface unit configured to interface, in use, between a robotic arm of a robot and one or more attachments which are attached, in use, to the robotic arm interface unit, the robotic arm interface unit comprising: a housing having an attachment portion for attaching to an attachment; and a control system configured to control the operation of an attachment attached, in use, to the robotic arm interface unit; wherein: in a first mode of operation the control system is arranged to cause the attachment to move in one or more first degrees of freedom.

[0041] According to another aspect there is provided a robot comprising: one or more robotic arms; a robotic arm interface unit described above, wherein the robotic arm interface unit is connected to one of the robotic arms; and one or more attachments attached to the robotic arm interface unit.

[0042] According to another aspect there is provided a method comprising: providing a robotic arm of a surgical robot; connecting a robotic arm interface unit to the robotic arm; attaching one or more surgical tools to the robotic arm interface unit, wherein the robotic arm interface unit comprises: (i) a housing having a connection portion for connecting to one of a plurality of different types of surgical tools; (ii) a user interface; and (iii) a control system configured to control the operation of a surgical tool connected to the robotic arm interface unit; and operating the surgical robot in a first mode of operation wherein the surgical tool is caused to move in one or more first degrees of freedom.

[0043] The one or more first degrees of freedom may be selected from the group consisting of: (i) forward; (ii) back; (iii) up; (iv) down; (v) left; (vi) right; (vii) yaw; (viii) pitch; and (ix) roll.

[0044] The method may comprise a method of surgery. The method may further comprise a method of arthroscopic surgery.

[0045] According to another aspect there is provided a method comprising: providing a robotic arm of a robot; connecting a robotic arm interface unit to the robotic arm; attaching one or more attachments to the robotic arm interface unit, wherein the robotic arm interface unit comprises: (i) a housing having an attachment portion for attaching to an attachment; (ii) a user interface; and (iii) a control system configured to control the operation of an attachment connected to the robotic arm interface unit; and operating the robot in a first mode of operation wherein the attachment is caused to move in one or more first degrees of freedom.

[0046] According to various embodiments a robotic arm interface unit is provided which is particularly advantageous. In particular, a robotic arm interface unit is provided which in conjunction with a controller enables a user (e.g. a surgeon) to control the movement of a surgical tool attached to a robotic arm of a surgical robot via the robotic arm interface unit in a highly precise manner. For example, a robotic arm interface unit may be provided which enables the surgical tool to move in one or more carefully controlled degrees of freedom or in a single degree of freedom. For example, the one or more degrees of freedom may be one of nine degrees of freedom namely forward, back, up, down, left, right, yaw, pitch and roll.

[0047] It will be appreciated that if the robotic arm interface unit is operated in a first mode of operation so as to move solely in a first degree of freedom, then this is a movement which a human surgeon is unable to replicate. Accordingly, the robotic arm interface unit according to various embodiments enables a higher level of surgical precision to be obtained than is possible for a human surgeon to perform.

[0048] The robotic arm interface unit according to various embodiments may form part of an arthroscopic surgical robot. A person skilled in the art will understand that arthroscopic surgery is highly skilled and involves very fine surgery in enclosed spaces such as joints which present a complex target for surgery with very limited freedom of movement. In contrast, other forms of surgery, such as laparoscopic surgery whilst still being skilled, operate across a wider range of distances and in a more flexible environment. Accordingly, the surgical interventions required when performing laparoscopic surgery do not need to be of the same level of precision as arthroscopic surgery.

[0049] A person skilled in the art would consider laparoscopic surgery as relating to general surgery whereas arthroscopic surgery is on a par with brain surgery in terms of the complexity of the surgery, although without the same level of risk in terms of patient outcomes as brain surgery. Nonetheless, a person skilled in the art would consider that arthroscopic surgery requires a higher level of skill than laparoscopic surgery.

[0050] As will be discussed in more detail below, various surgical robotic systems are known but these relate to general surgery such as laparoscopic surgery.

[0051] In contrast to known surgical robots which are capable of performing general surgery according to various embodiments a robotic arm interface unit is disclosed which enables a surgical tool to be moved in a single degree of freedom so as to perform highly specialised surgery. It will be appreciated that known surgical robots which are configured to perform laparoscopic surgery do not need the same high level of precision as an arthroscopic surgical robot.

[0052] Accordingly, known surgical robots are not configured so as to be controlled by a user (surgeon) such that a surgical tool may be moved very precisely e.g. in a single degree of freedom.

[0053] The robotic arm interface unit and / or a controller may further comprise a user interface. The user interface may comprise one or more buttons which are configured to send a signal to the control system so as either: (i) to cause the surgical tool to operate in the first mode of operation; (ii) to control the operation of the surgical tool whilst operating in the first mode of operation; or (iii) to cause the surgical tool to operate in a different second mode of operation. The user interface may be configured to cause the surgical tool to operate in a mode of operation wherein the surgical tool can be physically positioned or repositioned by a user. According to various embodiments the user may comprise a surgeon.

[0054] The control system may be provided either: (i) in the robotic arm interface unit; (ii) in the controller; or (iii) partially within the robotic arm interface unit and partially within the controller. If the control system is located solely within the controller then the robotic arm interface unit may be considered as including the controller.

[0055] According to an embodiment there is provided a robotic arm interface unit in combination with a controller. The robotic arm interface unit is configured to interface, in use, between a robotic arm of a surgical robot and one or more surgical tools attached, in use, to the robotic arm interface unit. The robotic arm interface unit may comprise: a housing having a connection portion for connecting to a plurality of different types of surgical tools. A control system may be provided and which may be configured to control the operation of a surgical tool connected to the robotic arm interface unit. The control system may be located in the robotic arm interface unit, the controller or partially within the robotic arm interface unit and partially within the controller. In a first mode of operation the control system may arranged to cause the surgical tool or one or more components of the surgical tool to move in one or more first degrees of freedom. According to various embodiments in a first mode of operation the control system may arranged to cause the surgical tool or one or more components of the surgical tool to move in a single first degree of freedom wherein simultaneous movement in other degrees of freedom is substantially prevented.

[0056] The surgical robot may further comprise a frame configurable to extend above or beside at least a portion of a patient to be operated and wherein the one or more robotic arms may extend from the frame. The surgical robot may further comprise at least one drape configured to extend over at least a portion of a robotic arm.

[0057] According to various embodiments an interface unit which forms part of a surgical robotic system is disclosed. The interface unit may be arranged to interface, in use, between an end of a robotic arm and one or more surgical tools. The interface unit may comprise a housing which is connected, in use, at a first end to an end of a robotic arm and at a second end to one or more surgical tools. The interface unit may further comprise an attachment portion which is configured to attach to one of a plurality of different types of surgical tools. The interface unit may further comprise a user interface portion. The interface unit may further comprise a control system arranged and adapted to control the operation of a surgical tool when attached to the interface unit. According to various embodiments, a user may interact with the user interface portion in order to cause the control system to control the movement of a surgical tool attached to the interface unit and to move the surgical tool in, within, or about a single degree of freedom at any instance in time, wherein the single degree of freedom is selected from the group consisting of: (i) forward; (ii) back; (iii) up; (iv) down; (v) left; (vi) right; (vii) yaw; (viii) pitch; and (ix) roll.

[0058] According to various embodiments the user interface may comprise one or more buttons which may control various aspects either of: (i) the operation of the robotic arm to which the robotic arm interface unit is attached to; and / or (ii) the operation of the robotic arm interface unit; and / or (iii) the operation of one or more surgical tools attached to the robotic arm interface unit. The user interface may be provided as a part of the robotic arm interface unit and / or may be provided as part of a controller. According to various embodiments the controller may be a sterile single-use controller which is disposable after use.

[0059] According to various embodiments the use of the robotic arm interface unit enables the movement of the robotic arm and / or one or more surgical tools to not necessarily be closely tied to a user’s accuracy and manual dexterity. Also, the surgical robot may be operated under the care of a highly skilled surgeon, but advantageously according to various embodiments the surgical robot and / or one or more surgical tools may be manoeuvred or otherwise moved with a precision and degree of control which is superior to that of a highly skilled surgeon.

[0060] According to various embodiments the movement of the robotic arm can be controlled in a highly precise manner enabling an accuracy in terms of movement to a level which is higher than conventional surgical robots whilst at the same time having the ability to be controlled locally e.g. by a surgeon whilst the surgeon performs surgery on a patient.

[0061] According to various embodiments the robotic arm interface unit may be referred to as a “smart end plate” (“SEP”). According to various embodiments the robotic arm interface unit forms a connection on an end of a robotic arm that provides a means to control both the robotic arm as well as a surgical tool which is mechanically and / or electronically attached or connected to the robotic arm (via the robotic arm interface unit).

[0062] The robotic arm interface unit may be used as (or form part of) an arthroscopic surgical robotic system which may have a plurality of robotic arms. The robotic arm interface unit may include a plurality of buttons or other activators which may be arranged in a layout. The plurality of buttons or other activators allows a user (e.g. surgeon) control over the position and orientation of the surgical tool, as well as the orientation and operation of the surgical tool tip itself.

[0063] The robotic arm interface unit provides an interface with surgical tools and include a mechanical connection that operates through a surgical drape connection, an electrical connection that allows sensor readings from the one or more surgical tools, and optionally an RFID connection that enables autonomous identification of the surgical tool that is attached.

[0064] The robotic arm interface unit provides the user with a high level of precise control over a surgical tool when used to assist perform surgery such as arthroscopic surgery.

