Robotic Arm With Hybrid Actuation Assemblies And Related Devices, Systems, And Methods

Robotic arms, and devices with such arms, having any combination of gear-driven actuator assemblies and cable-driven actuator assemblies, with some arm or device embodiments having solely gear-driven assemblies, some having solely cable-driven assemblies, and others having a combination of at least one of each. Further embodiments relate to arms or devices having one or more actuation assemblies with an actuator is disposed remotely (in a different component of the device—or even external to the device) in relation to the actuable component to which it is coupled.

FIELD

The embodiments disclosed herein relate to various medical devices and related components that can make up a surgical system, 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 body or support component disposed through an orifice or opening in the body cavity. Other embodiments relate to various systems that have a robotic surgical device and a controller.

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.

BRIEF SUMMARY

Discussed herein are various robotic arms that can be actuated by any combination of gear-driven actuator assemblies and cable-driven actuator assemblies, with some embodiments having solely gear-driven assemblies, some having solely cable-driven assemblies, and others having a combination of at least one of each. Further implementations herein relate to various such actuation assemblies in which the actuator is disposed remotely (in a different component of the device—or event external to the device—in relation to the actuable component to which it is coupled), and to devices having at least one such remotely positioned actuation assembly. Other embodiments relate to robotic devices and/or robotic surgical systems having any of the various actuation assembly implementations described herein.

In Example 1, a robotic device comprises an elongate body and a robotic arm operably coupled to the elongate body. The robotic arm comprises an upper arm segment, a forearm segment operably coupled to the upper arm segment, and at least two actuable components associated with the robotic arm. The device further comprises a first cable-driven actuation assembly comprising a first actuator disposed within one of the elongate body, the upper arm segment, and the forearm segment or external to the device, and a motive force transfer cable operably coupled to the first actuator and a first of the at least two actuable components. In addition, the device comprises a first gear-driven actuation assembly comprising a second actuator disposed within one of the elongate body, the upper arm segment, and the forearm segment or external to the device, and at least one gear operably coupled to the second actuator and a second of the at least two actuable components.

Example 2 relates to the robotic device according to Example 1, wherein the motive force transfer cable is a rotary force transfer cable.

Example 3 relates to the robotic device according to Example 1, wherein the motive force transfer cable is a lateral force transfer cable.

Example 4 relates to the robotic device according to Example 3, wherein the lateral force transfer cable comprises a single lateral push/pull cable or two lateral pull cables.

Example 5 relates to the robotic device according to Example 1, wherein the first of the at least two actuable components comprises actuable end effector grasper arms, and wherein the second of the at least two actuable components comprises a rotatable end effector grasper body.

Example 6 relates to the robotic device according to Example 1, wherein the first and second actuators are disposed within the forearm segment.

Example 7 relates to the robotic device according to Example 1, wherein the first actuator is disposed within the upper arm segment and the second actuator is disposed within the forearm segment.

Example 8 relates to the robotic device according to Example 1, wherein the first actuator is disposed within the elongate body and the second actuator is disposed within the forearm segment.

Example 9 relates to the robotic device according to Example 1, wherein the first actuator is disposed external to the device and the second actuator is disposed within the forearm segment.

In Example 10, a robotic device comprises an elongate body and a robotic arm operably coupled to the elongate body. The robotic arm comprises an upper arm segment, a forearm segment operably coupled to the upper arm segment, and at least two actuable components associated with the robotic arm. The device also comprises a first cable-driven actuation assembly comprising a first actuator disposed within one of the elongate body, the upper arm segment, and the forearm segment or external to the device, and a first motive force transfer cable operably coupled to the first actuator and a first of the at least two actuable components. Further, the device also comprises a second cable-driven actuation assembly comprising a second actuator disposed within one of the elongate body, the upper arm segment, and the forearm segment or external to the device, and a second motive force transfer cable operably coupled to the second actuator and a second of the at least two actuable components.

Example 11 relates to the robotic device according to Example 10, further comprising a first gear-driven actuation assembly comprising a third actuator disposed within one of the elongate body, the upper arm segment, and the forearm segment or external to the device, and at least one gear operably coupled to the third actuator and a third of the at least two actuable components.

Example 12 relates to the robotic device according to Example 10, wherein at least one of the first and second motive force transfer cables is a rotary force transfer cable.

Example 13 relates to the robotic device according to Example 10, wherein at least one of the first and second motive force transfer cables is a lateral force transfer cable.

Example 14 relates to the robotic device according to Example 10, wherein the first of the at least two actuable components comprises actuable end effector grasper arms, and wherein the second of the at least two actuable components comprises a rotatable end effector grasper body.

Example 15 relates to the robotic device according to Example 10, wherein the first and second actuators are disposed within the forearm segment.

Example 16 relates to the robotic device according to Example 10, wherein the first and second actuators are disposed external to the device.

In Example 17, a robotic device comprises an elongate body, an actuation unit coupled to the elongate body, the actuation unit comprising at least two actuators, and a robotic arm operably coupled to the elongate body. The robotic arm comprises an upper arm segment, a forearm segment operably coupled to the upper arm segment, and at least two actuable components associated with the robotic arm. The device also comprises a first cable-driven actuation assembly comprising a first actuator disposed within the actuation unit, and a first rotary force transfer cable operably coupled to the first actuator and a first of the at least two actuable components. Further, the device also comprises a second cable-driven actuation assembly comprising a second actuator disposed within the actuation unit, and a second rotary force transfer cable operably coupled to the second actuator and a second of the at least two actuable components.

Example 18 relates to the robotic device according to Example 17, wherein the first and second rotary force transfer cables are disposed through the elongate body.

Example 19 relates to the robotic device according to Example 18, further comprising a cable positioning block movably disposed within the elongate body, wherein the cable positioning block is operably coupled to the first rotary force transfer cable, and wherein the second rotary force transfer cable is attached to the cable positioning block.

Example 20 relates to the robotic device according to Example 17, wherein the first rotary force transfer cable is disposed through an opening in the cable positioning block such that the first rotary force transfer cable is rotatably coupled to the cable positioning block such that rotation of the first rotary force transfer cable results in axial movement of the cable positioning block with in the elongate body.

While multiple embodiments are disclosed, still other embodiments will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments. As will be realized, the various implementations are capable of modifications in various obvious aspects, all without departing from the spirit and scope thereof. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive.

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, having at least one robotic arm that can be actuated by one or more motors and related gears disposed within the arm, one or motors and related cables extending from the motor such that the motor can be disposed within any portion of the arm, the device body, or external to the device, or a combination of motors/gears and motors/cables. While the various embodiments herein are generally described in the context of a robotic device having two arms, it is understood that the various actuation assembly embodiments can be incorporated into any arm of any robotic device or system, including devices having solely one arm, three arms, four arms, or more. Further, any of the implementations herein can be incorporated into any type of robotic device or system, including non-surgical devices and systems.

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.

Certain device and system implementations disclosed herein and in the applications listed above can be positioned within a body cavity of a patient, or a portion of the device can be placed within the body cavity, in combination with an external support component. 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 through an incision and/or port disposed within an incision, and further including any device that is coupled to an external support component that is disposed outside the patient's body. It also includes any device positioned substantially against or adjacent to a wall of a body cavity of a patient, any device that is internally actuated (having no external source of motive force), and 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.

Certain embodiments provide for insertion of the a device implementation as disclosed herein into the cavity while maintaining sufficient insufflation of the cavity. Further embodiments minimize the physical contact of the surgeon or surgical users with the device during the insertion process. Other implementations enhance the safety of the insertion process for the patient and the device. For example, some embodiments provide visualization of the device 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. Other implementations include devices that can be inserted into the body via an incision or a natural orifice, including devices that can positioned through the incision during use. 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.

As in manual laparoscopic procedures, a known insufflation system can be used to pump sterile carbon dioxide (or other gas) into the patient's abdominal cavity. This lifts the abdominal wall from the organs and creates space for the robot. In certain implementations, the system has no direct interface with the insufflation system. Alternatively, the various system embodiments herein can have a direct interface to the insufflation system.

In certain implementations in which the device is inserted through an insertion port, the insertion port is a known, commercially-available flexible membrane placed transabdominally to seal and protect the abdominal incision. This off-the-shelf component is the same device or substantially the same device that is used in substantially the same way for Hand-Assisted Laparoscopic Surgery (HALS). The only difference is that the arms of the robotic device according to the various embodiments herein are inserted into the abdominal cavity through the insertion port rather than the surgeon's hand. The robotic device body is disposed within and seals against the insertion port when it is positioned therethrough, thereby maintaining insufflation pressure. The port is single-use and disposable. Alternatively, any known port can be used. In further alternatives, the device can be inserted through an incision without a port or through a natural orifice.

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.

Certain embodiments disclosed or contemplated herein can be used for colon resection, a surgical procedure performed to treat patients with lower gastrointestinal diseases such as diverticulitis, Crohn's disease, inflammatory bowel disease and colon cancer. Approximately two-thirds of known colon resection procedures are performed via a completely open surgical procedure involving an 8- to 12-inch incision and up to six weeks of recovery time. Because of the complicated nature of the procedure, existing robot-assisted surgical devices are rarely used for colon resection surgeries, and manual laparoscopic approaches are only used in one-third of cases. In contrast, the various implementations disclosed herein can be used in a minimally invasive approach to a variety of procedures that are typically performed ‘open’ by known technologies, with the potential to improve clinical outcomes and health care costs. Further, the various implementations disclosed herein can be used for any laparoscopic surgical procedure in place of the known mainframe-like laparoscopic surgical robots that reach into the body from outside the patient. That is, the less-invasive robotic systems, methods, and devices disclosed herein feature small, self-contained surgical devices that are inserted in their entireties through a single incision in the patient's abdomen. Designed to utilize existing tools and techniques familiar to surgeons, the devices disclosed herein will not require a dedicated operating room or specialized infrastructure, and, because of their much smaller size, are expected to be significantly less expensive than existing robotic alternatives for laparoscopic surgery. Due to these technological advances, the various embodiments herein could enable a minimally invasive approach to procedures performed in open surgery today.

FIG.1depicts one embodiment of a robotic surgical system10having several components that will be described in additional detail below. The components of the various system implementations disclosed or contemplated herein can include an external control console16and a robotic device12having a removable camera14as will also be described in additional detail below. In accordance with the implementation ofFIG.1, the robotic device12is shown mounted to the operating table18via a known, commercially available support arm20. The system10can be, in certain implementations, operated by the surgeon22at the console16and one surgical assistant24positioned at the operating table18. Alternatively, one surgeon22can operate the entire system10. In a further alternative, three or more people can be involved in the operation of the system10. It is further understood that the surgeon (or user)22can be located at a remote location in relation to the operating table18such that the surgeon22can be in a different city or country or on a different continent from the patient on the operating table18.

In this specific implementation, the robotic device12with the camera14are both connected to the surgeon console16via cables: a device cable24A and a camera cable24B. Alternatively, any connection configuration can be used. In certain implementations, the system can also interact with other devices during use such as a electrosurgical generator, an insertion port, and auxiliary monitors.

FIG.2depicts one exemplary implementation of a robotic device40that can be incorporated into the exemplary system10discussed above or any other system disclosed or contemplated herein. The device40has a body (or “torso”)42having a distal end42A and proximal end42B, with the imaging device (or “camera”)44disposed therethrough, as mentioned above and as will be described in additional detail below. Briefly, the robotic device40has two anthropometric robotic arms46,48operably coupled to a distal end of the body42, and the camera44is removably positionable through the body42and disposed between the two arms46,48. That is, device40has a first (or “right”) arm46and a second (or “left) arm48, both of which are operably coupled to the body42as discussed in additional detail below. In this embodiment, the body42of the device40as shown has an enclosure (also referred to as a “cover” or “casing”)52such that the internal components and lumens of the body42are disposed within the enclosure52. The device body42has two rotatable cylindrical bodies (also referred to as “shoulders” or “turrets”)54A,54B: a first (or “right”) shoulder54A and a second (or “left”) shoulder54B. Each arm46,48in this implementation also 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”)46A,48A, 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”)46B,48B. The right upper arm46A is operably coupled to the right shoulder54A of the body42at the right shoulder joint46C (such that the right shoulder54A is considered a component of the right shoulder joint46C) and the left upper arm48A is operably coupled to the left shoulder54B of the body42at the left shoulder joint48C (such that the left shoulder54B is considered a component of the left shoulder joint48C). Further, for each arm46,48, the forearm46B,48B is rotatably coupled to the upper arm46A,48A at the elbow joint46D,48D. In various embodiments, the forearms46B,48B are configured to receive various removeable, interchangeable end effectors56A,56B.

