Patent Publication Number: US-11653912-B2

Title: Needle driver devices and related systems and methods

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims priority to U.S. Provisional Application No. 62/947,081 (filed Dec. 12, 2019), titled “NEEDLE DRIVER DEVICES AND RELATED SYSTEMS AND METHODS,” the entire contents of which are incorporated by reference herein. 
    
    
     TECHNICAL FIELD 
     Aspects of the present disclosure relate to devices, systems, and methods for performing a suturing procedure. For example, aspects of the present disclosure relate to needle driver devices including, but not limited to, for example, devices configured to insert sutures during remote surgical, diagnostic, therapeutic, and other treatment procedures. Further aspects of the disclosure relate to methods of operating such devices. 
     INTRODUCTION 
     Sutures are used in a variety of surgical and other applications, such as closing ruptured or incised tissue, soft tissue attachment, attachment of grafts, etc. Additionally, sutures may have other medical and/or non-medical uses. Conventionally, suturing is accomplished by penetrating tissue with the sharpened tip of a suturing needle that has a thread of suturing material attached to the opposite blunt end of the needle. The needle is then pulled through the tissue, causing the attached thread of suturing material to follow the path of the needle. Typically, a knot is tied at the trailing end of the thread to anchor the first stitch. This action is performed repetitively with application of tension to the needle to pull a length of the thread through the tissue using subsequent stitches until the tissue is sutured as desired with one or more stitches. 
     While the above-described suturing process can be performed manually, automated suturing systems also exist. Such systems can include a needle driver device that has an open, C-shaped portion into which tissue segments are introduced. The C-shaped portion defines two arms, each with an entry/exit point for a curved needle. The curved needle is driven around a track (generally following the C-shaped portion) and across the opening in the C-shaped portion to draw a thread of suturing material into the needle driver device through the tissue segments, similar to the manual suturing process discussed above. It is desirable to provide needle driver devices that occupy a minimal amount of space relative to a size (e.g., gauge and/or radius) of the needle. Such tools are useful in space-limited applications, such as in the case of minimally invasive surgery, for example laparoscopic surgery including both manual and computer-assisted surgery. 
     A need exists to provide needle driver devices with an overall relatively small working end. A need also exists to provide robust mechanical parts and operational design of such devices to reduce complexity and/or wear on parts of the device. A further need exists to provide such devices with a greater level of reliability in use and manufacturability, which can contribute to low overall cost of use during a lifetime of the device. 
     SUMMARY 
     Exemplary embodiments of the present disclosure may solve one or more of the above-mentioned problems and/or may demonstrate one or more of the above-mentioned desirable features. Other features and/or advantages may become apparent from the description that follows. 
     In accordance with at least one aspect of the present disclosure, a needle driver device includes an arc-shaped track and an arc-shaped needle configured to be received in the arc-shaped track. The arc-shaped needle is moveable along a curved path including the arc-shaped track. The needle driver device further includes a rotary drive mechanism and a needle driver link. The needle driver link has a distal end portion configured to removably engage the arc-shaped needle and a proximal end portion coupled to the rotary drive mechanism. The needle driver device also includes a guide member coupled to the needle driver link and defining a pivot location of the needle driver link between the distal end portion and the proximal end portion of the needle driver link. The needle driver link is rotatable about the pivot location, and the guide member is moveable in response to movement of the needle driver link. 
     In accordance with at least another aspect of the present disclosure, a needle driver device includes an arc-shaped track and an arc-shaped needle configured to be received by the arc-shaped track. The arc-shaped needle is moveable along a path including the arc-shaped track. The needle driver device includes a rotary drive mechanism and a needle driver link. The needle driver link includes a distal end portion removably engageable with the arc-shaped needle and configured to be removably coupled to the arc-shaped track. The needle driver link also includes a proximal end portion coupled to the rotary drive mechanism. 
     Additional objects, features, and/or advantages will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the present disclosure and/or claims. At least some of these objects and advantages may be realized and attained by the elements and combinations particularly pointed out in the appended claims. 
