Robotic surgical devices, systems, and related methods

The embodiments disclosed herein relate to various medical device components, including components that can be incorporated into robotic and/or in vivo medical devices. Certain embodiments include various modular medical devices for in vivo medical procedures.

TECHNICAL FIELD

The embodiments disclosed herein relate to various medical devices and related components, including robotic and/or in vivo medical devices and related components. Certain embodiments include various robotic medical devices, including robotic devices that are disposed within a body cavity and positioned using a support component disposed through an orifice or opening in the body cavity. Further embodiment relate to methods of operating the above devices.

BACKGROUND

Invasive surgical procedures are essential for addressing various medical conditions. When possible, minimally invasive procedures such as laparoscopy are preferred.

However, known minimally invasive technologies such as laparoscopy are limited in scope and complexity due in part to 1) mobility restrictions resulting from using rigid tools inserted through access ports, and 2) limited visual feedback. Known robotic systems such as the da Vinci® Surgical System (available from Intuitive Surgical, Inc., located in Sunnyvale, Calif.) are also restricted by the access ports, as well as having the additional disadvantages of being very large, very expensive, unavailable in most hospitals, and having limited sensory and mobility capabilities.

There is a need in the art for improved surgical methods, systems, and devices.

DETAILED DESCRIPTION

The various systems and devices disclosed herein relate to devices for use in medical procedures and systems. More specifically, various embodiments relate to various medical devices, including robotic devices and related methods and systems. Certain implementations relate to such devices for use in laparo-endoscopic single-site (LESS) surgical procedures.

It is understood that the various embodiments of robotic devices and related methods and systems disclosed herein can be incorporated into or used with any other known medical devices, systems, and methods. It is understood that the various embodiments of robotic devices and related methods and systems disclosed herein can be incorporated into or used with any other known medical devices, systems, and methods. For example, the various embodiments disclosed herein may be incorporated into or used with any of the medical devices and systems disclosed in copending U.S. application Ser. No. 11/766,683 (filed on Jun. 21, 2007 and entitled “Magnetically Coupleable Robotic Devices and Related Methods”), Ser. No. 11/766,720 (filed on Jun. 21, 2007 and entitled “Magnetically Coupleable Surgical Robotic Devices and Related Methods”), Ser. No. 11/966,741 (filed on Dec. 28, 2007 and entitled “Methods, Systems, and Devices for Surgical Visualization and Device Manipulation”), 61/030,588 (filed on Feb. 22, 2008), Ser. No. 12/192,663 (filed Aug. 15, 2008 and entitled Medical Inflation, Attachment, and Delivery Devices and Related Methods”), Ser. No. 12/192,779 (filed on Aug. 15, 2008 and entitled “Modular and Cooperative Medical Devices and Related Systems and Methods”), 61/640,879 (filed on May 1, 2012), Ser. No. 13/493,725 (filed Jun. 11, 2012 and entitled “Methods, Systems, and Devices Relating to Surgical End Effectors”), Ser. No. 13/546,831 (filed Jul. 11, 2012 and entitled “Robotic Surgical Devices, Systems, and Related Methods”), 61/680,809 (filed Aug. 8, 2012), Ser. No. 13/573,849 (filed Oct. 9, 2012 and entitled “Robotic Surgical Devices, Systems, and Related Methods”), and Ser. No. 13/738,706 (filed Jan. 10, 2013 and entitled “Methods, Systems, and Devices for Surgical Access and Insertion”), and U.S. Pat. No. 7,492,116 (filed on Apr. 3, 2007 and entitled “Robot for Surgical Applications”), U.S. Pat. No. 7,772,796 (filed on Nov. 29, 2007 and entitled “Robot for Surgical Applications”), U.S. Pat. No. 8,179,073 (issued May 15, 2012, and entitled “Robotic Devices with Agent Delivery Components and Related Methods”), U.S. Pat. No. 8,343,171 (filed on Jul. 11, 2008 and entitled “Methods and Systems of Actuation in Robotic Devices”), and U.S. Pat. No. 8,679,096 (filed Nov. 26, 2008 and entitled “Multifunctional Operational Component for Robotic Devices”), all of which are hereby incorporated herein by reference in their entireties.

