Surgical tool with manual control of end effector jaws

A surgical tool of a robotic surgical device is provided that is configured to be removably and replaceably attached to an electromechanical arm of a surgical robotic system that is capable of supplying electrical power to the surgical tool when the tool is attached to the arm. The tool has an elongate shaft with an end effector having opposed jaws movable between open and closed positions. The tool also has a member configured to move distally and proximally within at least a portion of the end effector to open and close the jaws. An actuator disposed on the shaft is configured to be manually moved from a first position to a second position to cause the member to move proximally to thereby open the jaws when the surgical tool is in a mode in which it is not deriving electrical power from the surgical robotic system.

FIELD

Methods and devices are provided for robotic surgery, and in particular for controlling robotic tools.

BACKGROUND

Minimally invasive surgical (MIS) instruments are often preferred over traditional open surgical devices due to the reduced post-operative recovery time and minimal scarring. Laparoscopic surgery is one type of MIS procedure in which one or more small incisions are formed in the abdomen and a trocar is inserted through the incision to form a pathway that provides access to the abdominal cavity. The trocar is used to introduce various instruments and tools into the abdominal cavity, as well as to provide insufflation to elevate the abdominal wall above the organs. The instruments and tools can be used to engage and/or treat tissue in a number of ways to achieve a diagnostic or therapeutic effect. Endoscopic surgery is another type of MIS procedure in which elongate flexible shafts are introduced into the body through a natural orifice.

Although traditional minimally invasive surgical instruments and techniques have proven highly effective, newer systems may provide even further advantages. For example, traditional minimally invasive surgical instruments often deny the surgeon the flexibility of tool placement found in open surgery. Difficulty is experienced in approaching the surgical site with the instruments through the small incisions. Additionally, the added length of typical endoscopic instruments often reduces the surgeon's ability to feel forces exerted by tissues and organs on the end effector. Furthermore, coordination of the movement of the end effector of the instrument as viewed in the image on the television monitor with actual end effector movement is particularly difficult, since the movement as perceived in the image normally does not correspond intuitively with the actual end effector movement. Accordingly, lack of intuitive response to surgical instrument movement input is often experienced. Such a lack of intuitiveness, dexterity and sensitivity of endoscopic tools has been found to be an impediment in the increased the use of minimally invasive surgery.

Over the years a variety of minimally invasive robotic systems have been developed to increase surgical dexterity as well as to permit a surgeon to operate on a patient in an intuitive manner. Telesurgery is a general term for surgical operations using systems where the surgeon uses some form of remote control, e.g., a servomechanism, or the like, to manipulate surgical instrument movements, rather than directly holding and moving the tools by hand. In such a telesurgery system, the surgeon is typically provided with an image of the surgical site on a visual display at a location remote from the patient. The surgeon can typically perform the surgical procedure at the location remote from the patient whilst viewing the end effector movement on the visual display during the surgical procedure. While viewing typically a three-dimensional image of the surgical site on the visual display, the surgeon performs the surgical procedures on the patient by manipulating master control devices at the remote location, which master control devices control motion of the remotely controlled instruments.

While significant advances have been made in the field of robotic surgery, there remains a need for improved methods, systems, and devices for use in robotic surgery.

SUMMARY

In one aspect, a robotic surgical device is provided that in some embodiments includes a surgical tool configured to be removably and replaceably attached to an electromechanical arm of a surgical robotic system that is capable of supplying electrical power to the surgical tool when the surgical tool is attached to the electromechanical arm. The surgical tool has an elongate shaft with an end effector at a distal end thereof, the end effector having opposed jaws that are movable between open and closed positions with at least one of the jaws comprising a removable and replaceable staple cartridge assembly, a member configured to move distally and proximally within at least a portion of the end effector to open and close the jaws, and an actuator disposed on the shaft and configured to be manually moved from a first position to a second position to cause the member to move proximally to thereby open the jaws when the surgical tool is in a first mode in which it is not deriving electrical power from the surgical robotic system.

The robotic surgical device can vary in many different ways. For example, the actuator can be configured to be manually moved from the second position to the first position to cause the member to move distally to thereby close the jaws when the surgical tool is in the first mode and after the removable and replaceable staple cartridge assembly has been replaced with another removable and replaceable staple cartridge assembly. The surgical tool can be configured to be placed in a second mode in which it is deriving electrical power from the surgical robotic system after the surgical tool has been loaded with the another removable and replaceable staple cartridge assembly.

The actuator can have many different configurations. For example, it can be a lever or a tab. The at least one of the jaws can be configured to seat the removable and replaceable staple cartridge assembly. In some embodiments, the member includes or is an I-beam. In other embodiments, the member includes or is a drive member configured to move distally and proximally to cause the jaws to open and close.

In some embodiments, the elongate shaft includes a proximal portion and a distal portion having the end effector, the distal portion being removably and replaceably coupled to the proximal portion. The actuator can be disposed on the proximal portion of the elongate shaft.

In other aspects, a method is provided that in some embodiments includes placing a surgical tool in a first mode in which it is not deriving electrical power from a surgical robotic system, the surgical tool being configured to be removably and replaceably attached to an electromechanical arm of the surgical robotic system that is capable of supplying electrical power to the surgical tool when the surgical tool is attached to the electromechanical arm. The method further includes, when the surgical tool in the first mode, manually moving an actuator disposed on a portion of the surgical tool from a first position to a second position to cause a member extending through at least a portion of an elongate shaft of the surgical tool to move proximally to open jaws that are part of an end effector of the surgical tool, the member being configured to configured to move distally and proximally within at least a portion of the end effector to open and close the jaws.

The method can vary in many different ways. For example, at least one of the jaws can include a removable and replaceable staple cartridge assembly. The at least one of the jaws can be configured to seat the removable and replaceable staple cartridge assembly. Alternatively, the at least one of the jaws is the removable and replaceable staple cartridge assembly.

The method can include, before the surgical tool is placed in the first mode and before the actuator is moved to the second position, retracting the surgical tool from a surgical access instrument. The method can further include, after the jaws of the end effector have been opened, replacing the removable and replaceable staple cartridge assembly with another removable and replaceable staple cartridge assembly. The method can further include, after the removable and replaceable staple cartridge assembly has been replaced with the another removable and replaceable staple cartridge, manually moving the actuator from the second position to the first position to cause the member to move distally to thereby close the jaws. The method can further include placing the surgical tool in a second mode in which it is deriving electrical power from the surgical robotic system.

In some embodiments, the member includes a drive member configured to move distally and proximally to cause the jaws to open and close. The elongate shaft can include a proximal portion and a distal portion having the end effector, the distal portion being removably and replaceably coupled to the proximal portion.

DETAILED DESCRIPTION

In general, techniques are provided for controlling an end effector of a surgical tool assembly removably and replaceably attached to an electromechanical arm of a surgical robotic system that is capable of supplying electrical power to the surgical tool assembly. Specifically, the described techniques allow controlling the opening and closing of jaws of the end effector using a display. The jaws are controlled to be opened for reloading a removable and replaceable staple cartridge assembly supported by the end effector. The surgical tool assembly includes a housing having a display that has an interface configured to present user information related to operation of the surgical tool assembly. The housing also has formed thereon one or more controls (e.g., buttons or other control elements) configured to accept user input comprising at least one instruction to the surgical robotic system. The at least one instruction includes an instruction to withdraw the end effector from a surgical access instrument (e.g., a trocar) and an instruction to open the jaws of the end effector.

Techniques are also provided for controlling a surgical tool assembly configured to be removably and replaceably attached to an electromechanical arm of a surgical robotic system that is capable of supplying electrical power to the surgical tool when the surgical tool is attached to the electromechanical arm. Specifically, the surgical tool assembly is controlled manually, via an actuator on an elongate shaft with an end effector at a distal end thereof having opposed jaws that are movable between open and closed positions, to open and close jaws of the end effector. The staple cartridge assembly can be removably seated by a cartridge body (e.g., by a cartridge channel), or the entire jaw can be a removable and replaceable staple cartridge assembly. The surgical tool includes a member (e.g., an I-beam, a driver shaft, etc.) configured to move distally and proximally within at least a portion of the end effector to open and close the jaws, and the actuator disposed on the shaft and configured to be manually moved from a first position to a second position to cause the member to move proximally to thereby open the jaws when the surgical tool is in a mode in which it is not deriving electrical power from the surgical robotic system. In this way, the jaws can be opened manually a removable and replaceable staple cartridge assembly supported by one of the jaws can be replaced with another removable and replaceable staple cartridge assembly.

Robotic Surgical Systems

The systems, devices, and methods disclosed herein can be implemented using a robotic surgical system. As will be appreciated by a person skilled in the art, electronic communication between various components of a robotic surgical system can be wired or wireless. A person skilled in the art will also appreciate that all electronic communication in the system can be wired, all electronic communication in the system can be wireless, or some portions of the system can be in wired communication and other portions of the system can be in wireless communication.

Robotic System

FIG. 1is a perspective view of one embodiment of a surgical robotic system300that includes a patient-side portion310that is positioned adjacent to a patient312, and a user-side portion311that is located a distance from the patient, either in the same room and/or in a remote location. The patient-side portion310generally includes one or more robotic arms320and one or more tool assemblies330that are configured to releasably couple to a robotic arm320. The user-side portion311generally includes a vision system313for viewing the patient312and/or surgical site, and a control system315for controlling the movement of the robotic arms320and each tool assembly330during a surgical procedure.

The control system315can have a variety of configurations and it can be located adjacent to the patient, e.g., in the operating room, remote from the patient, e.g., in a separate control room, or it can be distributed at two or more locations. For example, a dedicated system control console can be located in the operating room, and a separate console can be located in a remote location. The control system315can include components that enable a user to view a surgical site of a patient312being operated on by the patient-side portion310and/or to control one or more parts of the patient-side portion310(e.g., to perform a surgical procedure at the surgical site312). In some embodiments, the control system315can also include one or more manually-operated input devices, such as a joystick, exoskeletal glove, a powered and gravity-compensated manipulator, or the like. These input devices can control teleoperated motors which, in turn, control the movement of the surgical system, including the robotic arms320and tool assemblies330.

The patient-side portion can also have a variety of configurations. As depicted inFIG. 3, the patient-side portion310can couple to an operating table314. However, in some embodiments, the patient-side portion310can be mounted to a wall, to the ceiling, to the floor, or to other operating room equipment. Further, while the patient-side portion310is shown as including two robotic arms320, more or fewer robotic arms320may be included. Furthermore, the patient-side portion310can include separate robotic arms320mounted in various positions, such as relative to the surgical table314(as shown inFIG. 3). Alternatively, the patient-side portion310can include a single assembly that includes one or more robotic arms320extending therefrom.

FIG. 2illustrates one embodiment of a robotic arm420and a tool assembly430releasably coupled to the robotic arm420. The robotic arm420can support and move the associated tool assembly430along one or more mechanical degrees of freedom (e.g., all six Cartesian degrees of freedom, as illustrated inFIG. 9, five or fewer Cartesian degrees of freedom, etc.).

