JP7560537B2 - Robot Manipulator - Google Patents

Description

Inventors: Matthew Robert Penny, Kevin Andrew Huffford, Paul Schnur
This application is a continuation-in-part of U.S. Provisional Application No. 16/732,307, filed December 31, 2019, which claims the benefit of U.S. Provisional Application No. 62/874,988, filed July 17, 2019, and U.S. Provisional Application No. 62/787,254, filed December 31, 2018. This application further claims the benefit of U.S. Provisional Application No. 62/874,988, filed July 17, 2019, U.S. Provisional Application No. 62/875,003, filed July 17, 2019, U.S. Provisional Application No. 62/874,985, filed July 17, 2019, and U.S. Provisional Application No. 62/874,982, filed July 17, 2019.

The present invention relates to the field of surgical devices and systems, including those that use electromechanical actuation.

Various types of surgical robotic systems are commercially available or in development. Some surgical robotic systems use multiple robotic arms. Each arm is equipped with a camera that is used to acquire images from within the body and display them on a surgical instrument or monitor. In a typical configuration, two or three instruments and cameras can be supported and operated by the system. Input to the system is generated based on input from the surgeon, typically located at a master console, using an input device such as an input handle. The motion and actuation of the surgical instruments and camera are controlled based on the user input. Images acquired by the cameras are displayed on a display at the surgeon console. The console can be located at the patient side, within the sterile field, or outside the sterile field.

The robotic arm/manipulator typically includes a portion at the end of the arm that is designed to support and operate a surgical device assembly. The surgical device assembly includes a surgical instrument having a shaft and a distal end effector on the shaft. The end effector is positionable within the patient.

Typically, the proximal housing of the instrument shaft contains an actuation mechanism that accepts motions transmitted from an actuator that drives the instrument's functions. End effectors can be one of many different types used in surgery, including but not limited to having one or more of the following features: jaws that open and close, a distal section of the shaft that bends or articulates with one or more degrees of freedom, a tip that rotates axially relative to the shaft, and a shaft that rotates axially relative to the manipulator arm. The instrument actuators for driving the motions of the end effector, which can be motors or other types of motors (e.g., hydraulic/pneumatic), are often located in the distal portion of the robotic manipulator. In some cases, they are located in the proximal housing of the surgical device assembly, while in other configurations, some are in the proximal housing while others are in the robotic manipulator. In the latter example, some motions of the end effector can be driven using one or more motors in the distal portion of the manipulator while other motions can be driven using a motor in the proximal housing.

The instruments are interchangeable during the course of the procedure, allowing one instrument to be removed from the manipulator and replaced with another. Engaging the proximal housing to the actuator interface on the manipulator may include the use of mechanical snaps, magnetic engagement, or sliding interfaces that securely dock the instrument to the manipulator to resist external forces from both the robot and the patient. There is a mechanical interface for engaging the surgical instrument. In this interface, motion generated using the instrument actuators in the robotic manipulator is transferred to one or more mechanical inputs on the proximal housing to control the instrument's degrees of freedom and, if applicable, its jaw opening and closing functions. This motion can be transferred through a drape placed between the sterile instrument and the non-sterile manipulator arm. In some current robotic systems, the mechanical control interface includes actuators located on only one side or plane of the instrument. For example, in the configuration shown in U.S. Pat. No. 6,491,701, all of the driven elements 118 that undergo mechanical motion are on the same face of the housing 108 at the proximal end of the instrument shaft 102.

In the embodiment shown in US Patent No. 9,358,682, a lateral slider pin 314 extends laterally from one side of a case attached to the proximal end of the instrument. It is movable to open and close the jaws of the instrument (FIG. 18 of the patent). When the instrument is attached to the manipulator arm, the slider pin 314 is received by a corresponding component 430 (FIG. 19) in the manipulator arm. When the jaws need to be opened or closed, the component 430 is moved on a carriage by a motor in a laparoscopic instrument actuator 400 in the manipulator arm, thereby advancing the slider pin 314 to actuate the jaws. US Patent Application No. 2016/20160058513 also shows a robotically controlled surgical instrument removably attached to a manipulator arm and describes a similar configuration in which a slider pin is used to actuate the jaws. In addition, a system is described that can provide additional electromechanically driven movements of the end effector of the instrument, such as articulation and rotation, in addition to jaw actuation. However, the motors for those additional movements are enclosed in a housing at the proximal end of the instrument, and therefore do not require the transmission of mechanical motion from the motors in the arms to mechanical actuators in the housing.

This application describes a robotically controlled surgical instrument having multiple mechanical actuators at its proximal end. These mechanical actuators are configured to accept motions transmitted from electromechanical actuators in the manipulator arm to drive various end effector functions or motions, such as jaw actuation, pitch, rotation, and/or yaw. The actuators are arranged in a compact configuration to allow the manipulator arm to engage with instruments and adapters of various sizes. The described embodiments also allow for configuration of the instrument or adapter such that actuation interfaces may be present on multiple surfaces of the instrument or adapter, including surfaces facing away from one another.