     It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the claims; rather the claims should be entitled to their full breadth of scope, including equivalents. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The present disclosure can be understood from the following detailed description, either alone or together with the accompanying drawings. The drawings are included to provide a further understanding of the present disclosure and are incorporated in and constitute a part of this specification. The drawings illustrate one or more embodiments of the present teachings and together with the description explain certain principles and operation. In the drawings, 
         FIG.  1    is a schematic side view of an embodiment of a needle driver device. 
         FIG.  2    is a perspective view of a distal portion of an embodiment of a needle driver device according to an exemplary embodiment of the present disclosure. 
         FIG.  3    is a top view of the needle driver device, with interior components depicted, of  FIG.  2   . 
         FIG.  4    is an enlarged perspective view of the needle driver device, with interior components depicted, according to the embodiment of  FIG.  2   . 
         FIG.  5    is a top view of the needle driver device according to the embodiment of  FIG.  2    with various interior components depicted to highlight aspects of the device. 
         FIG.  6 A  is a top view of the distal portion of the needle driver device, like the view of  FIG.  3   , showing the needle and needle driver link of  FIG.  2    in an initial configuration. 
         FIG.  6 B  is a perspective view of the C-shaped portion of the needle driver device, with internal component shown, in the configuration of  FIG.  6 A . 
         FIGS.  6 C and  6 D  are top views of the distal portion of the needle driver device of  FIG.  2    with the needle and needle driver link in various stages of advancement from the initial configuration of  FIGS.  6 A and  6 B . 
         FIGS.  6 E- 6 H  are detailed perspective views of the C-shaped portion of the needle driver device in various stages of advancement from the configuration of  FIGS.  6 C and  6 D . 
         FIGS.  6 I- 6 K  are top views of the distal portion of the needle driver device of  FIG.  2   , with internal components shown, in various stages of advancement from the configuration of  FIGS.  6 E- 6 H . 
         FIG.  7    is a top view of a needle driver device according to another exemplary embodiment of the present disclosure. 
         FIG.  8    is a perspective view, with internal components shown, of the needle driver device of  FIG.  7   . 
         FIG.  9    is a perspective view of the C-shaped portion of the needle driver device of  FIG.  7    in a configuration of driving the needle across the opening. 
         FIG.  10    is a sectional perspective view of the C-shaped portion of the needle driver device of  FIG.  7   . 
         FIGS.  11 A- 11 C  are top views of the distal portion of the needle driver device of  FIG.  7    showing internal components and various configurations of the needle and needle driver link from an initial configuration through various stages of advancement. 
         FIG.  12    is a perspective view of a manipulator system according to an exemplary embodiment of the disclosure. 
         FIG.  13    is a partial schematic view of an embodiment of a manipulator system having a manipulator arm with two instruments in an installed position according to the present disclosure. 
         FIG.  14 A  is a top view of the needle driver device of  FIG.  2    including a needle and suture material, with a needle retainer in a closed position. 
         FIG.  14 B  is a top view of the needle driver device of  FIG.  14 A  with the needle retainer in an open position. 
         FIG.  14 C  is perspective view of the needle driver device of  FIG.  14 A  with the needle retainer in the closed position. 
     
    
    
     DETAILED DESCRIPTION 
     The present disclosure provides various embodiments of needle driver devices, systems, and methods. Needle driver devices according to various embodiments of the present disclosure include features that kinematically constrain movement of an end portion (such as a distal end portion) of a needle driver link, to which the needle is coupled, to follow a desired path, such as along an arc of a circular path. In various configurations, the motion of the needle driver link can be constrained without occupying undue space in the distal portion of the needle driver device, thus enabling a smaller overall size of the device for a given needle size. 
     In some exemplary embodiments, movement of an end portion (such as a proximal end portion) of the needle driver link opposite the end portion to which the needle is coupled, also can be constrained within a desired path. The path to which the proximal end portion of the needle driver link is constrained can be chosen such that, in combination with other constraining features, the distal end portion of the needle driver link is constrained to move along a portion of a curved (e.g., circular) path within the distal end portion of the needle driver device and to drive the needle with a desired motion. For example, in some embodiments, the needle may be driven in full rotations or partial rotations around the needle track and opening of the needle driver device to carry out a suturing process in response to input at a drive mechanism, as will be explained further below. In some exemplary embodiments, movement of the distal end portion of the needle driver link itself is constrained to a desired path, such as a circular path, by features of the distal end portion of the needle driver link that directly interface with features in the distal portion of the needle driver device. Such features can be configured so that they occupy minimal space within the distal portion of the needle driver device, thereby contributing to a small overall size of the needle driver device for a given needle size. In addition to reducing space requirements, these features can also contribute to reduced assembly and operational complexity, and to improved reliability and useful life of the device. 