The end effectors56A,56B on the distal end of the arms46,48can be various tools56A,56B (scissors, graspers, needle drivers and the like), as will be described in additional detail below. In certain implementations, the tools56A,56B are designed to be removable, including in some instances by a small twist of the tool knob that couples the end effector56A,56B to the arm46,48. In certain implementations, at least two single-use, interchangeable, disposable surgical end effectors can be used with any of the robotic device embodiments herein (including device40). Such end effectors can include, but are not limited to, a fenestrated grasper capable of bi-polar cautery, scissors that deliver mono-polar cautery, a hook that delivers mono-polar cautery, and a left/right needle driver set. The tools can be selected for the specific surgical task. Certain forearm and end effector configurations that allow for the removability and interchangeability of the end effectors are disclosed in detail in U.S. application Ser. Nos. 16/504,793 and 15/687,113, both of which are incorporated herein (and above) by reference. Further, it is understood that any known forearm and end effector combinations can be used in any of the robotic device embodiments disclosed or contemplated herein.

In various implementations, the body40and each of the links of the arms46,48can contain a variety of actuators and/or motors, as will be described in additional detail below. In certain implementations, the body40has no motors disposed therein, while there is at least one motor in each of the arms46,48. Alternatively, the body40can have at least one motor disposed therein, while the each of the arms46,48has zero, one, two, three, four, or more motors disposed therein. In a further alternative, the various components of any device implementation herein can have any configuration of motors or no motors therein. In one embodiment, any of the motors discussed and depicted herein can be brush or brushless 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. There are many ways to actuate these motions, such as with DC motors, AC motors, permanent magnet DC motors, brushless motors, pneumatics, cables coupled to motors, hydraulics, and the like. As such, the actuation source can be at least one motor, hydraulic pressure source, pneumatic pressure source, or any other actuation source disposed remotely from or proximally to the device40such that an appropriate coupling or transmission mechanism (such as at least one cable, at least one hydraulic transmission hose, at least one pneumatic transmission hose, or any other transmission mechanism) is disposed through the body42.

In one embodiment, the various joints discussed above in accordance with any of the embodiments disclosed or contemplated herein can be driven by electrical motors disposed within the device and, in some implementations, near each joint. Other embodiments include the incorporation of pneumatic or hydraulic actuators in any of the device implementations herein. In additional alternative embodiments, the driving actuators are disposed within the device body or outside the device and/or body cavity and power transmission mechanisms are provided to transmit the energy from the external source to the various joints of any device herein. Such a transmission mechanism could, for example, take the form of gears, drive shafts, cables, pulleys, or other known mechanisms, or any combination thereof.

FIGS.3A and3Bdepict one embodiment of the robotic device40with the camera assembly44removed, according to one implementation. That is,FIG.3Adepicts the device40without the camera positioned through the body42, andFIG.3Bdepicts one embodiment of the camera44. In certain implementations, and as best shown inFIG.3B, the camera44has a handle (or “camera body”)60with an elongate shaft62coupled thereto such that the shaft62extends distally from the distal end of the handle60. In addition, the camera44has a steerable tip64coupled to the distal end of the shaft62via a flexible section68such that the steerability allows the user to adjust the viewing direction, as will be discussed in further detail below. Further, the tip64also includes a camera imager66at the distal end of the tip64that is configured to capture the desired images. Further, the tip64in certain implementations has an illumination light (not shown) disposed thereon, such that the light can illuminate the objects in the field of view. In one specific implementation, the camera44provides 1080p 60 Hz. digital video. Alternatively, the camera44can provide any known video quality.

As best shown inFIGS.3A and4A, the camera assembly44can be inserted into the body42of the robotic device40by positioning the distal end of the shaft62through a lumen (not shown) defined through the body42of the robotic device40as shown by the arrow A inFIG.3A. As will be described in further detail below, certain implementations of the device40include a removable nest (or “dock”)57disposed near the proximal end of the body42that includes a seal (not shown) that operates to ensure that the patient's cavity remains insufflated. That is, the seal (not shown) makes it possible to remove the camera44from the body42while maintaining insufflation (similar to a manual laparoscopic port). The nest57can also contain a connection or locking mechanism (not shown) that locks the camera44into the device body42until the camera latch button59is pressed to release the locking mechanism and thereby allow for removal of the camera44.

In accordance to certain embodiments, at least one or both of the nest57and device body42contain sensors (not shown) configured to indicate when the camera assembly44is properly disposed within the nest57and device body42and locked in place. In such implementations, the device40is inoperable unless the camera44properly locked in place. In such implementations and in some alternative embodiments, the device40is also inoperable for purposes of insertion or extraction unless the camera44has been removed (so it can be placed in an auxiliary port such as the port92as shown inFIG.6and discussed in additional detail below). Easy camera44removal also facilitates cleaning of the lens and other parts of the camera44to remove any debris that may be generated during surgery.

According to some implementations, the nest57, and specifically the locking mechanism, allow for the device40and the camera44locked therein to move together, thereby resulting in the camera44being positioned to provide constant visualization of the arms46,48and end effectors56A,56B while always maintaining proper triangulation between the device40, camera44, and arms46,48/end effectors56A,56B. That is, it ensures that the camera44is always well positioned with respect to the arms46,48and end effectors56A,56B and the configuration does not change during operation of the device40.

When the shaft62is inserted through the lumen of the body42as desired, according to certain embodiments as best shown inFIGS.2and4A, the distal end of the shaft62, including the flexible section68and the steerable tip64(containing the imager66) extends out of an opening at the distal end of the body42such that the tip64is positioned between the two arms46,48in the surgical environment as shown. Thus, the imager66is positioned to capture the view between the two arms46,48and the steerable tip64can be actuated to provide views of the surgical tools and surgical target. That is, the tip64can be moved such that the surgical tools and/or surgical target are captured within the field of view of the imager66. It is understood that this camera44embodiment and any other such camera embodiment disclosed or contemplated herein can be used with any similar robotic device having a camera lumen defined therethrough.

In various implementations, as best shown inFIG.4A, the steerable tip64and therefore also the camera imager66can be steered or otherwise moved in two independent directions in relation to the shaft62at a flexible section68disposed between the shaft62and the steerable tip64to change the direction of view. That is,FIG.4Ashows that the steerable tip64can be robotically articulated in the yaw direction (left and right in relation to the device40) as represented by arrow B or pitch direction (up and down in relation to the device40) as represented by arrow C. In various implementations, the camera44can be controlled via a console (such as console16discussed above, for example) or via control buttons (not shown) as will be discussed in additional detail below. In one embodiment, the features and operation (including articulation) of the steerable tip are substantially similar to the steerable tip as described in U.S. application Ser. Nos. 14,334,383 and 15/227,813, both of which are incorporated by reference above, and any other applications incorporated by reference above disclosing such steerable tips. Alternatively, any known robotic articulation mechanism for cameras or similar apparatuses can be incorporated into any camera embodiment utilized in any device or system disclosed or contemplated herein.

In various implementations, the camera44can be re-sterilized for multiple uses. In one specific embodiment, the camera44can be reused up to one hundred times or more. Alternatively, it is understood that any known endoscopic camera that can fit through a device body according to any implementation herein can be utilized.

Focusing now on the robotic arms46,48of the robotic device40according to one embodiment as shown inFIGS.4A-4B, each robot arm46,48in this implementation has six degrees of freedom, including the open/close function of the tool, as best shown inFIG.4B. For purposes of this discussion, the various degrees of freedom will be discussed in the context of the right arm46as shown inFIG.4B, but it is understood that both arms have the same degrees of freedom. The right shoulder joint46C is approximately a spherical joint similar to a human shoulder. The upper arm46A can yaw (J1), pitch (J2), and roll about the shoulder joint46C (J3). These first three axes of rotation roughly intersect at the shoulder joint46C. The robot elbow46D (J4) allows rotation of the forearm46B with respect to the upper arm46A. Finally, the end effector56A can roll (J5) about the long axis of the end effector56A and some tools that can be replaceably attached to the forearm46B have an open/close actuation function. On the other hand, it is understood that a hook cautery tool, for example, does not open/close.

As can be seen inFIG.4B, the arms46,48in this exemplary implementation have a molded silicon protective sleeve58that is disposed over the arms46,48and shoulder turrets54A,54B. In one embodiment, the sleeve58is fluidically sealed such that it protects the arms46,48and the robotic device40from fluid ingress and also helps to simplify post-surgery cleaning and sterilization. The fluidically sealed sleeve58is substantially similar to any of the sleeve embodiments disclosed or contemplated in U.S. application Ser. Nos. 14/334,383, 15/227,813, and 16/144,807, all of which are incorporated by reference above, and any other applications incorporated by reference above having other sleeve implementations.

The sleeve58and the other fluidically sealed components of the device40allow for the device40to be submersible in 1 meter of water, according to one embodiment.

The robotic arms46,48in this implementation have significant dexterity that enables the arms46,48to reach into confined spaces within the target cavity of the patient, such as the abdominal cavity. As shown inFIGS.5A and5B, the six degrees of freedom described above allow the arms46,48to reach into the confined spaces of the abdominal cavity. More specifically,FIGS.5A and5Bschematically depict the entire workspace70of the arms46,48of the robotic device40, according to certain implementations. In these implementations, “workspace”70means the space70around the robotic device40in which either arm46,48(and/or end effector thereof) can move, access, and perform its function within that space70. In other words, the workspace110is the volume that can be reached by at least one of the right and left arms46,48. The bi-manual workspace110is approximated by an ellipse that is rotated 180 degrees about the shoulder pitch joint (J2inFIG.4B). According to one embodiment, the arms46,48herein are substantially the same as or similar to the arms, the degrees of freedom, and the overall workspace and the individual workspaces of each arm as disclosed in U.S. application Ser. No. 17/367,915 and/or U.S. application Ser. No. 16,736,329, both of which are incorporated by reference above.

FIG.5Adepicts a perspective view of the device40and further schematically shows the collective workspace70of the first and second arms46,48and the cross-section72thereof, whileFIG.5Bdepicts a side view of the device40and workspace70. Note that the each arm46,48has a range of motion and corresponding workspace that extends from the front74of the device40to the back76of the device40. Thus, the first arm46moves equally to the front74and the back76, through about 180° of space relative to the axis of the device body42for each arm46,48. This overall workspace70, which constitutes an intersecting or collective workspace70based on the separate workspaces of the two arms46,48, allows the robotic device40to work to the front74and back76equally well without having to reposition the body42. That is, the bi-manual workspace70extends from in front74of the robotic device40to below the device40and is also behind the back76of the device40as shown. Thus, the workspace70represents a region that is reachable by both the left and right arms46,48and is defined as the bi-manual robot workspace70. The arms46,48function equally over any sweep angle from +90° to −90° as shown in FIG.5B, where the workspace70represents the full range of sweep angles. In other words, the surgeon will have full robot dexterity when working in this bi-manual region70.

The workspace cross section72as best shown inFIG.5Ais a rectangle with an arched top. As can be seen in the figures, this cross section72extends 180 degrees around the shoulder pitch (J2inFIG.4B). In accordance with one specific, non-limiting embodiment, the workspace cross section72can be about 5 inches (13 cm) wide and about 2.5 inches (6.75 cm) deep. Alternatively, the specific dimensions can vary accordingly to the size of the device (and its components) and the size of the target space.

In contrast, the camera sweep angle range78(the range that the camera44can move along the same path as the workspace sweep angle as shown inFIG.5B) is more limited in comparison to the sweep angle range of the robotic arms46,48(as represented by the workspace70). More specifically, the camera44can sweep between +75° to −75°, which is a sufficient range to ensure that the camera can capture the arms46,48and their end effectors56A,56B at any position throughout the full workspace70, thereby ensuring that the user(s) can visualize the instruments. The camera sweep defines a working camera plane80(the horizontal midline of the surgical view), as shown inFIG.5A.

