Abstract:
An adapter assembly includes an elongated body configured to couple to a handle assembly and a loading unit assembly. The adapter assembly includes an oscillator configured to output a voltage signal. A sensor determines a connection status of the loading unit assembly coupled to the adapter assembly based on a change in the voltage signal. The voltage signal includes a rectified voltage output and an induced voltage output and changes in response to the approximation of a winding disposed within a loading unit assembly to the oscillator.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims the benefit of and priority to U.S. Provisional Patent Application No. 62/266,791 filed Dec. 14, 2015, the entire disclosure of which is incorporated by reference herein. 
     
    
     BACKGROUND 
       [0002]    1. Technical Field 
         [0003]    The present disclosure relates to adapter assemblies and surgical loading units for use with an electromechanical surgical system and their methods of use. More specifically, the present disclosure relates to hand-held, electromechanical surgical instruments capable of detecting the presence of a loading unit and/or identifying one or more parameters of a loading unit attached to an adapter assembly. 
         [0004]    2. Background of Related Art 
         [0005]    Linear clamping, cutting, and stapling surgical devices may be employed in surgical procedures to resect tissue. Conventional linear clamping, cutting, and stapling devices include a handle assembly, an elongated shaft and a distal portion. The distal portion includes a surgical loading unit which may contain pair of gripping members that clamp about the tissue. 
         [0006]    A need currently exists for a contactless detection assembly between the surgical loading unit and the adapter assembly for the electromechanical surgical system. With the removal of a physical contact for detection between the surgical loading unit and adapter assembly, there is a decreased degradation of the exposed identification components of the surgical loading unit during use and/or over multiple sterilization processes. 
       SUMMARY 
       [0007]    The present disclosure relates to an adapter assembly, including an elongated body having a proximal portion and a distal portion, wherein the proximal portion is configured to couple to a handle assembly and the distal portion is configured to couple to a loading unit assembly. The adapter assembly includes an oscillator disposed within the elongated body and configured to output a voltage signal. A sensor disposed within the adapter assembly determines a connection status of a loading unit assembly coupled to the adapter based on a change in the voltage signal. 
         [0008]    In further embodiments, the voltage signal output by the oscillator includes a rectified voltage output and an induced voltage output. 
         [0009]    In another embodiment, the oscillator is a Colpitts Oscillator. 
         [0010]    In a further embodiment, the voltage signal changes in response to approximation of a winding disposed within a loading unit to the oscillator or in response to a wireless interaction with a winding disposed within a loading unit. 
         [0011]    In other embodiments, the sensor is further configured to determine at least one parameter of the loading unit assembly based on the change in the voltage signal. 
         [0012]    In other embodiment, the at least one parameter of the loading unit assembly is selected from the group consisting of a serial number of a loading unit assembly, a type of a loading unit assembly, a size of a loading unit assembly, a fastener size, a fastener type, prior use information, and maximum number of uses of a loading unit assembly. 
         [0013]    In another embodiment, a method for wireless detection of a surgical loading unit being coupled to an adapter assembly is disclosed. The method includes applying an input voltage and frequency to an oscillator circuit disposed within an adapter assembly and measuring at least one parameter of the oscillator circuit. The method additionally includes inserting the surgical loading unit containing a winding into the adapter assembly, thereby altering the at least one parameter and measuring the altered at least one parameter. The method further determines a difference between the at least one parameter and the altered at least one parameter and determining presence of the surgical loading unit based on the difference. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0014]    Embodiments of the present disclosure are described herein with reference to the accompanying drawings, wherein: 
           [0015]      FIG. 1  is a perspective view of an electromechanical surgical instrument according to an embodiment of the present disclosure; 
           [0016]      FIG. 2  is a perspective view of the surgical instrument of  FIG. 1  with components separated. 
           [0017]      FIG. 3  is a perspective view of a handle connector port of a handle assembly of the surgical instrument shown in  FIG. 1 ; 
           [0018]      FIG. 4  is a perspective view of an adapter connector port of an adapter assembly of the surgical instrument shown in  FIG. 1 ; 
           [0019]      FIG. 5  is a cross sectional view of the adapter assembly of  FIG. 1  taken along a section line “B-B” of  FIG. 1 ; 
           [0020]      FIG. 6  is a schematic connectivity diagram of each of the components of the surgical instrument of  FIG. 1 ; and 
           [0021]      FIG. 7  is a circuit diagram of an oscillator of the adapter assembly of  FIG. 1 . 
       