     In some exemplary embodiments, a portion of the needle driver link between the proximal and distal ends can be constrained along multiple degrees of freedom. In combination with other constraints on the proximal and/or distal end of the needle driver link, the multiple degrees of freedom permit the proximal end to move along a first path, for example, a path defined by a drive mechanism of the needle driver device, and concurrently control the distal end portion of the needle driver link to move in a desired path, such as along a needle track, which in various embodiments may be circular. 
     Referring now to  FIG.  1   , a schematic view of a needle driver device  100  according to an exemplary embodiment of the disclosure is shown. The needle driver device  100  includes an end effector  104  at a distal end portion  102  of a shaft  112 . The end effector  104  comprises a C-shaped portion  106 , which houses an arc-shaped needle  108  (a sharpened tip portion of which is illustrated). In an exemplary embodiment, the needle  108  has a curvature corresponding to a circular arc. A transmission mechanism  110  is coupled to a proximal end portion of the shaft  112 . The transmission mechanism  110  can be configured to be operably coupled with a computer-controlled (e.g., teleoperated) surgical manipulator system, such as the manipulator systems described below in connection with  FIGS.  12  and  13   , or it can be manually controlled with manually operated (e.g., handheld) actuators (not shown). The end effector  104  can optionally be coupled to the shaft  112  by a joint structure  105 , such as a wrist, imparting one or more degrees of freedom to the end effector  104  relative to the shaft  112 . 
     Drive inputs received at the transmission mechanism  110 , whether through manual actuation or via a manipulator system, can actuate the end effector  104 , such as by driving the needle  108  around a path defined partly by the C-shaped portion  106 . Movement of the needle  108  across the opening  109  of the C-shaped portion  106  can be used to, for example, suture tissue or other materials positioned within the opening  109  of the C-shaped portion  106 . For example, in some exemplary embodiments, the C-shaped portion  106  includes an arc-shaped needle track, as discussed further below, exhibiting a radius of curvature similar to a radius of curvature of the needle  108 , and the needle  108  rotates about a center of curvature of the arc-shaped track. 
     The transmission mechanism  110  can include one or more drive components configured to receive an oscillating, rotational drive input from the drive mechanism, and to transmit the rotational drive input through an actuation member, such as, for example, a cable or rod (not shown) located within the shaft  112  and coupled at opposite ends to the transmission mechanism  110  and the end effector  104 . In one exemplary embodiment, the actuation member can be a cable drive element having a pull/pull configuration. That is, the actuation member comprises a looped cable or two cables that can alternatingly be tensioned to achieve the desired drive motion. Various components within the end effector  104  can be configured to change the rotational, oscillating drive motion to a stepwise rotational motion of the needle  108 , as discussed in connection with the exemplary embodiments described in connection with  FIGS.  2 - 11   . 
       FIG.  2    shows one exemplary embodiment of a distal end portion  202  of a needle driver device  200  according to the present disclosure. The distal end portion  202  has a C-shaped portion  206  in which a needle track  214  is located. The needle track  214  receives an arc-shaped needle  208  and allows the needle  208  to travel along it. The distal end portion  202  further comprises a needle retainer  216  that is biased by a spring  218  to a normally closed position that can be retracted, against the biasing force, by a user to the open position illustrated in  FIG.  2    to expose the needle  208  within the needle track  214 . When not held in the retracted position, the needle retainer  216  is urged distally by spring  218  against stops  220  at distal edges of the distal end of the C-shaped portion  206  and covers the needle track  214 . Exposure of the needle  208  by retraction of the needle retainer  216  permits replacement of the needle  208  and/or suture thread. In use during a suturing procedure, the needle retainer  216  remains in the closed position. 