The robotic arm420can include a tool driver440at a distal end of the robotic arm420, which can assist with controlling features associated with the tool assembly430. The robotic arm420can also include an entry guide432(e.g., a cannula mount or cannula) that can be a part of or removably coupled to the robotic arm420, as shown inFIG. 2. A shaft436of the tool assembly430(shown inFIG. 4) can be inserted through the entry guide430for insertion into a patient.

In order to provide a sterile operation area while using the surgical system, a barrier434can be placed between the actuating portion of the surgical system (e.g., the robotic arm420) and the surgical instruments (e.g., the tool assembly430). A sterile component, such as an instrument sterile adapter (ISA), can also be placed at the connecting interface between the tool assembly430and the robotic arm420. The placement of an ISA between the tool assembly430and the robotic arm420can ensure a sterile coupling point for the tool assembly430and the robotic arm420. This permits removal of tool assemblies430from the robotic arm420to exchange with other tool assemblies430during the course of a surgery without compromising the sterile surgical field.

FIG. 3illustrates the tool driver440in more detail. As shown, the tool driver440includes one or more motors. e.g., five motors442are shown, that control a variety of movements and actions associated with the tool assembly430, as will be described in greater detail below. For example, each motor442can couple to and/or interact with an activation feature (e.g., gear) associated with the tool assembly430for controlling one or more actions and movements that can be performed by the tool assembly430, such as for assisting with performing a surgical operation. The motors442are accessible on the upper surface of the tool driver440, and thus the tool assembly is configured to mount on top of the tool driver440to couple thereto. The tool driver440also includes a shaft-receiving channel444formed in a sidewall thereof for receiving the shaft of the tool assembly430. In other embodiments, the shaft can extend through on opening in the tool driver440, or the two components can mate in various other configurations.

FIG. 4illustrates the tool assembly430uncoupled from the robotic arm420. The tool assembly430includes a puck or housing435coupled to a proximal end of a shaft436and an end effector438coupled to a distal end of the shaft436. The housing435can include coupling features that assist with releasably coupling the housing435to the tool driver440of the robotic arm420. The housing435can include gears and/or actuators that can be actuated by the one or more motors442in the driver440, as will be described in greater detail below. The gears and/or actuators in the housing435can control the operation of various features associated with the end effector438(e.g., clamping, firing, rotation, articulation, energy delivery, etc.), as well as control the movement of the shaft436(e.g., rotation of the shaft).

The shaft436can be fixed to the housing435, or it can be releasably coupled to the puck435such that the shaft436can be interchangeable with other shafts. This can allow a single housing435to be adaptable to various shafts436having different end effectors438. The shaft436can include actuators and connectors that extend along the shaft and assist with controlling the actuation and/or movement of the end effector438and/or shaft436. The shaft436can also include one or more joints or wrists437that allow a part of the shaft436or the end effector438to articulate relative to the longitudinal axis of the shaft436. This can allow for fine movements and various angulation of the end effector438relative to the longitudinal axis of the shaft436. The end effector438can include any of a variety of surgical tools, such as a stapler, a clip applier, forceps, a needle driver, a cautery device, a cutting tool, a pair of jaws, an imaging device (e.g., an endoscope or ultrasound probe), or a combined device that includes a combination of two or more various tools.

FIG. 5illustrates an embodiment of a robotic arm1120and a tool assembly1130releasably coupled to the robotic arm1120. The robotic arm1120can support and move the associated tool assembly1130along one or more mechanical degrees of freedom (e.g., all six Cartesian degrees of freedom, five or fewer Cartesian degrees of freedom, etc.).

The robotic arm1120can include a tool driver1140at a distal end of the robotic arm1120, which can assist with controlling features associated with the tool assembly1130. The robotic arm1120can also include a movable tool guide1132that can retract and extend relative to the driver1140. A shaft of the tool assembly1130can extend parallel to a threaded shaft of the movable tool guide1132and can extend through a distal end feature1133(e.g., a ring) of the movable tool guide1130and into a patient.

In order to provide a sterile operation area while using the surgical system, a barrier (not shown) can be placed between the actuating portion of the surgical system (e.g., the robotic arm1120) and the surgical instruments (e.g., the tool assembly1130) in the sterile surgical field. A sterile component, such as an instrument sterile adapter (ISA), can also be placed at the connecting interface between the tool assembly1130and the robotic arm1120. The placement of an ISA between the tool assembly1130and the robotic arm1120can ensure a sterile coupling point for the tool assembly1130and the robotic arm1120. This permits removal of tool assemblies1130from the robotic arm1120to exchange with other tool assemblies1130during the course of a surgery without compromising the sterile surgical field.

FIG. 6illustrates the tool driver1140in more detail. As shown, the tool driver1140includes one or more motors, e.g., seven motors M1-M7are shown, that control a variety of movements and actions associated with the tool assembly1130, as will be described in greater detail below. The driver1140can also include one or more lead screws (e.g., three lead screws L1, L2, and L3are shown) that can be individually rotated by a motor and, as a result of the rotation of the lead screw, cause linear and/or rotational movement of at least one actuator (e.g., see, for example, actuators A1and A2shown inFIG. 6). Movement of each actuator controls the movement of driving members (e.g., gears, cables) located in the tool assembly1130for controlling one or more actions and movements that can be performed by the tooling assembly1130, such as for assisting with performing a surgical operation. The actuators extend from a top end of the driver1140for coupling to the driving members of the tool assembly1130mounted on top of the tool driver1140.

The tool assembly1130can be loaded from a top side of the driver1140with the shaft of the tool assembly1130being positioned in a shaft-receiving channel1144formed along the side of the driver1140. The shaft-receiving channel1144allows the shaft, which extends along a central axis of the tool assembly1130, to extend along a central axis of the driver1140when the tool assembly1130is coupled to the driver1140. In other embodiments, the shaft can extend through on opening in the tool driver1140, or the two components can mate in various other configurations.

As shown inFIGS. 5 and 7, the tool assembly1130includes a puck or housing1135coupled to a proximal end of a shaft1136and an end effector1138coupled to a distal end of the shaft1136. The housing1135can include coupling features that assist with releasably coupling the puck1135to the tool driver1140of the robotic arm1120. The housing1135can include driving members (e.g., gears, cables, and/or drivers) that can be directly or indirectly actuated by the one or more motors M1-M5, as will be described in greater detail below. The driving members in the housing1135can control the operation of various features associated with the end effector1138(e.g., clamping, firing, rotation, articulation, etc.), as well as control the movement of the shaft1136(e.g., rotation and/or articulation of the shaft).

The shaft1136can be releasably coupled to the housing1135such that the shaft1136can be interchangeable with other shafts. This can allow a single housing1135to be adaptable to various shafts1136having different end effectors1138. The shaft1136can include actuators and connectors that extend along the shaft and assist with controlling the actuation and/or movement of the end effector1138and/or shaft1136. The shaft1136can also include one or more joints or wrists1137that allow a part of the shaft1136or the end effector1138to rotate and/or articulate relative to the longitudinal axis of the shaft1136. This can allow for fine movements and various angulation of the end effector1138relative to the longitudinal axis of the shaft1136. The end effector1138can include any of a variety of surgical tools, such as a stapler, a clip applier, forceps, a needle driver, a cautery device, a cutting tool, a pair of jaws, an imaging device (e.g., an endoscope or ultrasound probe), or a combined device that includes a combination of two or more various tools.

FIG. 7illustrates a part of a housing actuation assembly contained within the housing1135. As shown inFIG. 7, the housing1135includes at least one driving member (e.g., four driving members D1, D2, D3, and D4are shown) that can each become engaged with an actuator of the driver1140such that actuation of an actuator causes actuation of a driving member thereby controlling the operation of various features associated with the shaft1136and/or end effector1138. Each driving member D1-D4can be coupled to a proximal end of a shaft or cable (e.g., four cables C1, C2, C3, and C4are shown). Each cable can extend from a driving member and couple to a feature associated with either the shaft1136or the end effector1138thereby controlling a function of such feature.

FIG. 8illustrates the housing1135coupled to the driver1140with the actuators extending from the driver1140into the puck1135and engaging the driving members. For example, motor M1can cause lead screw L1to rotate thereby causing actuator A1, which is threadably coupled to lead screw L1, to linearly advance in the proximal direction (towards and into the puck1135). Actuator A1can include an extension threadably coupled to the lead screw L1. The extension can be coupled to or integrated with a partial cylindrical shaft that extends along the longitudinal axis of the housing1135and the driver1140. The partial cylindrical shaft of the actuator A1can engage with driving member D1such that when the actuator A1is linearly advanced, the driving member D1is caused to linearly advance in the same direction. Driving member D1can be coupled to cable C1such that when driving member D1is advanced in the proximal direction, cable C1is pulled in the proximal direction. Cable C1extends along the shaft of the tool assembly1130and is operatively coupled to a part of the end effector1138thereby controlling a function of the end effector1138(e.g., opening and closing of jaws, deployment of a staple, etc.) when the cable is C1translated in either the proximal or distal direction.

In some implementations, for example, four motors (e.g., M1-M4) can each individually control movement of a respective lead screw (e.g., L1-L4) thereby individually linearly translating a respective actuator (e.g., A1-A4) coupled thereto. Although the actuators are described as being linearly translated, the actuators can be linearly translated and/or rotationally moved as a result of actuation of a respective motor. Additional motors (e.g., motors M5and M6) can be included in the driver1140for actuating various other aspects of the tool assembly1130. For example, motor M5can cause a first driver shaft1141to rotate, which is operatively coupled to a first housing shaft1147having a first housing gear1143coupled to a distal end of the first puck shaft1147. Rotation of the first driver shaft1141thereby causes the first housing shaft1147and first housing gear1143to rotate. The first housing gear1143is engaged with a first shaft rotation gear1148that is caused to rotate as a result of the first housing gear1143rotating. The first shaft rotation gear1148is operatively coupled to the shaft1136of the tool assembly1130and can thereby cause rotation of the shaft1136and/or end effector1138. Motor M6can cause a second driver shaft to rotate, which is operatively coupled to a second puck gear1153. The second housing gear1153is engaged with a second shaft rotation gear1154that is caused to rotate as a result of the second puck gear1153rotating. The second shaft rotation gear1154is also operatively coupled to the shaft1136and, upon rotation, provides additional torque through the shaft1136and for various features associated with the end effector1138. Actuation of motor M7can cause shaft gears1161to rotate, thereby causing the threaded shaft of the movable tool guide1132to linearly translate.

Terminology

There are a number of ways in which to describe the movement of a surgical system, as well as its position and orientation in space. One particularly convenient convention is to characterize a system in terms of its degrees of freedom. The degrees of freedom of a system are the number of independent variables that uniquely identify its pose or configuration. The set of Cartesian degrees of freedom is usually represented by the three translational or position variables, e.g., surge, heave, and sway, and by the three rotational or orientation variables, e.g., Euler angles or roll, pitch, and yaw, that describe the position and orientation of a component of a surgical system with respect to a given reference Cartesian frame. As used herein, and as illustrated inFIG. 9, the term “surge” refers to forward and backward movement, the term “heave” refers to movement up and down, and the term “sway” refers to movement left and right. With regard to the rotational terms, “roll” refers to tilting side to side, “pitch” refers to tilting forward and backward, and “yaw” refers to turning left and right. In a more general sense, each of the translation terms refers to movement along one of the three axes in a Cartesian frame, and each of the rotational terms refers to rotation about one of the three axes in a Cartesian frame.