    
    
     DETAILED DESCRIPTION OF EMBODIMENTS 
       [0022]    Embodiments of the presently disclosed surgical devices, adapter assemblies, and surgical attachments are described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein the term “distal” refers to that portion of the adapter assembly or surgical device, or component thereof, farther from the user, while the term “proximal” refers to that portion of the adapter assembly or surgical device, or component thereof, closer to the user. 
         [0023]    With reference to  FIG. 1 , a surgical device  100 , in accordance with an embodiment of the present disclosure, is a powered hand held electromechanical surgical device configured for selective attachment thereto of a plurality of different end effectors. The end effectors may be any one of various surgical attachments including, but not limited to, a surgical stapler, a surgical cutter, a surgical stapler-cutter, a linear surgical stapler, a linear surgical stapler-cutter, a circular surgical stapler, a circular surgical stapler-cutter, a surgical clip applier, a surgical clip ligator, a surgical clamping device, a vessel expanding device, a lumen expanding device, a scalpel, a fluid delivery device or any other suitable type of surgical instrument. Each of the surgical attachments is configured for actuation and manipulation by the powered hand held electromechanical surgical device  100 . 
         [0024]    As illustrated in  FIG. 1 , the surgical instrument  100  includes handle assembly  200  configured for selective connection with an adapter assembly  300  (see  FIG. 3 ), and, in turn, adapter assembly  300  is configured for selective connection with a surgical loading unit  400  (e.g., an end effector, multiple or single-use loading unit, see  FIG. 4 ) that is configured to perform at least one function. Handle assembly  200  is configured and adapted to actuate adapter assembly  300 . Adapter assembly  300  is connectible with surgical loading unit  400 , as described herein. Surgical instrument  100  further defines a longitudinal axis “X.” 
         [0025]    For a detailed description of the construction and operation of an exemplary electromechanical, hand-held, powered surgical instrument reference may be made to U.S. Pat. No. 7,819,896, International Publication No. WO 2009/039506 and U.S. Publication No. 2011/0121049, the entire contents of which of each are incorporated herein by reference, 
         [0026]      FIG. 2  shows each of handle assembly  200 , adapter assembly  300 , and surgical loading unit  400  and the connectivity between therein. Handle assembly  200  includes a handle housing  202  having a controller  204  and a drive mechanism  215  disposed therein. The controller  204  is configured to control the various operations of surgical instrument  100 . Handle housing  202  also defines a cavity therein (not shown) for selective removable receipt of a power source, such as a rechargeable battery (not shown). The power source is configured to supply power to any of the electrical components of handle assembly  200  including electric motors  206  used to drive the operation of surgical loading unit  400  via adapter assembly  300 . 
         [0027]    Handle assembly  200  further includes gear selector boxes (not shown), and gearing mechanisms (not shown) coupled to the motors  206 . Controller  204  is configured to control motors  206  based on the presence of a loading unit, for example, surgical loading unit  400  coupled to the handle assembly  200  by the adapter assembly  300 . Handle assembly  200  further includes a control assembly  208 , which may include one or more finger-actuated control buttons, rocker devices, joystick or other directional controls, whose input is transferred to the drive mechanism  215  to actuate adapter assembly  300  and in turn surgical loading unit  400 . 
         [0028]    In particular, drive mechanism  215  is configured to drive shafts and/or gear components in order to selectively move an end effector  404  of surgical loading unit  400  and to rotate end effector  404  about longitudinal axis “X” defined by surgical instrument  100  as shown in  FIGS. 3 and 4   
         [0029]    Handle assembly  200  further includes a nose or connecting portion  210  configured to accept a corresponding adapter connector port  390  of adapter assembly  300 . Connecting portion  210  of handle assembly  200  is configured to receive adapter connector port  390  of adapter assembly  300  when adapter assembly  300  is mated to handle assembly  200  (see  FIG. 3 ). 
         [0030]    Connecting portion  210  houses one or more drive shafts  230  ( FIG. 3 ) that interface with corresponding one or more input shafts  330  ( FIGS. 2 and 4 ) of adapter assembly  300 . Connecting portion  210  further includes a planar face and a substantially circular configuration. In some embodiments, connecting portion  210  has alternative configurations, such as, for example, oval, oblong, triangular, square, rectangular, hexagonal, polygonal, or star-shaped, configured for mating engagement with adapter connector port  390  of adapter assembly  300 . The mating of handle assembly  200  with adapter assembly  300  allows rotational forces to be independently transmitted. 