     The needle  208  can be driven around the needle track  214  in a cyclical manner. Each complete rotation (i.e., 360-degree rotation) of the needle  208  can complete a single suture stitch in the tissue or other material positioned in the C-shaped portion of the needle driver device  200 . In exemplary embodiments, the thread of suture material can be coupled (e.g., tied) at a leading or trailing portion of the needle  208 , and the thread can follow the needle  208  through the needle track  214  as the needle  208  rotates to complete each suture.  FIGS.  14 A- 14 C  show views of the distal end portion  202  of the needle driver device with suture material  207  attached to a trailing portion of the needle  208 .  FIG.  14 A  shows the needle retainer  216  in the closed position.  FIG.  14 B  shows the needle retainer  216  in the open position to reveal the suture material  207  attached to the trailing portion of the needle. It should be appreciated, however, that in normal use, the needle retainer  216  would be in the closed position to conduct the suturing procedure.  FIG.  14 C  shows a perspective view of the distal end portion  202  of the needle driver device with the needle retainer  216  in the closed position. In the closed position of the needle retainer  216 , a clearance exists between the needle retainer  216  and the needle track  214 , which is formed in a portion of a housing  229  (see  FIGS.  2 - 4   ) of the needle driver device. The needle retainer  216  retains the needle  208  in the track  214  as it rotates, while the attached suture material  207  is drawn through the clearance between the needle retainer  216  and the needle track  214 . 
     Needle driver devices according to various embodiments of the present disclosure include drive components to rotate the needle through a full rotation, which can occur in a step-wise manner, without mechanical drive components entering a suturing area defined by the opening of the C-shaped portion. As described further below, such needle driver devices include various components that receive input from the transmission mechanism to actuate movement of the needle. In exemplary embodiments, the transmission mechanism is coupled to a rotary drive mechanism, such as for example, a pulley, in the distal end portion of the needle driver device via a drive member, such as a cable or belt, extending from the transmission mechanism and through the shaft to the distal end portion of the needle driver device. Additional drive components convert oscillating rotational movement of the rotary drive mechanism into a reciprocating movement of another drive component along a desired path. These drive components can include features that removably couple with the needle such that the reciprocating movement of a drive component removably coupled with the needle drives the needle to rotate, including, for example, in a stepwise manner. 
       FIGS.  3 - 5    show additional views of various drive system components and the operation of those components during use of the needle driver device  200  of  FIG.  2   . Referring now to  FIG.  3   , a top view of the needle driver device  200  is shown, with housing features omitted to display interior components of the drive system. The drive system of the needle driver device  200  includes a rotary drive mechanism in the form of a pulley drive assembly comprising a pulley disc  224  around which a drive member  226  extends. While the drive member  226  in  FIG.  3    is illustrated as a belt, other continuous or non-continuous drive members, such as belts, cables, rods, or other members can be used, as would be readily appreciated by one having ordinary skill in the art. The drive member  226  can extend through the shaft  112  ( FIG.  1   ) from the transmission mechanism  110  ( FIG.  1   ) to the distal end portion  202  of the needle driver device  200 . In some exemplary embodiments, the drive member  226  is operably coupled to a drive component (e.g., a capstan) (not shown) in the transmission mechanism (e.g., transmission mechanism  110 ), and operation of the manipulator (such as manipulator systems shown and described in connection with  FIGS.  12  and  13   , or a manual manipulator) actuates the drive component, placing tension on the drive member  226  to cause it to rotate the pulley disc  224 . 
     While a pulley drive assembly is shown and described as the rotary drive mechanism in the embodiment of  FIGS.  3 - 11   , the rotary drive mechanism is not limited to a pulley drive assembly and can include other drive mechanisms to cause the rotary motion of rotary drive mechanism. By way of nonlimiting example, those of ordinary skill in the art would appreciate that a direct drive mechanism could be used to rotate the rotary drive mechanism, such as by using a motorized or other rotating shaft mechanism coupled to impart rotary motion to the rotary drive mechanism, a gear train, or any other mechanical or electro-mechanical drivetrain. 
