Scissor sleeve assembly protection

A sleeve insertion assembly includes a sleeve inserter defining an inner chamber and having a distal end and a proximal end opposite the distal end, a sleeve receivable within the inner chamber, and a blade guard receivable within the sleeve and having a cylindrical body that defines an interior and an open end. The open end is sized to receive jaw members of an end effector into the interior but prevent the end effector from entering the interior, and the blade guard is forced out of the sleeve when the sleeve is installed on the end effector.

BACKGROUND

Minimally invasive surgical (MIS) instruments are often preferred over traditional open surgical devices due to reduced post-operative recovery time and minimal scarring. Laparoscopic surgery is one type of MIS procedure in which one or more small incisions are formed in the abdomen of a patient and a trocar is inserted through the incision to form a pathway that provides access to the abdominal cavity. Through the trocar, a variety of instruments and surgical tools can be introduced into the abdominal cavity. The trocar also helps facilitate insufflation to elevate the abdominal wall above the organs. The instruments and tools introduced into the abdominal cavity via the trocar can be used to engage and/or treat tissue in a number of ways to achieve a diagnostic or therapeutic effect.

Various robotic systems have recently been developed to assist in MIS procedures. Robotic systems can allow for more intuitive hand movements by maintaining natural eye-hand axis. Robotic systems can also allow for more degrees of freedom in movement by including a “wrist” joint that creates a more natural hand-like articulation. Although not necessary, the instrument's end effector can be articulated (moved) using a cable driven motion system that incorporates one or more drive cables that extend through the wrist joint. A user (e.g., a surgeon) is able to remotely operate an instrument's end effector by grasping and manipulating in space one or more controllers that communicate with a tool driver coupled to the surgical instrument. User inputs are processed by a computer system incorporated into the robotic surgical system and the tool driver responds by actuating the cable driven motion system and, more particularly, the drive cables. Moving the drive cables articulates the end effector to desired positions and configurations.

Some surgical tools, commonly referred to as electrosurgical instruments, are electrically energized. An electrosurgical instrument has a distally mounted end effector that includes one or more electrodes. When supplied with electrical energy, the end effector electrodes are able to generate heat sufficient to cut, cauterize, and/or seal tissue.

Electrosurgical instruments can be configured for bipolar or monopolar operation. In bipolar operation, current is introduced into and returned from the tissue by active and return electrodes, respectively, of the end effector. Electrical current in bipolar operation is not required to travel long distances through the patient before returning to the return electrode. Consequently, the amount of electrical current required is minimal, which greatly reduces the risk of accidental ablations and/or burns. In addition, the two electrodes are closely spaced and generally within the surgeon's field of view, which further reduces the risk of unintended ablations and burns.

In monopolar operation, current is introduced into the tissue by an active end effector electrode (alternately referred to as a “source electrode”) and returned through a return electrode (e.g., a grounding pad) separately located on a patient's body. Monopolar electrosurgical instruments facilitate several surgical functions, such as cutting tissue, coagulating tissue to stop bleeding, or concurrently cutting and coagulating tissue. The surgeon can apply a current whenever the conductive portion of the instrument is in electrical proximity with the patient, permitting the surgeon to operate with monopolar electrosurgical instruments from many different angles.

DETAILED DESCRIPTION

The present disclosure is related to robotic surgical systems that incorporate electrosurgical instruments and, more particularly, to preventing damage to a protective sleeve on a distal end of an electrosurgical instrument during installation of the protective sleeve, and further to devices used to ease assembly and removal of the protective sleeve.

FIG. 1is a block diagram of an example robotic surgical system100that may incorporate some or all of the principles of the present disclosure. As illustrated, the system100can include at least one master controller102aand at least one arm cart104, although the arm cart104is not necessarily required. The arm cart104may be mechanically and/or electrically coupled to a robotic manipulator and, more particularly, to one or more robotic arms106or “tool drivers”. Each robotic arm106may include and otherwise provide a location for mounting one or more surgical tools or instruments108for performing various surgical tasks on a patient110. Operation of the robotic arms106and instruments108may be directed by a clinician112a(e.g., a surgeon) from the master controller102a.

In some embodiments, a second master controller102b(shown in dashed lines) operated by a second clinician112bmay also direct operation of the robotic arms106and instruments108in conjunction with the first clinician112a. In such embodiments, for example, each clinician102a, bmay control different robotic arms106or, in some cases, complete control of the robotic arms106may be passed between the clinicians102a, b. In some embodiments, additional arm carts (not shown) having additional robotic arms (not shown) may be utilized during surgery on a patient110, and these additional robotic arms may be controlled by one or more of the master controllers102a, b.

The arm cart104and the master controllers102a, bmay be in communication with one another via a communications link114, which may be any type of wired or wireless telecommunications means configured to carry a variety of communication signals (e.g., electrical, optical, infrared, etc.) according to any communications protocol. In some applications, for example, there is a tower with ancillary equipment and processing cores designed to drive the robotic arms106.

The master controllers102a, bgenerally include one or more physical controllers that can be grasped by the clinicians112a, band manipulated in space while the surgeon views the procedure via a stereo display. The physical controllers generally comprise manual input devices movable in multiple degrees of freedom, and which often include an actuatable handle for actuating the surgical instrument(s)108, for example, for opening and closing opposing jaws, applying an electrical potential (current) to an electrode, or the like. The master controllers102a, bcan also include an optional feedback meter viewable by the clinicians112a, bvia a display to provide a visual indication of various surgical instrument metrics, such as the amount of force being applied to the surgical instrument (i.e., a cutting instrument or dynamic clamping member).

Example implementations of robotic surgical systems, such as the system100, are disclosed in U.S. Pat. No. 7,524,320, the contents of which are incorporated herein by reference. The various particularities of such devices will not be described in detail herein beyond that which may be necessary to understand the various embodiments and forms of the various embodiments of robotic surgery apparatus, systems, and methods disclosed herein.

FIG. 2is side view of an example surgical tool200that may incorporate some or all of the principles of the present disclosure. The surgical tool200may be the same as or similar to the surgical instrument(s)108ofFIG. 1and, therefore, may be used in conjunction with a robotic surgical system, such as the robotic surgical system100ofFIG. 1. Accordingly, the surgical tool200may be designed to be releasably coupled to a tool driver included in the robotic surgical system100. In other embodiments, however, the surgical tool200may be adapted for use in a manual or hand-operated manner, without departing from the scope of the disclosure.

As illustrated, the surgical tool200includes an elongated shaft202, an end effector204, a wrist206(alternately referred to as a “wrist joint”) that couples the end effector204to the distal end of the shaft202, and a drive housing208coupled to the proximal end of the shaft202. In applications where the surgical tool is used in conjunction with a robotic surgical system (e.g., the robotic surgical system100ofFIG. 1), the drive housing208can include coupling features that releasably couple the surgical tool200to the robotic surgical system.

The terms “proximal” and “distal” are defined herein relative to a robotic surgical system having an interface configured to mechanically and electrically couple the surgical tool200(e.g., the housing208) to a robotic manipulator. The term “proximal” refers to the position of an element closer to the robotic manipulator and the term “distal” refers to the position of an element closer to the end effector204and thus further away from the robotic manipulator. Alternatively, in manual or hand-operated applications, the terms “proximal” and “distal” are defined herein relative to a user, such as a surgeon or clinician. The term “proximal” refers to the position of an element closer to the user and the term “distal” refers to the position of an element closer to the end effector204and thus further away from the user. Moreover, the use of directional terms such as above, below, upper, lower, upward, downward, left, right, and the like are used in relation to the illustrative embodiments as they are depicted in the figures, the upward or upper direction being toward the top of the corresponding figure and the downward or lower direction being toward the bottom of the corresponding figure.