[0065] According to various embodiments the robotic arm interface unit provides local control of a robotically assisted instrument without losing the precision benefits of robotically assisted surgery. This is achieved by the provision of an in-built controller that includes one or more buttons which may each be used to control movement of a surgical tool in a single degree of freedom and in an independent manner.

[0066] It will be appreciated by those skilled in the art that according to various embodiments the robot precision is not tied to the precision of the user thereby preventing any reduction of performance as may occur from sole reliance upon using human accuracy.

[0067] The robotic arm interface unit according to various embodiments also addresses the problem of how to control a wide variety of surgical instruments with a single robotic arm. Different configurations of robotic arm interface unit may be provided. For example, different configurations allow for different types or classes of tools to be used. According to various embodiments, various different robotic arm interface unit configurations may be provided on different robotic arms of a surgical robot system. Each configuration of robotic arm interface unit may include one or more motors for actuation and one or more electrical connectors for communication and control which allows for a variety of tools to be used.

[0068] The robotic arm interface unit according to various embodiments further addresses the issue of how to connect a surgical instrument effectively and safely to a robotic arm without requiring precision tools or expert skills. This is achieved by utilising a robotic arm interface unit which is designed to be able to attach the surgical tools easily while still resulting in a high precision attachment. This streamlines the setup process which is valuable for the already laborious process of preparing for surgery.

[0069] The robotic arm interface unit may form part of an arthroscopic surgical robot system.

[0070] Other embodiments are contemplated wherein the robotic arm interface unit may be used in conjunction with a non-surgical robot and the attachments may relate to non- surgical tools.

[0071] BRIEF DESCRIPTION OF THE DRAWINGS

[0072] Various embodiments will now be described, by way of example only, and with reference to the accompanying drawings in which:

[0073] Fig. 1 shows an isometric view of a robotic arm interface unit according to various embodiments, wherein one end of the robotic arm interface unit is attached to an end of a robotic arm and the other end of the robotic arm interface unit is attached to a surgical tool via a surgical drape connector plate;

[0074] Fig. 2 shows a side view of a robotic arm interface unit according to an embodiment, wherein the robotic arm interface unit is connected to an end of a robotic arm, wherein a surgical drape connector plate is attached to the robotic arm interface unit, and wherein a surgical tool is connected to the robotic arm interface unit via the surgical drape connector plate;

[0075] Fig. 3A shows an embodiment wherein a controller associated with a robotic arm interface unit is positioned in-line with a longitudinal axis of a surgical instrument and Fig. 3B shows an alternative embodiment wherein a controller associated with a robotic arm interface unit is positioned off-axis relative to a longitudinal axis of a surgical instrument;

[0076] Fig. 4 shows a circuit configuration according to a chip on tip (“CoT”) embodiment;

[0077] Fig. 5 shows a circuit configuration according to a general use embodiment;

[0078] Fig. 6 shows a circuit configuration according to a high-speed embodiment;

[0079] Fig. 7 shows a circuit configuration according to high resolution camera embodiment;

[0080] Fig. 8 shows a robotic arm interface unit together with an associated controller which includes various buttons and triggers that allow a user to control the robotic arm motion and the attached instrument operation;

[0081] Fig. 9 shows an arthroscopic robotic system according to various embodiments comprising a robotic arm with a halo common platform and plurality of robotic arm interface units depending from the halo common platform;

[0082] Fig. 10 shows an embodiment wherein a controller is connected to a surgical tool via a gimbal and a U-shaped bracket arrangement connected to a robotic arm interface unit;

[0083] Fig. 11 shows a remote arm configuration according to an embodiment;

[0084] Fig. 12 shows an embodiment wherein multiple surgical instruments are utilised to perform arthroscopic surgery on a patient wherein the surgical instruments are operated under local control;

[0085] Fig. 13 shows an embodiment wherein multiple surgical instruments are utilised to perform arthroscopic surgery on a patient wherein the surgical instruments are operated under remote control;

[0086] Fig. 14 shows various designs for a user interface of a controller according to various embodiments;

[0087] Fig. 15 shows an embodiment wherein a finger shield is provided adjacent a controller;

[0088] Fig. 16 shows a controller mounted to a surgical instrument via a gimbal arrangement according to an embodiment;

[0089] Fig. 17 shows embodiments wherein a controller is aligned with the tip of a surgical instrument from both a top down and side on view;

[0090] Fig. 18 shows an embodiment wherein a controller is aligned with a camera;

[0091] Fig. 19 shows an embodiment wherein motion controllers are utilised;

[0092] Fig. 20 shows another embodiment and is provided to help visualisation;

[0093] Fig. 21 shows a further embodiment and is provided to help visualisation;

[0094] Fig. 22 shows three different gimbal configurations according to various embodiments;

[0095] Fig. 23 shows a surgical robot according to various embodiments including a robotic arm and different views of a robotic arm interface unit according to various embodiments;

[0096] Fig. 24 shows a surgical robot according to an embodiment and illustrates the surgical robot being used during surgery; Fig. 25 shows a robotic arm interface unit according to an embodiment;

[0097] Fig. 26 shows a graphical display according to an embodiment;

[0098] Fig. 27 shows a surgical robot according to an embodiment; and

[0099] Fig. 28 shows different stages in deploying a robotic arm with an attached surgical instrument to a desired position according to various embodiments.

[0100] DETAILED DESCRIPTION

[0101] Various embodiments will now be described in further detail below.

[0102] Fig. 1 shows a robotic arm interface unit 1 according to various embodiments. The robotic arm interface unit 1 is shown attached to an end of a robotic arm 5. The robotic arm interface unit 1 may comprise various components which may be used to actuate and operate various different surgical instruments 4 which may be attached to another end of the robotic arm interface unit 1 .

[0103] As will be explained in more detail below, a controller (not shown in Fig. 1) may be provided which may include a user interface (not shown). The controller and user interface may be used to control various aspects of the robotic arm interface unit 1 including the operation of motors and communication ports which may be provided within the robotic arm interface unit 1 . A user interface may be provided on the housing of the controller. A user (e.g. a surgeon) may use the user interface in order to input commands or to otherwise control the robotic arm 5 which is attached to the robotic arm interface unit 1 . The controller (not shown) may also be used to control both the position and orientation of one or more surgical instruments 4 which may be attached to the robotic arm interface unit 1 . Furthermore, the controller may be configured so as to provide additional control over the surgical instrument 4 itself and the operation as a whole.

[0104] The robotic arm interface unit 1 may be arranged to connect to and interface directly with a surgical drape connector plate 3. The surgical drape connector plate 3 may be configured to ensure sterility of the operating site whilst attaching securely to the robotic arm interface unit 1 . The surgical drape connector plate 3 provides the ability for the robotic arm interface unit 1 to control the operation of the attached surgical instrument 4. The robotic arm interface unit 1 may be mounted to a robotic arm 5 which may be actuated to allow for manoeuvrability of the surgical instrument 4. According to various embodiments one or more surgical instruments 4 may be connected to the surgical drape connection plate 3. The surgical instrument 4 may therefore connect to the robotic arm interface unit 1 via the surgical drape connection plate 3. However, the provision of surgical drape connection plate 3 is not essential and may be omitted. It should also be understood that the scope of the described embodiments is in no way limited by the types of surgical instruments 4 being used.

[0105] Fig. 2 shows a side view showing a robotic arm 5 attached to a robotic arm interface unit 1 . The robotic arm interface unit 1 is shown attached to a surgical instrument 4 via a surgical drape connection plate 3.

[0106] Fig. 3A shows an embodiment wherein a controller 2 is provided in-line with the shaft axis of the surgical instrument 4. Other embodiments are contemplated such as the embodiment shown in Fig. 3B wherein the controller 2 may be positioned in a configuration wherein the controller 2 is offset from the shaft axis of the surgical instrument 4.

[0107] The robotic arm interface unit 1 may house various components that may be used to operate and communicate with an attached surgical instrument 4. According to various embodiments different types of robotic arm interface unit 1 may be provided. In particular, different types of robotic arm interface units 1 may be provided which depend upon the type of surgical tool 4 which is intended to be attached to the robotic arm interface unit 1 .

[0108] According to various embodiments different types of robotic arm interface units 1 may share a number of common general or core components. In addition, different types of robotic arm interface units 1 may include other specialised components which relate to the type of surgical instrument which is intended to be attached to the robotic arm interface unit 1 and which is intended to be controlled by the robotic arm interface unit 1 .

[0109] According to various embodiments the robotic arm interface unit 1 may comprise a housing or external shell. The housing may be configured so as to have a high water resistance and to be capable of withstanding wet environments. In addition, the housing provides rigidity and protection to various internal components. The housing may include grooves and / or slots which may allow for effective connection of a surgical drape connector 3 and surgical tool 4 to the robotic arm interface unit 1 .

[0110] According to various embodiments, various different configurations of a robotic arm interface unit 1 may be provided which are designed to be used with different types of surgical instruments. Four different configurations are disclosed below and will be described in more detail with reference to Figs. 4-7. These configurations differ in terms of what components are installed within the robotic arm interface unit 1 , as well as how the components are interconnected together.

[0111] Fig. 4 shows a first circuit configuration which may be referred to as a “Chip on Tip” arrangement. According to this embodiment a RFID reader 40 may be provided within the housing of the robotic arm interface unit. The RFID reader 40 may be capable of reading an embedded RFID tag provided on a surgical instrument. For example, the RFID tag may be used to identify a surgical instrument which is attached to the robotic arm interface unit.