         [0031]    Handle housing  202  of handle assembly  200  includes an upper housing portion  202   a  which houses various components of hand-held electromechanical surgical device  200 , and a lower hand grip portion  202   b  extending from upper housing portion  202   a . Lower hand grip portion  202   b  may be disposed distally of a proximal-most end of upper housing portion  202   a . In some embodiments, lower hand grip portion  202   b  has various surface features, such as, for example, knurled, smooth, rough, and/or textured to enhance a practitioner&#39;s gripping of lower hand grip portion  202   b.    
         [0032]    In some embodiments, handle assembly  200  may include a display (not shown) configured to display information from the data signals received from adapter assembly  300  and surgical loading unit  400  for use by a user of the surgical instrument  100 . 
         [0033]    With continued reference to  FIG. 2 , the adapter connector port  390  of the adapter assembly  300  includes a knob housing  302 . The adapter assembly  300  also includes an elongated body  304  extending from a distal end of knob housing  302 . Knob housing  302  and elongated body  304  are configured and dimensioned to house the components of adapter assembly  300 . Elongated body  304  may be dimensioned for endoscopic insertion. For example, elongated body  304  may be passable through a typical trocar port, cannula or the like. Knob housing  302  is dimensioned to remain outside a trocar port, cannula of the like. 
         [0034]    Adapter connector port  390  is configured to mateably connect with connecting portion  210  of handle assembly  200  and includes one or more input shafts  330  configured to interface with corresponding one or more drive shafts  230  of connecting portion  210  of handle assembly  200  ( FIGS. 3 and 4 ). 
         [0035]    Adapter connector port  390  is configured to connect with connecting portion  210  includes one or more input shafts  330  extending therefrom, and defines a recess  370  formed therein, which is sized and configured to receive protrusion  270  of handle connector port  210 . One or more input shafts  330  are configured to rotatably interface with one or more drive shafts  230  of handle connector port  210 . In some embodiments, adapter connector port  390  may also include primary distal coil  350  and additional coils  360  positioned within recess  370 . 
         [0036]    Elongated body  304  has a distal portion  306   b  configured to be coupled to proximal portion  402   a  of surgical loading unit  400 . Elongated body  304  further includes a cylindrical outer housing  312  and a cylindrical inner housing  314  disposed therein. 
         [0037]    A controller  320  is disposed within or on cylindrical inner housing  314  ( FIG. 6 ). In addition, oscillator  340  is located within cylindrical inner housing  314  at distal portion  306   b  of adapter assembly  300 , as further detailed and described herein. 
         [0038]    Adapter assembly  300  may also include a plurality of sensors  319  disposed thereabout. Sensors  319  of adapter assembly  300  are coupled to controller  320  and are configured to detect various conditions of adapter assembly  300  and provide input to controller  320  in the form of data signals. 
         [0039]    With continued reference to  FIG. 2 , surgical loading unit  400  has a proximal portion  402   a  and is configured for engagement with distal end  306   b  of elongated body  304  of adapter assembly  300 . Surgical loading unit  400  includes a distal portion  402   b  having an end effector  404  extending therefrom. End effector  404  is pivotally attached to distal portion  402   b . End effector  404  may include an anvil assembly  408  and a cartridge assembly  406 . Cartridge assembly  406  is pivotable in relation to anvil assembly  408  and is movable between an open or unclamped position and a closed or clamped position for insertion through a cannula of a trocar. 
         [0040]    Surgical loading unit  400  further includes a housing  410  configured to contain the drive mechanisms, integrated circuits, processors, and memory for controlling end effector  404 . In particular, surgical loading unit  400  further includes a controller  420  disposed within or on inner housing  410   b  and loading winding  417  located at proximal portion  402   a , as further detailed and described herein. 
         [0041]    Surgical loading unit  400  may also include a sensors  419  disposed thereabout. Sensors  419  of the surgical loading unit  400  may be substantially similar to sensors  319  of adapter  300  and are configured to detect various conditions of surgical loading unit  400  or of the environment (e.g., if the end effector  404  is open, thickness of tissue within the end effector  404 , the temperature within the surgical loading unit  400 , etc.). Sensors  419  provide input to controller  420  in the form of data signals. 