During the procedure, the device40can be easily repositioned by moving the device body42, thus allowing access to different portions of the target cavity (such as the abdominal cavity). In certain implementations, the device body42can be moved quickly (in less than 10 seconds in some examples) and easily by adjusting the external support arm (such as arm20discussed above). The ability to change the overall position of the device40combined with the reach and dexterity of the arms46,48enable a surgeon to work anywhere in the target cavity.

Additional features and components of the robotic device include those disclosed in U.S. application Ser. Nos. 17/147,172, 17/075,122, 17,367,915, 17/236,489, and 16/736,329, all of which are incorporated by reference above, along with all of the other patents and applications incorporated by reference above. It is understood that any robotic device embodiment disclosed or contemplated herein (including, for example, the robotic devices12,40,80discussed above), can be incorporated into not only the system embodiments disclosed herein, but any other known robotic surgical system. It is further understood that, according to certain implementations, any robotic device disclosed or contemplated herein can be configured such that it can be cleaned and sterilized for multiple uses. In some embodiments, the device can be reused up to ten times or more.

In certain alternative implementations as shown inFIG.6, the camera44can be removed from the robotic device40and positioned through another, known laparoscopic port92typically used with a standard manual laparoscope. As such, in this embodiment, the device40is disposed through a main port (also known as an “insertion port”)90and the camera44is positioned through the known laparoscopic port92as shown. It is understood that this arrangement may be useful to visualize the robotic device40to ensure safe insertion and extraction via the main port90. According to various embodiments, the camera44can also be removed from the robotic device40so the optics can be cleaned, the camera44can be repaired, or for any other reason in which it is beneficial to remove the camera44. It is understood that while the device40and camera44are depicted and discussed herein, any device or camera according to any implementation disclosed or contemplated herein can also be used in a similar arrangement and any such camera can also be removed from the device for any reason as discussed herein.

It is understood that the insertion port90also can represent the port90through which any robotic device embodiment disclosed or contemplated herein is positioned for any procedure as contemplated herein (including those procedures in which the camera44is disposed through the device40). In one embodiment, the insertion port90can be a single use commercially available flexible membrane disposed transabdominally to seal and protect the abdominal incision and allow for positioning the body42of the device40therethrough. In specific implementations, the insertion port90is the same device used in Hand-Assisted Laparoscopic Surgery (HALS), including the exemplary port90depicted inFIG.6, which, according to one embodiment, is a GelPort™ 90. The device body42seals against the insertion port90, thereby establishing a fluidic seal and thus maintaining insufflation pressure. Alternatively, any known insertion port (or incision) that is configured to receive a device similar to that disclosed herein can be used.

The various implementations herein are devices having one or more robotic arms with specific actuation configurations. More specifically, while some of the embodiments relate to one or more robotic arms actuated by motors and gears that translate the motive force from the motors to the moveable arm components, other implementations have one or more arms that are actuated by motors and cables that translate the motive force from the motors to the moveable arm components. Further, additional embodiments relate to devices having one or more arms that are actuated by a combination of (1) motors and gears and (2) motors and cables. In the various implementations having at least one or more motor and cable configuration, the motor can be disposed anywhere in relation to the moveable component. That is, the motor can be disposed within the same arm component as the moveable component (such as the forearm), in the adjacent component (such as the upper arm), in the device body, or at an external location in relation to the device. Further details about these various embodiments are described in further detail below.

In any of the embodiments disclosed in additional detail below in which one or more cables is used, the cable(s) can be a standard pull cable using an opposing cable for restoration force (or a spring or other method for restoration force), a push/pull cable, Bowden cables, rotary torque transmission cables, or any other known cables for use in medical or robotic devices.

Further, there are many ways to actuate these motions, such as with pneumatics, hydraulics, and the like.

As mentioned above, certain device embodiments have at least one robotic arm actuated by motors that use gear drives to create motion at each joint. One such implementation is set forth inFIGS.7-20herein, which depict the internal components of the body110A and arms114,116of the device100, which are shown in these figures without their casings or housings. It is understood that in use, these implementations are covered by a housing, in a similar fashion as the embodiment depicted inFIGS.2-6.FIGS.7-20include the internal structural/support components and the actuation (motor and gear) components of the device100. It is further understood that any of the motor and gear configurations as set forth in U.S. application Ser. Nos. 16/890,424, 17/147,172, 17/075,122, 16/926,025, 17/367,915, 17/236,489, and 16/736,329, all of which are incorporated by reference above, can also be incorporated into any of the devices herein. In use, the various motors used to actuate the robot100and its associated components can include, but are not limited to, DC motors, AC motors, Permanent magnet DC motors, brushless motors, and the like. In one embodiment, any of the motors discussed and depicted herein can be brush or brushless 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.

FIG.7, according to one embodiment, shows an implementation of the robot100and each joint of one arm—here, the left arm116. It is understood that the right arm114of this implementation is a mirror image of the left116and that the internal components in the left arm116that operate/control/actuate the left arm116are substantially the same as those depicted and described herein and that the descriptions provided below apply equally to those components as well. Alternatively, the device100can have only one arm.

As shown inFIG.7, the shoulder joints114A,116A have a shoulder yaw joint101and a shoulder pitch joint102. In these implementations, an upper arm roll joint104, an elbow joint106, and a tool roll joint108are also provided which enable a substantial range of motion. In various implementations, a tool actuation joint (not shown) interfaces with the tool (not shown) to actuate open and close of the tool, as has been previously described.

In various implementations, these joints101,102,104,106have practical defined ranges of motions that, together with the robot geometry, lead to the final workspace of the robot100similar to the workspace discussed above. For the examples given herein, the joint limits allow for a significant robot workspace, as is described above. This workspace allows the various implementations of the robot to use both arms and hands effectively in several locations within the body cavity of the patient.

In the implementation ofFIG.7, the body110A and each link (meaning the upper arm116B, and forearm1160) contain Printed Circuit Boards (“PCBs”)110,112,114that have embedded sensor, amplification, and control electronics. One PCB is in each forearm and upper arm and two PCBs are in the body. Each PCB also has a full 6 axis accelerometer-based Inertial Measurement Unit and temperature sensors that can be used to monitor the temperature of the motors. Alternatively, any known processors can be used. Each joint can also have either an absolute position sensor or an incremental position sensor or both. In certain implementations, the some joints contain both absolute position sensors (magnetic encoders) and incremental sensors (hall effect). In other implementations, certain joints only have incremental sensors. These sensors are used for motor control. The joints could also contain many other types of sensors. A more detailed description of one possible method is included here.

In this implementation, a larger PCB110is mounted to the posterior side of the body110A. This body PCB110controls the motors116in the base link, or body110A (the shoulder yaw joint101and shoulder pitch joint102for left and right arms, respectively). Each upper arm has a PCB112to control the upper arm roll joint104and elbow joint106. Each forearm has a PCB114to control the tool roll joint108and tool actuation joint (not shown). In the implementation ofFIG.14, each PCB110,112,114also has a full six axis accelerometer-based inertial measurement unit and several temperature sensors that can be used to monitor the temperature of the various motors described herein.

In these embodiments, each joint101,102,104,106,108can also have either an absolute position sensor or an incremental position sensor or both, as described and otherwise disclosed in U.S. application Ser. Nos. 17/368,023 and 16/814,223, which are incorporated by reference above, and any other such sensors as described in any other applications incorporated by reference above. Further, in certain implementations, and as shown inFIG.8and elsewhere, any of the various actuators or motors115,130,154,178in any of the embodiments described herein can have at least one temperature sensor103disposed on the surface of the motor, for example by temperature-sensitive epoxy, such that the temperature sensor103(as shown inFIG.15) can collect temperature information from each actuator for transmission to the control unit, as discussed below.

In this implementation, joints1-4have both absolute position sensors (magnetic encoders) and incremental sensors (hall effect). Joints5&6only have incremental sensors, according to one embodiment. These sensors are used for motor control. It is understood that the joints could also contain many other types of sensors, as have been described in detail in the incorporated applications and references. In a further alternative, any combination of these sensors can be used, or no sensors can be used.

According to one implementation, certain other internal components depicted in the implementation ofFIGS.8and9are configured to actuate the rotation of the shoulder yaw joint101of the body110A around axis1, as shown inFIG.7. As mentioned above, it is understood that two of each of the described components are used—one for each arm—but for ease of description, in certain depictions and descriptions, only one is used.

As best shown inFIG.9, a shoulder yaw joint101motor115and gearhead combination drives a motor gear117first gear set118, which is best shown inFIG.16. The first gear set118drives a shaft supported by bearings120to drive a second gear set122. In turn, this second gear set122drives an output shaft124that is also supported by bearings126. This output shaft124then drives a turret114A,116A (representing the shoulder of the robot100) such that the shoulder116A rotates around axis1, as best shown inFIG.7. The various gears herein can be spur gears. Alternatively, any of the gears can be any known type of gear.

As will be discussed in further detail below, in certain alternative embodiments, the motors115,130(and all the motors discussed elsewhere herein with respect to the various implementations), can be placed in more proximal locations if various other shafts, pulleys, cables, and/or gears are included.

According to one implementation, certain internal components depicted in the implementation ofFIGS.10-12are configured to actuate the shoulder pitch joint102of the body110A and/or shoulder114A,116A around axis2, as is shown inFIG.7. In these implementations, the pitch joint102is constructed and arranged to pivot the output link140so as to move the upper arm (not shown) relative to the shoulder114A,116A.

In this specific implementation, as best shown inFIG.12, a motor130and gearhead combination drives a drive gear131and driven gear132that in turn drives a first shaft134. This shaft134then drives a shoulder gear pair136,137inside the shoulder turret. The shoulder gear pair136,137accordingly drives a driven shoulder gear set138,139directly connected to the shoulder pitch joint102output link140, such that the upper arm116B rotates around axis2, as best shown inFIG.7. In this implementation, the shoulder yaw joint101and the shoulder pitch joint102therefore have coupled motion. In these implementations, a plurality of bearings141support the various gears and other components, as has been previously described. The various gears herein can be spur gears, miter gears, bevel gears, or any other known type of gear.

FIGS.13-16depict various internal components of the upper arm116B constructed and arranged for the movement and operation of the arm116. In various implementations, multiple actuators or motors142,154are disposed within the housing (not shown) of the forearm116C.FIGS.17-20depict various internal components of the forearm116C constructed and arranged for the movement and operation of the end effectors. In various implementations, multiple actuators or motors175,178are disposed within the housing (not shown) of the forearm116C.

One implementation of the internal components of the upper arm116B constructed and arranged to actuate the upper arm roll joint104is shown inFIGS.13and14. In this implementation, a motor142and gearhead combination controlled by a PCB112drives a drive gear143and corresponding driven gear144where the output/driven gear144is supported by a shaft148and bearings150. The output shaft152and output spur gear144can have a mating feature146that mates to the shoulder pitch joint102output link140(shown inFIG.10).

One implementation of the internal components of the upper arm116B configured to operate the elbow joint106is shown inFIGS.15and16. In this implementation, a base motor154directly drives a gear set that includes three gears156,158,160(a drive gear156, a driven gear158, and a gearhead gear160). This gear set156,158,160transfers the axis of rotation from the axis of the motor154to the axis of a worm gear166. Alternatively, the worm gear166can be any other known type of gear.

As best shown inFIG.16, the gearhead gear160from this set drives a motor gearhead162that drives a shaft164that has a worm gear166mounted on it. This worm gear166then drives a worm wheel168(or other form of wheel) that is connected to the Joint4output shaft170. It should also be noted that the upper arm unit (as shown inFIG.15) shows a curved concave region172on the right side. It is understood that this region172is configured to allow for a larger motion of Joint4so as to allow the forearm to pass through the region172.

One implementation of the internal components of the forearm116C configured or otherwise constructed and arranged to operate the tool roll joint108is shown inFIGS.17and18. In these implementations, the tool roll joint108drives a tool lumen174that holds the tool (or end effector). The tool lumen174is designed to mesh with the roll features on the end effector to cause the end effector to rotate about its axis, as shown as axis5inFIG.7. In this implementation, a tool roll motor175with a gearhead is used to drive a drive gear176and thus drive two driven gears177A,177B. The second driven gear of this chain177B is rigidly mounted to the tool lumen174, so as to rotate the inner surface174A of the tool lumen, and correspondingly any inserted end effector.