Although the number of degrees of freedom is at most six, a condition in which all the translational and orientation variables are independently controlled, the number of joint degrees of freedom is generally the result of design choices that involve considerations of the complexity of the mechanism and the task specifications. For non-redundant kinematic chains, the number of independently controlled joints is equal to the degree of mobility for an end effector. For redundant kinematic chains, the end effector will have an equal number of degrees of freedom in Cartesian space that will correspond to a combination of translational and rotational motions. Accordingly, the number of degrees of freedom can be more than, equal to, or less than six.

With regard to characterizing the position of various components of the surgical system and the mechanical frame, the terms “forward” and “rearward” may be used. In general, the term “forward” refers to an end of the surgical system that is closest to the distal end of the input tool, and when in use in a surgical procedure, to the end disposed within a patient's body. The term “rearward” refers to an end of the surgical system farthest from the distal end of the input tool, and when in use, generally to the end farther from the patient.

The terminology used herein is not intended to limit the invention. For example, spatially relative terms, e.g., “superior,” “inferior,” “beneath,” “below,” “lower,” “above,” “upper,” “rearward,” “forward,” etc., may be used to describe one element's or feature's relationship to another element or feature as illustrated in the figures. These spatially relative terms are intended to encompass different positions and orientations of the device in use or operation in addition to the position and orientation shown in the figures. For example, if the device in the figures is turned over, elements described as “inferior to” or “below” other elements or features would then be “superior to” or “above” the other elements or features. Likewise, descriptions of movement along and around various axes include various special device positions and orientations. As will be appreciated by those skilled in the art, specification of the presence of stated features, steps, operations, elements, and/or components does not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups described herein. In addition, components described as coupled may be directly coupled, or they may be indirectly coupled via one or more intermediate components.

There are several general aspects that apply to the various descriptions below. For example, at least one surgical end effector is shown and described in various figures. An end effector is the part of a surgical instrument or assembly that performs a specific surgical function, e.g., forceps/graspers, needle drivers, scissors, electrocautery hooks, staplers, clip appliers/removers, suction tools, irrigation tools, etc. Any end effector can be utilized with the surgical systems described herein. Further, in exemplary embodiments, an end effector can be configured to be manipulated by a user input tool. The input tool can be any tool that allows successful manipulation of the end effector, whether it be a tool similar in shape and style to the end effector, such as an input tool of scissors similar to end effector scissors, or a tool that is different in shape and style to the end effector, such as an input tool of a glove dissimilar to end effector graspers, and such as an input tool of a joystick dissimilar to end effector graspers. In some embodiments, the input tool can be a larger scaled version of the end effector to facilitate ease of use. Such a larger scale input tool can have finger loops or grips of a size suitable for a user to hold. However, the end effector and the input tool can have any relative size.

A slave tool, e.g., a surgical instrument, of the surgical system can be positioned inside a patient's body cavity through an access point in a tissue surface for minimally invasive surgical procedures. Typically, cannulas such as trocars are used to provide a pathway through a tissue surface and/or to prevent a surgical instrument or guide tube from rubbing on patient tissue. Cannulas can be used for both incisions and natural orifices. Some surgical procedures require insufflation, and the cannula can include one or more seals to prevent excess insufflation gas leakage past the instrument or guide tube. In some embodiments, the cannula can have a housing coupled thereto with two or more sealed ports for receiving various types of instruments besides the slave assembly. As will be appreciated by a person skilled in the art, any of the surgical system components disclosed herein can have a functional seal disposed thereon, therein, and/or therearound to prevent and/or reduce insufflation leakage while any portion of the surgical system is disposed through a surgical access port, such as a cannula. The surgical systems can also be used in open surgical procedures. As used herein, a surgical access point is a point at which the slave tool enters a body cavity through a tissue surface, whether through a cannula in a minimally invasive procedure or through an incision in an open procedure.

Computer Systems

The systems, devices, and methods disclosed herein can be implemented using one or more computer systems, which may also be referred to herein as digital data processing systems and programmable systems.

FIG. 10illustrates one exemplary embodiment of a computer system100. As shown, the computer system100includes one or more processors102which can control the operation of the computer system100. “Processors” are also referred to herein as “controllers.” The processor(s)102can include any type of microprocessor or central processing unit (CPU), including programmable general-purpose or special-purpose microprocessors and/or any one of a variety of proprietary or commercially available single or multi-processor systems. The computer system100can also include one or more memories104, which can provide temporary storage for code to be executed by the processor(s)102or for data acquired from one or more users, storage devices, and/or databases. The memory104can include read-only memory (ROM), flash memory, one or more varieties of random access memory (RAM) (e.g., static RAM (SRAM), dynamic RAM (DRAM), or synchronous DRAM (SDRAM)), and/or a combination of memory technologies.

The various elements of the computer system100can be coupled to a bus system112. The illustrated bus system112is an abstraction that represents any one or more separate physical busses, communication lines/interfaces, and/or multi-drop or point-to-point connections, connected by appropriate bridges, adapters, and/or controllers. The computer system100can also include one or more network interface(s)106, one or more input/output (IO) interface(s)108, and one or more storage device(s)110.

The network interface(s)106can enable the computer system100to communicate with remote devices, e.g., other computer systems, over a network, and can be, for non-limiting example, remote desktop connection interfaces, Ethernet adapters, and/or other local area network (LAN) adapters. The IO interface(s)108can include one or more interface components to connect the computer system100with other electronic equipment. For non-limiting example, the IO interface(s)108can include high speed data ports, such as universal serial bus (USB) ports, 1394 ports, Wi-Fi, Bluetooth, etc. Additionally, the computer system100can be accessible to a human user, and thus the IO interface(s)108can include displays, speakers, keyboards, pointing devices, and/or various other video, audio, or alphanumeric interfaces. The storage device(s)110can include any conventional medium for storing data in a non-volatile and/or non-transient manner. The storage device(s)110can thus hold data and/or instructions in a persistent state, i.e., the value(s) are retained despite interruption of power to the computer system100. The storage device(s)110can include one or more hard disk drives, flash drives, USB drives, optical drives, various media cards, diskettes, compact discs, and/or any combination thereof and can be directly connected to the computer system100or remotely connected thereto, such as over a network. In an exemplary embodiment, the storage device(s) can include a tangible or non-transitory computer readable medium configured to store data, e.g., a hard disk drive, a flash drive, a USB drive, an optical drive, a media card, a diskette, a compact disc, etc.

The elements illustrated inFIG. 10can be some or all of the elements of a single physical machine. In addition, not all of the illustrated elements need to be located on or in the same physical machine. Exemplary computer systems include conventional desktop computers, workstations, minicomputers, laptop computers, tablet computers, personal digital assistants (PDAs), mobile phones, and the like.

The computer system100can include a web browser for retrieving web pages or other markup language streams, presenting those pages and/or streams (visually, aurally, or otherwise), executing scripts, controls and other code on those pages/streams, accepting user input with respect to those pages/streams (e.g., for purposes of completing input fields), issuing HyperText Transfer Protocol (HTTP) requests with respect to those pages/streams or otherwise (e.g., for submitting to a server information from the completed input fields), and so forth. The web pages or other markup language can be in HyperText Markup Language (HTML) or other conventional forms, including embedded Extensible Markup Language (XML), scripts, controls, and so forth. The computer system100can also include a web server for generating and/or delivering the web pages to client computer systems.

In an exemplary embodiment, the computer system100can be provided as a single unit, e.g., as a single server, as a single tower, contained within a single housing, etc. The single unit can be modular such that various aspects thereof can be swapped in and out as needed for, e.g., upgrade, replacement, maintenance, etc., without interrupting functionality of any other aspects of the system. The single unit can thus also be scalable with the ability to be added to as additional modules and/or additional functionality of existing modules are desired and/or improved upon.

A computer system can also include any of a variety of other software and/or hardware components, including by way of non-limiting example, operating systems and database management systems. Although an exemplary computer system is depicted and described herein, it will be appreciated that this is for sake of generality and convenience. In other embodiments, the computer system may differ in architecture and operation from that shown and described here.

In some embodiments, a surgical robotic system can include a surgical tool that is releasably coupled to a robotic arm. The surgical tool can include a housing coupled to a proximal end of an elongate instrument shaft and an end effector coupled to a distal end of the shaft.FIG. 11illustrates an embodiment of such robotic arm1220and a surgical tool assembly1230releasably coupled to the robotic arm1220. The robotic arm1220can support and move the associated surgical tool assembly1130along one or more mechanical degrees of freedom (e.g., all six Cartesian degrees of freedom, five or fewer Cartesian degrees of freedom, etc.).

The robotic arm1220includes a tool driver1240at a distal end of the robotic arm1220, which can assist with controlling features associated with the surgical tool assembly1230. As shown inFIG. 11, the robotic arm1220also includes a tool guide1232that couples to a trocar1251. The trocar1251, which can have any suitable configuration, can be reversibly mated to a distal end feature1233(e.g., a ring or other feature) of the tool guide1232. The tool guide1232holds the trocar1251to allow the shaft of the surgical tool assembly1230, which extends generally parallel to a threaded shaft of the tool guide1232, to be advanced through and retracted from the trocar.

While the tool driver1240is not shown in detail, it generally includes one or more motors that control a variety of movements and actions associated with the tool assembly1230. Each motor can be configured to couple to a drive assembly in the tool driver to thereby cause movement of a corresponding actuator, which in turn actuates the end effector. For example, actuation of one of the motors can rotate one or more gear assemblies, which in turn can cause linear and/or rotational movement of at least one actuator (e.g., gears, cables) extending through the tool shaft. Each actuator can cause actuation of the end effector, e.g., clamping, firing, rotating, articulation, etc.

As further shown inFIG. 11, the surgical tool assembly1230can be loaded from a top side of the driver1240with the shaft of the tool assembly1230being positioned in a shaft-receiving channel1244formed along the side of the driver1240. The shaft-receiving channel1244allows the shaft, which extends along a central axis of the tool assembly1230, to extend along a central axis of the driver1240when the tool assembly1230is coupled to the driver1240. In other embodiments, the shaft can extend through on opening in the tool driver1240, or the two components can mate in various other configurations.

As shown inFIG. 11, the surgical tool assembly1230includes a housing1235coupled to a proximal end of an elongate shaft1236that extends distally from the housing1235. The tool assembly1230also includes an end effector1238coupled to a distal end of the shaft1236. In some embodiments, as in the example illustrated, the surgical tool assembly1230can include a sterile barrier (not shown). However, it should be appreciated that, in some embodiments, the sterile barrier may not be present.