FIG. 1 is a perspective view of a robotic-assisted surgical system that may include arrangements described herein. FIG. 1 is a perspective view of a robotic manipulator arm with a receiver and an instrument assembly attached. FIG. 3 is a perspective view of the receiver of FIG. 2 and a surgical instrument separated from the receiver; 1 shows the surgical instrument with the base removed. 1 shows a proximal portion of a surgical instrument. FIG. 6 is similar to FIG. 5, but showing a portion of the housing removed. FIG. 7 is similar to FIG. 6, but showing a portion of the upper carriage removed. 3 shows the receiver of FIG. 2; FIG. 9 is similar to FIG. 8, but showing a portion of the arm removed. FIG. 13 is a side view of the carriage and motor assembly of one arm of the receiver. 13 is an alternative embodiment of a carriage for an instrument base. FIG. 13 is a perspective view of an alternative embodiment of a carriage for one of the arms of the receiver. FIG. 13 is a perspective view of an alternative embodiment of a carriage for one of the arms of the receiver. FIG. 2 is a top view of the receiver shown in an open position. FIG. 2 is a top view of the receiver shown in a closed position. FIG. 13 is a perspective view showing an instrument attached to a receiver. FIG. 13 is a perspective view showing the lever and linkage of the receiver. FIG. 16 is similar to FIG. 15, but shows a portion of the receiver housing removed to reveal the extension mechanism. FIG. 18 is a side view of the instrument and lever and associated motor of FIG. 17. FIG. 2 is a perspective view showing the receiver when draped. Similar to FIG. 16, but showing the drape in place. FIG. 2 is a perspective view of a drape connector. FIG. 2 is a rear plan view of the base of the appliance. FIG. 13 is a perspective view of an alternative embodiment of a base. FIG. 24 is similar to FIG. 23, but showing a portion of the housing removed. FIG. 24 is a perspective view showing the pulley mechanism and one of the springs of the embodiment of FIG. 23. 1 shows an example of a drape with an integrated EMI shield. FIG. 26B is a cross-sectional view of a portion of the drape shown in FIG. 26A. FIG. 26C is similar to FIG. 26B, but shows an embodiment including electrical connectors and terminations integrated into the drape. 17 is similar to FIG. 16, but further showing a graphical user interface located on the manipulator end effector. FIG. 28 is similar to FIG. 27, but illustrates the force feedback feature provided to the user during manual repositioning of the manipulator.

Although the concepts described herein can be used in a variety of robotic surgical systems, the embodiments are described with reference to a system of the type shown in FIG. 1. In the illustrated system, the surgeon console 12 has two input devices, such as handles 17, 18. The input device 12 is configured to be manipulated by a user to generate signals used to command the movement of the robotic control device in multiple degrees of freedom. In use, the user selectively assigns the two handles 17, 18 to two of the robotic manipulators 13, 14, 15, allowing the surgeon to control two of the surgical instruments 10a, 10b, and 10c located at the work site (patient at the patient's bed 2) at any one time. To control a third of the instruments located at the work site, one of the two handles 17, 18 can be operably detached from one of the first two instruments and then operably paired with the third instrument or control the third instrument with another form of input, as described in the next paragraph. A fourth robotic manipulator, not shown in FIG. 1, may optionally be provided to support and manipulate additional instruments.

One of the instruments 10a, 10b, 10c is a camera that captures images of the surgical field within the body cavity. The camera can be moved by a corresponding robotic manipulator using input from one of various types of input devices, including but not limited to handles 17, 18, additional controls on the console, foot pedals, an eye tracker 21, a voice controller, etc. The console is also configured to display images captured by the camera, and may optionally include a display or monitor 23 for displaying system information, patient information, etc.

The control unit 30 is operatively connected to the robotic arm and the user interface. The control unit receives user input from the input device corresponding to a desired movement of the surgical instrument and causes the robotic arm to manipulate the surgical instrument accordingly.

The input devices 17, 18 are configured to be manipulated by a user to generate signals that are processed by the system to generate commands used to command the movement of the manipulator, move the instrument in multiple degrees of freedom, and, as required, control the operation of electromechanical actuators/motors that drive the movement and/or actuation of the instrument's end effector.

Optionally, sensors can be used to determine the forces being applied by the robotic surgical tool to the patient during use. For example, force/torque sensors on the surgical robotic manipulator can be used to determine the tactile information required to provide force feedback to the surgeon at the console. U.S. Pat. No. 9,855,662, entitled Force Estimation for Minimally Invasive Robotic Surgical Systems, describes a surgical robotic system in which sensors are used to determine the forces being applied by the robotic surgical tool to the patient during use. The use of a six degree of freedom force/torque sensor attached to the surgical robotic manipulator is described as a method of determining the tactile information required to provide force feedback to the surgeon at the user interface. In the presently disclosed embodiment, this type of sensor can be optionally located on or immediately proximal to the receiver 104. The surgical system allows operating room staff to remove and replace the surgical instruments 10a, b, c carried by the robotic manipulator based on surgical needs. When an instrument needs to be replaced, the surgeon removes the instrument from the manipulator arm and replaces it with another instrument.