During use of the surgical tool200, the end effector204is configured to move (pivot) relative to the shaft202at the wrist206to position the end effector204at desired orientations and locations relative to a surgical site. The housing208includes (contains) various mechanisms designed to control operation of various features associated with the end effector204(e.g., clamping, firing, rotation, articulation, energy delivery, etc.). In at least some embodiments, the shaft202, and hence the end effector204coupled thereto, is configured to rotate about a longitudinal axis A1of the shaft202. In such embodiments, at least one of the mechanisms included (housed) in the housing208is configured to control rotational movement of the shaft202about the longitudinal axis A1.

The surgical tool200can have any of a variety of configurations capable of performing at least one surgical function. For example, the surgical tool200may include, but is not limited to, forceps, a grasper, a needle driver, scissors, an electro cautery tool, a stapler, a clip applier, a hook, a spatula, a suction tool, an irrigation tool, an imaging device (e.g., an endoscope or ultrasonic probe), or any combination thereof. In some embodiments, the surgical tool200may be configured to apply energy to tissue, such as radio frequency (RF) energy.

The shaft202is an elongate member extending distally from the housing208and has at least one lumen extending therethrough along its axial length. In some embodiments, the shaft202may be fixed to the housing208, but could alternatively be rotatably mounted to the housing208to allow the shaft202to rotate about the longitudinal axis A1. In yet other embodiments, the shaft202may be releasably coupled to the housing208, which may allow a single housing208to be adaptable to various shafts having different end effectors.

The end effector204can have a variety of sizes, shapes, and configurations. In the illustrated embodiment, the end effector204comprises surgical scissors that include opposing jaws210,212(alternately referred to as “blades”) configured to move (articulate) between open and closed positions. As will be appreciated, however, the opposing jaws210,212may alternatively form part of other types of end effectors such as, but not limited to, a tissue grasper, a clip applier, a needle driver, a babcock including a pair of opposed grasping jaws, bipolar jaws (e.g., bipolar Maryland grasper, forceps, a fenestrated grasper, etc.), etc. One or both of the jaws210,212may be configured to pivot at the wrist206to articulate the end effector204between the open and closed positions.

FIG. 3illustrates the potential degrees of freedom in which the wrist206may be able to articulate (pivot). The wrist206can have any of a variety of configurations. In general, the wrist206comprises a joint configured to allow pivoting movement of the end effector204relative to the shaft202. The degrees of freedom of the wrist206are represented by three translational variables (i.e., surge, heave, and sway), and by three rotational variables (i.e., Euler angles or roll, pitch, and yaw). The translational and rotational variables describe the position and orientation of a component of a surgical system (e.g., the end effector204) with respect to a given reference Cartesian frame. As depicted inFIG. 3, “surge” refers to forward and backward translational movement, “heave” refers to translational movement up and down, and “sway” refers to translational movement left and right. With regard to the rotational terms, “roll” refers to tilting side to side, “pitch” refers to tilting forward and backward, and “yaw” refers to turning left and right.

The pivoting motion can include pitch movement about a first axis of the wrist206(e.g., X-axis), yaw movement about a second axis of the wrist206(e.g., Y-axis), and combinations thereof to allow for 360° rotational movement of the end effector204about the wrist206. In other applications, the pivoting motion can be limited to movement in a single plane, e.g., only pitch movement about the first axis of the wrist206or only yaw movement about the second axis of the wrist206, such that the end effector204moves only in a single plane.

Referring again toFIG. 2, the surgical tool200may also include a plurality of drive cables (obscured inFIG. 2) that form part of a cable driven motion system configured to facilitate movement and articulation of the end effector204relative to the shaft202. Moving (actuating) at least some of the drive cables moves the end effector204between an unarticulated position and an articulated position. The end effector204is depicted inFIG. 2in the unarticulated position where a longitudinal axis A2of the end effector204is substantially aligned with the longitudinal axis A1of the shaft202, such that the end effector204is at a substantially zero angle relative to the shaft202. Due to factors such as manufacturing tolerance and precision of measurement devices, the end effector204may not be at a precise zero angle relative to the shaft202in the unarticulated position, but nevertheless be considered “substantially aligned” thereto. In the articulated position, the longitudinal axes A1, A2would be angularly offset from each other such that the end effector204is at a non-zero angle relative to the shaft202.

Still referring toFIG. 2, in some embodiments, the surgical tool200may be supplied with electrical power (current) via a power cable214coupled (permanent or detachable) to the housing208. In other embodiments, the power cable214may be omitted and electrical power may be supplied to the surgical tool200via an internal power source, such as one or more batteries or fuel cells. For purposes of the present description, however, it will be assumed that electrical power is provided to the surgical tool200via the power cable214. In either case, the surgical tool200may alternatively be characterized and otherwise referred to herein as an “electrosurgical instrument” capable of providing electrical energy to the end effector204.

The power cable214may place the surgical tool200in communication with a generator216that supplies energy, such as electrical energy (e.g., radio frequency energy), ultrasonic energy, microwave energy, heat energy, or any combination thereof, to the surgical tool200and, more particularly, to the end effector204. Accordingly, the generator216may comprise a radio frequency (RF) source, an ultrasonic source, a direct current source, and/or any other suitable type of electrical energy source that may be activated independently or simultaneously.

In applications where the surgical tool200is configured for bipolar operation, the power cable214will include a supply conductor and a return conductor. Current can be supplied from the generator216to an active (or source) electrode located at the end effector204via the supply conductor, and current can flow back to the generator216via a return conductor located at the end effector204via the return conductor. In the case of a bipolar tool with opposing jaws, for example, the jaws serve as the electrodes where the proximal end of the jaws are isolated from one another and the inner surface of the jaws (i.e., the area of the jaws that grasp tissue) apply the current in a controlled path through the tissue. In applications where the surgical tool200is configured for monopolar operation, the generator216transmits current through a supply conductor to an active electrode located at the end effector204, and current is returned (dissipated) through a return electrode (e.g., a grounding pad) separately coupled to a patient's body.

FIG. 4is an enlarged isometric view of the distal end of the surgical tool200ofFIG. 2. More specifically,FIG. 4depicts enlarged views of the end effector204and the wrist206, with the end effector204in the unarticulated position. The wrist206operatively couples the end effector204to the shaft202(FIG. 2). In the illustrated embodiment, however, a shaft adapter400may be directly coupled to the wrist206and otherwise interpose the shaft202and the wrist206. In other embodiments, the shaft adapter400may be omitted and the shaft202may instead be directly coupled to the wrist206, without departing from the scope of the disclosure. As used herein, the term “operatively couple” refers to a direct or indirect coupling engagement. Accordingly, the wrist206may be operatively coupled to the shaft202either through a direct coupling engagement where the wrist206is directly coupled to the distal end of the shaft202, or an indirect coupling engagement where the shaft adapter400interposes the wrist206and the distal end of the shaft202.