[0112] The circuit may further comprise a main PCB 41 which may contain various subcomponents such as a Microprocessor Unit (“MPU”) to facilitate communication and control of the other electrical components, an Inertial Measurement Unit (“IMU”) which may be used to measure the orientation and movement of the robotic arm interface unit, an Analogue to Digital Converter (“ADC”) to digitise any sensor readings from the instrument and conditioning and control circuits for each of the motors. LEDs 42 may also be provided as an illumination source. In particular, a RGB LED 42 may be provided which may be integrated to provide effective user feedback. The circuit may further comprise an electrical instrument connection port 43 which is configured to provide a secure and safe connection to allow sensor data and electrical energy through.

[0113] According to an embodiment the robotic arm interface unit may be configured to allow for the use of a Chip on Tip (“CoT”) arthroscopic camera probe. For example, the robotic arm interface unit may comprise three low speed motors which are configured to allow control over an actuated tip of the Chip on Tip probe and an Analogue to Digital Converter that encodes raw Chip on Tip video as a digital signal to send to the arthroscopic robot.

[0114] Type II - General use configuration

[0115] According to another embodiment the robotic arm interface unit may be configured to control various jawed or actuated tools (but excluding high speed instruments) and electrosurgical tools. According to this embodiment, the robotic arm interface unit 1 may be configured to include three low speed motors to control tool tip orientation and actuation and wiring to allow for electrosurgical tools to be attached.

[0116] According to various embodiments a circuit board as implemented in a general use configuration is shown in Fig. 5. It will be appreciated that the circuit board is similar to that shown and described above in relation to Fig. 4 with the exception that the CCU

[0117] According to another embodiment the robotic arm interface unit may be configured to operate with high speed tools such as a shaver, bur or power rasp. According to this embodiment two low speed motors may be utilised to control tip actuation. Furthermore, one high speed motor may be provided to actuate the shaft and wiring may be provided to allow for electrosurgical tools to be attached.

[0118] Fig. 6 shows a circuit board as implemented in a high speed configuration according to various embodiments. It will be appreciated that the circuit board is essentially similar to that shown and described above in relation to Fig. 5 with the exception that a high speed output encoder 60 is provided which is connected to the main PCB 41 .

[0119] According to a further embodiment the robotic arm interface unit may be configured to allow for arthroscopic lens array probes to be attached that provide a high resolution video feed. Fig. 7 shows a circuit diagram according to a high resolution camera embodiment. For example, according to various embodiments the robotic arm interface unit may include an ultra-high definition camera sensor which interfaces with an attached lens array to capture images within the joint. An analogue to digital converter may be provided that digitises the camera feed to send to an arthroscopic robotic system. A set of high power LEDs 42 may be provided to illuminate the joint through the probe shaft.

[0120] Type V-ID Chip Configuratoin

[0121] In further embodiments, an ID chip may be provided on the robotic interface unit whereby the ID chip may be energized through a pin connector provided on the robotic arm. When energized, the ID chip may execute an embedded program to notify the robot upon being connected by the pin connector.

[0122] Fig. 8 shows a robotic arm interface unit 10 and associated controller according to various embodiments. According to an embodiment a controller is provided which includes buttons and triggers that allow the user to control the motion of a robotic arm and the operation of an attached surgical instrument. The controller may include buttons for controlling motion with one hand as well as additional functions.

[0123] In particular, the embodiment as shown in Fig. 8 shows a robotic arm interface 10 unit having a power and / or communications line exit point 801 . As shown, various locations 802 are available for a PCB to be integrated. Various user Input / Output (I / O) interface locations 803 are shown. An instrument electrical connection 804 is shown. Also shown are the locations of one or more motor blocks and one or more high resolution cameras 805. An RFID reader 806 is shown. Also shown are RGB LEDs 807 and the location of a CCU ADC 808.

[0124] According to various embodiments the buttons may be arranged to be usable through a surgical drape and with a user (e.g. surgeon) wearing several sets of surgical gloves.

[0125] The controller may allow a user (e.g. surgeon) to move the surgical instrument in one or more single degrees of freedom. According to an embodiment the controller may be arranged to move or control the surgical instrument in a single degree of freedom wherein movement in other degrees of freedom is not permitted or is otherwise prevented. The controller may enable a user to control the surgical instrument position (x, y, z). The controller may be arranged to enable a user to control the surgical instrument orientation (roll, pitch, yaw). The controller may be arranged to enable a user to control the surgical instrument actuated tip orientation (pitch, yaw). According to an embodiment the controller may be arranged to enable a user to control the surgical instrument operation (activate jaws, cut with scissors, etc.) achieved with primary and secondary action haptic-enabled triggers. According to an embodiment the controller may be arranged to enable a user to control the fluid inflow / outflow. According to an embodiment the controller may be arranged to enable a user to control automated motions. According to an embodiment the controller may be arranged to enable a user to control other used selected functions.

[0126] The robotic arm interface unit and associated controller may further comprise integrated motors which may be actuated by primary and secondary action triggers and which according to an embodiment may provide simulated force feedback from the tool operation.

[0127] The robotic arm interface unit and associated controller may further comprise a manual override control which allows a user to control the instrument’s position and orientation in a similar manner to controlling the position and orientation of a manual instrument. In this mode the robotic arm may detect any forces applied to the robotic arm interface unit and assist the motion in the manner similar to a robotic exoskeleton.

[0128] The robotic arm interface unit and associated controller may have an ergonomic symmetrical design in order to facilitate use by a user with either hand. This includes a slidable thumbpad to facilitate use by users with different sized hands. The surgical drape connector may be arranged to attach rigidly to the tip of the robotic arm interface unit. This connection may be such so as to ensure sterility without compromising the interface with the surgical instrument.

[0129] The surgical instrument may comprise a custom proximal interface that connects to the robotic arm interface unit. The interface may be configured to lock into place easily around the drape connection plate. The proximal interface may be arranged to interact with robotic arm interface unit motors, the UHD camera sensor, and electrical connection (as appropriate for the configuration). The proximal interface may also include mechanical controls that are designed to be used in the case of manual use, such as when a power outage occurs. The proximal interface may include an entry for the saline tubing into the instrument itself. The surgical instrument proximal connection may also include an RFID tag for identification by the robotic arm interface unit or the arthroscopic robot.

[0130] According to various embodiments it is desired to have minimal interference between the user and the tactile sensation provided by the controller. According to an embodiment the controller associated with the robotic arm interface unit may comprise a sterile single-use controller which allows the surgeon to operate the controller without having to interact through a surgical drape thereby increasing the usability of the product.

[0131] According to various embodiments a single-use controller may be provided which may be a separately packaged and wherein the controller is easily attachable / detachable. The controller may be ergonomic and intuitive to use. It will be understood that a single-use controller provides a convenient usability update to existing surgical robots. The surgical robot according to various embodiments is designed to be controlled from one of two main places, either locally through the robotic arm interface unit and associated controller or remotely through the use of an external haptically enabled pair of arms. These remote arms may be arranged to provide force feedback to the user as if they were at the bedside with the added benefits that come from not being physically attached to the instrument (i.e. can use scaled movements, can swap control between different arms easily and can interact with the GUI more easily). With the addition of the single-use controller, the controller which would have otherwise been located onto the remote arms can now be the exact same single-use controller. This increases intuitive control and improves usability.

[0132] According to various embodiments the single-use controller may include a protective barrier to ensure that the user does not unintentionally touch the drape near the attachment point. When operating arthroscopic instruments in manual operation it will be understood that the surgeon needs to be able to effectively relate the position of the surgical tools they see on screen to the way they are holding them in order to be able to correctly move and manipulate the surgical tools. In order to reduce cognitive load, the surgical robot according to various embodiments may utilise a What You See Is What You Get (WYSIWYG) control scheme, wherein the user moves the controller based on what they see on screen and the instrument moves directly in line with that. This control method requires the controller to be in the correct alignment so that movement relative to the screen happens as expected for the controller (i.e. moving left on the screen moves the controller left, moving deeper into the screen moves the controller forward etc.). The correct alignment is independent of the orientation of the surgical instrument and as such the controller needs to be able to rotate independently of the surgical instrument. To this end a motorised U-shaped bracket may be utilised. The U-shaped bracket allows the controller when it is mounted on the robotic arm interface unit to rotate independently of the surgical instrument.

[0133] The controller may also be used to allow the surgeon to use manual tip control in which the surgeon can turn or twist the controller and use that to operate the surgical instrument tip without moving the surgical instrument shaft. This embodiment can also be used to further augment the usability of the robotic arm interface unit so that in normally compromising ergonomic positions, the controller can be reoriented for comfort.

[0134] According to various embodiments the U-shaped bracket may be powered by three low powered motors with three more powerful brakes which allows for repositioning of the controller as needed without stopping the user from using standard manual control as desired.

[0135] These aspects which utlise the U-shaped bracket will now be described in more detail below.

[0136] Various embodiments relate to an arthroscopic robot which is designed to facilitate higher precision arthroscopic surgeries and reduce the strain on the surgeon. According to an embodiment an arthroscopic surgical robot may include up to five operating robotic arms that can each hold a surgical instrument and can move and control the attached surgical instrument under the direction of the surgeon.

[0137] Fig. 9 shows an arthroscopic robot 100 according to various embodiments wherein a surgeon can control the operation of the robotic arms either using local control or via remote control. To achieve local control, the end of each arm denoted by 810 is provided with a Smart End Plate (“SEP”) or robotic arm interface unit. The robotic arm interface unit provides a mechanical interface for the surgical instruments to be attached to, houses the motors and electrical interface necessary to operate the surgical tools and provides a location for the controller to be attached to.

[0138] Fig. 10 shows an operating arm configuration wherein remote control is achieved by using a controller 2 which is mounted to a separate robotic arm optionally via a gimbal 5 (which will be described in greater detail below). According to various embodiments this robotic arm arrangement may be arranged to provide haptic force feedback which allows any sensation felt by the actual tool to be mimicked by the robotic arm and to be felt by the user as if they were at the bedside.