In general, the assembly includes a surgical instrument having a base configured such that its drive members (which receive mechanical drive inputs to actuate functions of the instrument's end effector) are located on multiple sides, faces, or planes of the base at the proximal end of the instrument. The base is received by the arm in use, within which is an electromechanical or hydraulic actuator that drives a mechanical output. To maintain sterility of the surgical instrument, the system is designed to facilitate the use of a surgical drape located between the base of the surgical instrument and a corresponding mechanical drive output of the arm. Locating the instrument's actuators on multiple sides, facets, faces, or planes of the instrument distributes the forces and deflections applied by these actuators to the drape, allowing multiple mechanical inputs to be transmitted to the instrument while maintaining the drape.

2 and 3, the present specification describes an assembly 100 of a surgical instrument 102 and a receiver 104. The receiver 104 is configured to removably receive the instrument 102. The receiver can be attached to a support or manipulator 15, which can be a robotic manipulator that robotically manipulates the instrument 102 in one or more degrees of freedom during a procedure, or a support that remains stationary during the course of an operative embodiment of a surgical instrument for a robotic surgical system. When the surgical instrument 102 and receiver 104 are assembled, the receiver transfers motion generated by an electromechanical actuator (e.g., a motor or a hydraulic/pneumatic actuator) in the receiver 104 or arm 15 to a mechanical actuator of the instrument to cause motion of a portion of the instrument. Examples of types of motion include, but are not limited to, articulation in one or more degrees of freedom (pitch, yaw), bending in one or more degrees of freedom, end effector roll, jaw actuation, etc. As described above, the surgeon moves the input devices 17, 18 (FIG. 1) to provide input to the system, which processes the information and develops commands for associated electromechanical actuators to move the instruments and, if necessary, operate the end effectors of the instruments.

The surgical instrument 102 includes an elongated shaft 106, which is preferably rigid, but may be flexible or partially flexible in alternative systems. An end effector 108 is disposed at the distal end of the shaft 106, and a proximal body or base assembly 110 is at the proximal end. The base assembly 110 (also referred to as the "base") may include an enclosed or partially enclosed structure, such as a housing or box, or it may be a frame or plate. The base 110 includes mechanical input actuators 112 exposed to the exterior of the surgical instrument 102. In FIG. 3, two actuators 112 are exposed on a first side of the base 110. A second two actuators 112 are exposed on a second, opposite side of the base 110, preferably, but optionally, in a configuration the same or similar to that shown in FIG. 3. See the rear view of the base 110 shown in FIG. 22.

Each of the actuators 112 is movable relative to the base 110 between a first position and a second position. In the particular configuration shown in the drawings, the actuators are movable longitudinally relative to the housing between a first (more distal) position and a second (more proximal) position as shown in FIG. 3. However, the direction of movement need not be longitudinal and can extend in any direction.

Thus, in this configuration, the base assembly has four drive inputs 122 exposed to its exterior. In this configuration, the base has two parallel planes, with two of these inputs located on each face. While it may be preferred to include inputs on both sides of the proximal body, other arrangements of inputs on multiple faces of the proximal body can be used instead. Each of these configurations advantageously arranges the drive inputs in a manner that maximizes the distance between the control inputs, and minimizes stress on the sterile drape that is placed between the proximal body and the receiver 104, as described below.

With reference to FIG. 4, the drive cable 114 extends through the shaft 106 to the end effector 108. Many different types of instruments having any of a variety of functions can be used in the disclosed system. The instrument depicted in the drawings is of the type described in commonly owned, co-pending application Ser. No. 16/732,306, entitled Articulating Surgical Instrument (Attorney Reference: TRX-12700R), filed Dec. 31, 2019, and incorporated herein by reference. It utilizes four drive cables 114, two of which terminate in one jaw member and the other two in the other jaw member. This can be two cables looped at the end effector (so that each of the two free ends of each cable loop is at the proximal end) or four separate cables. As described in the co-pending application, the tension in the cables varies in various combinations to affect the pitch and yaw motion of the jaw members and the opening and closing function of the jaws. Other instruments useful in the system have other numbers of cables, with the particular number being determined by the function of the instrument, the degrees of freedom of the instrument, and the particular configuration of the actuating components of the instrument. It is noted that in this description, the terms "tendon," "wire," and "cable" are used broadly to encompass any type of tendon that may be used for the purposes described.