Certain device and system implementations disclosed in the applications listed above can be positioned within a body cavity of a patient in combination with a support component similar to those disclosed herein. An “in vivo device” as used herein means any device that can be positioned, operated, or controlled at least in part by a user while being positioned within a body cavity of a patient, including any device that is coupled to a support component such as a rod or other such component that is disposed through an opening or orifice of the body cavity, also including any device positioned substantially against or adjacent to a wall of a body cavity of a patient, further including any such device that is internally actuated (having no external source of motive force), and additionally including any device that may be used laparoscopically or endoscopically during a surgical procedure. As used herein, the terms “robot,” and “robotic device” shall refer to any device that can perform a task either automatically or in response to a command from an external console or control system, as has been described previously.

Certain embodiments provide for insertion of the present invention into the cavity while maintaining sufficient insufflation of the cavity. Further embodiments minimize the physical contact of the surgeon or surgical users with the present invention during the insertion process. Other implementations enhance the safety of the insertion process for the patient and the present invention. For example, some embodiments provide visualization of the present invention as it is being inserted into the patient's cavity to ensure that no damaging contact occurs between the system/device and the patient. In addition, certain embodiments allow for minimization of the incision size/length. Further implementations reduce the complexity of the access/insertion procedure and/or the steps required for the procedure. Other embodiments relate to devices that have minimal profiles, minimal size, or are generally minimal in function and appearance to enhance ease of handling and use.

Certain implementations disclosed herein relate to “combination” or “modular” medical devices that can be assembled in a variety of configurations. For purposes of this application, both “combination device” and “modular device” shall mean any medical device having modular or interchangeable components that can be arranged in a variety of different configurations. The modular components and combination devices disclosed herein also include segmented triangular or quadrangular-shaped combination devices. These devices, which are made up of modular components (also referred to herein as “segments”) that are connected to create the triangular or quadrangular configuration, can provide leverage and/or stability during use while also providing for substantial payload space within the device that can be used for larger components or more operational components. As with the various combination devices disclosed and discussed above, according to one embodiment these triangular or quadrangular devices can be positioned inside the body cavity of a patient in the same fashion as those devices discussed and disclosed above.

As shown generally inFIGS. 1A, 1B, 1C, and 1D, certain exemplary embodiments relate to a device10having a body12with two arms14A,14B operably coupled thereto. The body12as shown further comprises a casing30. The body12is also referred to as a “device body.” Each arm14A,14B has a first coupling link16A,16B that couples the arm14A,14B to the body12.

As is best shown inFIGS. 1B-1C, this first coupling link16A,16B can also be referred to herein as a “first coupling component” or “shoulder link” and is part of the first rotatable joint24A,24B (also referred to herein as the “shoulder joint”). Each arm14A,14B has an upper arm (also referred to herein as an “inner arm,” “inner arm assembly,” “inner link,” “inner link assembly,” “upper arm assembly,” “first link,” or “first link assembly”)18A,18B, and a forearm (also referred to herein as an “outer arm,” “outer arm assembly,” “outer link,” “outer link assembly,” “forearm assembly,” “second link,” or “second link assembly”)20A,20B.

As is shown inFIGS. 1A-1Cand further discussed in relation toFIGS. 12-17below, the upper arms18A,18B are rotatably coupled to the coupling links16A,16B, which are rotatably coupled to the body12. Each arm14A,14B has a second coupling link22A,22B that couples the upper arm18A,18B to the forearm20A,20B. This second coupling link22A,22B can also be referred to herein as a “second coupling component” or “elbow link” and is part of the second rotatable joint26A,26B (also referred to herein as the “elbow joint”). More specifically, in the right arm14A, the upper arm18A is rotatably coupled to the forearm20A at the elbow joint26A via the elbow link22A, while in the left arm14B, the upper arm18B is rotatably coupled to the forearm20B at the elbow joint26B via elbow link22B.

As shown, each of the arms14A,14B also has an end effector28A,28B operably coupled to the distal end of the forearm20A,20B. An end effector can also be referred to herein as an “operational component.”