[0139] Fig. 11 shows a remote arm configuration with an attached controller 2. In order to provide a consistent user experience an equivalent controller on both the operating arms and the remote arms may be provided. In order to provide maximal tactile clarity, readability and general usability, the controller 2 may comprise a sterile single-use controller. According to various embodiments it may be advantageous to utilise a sterile single-use controller 2 rather than utilising a reusable controller in conjunction with a surgical drape in order to maintain the sterility of the controller. In order to provide haptic feedback the triggers within the robotic arm interface unit may be configured to output a force response equivalent to that felt by the user when controlling standard arthroscopic tools. In order to maximise the usability of a controller 2, the controller 2 may be configured to be easily attachable and detachable to a robotic arm and / or a robotic arm interface unit according to various embodiments.

[0140] Local control

[0141] Fig. 12 shows an embodiment wherein a surgical robot according to various embodiments is being operated under local control i.e. by a surgeon who is physically located alongside the patient as the patient is being operated on (as opposed to remote control wherein the surgeon is located at a remote distance from the patient). According to various embodiments the surgeon may be positioned at the bedside and alongside the patient and may seek to perform surgery assisted by operation of the robotic arms of the surgical robot. It should be understood that local control enables a surgeon to use his / her own hands to perform manual surgery on a patient in addition to a surgical robot assisting the surgeon. It will be understood that, by contrast, with remote surgery since the surgeon is not located in proximity to the patient then the surgeon does not and may physically be unable to perform manual surgery upon the patient i.e. all surgical interventions are made by the surgical robot. With local control, some but not all surgical interventions may be made by the surgical robot.

[0142] In order to perform surgery with local control, a surgeon may attach a controller to a robotic arm which they wish to control. The surgeon will either connect a controller to each robotic arm which they plan to use during the operation, or they will use just two controllers (one for each hand) and will take them with them as they seek to control different robotic arms.

[0143] According to various embodiments the controller may be configured to attach onto a robotic arm after it is draped and according to various embodiments it may provide protection to ensure that a user does not accidentally touch the surgical drape which is installed around each robotic arm during surgery in order to maintain the sterility of the surgical robot.

[0144] According to various embodiments a surgeon controlling a robotic arm locally may cause the robotic arm to operate in a plurality of different modes of control and operation. For example, according to a mode of operation the surgeon may place the robotic arm into a precision control mode of operation. According to another mode of operation the surgeon may place the robotic arm into a manual control mode of operation. In a precision control mode of operation the surgeon can use one or more button inputs in order to provide consistent and accurate movement commands to an attached surgical tool or surgical instrument. An attached surgical tool or surgical instrument may be configured to be manipulated in up to nine degrees of freedom when attached to a robotic arm. The nine degrees of freedom may include position in x, y and z, orientation in roll, pitch and yaw, tool tip orientation for articulating tools (typically only pitch and yaw) as well as primary actions such as grasping or cutting (different for different tools). Accordingly, the controller may be provided with a plurality of buttons in order to allow the user to input their commands in respect of operating or moving in one or more degrees of freedom.

[0145] In manual control, the user may seek to control an attached surgical tool or surgical instrument in the same as they would during regular or conventional arthroscopic procedures not involving a surgical robot. As a user pushes, pulls and rotates on the controller, the robotic arm may sense these forces and account for them and assist the motion and may make the tool feel very light to the user. In order to control additional functions (such as taking pictures or controlling fluid) the controller may be provided with additional buttons or other user interface controls which a user can select from. The controller may be attached to a motorised gimbal that can be used to allow the controller to rotate independent of a surgical tool or surgical instrument if desired. The use of a gimbal also helps correct some of the otherwise confusing controls associated with the local control of the instruments.

[0146] Remote control

[0147] Fig. 13 shows an embodiment wherein surgical instruments or surgical tools are operated under remote control. When the surgeon is not at the bedside, a surgeon can control the operation of the robotic arms by connecting a controller to a non-operating robotic arm. The non-operating robotic arm may be draped in a similar manner to operating robotic arms. According to various embodiment a controller 2 may be configured to connect onto either an operating robotic arm and / or a non-operating robotic arm and may further be arranged to prevent a surgeon from touching any draped surface when operating the controller.

[0148] According to various embodiments when using the remote robotic arms a surgeon can use both precision control and manual control. Manual control in this context allows a user to scale their movements so as to provide significantly higher accuracy and precision than regular manual control under local control. A user may select a robotic arm which they wish to utilise via a user interface assisted by visual feedback from a display or visual monitor. According to various embodiments similar techniques as are utilised by virtual reality (“VR”) controllers may be used wherein a user can simply point and select on the screen and the robotic arm becomes linked. The controller may be provided with an interface to allow a user to disconnect the controller from a robotic arm.

[0149] Controller specification

[0150] According to various embodiments a single-use controller may be provided. The controller may be configured to be connectable and disconnectable from a physical mounting bracket. The controller may be symmetrical to provide easy use with either hand. The controller may have an ergonomic form to create a positive user experience.

[0151] User interface

[0152] Fig. 14 illustrates an embodiment of a single use controller 200 to interface with the distal ends of the robotic arms and the haptic arms. The connection interface for the controllers are the same on both sets of arms. According to various embodiments the user interface may comprise an easy attach and release mechanism that can be used with one hand without the risk of touching drape. A shield or similar component may be provided that prevents the user from touching a surgical drape during use.

[0153] Figures 14A to 14 illustrates four main areas of interest: the superior Ul interface (202); the inferior Ul interface (204); the controller interface connection site (206) and the controller clutch pad (208). The shell of the controller 200 is rigid so that the surgeon can get a firm grip on the controller. There is a guard 210 from the connection site to the clutch pad to help maintain sterility of the user. The guard functions as a projecting skirt feature, when the controller is connected to the (non-sterile) mounting points. The skirt guard 210 covers the attachment to provide a female connection and a barrier between the sterile user and the non-sterile attachment interface. Within the connection part of the controller 200 there is a push button 212 activated mechanical retention mechanism, allowing the controller 200 to be easily connected and disconnected from a physical mounting bracket in either the teleoperated or local control. The design should be symmetrical for either hand usage and ergonomic so that the user has a positive user experience.

[0154] The shell is the external component that the user holds, and it supports all internal components within the controller. The shell includes several subcomponents:

[0155] • Main shell (superior): This is the upper clamshelled component of the controller. It includes openings for Ul elements to be accessible to the user.

[0156] • Main shell (inferior): This is the lower channelled component of the controller. It includes openings for Ul elements to be accessible to the user.

[0157] • Connector shell: This is the proximal part of the controller, which connects around the main shell, and facilitates the controller mounting surface functionality

[0158] • Shell seam seals: In between each of the shell components, at the seams of where they join to each other, seals are needed. These prevent fluid from passing through the gap between components.

[0159] • Shell fixators: These affix the parts of the shell together, and ensure that the seals are compressed and effective between the shell seams

[0160] • Interior shell mounting surfaces: These are the surface and features within the shell that facilitate accurate and rigid mounting within the controller

[0161] The superior user interface shown most clearly in Fig. 14B includes several different elements that are designed for intuitive control and ease of use.

[0162] The interface elements include:

[0163] • 4 multi-purpose buttons: These are designed to provide multiple different usages in different conditions. The multi-colour illumination allows for more clarity of function and context. These buttons involve transparent button caps over the actual switch. These should be tactile single pole switches. See Annex 4 for an example switch.

[0164] • Yaw control rocker switch: These are designed to give the user “discrete” control over the yaw angle of the instrument of the associated arm. This includes an opaque button cap with representative arrows on it. This should be a single-pole double-throw (SPDT) momentary rocker switch ((On)-Off-(On)). See Annex 4 for an example switch.

[0165] • Roll control rocker switches: These are rocker switches that allow the user to control the roll / twist of the instrument attached to the associated arm. These would include button caps that provide ease of use to the user. This should be a single-pole double-throw (SPDT) momentary rocker switch ((On)-Off-(On)). See Annex 4 for an example switch.

[0166] • Translational control joystick: This joystick is designed to give intuitive forward & back / left & right control of the instrument. It can also be used for controlling the orientation of the instrument tip if it is actuated and the correct mode is enabled. This joystick should be low profile to ensure that other Ul elements can still be reached by the user’s thumb. It should also be capable of being clicked, as an additional means of user input. See Annex 4 for an example switch.

[0167] Pitch control rocker switch: This is a rocker that is designed to allow the user to control the pitch of the instrument. This would include a button cap that provides ease of use to the user without obstructing the other buttons / joystick. This should be a single-pole double-throw (SPDT) momentary rocker switch ((On)-Off-(On)). See Annex 4 for an example switch.

[0168] Feedback LED: This multi-colour LED gives general feedback to the user, including signals for “attached”, “healthy”, “error” and others.

[0169] In addition to these Ul elements, there are also sealing elements included to ensure that moisture doesn’t get into the controller. These include: button sealing membranes which forms a waterproof layer that sits between the button caps and the PCB mounts switches and ensures that the holes through which the buttons extend don’t allow fluid in.

[0170] Figure 14C illustrates the inferior user interface. The inferior user interface includes several elements that are critical for the function of the controller, the elements being listed below:

[0171] • Primary action trigger: This potentiometer trigger with a resistive haptic drive connection is the means by which the user controls the most critical function of the instrument that is attached (activating RF signal, biting the grasper jaws, etc). This trigger is attached to a low power DC motor (through a geared interface) that serves two functions: reading the angle of the trigger for variable control, and providing some force feedback to the user. This is important for highly sensitive tasks, such as probing tissue, in which force feedback is useful for diagnosis and correct application.