The four cables extend to the base 110 assembly. In this embodiment, where the base includes a housing, the cables extend from the shaft 106 into the housing where they are engaged to the actuators 112. FIG. 6 shows the base with a portion of the housing removed to allow a clearer view of the actuators 112. Each actuator 112 includes a carriage 118 that is movable along a rail 120. In this embodiment, these structures are oriented for longitudinal movement of the carriage, but in other embodiments, the motion may be in a different direction. A portion of the carriage 118 is exposed through a window in the base and includes a drive input or member 122 that extends laterally from the carriage and can optionally extend through the outermost plane of the window (see FIG. 5). In FIG. 7, the carriage of the upper actuator is partially exploded to show that the proximal end of the cable 114 is attached to the carriage 118. The cable may run around a pulley or through a cable path defined by features of the base assembly. In this configuration, the second cable end is similarly connected to the carriage 118 of the lower actuator of FIG. 7, and the remaining two cable ends are connected to carriages on the opposite side (not shown) of the base 100. In this manner, the base assembly is arranged such that the actuators 112 are exposed on at least two sides or faces of the base. Each actuator 112 is connected to one of the cables 114, such that moving the actuator in a first direction relative to the base increases tension in the corresponding cable, and moving the actuator in a second, different (or opposite) direction decreases tension in that cable. In the illustrated embodiment, moving the actuator carriage 118 in a proximal direction increases or decreases tension on that cable (depending on the cable's path), and moving the carriage in a distal direction has the opposite effect on cable tension.

In this embodiment, the extension spring 124 is connected between the carriage 118 and the support structure of the base (in this case to an outer housing 126 or a partition 128 that divides the interior of the housing into two laterally adjacent regions). Applying a force to the carriage to actively move the carriage in a direction against the spring force (in this case the distal direction) increases tension in the corresponding cable. When the applied force is released, the spring force moves the carriage back to or toward the home position and decreases tension in the cable. In other embodiments, the carriage can instead be actively moved in both directions instead of using a spring force for unidirectional motion.

8, the receiver 104 in the illustrated embodiment has a generally U-shaped cross-section with two elongated sides and a seat spanning between the two sides. The sides of the "U" are formed by a pair of arm sections 130a, 130b extending distally, providing the receiver with an opening through which the base 110 is received when the system is assembled (FIG. 3). Drive members 132, also referred to as "drive outputs", extend inwardly from the arm sections 130a, b. They are positioned such that each drive input member 122 (FIGS. 5 and 6) of the instrument contacts a corresponding one of the drive output members 132 when the instrument is attached to the receiver 104. Two drive members 132 are shown in FIG. 8. The other two extend from the arm 130b but are not shown in the drawing. In FIG. 9, a portion of the arm 130a is removed to show that the drive members 132 are carried by a carriage 134 housed within the arms 130a, 130b. A motor 136 in the receiver 104 (FIG. 10) drives the linear movement of the carriage 134, and thus the drive members 132, along their respective arm sections 132a,b.

The type of contact between the drive members 132 of the receiver and their corresponding driven members 122 of the instrument is selected based on the nature of the drive motion to be transmitted to the driven members 122. In the linear drive configuration shown, the components can be configured to allow the carriage of the instrument to be pushed, pulled, or both pushed and pulled by the corresponding drive components of the receiver. Additionally, different carriage configurations may be different, with some only pushing and others only pulling (or other combinations of pushing, pulling, and bidirectional drive).

If the motion is driven in one direction, contact between the drive member 132 and the driven member 122 is only required in the direction of motion. In Figs. 3-10, the drive member 132 and the driven member 122 are configured such that the drive member 132 pushes the driven member in a distal direction, but does not need to pull the driven member in a proximal direction due to the presence of the spring 124 discussed in connection with Fig. 7. Thus, the face or area of each drive member 132 facing the direction of motion (here, the distal direction) contacts the driven member 122. Thus, in this example, the drive member and the driven member do not need to be mated or otherwise engaged with each other, although they could. Instead, these members 122, 132 could simply be configured to have opposing surfaces (which could optionally be planar) that contact each other. In this embodiment, if the motion was driven in a proximal direction rather than a distal direction, the proximal face of the drive member would contact the driven member.

In other embodiments, the motion of the driven member is driven in two directions. In a linear drive configuration as shown in the drawings, this can mean that the drive member can both pull and push the driven member. In such embodiments, the drive member and driven member are configured such that they are designed to engage, mate, or contact regardless of the direction of motion. For example, FIG. 11 shows an alternative carriage 120a for an instrument, which includes a driven member 122a shaped to mate with the drive member 132 (FIG. 10).

Figure 12 shows a receiver carriage in which the drive member 132a is comprised of a female receptacle wall shaped to receive a driven member 122 of the type shown in Figure 5. Figure 13 shows a receiver carriage with two different drive member designs. In the upper carriage, the drive member 132 is similar to that described above. In the lower carriage, the drive member 132a is comprised of a female receptacle wall shaped to receive a driven member 122 of the type shown in Figure 5. In this configuration, the upper carriage drives the corresponding driven member in one direction (pushing or pulling), while the lower carriage can drive the corresponding driven member in both pushing and pulling.

The receiver 104 may expand to receive the base 110. In this embodiment, the receiver 104 is movable from a closed position to an open position by increasing the spacing between the arms 130a, 130b. When moved to the open position, any instruments held by the receiver can be removed and the first instrument or the base of a replacement instrument can be received. The receiver is also movable to reduce the spacing between the arms as they move from the open position to the closed position, in which the base is captured by the receiver 104 110. In a closed system with the base 110 between the arms 130a, b, the drive input 122 of the base is operatively engaged (but not necessarily physically engaged as described above) with the drive output (output terminal, output) 132 of the receiver.