The housing1235can have various configurations. In this example, as shown inFIG. 11, the housing1235can be generally cylindrical, though it can have other shapes. As also shown, the housing1235can include a display1246which is discussed in more detail below. In at least some embodiments, the housing1235can include coupling features that assist with releasably coupling the housing1235to the tool driver1240of the robotic arm1220. The housing1235can include drivers (e.g., gears, shafts, cables etc.) that can be directly or indirectly actuated by the one or more motors in the tool driver. Each driving member in the housing1235can cause rotation or translation of an actuator (e.g., shaft, cable) extending through the elongate shaft and coupled to the end effector. Movement of the actuators can control the operation of various features associated with the end effector1238(e.g., clamping, firing, rotation, articulation, etc.), as well as control the movement of the shaft1236(e.g., rotation and/or articulation of the shaft).

The shaft1236can be releasably coupled to the housing1235such that the shaft1236can be interchangeable with other shafts. This can allow a single housing1235to be adaptable to various shafts1236having different end effectors1238. The shaft1236can also include one or more joints or wrists1237that allow a part of the shaft1236or the end effector1238to rotate and/or articulate relative to the longitudinal axis of the shaft1236. This can allow for fine movements and various angulation of the end effector1238relative to the longitudinal axis of the shaft1236.

The end effector1238can have various different configurations. In the example illustrated, as shown inFIG. 11, the end effector1238has opposed first and second jaws1250,1252that are movable between open and closed positions. At least one of the jaws can include a removable and replaceable staple cartridge assembly. In this example, the first jaw1250can include a removable and replaceable staple cartridge assembly1254, whereas the second jaw1252can be an anvil configured to approximate with respect to the first jaw1250having the cartridge assembly1254. The first jaw1250can removably and replaceably seat the staple cartridge assembly1254. Additionally or alternatively, the first jaw1250can be configured such that the entire jaw1250with the staple cartridge assembly1254is a removable and replaceable jaw.

As described above, an end effector of a surgical tool can have a removable and replaceable staple cartridge assembly. For example, as discussed above in connection withFIG. 11, at least one of the jaws of the end effector (e.g., a cartridge body) can seat the staple cartridge assembly. For example, one of the jaws can have a channel configured to removably and replaceably seat the staple cartridge assembly. The staple cartridge assembly holds staples configured to be applied by the end effector to seal tissue held by the jaws. When a replacement of the staple cartridge assembly is required (e.g., when the staple cartridge assembly is out of staples, or for other reasons), the staple cartridge assembly can be removed from the end effector and the end effector can be reloaded with a new staple cartridge assembly. Depending on a configuration of the end effector, the cartridge assembly can be removed from a jaw carrying the cartridge assembly (e.g., the first jaw1250inFIG. 11), or the entire removable and replaceable jaw can be removed and then replaced with another removable and replaceable jaw having a staple cartridge assembly.

Regardless of the specific configuration of the staple cartridge assembly and the way in which it is removably associated with the end effector of a surgical tool, for the staple cartridge assembly to be removed, the jaws of the end effector need to be open so that the end effector is properly accessible. Also, if the staple cartridge assembly is to be removed, a cutting element (e.g., a knife), if present, needs to be retracted proximally. Furthermore, to access the end effector for removal of the staple cartridge assembly, the surgical tool having the end effector needs to be retracted from a surgical access instrument. The surgical access instrument can be, for example, a trocar (e.g., the trocar1251inFIG. 11), that is inserted through an incision to form a pathway that provides access to a surgical site. The surgical access instrument is used to introduce the surgical tool (as well as other instruments) to the surgical site.

In some embodiments, to retract the surgical tool or at least a portion thereof (e.g., the end effector coupled to an elongate shaft of the tool) from the trocar, the tool should be placed in a mode (also referred to herein as a “first mode”) in which it is not deriving electrical power from the surgical robotic system. For example, the tool can be disconnected from the tool driver, or supply of electrical power to the tool can be otherwise terminated. Thus, prior to retracting the surgical tool from the surgical access instrument, while the end effector coupled to an elongate shaft of the tool is still at least partially disposed within the trocar, the surgical tool is placed in such a mode. However, while the end effector is at least partially disposed within the trocar, its jaws are closed such that the end effector can fit within the inner opening of the trocar. In this way, when the power is not supplied to the tool and thus to the end effector, the end effector is “locked” in the closed-jaw configuration and it is retracted from the trocar with the jaws being closed. Thus, after the tool is retracted from the trocar, the end effector has its jaws closed and access to the cartridge assembly supported by the end effector is therefore prevented.

To overcome the above shortcoming, in some embodiments, a surgical tool can include an actuator disposed on the elongate shaft and configured to be manually moved from a first position to a second position to open the jaws when the surgical tool is in the first mode in which it is not deriving electrical power from the surgical robotic system. The surgical tool has a member that extends at least partially through the end effector and the shaft, the member being configured to move distally and proximally within at least a portion of the end effector to open and close the jaws. The actuator disposed on the shaft is configured to be manually moved from the first position to the second position to cause the member to move proximally to thereby open the jaws.

Accordingly, when the surgical tool is in the first mode, the actuator can be manually moved from the first position to the second position to cause the member to move proximally to open the jaws of the end effector. After the jaws of the end effector have been opened, a removable and replaceable staple cartridge assembly supported by at least one of the jaws can be replaced with another removable and replaceable staple cartridge assembly. The actuator can then be manually moved from the second position to the first position to cause the member to move distally to thereby close the jaws. After the jaws are closed, the surgical tool can be placed in the second mode in which it derives electrical power from the surgical robotic system.

FIG. 12illustrates an example of a surgical tool assembly or surgical tool1300having an actuator in accordance with the described techniques. The surgical tool1300, which can be part of a tool assembly1301of a surgical robotic system, is configured to be removably and replaceably attached to an electromechanical arm1302of a surgical robotic system that is capable of supplying electrical power to the surgical tool when the surgical tool is attached to the electromechanical arm. The electromechanical arm1302can have any suitable configuration, and only a portion of the arm1302is shown inFIG. 12. The surgical tool1300can be removably and replaceably coupled to the arm1302in any suitable way.

As shown inFIG. 12, the surgical tool1300has a housing1304and an elongate shaft1306extending distally from the housing1304. The elongate shaft1306has, at a distal end1307dthereof, an end effector1308having opposed first and second jaws1310,1312that are movable between open and closed positions. The housing1304can be a tool driver that assists with controlling features associated with the surgical tool1300. The elongate shaft1306can include a proximal portion1306pand a distal portion1306dhaving the end effector1308. The distal portion1306dcan be removably and replaceably coupled to the proximal portion1308p. In this way, the distal portion1306dwith the end effector1308can be replaced with another portion of an elongate shaft having an end effector coupled thereto. In such a configuration, the proximal portion1306pof the end effector1308and at least a part of the tool driver can form an adapter configured to mate with various modular shaft assemblies such as, in this example, the distal portion1306dwith the end effector1308. The tool driver can supply electrical power to a tool attachment including at least a portion of the shaft1306and the end effector1308when the tool attachment is attached to the tool driver. However, it should be appreciated that in some embodiments the elongate shaft1306may be formed as a single element such that its distal portion is not separable from its proximal portion.

In use, the tool assembly1301can be provided to a surgical site via a surgical access instrument, such as a trocar1303, which can have any suitable configuration. The trocar1303can be reversibly mated to a distal end feature1305(e.g., a ring or other feature) of a tool guide (e.g., the tool guide1232inFIG. 11) or other feature.

Regardless of the specific configuration of the tool assembly1301, as mentioned above, the surgical tool1300includes the end effector1308coupled to a distal end1307dof the elongate shaft1306. At least one of the opposed first and second jaws1310,1312of the end effector1308can be removable and replaceable or can include a removable and replaceable staple cartridge assembly. Thus, as shown inFIGS. 13A and 13Bwhich are discussed in more detail below, the first jaw1310can include a staple cartridge assembly1311, whereas the second jaw1312can be an anvil. As shown inFIG. 12, when the end effector1308is at least partially inserted into the trocar1303, the jaws1310,1312are closed. To remove the surgical tool1300from the trocar1303, the tool1300is placed in a mode in which it is not deriving electrical power from the surgical robotic system. For example, the surgical tool1300can be disconnected from the tool driver or other component supplying electrical power to the tool1300. Supply of the electrical power to the tool1300is terminated while the jaws1310,1312of the end effector1308are closed. In this way, the jaws1310,1312are locked in the closed position. Thus, the tool1300is retracted from the trocar1303with the end effector's jaws in this closed position such that the staple cartridge assembly1311(FIG. 13B) is not accessible for removal.

In the illustrated embodiments, the surgical tool1300includes an actuator1314disposed on the elongate shaft1306. The actuator1314is configured to be manually moved, within a slot1315formed in the elongate shaft1306, from a first position to a second position to open the jaws1310,1312when the surgical tool1300is in a mode in which it is not receiving electrical power from the surgical robotic system. In this way, the jaws1310,1312of the end effector1308can be opened even if no electrical power is supplied to the surgical tool1300. Thus, after the tool1300is retracted from a surgical access instrument (e.g., the trocar1311) with the jaws1310,1312closed, the actuator1314can be manually manipulated to cause the jaws1310,1312to open.

Any suitable mechanism can be used to cause the jaws1310,1312to open using the actuator1314. The surgical tool1300also includes an elongate member1400(shown inFIGS. 14A-14Cdiscussed in more detail below) extending through a least a portion of the length of the elongate shaft1306and configured to move distally and proximally within at least a portion of the end effector1308to open and close the jaws1310,1312. The member1400can be, for example, a drive member (e.g., a drive shaft), an I-beam compression member, an articulation cable, or any other element configured to move distally and proximally within at least a portion of the end effector1308to open and close the jaws1310,1312. Where the member is an I-beam compression member, the member is configured to travel through slots formed in each jaw to pull the jaws into a parallel orientation and to compress tissue therebetween. The compression member can include a cutting element that can be integrally formed with the compression member or that can be a separate element. In some embodiments, the member can be a drive shaft that advances a sled through the end effector for firing staples from the end effector. In other embodiments, the member can be, or can be coupled to, a closure tube that advances to close opposed jaws of an end effector. Regardless of the specific configuration of the member1400, it is coupled to the actuator1314such that the actuator1314is manually moved from the first position to the second position to cause the member1400to move proximally to thereby open the jaws1310,1312of the end effector1308. If a cutting element is present, the cutting element is retracted proximally when the jaws are open.

FIGS. 13A and 13Billustrate a portion of the surgical tool1300configured in accordance with the described techniques, andFIGS. 14A-14Cillustrate an example of operation of a coupling mechanism that couples the actuator1314with the member1400. As shown inFIG. 14A, the coupling mechanism is disposed within the elongate shaft1306. In embodiments in which the elongate shaft1306includes the distal and proximal portions1306d,1306p, the coupling mechanism and the actuator1314can be disposed at the proximal portion1306.