In one implementation, each of the arms14A,14B has six degrees of freedom. That is, as explained in further detail below, each arm14A,14B has three degrees of freedom at the shoulder, one degree of freedom at the elbow, and two degrees of freedom at the end effector (which can be rotated—end effector roll—and opened/closed). As such, the six degrees of freedom of each arm14A,14B are analogous to the degrees of freedom of a human arm, which also has three degrees of freedom at the shoulder and one at the elbow. One advantage of an arm having four degrees of freedom (with an end effector having two degrees of freedom) is that the end effector can have multiple orientations at the same Cartesian point. This added dexterity allows the surgeon or other user more freedom and a more intuitive sense of control while operating the device.

The internal components of the body12are depicted in the various embodiments shown inFIGS. 2A, 2B, 2C, 2D, and 2E. The body12is shown in these figures without its casing30. More specifically, these figures depict the right half of the body12and the internal components that control/actuate the right arm14A. It is to be understood that the internal components in the left half (not shown) that operate/control/actuate the left arm14B are substantially the same as those depicted and described herein and that the descriptions provided below apply equally to those components as well.

FIGS. 2A, 2B, and 2Cinclude the internal structural or support components of the body12. In one implementation, the body12has an internal top cap40, an internal support rod42, and an internal support chassis44, as shown. The support rod42couples the top cap40to the support chassis44. In certain embodiments, the support chassis comprises an aluminum structure. In alternate embodiments, an injection-molded polymer may be used. These components maintain the structure of the body12and provide structural support for the components disposed therein, and in certain embodiments are surrounded by a housing or shell. According to one embodiment, the internal top cap40defines three partial lumens46A,46B,46C as best shown inFIG. 2C. The top cap40couples to the body casing30such that each of the partial lumens46A,46B,46C is formed into a full lumen defined by the coupling of the cap40and casing30. As will be described in further detail below, these lumens46A,46B,46C can be configured to receive various wires, cords, or other components to be inserted into or through the body12.

In contrast toFIGS. 2A-2C,FIG. 2Ddepicts the internal actuation and control components of the right half of the body12with the internal structural or support components hidden in order to better display the internal actuation and control components. These internal actuation and control components are configured to provide two degrees of freedom at the shoulder joint24A.

FIG. 2Eis an enlarged view of the distal end of the body12. In one embodiment, certain of the internal components depicted inFIGS. 2D and 2Eare configured to actuate rotation at the shoulder joint24A around axis A (as best shown inFIG. 2B), which is parallel to the longitudinal axis of the body12. This rotation around axis A is also referred to as “yaw” or “shoulder yaw.” The rotation, in one aspect, is created as follows. An actuator60is provided that is, in this implementation, a motor assembly60. The motor assembly60is operably coupled to the proximal motor gear62, which is coupled to the proximal driven gear64such that rotation of the proximal motor gear62causes rotation of the proximal driven gear64. The proximal driven gear64is fixedly coupled to a proximal transmission shaft66, which has a distal transmission gear68at the opposite end of the shaft66. The distal transmission gear68is coupled to a distal driven gear70, which is fixedly coupled to the distal transmission shaft72. A magnet holder76containing a magnet is also operably coupled to the distal transmission gear68. The holder76and magnet are operably coupled to a magnetic encoder (not shown).

It is understood that the magnet holder76, magnet, and magnetic encoder (and those similar components as discussed elsewhere herein in relation to other joints) are components of an absolute position sensor that is the same as or substantially similar to one or more of the absolute position sensors disclosed in U.S. application Ser. No. 13/573,849 filed Oct. 9, 2012, and Ser. No. 13/833,605 filed Mar. 15, 2013, which are hereby incorporated by reference in their entirety. The distal transmission shaft72is fixedly coupled at its distal end to a rotatable pitch housing74(as best shown inFIGS. 2B and 2E) such that rotation of the distal driven gear70causes rotation of the shaft72and thus rotation of the housing74around axis A as shown inFIG. 2B.