One implementation of a tool actuation joint109is shown inFIGS.19and20. In this implementation, the Joint6motor178does not visibly move the robot. Instead, this tool actuation joint109drives a female spline184(as best shown inFIG.20) that interfaces with the end effector and is configured to actuate the end effector to open and close (in those embodiments in which the end effector is a grasper or any other type of end effector that opens and closes). 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 actuator178is provided that is, in this implementation, a motor assembly178. The motor assembly178is operably coupled to the drive gear180, which is a spur gear in this embodiment but can be any type of gear. The drive gear180is coupled to first182and second183driven gears such that rotation of the drive gear180causes rotation of the two driven gears182,183. The driven gears182,183are fixedly coupled to a female tool spline184, which is supported by bearing pair186. The female tool spline184is configured to interface with a male tool spline feature on the end effector to open/close the tool as directed.

According to one implementation, the end effector can be quickly and easily coupled to and uncoupled from the forearm116C in the following fashion. With both the roll and drive axes fixed or held in position, the end effector (such as either end effector56A,56B) can be rotated, thereby coupling or uncoupling the threads (not shown). That is, if the end effector is rotated in one direction, the end effector is coupled to the forearm116B, and if it is rotated in the other direction, the end effector is uncoupled from the forearm116B.

Various implementations of the system10are also designed to deliver energy to the end effectors so as to cut and coagulate tissue during surgery. This is sometimes called cautery and can come in many electrical forms as well as thermal energy, ultrasonic energy, and RF energy all of which are intended for the robot.

Alternatively, as mentioned above, certain device embodiments have one or more arms that are actuated by at least one motor coupled to a cable that translates the motive force from the motor to a moveable arm component. Such actuation configurations are also referred to herein as cable-driven actuation or cable actuation and intended to describe any actuation arrangements in which a cable is coupled to both a motor (or other type of actuator) and an actuable component of a robotic device.

One exemplary implementation of a robotic device200with a forearm208B having two cable-driven actuation assemblies212,214disposed therein or associated therewith is depicted inFIGS.21A and21B. More specifically,FIG.21Bshows a robotic device200having an elongate body202with two robotic arms204,206. For purposes of this application, the discussion will focus on the right arm204, but it is understood that the same or similar cable-driven assemblies can be incorporated into the left arm206. The right arm204has an upper arm208A, a forearm208B, and an end effector210.

FIG.21Bprovides an expanded view of the right forearm208B, which contains the two cable-driven actuation assemblies212,214. The first actuation assembly212is the tool roll actuation assembly212and has a first actuator216coupled to a first cable218via a first rotating drive mechanism (also referred to herein as a “spool”)220. The cable218extends from the spool220to the first target actuable component of the forearm208B. More specifically, in this example, the cable218extends to the tool roll mechanism (not shown) and is operably coupled thereto such that the actuation assembly212can be used to actuate the tool roll mechanism.

The second actuation assembly214is the tool open/close actuation assembly214and has a second actuator222coupled to a second cable224via a second rotating drive mechanism (also referred to herein as a “spool”)226. The cable224extends from the second spool226to the second target actuable component of the forearm208B. More specifically, in this example, the cable224extends to the tool open/close mechanism (not shown) and is operably coupled thereto such that the actuation assembly214can be used to actuate the tool open/close mechanism.

In some embodiments, the actuators216,222are motors216,222. For example, the motors216,222can be brushless direct current motors with gearheads. Alternatively, the actuators216,222can be any motors as described elsewhere herein or any other known motors for use in such devices. Alternatively, the actuators216,222can be any known actuators.

The cables218,224in this specific implementation and any other embodiments may require one or more pulleys to properly position the cables and/or tensioning mechanisms to ensure proper tension of the cables. For example, a first pulley228is disposed within the forearm208B to route or otherwise control the position of the first cable218as shown. Similarly, second and third pulleys230,232are disposed within the forearm208B to route or otherwise control the position of the second cable224as shown. It is understood that the specific number and positioning of any pulleys will depend on the specific arm component and actuation assembly.

According to other embodiments, any such cable-driven actuation assembly can be used to actuate any actuable component. More specifically, the cable of such an assembly is coupled to a component that requires motive force to operate/function. In one specific alternative example, the cables218,224are rotary drive cables. In a further alternative, one of the two cables218,224can be one type of drive cable (such as a push/pull cable, for example) while the other is another type of drive cable (such as a rotary drive cable, for example).

Any spool implementation herein can be sized to allow some length of cable to be wound around the spool. The size of the spool can be determined based on the dimensions of the actuation mechanism.

In this specific embodiment, both of the actuation mechanisms212,214are locally actuated mechanisms212,214. That is, the actuators216,222are positioned locally, which means that they are disposed in the same component as the actuable components that are actuated by the actuation mechanisms. In other words, the actuators216,222and the actuable components are both disposed within the forearm208B. In various alternative implementations as will be described in additional detail below, the actuators216,222are not disposed in the same component as the actuable components. That is, either or both of the actuators216,222can be disposed in the forearm208B, the upper arm208A, the elongate body202, or at some location external to the device200.

A further, more detailed exemplary embodiment of locally actuated cable-driven actuation assemblies is shown inFIGS.22A-28B. More specifically, as best shown inFIGS.22A-22B, a forearm250is provided to which a grasper end effector252is removably coupleable. The forearm250has three actuators254,256,258disposed therein, with each of the actuators254,256,258having a rotatable drive component260,262,264, each of which has a mateable female structure260A,262A,264A at its distal end. Each of the mateable female structures260A,262A,264A is mateable with a corresponding mateable male structure such that the motive force can be transferred from each rotatable drive component260,262,264via the mateable structures, as will be described in additional detail below.

Continuing withFIGS.22A and22B, the detachable end effector252has three mateable male structures266A,268A,270A (with266A not being visible in the figures due to the perspective) extending from its proximal end as shown that are mateable with the mateable female structures260A,262A,264A. The three male structures266A,268A,270A are rotatable and configured to mate with the female structures260A,262A,264A. Further, the male structures266A,268A,270A are fixedly coupled to rotatable driven components (also referred to herein as “spools”)296,312,330disposed within the end effector252, as discussed in additional detail below. As such, the female (260A,262A,264A) and male (266A,268A,270A) structures make it possible to transfer motive force from the actuators254,256,258to the driven spools296,312,330when the end effector252is coupled to the forearm250.

In one specific implementation, the female (260A,262A,264A) and male (266A,268A,270A) coupling/motive transfer structures are mateable torque-transferring drive interfaces. Alternatively, any known mateable structures that allow for removable coupling and transfer of rotational motive force can be used.

As will be explained in further detail below, the three actuators254,256,258provide motive force for articulation of three actuable components motions of the end effector252. In this embodiment, each of the actuation assemblies (with each assembly being an actuator and the cable coupled thereto) are local (or disposed locally) in that both the actuation assembly and the actuable component coupled thereto are disposed within the same device component (in this case, the forearm250with the end effector252coupled thereto).

As best shown inFIGS.23-24C, according to certain embodiments, the end effector252is a grasper252(as mentioned above), which has two independently-moving paddles280A,280B. More specifically, the first paddle280A and the second paddle280B both rotate around the same axis A1to effectuate both an open/close motion as shown inFIG.24C, and a wrist pitch motion as shown inFIGS.24A-B. Further, both paddles280A,280B (and the entire grasper assembly282, which is made up of the paddles280A,280B and the grasper body284as discussed in detail below) can also rotate together around axis B1to effectuate a wrist yaw motion, as shown inFIGS.25A-C. It should be noted that the third axis (Cl) depicts the axis around which the entire end effector252and forearm250can rotate as a result of the forearm being able to rotate around its own axis (“roll”), which is a motion that is not effectuated by the actuators254,256,258discussed herein in relation toFIGS.22A-28B.

Focusing on the independent rotation of the paddles280A,280B around axis A1, the two different motions can be accomplished in the following fashion. The open/close motion as shown inFIG.24Ccan be accomplished by rotating the two paddles280A,280B in different directions. More specifically, to open the two paddles280A,280B, they are urged to rotate away from each other as represented by the arrows BB inFIG.24C. In contrast, to close the two paddles280A,280B, they are urged to rotate toward and into contact with each other. Further, the wrist-like motion as shown inFIGS.24A-Bcan be accomplished by rotating the paddles280A,280B in the same direction. For example, to move the two paddles280A,280B from the position depicted inFIG.24Ato the position depicted inFIG.24B, both paddles280A,280B are urged to rotate in the same direction as shown by arrow AA.

Turning now to the rotation of the grasper assembly282, the wrist yaw motion can be accomplished in the following fashion. As shown inFIGS.25A-C, the grasper assembly282includes a grasper body284and the two graspers280A,280B, which are rotatably coupled to the grasper body284around the axis A1discussed above. The grasper body284is rotatably coupled to the end effector body286at the wrist joint288. More specifically, in accordance with one embodiment, the wrist joint288includes a pin290that extends between the two end effector body protrusions292A,292B (as best shown inFIG.25A) such that the grasper body284can be rotatably coupled to the pin290. As such, the grasper body284can rotate around the pin290at the axis B1(which is perpendicular to the axis A1), thereby allowing for the entire grasper assembly282to rotate around axis B1, resulting in the wrist yaw motion as depicted inFIGS.25A-25C.

The combination of actuation assemblies produce the three motions that result in three degrees of freedom, which include the two different wrist motions and the open/close motion. The operation of the actuation assemblies to accomplish each of these three motions will now be explained in detail.

The actuation of paddle280A rotating around axis A1is depicted inFIGS.26A-Baccording to one embodiment, withFIG.26Adepicting a first perspective view of the end effector252(the same perspective view provided inFIGS.22A-24C) andFIG.26Bdepicting a second perspective view that is 180° in relation to the first view (thereby providing a view of an opposite side of the end effector252in comparison toFIG.26A). The paddle280A is fixedly coupled to a first driven wheel294such that rotation of the wheel294causes rotation of the paddle280A around axis A1. Further,FIGS.26A-Bdepict the first driven spool (or “mandrel”)296coupled to the male mateable structure270A as discussed above (such that actuator258is rotationally coupled to the driven spool296when the end effector252is coupled to the forearm250). A first cable298forms a closed loop such that the cable298is coupled to the first driven mandrel296and further ultimately extends to and is coupled with the first driven wheel294. More specifically, in this particular implementation, the cable298is routed through (or otherwise positioned within) the end effector252via a set of pulleys300that ultimately result in the cable298extending from the driven mandrel296to the driven wheel294and back to the mandrel296such that rotation of the mandrel296causes translation of the cable298, which causes rotation of the wheel294(which is coupled to the first paddle280A). It is understood that any number of pulleys300that are positioned in any configuration can be provided to ensure proper positioning of the cable298and eliminate any unwanted slack therein. Further, as best shown inFIG.26A, a tensioning screw302coupled to a tensioning pulley304is provided to adjust the cable298to the desired tension. Thus, actuation of the actuator258can cause rotation of the first paddle280A around the axis A1.

The actuation of paddle280B rotating around axis A1is depicted inFIGS.27A-Baccording to one embodiment, withFIG.27Adepicting a first perspective view (the same perspective view provided inFIG.26A) andFIG.27Bdepicting a second perspective view (the same view provided inFIG.26B). The paddle280B is fixedly coupled to a second driven wheel310such that rotation of the wheel310causes rotation of the paddle280B around axis A1. Further,FIG.27Bdepicts the second driven spool (or “mandrel”)312coupled to the male mateable structure266A as discussed above (such that actuator254is rotationally coupled to the driven spool312when the end effector252is coupled to the forearm250). A second cable314forms a closed loop such that the cable314is coupled to the second driven mandrel312and further ultimately extends to and is coupled with the second driven wheel310. More specifically, in this particular implementation, the second cable314is routed through (or otherwise positioned within) the end effector252via a set of pulleys316that ultimately result in the cable314extending from the driven mandrel312to the driven wheel310and back to the mandrel312such that rotation of the mandrel312causes translation of the cable314, which causes rotation of the wheel310(which is coupled to the second paddle280B). It is understood that any number of pulleys316that are positioned in any configuration can be provided to ensure proper positioning of the cable314and eliminate any unwanted slack therein. Further, a tensioning screw318coupled to a tensioning pulley320is provided to adjust the cable314to the desired tension. Thus, actuation of the actuator254can cause rotation of the second paddle280B around the axis A1.