The coupling mechanism, shown in cross-section inFIGS. 14A-14B, is formed such that it is interposed between proximal and distal portions1400p,1400dof the member1400and such that it couples the proximal and distal portions1400p,1400dso that actuator1314can be used to manually override jaw opening/closing. As shown inFIGS. 14A-14C, the coupling mechanism includes a bracket1402having an L-shaped slot1404, a worm gear1410formed on or coupled to the proximal portion1400pand having a thread formed thereon, a nut1412within which worm gear1410is threaded, and a pin1414disposed on the nut1412and extending through the L-shaped slot1404of the bracket1402. As shown, the bracket1402includes L-shaped proximal and distal legs1416,1418. The proximal leg1416has, in the knee and in the shorter portion of the “L,” the L-shaped slot1404formed therein. The shorter portion of the “L” of the distal leg1418sits in an opening1420formed in the distal-most end of the distal portion1400pof the member1400.

The actuator1314can have many various configurations. For example, the actuator1314can be a lever, a tab, or any other feature coupled to a member configured to move proximally and distally to close and open end effector's jaws. In the example illustrated, the actuator1314extends from the proximal leg1416of the bracket1402as shown inFIG. 14A. The actuator1314can be formed integrally with the bracket1402or it can be a separate component attached to the bracket1402in a suitable way. The actuator1314is shaped such that it has a grip surface that can be manually engaged and moved in a convenient manner. For example, as shown inFIGS. 14A-14C, the actuator1314can be T-shaped such that it has a leg or stem1406and a head1408extending from the stem1406. It should be appreciated, however, that the actuator1314can have other shapes, as the described techniques are not limited in this respect.

As shown inFIGS. 12, 13A, andFIGS. 14A-14C, the actuator1314is disposed on the elongate shaft1306such that the actuator1314can move within the slot1315formed in the shaft1306. The jaws of the end effector (e.g., the end effector1308inFIG. 12, not shown inFIGS. 14A-14C) are coupled to the distal end of the shaft1306. The portion1400dof the member1400is coupled to the end effector such that, when the member1400is moved proximally and distally, the jaws of the end effector are caused to close and open, respectively.

FIG. 14Aillustrates the actuator1314in the first position when the jaws of the end effector are closed. For example,FIG. 12illustrates the end effector1308when its jaws1310,1312are closed. In the first position, the actuator1314is disposed on the elongate shaft1306such that the actuator's stem1406is positioned within the slot1315and the head1408of the actuator1314protrudes above the outer surface of the shaft1306. The shorter portion of the “L” of the distal leg1418sits in the opening1420in the member1400.

When it is desired to open the jaws of the end effector1308, the actuator1314can be manually moved from the first to the second position, as shown inFIG. 14B. For example, when the surgical tool is in the mode in which it is not deriving electrical power from the surgical robotic system and after the tool is retracted from the trocar, the actuator1314can be manually moved from the first to the second position to open the jaws1310,1312.

In the illustrated embodiment, the actuator1314can be pulled away from the shaft1306, as shown by an arrow1422inFIG. 14B, and then moved proximally as shown by an arrow1424inFIG. 14B.FIG. 14Balso illustrates in phantom lines the position of the bracket1402when the actuator1314is in the first position. These movements cause the L-shaped slot1404of the bracket1402to move about the pin1414such that the pin is seated within the opposite end of the L-slot's “L,” as shown inFIG. 14B. The shorter portion of the “L” of the distal leg1418is moved in the opening1420in the direction shown by the arrow1422such that the distal leg1418is partially retracted from the opening. The actuator1314is moved proximally within the slot1315in the shaft1306, as shown by an arrow1425, thus causing the distal portion1400dof the member1400to move proximally. This proximal movement of the member1400causes the jaws of the end effector1308to open. In this way, after the tool is retracted from the trocar with the end effector's jaws closed, the jaws can be opened by a user (e.g., a surgeon or other person) manually, despite the tool being disconnected from a power source. This then allows replacement of a staple cartridge assembly.

FIG. 13Ashows the end effector1308with the jaws1310,1312open by manually moving the actuator1314from the first to the second position, in the directions of the arrows1422and1424. After the jaws of the end effector1308are opened, the removable and replaceable staple cartridge assembly1311can be removed from the first jaw1310, as schematically shown inFIG. 13B. The end effector1308can thus be loaded with another removable and replaceable staple cartridge assembly. Furthermore, in some embodiments, the entire first jaw1310can be a removable and replaceable staple cartridge assembly removably coupled to the end effector in a suitable way. Thus, the entire first jaw1310can be removed and replaced with another removable and replaceable staple cartridge assembly.

After the staple cartridge assembly has been replaced, or at any other point when it is desirable to close the jaws of the end effector, the actuator1314can be returned from the second, “open-jaws,” position to the first, “closed-jaws,” position.FIG. 14Cillustrates the actuator1314moved from the second to the first position, with the components of the coupling mechanism in the previous, second position, shown in phantom lines. As shown, the actuator1314is manually moved within the slot1315such that it is moved distally in the direction of an arrow1434and is then pushed towards the shaft1306as shown by an arrow1432. Such movements of the actuator1314cause the member1400to move distally, in the direction show by an arrow1435, which causes the jaws of the end effector to close.

After the jaws of the end effector are closed, the surgical tool can be placed in a mode (e.g., a “second mode”) in which it is deriving electrical power from the surgical robotic system. For example, after the jaws are closed, the surgical tool can be inserted into a surgical access instrument to access a surgical site, and the surgical tool can be reconnected with the tool driver such that the tool can be operated as part of the surgical robotic system.

In some embodiments, techniques for controlling opening and closing of jaws of an end effector of a surgical tool of a surgical robotic system via a display disposed on a housing of the tool are provided. Such control can be performed when the surgical tool having the end effector at a distal end of its elongate instrument shaft thereof receives electrical power from a suitable power source. In this way, information, instructions, and any feedback related to operation of the surgical tool can be presented to a surgeon on the display. Also, the surgical tool's housing can include one or more controls configured to receive user input with respect to operation of the surgical tool. For example, the display can present an instruction to a user (in a textual and/or other format) that a staple cartridge assembly needs to be replaced, and a control of the one or more controls can accept user input in the form of an instruction to the surgical robotic system to open the jaws of the end effector. After the end effector's jaws are automatically opened in response to such instruction, the staple cartridge assembly supported by the end effector can be removed and the end effector can be reloaded with another staple cartridge assembly. The display can provide any other information related to operation of the surgical tool. Also, the one or more control can be configured to accept user input with respect to various other functions of the surgical tool.

FIG. 15illustrates an example of a surgical tool assembly1500that includes a display1502and one or more controls1504in accordance with the described techniques. The surgical tool assembly1500can be part of any robotic surgical device and it can be similar, for example, to the surgical tool assembly1130shown inFIG. 11. Thus, as shown inFIG. 15, the surgical tool assembly1500is removably and replaceably attached to an electromechanical arm1520of a surgical robotic system that is capable of supplying electrical power to the surgical tool assembly1500. The tool assembly1500is coupled to the electromechanical arm1520via a tool driver1540. As shown, the tool assembly1500includes a housing1506having the display1502and the control(s)1504, and an elongate shaft1508extending distally from the housing1506and having an end effector1510at a distal end1508dthereof. The end effector1510has opposed first and second jaws1512,1514that are movable between open and closed positions. At least one of the jaws, such as, in this example, the first jaw1512, includes a removable and replaceable staple cartridge assembly1516.

The surgical tool assembly1500can access a surgical site via a suitable surgical access instrument, an example of which is shown inFIG. 15as a trocar1518. Similar to the example ofFIG. 11, the robotic arm1520can include a movable tool guide1532that can retract and extend relative to the tool driver1540. The elongate shaft1508of the tool assembly1500can extend parallel to a shaft of the movable tool guide1532and can extend through a distal end feature1520(e.g., a ring or other feature) of the movable tool guide1532and into a patient. The trocar1518can be reversibly mated to the distal end feature1520such that the tool guide1532holds the trocar1518to allow the elongate shaft1508to be advanced through and retracted from the trocar1518. It should be appreciated that the tool guide1532and the trocar1518are shown inFIG. 15by way of example only, as these components can have any suitable configurations and the described techniques are not limited in this respect.

The housing1506of the surgical tool assembly1500can have a variety of different configurations. For example, the housing can be configured as shown inFIGS. 18 and 19which are discussed in more detail below. The housing can be coupled to a tool driver and other components of the surgical robotic system in many different ways. Regardless of the specific configuration of the housing1506, as mentioned above, it includes the display1502and one or more controls1504.

The display1502can have a variety of different configurations and it can be of any suitable type. For example, the display1502(and/or its user interface) can be a liquid-crystal display (LCD), a light-emitting diodes (LED) display, or any other type of a display. The display can be shaped and sized such that it can present information thereon in a user-convenient manner. In the example illustrated inFIG. 15, the display1502can be formed on the housing1506such that an upper surface of the display1502is raised above the outer surface of the rest of the housing1506. However, the display can have any other configuration. The display1502includes a user interface1522that can present information related to operation of the surgical tool assembly in textual and/or other formats. For example, the user interface1522can present information about an operational status of the surgical tool assembly1500. The information can include indication(s) about a current operational status of components (e.g., the end effector) of the tool assembly, indication(s) (e.g., in the form of at least one instruction) about next steps to take, indication(s) about access control and any other type of information, as discussed in more detail below.

The one or more controls1504disposed on the housing1506can have any suitable configuration and they can be of any suitable type. The controls1504are configured to accept user input, which is shown inFIG. 15by way of example only as a hand1501. It should be appreciated that two controls1504are shown by way of example only, as the surgical tool assembly's housing can include one, three, or any other number of controls. The controls can be in the form of push buttons and/or other control elements (e.g., a lever, tab, switch, etc.). The controls can be part of the display, as in the example illustrated inFIG. 15. Additionally or alternatively, in some embodiments, the controls can be disposed on other portions of the housing1506. Furthermore, the controls1504can be disposed above (e.g., as inFIG. 15), below, or on the side of the user interface1522of the display1502, as the described techniques are not limited in this respect. In some embodiments, the display1502can be a touch screen display and the controls can be in the form of portions of the touch screen display.

The controls can vary in many different ways. For example, the controls can be pre-assigned specific functions such that a particular control is used to only accept user input to cause the surgical system to perform a certain function. In other embodiments, however, the same control can be used for more than one function, depending on one or more of an operational status of the surgical tool assembly, an operational status of the surgical system, and/or other factors. For example, when there is a need to receive certain input from a user, an indication indicating this need can be presented on the display, and one or more of the controls can be activated to receive respective user input. In some cases, the information presented on the display can indicate which control should be used to accept user input. Additionally, in some embodiments, one or more of the controls can be associated with a light indicator indicating a status of that control. For example, if user input is required to be received with respect to a control, the light indicator of that control can be red. Once the required used input is received (e.g., the button is pressed or other type of input is detected), the color of the control can change to green. It should be appreciated, however, that the controls can additionally or alternatively have any other features.