To operatively couple the end effector204to the shaft202(e.g., via the shaft adapter400), the wrist206includes a distal clevis402aand a proximal clevis402b. The end effector204(i.e., the jaws210,212) is rotatably mounted to the distal clevis402aat a first axle404a, the distal clevis402ais rotatably mounted to the proximal clevis402bat a second axle404b, and the proximal clevis402bis coupled to a distal end406of the shaft adapter400(or alternatively the distal end of the shaft202).

The wrist206provides a first pivot axis P1that extends through the first axle404aand a second pivot axis P2that extends through the second axle404b. The first pivot axis P1is substantially perpendicular (orthogonal) to the longitudinal axis A2of the end effector204, and the second pivot axis P2is substantially perpendicular (orthogonal) to both the longitudinal axis A2and the first pivot axis P1. Movement about the first pivot axis P1provides “yaw” articulation of the end effector204, and movement about the second pivot axis P2provides “pitch” articulation of the end effector204. In the illustrated embodiment, the jaws210,212are mounted at the first pivot axis P1, thereby allowing the jaws210,212to pivot relative to each other to open and close the end effector204or alternatively pivot in tandem to articulate the orientation of the end effector204.

A plurality of drive cables, shown as drive cables408a,408b,408c, and408d, extend longitudinally within a lumen410defined by the shaft adapter400(and/or the shaft202ofFIG. 2) and pass through the wrist206to be operatively coupled to the end effector204. While four drive cables408a-dare depicted inFIG. 4, more or less than four drive cables408a-dmay be included, without departing from the scope of the disclosure.

The drive cables408a-dform part of the cable driven motion system briefly described above, and may be referred to and otherwise characterized as cables, bands, lines, cords, wires, ropes, strings, twisted strings, elongate members, etc. The drive cables408a-dcan be made from a variety of materials including, but not limited to, metal (e.g., tungsten, stainless steel, etc.) or a polymer. Example drive cables are described in U.S. Patent Pub. No. 2015/0209965 entitled “Compact Robotic Wrist,” and U.S. Patent Pub. No. 2015/0025549 entitled “Hyperdexterous Surgical System,” the contents of which are hereby incorporated by reference. The lumen410can be a single lumen, as illustrated, or can alternatively comprise a plurality of independent lumens that each receive one or more of the drive cables408a-d.

The drive cables408a-dextend proximally from the end effector204to the drive housing208(FIG. 2) where they are operatively coupled to various actuation mechanisms or devices housed (contained) therein to facilitate longitudinal movement (translation) of the drive cables408a-dwithin the lumen410. Selective actuation of all or a portion of the drive cables408a-dcauses the end effector204(e.g., one or both of the jaws210,212) to articulate (pivot) relative to the shaft202. More specifically, selective actuation causes a corresponding drive cable408a-dto translate longitudinally within the lumen410and thereby cause pivoting movement of the end effector204. One or more drive cables408a-d, for example, may translate longitudinally to cause the end effector204to articulate (e.g., both of the jaws210,212angled in a same direction), to cause the end effector204to open (e.g., one or both of the jaws210,212move away from the other), or to cause the end effector204to close (e.g., one or both of the jaws210,212move toward the other).

Moving the drive cables408a-dcan be accomplished in a variety of ways, such as by triggering an associated actuator or mechanism operatively coupled to or housed within the drive housing208(FIG. 2). Moving a given drive cable408a-dconstitutes applying tension (i.e., pull force) to the given drive cable408a-din a proximal direction, which causes the given drive cable408a-dto translate and thereby cause the end effector204to move (articulate) relative to the shaft202.

The wrist206includes a first plurality of pulleys412aand a second plurality of pulleys412b, each configured to interact with and redirect the drive cables408a-dfor engagement with the end effector204. The first plurality of pulleys412ais mounted to the proximal clevis402bat the second axle404band the second plurality of pulleys412bis also mounted to the proximal clevis402bbut at a third axle404clocated proximal to the second axle404b. The first and second pluralities of pulleys412a, bcooperatively redirect the drive cables408a-dthrough an “S” shaped pathway before the drive cables408a-dare operatively coupled to the end effector204.

In at least one embodiment, one pair of drive cables408a-dis operatively coupled to each jaw210,212and configured to “antagonistically” operate the corresponding jaw210,212. In the illustrated embodiment, for example, the first and second drive cables408a, bare coupled with a connector (not shown) at the first jaw210, and the third and fourth drive cables408c, dare coupled with a connector (not shown) at the second jaw212. Consequently, actuation of the first drive cable408apivots the first jaw210about the first pivot axis P1toward the open position, and actuation of the second drive cable408bpivots the first jaw210about the first pivot axis P1in the opposite direction and toward the closed position. Similarly, actuation of the third drive cable408cpivots the second jaw212about the first pivot axis P1toward the open position, while actuation of the fourth drive cable408dpivots the second jaw212about the first pivot axis P1in the opposite direction and toward the closed position.

Accordingly, the drive cables408a-dmay be characterized or otherwise referred to as “antagonistic” cables that cooperatively (yet antagonistically) operate to cause relative or tandem movement of the first and second jaws210,212. When the first drive cable408ais actuated (moved), the second drive cable408bnaturally follows as coupled to the first drive cable408a, and when the third drive cable408cis actuated, the fourth drive cable408dnaturally follows as coupled to the third drive cable408c, and vice versa.

The end effector204further includes a first jaw holder414aand a second jaw holder414blaterally offset from the first jaw holder414a. The first jaw holder414ais mounted to the first axle404aand configured to receive and seat the first jaw210such that movement (rotation) of the first jaw holder414aabout the first pivot axis P1correspondingly moves (rotates) the first jaw210. The first jaw holder414amay also provide and otherwise define a first pulley416aconfigured to receive and seat one or more drive cables, such as the first and second drive cables408a, bto effect such movement (rotation). The second jaw holder414bis similarly mounted to the first axle404aand is configured to receive and seat the second jaw212such that movement (rotation) of the second jaw holder414babout the first pivot axis P1correspondingly moves (rotates) the second jaw212. The second jaw holder414bmay also provide and otherwise define a second pulley416bconfigured to receive and seat one or more drive cables, such as the third and fourth drive cables408c, d, to effect such movement (rotation).

The term “jaw holder,” as used herein, is intended to apply to a variety of types of end effectors having opposing jaws or blades that are movable relative to one another. In the illustrated embodiment, the jaws210,212comprise opposing scissor blades of a surgical scissors end effector. Accordingly, the jaw holders414a, bmay alternately be referred to as “blade holders”. In other embodiments, however, the jaws210,212may alternatively comprise opposing jaws used in a grasper end effector, or the like, and the term “jaw holder” similarly applies, without departing from the scope of the disclosure. Moreover, the term “holder” in “jaw holder” may be replaced with “mount,” “drive member,” or “actuation member.”

The surgical tool200may also include an electrical conductor418that supplies electrical energy to the end effector204, thereby converting the surgical tool200into an “electrosurgical instrument”. Similar to the drive cables408a-d, the electrical conductor418may extend longitudinally within the lumen410. In some embodiments, the electrical conductor418and the power cable214(FIG. 2) may comprise the same structure. In other embodiments, however, the electrical conductor418may be electrically coupled to the power cable214, such as at the drive housing208(FIG. 2). In yet other embodiments, the electrical conductor418may extend to the drive housing208where it is electrically coupled to an internal power source, such as batteries or fuel cells.