The actuation of the grasper assembly282rotating around axis B1is depicted inFIGS.28A-Baccording to one embodiment, withFIG.28Adepicting a first perspective view (the same perspective view provided inFIGS.26A and27A) andFIG.28Bdepicting a second perspective view (the same view provided inFIGS.26B and27B). As discussed above, the grasper assembly282has a grasper body284with the paddles280A,280B such that rotation of the body284at wrist joint288causes rotation of the assembly282around axis B1. Further,FIGS.28A-Bdepict the third driven spool (or “mandrel”)330coupled to the male mateable structure268A as discussed above (such that actuator256is rotationally coupled to the driven spool330when the end effector252is coupled to the forearm250). A third cable332forms a closed loop such that the cable332is coupled to the third driven mandrel330and further ultimately extends to and is coupled with the grasper body284. More specifically, in this particular implementation, the third cable332is routed through (or otherwise positioned within) the end effector252via a set of pulleys334that ultimately result in the cable332extending from the driven mandrel330to the grasper body284and back to the mandrel330such that rotation of the mandrel330causes translation of the cable332, which causes rotation of the grasper body284and thus the grasper assembly282. It is understood that any number of pulleys334that are positioned in any configuration can be provided to ensure proper positioning of the cable332and eliminate any unwanted slack therein. Further, a tensioning screw336coupled to a tensioning pulley338is provided to adjust the cable332to the desired tension. Thus, actuation of the actuator256can cause rotation of the grasper assembly282around the axis B1, which results in wrist yaw motion.

As mentioned above, the various actuator/cable actuation assemblies disclosed or contemplated according to any of the embodiments herein allow for the positioning of the actuator in any number of different locations within or external to the robotic device. In one specific example,FIGS.29A-Ddepict various different implementations in which the actuator of an actuator/cable actuation assembly can be located in a variety of locations while providing actuation of the same actuable component (which in this case is the open/close action of the end effector). Alternatively, the actuable component can be any such actuable component within a robotic device embodiment.

In one specific exemplary embodiment as shown inFIG.29A(which is similar to the implementation depicted inFIGS.21A-Band discussed above), a robotic device350has a device body352and at least one arm (in this case, a right arm)354with an upper arm354A, a forearm354B, and an end effector354C attached to the forearm354B. Two actuation assemblies356,358are disposed within or otherwise associated with the forearm354B. More specifically, the first actuation assembly (the tool roll actuation assembly)356is an actuator/cable assembly356having an actuator356A and an attached cable356B that is coupled to the actuable tool roll mechanism (not shown) and positioned between the actuator356A and tool roll mechanism via one or more pulleys359. As such, actuation of the assembly356causes actuation of the tool roll mechanism, thereby causing the end effector354C to rotate around its axis. In addition, the second actuation assembly (the open/close actuation assembly)358is an actuator/cable assembly358having an actuator358A and an attached cable358B that is coupled to the actuable end effector354C and positioned between the actuator358A and the end effector354C via one or more pulleys360. As such, actuation of the assembly358causes actuation of the end effector354C to open and close. In this specific implementation, the actuators356A,358A of both assemblies are disposed within or associated with the forearm354B such that the actuators356A,358A are disposed “locally” in relation to the actuable components to which they are coupled. The specific number and positioning of the pulleys (such as pulleys359,360) in this embodiment and the additional embodiments disclosed or contemplated below and elsewhere in this application can vary as needed depending on the various parameters relating to the arm, the actuation assembly, and other known variables within any known device in which such an actuation assembly may be incorporated. Further, it is understood that other mechanisms and/or structures can be used in addition to or in place of the pulleys to position the cable (such as cables356B,358B) as desired/needed.

Alternatively, as shown inFIG.29B, either or both of the actuation assemblies discussed above can be configured such that the actuator is disposed within or otherwise associated with the upper arm354A (instead of the forearm354B). More specifically, in this exemplary embodiment, the open/close actuation assembly358is configured such that the actuator258A is disposed within or otherwise associated with the upper arm354A, with the cable358B extending from the actuator258A in the upper arm354A through the forearm354B to the end effector354C attached to the forearm354B. More specifically, the cable358B is positioned within the upper arm354A and the forearm354B as desired via appropriately positioned pulleys360. The specific number and positioning of the pulleys360and/or other mechanisms can vary as mentioned above. In this embodiment, while not shown inFIG.29B, the tool roll actuation assembly356is disposed within the forearm354B as described above with respect toFIG.29A.

Alternatively, as shown inFIG.29C, either or both of the actuation assemblies discussed above can be configured such that the actuator is disposed within or otherwise associated with the device body352(instead of the upper arm354A or the forearm354B). More specifically, in this exemplary embodiment, the open/close actuation assembly358is configured such that the actuator358A is disposed within or otherwise associated with the device body352as shown, with the cable358B extending from the actuator358A in the device body352through the upper arm354A and the forearm354B to the end effector354C attached to the forearm354B. More specifically, the cable358B is positioned within the device body, upper arm354A, and forearm354B as desired via appropriately positioned pulleys360. The specific number and positioning of the pulleys360and/or other mechanisms can vary as mentioned above. In this embodiment, while not shown inFIG.29C, the tool roll actuation assembly356is disposed within the forearm354B as described above with respect toFIG.29A.

In a further alternative as shown inFIG.29D, either or both of the actuation assemblies discussed above can be configured such that the actuator is disposed at a location external to the device body352. More specifically, the actuator358A can be located in an external controller, a separate actuation component (including, for example, a detachable actuation component that can be removably attached to the device body352), or any other location from which the cable358B coupled thereto can extend into the device350. In this exemplary embodiment as shown, the open/close actuation assembly358is configured such that the actuator358A is disposed in an external controller362, with the cable358B extending from the actuator358A to the device body352and through the device body352, the upper arm354A, and the forearm354B to the end effector354C attached to the forearm354B. More specifically, the cable358B is positioned external to the device350and through the device body352, upper arm354A, and forearm354B as desired via appropriately positioned pulleys360. The specific number and positioning of the pulleys360and/or other mechanisms can vary as mentioned above. In this embodiment, while not shown inFIG.29D, the tool roll actuation assembly356is disposed within the forearm354B as described above with respect toFIG.29A.

In some embodiments, the actuators356A,358A inFIGS.29A-29Dare motors. For example, the motors can be brushless direct current motors with gearheads. Alternatively, the actuators356A,358A can be any motors as described elsewhere herein or any other known motors for use in such devices. Alternatively, the actuators356A,358A can be any known actuators.

While each of the implementations inFIGS.29A-29Das discussed above are described as having known push/pull cables or known pull and opposing cables, according to other embodiments, the cables356B,358B can be rotary drive cables. In a further alternative, one of the two cables356B,358B can be one type of drive cable (such as a push/pull cable or opposing pull cables, for example) while the other is another type of drive cable (such as a rotary drive cable, for example). Thus, in the various embodiments utilizing at least one rotary drive cable, no pulleys are required for that cable and thus do not need to be included in the device.

The specific embodiments discussed above and depicted inFIGS.29A-Dare provided as non-limiting examples. Any actuable component can be actuated by an actuator disposed in or associated with any component of a device (or external to such device) through the routing of cables through various lumens and/or pulleys. That is, according to other embodiments, any such cable-driven actuation assembly with an actuator disposed at any of the locations described above can be used to actuate any actuable component. More specifically, the cable of such an assembly is coupled to a component that requires motive force to operate/function. In one specific implementation, all of the actuators of all the actuation assemblies can be disposed at an external location in a fashion similar to that shown inFIG.29D.

As discussed above, the various actuator/cable actuation assemblies disclosed or contemplated according to any of the embodiments herein allow for combinations of different actuator assemblies within the same device and/or in the same component of the same device. That is, a robotic arm or one segment of such an arm (such as the upper arm or forearm) can contain both an actuator/gear actuation assembly and an actuator/cable assembly. Further, any device can contain any combination of such assemblies.

One exemplary implementation of a robotic device380with a forearm384B having two different actuation assemblies388,390disposed therein or associated therewith is depicted inFIGS.30A and30B. More specifically,FIG.30Bshows a robotic device380having an elongate body382with two robotic arms384,386. For purposes of this application, the discussion will focus on the right arm384, but it is understood that the same or similar actuation assemblies can be incorporated into the left arm386. The right arm384has an upper arm384A, a forearm384B, and an end effector384C.

FIG.30Aprovides an expanded view of the right forearm384B, which contains the two actuation assemblies388,390. The first actuation assembly388is the tool roll actuation assembly388and has a first actuator388A coupled to a driven gear set388B via a first rotating drive mechanism388C. The driven gear set388B is coupled to the first target actuable component of the forearm384B. More specifically, in this example, the drive gear set388B is coupled to the tool roll mechanism (not shown). Alternatively, the tool roll actuation assembly388can be any known gear driven actuation assembly having any configuration of an actuator and at least one gear.

The second actuation assembly390is the tool open/close actuation assembly390and has a second actuator390A coupled to a cable390B via a second rotating drive mechanism390C which is, in some embodiments, a spool390C. The cable390B extends from the spool390C to the second target actuable component of the forearm384B via two appropriately positioned pulleys392. More specifically, in this example, the cable390B extends to and is coupled to the tool open/close mechanism (not shown). The specific number and positioning of the pulleys392and/or other mechanisms can vary as mentioned above with respect to other embodiments. Alternatively, instead of the cable290B being a lateral movement cable (such as a push/pull cable or known pull and opposing cable), the cable290B can be a rotary drive cable. In such embodiments, no pulleys are required for the cable290B and thus are not included in the device.

Thus, the forearm384B in this specific implementation has a first actuation assembly388that is an actuator/gear assembly388and a second actuation assembly390that is an actuator/cable assembly390. Each actuable component in a robotic device has specific torque and speed requirements, and the appropriate actuation assembly that satisfies those requirements can be used for each.

In some embodiments, the actuators388A,390A are motors. For example, the motors388A,390A can be brushless direct current motors with gearheads. Alternatively, the actuators388A,390A can be any motors as described elsewhere herein or any other known motors for use in such devices. Alternatively, the actuators388A,390A can be any known actuators.

According to other embodiments, any such cable-driven actuation assembly can be used to actuate any actuable component in any configuration disclosed or contemplated in the various embodiments herein, including in combination with one or more actuator/gear assembly. For example, various alternative configurations of assembly combinations are shown inFIGS.31A-D, in which both the types of actuation assemblies can be combined in the same device and the location of the actuators can vary as well. For purposes of this application, the various device embodiments having at least one cable-driven actuation assembly and at least one gear-driven actuation assembly can be referred to as hybrid devices.

In one specific exemplary embodiment as shown inFIG.31A, a robotic device400has a device body402and at least one arm (in this case, a right arm)404with an upper arm404A, a forearm404B, and an end effector404C attached to the forearm404B. In this implementation of a hybrid device400, one of the actuation assemblies406disposed within or otherwise associated with the forearm404B is an actuator/gear assembly for actuation of the tool roll mechanism, while at least one of the other actuation assemblies (not shown) within the device400is a actuator/cable assembly (not shown) according to any of the various embodiments herein. More specifically, the actuation assembly (the tool roll actuation assembly)406is an actuator/gear assembly406having an actuator406A and an attached gear set406B that is coupled to the actuable tool roll mechanism (not shown). As such, actuation of the assembly406causes actuation of the tool roll mechanism, thereby causing the end effector404C to rotate around its axis. Further, in this embodiment, the tool open/close actuation assembly (not shown) is an actuator/cable assembly in a fashion similar to the assembly390depicted inFIG.30Aand described above or any other actuator/cable assembly as described elsewhere herein. In addition, according to various embodiments, any other actuation assemblies within this device can be any combination of actuator/cable assemblies and/or actuator/gear assemblies.

Alternatively, as shown inFIG.31B, the tool roll actuation assembly408within the forearm404B is an actuator/cable assembly408. More specifically, the actuation assembly408has an actuator408A and an attached cable408B that is coupled to the actuable tool roll mechanism (not shown) such that the cable408B extends from the actuator408A to the mechanism and is positioned via a pulley410. Alternatively, instead of the cable408B being a lateral movement cable (such as a push/pull cable or known pull and opposing cable), the cable408B can be a rotary drive cable. In such embodiments, no pulleys are required for the cable408B and thus are not included in the device. Further, in this embodiment, the tool open/close actuation assembly (not shown) can be an actuator/gear assembly, or, alternatively, an actuator/cable assembly in a fashion similar to the assembly390depicted inFIG.30Aand described above. According to various embodiments, any other actuation assemblies within this device can be any combination of actuator/cable assemblies and/or actuator/gear assemblies.