     Referring again to  FIG.  3   , the pulley disc  224  is operably coupled with a needle driver link  228  that extends generally distally from the pulley disc  224  and terminates at the distal end portion  202 . The driver link  228  removably engages with the needle  208  at a distal end portion  230  of the driver link  228 , which is described in further detail below in connection with  FIGS.  6 A- 6 I . The motion of the distal end portion  230  is constrained to follow the arc defined by the needle track  214 . However, in the exemplary embodiment of  FIGS.  2 - 5   , the distal end portion  230  of the driver link  228  is not physically constrained by way of engagement within or adjacent to the needle track  214 . Instead, other portions of the driver link  228  are constrained by various components of the drive system, which ensures that the motion of the distal end portion  230  of the driver link  228  follows the arc of the needle track  214 . This can enable a smaller overall size of the needle driver device  200 . 
     As shown in  FIG.  3   , motion of a proximal end portion  232  of the driver link  228  also is constrained by components of the drive system. A housing  229  (shown in  FIG.  2    and partly in ghost in  FIG.  4   ; not shown in  FIG.  3    to reveal interior components of the needle driver device  200 ) includes on an interior surface a guide track  234 . The guide track  234  is adjacent the proximal end portion  232  of the driver link  228  and is defined within an area defined by the projection of the pulley disc  224  on to the interior surface of the housing  229 . In other words, the guide track  234  does not extend radially beyond the circumference of the pulley disc  224 . In the embodiment of  FIGS.  2 - 5   , a pin  236  extends generally perpendicular to the longitudinal direction of the driver link  228  through the proximal end portion of the driver link  228  and has one end received in the guide track  234 . In this way, motion of the proximal end portion  232  of the driver link  228  is constrained to generally follow the path of the guide track  234  as the pulley disc  224  rotates. In the embodiment of  FIG.  3   , the drive track  234  has a curved path with a non-constant radial distance from an axis of rotation A P  of the pulley disc  224 . The shape of the guide track  234  is chosen such that as the proximal end portion  232  and pin  236  of the driver link  228  generally traverses the path of the guide track  234 , the distal end portion  230  of the driver link  228  generally traverses the path of the needle track  214 . The shape of the guide track  234  can be chosen based on various other dimensions and desired motion of the needle driver device  200 , as discussed in greater detail below. 
     As shown best in  FIGS.  3  and  4   , the pin  236  also engages with the pulley disc  224 . The pin  236  extends generally perpendicularly to a plane of motion of the driver link to engage the drive track  234  at one end of the pin  236  and a radial slot  238  in the pulley disc  224  at the other end of the pin  236 , with the portion of the pin  236  between the two ends extending thorough the driver link  228 . Thus, the proximal end portion  232  of the driver link  228  is simultaneously constrained by the pin  236  to follow the guide track  234  and the slot  238  as the pulley disc  224  rotates. Because the radial distance between the guide track  234  and the rotational axis A P  ( FIG.  3   ) of the pulley disc  224  varies along the guide track  234  (i.e., the guide track  234  does not follow a circular arc), the radial slot  238  is provided in the pulley disc  224  to allow radial movement of the proximal end portion  232  of the driver link  228  relative to the rotational axis A P  of the pulley disc  224  as the pulley disc  224  rotates and the pin  236  traverses the guide track  234 . 
     To convert the motion of the proximal end portion  232  of the driver link  228  to reciprocating motion at the distal end portion  230  of the driver link  228  to drive the needle  208  along the needle track  214  as discussed above, motion of the driver link  228  may further be constrained along a central portion  240  of the driver link  228 . 
     With continued reference to  FIGS.  3  and  4   , a rotatable guide member  242  has a puck configuration with a slot  245  running through the guide member  242  that is transverse to a pinned joint  241  defining a rotational axis A B  of the guide member  242 . The rotational axis A B  of the guide member  242  defines a pivot location of the driver link  228 . The driver link  228  passes through the slot  245  to operably couple the driver link  228  to the guide member  242  between the proximal and distal end portions of the driver link  228 . The driver link  228  can freely slide longitudinally within the slot  245 . Thus, the rotational axis A B  of the guide member  242  is not fixed relative to the driver link  228 , but the location at which the rotational axis A B  passes through the driver link  228  changes as the driver link  228  translates through the slot  245 . 