Regardless of their specific configurations, the controls include a control element configured to receive user input to cause the surgical tool assembly to be removed from a surgical access instrument. For example, with reference to components ofFIG. 15, one of the controls1504can be a control configured to receive a user input that instructs the surgical robotic system to retract the surgical tool assembly1500from the trocar1518, in the direction shown by an arrow1550. In this way, the surgical tool assembly1500can be automatically retracted from the trocar1518when required, while the surgical tool assembly is receiving electrical power from surgical robotic system (e.g., via the tool driver1540). The controls1504also include a control configured to accept user input comprising an instruction to the surgical robotic system to open jaws of an end effector coupled to the distal end of the tool's shaft (e.g., the end effector1510inFIG. 15or any other end effector). The instruction to open the jaws can include an instruction to automatically disconnect a removable and replaceable staple cartridge assembly from the end effector. Accordingly, the described techniques allow the surgical robotic system to accept user input with respect to one of the controls1504to instruct the surgical robotic system to retract the tool with the end effector from the trocar, and to accept user input with respect to another of the controls1504to instruct the surgical robotic system to open the jaws of the end effector while the surgical tool assembly is receiving electrical power from surgical robotic system. In response to these inputs, the surgical robotic system automatically retracts the tool with the end effector from the trocar, opens the jaws of the end effector, and ejects the staple cartridge assembly from the tool.

The surgical robotic system can open the jaws of the end effector using any suitable mechanism. For example, the surgical tool assembly can include a member configured to move distally and proximally within at least a portion of the end effector to open and close the jaws. As described above in connection withFIGS. 11 and 12, the member can be an I-beam compression member, a drive shaft, a closure tube, or any other member configured to move distally and proximally within at least a portion of the end effector to open and close the end effector's jaws. Thus, regardless of the configuration of such member, the instruction to open the jaws that can be received by the surgical system via a control on the tool's housing can include an instruction to cause the member to automatically move proximally to thereby open the jaws. The member can be moved using any suitable mechanism. For example, motors in the tool driver can be operated to cause movement of the member.

It should be appreciated that, in some implementations, the surgical tool assembly includes an end effector that supports a staple cartridge assembly that is removable from a jaw of the end effector. In such implementations, after the surgical robotic system automatically opens the jaws of the end effector of the surgical tool assembly in response to receiving, via one or more controls, a respective user input, the staple cartridge assembly needs to be manually removed and replaced with another staple cartridge assembly.

It should also be appreciated that the controls on the housing of the surgical tool assembly can include any controls for accepting any suitable instructions related to operation of the surgical tool assembly. For example, one or more controls can be used to accept user input instructing the jaws of the end effector to close. As another example, one or more controls can be used to accept user input related to operation of the end effector during a surgical procedure. Any other controls can be used additionally or alternatively, including different types of controls that can be configured to receive used input in various manners.

Referring back toFIG. 15, the information presented on the user interface1522can include an indication that a staple cartridge assembly (e.g., the staple cartridge assembly1516) must be replaced or reloaded. The surgical robotic system can determine in a suitable way (e.g., via suitable sensors) that the staple cartridge assembly of the end effector1510needs to be replaced, and the respective indication can be presented on the display1502. For example, as shown inFIG. 16Aby way of example only, a display1602, which can be similar to the display1502inFIG. 15, can present, on a user interface1622, an indication1624stating “Used Reload. Need to Replace.” Such indication indicates that a staple cartridge assembly, referred to as a “reload,” of an end effector of a surgical tool assembly must be replaced. The end effector can be configured such that the entire jaw supporting a staple cartridge assembly can be removable and replaceable.FIG. 17illustrates an example of such an end effector1710having first and second opposed jaws1712,1714configured to hold tissue therebetween. The first jaw1712is configured as a “reload”—a removable and replaceable staple cartridge assembly that can be removed as shown inFIG. 17and replaced with another reload in the form of a removable and replaceable jaw carrying a staple cartridge assembly. It should be appreciated that the indication1624is only an example of a message that can be presented to a user via a display in accordance with the described techniques, as any other indication can provided to indicate that the staple cartridge assembly is required to be replaced.

Referring back toFIG. 15, when an indication, such as the indication1624shown inFIG. 16Aor other indication, indicating that a staple cartridge assembly is required to be replaced is presented on the display, the one or more controls1504can be used to accept required user input. As discussed above, the controls1504can include a control element configured to accept user input to cause the surgical tool assembly to be removed from a surgical access instrument, and a control element configured to accept user input to cause the jaws of the end effector to open. These controls can be used to accept user input when the display presents the indication indicating that a staple cartridge assembly is required to be replaced.

Referring back toFIG. 15, the information presented on the display1502can include an indication that the staple cartridge assembly has been removed from the end effector1510when the staple cartridge assembly is absent from the end effector1510. The surgical robotic system can determine in a suitable way (e.g., via suitable sensors) that the staple cartridge assembly is absent from the end effector1510and the respective indication can be presented on the display1502. The information that the staple cartridge assembly has been removed from the end effector can be presented after the staple cartridge assembly has been removed (e.g., automatically ejected as discussed above or removed manually) and before the tool has been loaded with another staple cartridge assembly. After the tool has been loaded with another staple cartridge assembly (which may be done as respective loading instructions are presented on the display1502), the display1502can present feedback information indicating whether the staple cartridge assembly has been installed correctly or incorrectly. For example, as shown inFIG. 16Bby way of example only, the user interface1622of the display1602can present a message stating “Cartridge Installed Correctly. Ready,” indicating that the staple cartridge assembly has been installed correctly and that the surgical tool assembly can be used (i.e., is “ready”) for a surgical procedure. Like in the example ofFIG. 16A, any other message can be displayed to indicate a status of the installation of the staple cartridge assembly, including a message that the staple cartridge assembly has been installed incorrectly if this is determined to be the case. Any other feedback information can be presented additionally or alternatively.

Any other information can be presented on the display1502onFIG. 15, the display1602ofFIGS. 16A and 16B, or any other display in accordance with the described techniques. For example, the information can include instructions for reloading the end effector, such as, e.g., steps for removing and replacing a staple cartridge assembly either in the form of an assembly seated by a jaw or in the form of a jaw removable and replaceable as a reloading unit. Additionally or alternatively, the information can include instructions for operating the surgical tool assembly, which can be presented at any time during a time when the surgical tool assembly is in use. More than one indication can be displayed on the display at the same time. The information presented on the display can be in a textual, visual, a combination thereof, or in any other format. In addition, in some embodiments, the housing can additionally be configured to provide indication(s) in audio format.

In some embodiments, the information presented on the display of the housing of the surgical tool assembly can include instructions for resolving at least one error in operation of the end effector. For example, in embodiments in which the surgical tool assembly includes one or more bailout mechanisms for retracting an actuator on a surgical tool when a failure is encountered, the display can present instructions on how to perform the bailout process using the bailout mechanisms(s). In some embodiments, the information presented on the display of the surgical tool assembly can include indications and instructions on how to resolve an improperly attached modular shaft of a surgical tool, and/or other indications and instructions related to operation and “hot-swapping” of modular shafts.

The display and controls on a housing of a surgical tool assembly in accordance with the described techniques can be included in a variety of different surgical tool assemblies.FIGS. 18 and 19illustrate examples of surgical tools assemblies that can include a display and control in accordance with the described techniques.FIG. 18illustrates a portion of a surgical tool assembly1800having a housing1806, a tool driver1840, and an elongate shaft1808extending distally from the housing1806and having an end effector1810at a distal end thereof. The housing1806and the tool driver1840can be coupled to one another in any suitable way. The end effector1810has opposed first and second jaws1812,1814, with the first jaw1812having a removable and replaceable staple cartridge assembly. The housing1806includes a display1802that can have a user interface1822and one or more controls1804. The display1802and the controls1804can be similar to the display1502and the controls1504inFIG. 15, respectively. The elongate shaft1808can be an attachable modular shaft. When multiple modular shafts can be used with the same housing, the surgical tool assembly can further include an adapter (not shown), e.g., as described in the above-referenced applications.

FIG. 19illustrates a portion of a surgical tool assembly1900having a tool housing1906including a display1902that can have a user interface1922and one or more controls1904. The tool housing1906can be configured to receive a surgical tool (not shown) in a channel1907of the housing. The tool housing1906can have a bailout mechanism1903, as shown inFIG. 19. In embodiments in which the surgical tool assembly includes one or more bailout mechanisms, the display1902can present (e.g., on the user interface1922) information related to using the bailout mechanism(s). Furthermore, any other information related to operation of the surgical tool assembly can be presented, as discussed above. The controls1904, which allow accepting user instructions with respect to various aspects of operation of the surgical tool assembly, can be configured similar to the controls1504inFIG. 15, or in any other manner.

In embodiments described above, a removable and replaceable staple cartridge assembly supported by at least one of jaws of an end effector coupled to an elongate instrument shaft of a surgical tool assembly can be replaced manually. In some embodiments, however, a surgical robotic system can automatically replace the staple cartridge assembly with another removable and replaceable staple cartridge assembly. Furthermore, the jaws can be prepared for accepting another removable and replaceable staple cartridge assembly. The preparation process can include, for example, cleaning the jaws (e.g., from unused staples that can be stuck in the cartridge and/or from any dirt, debris, etc.) and drying the cleaned jaws. Also, in embodiments in which one or both jaws removably hold a buttress, after the end effector is loaded with a new removable and replaceable staple cartridge assembly, the end effector can be loaded with a buttress. The end effector with the buttress can then be inspected to ensure proper positioning of the buttress on the jaw(s) of the end effector.

FIGS. 20-23illustrate exemplary processes involved in replacing a removable and replaceable staple cartridge assembly supported by an end effector with a new removable and replaceable staple cartridge assembly effector. The processed can be performed using an automated reloading system, a cleaning/drying station, and/or any other systems, as described in more detail below.

FIG. 20illustrates an example of an automated reloading system2000that can be used to reload an end effector. The automated reloading system2000is similar to an automated reloading system described in U.S. Pat. No. 8,931,682, entitled “Robotically-Controlled Shaft Based Rotary Drive Systems for Surgical Instruments,” issued on Jan. 13, 2015, the content of which is incorporated herein by reference in its entirety. The automated reloading system2000is configured to replace a “spent” surgical end effector component in a manipulatable surgical tool assembly2001of a surgical robotic system with a “new” surgical end effector component. The manipulatable surgical tool assembly2001can be, for example, the surgical tool assembly1300(FIG. 12), the surgical tool assembly1500(FIG. 15), or any other surgical tool assembly. The end effector is coupled to a distal end of an elongate shaft2008of the surgical tool assembly2001. As used herein, the term “surgical end effector component” may include, for example, a surgical staple cartridge, a disposable loading unit or other end effector components that, when used, are spent and must be replaced with a new component.

Furthermore, the term “spent” means that the end effector component has been activated and is no longer useable for its intended purpose in its present state. For example, in the context of a surgical staple cartridge or disposable loading unit, the term “spent” means that at least some of the unformed staples that were previously supported therein have been “fired” therefrom. As used herein, the term “new” surgical end effector component refers to an end effector component that is in condition for its intended use. In the context of a surgical staple cartridge or disposable loading unit, for example, the term “new” refers to such a component that has unformed staples therein and which is otherwise ready for use.