Further, the various embodiments in which a device has a combination of both at least one actuator/gear assembly and at least one actuator/cable assembly (a hybrid device) can also include at least one actuator that is not disposed in the same component as the actuable component. For example, inFIG.310according to one exemplary implementation, the tool roll actuation assembly412is configured such that the actuator412A is disposed within or otherwise associated with the upper arm404A, with the cable412B extending from the actuator412A in the upper arm404A into the forearm404B to the tool roll mechanism (not shown) within the forearm404B. More specifically, the cable412B is positioned within the upper arm404A and the forearm404B as desired via appropriately positioned pulleys414. The specific number and positioning of the pulleys414and/or other mechanisms can vary as mentioned above. Alternatively, instead of the cable412B being a lateral movement cable (such as a push/pull cable or known pull and opposing cable), the cable412B can be a rotary drive cable. In such embodiments, no pulleys are required for the cable412B and thus are not included in the device. Further, in this embodiment, the tool open/close actuation assembly (not shown) can be an actuator/gear assembly, or, alternatively, an actuator/cable assembly in a fashion similar to the assembly390depicted inFIG.30Aand described above. Like the tool roll actuation assembly, the actuator in the tool open/close actuation assembly can have an actuator that is disposed within the forearm404B, the upper arm404A, or elsewhere in the device400. According to various embodiments, any other actuation assemblies within this device can be any combination of actuator/cable assemblies and/or actuator/gear assemblies, with the actuators disposed locally or at least one component away from the actuable component (or external to the device) as described in various embodiments herein.

In another exemplary embodiment as shown inFIG.31D, the tool roll actuation assembly416is configured such that the actuator416A is disposed within or otherwise associated with the device body402, with the cable416B extending from the actuator416A in the device body402through the upper arm404A and into the forearm404B to the tool roll mechanism (not shown) within the forearm404B. More specifically, the cable416B is positioned within the device body402, the upper arm404A, and the forearm404B as desired via appropriately positioned pulleys418. The specific number and positioning of the pulleys418and/or other mechanisms can vary as mentioned above. Alternatively, instead of the cable416B being a lateral movement cable (such as a push/pull cable or known pull and opposing cable), the cable416B can be a rotary drive cable. In such embodiments, no pulleys are required for the cable416B and thus are not included in the device. Further, in this embodiment, the tool open/close actuation assembly (not shown) can be an actuator/gear assembly, or, alternatively, an actuator/cable assembly in a fashion similar to the assembly390depicted inFIG.30Aand described above. Like the tool roll actuation assembly, the actuator in the tool open/close actuation assembly can have an actuator that is disposed within the forearm404B, the upper arm404A, the device body402, or elsewhere in the device400. In accordance with other alternative embodiments, the actuators for either or both of the tool roll actuation assembly and/or the tool open/close actuation assembly can be disposed at some external location as described elsewhere herein. According to various embodiments, any other actuation assemblies within this device can be any combination of actuator/cable assemblies and/or actuator/gear assemblies, with the actuators disposed locally or at least one component away from the actuable component (or external to the device) as described in various embodiments herein.

According to some exemplary implementations having a high power tool open/close mechanism (which may require more force than other such mechanisms), a local actuator/gear assembly is coupled to the open/close mechanism while an actuator/cable assembly is provided for tool roll with the actuator being disposed more “remotely” (disposed within the upper arm, the device body, or external to the device). Alternatively, the opposite can be true, such that a local actuator/cable assembly is coupled to the open/close mechanism while the tool roll actuation assembly can be either cable-driven or gear-driven and can have an actuator that is local or remote. In accordance with another embodiment, both the tool roll and tool open/close mechanisms in the forearm can be coupled to actuation assemblies with actuators disposed within the device body and the remaining actuation assemblies are disposed locally. All combinations of actuation assemblies are contemplated herein.

In accordance with other embodiments, any of the actuable components within any robotic device disclosed or contemplated herein can be actuated with an assembly having an actuator that is disposed at least one component away from the actuable component. More specifically, any of the rotatable joints within any such device can be actuated by an actuator disposed anywhere in the device or external to the device.

Further, any type of actuable component is contemplated for any embodiment herein as well. That is, the various actuable components that are contemplated herein—in addition to the specific grasper end effector and other end effectors and actuable components described herein—include any end effector or other actuable component that can be incorporated into a robotic device. For example, in some other exemplary embodiments, another actuable component that can be actuated by any of the assemblies disclosed or contemplated herein is an end effector with a linear drive for a cutting blade. Any of the actuation assemblies in any of the embodiments herein can be used to actuate such a linear drive, including a remote actuator with a linear push/pull cable.

As noted elsewhere, any of the actuators disclosed or contemplated herein can be any known type of actuator, including, but not limited to, motors, muscle wire, hydraulics, pneumatics, etc.

In accordance with various device embodiments herein, the various actuation assembly configurations herein make it possible for the devices to be handheld (as shown inFIG.32) or of similar size, which provides various advantages during surgical procedures. That is, the ability to position one or more actuators at a location that is at least one component away from the actuable component allows for the components to have smaller dimensions because such components do not have to contain actuators. For example, if all of the actuators for the entire device are disposed within the device body, the arms can have smaller dimensions in comparison to arms containing actuators. In another example, if all of the actuators for the entire device are disposed external to the device, the arms and the device body can have smaller dimensions in comparison to similar arms and a device body containing actuators. More specifically, the various devices herein (including the device body, camera, and any arms attached thereto) can have a weight ranging from about 2 pounds to about 25 pounds. Alternatively, the weight can be any weight that is about 25 pounds or less, about 10 pounds or less, about 5 pounds or less, or about 2 pounds. Thus, the various device implementations herein are small enough that they can be easily stored, transported, and set up for use, along with being easily deployed and repositioned during use. A further advantage of the device size is that the device saves space in the operating room, including, for example, the space above the patient and next to the operating table.

Yet another advantage of the device implementations herein and specifically the size thereof is that the various devices herein are not so large that they are required to be attached to or resting on the ground or to the wall or ceiling (which is a common requirement of other such devices/systems as a result of their size). Instead, the device embodiments herein are sized such that each can be attached to and supported by the standard rail on the side of the operating table (such as the setup ofFIG.1above with the support arm attached to the operating table) or a similar attachment mechanism or method.

In addition, the size of the device embodiments herein allow for such a device to be easily repositioned to different locations/positions within the target cavity of the patient, such as the peritoneal cavity. For example, as shown inFIGS.33A-C, the distal end of the device (the portion of the device—including the distal end of the body and the arms—disposed within the patient cavity) can be easily positioned near the rectum (FIG.33A), near the colon (FIG.33B), and near the transverse colon (FIG.33C). The repositioning of the device to move it into any of these three positions is simple and easy as a result of the size of the device. For example, in certain embodiments, the mounting structure (such as a support arm) need not be moved from one side of the operating table to the other as a result of the small size of the device implementations herein, and instead the device can simply be repositioned in relation to the support arm.

In contrast, various prior art systems require larger components that are cumbersome and restrict the use of such systems in comparison to the various embodiments herein. For example, various known systems require that the actuators be disposed within an external proximal component such as a drive unit that is connected to the device via a direct connection or a power transmission mechanism or the like. Due to the size of the systems, as shown inFIG.34A, such drive units typically need to be supported with an external attachment such as an extended arm attached to a cart, a wall or ceiling attachment, or the like. Other such systems have drive units that need to be supported with a floor base unit as shown inFIG.34B. In contrast, the various device and system embodiments herein require no such carts, wall/ceiling attachments, or floor units to support such drive units.

In accordance with one exemplary embodiment, a robotic device500having an external actuation unit512with multiple external actuators is depicted inFIGS.35A-35E. That is, as will be discussed in further detail below, the device500has multiple separate actuation assemblies, each having an external actuator (in the external actuation unit512) with a force transmission cable attached thereto that extends into the device500and is coupled to the intended actuable component of the device500. As such, force generated by each actuator in the actuator unit512is transmitted to the intended actuable component via the force transmission cable coupled thereto, as will be described in additional detail below. The device500can be incorporated into the exemplary system10discussed above or any other system disclosed or contemplated herein.

The device500has an elongate body502having a distal section502A and proximal section502B, two anthropometric robotic arms504,506(a right arm504and a left arm506) operably coupled to a distal end of the distal section502A of the body502, and an imaging device (or “camera”)508removably disposed through the elongate body502such that the distal end of the camera508is disposed between the two arms504,506as shown. The handle510at the proximal end of the camera508is coupled to a proximal end of the proximal section502B, as will be discussed in further detail below. Except as expressly discussed below, the various components and features of the device500can be substantially similar to any of the embodiments disclosed or contemplated herein, and further can be substantially similar to any of the components and/or features of the devices disclosed in U.S. application Ser. Nos. 16/736,329, 16/926,025, 17/075,122, and 17/367,915, all of which are incorporated herein by reference in their entireties.

Further, an attachment or stabilization device516is also provided that can be removably coupled to the elongate device body502to maintain the desired position of the device500in relation to the surgical space and the patient (not shown). Any known attachment device can be used.

In this exemplary implementation as shown inFIGS.36A-36D, the actuation unit512is coupled to the elongate body502via an arm514that extends from the elongate body502to the actuation unit512as shown. The arm514in this embodiment has a radial link520attached to and extending radially from the body502, and an extension link522attached to the radial link520, with the actuation unit512attached to the extension link522. More specifically, the extension link522in this exemplary embodiment is a curved extension link522that extends both radially and axially (in relation to the elongate body502) from the radial link520as shown. Alternatively, the arm514can be any structure that can couple the unit512to the body502and position the unit512in relation to the body502as desired.

In one embodiment, the arm514(and more specifically, the extension link522) is coupled to the actuation unit512via a support plate524. That is, the actuation unit512has a support plate524that couples to the arm514and has all of the actuators534,536coupled thereto as shown. More specifically, each of the actuators534,536is attached to the support plate524such that the actuators534,536are disposed on one side of the plate524and the actuator gears extend through openings (not shown) in the plate524to the other side of the plate524.

In some embodiments, the actuators534,536are motors534,536. For example, the motors534,536can be brushless direct current motors with gearheads from Maxon. Alternatively, the actuators534,536can be any motors as described elsewhere herein or any other known motors for use in such devices. Alternatively, the actuators534,536can be any known actuators.

As best shown inFIGS.37A-37C, the actuation unit512has twelve motors534A-F,536A-F as shown. More specifically, the unit512has six right arm actuators534and six left arm actuators536. Thus, the unit512has the same number of right arm actuators534as the number of degrees of freedom in the right arm504(which is six in this case), and similarly has the same number of left arm actuators536as the number of degrees of freedom in the left arm506(which is also six in this case). Alternatively, the actuation unit512has any number of actuators to match the number of degrees of freedom in the device500.

According to one implementation, the actuation unit512is easily detachable from the elongate body502and/or from the arm514. For example, in those embodiments in which the device500is disposable, the unit512can be easily attachable and removable such that the unit512can be attached to the device500prior to use and further can be easily detached after use such that the unit512can be retained while the device500is disposed of.

Returning toFIGS.36B-D, the motors534,536are coupled to the actuable components of the device500via the motive force transfer cables532. More specifically, each actuation assembly (described in further detail below) is made up of one of the motors534,536and the cable532coupled thereto. While not shown in the figures, each cable532is operably coupled at its proximal end to a separate one of the motors534,536and extends from the actuation unit512through an opening530in the proximal section502B and into the elongate body502as shown.

As shown inFIGS.38A-D, according to one embodiment, each cable532extends distally along the interior of the elongate body502. More specifically, the elongate body502has three interior body supports550A,550B,550C, each of which is disposed in the interior of the elongate body502at a different location along the length thereof as shown. Further, each body support550A,550B,550C has openings552defined therein to allow each of the cables532to pass therethrough such that each separate cable532passes through a separate opening552as shown. As such, the supports550A,550B,550C provide structural support to the elongate body502and the cables532disposed therethrough.