Expansion can be accomplished in a variety of ways. In the example shown in the drawings, the arms 130a, 130b pivot between an open position (FIG. 14) and a closed position (FIG. 15). In other configurations, they may move in parallel. When the receiver is closed to engage the instrument base, the arms of the receiver 104 reach around either side of the base 110 to hold the base and move the drive inputs to position the drive outputs that actuate the instrument degrees of freedom or other functions as described.

The receiver can be selectively opened or closed manually or electromechanically to move an arm toward or away from another arm. In a first embodiment, the arms 130a, 130b are pivoted relative to their proximal ends by a rotatable lever or knob 138 having a linkage 140 spiraling outwardly therefrom. When the lever/knob is manually rotated in a first direction, the linkage 140 cams the arms 130a, b to an open position. When the lever/knob is rotated in the opposite direction, the arms cam to a closed position. Additionally or alternatively, the linkage 140 can be rotated by actuation of a motor 142. A switch 144 on the receiver 104 can be used by a surgical assistant to actuate the motor 142 to easily open and close the receiver during instrument exchange.

The system may include features to facilitate alignment and retention of the instrument adapter while the actuator assembly of the manipulator arm is open. Examples include tabs 146 on the base 110 or receiver 104 that are received in a corresponding seat 148 (FIG. 20) on the receiver 104 or base 110. The proximal surface of the base 110 may further include alignment features. FIG. 22 shows a female part 150 (e.g., a recess, divot, hole or similar alignment feature) that receives a male part 150 (FIG. 21), as discussed in connection with draping below. Thus, this embodiment has engagement and/or control features on three sides of the base 110. It should be understood that the control points (drive inputs) may be on any side of the base and may be actuated by either the electromechanical actuators of the receiver/manipulator or by the bedside operator. Furthermore, these control points may share an axis, have parallel axes, slide linearly along the same plane, or be a combination of unrelated (i.e., not planar, parallel, or sharing the same axis) movements.

Finally, there is no need for the base to have planes or interface points defined. For example, the adapter body could be essentially spherical or cylindrical, with the control points located across the surface of the body.

The second embodiment is similar to the first embodiment, with a "U" structure, but instead of angling the two sides of the "U" to reach the open position, the sides extend while keeping the inner surfaces parallel. In this embodiment, a four-bar mechanism can be used in cooperation with a lever or knob system or motor to drive the opening and closing of the system.

Each of these concepts allows the space between the "U" sides to be expanded, a feature that allows for bases of various widths to be accommodated for instruments, cameras, or other adapters (e.g., a removable adapter on the proximal end of the camera or instrument, allowing cameras and instruments from various manufacturers to be used with the system). For instruments with different width bases, the system identifies the instrument and closes the appropriate amount to hold the instrument base or adapter securely. For example, a non-contact reed switch board can be used to identify instruments or adapters of various widths. One digital reading could result in closure to a 30mm space between the arms 130a,b, while another digital reading could result in 40mm. As a mechanical solution, a lever system could be used to allow the instrument to push the lever system at various distances. For example, the lever system could allow an input of 0-4mm, with 0mm being fully open and 4mm being fully closed. One instrument could push 4mm to result in a 30mm space between the arms 130a,b or fully closed, while another instrument could push 3mm to result in a 40mm space.

Note that the shape and size of the "U" as well as the space defined by the arms 130a,b can be adjusted to accommodate a wide variety of instruments or adapters. Additionally, while a "U" shape may be preferred for this application, other shapes having at least two partially opposing sides may be used, and the sides may not have parallel opposing surfaces.

An additional benefit of the "U" shaped embodiment is the ability to engage some instruments such that they share an axis with the receiver, but not others. For example, a receiver engaging a camera system may be able to hold the camera such that the camera shaft and receiver axis are at up to a 90 degree angle to each other. This allows the camera and light cords to pass through the receiver rather than around it. Other instruments such as harmonic energy devices and staplers may also benefit from this feature, but the mass of the instrument can be as close as possible to the 6 DOF force sensor.

20A and 20B, the receiver 104 is a non-sterile component that is typically covered by a sterile drape 154 or barrier prior to attachment of a sterile surgical instrument. At the interface between the driving and driven elements, the motion is transferred through the drape to control the instrument's degrees of freedom. In one embodiment of the drape 154, the drape material is shaped to fit the shape of the receiver and has two "fingers" to cover the arms 130a,b that open and close. It is best to ensure that the drape is properly oriented relative to the receiver and that the instrument area is clear for the instrument to be engaged and removed. In this embodiment, the drape includes an embedded plastic "drape connector" 156 that is bonded such that the connector has a shape that extends to both sides of the drape. One side of the drape connector includes mating pins, posts, cone elements, etc. They mate with female features (e.g., depressions, conical divots, holes, or similar alignment features) in the receiver 104 sheet, and the other mates with female features 150 on the proximal surface of the base. The mating pins provide retention for both the manipulator and the instrument, and may provide orientation for the drape and the instrument.