In some embodiments, the electrical conductor418may comprise a wire. In other embodiments, however, the electrical conductor418may comprise a rigid or semi-rigid shaft, rod, or strip (ribbon) made of a conductive material. In some embodiments, the electrical conductor418may be partially covered with an insulative covering420(shown in dashed lines) made of a non-conductive material. The insulative covering420, for example, may comprise a plastic applied to the electrical conductor418via heat shrinking, but could alternatively be any other non-conductive material.

In operation, the end effector204may be configured for monopolar or bipolar operation, without departing from the scope of the disclosure. Electrical energy is transmitted by the electrical conductor418to the end effector204, which acts as an active (or source) electrode. In at least one embodiment, the electrical energy conducted through the electrical conductor418may comprise radio frequency (“RF”) energy exhibiting a frequency between about 100 kHz and 1 MHz. The RF energy causes ultrasonic agitation or friction, in effect resistive heating, thereby increasing the temperature of target tissue. Accordingly, electrical energy supplied to the end effector204is converted to heat and transferred to adjacent tissue to cut, cauterize, and/or coagulate the tissue (dependent upon the localized heating of the tissue), and thus may be particularly useful for sealing blood vessels or diffusing bleeding.

The surgical tool200may further include a protective sleeve422configured to insulate various live (energized) portions of the end effector204(including the wrist206), and thereby protect the patient from stray electrical discharge during operation. As illustrated, the sleeve422may comprise an elongate and generally cylindrical body424having a first or distal end426aand a second or proximal end426bopposite the distal end426a. The body424may be sized to extend over portions of the end effector204, the wrist206, and the shaft adapter400(or alternatively the shaft202when the shaft adapter400is omitted). When the sleeve422is properly positioned for use, the jaw members210,212protrude out an aperture430defined in the distal end426aof the body424and the proximal end426bengages or comes into close contact with a radial shoulder428(alternately referred to as a “shaft adapter flange”) defined on the shaft adapter400(or the shaft202). When the sleeve422is properly positioned (installed), electrical current can only be conducted to patient tissue as intended at the exposed jaw members210,212.

FIG. 5is a side view of the sleeve422as assembled onto the end effector204. As illustrated, the sleeve422is advanced proximally until the jaw members210,212protrude out of the aperture430at the distal end426aof the body424and the proximal end426bengages the radial shoulder428of the shaft adapter400(or the shaft202ofFIG. 2). The sleeve422may be assembled onto the end effector204within a sterile field before surgery and removed before cleaning the tool200(FIG. 2). The sleeve422must be properly installed to mitigate electrical discharge in unintended pathways, and the responsibility for proper installation is often left to the various scrub nurses on hand in an operating room. One challenge is error proofing proper installation of the sleeve422and ensuring that the sleeve422is properly positioned for use. While extending the sleeve422over the jaw members210,212, there is a risk that the jaw members210,212may engage and cut into the inner wall of the sleeve422, which could result in the creation of holes and subsequent inadvertent electrical discharge to the patient through the holes during use. The present disclosure includes embodiments that ensure proper assembly (installation) of the sleeve422while simultaneously preventing the jaw members210,212from gouging the inner wall of the sleeve422during installation.

Moreover, the sleeve422may be made of a flexible material and installed via an interference fit between the inner radial surface of the sleeve422and the outer radial surfaces of the end effector204, the wrist206(FIG. 4), and/or the shaft adapter400. Suitable flexible materials include, but are not limited to, thermoplastic polyurethane (TPU), nitrile rubber, polyisoprene, silicone, or any combination thereof. The flexibility of the sleeve422allows the wrist206to articulate during use, but as the wrist206articulates, the sleeve422may have a tendency to creep axially, which can result in the proximal end426bseparating from the radial shoulder428and increasing the likelihood of electrical discharge in unintended pathways. Embodiments described herein also provide means for securing the sleeve422in position, and sleeve extraction tools that may be used to remove the sleeve422.

FIGS. 6A and 6Bare exploded and cross-sectional side views, respectively, of an example sleeve insertion assembly602that may be used in accordance with one or more principles of the present disclosure. The sleeve insertion assembly602may be used to help install (assemble) the sleeve422on the end effector204(FIGS. 4-5) and simultaneously protect a user (e.g., a scrub nurse, surgeon, etc.) and the sleeve422from inadvertent accidental contact with the jaw members210,212(FIGS. 4-5). As will be appreciated, the jaw members210,212are required to be exceptionally sharp and the user is commonly tasked with assembling the sleeve422over the jaw members210,212. If proper precaution is not taken, the user may inadvertently cut or puncture the sleeve422and/or his/her hand(s) by coming into contact with the jaw members210,212. The sleeve insertion assembly602may prove advantageous in mitigating the occurrence of damage or cuts caused by accidental mishandling of the end effector204.

As illustrated, the sleeve insertion assembly602includes a sleeve inserter604, the sleeve422, and a blade guard606. The sleeve inserter604includes an elongate, generally cylindrical body608having a distal end610aand a proximal end610bopposite the distal end610a. The body608may be made of a variety of materials including, but not limited to, plastic, metal, rubber, an elastomer, silicone, or any combination thereof.

The body608defines an inner chamber612large enough and otherwise sized to extend over and receive the sleeve422. In some embodiments, the body608may define one or more longitudinal slots614(two shown) that extend from the proximal end610btoward the distal end610a. The slots614create weak points in the body608that allow a user to pinch and thereby collapse the body608against the outer radial surface of the sleeve422during installation. This allows the user to advance the sleeve422toward the installed position by gripping and moving the sleeve inserter604instead of directly contacting the outer surface of the sleeve422.

While two slots614are shown in the illustrated embodiment, more or less than two may alternatively be employed. In some embodiments, as illustrated, one or more of the slots614may exhibit an axial length that is greater than half the overall length of the body608. In other embodiments, the axial length of the slots614may be less than half the overall length of the body608, without departing from the scope of the disclosure.

The blade guard606provides an elongate, generally cylindrical body616having a closed distal end618aand an open proximal end618bopposite the distal end618a. The body616may be sized and otherwise configured to be received within the sleeve422, and the distal end618amay extend through the aperture430of the sleeve422when properly installed. Accordingly, the sleeve insertion assembly602forms a nested assembly where the blade guard606is received within the sleeve422, and the sleeve422and the blade guard606are jointly received within the sleeve inserter604.

In at least one embodiment, the sleeve inserter604may provide or otherwise define a retention mechanism620(FIG. 6B) at the proximal end610bto help contain the sleeve422and the blade guard606within the sleeve inserter604and otherwise prevent them from falling out of the sleeve inserter604. In some embodiments, as illustrated, the retention mechanism620may comprise a protrusion that extends a short distance into the inner chamber612, but could alternatively comprise any other structural feature that helps maintain the sleeve422and the blade guard606within the sleeve inserter604.

The blade guard606may define an interior622sized to receive the jaw members210,212(FIGS. 4-5) when installing the sleeve422on the end effector204(FIGS. 4-5). The blade guard606may be configured to prevent the jaw members210,212from piercing or otherwise engaging the inner wall of the sleeve422during installation of the sleeve422. To accomplish this, the body616of the blade guard606may be made of a variety of rigid materials such as, but not limited to, a metal, a thermoplastic (e.g., acrylonitrile butadiene styrene, polycarbonate, polyether ether ketone, etc.), a composite material, and any combination thereof.