       FIG.  5    shows a top view of the needle driver device  200  of  FIGS.  3  and  4    taken in a cross-sectional plane parallel to a longitudinal axis of the needle driver device  200  and illustrates how the driver link  228  extends through the guide member  242 . As discussed above, the guide member  242  allows translational movement of the driver link  228  along a longitudinal axis A L  of the drive link  228  as the pulley disc  224  rotates and the pin  236  follows the guide track  234 , while also constraining the driver link  228  motion such that the longitudinal axis A L  always intersects a fixed point on the housing  229 , i.e., an axis of rotation A B  of the guide member  242 . 
     The combination of constraints imparted to movement of the driver link  228  by the guide track  234  and the guide member  242  ensures movement of the distal end portion  230  of the driver link  228  follows the path (e.g., circular arc) defined by the needle track  214 . Thus, the distal end portion  230  of the driver link  228  is not directly physically constrained by engagement within or adjacent the needle track  214  to move along the needle track  214 , but the constraints on movement of the proximal end portion  232  and central portion of the driver link  228  ensure the movement of the distal end portion  230  follows the needle track  214 . In other words, the distal end portion of the driver link  228  is mechanically unconstrained (is a free end of the link  228 ) but nonetheless follows the needle track  214  due to constraints acting at other locations on the driver link  228 . 
     Such an arrangement can contribute to a relatively small overall size of the needle driver device  200  for a given needle size. In some exemplary embodiments, the needle driver device  200  can be less than 8 mm in diameter, less than 10 mm in diameter, or less than 12 mm in diameter, while accepting relatively larger needle sizes than conventional needle driver devices having similar dimensions. Needle driver devices of the present disclosure can exhibit outside diameters only slightly larger than a needle accepted by the needle driver device. For example, a needle driver device according the present disclosure configured with an 8 millimeter (mm) overall outer diameter could have a needle diameter of only slightly less than 8 mm, such as a diameter greater than 7 mm and less than 8 mm. Likewise, a device with a 10 mm overall outer diameter could have a needle diameter only slightly less than 10 mm, such as a diameter greater than 9 mm and less than 10 mm, a device with a 12 mm overall outer diameter could have a needle diameter only slightly less than 12 mm, such as a diameter greater than 11 mm and less than 10 mm, and so on. 
     As mentioned above, the shape of the guide track  234  can be chosen such that the path of the guide track  234  and the guide member  242  constrain the motion of the distal end portion  230  of the driver link  228  along the desired path. In exemplary embodiments in which the desired path of the distal end portion  230  of the driver link  228  is a circular arc, the shape of the guide track  234  path does not follow a circular arc, and can be mathematically determined based on the geometries of various drive system components. For example, with continued reference to  FIG.  5   , the shape of the guide track  234  can be determined as a function of a length L of the driver link  228  between the proximal end portion  232  and the distal end, a distance D from the rotational axis A B  of the guide member  242  to a radius of curvature CN of the circular motion of the needle, a radius R of the curvature of the needle  208 , and an engagement angle θ at which the driver link  228  engages the needle  208 , as discussed below in connection with  FIGS.  6 A- 6 K . 
     For example, in one embodiment, given the constant parameters D, L, and R discussed above, the shape of the track can be given in a Cartesian plane by the following two equations: 
     
       
         
           
             
               
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     Operation of the needle driver device  200  of  FIGS.  2 - 5    is shown and described with reference to  FIGS.  6 A- 6 K . In  FIG.  6 A , the driver link  228  is shown in an initial position, with the pin  236  positioned at a first terminus end of the guide track  234  located generally in a first (top, right) quadrant of the pulley disc  224 , as viewed in  FIG.  6 A . The distal end portion  230  of the driver link  228  is positioned at an initial location at the bottom of the guide track  234  as viewed in  FIG.  6 A . As shown in  FIG.  6 B , which shows a perspective view of the distal end portion  202  of the needle driver device  200 , the distal end portion  230  of the driver link  228  includes a needle engagement member  244  that removably engages the needle  208  to enable the driver link  228  to drive the needle  208  around the needle track  214 . 