According to certain implementations, each of the force transmission cables532is a flexible rotary torque transmission cable532. More specifically, any known flexible rotary torque transmission cable532can be used. As such, each cable532has an outer sheath or casing with a rotatable shaft disposed within the outer sheath such that the rotatable shaft transmits the motive force from the specific actuator to which the cable532is coupled at its proximal end to the intended actuable component to which the cable532is coupled at its distal end. In one specific implementation, the rotary torque transmission cable532and any other rotary transmission cable disclosed or contemplated herein is a flexible rotary shaft, which is commercially available from Suhner Manufacturing Co. In some embodiments, certain of the flexible rotary shafts are custom-made flexible cables with an internal rotary shaft that is rotatable within an exterior sheath. Certain specific implementations include flexible rotary cables with an internal rotary shaft made up of multiple layers of small diameter counter wound wires (thereby allowing for bi-directional rotation without unwinding the rotary shaft). Alternatively, any force transmission cable can be used.

As discussed above, each of the cables532extend through the interior of the elongate body502and extend out of the distal end of the body502, as shown inFIG.39according to one embodiment. More specifically, some exemplary cables532are visible extending through and out of the distal end of the body502in the figure. These particular cables532are coupled to the intended actuable components in the forearm of the left arm506. However, the lengths of the cables532extending along an exterior of the upper arm of the left arm506are not shown. Thus, a length of each of the cables532is visible extending distally out of the body502as discussed above, and a corresponding length of each of the cables532is depicted extending proximally out of the forearm.

The various actuation assemblies herein (with each actuation assembly made up an actuator, a cable, and an actuable component) will be described in additional detail below. Both arms504,506have six degrees of freedom, which means that each arm504,506has six actuation assemblies operably coupled thereto (with six actuators disposed in the actuation unit512, as discussed above). As best shown inFIGS.40A-40D, the right arm504in this specific implementation has a first link (or “upper arm”)540, a second link (or “forearm”)542coupled to the upper arm540at an elbow joint (or “elbow”)544, and a removable end effector546operably coupled to the forearm542. The right arm504is operably coupled to the elongate body502via the shoulder (or “shoulder joint” or “shoulder housing”)548. While the right arm504and the various actuation assemblies related thereto will be discussed in detail here, it is understood that the left arm506is substantially similar and has the same components, actuation assemblies, and features therein.

According to one embodiment, the first degree of freedom or axis of rotation of the right arm504is the shoulder roll or “yaw.” More specifically, as shown inFIGS.41A-410according to one embodiment, the shoulder roll actuation assembly560includes an actuator (not shown), a rotary transmission cable562, a cable gear564, a driven gear566, and the actuable component coupled thereto, which in this case is the shoulder housing548. As discussed above, the cable562is coupled at its proximal end to an actuator (not shown) in the actuation unit512and extends from the actuation unit512through the opening530in the elongate body502and along the length of the elongate body502toward the distal end of the body502as best shown inFIG.41A. The cable gear564is fixedly attached (or rotationally constrained) to the distal end of the cable562such that rotation of the cable562causes rotation of the gear564. The cable gear564is rotatably coupled to the driven gear566such that rotation of the cable gear564causes rotation of the driven gear566. Further, the driven gear566is fixed attached (or rotationally constrained) to the shoulder housing548such that rotation of the driven gear566results in rotation of the shoulder housing548. In certain embodiments (including the exemplary embodiment as shown), both gears564,566have external teeth that mesh together such that the rotation of the cable gear564causes rotation of the driven gear566. Alternatively, any known mechanism(s) can be used to rotatably couple the cable562to the shoulder housing548.

According to one embodiment, the right arm yaw actuation assembly560operates in the following fashion. The right arm yaw actuator (now shown) in the actuation unit512is actuated to generate motive force, which is transmitted via a physical coupling to the rotary drive cable562. The rotation of the drive cable562causes rotation of the cable gear564, which causes rotation of the driven gear566. Further, the rotation of the driven gear566causes rotation of the shoulder housing548around the rotational axis J1as best shown inFIG.41B. This rotation of the shoulder housing548results in the shoulder roll or yaw rotation of the right arm504as best shown inFIGS.41B and41C.

In accordance with a further embodiment, the second degree of freedom or axis of rotation of the right arm504is the shoulder pitch. More specifically, as shown inFIGS.42A-42Baccording to one embodiment, the shoulder pitch actuation assembly570includes an actuator (not shown), a rotary transmission cable572, cable threaded end574, a translation rod576, and a coupling link (or arm)578coupled to the actuable component, which in this case is the upper arm540. As discussed above, the cable572is coupled at its proximal end to an actuator (not shown) in the actuation unit512and extends from the actuation unit512through the opening530in the elongate body502and along the length of the elongate body502toward the distal end of the body502as shown inFIGS.42A-B. The threaded screw (or “end”)574is fixedly attached (or rotationally constrained) to the distal end of the cable572such that rotation of the cable572causes rotation of the screw574. Alternatively, the threaded screw574can be any known rotational component (such as a gear or other such mechanism or component) for coupling to the translation rod576. As best shown inFIG.42B, the threaded screw574is rotatable disposed within the lumen577of the slidable translation rod576. The inner surface of the lumen577is also threaded such that the threaded screw574threadably couples with the translation rod576. The translation rod576can be any structure, such as a tube, a block, or any other structure or shape having a threaded lumen that allows for conversion of the rotational motion of the cable572to translation or axial motion of the rod576. Thus, rotation of the threaded screw574within the lumen577causes the translation rod576to move axially within the shoulder housing548. Further, the translation rod576is rotatably attached to a coupling link (or “arm”)580at a first rotatable joint578at one end of the link580such that axial movement of the rod576causes movement of the link580. Further, the coupling link580is rotatably coupled to the upper arm540of the right arm504at a second rotatable joint582at the other end of the link580such that the movement of the link580causes movement of the upper arm540. Alternatively, any known rotation-to-translation mechanism can be used to moveably couple the cable572to the upper arm540.

According to one embodiment, the right arm shoulder pitch actuation assembly570operates in the following fashion. The right arm shoulder pitch actuator (not shown) in the actuation unit512is actuated to generate motive force, which is transmitted via a physical coupling to the rotary drive cable572. The rotation of the drive cable572causes rotation of the threaded screw574, which causes translation (axial movement) of the translation rod576as described above. The axial movement of the rod576causes movement of the coupling arm580, which causes rotation of the upper arm540around the rotational axis J2as best shown inFIG.42B. This rotation of the upper arm540results in the shoulder pitch rotation of the right arm504as best shown inFIGS.43A-43C.

The third degree of freedom or axis of rotation of the right arm504, in certain implementations, is the upper arm roll. More specifically, as shown inFIGS.44A-44Caccording to one embodiment, the upper arm roll actuation assembly590includes an actuator (not shown), a rotary transmission cable592, cable threaded end594, a translation nut596, and a driven shaft598coupled to the actuable component, which in this case is the shoulder coupling component600. As discussed above, the cable592is coupled at its proximal end to an actuator (not shown) in the actuation unit512and extends from the actuation unit512through the opening530in the elongate body502, along the length of the elongate body502and out of the distal end of the body502(as shown for example inFIG.39) and then extends into the upper arm540as best shown inFIG.44B. The threaded screw (or “end”)594is fixedly attached (or rotationally constrained) to the distal end of the cable592such that rotation of the cable592causes rotation of the screw594. Alternatively, the threaded screw594can be any known rotational component (such as a gear or other such mechanism or component) for coupling to the translation nut596. As shown inFIGS.44A-44C, according to one embodiment, the translation nut596has two lumens defined therethrough: a screw lumen596A and a driven shaft lumen596B. The screw lumen596A receives the cable screw594and has a threaded inner surface (not shown) that threadably couples to the threads of the threaded screw594. The driven shaft lumen596B receives the driven shaft598and has a protrusion597therein such that the protrusion597matches with and is disposed within the groove598A of the driven shaft598as best shown inFIG.44C. Thus, the threaded screw594is rotatably disposed within the screw lumen596A and the driven shaft598is rotatably disposed within the shaft lumen596B. The translation nut596can be any structure, such as a barrel, a block, or any other structure or shape having two lumens defined therein that allow for conversion of the rotational motion of the cable592to translation or axial motion of the nut596and then conversion of that translation back to rotational motion of the drive shaft598. Thus, rotation of the threaded screw594within the lumen596A causes the translation nut596to move axially within the upper arm540. Further, the axial movement of the nut596causes the driven shaft598to rotate due to the protrusion597being disposed within the groove598A that winds around the shaft598. The driven shaft598is fixedly attached (or rotationally constrained) to the shoulder coupling component600such that rotation of the shaft598causes rotation of the coupling component600. Alternatively, any known rotation-to-translation-to-rotation (or just rotation-to-rotation) mechanism can be used to moveably couple the cable592to the shoulder coupling component600.

According to one embodiment, the right upper arm roll actuation assembly590operates in the following fashion. The right upper arm roll actuator (not shown) in the actuation unit512is actuated to generate motive force, which is transmitted via a physical coupling to the rotary drive cable592. The rotation of the drive cable592causes rotation of the threaded screw594, which causes translation (axial movement) of the translation nut596as described above. This translation causes rotation of the driven shaft598as also described above. The rotation of the driven shaft598causes rotation of the shoulder coupling component600, which causes rotation of the upper arm540around the rotational axis J3as best shown inFIG.44D. This rotation of the upper arm540results in the roll of the right upper arm540around that axis as a result of the rotation of the coupling component600as best shown inFIGS.44D and44E.

In another aspect, the fourth degree of freedom or axis of rotation of the right arm504is the elbow pivot. More specifically, as shown inFIGS.45A-45Eaccording to one embodiment, the elbow pivot actuation assembly610includes an actuator (not shown), a rotary transmission cable612, cable threaded end614, a translation block616, and a coupling link (or arm)618coupled to the actuable component, which in this case is the elbow housing620. As discussed above, the cable612is coupled at its proximal end to an actuator (not shown) in the actuation unit512and extends from the actuation unit512through the opening530in the elongate body502, along the length of the elongate body502, out of the distal end of the body502(as shown for example inFIG.39) and then extends into the upper arm540as best shown inFIGS.45C-E. The threaded screw (or “end”)614is fixedly attached (or rotationally constrained) to the distal end of the cable612such that rotation of the cable612causes rotation of the screw614. Alternatively, the threaded screw614can be any known rotational component (such as a gear or other such mechanism or component) for coupling to the translation block616. As best shown inFIGS.44C and44E, the translation block616has both a screw lumen616A to receive (and couple to) the screw614and an arm slot616B to receive (and couple to) the coupling arm618. The screw lumen616A receives the cable screw614and has a threaded inner surface (not shown) that threadably couples to the threads of the threaded screw614. The arm slot616B receives one end of the coupling arm618and has a rod617extending through the slot616B such that the rod617is rotatably coupled with the arm618such that the arm can rotate in relation to the translation block616around the rod617. Thus, the threaded screw614is rotatably disposed within the screw lumen616A and the end of the coupling arm618is rotatably disposed within the slot616B as shown. Alternatively, the translation block616can be any structure, such as a barrel, a nut, or any other structure or shape having two coupling features defined therein that allow for conversion of the rotational motion of the cable612to translation or axial motion of the block616and the arm618(with the arm being pivotable in relation to the block616as disclosed herein).

Further, as best shown inFIG.45Eaccording to one embodiment, the coupling arm618is rotatably attached to the elbow housing620at a first rotatable joint622at the end of the arm618opposite the coupling to the rod617. Further, the elbow housing620is rotatably coupled to a distal extension628of the upper arm540at a second rotatable joint624such that the elbow housing620is rotatable in relation to the upper arm540. As such, axial movement of the arm618causes the elbow housing620to rotate around the second rotatable joint624. In addition, the forearm542has a proximal extension630that is rotatably coupled to the elbow housing620at a third rotatable joint626such that the forearm542is rotatable in relation to the elbow housing620. According to the exemplary implementation as shown, the distal extension628of the upper arm540is rotatably coupled to the proximal extension630of the forearm542such that the outer edge of the proximal extension630rotates around and in contact with (and in relation) to the outer edge of the distal extension628. In certain implementations, both extensions628,630have teeth that mate with each other as shown such that the teeth will cause the forearm542to rotate around the third rotatable joint626as the proximal extension630rotates around the distal extension628. As such, axial movement of the arm618causes the elbow housing620to rotate around the second joint624, which causes the forearm542to rotate around the third joint626. Alternatively, any known rotation-to-translation-to-rotation mechanism can be used to moveably couple the cable612to the elbow housing620and the forearm542.