[0172] • Secondary action trigger: This potentiometer trigger with a resistive haptic drive connection is for any additional actions that the user would want to use (activate EMS, withdraw suture, etc). This trigger is attached to a low power DC motor (through a geared interface) that serves two functions: reading the angle of the trigger for variable control, and providing some force feedback to the user.

[0173] • Up / down control rocker switch: This rocker switch allows the user to discretely control the “height” of the instrument. This includes a textured button cap that is easy to use without seeing the switch (as it is obscured). This should be a singlepole double-throw (SPDT) momentary rocker switch ((On)-Off-(On)). See Annex 4 for an example switch.

[0174] In addition to these Ul elements, there are additional sealing elements that prevent the ingress of fluid into the electrical interior of the controller. These include:

[0175] • Button sealing membrane: This is a waterproof layer that sits between the button caps and the PCB mounts switches and ensures that the holes through which the buttons extend don’t allow fluid in.

[0176] • Trigger mount seals: The triggers are mounted into the controller shell. The point where that interacts with the shell must ensure that fluid cannot pass through at that point.

[0177] • Motor shaft seals. The DC motors that actuate with the triggers extend through from the inside of the shell. The motor shaft must be sealed effectively to ensure that fluid can ingress through the same hole as the shaft. The clutch pad shown in Fig. 14B is present as a means for the user to intuitively engage the “manual” control mode. In this mode the user grasps the clutch pad and can then move around the controller, whose motion is then mapped to the corresponding operating arm. This section includes a few specific elements:

[0178] • Clutch pad surface: This is the surface that the user interacts with. This surface is semi-transparent, allowing illumination from within to colour the clutch pad.

[0179] • Clutch pad mount: This is the pivot point that the clutch pad actuates around.

[0180] • Stiffener spring: To ensure that the clutch pad isn’t activated without intentional effort, a stiffener spring is used to hold the clutch pad in the “open” position when not used. This spring should be so strong as to prevent a user from comfortably being able to activate the clutch pad button.

[0181] • Tuning spring: This is an additional means to control the actuation of the clutch pad. May not be necessary.

[0182] • Alignment mechanism: To ensure that the clutch pad moves in a smooth way regardless of where the user force is applied, an alignment mechanism ensures that the clutchpad depresses along the correct axis.

[0183] • Multi-coloured LED: This provides a means to illuminate the clutch pad for the use of communication to the user.

[0184] • Button: This is the means by which the clutch pad being sgueezed is measured. This should be a single pole tactile switch.

[0185] In addition to these Ul elements, there are also sealing elements included to ensure that moisture doesn’t get into the controller. These include a Button sealing membrane that is a waterproof layer that sits between the clutch pad and the PCB mounted switch and ensures that the hole through which the button extends doesn't allow fluid in. Clutch pad mount seals are also to connect around the clutch pad pivot point. This sealing protects fluid and material from travelling around this pivot point.

[0186] The internal PCB shown in Figs. 14D to F, is designed to be either in multiple parts that are connected together during assembly, or a single foldable part so that the various surfaces of the controller can easily be accessed by the board for surface mounted switches to attach to their corresponding buttons. The PCB comprises several on board elements, including:

[0187] • Microcontroller: This microcontroller facilitates communication and control between all of the onboard components and the external communication port. This includes capturing button press information, controlling the LEDs, and operating the onboard motors. This microcontroller needs at least the following pins: o 5 single pole buttons (5 digital pins, +ve, gnd) o 5 single pole double throw rocker switches (10 digital pins, +ve, gnd) o 1 clickable joystick (5 digital pins, +ve, gnd) o 2 trigger potentiometers (2 analogue pins, +ve, gnd) o |2C communication (SDA + SCL)

[0188] This is a total of 20 digital pins, 2 analogue pins, l2C communication pins, as well as power and ground lines

[0189] • LED conditioning circuitry: To operate the various multi-coloured LEDs within the controller, there is some required circuitry to appropriately set colour and intensity. • Surface mounted user interfaces: All of the external Ul elements (rocker switches, buttons, roll wheel, joystick) are connected to surface mounted switches that actually pick up the activation of the components.

[0190] • Cabling to DC motors. To operate the DC motors, there is power cabling that runs to them. These are connected to motor drivers that are external to the controller (in the reusable U-bracket mount for the controller). The cabling from the DC motors runs through the PCB through to the external connection. This also includes connection to potentiometers on these motors / triggers, as they are needed for feedback to the system.

[0191] • Cabling to external connection: This is the means through which signals are between the internal components of the controller and the external world / the rest of the robot. This cabling includes the reguired cabling for I2C communication and the cabling necessary for operating motor drivers through to the onboard DC motors.

[0192] • Physical mounting fixators: To ensure that the buttons are held in place appropriately and that the PCB is fully functional, the PCB must be held in place appropriately. This is done through various fixators that hold the board in place.

[0193] Fig. 14F shows a layout component layout for the PCB that is used within the controller. These components are not to scale, but provide an idea of how the components can be laid out to enable foldability (folding sections shown in dark green). Rather than using a foldable PCB, it is also possible to use a series of separate PCBs and wire them together appropriately (separated at the dark green sections). Not shown on this diagram are cabling between components, fixation features that would allow this to be held in place, and any supplementary electrical components (resistors, capacitors, etc) that would be needed to enable the operation of the shown components.

[0194] Figs. 14G, 14H and 14J illustrates the connection interface 600 which allows attachment of the controller. It includes a few components that allow the controller to operate in tandem with the rest of the V01 . These include:

[0195] • A communication PCB

[0196] • A force / torgue sensor

[0197] • Motor drivers o For the primary and secondary controller triggers o For the U-bracket actuating mechanism

[0198] • Electrical ports o For incoming CAN communication o For U-bracket motor control o For the controller

[0199] Figure 14K illustrates the PCB and includes:

[0200] • MPU

[0201] • Motor drivers o Controller trigger motors o U-bracket motors

[0202] • Electrical connections: This includes ports for: o CAN communication (8 pin protocol) o Controller connection (2 pin l2C, 4 pins fortrigger motor control, 1 ground and 1 power; 8 total) o U-bracket connection (6 pins for motor control, 12 for encoders, 1 ground and 1 power; 20 total) o Force / torque sensor connection (CAN / Ethernet connection (based on sensor))

[0203] The force / torque sensor is needed to measure the directing force from the user that is intended to move the arm. By detecting this loading, the arm can be controlled to move in conjunction with that force, essentially providing a manual mode, where the user can move the instruments with minimal effort. This is meant to imitate the way by which surgeons currently use their instruments.

[0204] To ensure that the force is being accurately read, the distal section of the controller must be mounted solely through the sensor.

[0205] The force / torque sensor needs to:

[0206] • Provide sensing of force in X, Y, and Z components o Precision of <1 N in each axis

[0207] • Provide sensing of torque around the X, Y, and Z axes (roll, pitch and yaw) o Precision of <0.1 Nm around each axis

[0208] • Fit adjacent to the controller o <50mm diameter

[0209] • Withstand loading forces without damage o Up to 120N in any direction o Up to 12Nm (pitch or yaw, 120N over 100mm to controller)

[0210] • Must be functional for 100,000 hours

[0211] • Must communicate through CAN / Ethernet (Must connect with connection interface PCB)

[0212] The mechanical interface would need to be able to interface directly with the controller’s retention mechanism. As such, it needs to be designed in conjunction with that component. It must be able to:

[0213] • Withstand the same loading as the retention mechanism (120N in any direction).

[0214] • Be cleanable (minimal cracks and grooves where grime can get caught)

[0215] The controller PCB and the connection PCB must be able to communicate with each other (These will be colour-coded for ease of reading for this section). They must in conjunction be able to do the following:

[0216] • Pass button / switch / trigger press information from the controller: Any button press on the controller should cause the con ro^er PCB to send an l2C package to the connection PCB, detailing the button ID and the new value. This should be limited to a certain number of updates per second (60Hz, though should be an overwritable value)

[0217] • Pass LED illumination to the controller: For each of the LEDs on the controller, the connection PCB should be able to send an updated LED signal, with the colour and intensity of the signal for each LED, to the controller PCB within an l2C message. This should only be sent when an update is sent to the connection PCB from the V01 via CAN communication. • Produce motor signals: The U-bracket motors and the controller trigger motors both have motor drivers on the conn eUon PO8. At the command from the V01 (via CAN signal) the co nacti n PCS should update the running of those drivers, either to apply a certain torque, a certain speed, or move to a certain position.

[0218] • Read force / torque sensor: The connection PC 8 should read the force / torque sensor regularly to determine the loading that is being experienced. This is then communicated to the V01 via CAN signal. The frequency of this querying should also be able to be changed at request (60Hz by default)

[0219] • Read U-bracket encoders: The connection PCS is connected to the encoders for the U-bracket, and these are read at a consistent frequency (60Hz, though rate is changeable). This is then communicated to the V01 via CAN signal.

[0220] • Communicate with the V01 through CAN: The connetiion PCS communicates through the CAN network to the robot. This communication is used for all of the information from the U-bracket, sensors, and controller, and is also used for the control of the motors and LEDs. It is recommended that all communication from individual components are combined into a single package that is then sent to the robot (this is to minimise bandwidth congestion). The frequency of these messages should be changeable (60Hz by default), and should also be able to be changed to only update on request.