According to one implementation, certain other internal components depicted inFIG. 2Dare configured to actuate rotation at the shoulder joint24A around axis B (as best shown inFIG. 2D), which is perpendicular to the longitudinal axis of the body12. This rotation around axis B is also referred to as “pitch” or “shoulder pitch.” The rotation, in one embodiment, is created as follows. An actuator80is provided that is, in this implementation, a proximal shoulder motor assembly80. The motor assembly80is operably coupled to a proximal shoulder motor gear82, which is coupled to the proximal shoulder driven gear84such that rotation of the proximal shoulder motor gear82causes rotation of the proximal shoulder driven gear84. This driven gear84is fixedly coupled to a proximal shoulder transmission shaft86, which has a proximal shoulder transmission gear88at the opposite end of the shaft86.

The proximal transmission gear88is coupled to a distal shoulder driven gear90, which is fixedly coupled to the distal shoulder shaft92. A magnet holder98containing a magnet is also operably coupled to the driven gear90. The holder98and magnet are operably coupled to a magnetic encoder (not shown). As best shown inFIG. 2E, a portion of the distal shoulder shaft92is disposed within the lumen72A of the shaft72described above and extends out of the distal end of the shaft72into the housing74. As best shown inFIG. 2E, the distal end of the shaft92is coupled to a rotation gear94that is a bevel gear94. The rotation gear94is operably coupled to link gear96, which is also a bevel gear96according to one implementation. The link gear96is operably coupled to the shoulder link16A (discussed above) such that rotation of the shaft92causes rotation of the rotation gear94and thereby the rotation of the link gear96and thus rotation of the link16A around axis B as best shown inFIG. 2D.

In this embodiment, the two axes of rotation are coupled. That is, if solely rotation around axis A (pure yaw) is desired, then the “pitch drive train” (the motor80and all coupled gears and components required to achieve rotation around axis B) must match the speed of the “yaw drive train” (the motor60and all coupled gears and components required to achieve rotation around axis A) such that there is no relative angular displacement between the pitch housing74and the rotation gear94. In contrast, if solely rotation around axis B (pure pitch) is desired, then the yaw drive train must hold position while the pitch drive train is actuated.

In one implementation as shown inFIG. 2A, the body12has a rigid-flex PCB100positioned in the body. The PCB100is operably coupled to and communicates with the motors60,80and magnetic encoders (not shown) to perform the yaw and pitch functions.

According to another embodiment, at least one connection component is associated with the body12. More specifically, in this implementation, a power/communication line102and a cautery power line104are coupled at their proximal ends to one or more external power sources (not shown) and extend into the device10through one or more of the three lumens46A,46B,46C defined partially by internal top cap40. The lines102,104extend through the body12and exit as shown inFIG. 2Band extend to the upper arm segment. In certain embodiments, the lines102,104are not continuous, but occur in series. In certain of these embodiments, the lines contain terminus at various PCB boards. In yet further embodiments of the lines may run in parallel.

In one embodiment, the body12can be coupled at its proximal end to a positioning rod (also referred to as an “insertion rod”) (not shown). It is understood that the positioning rod can be any such known component for helping to position the device10and/or maintain and stabilize the position of the device10. According to one implementation, the power/communication line102and/or the cautery power line104can extend proximally through one or more lumens in the positioning rod.

In one embodiment, any of the motors discussed and depicted herein can be brush or brushless motors, such as brushless DC motors. Further, the motors can be, for example, 6 mm, 8 mm, or 10 mm diameter motors. Alternatively, any known size that can be integrated into a medical device can be used. In a further alternative, the actuators can be any known actuators used in medical devices to actuate movement or action of a component. Examples of motors that could be used for the motors described herein include the EC 10 BLDC+GP10A Planetary Gearhead, EC 8 BLDC+GP8A Planetary Gearhead, or EC 6 BLDC+GP6A Planetary Gearhead, all of which are commercially available from Maxon Motors, located in Fall River, Mass.

FIGS. 3A, 3B, 3C, 3D, 3E, 4A, 4B, 4C, 4D, and 4Eaccording to one embodiment, depict the internal components of the right upper arm18A, which is shown in these figures without its casing. More specifically, these figures depict the right arm14A and the internal components therein. It is understood that the internal components in the left upper arm18B are substantially the same as those depicted and described herein and that the descriptions provided below apply equally to those components as well.