According to one embodiment, the right arm elbow pivot actuation assembly610operates in the following fashion. The right arm elbow pivot actuator (not shown) in the actuation unit512is actuated to generate motive force, which is transmitted via a physical coupling to the rotary drive cable612. The rotation of the drive cable612causes rotation of the threaded screw614, which causes translation (axial movement) of the translation block616as described above. The axial movement of the block616causes axial movement of the coupling arm618, which causes rotation of the elbow housing620around the rotatable joint624, which cause rotation of forearm542around the rotatable joint626, which is the rotational axis J4as best shown inFIGS.45B and45D. This rotation of the forearm542results in the elbow pivot rotation of the right arm504as best shown inFIGS.45C-45E.

According to some implementations, the fifth degree of freedom or axis of rotation of the right arm504is the end effector roll. More specifically, as shown inFIGS.46A-46Caccording to one embodiment, the end effector roll actuation assembly640includes an actuator (not shown), a rotary transmission cable642, a cable gear644, a driven gear646, and the actuable component coupled thereto, which in this case is the end effector housing648. As discussed above, the cable642is coupled at its proximal end to an actuator (not shown) in the actuation unit512and extends from the actuation unit512through the opening530in the elongate body502, along the length of the elongate body502, out of the distal end of the body502(as shown for example inFIG.39) and then extends into the forearm542as best shown inFIGS.46A-46C(wherein the forearm542itself is not shown). The cable gear644is fixedly attached (or rotationally constrained) to the distal end of the cable642such that rotation of the cable642causes rotation of the gear644. The cable gear644is rotatably coupled to the driven gear646such that rotation of the cable gear644causes rotation of the driven gear646. Further, the driven gear646is fixed attached (or rotationally constrained) to the end effector housing648such that rotation of the driven gear646results in rotation of the end effector housing648. In certain embodiments (including the exemplary embodiment as shown), both gears644,646have external teeth that mesh together such that the rotation of the cable gear644causes rotation of the driven gear646. Alternatively, any known mechanism(s) can be used to rotatably couple the cable642to the end effector housing648.

According to one embodiment, the right arm end effector roll actuation assembly640operates in the following fashion. The right arm end effector roll actuator (not shown) in the actuation unit512is actuated to generate motive force, which is transmitted via a physical coupling to the rotary drive cable642. The rotation of the drive cable642causes rotation of the cable gear644, which causes rotation of the driven gear646. Further, the rotation of the driven gear646causes rotation of the end effector housing648(and thus the end effector546) around the rotational axis J5as best shown inFIG.46A. This rotation of the end effector housing648results in the end effector roll of the right arm504as best shown inFIGS.46B and46C.

In accordance with a further embodiment, the sixth degree of freedom or axis of rotation of the right arm504is the end effector open/close actuation. More specifically, as shown inFIGS.47-49Caccording to one embodiment, the end effector actuation assembly660includes an actuator (not shown), a rotary transmission cable662, cable female drive barrel664, a translation rod666, and a protrusion668coupled to the actuable component, which in this case is the end effector546. As discussed above, the cable662is coupled at its proximal end to an actuator (not shown) in the actuation unit512and extends from the actuation unit512through the opening530in the elongate body502, along the length of the elongate body502, out of the distal end of the body502(as shown for example inFIG.39), and then extends into and through the forearm542as best shown inFIGS.48A-48C(wherein the forearm542itself is not shown). The female drive barrel664is fixedly attached (or rotationally constrained) to the distal end of the cable662such that rotation of the cable662causes rotation of the barrel664. Alternatively, the drive barrel664can be any known rotational component with a female opening (such as a tube or other such mechanism or component) for coupling to the translation rod666, or any other rotation-to-translation component or mechanism. As best shown inFIG.48A, the drive barrel664has a lumen664A defined therein with an opening at the distal end thereof to receive the translation rod666. In this exemplary implementation, the lumen664A has threads on the inner surface of the lumen664A. The translation rod666is rotatably disposed within the lumen664A of the barrel664. Further, the outer surface of the rod666is threaded such that the threads of the rod666mate with the threads of the inner surface of the lumen664A. As such, rotation of the drive barrel664causes translation or axial motion of the rod666. Further, the translation rod666has a radial protrusion668at the distal end of the rod666(or alternatively, the rod666is fixedly attached to a radial protrusion668). In addition, the two grasper arms546A,546B of the grasper end effector546have slots670defined within the proximal ends of the arms546A,546B that are sized and configured to receive the protrusion668therein such that axial movement of the protrusion668causes the grasper arms546A,546B to move between their open and closed positions. Alternatively, any known rotation-to-translation-to-transverse-rotation (or rotation-to-transverse-rotation) mechanism can be used to moveably couple the cable662to the end effector546.

According to one embodiment, the right arm end effector open/close actuation assembly660operates in the following fashion. The right arm shoulder pitch actuator (not shown) in the actuation unit512is actuated to generate motive force, which is transmitted via a physical coupling to the rotary drive cable662. The rotation of the drive cable662causes rotation of the drive barrel664, which causes translation (axial movement) of the translation rod666as described above. The axial movement of the rod666causes axial movement of the protrusion668, which causes rotation of the grasper arms546A,546B around the rotational axis J6as best shown inFIG.48A. More specifically, the axial movement of the rod666(and protrusion668) causes rotation of the grasper arms546A,546B between a closed configuration as shown inFIG.49A, an open configuration as shown inFIG.49B, and any position of the two arms546A,546B therebetween, such as the position as shown inFIG.49C.

FIGS.50A and50Bdepict one implementation of the device500with the removable camera508. More specifically, in contrast toFIGS.35A-36Bin which the removable camera508is disposed within and fully attached to the elongate body502,FIG.50Adepicts the camera508in position to be inserted into the device500. Further,FIG.50Bdepicts the camera508being urged into the fully attached or docked position such that the elongate tube508A of the camera508is extending out of the proximal section502B of the elongate body502. In one embodiment, the camera508and the interface with the device500can be substantially similar to the device40embodiment or any other embodiments described above, or alternatively can be substantially similar to any of the camera and interface components and/or features of the devices disclosed in U.S. application Ser. Nos. 16/736,329, 16/926,025, 17/075,122, and 17/367,915, all of which are incorporated herein by reference in their entireties.

Returning toFIGS.38A-38D, certain embodiments of the device500can also include a mechanism to control and/or manage the movement of the drive cables532in relation to the elongate device body502to avoid excessive slack in the cables532. More specifically, as discussed in further detail above and depicted inFIGS.38A-Band39, several of the cables532extend from the distal end of the elongate body502to the forearm542such that the lengths of those cables532between the elongate body502and the forearm542are disposed outside of the body502and arm504. Thus, when the arms504,506extend into their fully extended positions (as shown with respect to arm504inFIG.40A, for example), it is necessary for the cables532have sufficient length to extend the full distance between the distal end of the elongate body502and the forearm542. In contrast, when the arms504,506are disposed such that the forearms542are closer to the distal end of the elongate body502, the external cables532have excess length. As such, these externally disposed cables532could cause problems if they have too much slack in them (including possible snagging on certain movable components of the device500during use) based on the position of the arms504.

In this exemplary embodiment, the cable positioning block (or “insert”)555controls the amount of the cable length of the cables532extending out of the distal end of the elongate body502depending on the position and movement of the arms504,506, thereby eliminating the excess cable length that could create problems. As best shown inFIGS.38C,38D, and42A, the cable block actuation assembly is coupled to the shoulder pitch actuation assembly570such that both assemblies utilize the same rotary transmission cable572. The cable572has a cable gear554disposed at a midpoint along the length of the cable572as best shown inFIG.42Asuch that actuation of the shoulder pitch actuation assembly570also causes actuation of the cable gear554and the actuable component coupled thereto, which in this case is the positioning block555. That is, the cable gear554is fixedly attached (or rotationally constrained) or incorporated into a midpoint of the length of the cable553such that rotation of the cable553causes rotation of the gear554. The cable gear554is rotatably disposed within a first lumen556of the cable block555, wherein the inner surface of the lumen556is threaded (as is the cable gear554) such that rotation of the cable gear564causes translation or axial movement of the cable block555. Further, an elongate support557is disposed within and extends along the length of the elongate body502and is disposed through a second lumen558in the block555such that the block555is slidable along the support557via the second lumen558. As such, the support557helps to ensure that the block555maintains its radial disposition as it is urged axially. Alternatively, any known rotation-to-translation mechanism(s) can be used to rotatably couple the cable553to the block555and thereby actuate the block555as described herein.

According to one embodiment, the cable positioning block actuation assembly operates in the following fashion. The shoulder pitch actuator (not shown) in the actuation unit512(or elsewhere) is actuated to generate motive force and cause the upper arm540to rotate in relation to the elongate body502into any of the positions as shown inFIGS.43A-43C. As discussed above, it is this movement of the upper arm540that has the greatest effect on the external cables. Thus, when the shoulder pitch actuator is actuated, it also causes the cable gear554to rotate, which causes axial movement of the cable positioning block555. More specifically, when the upper arm540is urged into an acute angle as best shown inFIG.43C, the cable positioning block555is urged into its proximal position as best shown inFIGS.38B and38D, which urges the cables532into their retracted position at the distal end of the elongate body502as best shown inFIG.38B. Similarly, when the upper arm540is urged into its extended or straight position as shown inFIG.43A, the cable positioning block555is urged into its distal position as best shown inFIGS.38A and38C, which urges the cables532into their extended position at the distal end of the elongate body502as best shown inFIG.38A. As such, the cable positioning block555operates to control the length of the external cables.

Continuing withFIGS.38A-38D, along withFIG.39, certain embodiments of the device500can also include certain improved cable features or characteristics to control and/or manage the radial and rotational flexibility of the drive cables532. As described elsewhere herein, one of the benefits of the cables532is that they are radially flexible (or bendable) such that some can extend distally from the elongate body502to the forearm542and can flex as needed when the arm504moves into different configurations (as best shown inFIG.39). Further, proximal lengths of the cables532(as best shown inFIGS.36C-36D) must also be radially flexible such that the cables532can bend as they extend through the opening530and are coupled to the actuators534,536of the actuation unit512. However, the more radially flexible each cable is, the greater the rotational flexibility of that cable, such that there is risk of the cable bending when actuation of the cable is attempted. Thus, as best shown inFIG.39, in certain embodiments, each of the cables532can have a rigid length532A disposed within the elongate body502such that the cables532are not radially flexible or are prevented from any radial movement. In contrast, the cables532can have a flexible length532B along the length that is disposed between the elongate body502and the forearm542. Further, in certain implementations, the cables532can have a thick flexible length532C that is thicker than the flexible length532B but still flexible along the length that is disposed between the opening530and the actuation unit512as best shown inFIGS.36B-36D. Thus, the rigid length532A of each cable532helps to reduce the risk of bending of the flexible length532B as a result of actuation of the cable532. Similarly, the thickness of the thick flexible length532C allows for radial bending of the cables532along the length532C while also reducing the risk of bending of the thick flexible length532C as a result of actuation of the cable532.

While the various systems described above are separate implementations, any of the individual components, mechanisms, or devices, and related features and functionality, within the various system embodiments described in detail above can be incorporated into any of the other system embodiments herein.

The terms “about” and “substantially,” as used herein, refers to variation that can occur (including in numerical quantity or structure), for example, through typical measuring techniques and equipment, with respect to any quantifiable variable, including, but not limited to, mass, volume, time, distance, wave length, frequency, voltage, current, and electromagnetic field. Further, there is certain inadvertent error and variation in the real world that is likely through differences in the manufacture, source, or precision of the components used to make the various components or carry out the methods and the like. The terms “about” and “substantially” also encompass these variations. The term “about” and “substantially” can include any variation of 5% or 10%, or any amount—including any integer—between 0% and 10%. Further, whether or not modified by the term “about” or “substantially,” the claims include equivalents to the quantities or amounts.