[0221] Robotic arm interface unit gimbal mounted controller configurations

[0222] It is recognised that a problem with conventional arthroscopic surgery is the issue of arthroscopic disorientation since arthroscopy can be a confusing operation. It will be understood that a surgeon is primarily looking at a screen that shows a camera feed from one instrument and then sees the orientation of one of the surgical tools from the viewpoint of the camera. It will be understood that in order to move a surgical tool in a desired direction, the surgeon must perform a complicated mapping from what the surgeon sees on screen to what their hand must do in order to move the surgical tool or surgical instrument in the correct direction or to control the surgical tool or surgical instrument in a correct manner. It will be appreciated by those skilled in the art that in order to perform this mapping requires extensive and specific training as any incorrect motion could potentially cause unintended damage to the patient.

[0223] With a surgical robot, the issue can become particularly pronounced since the arthroscopic robot according to various embodiments may use tools which articulate or change direction such as a camera. This means that beyond even just the disconnect between screen and hand, there is a further disconnect due to the potential angle change which would not be easy to keep track of. The arthroscopic robot according to various embodiments is advantageous in that it is capable of mapping motion controls input from the user relative to the camera. This can make it so that the button press of forward moves the instrument forward as seen on the camera. However, this might also mean that pressing forward could move the surgeon’s hand sideways which might be confusing.

[0224] According to various embodiments this disconnect may be corrected on the haptic controllers as the orientation of the controller can be different from the robotic arm interface unit orientation and can even be forced into alignment with the instrument tip if desired. This solution allows for more intuitive use, by abstracting away the many steps of confusing relationships between user and instrument.

[0225] Robotic arm interface unit gimbal

[0226] Figs. 16A to 16G shows embodiments wherein a three degree of freedom (“3DoF”) gimbal mount 6 for a controller 2 is provided. The controller 2 may be mounted behind the SEP or robotic arm interface unit 1 on a gimbal 6 which may include a U- shaped bracket which allows rotation in line with the surgical instrument 4 as needed and may provide electrical connections to the controller 2. The gimbal 6 may comprise three motors which are orientated orthogonally to each other and which allow the controller 2 to rotate independently of the SEP or robotic arm interface unit 1 if desired. Figs. 16A to 16C illustrate a controller 2 of a first type that is fixedly attached. Figs. 16D to 16J illustrate a one-time use controller 200 (not shown) with controller connection mount 201 being provided on the gimbal 6.

[0227] Controller oriented usage

[0228] When using the local control through the SEP or robotic arm interface unit 1 various different modes of operation can be employed which include: (i) button control for precise control of surgical instrument 4 and surgical instrument tip position and orientation; (ii) motion control for surgical instrument 4 position and orientation; and (iii) motion control for surgical instrument tip orientation. Button control

[0229] When using button control a user may push a button to move or rotate the position of the surgical instrument 4 or surgical instrument tip. This is where a disconnect can be overcome using the gimbal and two different methodologies may be employed. Firstly, the controller 2 can be positioned to be in line with the surgical instrument tip in the physical space such that any translational motion to move along the axis of the surgical instrument tip, or in relation to the surgical instrument tip would feel correct to the user’s awareness.

[0230] Fig. 17 shows top down and side on views showing the angle of the controller 2 moving so as to be aligned with the angle of the tip of the surgical tool or surgical instrument 4. If there is any change in orientation between the surgical instrument tip and the surgical instrument then according to various embodiments the controller 2 may change inclination so as to match the surgical instrument tip.

[0231] Secondly, the controller 2 can be positioned in line with the camera from which the vision is being streamed. This allows any translational commands to feel correct if the user is controlling the tool from the camera’s point of view. The controller 2 is therefore independent of the surgical instrument 4 and surgical instrument tip orientation (except for the camera). This control method is particularly intuitive for a user who is looking at the screen to operate.

[0232] Fig. 18 shows an embodiment wherein the controller 2 may be controlled so as to be aligned / inclined with the camera.

[0233] Thirdly, the controller 2 can be operated so as to have no tied orientation and can be moved by the user as they prefer. This would be up to the user to overcome the proprioceptive control.

[0234] Finally, the controller 2 can may be operated in a mode wherein it held a zero position with the controller 2 always aligning with the surgical instrument shaft. This would be the same as standard arthroscopic tools.

[0235] Motion control for the surgical instrument shaft

[0236] According to various embodiments motion control for the surgical instrument shaft may be enabled which allows the user to grasp the controller 2 and move the surgical instrument 4 similar to how arthroscopic tools are currently used. Accordingly, in this mode of operation the controller 2 is stationary and a user pushes force through the robotic arm to the attached surgical tool 4. The robotic arm may be configured to move the surgical tool 4 precisely but the user could still push the surgical tool 4. According to this embodiment the gimbal motors are configured to be sufficiently robust so as to withstand the forces applied by the user that they would normally use. This mode of control may be used with any of the controller orientations detailed above. It will be understood that the zero position controller orientation would feel most similar to a standard arthroscopic orientation, while the other orientations have various benefits as discussed above.

[0237] Motion control for the surgical instrument tip

[0238] Motion control for the surgical instrument tip allows a user to move the surgical instrument tip in a very natural way. As the user changes the orientation of the controller 2, the surgical instrument tip may be configured to change orientation proportionally. This allows very clear control by the user to move the surgical instrument tip as desired. This mode of control may be used in the controller aligned with tip mode, or the controller orientation could become unrelated to any of the other landmarks (not in alignment with tip or camera) after the user has moved the tool partially.

[0239] Screen oriented control

[0240] According to other embodiments motion controllers may be used.

[0241] Fig. 19 shows an embodiment wherein motion controllers may be used. The example shown in the left hand diagram of Fig. 19 illustrates such an implementation. In order to provide correlation between screen and controller 2, the relative position and orientation of the screen and the controller 2 may be determined. The zero axis may be determined which allows the orientation of the controller 2 to be related to the instrument. This may be determined by aligning the z axis with the direction from the user to the screen, the y axis vertically, and the x axis to complete the right hand rule (see right hand figure of Fig. 19). This notably is independent of the orientation of the screen but is dependent on the starting position of the user.

[0242] After this the zero axis may be determined and the orientation difference between the tool and the camera may be determined. This may be done by comparing the orientation of the camera and tool to each other finding Rt00i. After this rotation difference is found, the controller 2 may then be rotated to provide a rotation between the zero axis and the controller 2 that is equivalent to Rt00i. As Rt00ichanges, the controller 2 may move to match it. Translation with respect to the tool tip’s reference frame may also be translated to the controller 2 an equivalent amount in the controller’s reference frame. This method of movement effectively maps the controller 2 directly to the surgical instrument tip, and this can be used in reverse to allow the controller 2 to move the surgical instrument tip.

[0243] Relating this to the control desired from the robotic arm interface unit mounted controller, the required mount versatile for the controller 2 can be determined. This can be determined fortranslation and rotation independently and then can be related together.

[0244] Fig. 20 and Fig. 21 are provided to help visualise the configuration of the instruments and the screen.

[0245] The examples show some visualisations of translation and rotation. Assuming the controller 2 should only move in the corresponding direction as the surgical instrument moves, and the rotation should not move the surgical instrument tip or the controller 2, it can be seen that there is an angular change of the bridge as well as a length change. This is true for all motion except for translational motion when the controller 2 is in line with the instrument. This is acceptable in small steps, as would be the case for translation, as the distance travelled within a joint would be < 10 cm.

[0246] Rotational control may be facilitated utilising a variable length U-shaped bracket.

[0247] According to various embodiments the gimbal motors may be configured to resist any force exerted by a user. The controller may be mounted so as not to contact the SEP or robotic arm interface unit 1 regardless of orientation or provide a pinching hazard for the user. The controller 2 may be configured to be close to the surgical tool tip in order to minimise motion requirements. According to various embodiments the rotation point for the gimbal mechanism may be in the centre of the controller 2. The haptic triggers may be drive shafted easily from outside the controller 2 rather than necessitating locating the haptic motors inside the controller 2. According to various embodiments motors may be utilised which are small, lightweight and inexpensive.

[0248] Fig. 22 shows three different gimbal configurations.

[0249] Configuration A benefits from a short distance to the motors meaning low torque requirements. Furthermore, the U-shaped bracket is unlikely to get in the way of the hand and the configuration benefits from a very wide (360°) yaw rotation limit. However, the orientation of the joint also makes it easy to hit the SEP or robotic arm interface unit 1 unless it is positioned back significantly, the configuration only permits limited pitch downwards, the roll axis is out of alignment with the surgical instrument and adding haptic motors increases the distance from the SEP or robotic arm interface unit 1 by increasing pitch radius. Configuration B benefits from a shorter pitch radius which is beneficial when seeking to include haptic motors, the U-shaped bracket is unlikely to get in the way of the hand and the configuration has quite a wide (140°) yaw rotation limit. However, the configuration has a higher torque requirement for yaw motor, the orientation of the joint runs the risk of hitting the SEP or robotic arm interface unit 1 unless it is positioned back, the configuration has limited downwards pitch and the roll axis is out of alignment with the surgical instrument 4.

[0250] Configuration C benefits from a roll axis which is aligned with the surgical instrument 4, the short distances require low torques for motors and there is a wider range of pitch, the configuration does not interfere with the SEP or robotic arm interface unit 1 and the drape can be quite simple. However, there is a lower range of yaw, fingers interact closer to the connection point (and may need a guard to prevent touching drape) and adding haptic motors to the connection further distances the controller from the tip.