FIGS. 3A-3Edepict the internal components of the right upper arm18A, including actuators, drive components, and electronics, with the internal structural or support components hidden in order to better display the internal components. In contrast toFIGS. 3A-3E,FIGS. 4A-4Einclude both the internal actuator, drive, and electronics components, but also the internal structural or support components of the right upper arm18A.

In one embodiment, certain of the internal components depicted inFIGS. 3A-3Eare configured to actuate rotation at the shoulder link16A around axis C (as best shown inFIG. 3B), which is parallel to the longitudinal axis of the right upper arm18A. This rotation around axis C is also referred to as “shoulder roll.” The rotation, in one aspect, is created as follows: a first shoulder actuator120is provided that is, in this implementation, a motor assembly120. This motor assembly120is operably coupled to a first shoulder motor gear122. This motor gear122is supported by a first shoulder bearing pair124. This motor gear122is coupled to the shoulder driven gear126such that rotation of the first shoulder motor gear122causes rotation of the driven gear126. The driven gear126is fixedly coupled to the shoulder link16A such that rotation of the driven gear126causes rotation of the shoulder link16A around axis C as shown inFIG. 3B. The driven gear126is supported by a second bearing pair128. A magnet holder130further comprising a magnet is also operably coupled to the driven gear126. The holder130and magnet are operably coupled to a magnetic encoder132.

The rotation of the shoulder link16A around axis C causes the right upper arm18A (and thus the forearm20A) to rotate in relation to the body12. According to one embodiment, this rotation adds an additional degree of freedom not provided in prior two-armed surgical devices.

According to one implementation, certain of the internal components depicted inFIGS. 3A-3Eare configured to actuate rotation at the elbow link22A around axis D (as best shown inFIG. 3C), which is perpendicular to the longitudinal axis of the right upper arm18A. This rotation around axis D is also referred to as “elbow yaw.” The rotation, in one aspect, is created as follows. An actuator140is provided that is, in this implementation, a second upper arm motor assembly140. This motor assembly140is operably coupled to the second upper arm motor gear142, which is a beveled gear in this embodiment. This motor gear142is supported by a bearing144. The motor gear142is coupled to the driven gear146such that rotation of the motor gear142causes rotation of the driven gear146. The driven gear146is fixedly coupled to a link gear148, which is coupled to the gear teeth158(as best shown inFIG. 3B) of the elbow link22A such that rotation of the driven gear146causes rotation of the elbow link22A around axis D as shown inFIG. 3C. The driven gear146and link gear148are supported by a bearing pair150. Further, the elbow link22A is supported by a bearing pair152. A magnet holder154containing a magnet is also operably coupled to the elbow link22A. The holder154and magnet are operably coupled to a magnetic encoder156.

According to one embodiment, the additional coupling of the link (or mesh) gear148and the elbow link22A can provide certain advantages, including an additional external reduction (because the gear148has fewer gear teeth than the elbow link22A), shortening of the upper arm18A and improved joint range of motion. In various embodiments, as with the embodiment shown inFIGS. 4A-E, the robotic devices represent an improvement in range of motion of the elbow joint by reducing the relative distance between the center of the rotational center of the elbow link22A and the desired direction of travel and preventing physical impediment (as is depicted by arrow A inFIG. 2B).

As shown inFIG. 4B, the upper arm18A can have a rigid-flex PCB160positioned therein. In one embodiment, the PCB160is operably coupled to and communicate with the actuators120,140and magnetic encoders132,156.

According to another embodiment, at least one connection component is associated with the upper arm18A. More specifically, in this implementation, the power/communication line102and the cautery power line104enter through a port (not shown) at the proximal end of the upper arm18A and exit through a port (not shown) at the distal end.