         [0042]    Referring now to  FIGS. 3 and 4 , components of connecting portion  210  of handle assembly  200  and adapter connector port  390  of adapter assembly  300  are shown. 
         [0043]    Connecting portion  210  of handle assembly  200  includes a protrusion  270  extending distally therefrom. In some embodiments, a proximal coil  250  is disposed within protrusion  270  of connecting portion  210  of handle assembly  200 . Protrusion  270  may also include includes additional coils  260  adjacent to, but electrically shielded from the proximal coil  250 . 
         [0044]    As described herein adapter connector port  390  is configured to mateably connect with connecting port  210 . 
         [0045]    Referring now to  FIG. 5 , surgical loading unit  400  and adapter assembly  300  are shown in an inserted and engaged position. In use, surgical loading unit  400  is inserted within the distal end of elongated tube  304  of adapter assembly  300 . In some embodiments, surgical loading unit  400  may be rotated in a clockwise or counter-clockwise direction thereby locking surgical loading unit  400  in position. Once inserted and engaged, distal portion  306   b  of the adapter assembly  300  is located within proximal portion  402   a  of loading unit  400 . 
         [0046]    Upon insertion and engagement, loading winding  417  of surgical loading unit  400  inductively couples to oscillator winding  342  of oscillator  340  ( FIGS. 6 and 7 ). It is also contemplated that once engaged, the magnetic field produced by the oscillating current in oscillator winding  342  energizes loading winding  417  as described below. Once energized, loading winding  417  (via a connection with integrated circuits  430  and controller  420 ) is able to provide energy wirelessly to surgical loading unit  400  ( FIG. 5 ). 
         [0047]    Once surgical loading unit  400  and adapter assembly  300  are coupled to each other, a wireless interface  500  ( FIG. 6 ) is created between surgical loading unit  400  and adapter assembly  300 . As used herein “wireless interface” denotes a non-contact interface that is capable of transmitting energy from adapter assembly  300  to surgical loading unit  400  and transmitting data signals between adapter assembly  300  and surgical loading unit  400 . It is also contemplated that control signals may be transmitted via wireless interfaces  500  and  600  from handle assembly  200  to loading unit  400  via adapter assembly  300 . 
         [0048]    Additionally and as further described in description of  FIG. 7 , inductive coupling of loading winding  417  to oscillator winding  342  changes the overall impedance of oscillator winding  342 , which also changes the amplitude of the sinusoidal voltage output. The present disclosure provides for determining whether the surgical loading unit  400  is inserted into adapter  300  as well as identifying the type of surgical loading unit based on the change in amplitude of the voltage waveform passing through the oscillator  340 . 
         [0049]    Referring now to  FIG. 6 , a diagram of the connectivity between handle assembly  200 , adapter assembly  300 , and surgical loading unit  400 , and each of their internal components is shown. 
         [0050]    As described above, handle assembly  200  includes a controller  204 , one or more motors  206 , and drive mechanism  215 . Controller  204  is configured to control one or more motors  206  and drive mechanism  215 . Once handle assembly  200  is engaged with adapter assembly  300 , the wireless interface  600  provides for the input and output transmission of data signals between handle assembly  200  and adapter assembly  300 . Interface  600  may also be created using induction coils or any other RF transceivers suitable for transmitting data signals and/or energy wirelessly. 
         [0051]    The controller  320  of the adapter assembly  300  includes processor  320   a  and memory  320   b . The memory  320   b  may be one or more of volatile, non-volatile, magnetic, optical, or electrical media, such as read-only memory (ROM), random access memory (RAM), electrically-erasable programmable ROM (EEPROM), non-volatile RAM (NVRAM), or flash memory. Memory  320   b  is configured to store one or more parameters relating to adapter assembly  300 . Processor  320   a  is further configured to include analog to digital converter (ADC)  323  of a microcontroller  325  which is coupled to an integrated circuit  330  within adapter  300 . The processor  320   a  may be any suitable logic unit (e.g., control circuit) adapted to perform the operations, calculations, and/or set of instructions described in the present disclosure including, but not limited to, a hardware processor, a field programmable gate array (FPGA), a digital signal processor (DSP), a central processing unit (CPU), an application specific integrated circuit (ASIC), or discrete logic circuitry, a microprocessor, and combinations thereof. 
         [0052]    Integrated circuit  330  contains and/or is coupled to an oscillator  340  capable of interfacing with the surgical loading unit  400  once adapter  300  is engaged. In one embodiment, oscillator  340  is a Colpitts Oscillator as shown in  FIG. 7 , an inductor/capacitor circuit which controls the frequency of oscillations and consists of a single inductor and two capacitors in series. 