[0251] When considering the various different configurations, it will be understood that gimbal configuration C is particularly preferred. However, there are also situations where either configuration A or configuration B may be preferable. Additional design considerations include using small motors capable of actuating the controller 2, with electrical brakes capable of resisting motion caused by user force, and having a finger guard to minimise the chance the surgeon accidentally contacts the drape. Haptic motors may be provided inside and / or outside of the controller 2.

[0252] The design, function and potential user experience of surgeons interacting with robot arm mounted controls will now be explored in more detail below. In particular, the following highlights the specific form and function of the controls and reviews in detail how these features could either assist or impact surgical technique and the user experience.

[0253] The arthroscopic surgical robot according to various embodiments has been specifically designed to assist surgeons to perform arthroscopic procedures such as rotator cuff repair. It has been recognised that the surgeon requires the ability to control the robot and attached instruments both at the “operative bedside” and at the “console”. This increased requirement creates some unique user experiences (UX).

[0254] Some of the key details relating to the decisions that have guided the development of the user experience of a surgeon utilising an arthroscopic robot according to various embodiments include seeking to maintain the user interface and user experience as similar as possible to the familiar platforms used in the past. An important difference between conventional arrangements and the surgical robot 100 according to various embodiments is that instead of the surgeon having to manually coordinate and use by hand multiple disconnected devices, the present surgical robot 100 provides a platform which incorporates all the required features and allows surgical instruments to be attached and controlled by highly precise robotic arms. This change means that instead of the surgeon having to physically stabilise and manipulate the surgical tools, the user may instead command the surgical robot 100, and the surgical robot 100 will control the robotic arms to realise the desired intent.

[0255] The surgical robot 100 according to various embodiments has been designed to make the user experience with the surgical robot as intuitive as possible.

[0256] As traditional practice is solely based on the use of manual handheld instruments at the bedside, the design inspiration used to guide the development of the surgical robot 100 according to various embodiments and the bedside controls has been based on realising a similar “user-controller-interaction” to the experience encountered with the physical manipulation of tools in the past. However, the surgical robot 100 according to various embodiments advantageously provides both connectivity with integrated technologies whilst addressing the no longer present limitations of precision, fatigue and dexterity.

[0257] The robotic arm interface unit 1 may comprise a robotic arm connection, a manual clutch, directional buttons, instrument connection, drive motors, electrical connection, a primary action and secondary action. The SEP or robotic arm interface unit 1 enables manual or mechanised control of the surgical instrument at the bedside. The robotic arm interface unit 1 may be connected to the end of a robotic arm to provide complete system control at the surgeon’s fingertips.

[0258] It is noted that whilst console-based control of arthroscopic instruments is new, virtual control of objects on a graphical display shares familiar aspects seen with gamming or when working with computers. These experiences and the user experience trends common across these adjacent areas have been implemented in the development of the surgical robot console-controls according to various embodiments.

[0259] It will be understood that best user experience practice is that when a system has more than one control interface then it is important to ensure either that the form and function is consistent or that there are design features that address any unavoidable differences. It will be appreciated that any such features should not be obvious to the user and hence do not interfere with the user experience.

[0260] With regards user experience the following comparisons may be made.

[0261] Awareness of the patient: From the bedside, there is direct knowledge and standing in vicinity of patient. There is also aware of internal and external interactions with the patient. From a console, then whilst in the same room, and not directly near the patient and there is less awareness of external interactions with the patient.

[0262] Location of screen: From the bedside, whilst the screen is in the same room, it is not directly in front of surgeon and hence is not as immersive and might require some features to be hidden so they do not create distraction. From a console, the screen is directly in front of the user and is the primary focus the user. Hence, the screen is able to be configured to provide maximum capability.

[0263] Method of command: From the bedside, there is physical manipulation of controls mounted on the distal end of the robotic arms. Moving the controls (or pressing buttons) corresponds with the specific movement of the instrument attached to that robotic arm. From a console, there is interaction with controllers connected to haptic enabled joysticks paired with the console. Moving the controls (or pressing buttons) corresponds with the paired instrument tip / arm moving in the video feed in the same direction as the controller / users hand.

[0264] Motion scaling: From the bedside, minimal motion scaling is possible when controlling the instrument via “physical manipulation” of the distal arm controller. However, when pressing buttons scaling is consistent with console (but movement is small and respectively slower). From a console, scaling settings 1 to 10 (1 :20 up to 1 :200) are possible. This allows instrument tip movement speeds from 0.5 mm / sec to 5 mm / sec.

[0265] Spatial orientation: From the bedside, the surgeon maintains awareness of the physical / spatial position and orientation of the proximal instrument, shaft and the relationship with the external joint surface and patient. However, the configuration of instruments with variable angle tips is not obvious. From a console, the internal position, orientation and pose of instruments is known and the 3D structure of the joint modelled. Whilst a digital map of the surgical robot and operative area is simulated and displayed, due to the remote position of the console and lack of a direct physical relationship between the surgeon and tools the spatial perception can change (however this might not be detrimental). Controllers: From the bedside, this is the same as is used with the console, however mounted to the distal end of the robot arm. From a console, a sterile single use controller may be provided with integrated haptic transducers and force transmitting action triggers.

[0266] Robot interaction: From the bedside, due to the direct connection of the controllers with the robot arms, whenever the arms move so does the controller position / orientation. If the surgeon is holding the controller at the time of movement, they will be notably aware of this displacement. If they are not contacting the controller, it will change its location in space without their awareness. From a console, whilst the console controllers are not physically connected to the robot, they may be mounted on six degree of freedom haptic enabled joysticks. The haptic joysticks only specifically move when acted on by the user, however the resistance settings of the joystick motors may be arranged to constantly update to reproduce the physical sensation of the instrument.

[0267] Tool orientation: From the bedside, due to the physical association with the instrument, arm and controller the user is consistently aware of the orientation of the tool shaft. However, due to the variable angle tips, this orientation does not always specifically relate to either the distal instrument alignment or orientation on the video feed. From a console, the user is not directly aware of the real world orientation of the tool shaft (however, it is rendered in the digital map). However, the instrument tip, video feed displayed tool orientation and alignment of the console controllers / users’ hands is well known and correct.

[0268] With regards the design of the controllers according to various embodiments it is noted that the hand controllers support both discrete button control and spatial positioning (so the user can control position and orientation of the virtual objects by directly moving the controllers in space). Furthermore, the action triggers may be enabled for force transmission (so that the forces experienced by the “real tool” can be sensed and shared with the user to experience as “haptic signals”). Also, the controllers may be mounted on six degree of freedom haptic enabled joysticks allowing controller position and orientation to vary. This facilitates the generation of forces on the controllers representative of the physical sensation experienced by the instrument.

[0269] According to various embodiments the controllers may provide “What You See Is What You Get” (WYSIWYG) control. As a result the instrument tips that are viewed on the video feed respond in a consistent manner and with a direct relationship to the movement commands of their paired controller.

[0270] Various further embodiments are contemplated wherein the orientation of the bedside controller may be adjusted by the robot during use to align with how it’s tool tip is viewed of the video feed in order to facilitate WYSIWYG control wherein the controller aligns with the relative orientation of respective tool tip in relation to how it is viewed on the video feed, so that movement of the controller has a consistent and direct relationship to the intended movement of the tip on the screen.

[0271] Embodiments are contemplated wherein the robot arm may move should the orientation of the attached bedside controller be adjusted by the robot to compensate for any difference between the external arm trajectory and the path visualised by the tip on the video feed.

[0272] Various aspects of a surgical robot system 100 according to various embodiments include the capability of direct and immersive console integration, maximum feature capability, motion scaling and precision control, orientated awareness of internal elements (e.g. camera, instrument tips and joint surfaces), synchronised robot and controller movement, indirect view of screen and proximity awareness of external elements (patient, instrument shaft and robot).

[0273] According to various embodiments a bedside controller is disclosed which is physically attached to the distal end of the robot arm. The bedside controller may be adjusted by the robot during use. According to various embodiments when the robot arm moves, the orientation the bedside controller may be adjusted by the robot to compensate for any difference between the external arm trajectory and the path visualised by the tip on the video feed.

[0274] It is noted that traditional manual handheld instruments have required surgeons in the past to cognitively evaluate the orientational misalignment between the images on the video feed and the real-world instruments. Hence, it is desired to provide WYSIWYG console control in any order minimise potential confusion. Due to the variable angle tips found on surgical robot instruments, it is no longer possible for a user to reliably understand the position of the internal tip or the axis of the video feed in relation to a surgical instrument shaft. Due to the potential to lose awareness of the internal orientation, without some orientational correction of the bedside controller knowing what movement commands to action could be a complex task. According to various embodiments the bedside controller may be attached to the distal end of the robot arm and the surgeon can command to movement of the arm by the controller. If the disconnect between the axis of motion of the real-world arm and what was digitally anticipated this can be confusing or lead to second guessing.

[0275] In order to demonstrate the utility of the present invention an exaggerated rotator cuff repair simulation was performed. The results of this simulation showed that any disconnect between the alignment of the controller direction control orientation and the viewing axis can prompt errors. Accordingly, it is desirable to correct the axis of the camera tip in relation to controllers. It was found that adjusting the controller alignment so that the controller direction control orientation was aligned with the viewing axis was particularly successful. It was also found that the location of the viewing screen does not seem to affect the required correction to any significant degree. Whilst the robotic arm and the surgeon’s hand motion might not always be in line (in reference to the world frame or the surgeon’s body) to the digitally anticipated axis, with the stated intervention the movement of the controller direction control axis and the surgeon’s hand in relation to the control axis of the surgical robot will have movement consistent with the digitally anticipated movement axis. According to various embodiments the bedside controller may be arranged to actively adjust its orientation so that the controller direction control orientation and the viewing axis maintain alignment.