FIGS. 5A-9Bdepict various embodiments of a right forearm20A. The various implementations disclosed and depicted herein include the actuators, drive components, and electronics that can be used to accomplish both tool roll and tool drive (open/close action), as will be described in further detail below. As set forth below, the forearm20A also has two electrically isolated cautery circuits, enabling both bipolar and monopolar cautery end effectors. Certain embodiments are configured to allow for easy removal and replacement of an end effector (a “quick change” configuration). Further embodiments contain sealing elements that help to prevent fluid ingress into the mechanism.

According to one implementation, certain of the internal components depicted inFIGS. 5A-5Care configured to actuate rotation at the end effector28A around axis E (as best shown inFIG. 5B), which is parallel to the longitudinal axis of the right forearm20A. This rotation around axis E is also referred to as “tool roll.” The rotation, in one aspect, is created as follows. An actuator180is provided that is, in this implementation, a motor assembly180. The motor assembly180is operably coupled to the motor gear182, which is a spur gear in this embodiment. The motor gear182is coupled to the driven gear184such that rotation of the motor gear182causes rotation of the driven gear184. The driven gear184is fixedly coupled to the roll hub186, which is supported by a bearing188. The roll hub186is fixedly coupled to the tool base interface190, which has external threads190A which are threadably coupled to the end effector28A. Thus, rotation of the driven gear184causes rotation of the roll hub186, which causes rotation of the tool base interface190, which causes rotation of the end effector28A around axis E as shown inFIG. 5B.

In one embodiment, certain of the internal components depicted inFIGS. 5A-5Care configured to actuate the end effector to open and close. This rotation of the end effector arms such that the end effector opens and closes is also called “tool drive.” The actuation, in one aspect, is created as follows. An actuator200is provided that is, in this implementation, a motor assembly200. The motor assembly200is operably coupled to the motor gear202, which is a spur gear in this embodiment. The motor gear202is coupled to the driven gear204such that rotation of the motor gear202causes rotation of the driven gear204. The driven gear204is fixedly coupled to a tool drive nut206, which is supported by a bearing pair208. The tool drive nut206has a threaded inner lumen206A, and this threaded inner lumen206A is threadably coupled to the lead screw210. More specifically, the outer threads of the lead screw210are threadably coupled to the threads on the inner lumen206A. The lead screw210is rotationally coupled to the tool base interface190(discussed above). More specifically, the tool base interface190has a square-shaped inner lumen190A, and the distal end of the lead screw210has a square-shaped protrusion that fits within the inner lumen190A, thereby coupling with the tool base interface190. The distal end of the lead screw210can move translationally within the lumen190A, but cannot rotate in relation to the tool base interface190, so the lead screw210can move translationally in relation to the tool base interface190, but cannot rotate in relation thereto.

The lead screw210also has an insulating sleeve212disposed to an external portion of the lead screw210and thereby plays a role in maintaining separate electrical cautery channels as will be described below. Further, the lead screw210has a threaded inner lumen210A, which is threadably coupled to the tool pin214. The tool pin214is operationally coupled to a known linkage mechanism within the end effector28A such that translation of the tool pin214causes the grasper arms or blades to open and close. As such, actuation of gear202causes rotation of the driven gear204, which rotates the tool drive nut206. The rotation of the tool drive nut206causes the lead screw210to translate as a result of the threadable coupling of the nut206and the screw210. The translation of the screw210causes the tool pin214to translate, thereby causing the end effector28A arms or blades to open and close.

In this embodiment, these two axes of rotation are coupled. That is, if pure roll is desired, then the tool open/close drive train must match the speed of the roll train such that there is no relative angular displacement between the tool drive nut206and the tool base interface190.

According to one implementation, the end effector28A can be quickly and easily coupled to and uncoupled from the forearm20A in the following fashion. With both the roll and drive axes fixed or held in position, the end effector28A can be rotated, thereby coupling or uncoupling the threads190A and210A. That is, if the end effector28A is rotated in one direction, the end effector28A is coupled to the forearm20A, and if it is rotated in the other direction, the end effector28A is uncoupled from the forearm20A.

In accordance with one embodiment, the forearm20A has two independent cautery channels (referred to herein as “channel A” and “channel B”), which enables the use of either bipolar or monopolar cautery end effectors with this forearm20A.