FIGS. 7A-7Care progressive cross-sectional side views of the sleeve insertion assembly602showing example installation of the sleeve422, according to one or more embodiments. InFIG. 7A, the sleeve insertion assembly602has the blade guard606nested within the sleeve422and both are arranged within the sleeve inserter604and prepared to deploy the sleeve422. In some embodiments, the sleeve inserter604, the sleeve422, and the blade guard606may be packaged in a common sterile packaging and shipped together. Upon opening the sterile pack, a user (e.g., a scrub nurse, surgeon, etc.) may mate the sleeve422and the blade guard606, as generally described above, and extend the nested sleeve422and blade guard606into the sleeve inserter604. In other embodiments, however, the sleeve422and the blade guard606may be pre-assembled into the sleeve inserter604upon delivery.

To deploy the sleeve422, the sleeve insertion assembly602is brought into proximity of the end effector204and the jaw members210,212are aligned with and inserted into the interior622of the blade guard606. In some embodiments, the opening of the blade guard606at the proximal end618bmay be tapered or otherwise angled to help receive the jaw members210,212without binding against sharp corners. Inserting the jaw members210,212within the blade guard606prevents the jaw members210,212from inadvertently contacting and potentially cutting the inner wall of the sleeve422. The user may then advance the sleeve inserter604proximally relative to the end effector204and simultaneously advance the sleeve422over the end effector204, the wrist206, and the shaft adapter400(or the shaft202ofFIG. 2).

The opening of the blade guard606at the proximal end618bis large enough to receive the jaw members210,212, but smaller than the body of the end effector204(i.e., the jaw holders414a, bofFIG. 4). Consequently, the entire end effector204is prevented from entering the interior622. Instead, as the sleeve inserter604is advanced proximally relative to the end effector204(i.e., to the right inFIGS. 7A-7C), portions of the end effector204will engage the proximal end618bof the blade guard606and further proximal movement of the sleeve inserter604will correspondingly urge the blade guard606distally relative to the sleeve422and the sleeve inserter604.

InFIG. 7B, the sleeve inserter604has moved further in the proximal direction relative to the end effector204. In some embodiments, the sleeve422may be advanced over the end effector204by applying an opposing radial load F on the sleeve inserter604at or near the proximal end610b, such as by pinching the sleeve inserter604with the thumb and index fingers of one hand. The radial load F may cause the inner radial surface of the sleeve inserter604to engage and otherwise grip the outer radial surface of the sleeve422. In some embodiments, the inner radial surface at or near the proximal end610bmay include a gripping interface, such as a knurled surface or a ribbed contour, configured to help grip the outer radial surface of the sleeve422. The slots614(FIG. 6A) allow the sleeve inserter604to flex radially inward, and the sleeve inserter604may then be advanced proximally relative to the end effector204without potentially binding (crumpling) the sleeve422within the sleeve inserter604. Alternatively, the inside of the sleeve inserter604may be larger than the outer diameter of the sleeve422such that the user can push the sleeve422on by gripping the distal end of the sleeve inserter604. This clearance between the inside surface of the sleeve inserter604and the sleeve422may be 0.05 mm to 1.0 mm, for example. This clearance prevents pinching of the sleeve422against the shaft adapter400and at the same time contains the sleeve422enough to prevent buckling of the sleeve422during assembly of the sleeve422.

As the sleeve inserter604moves proximally relative to the end effector204, the blade guard606may correspondingly move distally relative to the sleeve422as engaged against the end effector204at the distal end618a. The sleeve inserter604may define or otherwise provide an aperture702at the distal end610a, and the distal end618aof the blade guard606may extend through the aperture702as the blade guard606moves distally. The sleeve inserter604may be made of a flexible material that allows the aperture702to flex and expand radially outward to receive the blade guard606as it advances through the aperture702.

InFIG. 7C, the sleeve inserter604is advanced proximally relative to the end effector204until the sleeve422is properly installed over the end effector204, the wrist206, and the shaft adapter400(or the shaft202ofFIG. 2). In some embodiments, the sleeve inserter604is advanced proximally until the proximal end426bof the sleeve422engages or comes into close contact with the radial shoulder428of the shaft adapter400(or the shaft202ofFIG. 2). In other embodiments, or in addition thereto, the sleeve inserter604may be advanced proximally until the end effector204bottoms out, at which point the sleeve422will be properly seated against the radial shoulder428. More specifically, when the sleeve422is pushed up against the radial shoulder428, the sleeve inserter604presents a hard stop such that the sleeve inserter604cannot be pushed proximally any more. This prevents the sleeve422from being pushed too far proximally on the shaft adapter400and possibly over the radial shoulder428. In at least one embodiment, for example, this end of travel hard stop can be provided by a proximal portion of the blade guard606engaging the inner distal diameter of the sleeve inserter604.

The sleeve inserter604may then be retracted distally to thereby remove the sleeve inserter604from the end effector204and leave the sleeve422properly installed. In embodiments where the sleeve inserter604is made of a pliable material (e.g., an elastomer or silicone), the slots614(FIG. 6A) may allow the sleeve inserter604to be “peeled away” from the end effector204after assembly. In such embodiments, the user may grasp the sleeve inserter604at or near the proximal end610band the slots614may help progressively detach the sleeve inserter604similar to how a banana is peeled.

In some embodiments, the blade guard606may be removed from the aperture702by the user, but may alternatively be left engaged with the sleeve inserter604at the aperture702. In some embodiments, the blade guard606may be manufactured or otherwise fabricated of a color that is readily perceivable by a user (e.g., a scrub nurse, surgeon, etc.), such as bright or fluorescent orange. In at least one embodiment, one or more visual indicators (not shown) may be included on the body of the blade guard606. Once the visual indicator(s) is exposed, that may be an indication to the user that the sleeve422is properly seated.

In some embodiments, the sleeve inserter604may also be used to help remove the sleeve422. In such embodiments, the sleeve inserter604may be extended over the sleeve422, and the radial load F (FIG. 7B) may again be applied to engage and otherwise grip the outer radial surface of the sleeve422at or near the proximal end426b. Once the sleeve422is engaged, the user may move the sleeve inserter604and the sleeve422distally together relative to the end effector204. In such embodiments, the gripping interface mentioned above may prove advantageous to help grip the outer radial surface of the sleeve422.

FIG. 8is an exploded, partial cross-sectional view of the sleeve422and the shaft adapter400, according to one or more embodiments of the disclosure. The flexibility of the sleeve422allows the wrist206(FIGS. 2 and 4) to articulate during use, but as the wrist206articulates, the sleeve422may have a tendency to creep axially, which can result in the proximal end426bof the sleeve422separating from the radial shoulder428and increasing the likelihood of electrical discharge in unintended pathways. In some embodiments, as illustrated, the shaft adapter400may provide or otherwise define one or more annular grooves802on its outer surface, and the inner surface of the sleeve422may provide or otherwise define a corresponding one or more annular protrusions804(two shown) configured to mate with the annular grooves802. The sleeve422may be advanced proximally until the protrusions804locate and snap into engagement with the grooves802, which helps maintain the sleeve422in position during use but also provides a positive indicator that the sleeve422is properly installed.

In some embodiments, the groove802and the protrusion804may be spaced from the radial shoulder428and the proximal end426b, respectively, by known distances such that when the protrusion804locates the groove802, the proximal end426bof the sleeve422may simultaneously engage (or come into close contact with) the radial shoulder428. Moreover, it should be noted that whileFIG. 8depicts the sleeve422being secured to the shaft adapter400, the sleeve422may alternatively be coupled to the shaft202via similar engagement means, without departing from the scope of the disclosure. Furthermore, the placement of the groove802and the protrusion804may be reversed, where the groove802is alternatively defined on the sleeve422and the protrusion804is defined on the shaft adapter400(or the shaft202), without departing from the scope of the disclosure.