In this embodiment, the central male element 152 of the drape connector has two annular rings that allow the mating shape to snap together and provide retention. In this case, the mating shape can be a coiled spring. During the draping process, the drape is placed over the receiver arms 130a,b. The inward facing surface of the drape connector 156 is positioned so that the male member is inserted into the female part of the receiver sheet, and the outward facing surface of the drape connector similarly snaps together to engage the proximal surface of the appliance base 110.

Because the drape connector extends through both sides of the drape, it can be used as a sterile conduit for a variety of mechanical, electrical, optical, or other tasks, a non-exhaustive list of which is given below:
- Drape connectors can be used to provide electrical signals such as power, ground, and communications between, for example, robotic manipulators and instruments.
This electrical energy can be used to power instrument recognition devices such as RFID transceivers, cameras, proximity sensors, or switches (including Hall sensors and reed switches). These devices can determine which instrument shaft is attached to a given base/adapter while making a particular base/adapter common to a variety of instrument types.
This energy can also power force, torque, and other sensors and displacement devices as a means of measuring activity within the instrument or instrument adapter. These measurements enable better instrument control and user feedback such as force feedback and haptic response.
- This electrical energy can be used for monopolar/bipolar or advanced energy devices, eliminating the need for cables to wrap around the manipulator or instrument when the manipulator is rotated.
- The drape connector can be used to provide optical signals or transmission between the robotic manipulator and the instrument.
- These optical signals can be used for communication purposes, including identification of the instrument by spectroscopy or other methods.
These optical signals can be mated with a rod lens scope to provide an intraoperative viewpoint without the need for a camera head as with other endoscopes.
The optical signal can be coupled to a sensor, for example an optical fiber, to measure the deflection, which can be used to interpret the force applied to the instrument or adapter.

The drape connector can be used for other functions as well. In this embodiment, for example, the proximal face of the base has a flush port that is intended to be used to clean the instrument adapter and instrument shaft after a surgical procedure. If left open during a procedure, this flush port becomes a leak path for CO2 to escape from the surgical site. The drape connector is used to plug this flush port, eliminating the leak path while also eliminating components of the instrument adapter such as a check valve and an elastomeric flush port cover.

Second embodiment As described, in the first embodiment, the assembly is configured to transmit a linear motion of the push/pull type from the drive output to the drive input, but other embodiments can be envisioned that can transmit a rotational motion, or a combination of linear and rotational motion. For example, with reference to the second embodiment in Figs. 23-25, an alternative base 110b is shown. Here, each of the drive elements 122b extends from a pulley 123 that is rotatably mounted to a structure (e.g., a partition) in the base. Each cable is coupled to a corresponding one of the pulleys 123. Linear motion of the drive output 132 (Fig. 8) causes a rotation of the corresponding pulley 123, and thus a change in tension in the cable. This affects the movement or actuation of the end effector as described in connection with the first embodiment. The extension spring 125 can help return the pulley to an unbiased position when the drive member removes or reduces the force on the driven member, in a similar manner as described in the first embodiment.

Drapery incorporating EMI shielding The manipulator and associated components can be draped using various types of materials suitable for surgical draping. One example of a drape that can be used is now described in connection with Figures 26A-26C. It is noted that this drape can be used to drape the disclosed components, to drape components of alternative surgical robotic systems other than those described above, and to drape many other components of sterile equipment (other than surgical robotic systems).

When used with the embodiments described herein, the drape may be placed over the receiver 104 of that embodiment as shown in FIGS. 20A and 20B prior to inserting the proximal body 110 into the actuator assembly.

The drape 200 is formed of a stretchable multi-layer polymer containing an integral circuit printed with conductive (or insulating) ink 204. The printed circuit may act as a flexible Faraday cage to shield contained devices from electrostatic discharge and/or electromagnetic interference. The ink may be printed in a mesh pattern or other pattern suitable for creating a Faraday shield. The printed circuit may also act as a passive functional circuit such as capacitive sensing (buttons), resistive sensing (strain measurement), antenna (RFID), etc. The printed traces may be sandwiched between laminates 202 of drape material. If electrical signals are to be transferred from one side of the drape to the other, the printed traces may be connected to conductive pads 205 to transfer electrical signals to and from the printed circuit. Similarly, the printed circuit may be connected to molded components and features such as connectors 210 and vias 208. The drape may take any form desired and may be formed from flat sheets (or rolls) of material.

The drape 200 provides a low-cost, efficient means for shielding an instrument driver from ESD or EMI generated by high energy instruments that may be attached to the instrument driver. In shielding applications, this method reduces the design complexity of electrical seals (such as springs) between moving interfaces within the device and eliminates the need for additional conductive plating on the external cover. It can also be used to span gaps in enclosed devices that may be difficult to shield. It can also add functionality to distal drapes on surgical robotic arms.

A graphical user interface can be placed on the manipulator. This functionality is applicable to any surgical robotic manipulator and is suitable for use in the configuration described above, but is equally suitable for use in other surgical robotic system components.