Turning toFIG. 6A, the channel A components of certain exemplary embodiments are set forth in the forearm20A as shown. A PCB220is electrically coupled to lead A of a cautery power line (such as cautery line104discussed above) that is coupled to an external power source, such as a cautery generator. The PCB220is further electrically coupled to a pin222, which is electrically coupled to socket224(defined in or coupled—electrically and mechanically—to a proximal end of the lead screw210discussed above) and is slidably positioned within the socket224. The lead screw210is coupled electrically and mechanically to the end effector pin214as best shown inFIG. 5C. As such, energizing lead A in the cautery line104energizes channel A in the bipolar cautery end effector28A. Certain embodiments of the forearm further comprise at least one insulator225.

As shown inFIGS. 6B and 7, the channel B components are set forth in the forearm20A as shown. The PCB220discussed above is also electrically coupled to lead B of a cautery power line (such as cautery line104discussed above) that is coupled to an external power source. The PCB220is further electrically coupled to a conducting rod240, which is electrically coupled to a wiper242. The wiper242is a tensioned component that supported on one end by a mechanical strut244. An insulating insert246is positioned between the wiper242and the mechanical strut244. At its free end, the wiper242is supported by a preloader248. Based on this configuration, the wiper242is loaded or urged—like a leaf spring—against the tool base interface190(discussed above) and thus becomes electrically coupled to the tool base interface190. The tool base interface190is mechanically coupled to the end effector28A and electrically coupled to channel B of that end effector28A. As such, energizing lead B in the cautery line104energizes channel B in the bipolar cautery end effector28A. In exemplary embodiments, the channel A components are electrically isolated from the channel B components, and both channels are electrically isolated from the chassis to enhance patient safety.

In one implementation, the forearm20A has at least one fluidic seal interface that helps to prevent fluid ingress into the forearm20A. One such mechanism is a monolithic single-piece housing260as depicted inFIGS. 9A and 9Baccording to one embodiment. The one-piece nature of the housing260greatly reduces the number of interfaces that must be sealed and thus reduces the number of interfaces where fluidic leaks are more likely to occur. The housing260is configured to slide over the internal components of the forearm20A. That is, the proximal end of the housing260defines an opening that can be positioned over the forearm20A (or the forearm20A is inserted into the lumen) until the housing260is correctly positioned over the forearm20A. As best shown inFIG. 9B, the housing260can have an O-ring262positioned in a groove defined in the housing260around the hole264defined in the distal end of the housing260. The hole264is configured to receive the end effector28A, which in certain embodiments is the distal end of the roll hub186. In one embodiment, the roll hub186(discussed above) is positioned through the hole264such that the O-ring262is configured to be preloaded against that roll hub186, thereby forming a fluidic seal between the housing260and the external surface of the hub186, which in certain embodiments may further comprise a stainless steel ring to enhance the seal.

In a further embodiment as shown inFIG. 8A, the forearm20A has two grooves270,272defined in the external portion of the forearm housing260(as described above). The grooves270,272can be configured to provide an attachment point for an outer barrier (such as the first barrier300described in further detail below) such that an elastic band defined in the opening of the sleeve of the inner barrier300can be positioned in the grooves270,272, thereby enhancing the coupling of the barrier300to the housing260and thus enhancing the fluidic seal. In one embodiment, the grooves270,272encircle the entire forearm housing260. Alternatively, the first barrier300can be bonded to the housing260via an adhesive or welding. In a further alternative, the housing260and the first barrier300can be fabricated as a single piece.

According to another implementation as shown inFIG. 8A, the forearm20A housing260can have a groove280defined in the housing260around the hole282in the housing260through which the end effector28A is positioned. The groove280can be configured to provide an attachment point for an outer barrier (such as the outer barrier310described in further detail below) such that an elastic band defined in the opening of the sleeve of the second barrier310can be positioned in the grooves270,272, thereby enhancing the coupling of the second barrier310to the housing260and thus enhancing the fluidic seal.