         [0053]    Oscillator  340  contains one of more oscillator windings  342  which are disposed within cylindrical inner housing  314  of adapter assembly  300  ( FIG. 2 ) and are configured to interface with one or more loading winding  417  disposed within surgical loading unit  400  upon insertion of surgical loading unit  400  into adapter assembly  300 . 
         [0054]    Controller  420  of surgical loading unit  400  includes loading unit processor  420   a  and memory  420   b . Processor  420   a  and memory  420   b  may be substantially similar to the processor  320   a  and memory  320   b  as described above. Memory  420   b  is configured to store one or more parameters relating to surgical loading unit  400 . The parameter may include at least one of a serial number of a loading unit assembly, a type of a loading unit assembly, a size of a loading unit assembly, a fastener size, a fastener type, prior use information, and maximum number of uses of a loading unit assembly, and combinations thereof. Memory  420   b  is configured to communicate to handle assembly  200  and adapter  300  a presence of surgical loading unit  400  and one or more of the parameters of surgical loading unit  400  described herein, upon engagement of surgical loading unit  400  with adapter assembly  300 . 
         [0055]    Loading unit processor  420   a  may include a voltage to current converter  423  that converts data signals of the plurality of sensors  419  to high frequency signals for transmission across interface  500  as detailed herein. Loading unit processor  420   a  further includes a microcontroller  435  which is coupled to an integrated circuit  430  within surgical loading unit  400 . Loading unit processor  420   a  is further configured to transmit data signals via interface  500  to adapter assembly  300 . It is contemplated that the loading unit processor  420   a  may be directly wired to loading winding  417 . 
         [0056]    Loading winding  417  is configured to interface with oscillator winding  342  of oscillator  340  once surgical loading unit  400  is engaged to the adapter assembly  300 . Once engaged, loading winding  417  is energized via the connection with oscillator windings  342  and able to power one or more integrated circuits  430  and/or controller  420  contained therein. Integrated circuits  430  may be identification integrated chips (i.e., a 1-Wire chip), sensors  419 , and any other circuits. It is contemplated that one or more integrated circuits  430  may be powered by loading winding  417 . 
         [0057]    Once loading winding  417  and oscillator winding  342  are coupled, a signal passing through the oscillator winding  342  is modified. In particular, the amplitude of the voltage of the signal is modified. In further embodiments, other parameters of the signal may also be modified, such as its frequency. The processor  320   a  is configured to detect the presence of the surgical loading unit  400  based on the change in a parameter of the signal, such as its amplitude and/or its frequency. In addition, processor  320   a  is capable of identifying the surgical loading unit. The controller  320  and/or the processor  320   a  are configured to analyze the change in the parameter of the signal and compare the change in the parameter to a plurality of changes in the parameter stored in memory  320   b . In particular, the memory  320   b  includes a look-up table which matches the stored changes in the parameters of the signal to specific surgical loading units  400 . Thus, if there is a match, the controller  320  may then identify the surgical loading unit  400  based on the detected change in the parameter of the signal. In addition, the controller  320  is also configured to determine other properties of the surgical loading unit  400 . In embodiments, this information may be transmitted via the wireless interface  600  to handle assembly  400 . 
         [0058]    Referring now to  FIG. 7 , an example circuit diagram of oscillator  340  is shown using a Colpitts Oscillator. Although  FIG. 7  includes specific numeric values for each of the components, the specific values are included for illustrative purposes. 
         [0059]    Oscillator  340  is used to produce a voltage sine wave whose amplitude, once surgical loading unit  400  is engaged with adapter assembly  300 , namely, once loading winding  417  is inductively coupled to oscillator winding  342 . Oscillator  340  is driven by an inductor (L 1 ) and capacitors (C 1  and C 2 ) whose values determine the frequency (f r ) of the output voltage signal (V out ). As stated above and shown in  FIG. 5 , as loading winding  417  (L 2 ) is engaged with oscillator winding  342  (L 1 ), the total value of inductance (L tot ) is changed thereby altering the frequency (f r ), via mutual inductance. Formulas (1), (2), and (3) describe the total capacitance, frequency of the oscillator circuit, and changes in inductance. 
         [0000]    
       