[0276] According to various embodiments the controller may be configured to allow the user to control both the instrument position, orientation and pose as well as the surgical arm configuration.

[0277] According to various embodiments the controller may be configured to allow the user to control both the instrument position, orientation and pose as well as the surgical arm configuration. This is needed to allow free movement of the instrument to mimic the movements of regular arthroscopy as the user desired.

[0278] Fig. 23 shows a simplified image which illustrates a method which may be used to control a robotic arm to operate a desired instrument. As shown in the first image, a target point (circle) may be acquired. Then as shown in the second image, a required wrist position may be determined as indicated by the square. As shown in the third image, a calculation related to the upper arm motor may then be made in order to reach the wrist position. Finally, as shown in the fourth image, a calculation may be made to determine lower arm motors to reach the tip position

[0279] While particular embodiments have been illustrated and described, it would be obvious to those skilled in the art that various changes and modifications can be made without departing from the scope of the present invention.

Claims

Claims1 . A robotic arm interface unit configured to interface, in use, between a robotic arm of a surgical robot and one or more surgical tools attached, in use, to the robotic arm interface unit, the robotic arm interface unit comprising: a housing having a connection portion for connecting to a plurality of different types of surgical tools; and a control system configured to control the operation of a surgical tool connected to the robotic arm interface unit; wherein: in a first mode of operation the control system is arranged to cause the surgical tool or one or more components of the surgical tool to move in one or more first degrees of freedom.

2. A robotic arm interface unit as claimed in claim 1 , wherein the one or more first degree of freedoms are selected from the group consisting of: (i) forward or back (surge); (ii) up or down (heave); (iii) left or right (sway); (iv) rotation forward and backward about a lateral axis (pitch); (v) rotation left and right around the vertical axis (yaw); and (vi) rotation side to side about a longitudinal axis (roll).

3. A robotic arm interface unit as claimed in claim 1 or 2, wherein in the first mode of operation the control system is arranged to cause the surgical tool or one or more components of the surgical tool to move in a single first degree of freedom.

4. A robotic arm interface unit as claimed in claim 1 , 2 or 3, wherein the control system is configured either: (i) to control and / or operate and / or move the robotic arm or one or more portions of the robotic arm; (ii) to control and / or operate and / or move an attached surgical tool or one or more components of an attached surgical tool; or (iii) to control and / or operate and / or move both the robotic arm or one or more portions of the robotic arm and an attached surgical tool or one or more components of an attached surgical tool.

5. A robotic arm interface unit as claimed in any preceding claim, wherein an attached surgical tool comprises a first portion and a second portion, wherein in a mode of operation the control system is configured to control and / or operate and / or move either: (i) the first portion of the attached surgical tool in an independent manner relative to the second portion of the attached surgical tool; (ii) the second portion of the attached surgical tool in an independent manner relative to the first portion of the attached surgical tool; or (iii) both the first portion and the second portion of the attached surgical tool in an independent manner relative to each other.

6. A robotic arm interface unit as claimed in claim 5, wherein the first portion of theattached surgical tool comprises: (i) a camera or a portion of a camera; (ii) a sensor or a portion of a sensor; (iii) a tool or a portion of tool; (iv) an instrument or a portion of an instrument; (v) a detector or a portion of a detector; (vi) a proximal or distal end of the surgical tool; or (vii) a furthermost point, end point or instrument tip of the surgical tool.

7. A robotic arm interface unit as claimed in claim 5 or 6, wherein the second portion comprises: (i) a body or housing of the surgical tool; or (ii) a connection or attachment portion for connecting or attaching to the robotic arm interface unit.

8. A robotic arm interface unit as claimed in any preceding claim, wherein the control system is configured either: (i) to control the position and / or orientation and / or pose and / or configuration of the robotic arm or one or more portions of the robotic arm;(ii) to control the position and / or orientation and / or pose and / or configuration of an attached surgical tool or one or more components of an attached surgical tool; (iii) to control the position and / or orientation and / or pose and / or configuration of both the robotic arm or one or more portions of the robotic arm and an attached surgical tool or one or more components of an attached surgical tool.

9. A robotic arm interface unit as claimed in any preceding claim, wherein the control system is configured to operate an attached surgical tool.

10. A robotic arm interface unit as claimed in claim 9, wherein the control system is configured to cause an attached surgical tool to perform: (i) aspiration; (ii) electrosurgery; (iii) clamping; (iv) suturing; (v) drilling; (vi) cutting; (vii) diagnosing; (viii) debridement; (ix) menisectomy; (x) synovectomy; (xi) repairing; (xii) reconstruction; (xiii) joint lavage; (xiv) microfracture surgery; (xv) osteochondral autograft transfer; or (xvi) rotator cuff repair.

11. A robotic arm interface unit as claimed in any preceding claim, wherein the robotic arm interface unit comprises a sterile single use or disposable controller.

12. A robotic arm interface unit as claimed in any preceding claim, wherein the robotic arm interface unit comprises a sterile single use or disposable unit.

13. A robotic arm interface unit as claimed in any preceding claim, further comprising a user interface.

14. A robotic arm interface unit as claimed in claim 13, wherein the user interface further comprises one or more buttons or user interface portions configured to send a signal to the control system so as either: (i) to cause the surgical tool to operate in the first mode of operation; (ii) to control the operation of the surgical tool whilst operating in the first mode of operation; or (iii) to cause the surgical tool to operate in a seconddifferent mode of operation.

15. A robotic arm interface unit as claimed in claim 13 or 14, wherein the user interface is configured to cause the surgical tool to operate in a mode of operation wherein the surgical tool can be physically positioned or repositioned by a user.

16. A robotic arm interface unit as claimed in any preceding claim, wherein the robotic arm interface unit further comprises a reader for reading a readable identifier attached to or forming part of a surgical tool.

17. A surgical robot configured to perform arthroscopic surgery comprising: one or more robotic arms; a robotic arm interface unit as claimed in any of claims 1-16, wherein the robotic arm interface unit is connected to one of the robotic arms; and one or more surgical tools attached to the robotic arm interface unit.

18. A surgical robot as claimed in claim 17, further comprising: a controller having a user interface.

19. A surgical robot as claimed in claim 18, wherein the user interface further comprises one or more buttons or user interface portions configured to send a signal to the control system so as either: (i) to cause the surgical tool to operate in the first mode of operation; (ii) to control the operation of the surgical tool whilst operating in the first mode of operation; or (iii) to cause the surgical tool to operate in a second different mode of operation.

20. A surgical robot as claimed in claim 18 or 19, wherein the controller comprises a sterile single-use or disposable unit.21 . A surgical robot as claimed in claim 18, 19 or 20, further comprising a gimbal mounted between the controller and the robotic arm interface unit.

22. A surgical robot as claimed in claim 21 , wherein the gimbal comprises a pivoted support which is configured to stabilise any movement of the controller relative to any movement of the robot arm interface unit and / or a surgical tool attached to the robotic arm interface unit.

23. A surgical robot as claimed in any of claims 18-22, further comprising a motorised U-shaped bracket mounted between the controller and the robotic arm interface unit, wherein the motorised U-shaped bracket enables independent rotation or movement of: (i) a surgical tool attached to the robotic arm interface unit; (ii) the robotic arm interface unit; or (iii) the controller.

24. A surgical robot as claimed in any of claims 17-23, wherein at least one of the surgical tools comprises a surgical camera.

25. An arthroscopic surgical robot comprising: a surgical robot as claimed in any of claims 17-24; wherein the one or more surgical tools are configured for assisting in performing arthroscopic surgery.

26. A robotic arm interface unit configured to interface, in use, between a robotic arm of a robot and one or more attachments which are attached, in use, to the robotic arm interface unit, the robotic arm interface unit comprising: a housing having an attachment portion for attaching to an attachment; and a control system configured to control the operation of an attachment attached, in use, to the robotic arm interface unit; wherein: in a first mode of operation the control system is arranged to cause the attachment to move in one or more first degrees of freedom.

27. A robot comprising: one or more robotic arms; a robotic arm interface unit as claimed in claim 26, wherein the robotic arm interface unit is connected to one of the robotic arms; and one or more attachments attached to the robotic arm interface unit.

28. A method comprising: providing a robotic arm of a surgical robot; connecting a robotic arm interface unit to the robotic arm; attaching one or more surgical tools to the robotic arm interface unit, wherein the robotic arm interface unit comprises: (i) a housing having a connection portion for connecting to one of a plurality of different types of surgical tools; (ii) a user interface; and (iii) a control system configured to control the operation of a surgical tool connected to the robotic arm interface unit; and operating the surgical robot in a first mode of operation wherein the surgical tool is caused to move in one or more first degrees of freedom.

29. A method as claimed in claim 28, wherein the one or more first degrees of freedom are selected from the group consisting of: (i) forward; (ii) back; (iii) up; (iv) down; (v) left; (vi) right; (vii) yaw; (viii) pitch; and (ix) roll.

30. A method as claimed in claim 28 or 29, wherein the method comprises a method of surgery.31 . A method as claimed in claim 30, wherein the method further comprises a method of arthroscopic surgery.

32. A method comprising: providing a robotic arm of a robot; connecting a robotic arm interface unit to the robotic arm; attaching one or more attachments to the robotic arm interface unit, wherein the robotic arm interface unit comprises: (i) a housing having an attachment portion for attaching to an attachment; (ii) a user interface; and (iii) a control system configured to control the operation of an attachment connected to the robotic arm interface unit; and operating the robot in a first mode of operation wherein the attachment is caused to move in one or more first degrees of freedom.

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