As shown inFIG. 20, the automated reloading system2000includes a base portion2002. The base portion2002includes a new component support section or arrangement2010that is configured to operably support at least one new surgical end effector component in a “loading orientation.” As used herein, the term “loading orientation” means that the new end effector component is supported in such away so as to permit the corresponding component support portion of the surgical tool assembly to be brought into loading engagement with (i.e., operably seated or operably attached to) the new end effector component (or the new end effector component to be brought into loading engagement with the corresponding component support portion of the surgical tool assembly) without human intervention beyond that which may be necessary to actuate the robotic system. However, in some cases, at least one new surgical end effector component can be loaded manually, or based at least in part on manual manipulations by a surgical nurse or other medical personnel.

A surgical end effector that can be reloaded using the described systems and methods can have any suitable configurations. In the example shown inFIG. 20, the surgical end effector2012includes an anvil2024, and an elongated channel2022configured to operably seat a staple cartridge2034b. It should be appreciated, however, that the elongated channel is shown by way of example only, as the described techniques can be used for reloading of an end effector including any component support portion configured to operably seat a staple cartridge.

For explanation purposes, new (unused) cartridges are designated herein as “2034a” and a spent cartridge is designated as “2034b,” as inFIG. 20. In some embodiments, the cartridges2034a,2034bcan be configured to be retained through a snap fit engagement (i.e., loading engagement) within the channel2022of a surgical end effector2012. However, as a person skilled in the art will appreciate, the described automated cartridge reloading system2000can be effectively employed in connection with the automated removal and installation of other cartridge arrangements.

In the “loading orientation,” a distal tip portion2035aof the a new surgical staple cartridge2034ais inserted into a corresponding support cavity2042in the new cartridge support section2010such that a proximal end portion2037aof the new surgical staple cartridge2034ais located in a convenient orientation for enabling a suitable component of the surgical robotic system to manipulate the surgical end effector2012into a position wherein the new cartridge2034acan be automatically loaded into the channel2022of the surgical end effector2012. In some embodiments, the base2002includes at least one sensor2044which communicates with a control system of a robotic controller of a suitable control system, such as the control system315of the user-side portion311ofFIG. 1.

As shown inFIG. 20, the base2002further includes a collection receptacle2020that is configured to collect spent cartridges2034bthat have been removed or disengaged from the surgical end effector2012that is operably attached to the surgical robotic system. In addition, in one form, the automated reloading system2000includes an extraction system2030for automatically removing the spent end effector component from the corresponding support portion of the end effector or manipulatable surgical tool assembly without specific human intervention beyond that which may be necessary to activate the surgical robotic system.

In some embodiments, the extraction system2030includes an extraction member2032. In one form, for example, the extraction member2032is rigidly supported on the base portion2002. The extraction member can have one or more suitable features (e.g., a hook or other feature, not shown inFIG. 20) configured to engage the distal end2035of a spent cartridge2034bwhen it is supported in the elongated channel2022of the surgical end effector2012. In various forms, the extraction member2032is conveniently located within a portion of the collection receptacle2020such that when the spent end effector component (cartridge2034b) is brought into extractive engagement with the extraction member2032, the spent end effector component (cartridge2034b) is dislodged from the corresponding component support portion (elongated channel2022), and falls into the collection receptacle2020. Thus, the manipulatable surgical tool assembly manipulates the end effector attached thereto to bring the distal end2035of the spent cartridge2034btherein into engagement with a suitable feature of the extraction member2032and then moves the end effector in such a way to dislodge the spent cartridge2034bfrom the elongated channel2022. It should be appreciated that the extraction member2032can have any other configuration. For example, it can be coupled to an extraction motor2048that is controlled by the controller of surgical robotic system.

In some embodiments, a sensor arrangement can be located adjacent to the extraction member2032. The sensor arrangement can comprise a sensor that is configured to sense the presence of the surgical end effector2012and, more particularly the tip2035bof the spent surgical staple cartridge2034bthereof as the distal tip portion2035bis brought into engagement with the extraction member2032. In some embodiments, the sensor arrangement can comprise, for example, a light curtain arrangement. However, other forms of proximity sensors can be employed additionally or alternatively. In such arrangement, when the surgical end effector2012with the spent surgical staple cartridge2034bis brought into extractive engagement with the extraction member2032, the sensor senses the distal tip2035bof the surgical staple cartridge2034b(e.g., the light curtain is broken). When the extraction member2032removes the surgical staple cartridge2034band the cartridge2034bfalls into the collection receptacle2020, the light curtain is again unbroken. A person skilled in the art will appreciate that any other sensor arrangements can also be employed to provide the robotic controller with an indication that the spent surgical staple cartridge2034bhas been removed from the surgical end effector2012.

After the spent surgical staple cartridge2034bhas been removed from the surgical end effector2012, the surgical end effector2012can be positioned to grasp a new surgical staple cartridge2034abetween the channel2022and the anvil2024. As shown inFIG. 20, each cavity2042has a corresponding upstanding pressure pad2046associated with it. The surgical end effector2012can be positioned such that the pressure pad2046is located between the new cartridge2034aand the anvil2024. Once in that position, the robotic system causes the anvil2024to close onto the pressure pad2046, which serves to push the new cartridge2034ainto snapping engagement with the channel2022of the surgical end effector2012. Once the new cartridge2034ahas been snapped into position within the elongated channel2022, the robotic system then withdraws the surgical end effector2012from the automated cartridge reloading system2000for use in connection with performing another surgical procedure.

It should be appreciated that the automated cartridge reloading system2000is shown inFIG. 20by way of example only, as automated cartridge reloading systems having other configurations can be used. Furthermore, in some embodiments, after a spent surgical staple cartridge (e.g., the spent surgical staple cartridge2034binFIG. 20) has been removed from an end effector (e.g., the end effector2012), the surgical system can cause the surgical end effector to be moved to a cleaning and drying station. An example of such cleaning and drying station2100is shown inFIG. 21. The cleaning and drying station2100can be controlled via a controller of the surgical robotic system, e.g., the control system315inFIG. 1, or any other control controller(s).

As shown inFIG. 21, the cleaning and drying station2100, which is configured to be connected to a power source via a wired connector2103, includes a base portion2102supporting thereon a cleaning portion or station2104and a drying portion or station2106. The base portion2102also includes a display2114configured to display information related to operating status of the base portion2102, such as information related to cleaning or drying jaws of an end effector. The display2114can include, or it can be associated, with one or more controls (e.g., buttons)2116that are configured to accept user instructions with respect to operation of the cleaning and drying station2100.

As further shown inFIG. 21, the cleaning station2104includes a bracket2118configured to removably hold a generally cylindrical container2120(e.g., a cap or other container). The bracket2118is coupled, via an arm2122, to a first panel2124of the drying station2106, as also shown inFIG. 21. However, it should be appreciated that the container2120, which can have various shapes, can be coupled to the base portion2102in any other way. The container2120is configured to hold therein a cleaning solution, such as, for example, a saline solution, or any other cleaning solution). In some embodiments, the base portion2102in proximity to the container2120can include one or more sensors configured to sense amount of fluid in the container2120. For example,FIG. 21shows by way of example a circular pressure sensor2130configure to sense amount of fluid in the container2120. When it is determined that the amount of fluid in the container2120is not sufficient or excessive, the controller can cause the display2114to display a respective indication, or it can be indicated in other manner that the amount of fluid in the container2120is above or below a required level.

Furthermore, the part of the base portion2102that forms the cleaning station2104includes one or more electromagnets (not shown) disposed in the area underneath the container2120, and the container2120includes a stirring element2132, such as a magnet. The electromagnets create a rotating magnetic field that causes the stirring element2132immersed in the solution disposed in the container2120to spin, thus stirring the solution.

An end effector operatively coupled to a shaft of a surgical tool assembly of the surgical robotic system (e.g., the end effector2012shown inFIG. 20, or any other end effector), can be brought to the cleaning station2104after the staple cartridge assembly has been removed from the end effector, as in the example ofFIG. 20.FIG. 21illustrates an end effector2110coupled to a shaft2108and having first and second jaws2112,2114. At least one of the jaws (in this example, the first jaw2112) is configured to replaceably seat a staple cartridge assembly. The surgical tool assembly having the end effector2110at a distal end of the shaft2108can be coupled to an electromechanical arm of the surgical robotic system, and the cleaning of the end effector2110, as well as the subsequent drying, can be performed automatically. As shown inFIG. 21, the shaft2108having the end effector2110coupled thereto has a trocar holding ring2134of a movable tool guide disposed therearound. The trocar holding ring2134can be similar, for example, to the distal end feature or ring1133of the movable tool guide1130shown inFIG. 11. The trocar holding ring2134, configured to engage with a trocar, can be part of a trocar holding member, a portion (e.g., arm)2137of which is shown inFIG. 21. The trocar holding member can be disengaged from the trocar for any number of reasons, including, as in this example, for replacing a staple cartridge assembly.

The cleaning station2104can be configured to communicate wirelessly with one or more components of the surgical robotic system. In this example, the trocar holding ring2134can include one or more sensors2136(e.g., Hall sensors or other proximity sensors) configured to communicate with one or more sensors2138(e.g., Hall sensors or other proximity sensors) disposed on the container2120. In this way, the cleaning station2104can determine, based on the information sensed by the sensors2138, that the shaft2108with the end effector2110is inserted into the container2120, using the trocar holding ring's sensors2136. It should be appreciated that two sensors2136on the trocar holding ring2134and one sensor2138disposed on the container2120are shown by way of example only, as any number of sensors of a suitable type can be employed. Also, although the sensor2138is shown to be disposed adjacent a rim of the container2120, it should be appreciated that one or more sensors2138can be disposed at other locations on the container2120, or at other locations at the cleaning station2104.

In use, the end effector2110is manipulated such that its jaws2112,2114are open using any of the techniques described above, and the end effector2110coupled to the shaft2108is immersed into the cleaning solution in the container2120. The cleaning station2104will then be activated, manually (e.g., via the control(s)2116) and/or automatically, to perform cleaning of the end effector2110. The stirring element2132immersed in the solution in the container2120is agitated and the solution thus swished is stirred to help clean the end effector2110. In this way, the cleaning station2104is used to get rid of unformed surgical staples that could have remained in the support portion (e.g., a channel) of the jaw2012, and to clean the jaw2012from dirt and other impurities in preparation for a new staple cartridge assembly.

The processing at the cleaning station2104can be performed for a certain duration of time, which can be monitored automatically or based on user input using a timer, including a timer build-in into the cleaning, based on an instruction received via the one or more controls2116, or in any other manner. The display2114can display information related to the cleaning process, including the timing information. In some embodiments, the display2114can be a touch-screen display that can be configured to receive user input setting a time of the cleaning process.