FIGS. 9A and 9Bare isometric and side views, respectively, of an example sleeve extractor900, according to one or more embodiments. The sleeve extractor900may be designed and used to remove the sleeve422from the end effector204following use. As illustrated, the sleeve extractor900has a generally cylindrical body902having a distal end904aand a proximal end904b. The proximal end904bmay be open to receive the end effector204and the sleeve422.

The sleeve extractor900may be capable of engaging the proximal end426bof the sleeve422such that the user does not have to grab (grip) the outer radial surface of the sleeve422or pull on the distal end426aof the sleeve422for removal. To accomplish this, the sleeve extractor900may provide or otherwise define one or more longitudinally-extending fingers906configured to engage the proximal end426bof the sleeve422. Each finger906may provide a tab908that extends radially inward and is sized to be received within a notch910defined in the shaft adapter400(or the shaft202ofFIG. 2). In at least one embodiment, as illustrated, the notch910may be defined in the radial shoulder428, which may comprise a shaft adapter ring configured to help secure the shaft adapter400to the shaft202. The notch910may be located proximal to the proximal end426bof the sleeve422when the sleeve422is properly installed.

To remove the sleeve422, the sleeve extractor900is advanced over the end effector204and the sleeve422. The sleeve extractor900may be advanced proximally and rotated relative to the sleeve422until the tab908of the finger906angularly and axially locates the notch910. In at least one embodiment, as illustrated, a marking912(e.g., an arrow or the like) may be provided on the shaft adapter400(or the shaft202ofFIG. 2) to help the user accurately locate the notch910. The marking912may be laser etched or painted onto the outer surface, or may alternatively comprise a sticker adhered thereto in the proper location.

Once the notch910is located, the user may provide a radial inward load on the finger906to seat (receive) the tab908within the notch910and thereby place the tab908at the proximal end426bof the sleeve422. The sleeve extractor900may then be retracted distally relative to the shaft adapter400and the tab908may engage the proximal end426band urge the sleeve422in the same direction. Continued distal movement of the sleeve extractor900will eventually remove the sleeve422from the shaft adapter400and the end effector204.

While the sleeve extractor900is depicted inFIGS. 9A-9Bas having an open distal end904a, it is contemplated herein to have a closed distal end904a. A closed distal end904amay prevent the jaw members210,212of the end effector204from extending out of the distal end904a, which thereby prevents the jaw members210,212from contacting the user during use of the sleeve extractor900. Moreover, the closed distal end904amay also serve to contain the sleeve422inside its cylindrical body after removal of the sleeve422for easy disposal of the sleeve422and the sleeve extractor900together.

FIGS. 10A and 10Bare isometric and side views, respectively, of another example sleeve extractor1000, according to one or more embodiments. The sleeve extractor1000may be similar in some respects to the sleeve extractor900ofFIGS. 9A-9Band therefore may be best understood with reference thereto, where like numerals correspond to similar components not described again. As illustrated, the sleeve extractor1000includes the body902that defines the longitudinally-extending finger(s)906configured to engage the proximal end426bof the sleeve422with the tab908when the tab908is received within the notch910.

The sleeve extractor1000may further include a cylindrical lock1002that provides a generally cylindrical body1004capable of extending about the body902. The cylindrical lock1002may provide or define a locking arm1006that provides an extension1008receivable within a slot1010defined on the body902. The cylindrical lock1002may be able to translate axially relative to the sleeve extractor1000, and the extension1008received within the slot1010prevents the cylindrical lock1002from moving beyond the confines of the slot1010.

To remove the sleeve422, the sleeve extractor1000with the cylindrical lock1002positioned thereabout are advanced over the end effector204and the sleeve422. The sleeve extractor1000may be advanced proximally and rotated relative to the sleeve422until the tab908of the finger906angularly and axially locates the notch910. Once the notch910is located, the cylindrical lock1002may be advanced proximally relative to the underlying body902, as shown inFIG. 10B. Proximal movement of the cylindrical lock1002will be limited by the axial length of the slot1010and the extension1008received therein.

Advancing the cylindrical lock1002proximally acts on the finger906and forces the tab908into engagement with the notch910, which places the tab908at the proximal end426bof the sleeve422. In some embodiments, for instance, one or both of the inner radial surface of the cylindrical lock1002and the outer radial surface of the finger906may be tapered or otherwise angled such that the finger906is urged radially inward as the cylindrical lock1002advances. Alternatively, the finger906may be naturally biased away from the sleeve422, and advancing the cylindrical lock1002proximally acts on the finger906and forces the arm906radially inward.

Once the tab908is seated within the notch910, the sleeve422may be removed by retracting the sleeve extractor1000distally relative to the shaft adapter400. As the sleeve extractor1000moves distally, the tab908may engage the proximal end426bof the sleeve422and simultaneously urge the sleeve422in the same direction. Continued distal movement of the sleeve extractor1000will eventually remove the sleeve422from the shaft adapter400and the end effector204.

While the sleeve extractor1000is depicted inFIGS. 10A-10Bas having an open distal end, it is contemplated herein to have a closed distal end for the same reasons mentioned above for the sleeve extractor900ofFIGS. 9A-9B.

FIGS. 11A and 11Bare isometric exploded and assembled views, respectively, of another example sleeve insertion assembly1102that may be used in accordance with the principles of the present disclosure. The sleeve insertion assembly1102may be similar in some respects to the sleeve insertion assembly602ofFIGS. 6A-6Band therefore may be used to help install (assemble) the sleeve422on the end effector204(FIGS. 4-5) and simultaneously protect the sleeve422from inadvertent accidental contact with the jaw members210,212(FIGS. 4-5).

As illustrated, the sleeve insertion assembly1102includes a sleeve inserter1104, a sleeve extraction tool1106, the sleeve422, and a blade guard1108. The sleeve inserter1104includes an elongate, generally cylindrical body1110having a distal end1112aand a proximal end1112bopposite the distal end1112a. The body1110may be made of a variety of materials including, but not limited to, plastic, metal, rubber, an elastomer, silicone, and any combination thereof. In at least one embodiment, however, the body1110will be made of a flexible material, such as silicone or a pliable elastomer that allows the body to flex or expand during use.

The body1110defines an inner chamber1114large enough and otherwise sized to extend over and receive the sleeve422and portions of the sleeve extraction tool1106. The body1110may define one or more longitudinal slots1116(one shown) that extend from the proximal end1112btoward the distal end1112a. The slots1116allow the sleeve inserter1104to flex outward upon receiving the end effector204(FIGS. 4-5), as described below.

The sleeve extraction tool1106may be made of a rigid or semi rigid material, such as a thermoplastic or a metal. As illustrated, the sleeve extraction tool1106provides an annular ring1118and one or more arms1120(two shown) that extend longitudinally from the ring1118. When the sleeve insertion assembly1102is properly assembled, the ring1118may be received within the inner chamber1114of the sleeve inserter1104, and each arm1120may be received within a corresponding one of the longitudinal slots1116.