As shown inFIG. 8B, another fluidic seal can be provided according to another embodiment in the form of a flexible membrane290that is attached at one end to the lead screw210(discussed above) and at the other end to the tool base interface190(discussed above). More specifically, the membrane290is coupled to the lead screw210at the O-ring292and is coupled to the tool base interface190at the groove292. In one embodiment, the membrane290is retained at the groove292with an attachment mechanism such as a cinch (not shown). This membrane290serves to provide a fluidic seal for the internal components of the forearm20A against any external fluids. In one implementation, the seal is maintained whether the end effector28A is coupled to the forearm20A or not. Alternatively, the membrane290can be replaced with a metallic bellows.

Additional fluidic seals can be provided according to certain embodiments as depicted inFIGS. 10A and 10B. As shown inFIGS. 10A and 10B, the device10can have two fluidically sealed barriers protecting each of the device arms14A,14B. The first barrier (also referred to herein as an “inner barrier”)300is shown inFIG. 10A, in which it is positioned around each arm and coupled at the sleeve ends302A,302B to the device body12via elastic components304A,304B that urge the openings in the sleeve ends302A,302B, thereby enhancing the fluidic seal. In the embodiment as shown, the elastic components304A,304B are positioned around the forearms of the arms14A at the distal ends of the forearms. Alternatively as described in detail above with respect toFIG. 8A, the elastic components304A,304B can be positioned in grooves defined in the forearms (such as grooves270,272described above).

In one embodiment, the inner barrier300is a membrane that is permanently bonded to the device10and is not removed for the entire operational life of the device10. The barrier300is sterilized with the device10.

The second barrier (also referred to herein as an “outer barrier”)310is shown inFIG. 10B, in which is positioned around each arm14A,14B, over the inner barrier300discussed above, and coupled at the sleeve ends312A,312B to the device body12via elastic components314A,314B that urge the openings at the sleeve ends312A,312B against the arms14A,14B, thereby enhancing the fluid seal.

FIGS. 11A and 11Bdepict one embodiment of a rigid-flex PCB component320that can be used as the PCB component within the device embodiments described above. It is understood that the rigid-flex assembly is a known fabrication method. In one embodiment, the PCB component320that has been assembled using a known fabrication method, but is custom designed and fabricated.

In use as shown inFIGS. 12A-17D, the device embodiments disclosed and contemplated herein are configured to have a consistent cross-section and minimal profile, thereby enhancing the ease of inserting the device through an incision and into a patient's cavity. Further, in one embodiment, the device10can be inserted via a specific set of steps that maintain the minimal profile and consistent cross-section in an optimal fashion. As shown inFIG. 12, the device10is being prepared to be inserted through the incision330and into the cavity340. Note that the arms14A,14B of the device10are straight. InFIG. 13, the device10is inserted such that the forearms20A,20B are positioned in the cavity340. As shown inFIG. 14, the forearms20A,20B can then be rotated as shown to maximize the amount of the device10that can be inserted. As the insertion continues as shown inFIG. 15, the upper arms18A,18B are also rotated to optimize the surgical space. At this point, the arms14A,14B can be moved into their operational position, first by urging them to move in opposite directions as shown inFIG. 16.

Finally, the arms14A,14B are rotated so that the elbows are projecting outward inFIG. 17, thereby moving the arms14A,14B into their preferred operational position. In exemplary embodiments, the device may be rotated and/or tilted inside the patient relative to the initial insert position, so as to provide the user with access to all four quadrants from the single insertion. Further, as is apparent from the insertion of the device depicted inFIGS. 12A-17D, the arms of the device are inserted in parallel, rather than sequentially, as had been the case in prior surgical robotic devices.

In one implementation, the device10has at least one camera that is used in conjunction with the device10. For example, a camera (not shown) such as a camera having two degrees of freedom (a pan-and-tilt camera) having digital zoom could be used. In one embodiment, it is inserted through the camera lumen32defined in the proximal end of the device body12as best shown inFIG. 1C. According to one implementation, the camera can be controlled by the user or surgeon using a foot controller and would be easy to remove, clean, and re-insert during a procedure. In another embodiment, the camera can be a standard laparoscope inserted through the same incision, through the lumen32, or through a different incision.