After the processing at the cleaning station2104is determined to be complete, the shaft2108with the end effector2110can be transported to the drying station2106. As shown inFIG. 22, the base2102at the drying station2106can have an air intake component2143with an air filter inside (not shown). The drying station2106can include a fan and a heater (not shown). Regardless of the specific components and their configuration, the drying station2106is configured to provide hot air. For example, as shown inFIG. 22, the end effector can be placed between the first and second panels2124,2126of the drying station2106that each are configured to expel hot air, schematically shown as2145, from its side facing another panel. The first and second panels2124,2126can have sensors2144,2146(e.g., Hall sensors or other proximity sensors) configured to communicate with the sensors2136on the trocar holding ring2134to detect presence of the end effector2110in proximity to the panels2124,2126. This detection can activate the drying station2106to perform the drying process. Additionally or alternatively, the drying process can be controlled via one or more of the controls2116.FIG. 22shows schematically that multiple openings, one of which is labeled as2140, on the side2142of the first panel2124blow hot air onto the end effector2110placed between the first and second panels2124,2126. In this example, the side2142of the first panel2124has ten openings2140, although any other number of the openings can be formed, or the first panel2124can have other features configured to expel hot air in the direction of the second panel2126. The second panel2126can have similar ten openings2142(as shown inFIG. 21), or any other features to expel hot air in the direction of the first panel2124. The panels2124,2126can be configured in the same or different ways to dry an end effector placed therebetween. In addition, it should be appreciated that the first and second panels2124,2126can have other shapes and configurations.

Similar to the cleaning process, the drying can be performed for a predetermined period of time which can be set automatically or in any other manner. For example, the control(s)2116can be used to receive input with respect to setting the time of the drying. The display2114can display information related to a progress of the drying process (e.g., a time remaining), or it can display any other information.

After it is determined that the process of drying the end effector2110is completed, the end effector2110can be loaded with a new staple cartridge assembly.FIG. 23, which illustrates a cross-sectional view of the surgical tool assembly2001ofFIG. 20, illustrates schematically the new staple cartridge assembly loading process. Components ofFIG. 23are described above in connection withFIG. 20and are therefore not described in detail in conjunction withFIG. 23. As shown inFIG. 23, the end effector2012is positioned to grasp a new surgical staple cartridge2034abetween the channel2022and the anvil2024. Specifically, each cavity2042has a corresponding upstanding pressure pad2046associated with it. The surgical end effector2012is located such that the pressure pad2046is located between the new cartridge2034aand the anvil2024. Once in that position, the surgical robotic system closes the anvil2024onto the pressure pad2046which serves to push the new cartridge2034ainto snapping engagement with the channel2022of the surgical end effector2012. Once the new cartridge2034ahas been snapped into position within the elongated channel2022, the robotic system then withdraws the surgical end effector2012from the automated cartridge reloading system2000for use in connection with performing another surgical procedure.

In some embodiments, at least one of the jaws of an end effector coupled to a shaft of a surgical tool assembly operably coupled to a robotic surgical system can be associated with a buttress. The buttress can be used for a variety of purposes, including for hemostasis, for promoting healing of a wound at the surgical site, and/or for multiple other purposes. If the buttress is to be loaded on one or both jaws of the end effector prior to deployment of the end effector during a surgical procedure, the end effector can be moved to a buttress loading station.

FIGS. 24 and 25illustrate an example of a buttress loading station2400that can be used to load an end effector with a buttress and to then verify whether the buttress has been properly placed. As shown inFIGS. 24 and 25, the buttress loading station2400, which is configured to be connected to a power source via a wired connector2403, includes a base portion2402having a display2414(e.g., an LCD or any other type of a display), and one or more controls2416. The buttress loading station2400includes a buttress loading portion2404and a buttress inspection portion2406, as also shown inFIGS. 24 and 25. The loading portion2404includes a cartridge holder2408having a plurality of buttress reload cartridges, two of which are labeled as buttress cartridges2410a,2410b. Other buttress cartridges have the same or similar configurations and features. In this example, the cartridge holder2408includes six buttress cartridges. It should be appreciated, however, that the cartridge holder can removably hold any other number of buttress cartridges, such as less or greater than six.

In the example illustrated, each buttress cartridge is shaped as an inverted “U,” with the straight edges between the base and arms of the “U.” For example, as shown for the buttress cartridge2410a, each of the buttress cartridges includes a base2420and arms2422a,2422bextending from opposite sides of the base. The arms2422a,2422bcan have a buttress removably held therebetween. For example, the buttress can be held within slots2425formed on inner walls of the arms2422a,2422bof the buttress cartridge buttress cartridge2410a. InFIG. 24, the buttress cartridge2410ais shown without the buttress, indicating that the buttress has been removed to be placed onto a jaw of the end effector, as discussed below. The buttress cartridge2410b, similar to the rest of the buttress cartridges in the holder2408, is shown to have a buttress2430held between its arm.

Each of the buttress cartridges can include a sensor configured to communicate with the buttress loading station2400. Thus, inFIG. 24, the buttress cartridge2410ais shown to include at least one sensor2412a(e.g., a Hall sensor or any other suitable type of a sensor) configured to communicate with one or more sensors associated with the buttress loading station2400. In this way, the buttress loading station2400can detect presence of buttress cartridges. Also, it can keep track of how many “unused” (i.e., having their buttress intact) and “used” (i.e., without buttresses) buttress cartridges are held by the holder2408. A type of the buttresses can also be sensed. This can be done additionally using other sensors disposed on the buttress cartridges, such as three sensors2432a,2432b,2432c(e.g., Hall sensors or any other suitable type of sensors) on the buttress cartridge2410a. It should be appreciated that the buttress cartridge can include other number of sensors (e.g., two or greater than three).

In use, as illustrated inFIG. 24, an end effector, such as the end effector2110coupled to the distal end of the shaft2108and also shown inFIGS. 20-22, is brought to the buttress loading portion2404of the buttress loading station2400and placed such that its jaws have a buttress2440removably held by the buttress cartridge2410ctherebetween. The jaws are then caused to close and engage the buttress2440such that the buttress2440becomes attached to the jaws of the end effector2110. Thus, as shown inFIG. 25, the buttress2440becomes attached to both channel2112having the staple cartridge assembly loaded therein and the anvil2114of the end effector2110.

The one of more sensors2136on the trocar holding ring2134of the movable tool guide that is disposed around the shaft2108can communicate with the sensors disposed on the buttress cartridge2410c(which can be the same or similar sensors to the sensors2432a,2432b,2432con the buttress cartridge2410a). In this way, the surgical robotic system can communicate wirelessly with the buttress loading station2400to exchange suitable information. Also, a relative position of the shaft2108with the end effector2110with respect to the buttress cartridge can be sensed. Furthermore, the sensors2136on the trocar holding ring2134can communicate wirelessly with the buttress loading station2400via suitable sensors on the station and/or other sensor(s) on the buttress (e.g., a sensor similar to the sensor2412aon the buttress cartridge2410a) to sense a status of the buttress cartridge and any other features.

The display2414can display information related to a status of the buttress currently in use (being loaded), a type of that buttress, and any other information. The controls2416can be used to control operation of the buttress loading station2400.

The described techniques can thus be used to engage the end effector with one or more piece of buttress to releasably attach the buttress to the end effector. The buttress can be attached to one or both of the cartridge body and the anvil of the end effector. The buttress can be configured to be attached to one or both jaws of the end effector using a pressure sensitive adhesive material disposed on one or both sides of the buttress. Thus, as in this example, where the buttress can attach to both jaws and is thus formed of two separate portions each being attached to a respective jaw, both portions of the buttress facing the jaw's opposed surfaces can have a pressure sensitive adhesive material disposed thereon. Thus, when the jaws of the end effector are closed upon the buttress disposed on the buttress cartridge such that pressure is applied to the buttress, the buttress becomes attached to the jaws. The entire buttress material carried by the buttress cartridge can be transferred onto the end effector, as in the example illustrated inFIGS. 24 and 25. Alternatively, a portion of the buttress material can be attached to the jaw(s) of the end effector.

The buttress can be formed from any suitable materials. For example, it can be formed from any absorbable polymer, such as, e.g., VICRYL®, or any other. The buttress can releasably incorporate therein various drugs and/or healing agents.

Once the end effector is loaded with the buttress, it can be moved from the buttress loading portion2404to the buttress inspection portion2406. Referring toFIG. 25, after the end effector2110has been loaded with the buttress2440as described above, such that the cartridge body2112includes a buttress portion2440aand the anvil2114includes a buttress portion2440b, it can be transported to the buttress inspection portion2406of the buttress loading station. The buttress inspection portion2406determines whether the buttress2440has been attached to the end effector's jaw properly. As shown inFIG. 25, the buttress inspection portion2406includes a compartment2450configured to removably seat an end effector therein. The compartment2450, shown partially in cross-section inFIG. 25, can be generally rectangular and configured to accept the end effector into a cavity2451formed therein, from the top. It should be appreciated, however, that the compartment2450can have any other configurations. The compartment2450can include two or more sensors2454a,2454b(e.g., Hall or other types) configured to communicate with the sensors2136on the trocar holding member2134such that the buttress inspection portion2406communicates with the surgical robotic system having the end effector2110operatively coupled thereto. The sensors2454a,2454bare also used to determine a proper positioning of the end effector2100within the compartment2450.

The buttress inspection portion2406can inspect a buttress attached to one or both jaws of the end effector in a number of different ways. In this example, the compartment2450houses one or more cameras2452configured to swipe across the surfaces of the jaws2112,2114to determine whether the buttress portions2440a,2440bare placed correctly on the jaws. Specifically, the camera2452can detect exposed anvil pockets and exposed cartridge pockets, and thus detect whether some areas of the surface of the end effector's jaws are not properly covered. The detection information, as well as any other information related to the status of the newly loaded buttress2440, can be displayed on the display2414. This information can also be communicated to the controller of the surgical robotic system. If it is determined that the buttress has not been attached properly to the jaw(s), the surgical robotic system can be notified accordingly and appropriate measures can be taken.

As discussed above, the controls2416can be used to operate the buttress inspection portion2406and its components, such as the camera2452, or any other components. The display2414can communicate with a controller of the surgical robotic system and can indicate to the system when the end effector2100having the staple cartridge and the buttress is ready to be used for a surgical procedure.

In should be appreciated that an end effector can be processed at the cleaning and drying station2100and the buttress loading station2500automatically, such that a robotic arm to which a surgical tool having the end effector is coupled can bring the shaft with the end effector to the stations2100,2500. Also, in some embodiments, some of the operations of the preparation of the end effector for use in a surgical procedure can be manual. For example, in embodiments where the shaft is modular, such shaft with an end effector can be manually brought to one or both the stations to prepare the end effector for surgical procedure.

Reuse

Typically, the device is sterilized. This can be done by any number of ways known to those skilled in the art including beta or gamma radiation, ethylene oxide, steam, and a liquid bath (e.g., cold soak). An exemplary embodiment of sterilizing a device including internal circuitry is described in more detail in U.S. Pat. Pub. No. 2009/0202387 filed Feb. 8, 2008 and entitled “System And Method Of Sterilizing An Implantable Medical Device.” It is preferred that device, if implanted, is hermetically sealed. This can be done by any number of ways known to those skilled in the art.