In some robotic systems, for the convenience of the surgeon, each manipulator can be individually identified using color coding, color-coded tape, numbers, or other markings in one or more locations on each manipulator. Additionally, the cart supporting each manipulator may include a screen for displaying error messages and a set of lights indicating the status of the machine.

During the course of a surgical procedure, it may become necessary for a surgical assistant or other operating room personnel to reposition the manipulator. This can be done by applying manual forces to the robotic arm, physically moving it to a desired direction or position. This may be a purely manual activity, as in prior art systems, or it may be a powered activity. In either case, it is an advantage to inform the user about the forces being applied to the instrument as they are performing manually driven movements. Typically, to move the manipulator when not actively teleoperated from the surgeon's console, the user performs an action that unlocks the manipulator (e.g., pressing two buttons on the manipulator simultaneously) so that the manipulator end effector can be manually moved to the desired position.

This section describes an embodiment that integrates the functions of communication of instrument status and error messages, identification of the manipulator, and easily accessible touch points for the user to manipulate the arm at a single site on the manipulator arm that is easily accessible to the user regardless of the orientation of the manipulator end effector.

The first embodiment includes a surgical robotic system that includes at least one manipulator arm. As shown in FIG. 27, the manipulator arm (e.g., 13, 14, 15 in FIG. 1) has an end effector distal to at least one degree of freedom of the manipulator arm. In this particular embodiment, the receiver 104 is part of the end effector. In use, as described above, the surgical instrument 106 can be removably attached to the end effector.

The end effector has a capacitive display screen 212 that can display a variety of information. In this embodiment, the display screen 212 is cylindrical and extends around the body of the end effector. The screen can be configured to change color, display text, icons, or other GUI items to communicate machine status, arm identification, instrument identification, etc. to the user. Icons can be displayed and selected by touching the capacitive screen to perform tasks such as calibration, homing, or docking the end effector to a trocar.

Furthermore, touch gestures by the user on the capacitive screen may elicit responses by the machine. For example, touching two spaced points unlocks degrees of freedom, allowing the manipulator to be manipulated or manually moved around a joint. A swipe may change between menus or instruct the machine to transition to a particular state (e.g., draping). Gestural interaction with the display may also be used to cause the system to position the manipulator to its next state, or to activate actuators in the manipulator to configure it into a position or orientation suitable for performing various tasks (e.g., docking an instrument, changing instruments, calibrating, homing, storing, draping, etc.).

In a preferred configuration, the touch screen completely envelops the end effector. In this configuration, the capacitive points are easily accessible at all times. Additionally, the inclusion of an Inertial Measurement Unit (IMU) on or within the end effector provides feedback to the system indicating the orientation of the end effector. Based on this feedback, the system maintains or changes the position and orientation of messages and menus displayed in the GUI so that, from the operator's perspective, the messaging/menus are always in a particular orientation regardless of the rotation of the end effector relative to the operator. That is, the IMU detects the orientation of the end effector, and the system's processor selects the area of the screen that is displayed to the user in that orientation, and displays the associated messaging and menus in that area, preferably in an orientation that is easy for the user to read.

This feature increases the convenience of using the surgical system by including all available information about the system displayed in an easily accessible location at the patient side. Touch points can be wrapped around the entire end effector, meaning they are always accessible and in the same location (from the user's perspective) regardless of the orientation of the end effector. Displays can include color-changing displays that use colors to indicate different operating states or allow the user to identify different arms.

Force Notification During Manually Driven Operations of the Manipulator As described in the sections above, during the course of a surgical procedure, it may be necessary for a surgical assistant or other operating room personnel to reposition the manipulator. This can be accomplished by applying manual forces to the manipulator, physically moving it to a desired orientation or position. This may be a purely manual activity, as in some commercially available systems, or it may be a powered activity. In either case, it is advantageous to inform the user about the forces being applied to the instrument as the user is performing a manually driven operation.

As also described herein, a force/torque sensor, which may be a six degree of freedom force/torque sensor, may be attached to the manipulator and may be used to determine the haptic information required to provide force feedback to the surgeon at the user interface. FIG. 28 shows the end effector described above. In the area proximal to the instrument location in the manipulator is a six degree of freedom force/torque sensor 214, which, as described above, is used to measure the forces experienced by the surgical instrument and allows the system to communicate these forces to the user via the haptic interface. Proximal to the sensor 214 is at least one notification component 216, which may be at least one of a vibration transducer and a visual indicator or light emitter. If a vibration transducer is used, placing it proximal to the sensor 214 on the manipulator helps to avoid interference with the force measurements of the sensor 214. The visual indicator may be a light, an LED or collection of LEDs, a visual display, or the like. If a GUI of the type described in the previous section is used, it may be part of that GUI. These components are used to alert the user to the presence of forces on the instrument while the system is being manually repositioned.