         
           
             
               
                 
                   
                     C 
                     TOT 
                   
                   = 
                   
                     
                       
                         C 
                         1 
                       
                        
                       
                         C 
                         2 
                       
                     
                     
                       
                         C 
                         1 
                       
                       + 
                       
                         C 
                         2 
                       
                     
                   
                 
               
               
                 
                   ( 
                   1 
                   ) 
                 
               
             
           
         
       
     
         [0060]    Formula (1) describes the total capacitance (C tot ) of the oscillator circuit, and is based on the two capacitors (C 1  and C 2 ) in series. The total capacitance (C tot ) is used in determination of the frequency (f r ) of the output voltage (V out ). 
         [0000]    
       
         
           
             
               
                 
                   
                     f 
                     r 
                   
                   = 
                   
                     1 
                     
                       2 
                        
                       π 
                        
                       
                         
                           
                             L 
                             Tot 
                           
                            
                           
                             C 
                             TOT 
                           
                         
                       
                     
                   
                 
               
               
                 
                   ( 
                   2 
                   ) 
                 
               
             
           
         
       
     
         [0061]    Formula (2) describes the frequency of the output voltage (V out ) and is based on the values of L tot  and C tot  of formula (1). In the case where loading winding  417  (L 2 , not shown) is not engaged with oscillator winding  342  (L 1 ), total inductance (L tot ) remains equal to the value of inductor (L 1 ). 
         [0000]        L   TOT =√{square root over ( L   1   L   2 )}  (3)
 
         [0062]    Formula (3) described the total inductance (L tot ) once loading winding  417  (L 2 , not shown) is engaged with oscillator winding  342  (L 1 ). Using the altered total inductance (L tot ) value based on varying loading winding  417  (L 2 , not shown) causes a change of frequency (f r ), which can be measured by analog to digital converter (ADC)  323  of a microcontroller  325 . 
         [0063]    In some embodiments, it is contemplated that various types of surgical loading units each include a distinct loading winding  417  (L 2 ) which, once engaged with oscillator winding  342  (L 1 ), change the frequency (f r ) in such a manner that it can be determined the type of surgical loading unit engaged based on the change in frequency (f r ). 
         [0064]    In use, oscillator  340  is provided an input signal at a specific voltage and frequency. In an exemplary embodiment, as shown in  FIG. 7 , an input voltage of +5V is provided to the oscillator  340 . Based on this input voltage, a first, namely, an unaltered parameter, of the input signal is measured. As noted above, the parameter may be the signal&#39;s output voltage, frequency, or combinations thereof. The loading winding  417  of the surgical loading unit  400  is then coupled with oscillator winding  342  of the oscillator  340  of the adapter assembly  300 . Upon coupling loading winding  417  with oscillator winding  342 , one or both of the output voltage and output frequency of the signals is altered based on the mutual inductance between oscillator winding  342  and loading winding  417 . Once coupled, the signal parameters are measured again and compared to the previously measured unaltered parameters, to determine a difference therebetween. The measured difference may then be used to determine the presence of and/or identity of the surgical loading unit  400 . 
         [0065]    Surgical instruments according to the present disclosure may also be configured to work with robotic surgical systems, such as telesurgery systems. Such systems employ various robotic elements to assist the surgeon and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the surgeon during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc. 
         [0066]    The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of surgeons or nurses may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another surgeon (or group of surgeons) remotely control the instruments via the robotic surgical system. As can be appreciated, a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients. 
         [0067]    The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc.) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s). 
         [0068]    The master handles may include various sensors to provide feedback to the surgeon relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the surgeon with enhanced tactile feedback simulating actual operating conditions. The master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the surgeon&#39;s ability to mimic actual operating conditions. 
         [0069]    It will be understood that various modifications may be made to the embodiments of the presently disclosed adapter assemblies. Therefore, the above description should not be construed as limiting, but merely as exemplifications of embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the present disclosure.