Each arm1120may provide a tab1122that extends radially inward and is sized to be received within a notch (e.g., the notch910ofFIGS. 9A-9B) defined in the shaft adapter400(FIGS. 4-5 and 9A-9B) or the shaft202(FIG. 2). Each arm1120may be naturally biased outward and, as described below, a user may provide opposing forces F on the ends of the arms1120to seat the tabs1122within corresponding notches in preparation for removing the sleeve422. In some embodiments, as illustrated, a finger grip1124may be provided or otherwise defined at the proximal end of each arm1120, and each finger grip1124may provide a location for a user to apply the opposing force F with opposing fingers.

In at least one embodiment, the finger grips1124may be angled to provide a mechanical advantage that helps reduce removal force. More specifically, the angle of the finger grips1124drives the force vector F toward pushing the sleeve422off in the distal direction as opposed to pinching the outer radial surface of the sleeve422. This may prove advantageous since the sleeve422may be secured to the outer radial surface of the shaft adapter400via a tight interference fit, and the angled finger grips1124may help overcome this engagement.

The blade guard1108may be similar in some respects to the blade guard606ofFIGS. 6A-6B. As best seen inFIG. 11A, the blade guard1108provides an elongate, generally cylindrical body1126having a closed distal end1128aand an open proximal end1128bopposite the distal end1128a. The body1126may be sized and otherwise configured to be received within the sleeve422, and the distal end1128amay extend through the aperture430of the sleeve422when properly installed. Moreover, the distal end426aof the sleeve422may be sized to be received at the ring1118of the sleeve extraction tool1106when properly installed. Accordingly, the sleeve insertion assembly1102forms a nested configuration when properly assembled, where the blade guard1108is received within the sleeve422, the sleeve422is partially received within the sleeve extraction tool1106, and the sleeve extraction tool1106, the sleeve422, and the blade guard1108are jointly received within the sleeve inserter1104.

FIGS. 12A and 12Bare progressive cross-sectional side views of the sleeve insertion assembly1102ofFIGS. 11A-11Bshowing example installation of the sleeve422, according to one or more embodiments. InFIG. 12A, the sleeve insertion assembly1102is assembled with the blade guard1108nested within the sleeve422, the distal end426aof the sleeve422is received within the ring1118of the sleeve extraction tool1106, and the blade guard1108, the sleeve422, and the sleeve extraction tool1106are all at least partially received within the inner chamber1114of the sleeve inserter1104. In this state, the sleeve insertion assembly1102is prepared to deploy the sleeve422.

In at least one embodiment, the sleeve inserter1104may provide or otherwise define a retention mechanism1202at the proximal end1112b. The retention mechanism1202may be similar to the retention mechanism620ofFIG. 6Band, therefore, may be used to help contain the sleeve422and the blade guard1108within the sleeve inserter1104and prevent them from falling out. In some embodiments, as illustrated, the retention mechanism1202may comprise a protrusion that extends a short distance into the inner chamber1114at the proximal end1112b, but could alternatively comprise any other structural feature that helps maintain the sleeve422and the blade guard1108within the sleeve inserter1104.

In some embodiments, the sleeve insertion assembly1102may include a second retention mechanism1204at or near the distal end1112aof the sleeve inserter1104. The second retention mechanism1204may be configured to help retain the blade guard1108within the sleeve inserter1104. In some embodiments, the second retention mechanism1204may comprise a tongue-and-groove mated relationship between the blade guard1108and the sleeve inserter1104. In the illustrated embodiment, a protrusion1206is defined on the inner radial surface of the inner chamber1114of the sleeve inserter1104, and the protrusion1206is sized to be received within a groove1208defined on the outer radial surface of the blade guard1108. Mated engagement between the blade guard1108and the sleeve inserter1104at the second retention mechanism1204may be broken by applying an axial load on the blade guard1108, as described below.

The blade guard1108may define an interior1210sized to receive the jaw members210,212of the end effector204. The blade guard1108may be configured to prevent the jaw members210,212from piercing or otherwise engaging the inner wall of the sleeve422during installation of the sleeve422. To accomplish this, the blade guard1108may be made of a variety of rigid materials such as, but not limited to, a metal, a thermoplastic (e.g., acrylonitrile butadiene styrene, polycarbonate, polyether ether ketone, etc.), a composite material, and any combination thereof.

To deploy the sleeve422, the sleeve insertion assembly1102is brought into proximity of the end effector204and the end effector204is first advanced into the inner chamber1114of the sleeve inserter1104. As the end effector204enters the inner chamber1114, the end effector204may engage the retention mechanism1202at the proximal end1112bof the sleeve inserter1104, thus causing the sleeve inserter1104to flex outward to receive the end effector204. The slots1116defined in the sleeve inserter1104allow the sleeve inserter1104to flex open. Moreover, flexing the sleeve inserter1104outward disengages the retention mechanism1202and thereby allows the sleeve422to displace out of the sleeve inserter1104during further operation.

The jaw members210,212are aligned with and inserted into the interior1210of the blade guard1108. In some embodiments, the opening of the blade guard1108at the proximal end1128bmay be tapered to help receive the jaw members210,212without binding against sharp corners. Inserting the jaw members210,212within the blade guard1108prevents the jaw members210,212from inadvertently contacting and potentially cutting the inner wall of the sleeve422. The user may then advance the sleeve inserter1104proximally (i.e., to the right inFIGS. 12A-12B) relative to the end effector204and simultaneously advance the sleeve422over the end effector204, the wrist206, and the shaft adapter400(or the shaft202ofFIG. 2).

The opening of the blade guard606at the proximal end618bis large enough to receive the jaw members210,212. Consequently, the entire end effector204is prevented from entering the interior1210. Instead, as the sleeve inserter1104is advanced proximally relative to the end effector204, portions of the end effector204will engage the proximal end1128bof the blade guard1108and further proximal movement of the sleeve inserter1104will correspondingly urge the blade guard1108distally relative to the sleeve422and the sleeve inserter604.

InFIG. 12B, the sleeve inserter1104has moved further in the proximal direction relative to the end effector204. As the sleeve inserter1104moves proximally, the blade guard1108may be correspondingly urged distally relative to the sleeve422as engaged against the end effector204at the distal end1128bof the blade guard1108. The axial load applied on the blade guard1108by the end effector204resulting from moving the sleeve inserter1104proximally may cause the second retention mechanism1204to fail. More specifically, the sleeve inserter1104may be made of a flexible material (e.g., silicone), and the axial load placed on the blade guard1108by the end effector204may cause the protrusion1206of the sleeve inserter1104to flex out of engagement with the groove1208of the blade guard1108. Once the second retention mechanism1204is broken, the blade guard1108may be able to move distally generally unobstructed.

In some embodiments, the sleeve inserter1104may define or otherwise provide an aperture1212at the distal end1112a, and the distal end1128aof the blade guard1108may extend through the aperture1212as the blade guard1108moves distally. Since the sleeve inserter1104is made of a flexible material, the aperture1212may flex and expand radially outward to allow the blade guard1108to advance distally.

The sleeve inserter1104is advanced proximally relative to the end effector204until the sleeve422is properly installed over the end effector204, the wrist206, and the shaft adapter400(or the shaft202). While the sleeve inserter1104is advanced proximally, the arms1120of the sleeve extraction tool1106are naturally flexed outward and out of engagement with the outer surface of the sleeve422. In some embodiments, the sleeve inserter1104is advanced proximally until the proximal end426bof the sleeve422engages or comes into close contact with the radial shoulder428of the shaft adapter400. In other embodiments, or in addition thereto, the sleeve inserter1104may be advanced proximally until the end effector204bottoms out, at which point the sleeve422will be properly seated against the radial shoulder428. Once the sleeve422is properly installed, the sleeve inserter1104may then be retracted distally to thereby remove the sleeve inserter1104and the sleeve extraction tool1106from the end effector204and leave the sleeve422installed for use.