During manual actuation (where the user places their hand on the arm to control its movement), any force applied to the instrument attached to the arm will trigger a vibration from the light and a visual warning. This will alert the person moving the arm that the instrument is in contact with tissue or another structure so that additional precautions can be taken if necessary. This would be particularly beneficial if, for example, an instrument is being inserted into a trocar placed at the incision site while it is engaged with the arm.

The visual indicator may be configured to provide directional information to the user to advise the surgeon. For example, it may provide a visual indication of the direction the arm needs to be moved to relieve force between the instrument and tissue or other object. If the illuminator is a ring of lights or LEDs surrounding a portion of the arm, a quadrant of these lights may be illuminated to indicate the direction the user needs to push the arm or the direction of force on the instrument. If a flexible display or GUI is used, one or more arrows or other symbols, icons, text, etc. may be displayed for the same purpose. In some embodiments, the system may be configured such that the amplitude/frequency of the vibrations and the intensity/flashing of the light are proportional to the force measured by the force sensor 214.

During a remote actuation movement (a movement performed by a user remotely controlling the arm using one of the user input devices 17, 18), a visual warning from the light emitter may be emitted if a force is applied to the instrument attached to the arm (or if a force exceeding a defined threshold is applied).

This functionality can be used with any robotic manipulator and is not limited to the embodiments described herein. In general, it will be part of a surgical robotic system including a manipulator arm including force and torque sensors, a surgical instrument mountable to the manipulator arm, and a tactile user input device. The system includes at least one processor and at least one memory stored instruction executable by said at least one processor to: In response to user manipulation of the tactile user input device, the manipulator arm moves the surgical instrument; In response to signals from the sensor during user manipulation of the tactile user interface, an actuator of the tactile user input device applies force feedback to the tactile user input device, and in response to signals from the sensor during manual user movement of the manipulator arm, activates a vibration transducer in the arm; The instructions may be further executable by the at least one processor to activate a visual alert in the arm in response to signals from the sensor.

It should be noted that the vibration transducer can be used to provide other types of feedback to the user in addition to or instead of force feedback. For example, if the system is configured to use force/torque to determine the fulcrum of the instrument passing through the incision, as described in U.S. Pat. No. 9,855,662, a vibration alert can be activated to notify the user that the fulcrum determination process is complete and the fulcrum has been set.

While specific embodiments have been described above, it should be understood that these embodiments are presented by way of example, not limitation. It will be apparent to those skilled in the relevant art that various changes in form and detail can be made therein without departing from the spirit and scope of the invention. This is particularly true in light of techniques and terminology within the relevant art that may be subsequently developed. Moreover, features of the various disclosed embodiments can be combined in various ways to produce a variety of additional embodiments.

Any and all patents, patent applications, and printed publications mentioned above, including for purposes of priority, are hereby incorporated by reference.

Claims (10)

1. A robotic manipulator having an actuator assembly at a distal end thereof,
the actuator assembly having an open position in which a base of a surgical instrument may be introduced into the actuator assembly and a closed position in which the base is releasably engaged;
The actuator assembly includes:
A first surface;
a first drive element exposed on the first surface;
a first motor operable to advance the first drive element relative to the first surface;
a second surface, the first surface and the second surface being different surfaces; and
a second drive element exposed on the second surface; and
a second motor operable to advance the second drive element relative to the second surface ;
A robot manipulator, wherein the first surface and the second surface are opposing surfaces . The actuator assembly includes:
a first arm provided with the first surface;
a second arm provided with the second surface;
the opposing first and second surfaces define an instrument receiving portion between the first and second arms ;
2. The manipulator of claim 1, wherein at least one of the first arm and the second arm is pivotally movable relative to the other of the first arm and the second arm to move the actuator assembly between a first position at a first distance between the first arm and the second arm to place the actuator assembly in the closed position and a second position at a greater second distance between the first arm and the second arm to place the actuator assembly in the open position. The manipulator of claim 1, wherein the robotic manipulator includes a pass-through for an instrument or camera cable. The manipulator of claim 3 , wherein the pass-through comprises a portion of the actuator assembly. The manipulator of claim 1, wherein the first drive element and the second drive element are movable relative to the manipulator to advance a drive input on the base. The manipulator of claim 1, wherein the first motor and the second motor are each operable to independently advance the first drive element and the second drive element, respectively, to actuate the surgical instrument. The manipulator of claim 2 , wherein the first drive element extends into the instrument receiving portion from the first surface and the second drive element extends into the instrument receiving portion from the second surface. a third drive element exposed on the first surface; and
a third motor operable to advance the third drive element relative to the first surface;
a fourth drive element exposed on the second surface; and
a fourth motor operable to advance the fourth drive element relative to the second surface;
2. The manipulator of claim 1, wherein the first, second, third, and fourth motors are each operable to independently advance the first, second, third, and fourth drive elements, respectively, to actuate the surgical instrument. The manipulator of claim 1 , wherein the first surface and the second surface are parallel to one another when the actuator assembly is in the closed position. 3. The manipulator of claim 2, wherein at least one of the first arm and the second arm is pivotable relative to the other of the first arm and the second arm to move the actuator assembly between the open and closed positions.