The sleeve insertion assembly1102may also be used to help remove the sleeve422when needed. In such embodiments, the sleeve inserter1104and the sleeve extraction tool1106may once again be extended over the sleeve422and the sleeve inserter1104may be advanced proximally and rotated relative to the sleeve422until the tabs1122of each arm1120angularly and axially locate corresponding notches910defined at the radial shoulder428. Once the notches910are located, the user may provide a radial inward load F on each arm1120at the finger grips1124, for example, to seat (receive) the tabs1122within the notches910and thereby place the tabs1122at the proximal end426bof the sleeve422. The sleeve inserter1104and the sleeve extraction tool1106may then be retracted distally relative to the shaft adapter400and the tabs1122may engage the proximal end426band simultaneously urge the sleeve422in the same direction. Continued distal movement of the sleeve extractor900will eventually remove the sleeve422from the shaft adapter400and the end effector204.

A. A sleeve insertion assembly that includes a sleeve inserter defining an inner chamber and having a distal end and a proximal end opposite the distal end, a sleeve receivable within the inner chamber, and a blade guard receivable within the sleeve and having a cylindrical body that defines an interior and an open end, wherein the open end is sized to receive jaw members of an end effector into the interior but prevent the end effector from entering the interior, and wherein the blade guard is forced out of the sleeve when the sleeve is installed on the end effector.

B. A method of installing a sleeve on an end effector of a surgical tool includes bringing a sleeve insertion assembly into proximity of the end effector, the sleeve insertion assembly having a sleeve inserter, the sleeve positioned within the sleeve inserter, and a blade guard received within the sleeve, inserting jaw members of the end effector into an interior of the blade guard, advancing the sleeve inserter proximally relative to the end effector and thereby advancing the sleeve over the end effector, engaging the end effector on the blade guard and thereby displacing the blade guard out of the sleeve as the sleeve inserter advances proximally, and preventing the jaw members from contacting the sleeve with the blade guard as the sleeve inserter advances proximally.

C. A sleeve extractor includes a cylindrical body having a distal end and a proximal end, one or more longitudinally-extending fingers defined in the body, and a tab provided on an end of each finger and receivable within a notch defined in a shaft adapter or a shaft of a surgical tool, the notch being located proximal to a proximal end of a sleeve, wherein the sleeve is removed by locating the tab of each finger in a corresponding notch and retracting the body and the sleeve distally relative to the shaft adapter or the shaft.

D. A method of removing a sleeve from an end effector includes extending a sleeve extractor over the sleeve, the sleeve extension device including a cylindrical body having a distal end and a proximal end, and one or more longitudinally-extending fingers defined in the body, axially and angularly aligning the one or more longitudinally-extending fingers with a corresponding one or more notches defined in the shaft adapter or the shaft, applying a radial load on the longitudinally-extending fingers and thereby receiving a tab defined on each finger into the corresponding one or more notches, and moving the sleeve extractor distally relative to the end effector and thereby removing the sleeve from the end effector and the shaft adapter or the shaft.

Each of embodiments A, B, C, and D may have one or more of the following additional elements in any combination: Element 1: wherein the sleeve inserter is made of a material selected from the group consisting of a plastic, a metal, a rubber, an elastomer, silicone, and any combination thereof. Element 2: further comprising a retention mechanism defined at the proximal end of the sleeve inserter to help maintain the sleeve and the blade guard within the sleeve inserter. Element 3: wherein the blade guard is made of a rigid material selected from the group consisting of a metal, a thermoplastic, a composite material, and any combination thereof. Element 4: further comprising one or more longitudinal slots defined in the sleeve inserter and extending from the proximal end toward the distal end. Element 5: further comprising a sleeve extraction tool that provides an annular ring receivable within the inner chamber, one or more arms extending longitudinally from the ring, wherein each arm is received within a corresponding one of the one or more longitudinal slots, and a tab extending from an end of each arm, wherein the tab is receivable within a notch defined in a shaft adapter or a shaft of a surgical tool. Element 6: further comprising a finger grip provided at the end of each arm, wherein the finger grip is angled to provide a mechanical advantage that helps reduce removal force for the sleeve. Element 7: further comprising a retention mechanism at or near the distal end of the sleeve inserter to help retain the blade guard within the sleeve inserter.

Element 8: further comprising displacing the blade guard out of an aperture defined in a distal end of the sleeve inserter as the sleeve inserter advances proximally. Element 9: further comprising extending the sleeve inserter over the sleeve, applying a radial load on the sleeve inserter and thereby gripping an outer radial surface of the sleeve at or near a proximal end of the sleeve, and moving the sleeve inserter and the sleeve distally relative to the end effector and thereby removing the sleeve from the end effector. Element 10: wherein the sleeve inserter defines one or more longitudinally-extending fingers, the method further comprising extending the sleeve inserter over the sleeve, axially and angularly aligning the one or more longitudinally-extending fingers with a corresponding one or more notches defined in a shaft adapter or a shaft of a surgical tool, applying a radial load on the longitudinally-extending fingers and thereby receiving a tab defined on each finger into the corresponding one or more notches, and moving the sleeve inserter and the sleeve distally relative to the end effector and thereby removing the sleeve from the end effector. Element 11: wherein the sleeve inserter defines one or more longitudinal slots extending from the proximal end and the sleeve insertion assembly further includes a sleeve extraction tool providing an annular ring receivable within the sleeve inserter, and one or more arms extending longitudinally from the ring and received within a corresponding one of the one or more longitudinal slots, the method further comprising extending the sleeve inserter and the sleeve extraction tool over the sleeve, axially and angularly aligning the one or more arms with a corresponding one or more notches defined in a shaft adapter or a shaft of a surgical tool, applying a radial load on the one or more arms and thereby receiving a tab defined on each arm into the corresponding one or more notches, and moving the sleeve inserter, the sleeve extraction tool, and the sleeve distally relative to the end effector and thereby removing the sleeve from the end effector and the shaft adapter or the shaft. Element 12: wherein a finger grip is provided on each arm and each finger grip is angled, and wherein applying the radial load on the one or more arms comprises applying the radial load on the finger grip, and reducing a removal force for the sleeve based on an angle of the finger grip relative to the sleeve. Element 13: wherein the sleeve extraction tool has a closed distal end, the method further comprising preventing the jaw members from contacting a user with the sleeve extraction tool and containing the sleeve within the sleeve extraction tool once the sleeve is removed.

Element 14: further comprising a marking provided on the shaft adapter or the shaft to indicate a location of the notch. Element 15: further comprising a cylindrical lock extendable about the body, wherein the cylindrical lock is axially translatable relative to the body to locate the tab of each finger in the corresponding notch. Element 16: wherein the cylindrical lock defines a locking arm having an extension receivable within a slot defined on the body.

By way of non-limiting example, exemplary combinations applicable to A, B, C, and D include: Element 4 with Element 5; Element 5 with Element 6; Element 11 with Element 12; Element 11 with Element 13; and Element 15 with Element 16.