     In exemplary embodiments, the needle  208  includes features that interact with the needle engagement member  244 . For example, in the embodiment shown in  FIGS.  6 A- 6 K , the needle  208  includes a first, ramped notch  246  and second, ramped notch  256  ( FIG.  6 G ). The first notch  246  is located at a proximal end portion of the needle  208  (e.g., an end of the needle  208  opposite the sharp end) and is defined by a ramped upper surface profile  248  terminating in a shoulder portion  250  toward a distal end of the notch  246  (the distal end of the needle  208  being the sharp end). The second notch  256  is located at the distal end portion of the needle  208  (i.e., proximate the sharp end of the needle  208 ) and is similarly defined with a ramped upper surface profile  258  ( FIG.  6 G ) and a shoulder portion  260  ( FIG.  6 G ). The shoulder portions  250  and  260  allow the needle engagement member  244  to push against the needle  208  to move the needle  208  through the needle track  214 , while the ramped surface profiles allow for the disengagement of the needle engagement member  244 . 
     The needle engagement member  244  is configured to engage the needle  208  within the first notch  246  or the second notch  256  as needed to advance the needle  208  around the needle track  234 , as discussed further below. In the embodiment of  FIGS.  6 A- 6 K , the needle engagement member  244  is a pin coupled to the driver link  228  by a biasing element, such as a leaf spring  252 . The leaf spring  252  biases the needle engagement member  244  into contact with the needle  208 . 
     Referring now to  FIG.  6 C , as the pulley disc  224  rotates counterclockwise, e.g., based on input from a manipulator (not shown) at the needle driver transmission mechanism, the pin  236  of the driver link  228  advances along the guide track  234 , drawing the distal end portion  230  of the driver link  228  along the needle track  214 . The needle engagement member  244  ( FIG.  6 B ) engages the needle  208  by bearing against the shoulder portion  250  of the notch  246  of the needle  208  and advances a tip  209  of the needle  208  through the needle track  214  and into the suturing area  222  defined by the C-shaped portion  206 . As the pulley disc  224  rotates counterclockwise, resulting movement of the needle driver link  228  causes passive rotation of the guide member  242  about the rotational axis A B , and the needle driver link  228  moves longitudinally within the guide member  242  as its proximal end portion follows the non-circular guide track  234 . 
     As shown in  FIG.  6 D , when the pin  236  of the driver link  228  advances to a fourth-quadrant (bottom, right) position in the guide track  234 , the distal end portion  230  of the driver link  228  is at an upper position in the needle track  214 , and the tip  209  ( FIG.  6 C ) of the needle  208  re-enters the C-shaped portion  206  at an opposite end of the needle track  214 . At this point, rotation of the pulley disc  224  is reversed and the pulley disc  224  rotates clockwise, and, as shown in  FIGS.  6 E and  6 F , the needle engagement member  244  rides up the ramped upper surface profile  248  of the notch  246  against force of the leaf spring  252 , thereby disengaging from the needle  208 . With continued rotation of the pulley disc  224  in the clockwise direction, the distal end portion  230  of the driver link  228  traverses the needle track  214  to the opposite end without moving the needle  208 . As shown in  FIG.  6 G , the needle engagement member  244  rides over a needle ramp  254  against force of the leaf spring  252  and enters the second notch  256  to again engage the needle  208 , as shown in  FIG.  6 H . 
     Referring to  FIG.  6 I , rotation of the pulley disc  224  is again reversed and the pulley disc  224  rotates counterclockwise, moving the distal end portion  230  of the driver link  228  towards the upper (in the view of  FIG.  6 I ) end of the needle track  214 . As the pulley disc  224  acts on the proximal end portion  232  of the driver link  228 , the driver link  228  and guide member  242  pivot in the housing  229  ( FIG.  4   ). The guide member  242  passively rotates, enabling the driver link  228  to pivot about the rotational axis A B  of the guide member  242 . The needle engagement member  244  rests in the second notch  256  and, bearing against the shoulder portion  260  of the second notch  256 , draws the needle  208  from the position shown in  FIG.  6 I , through the position shown in  FIG.  6 J , and finally to the position shown in  FIG.  6 K . A subsequent reversal of the rotation of the pulley disc  224 , disengagement of the needle engagement member  244  from the second notch  256  of the needle  208 , and entry of the needle engagement member  244  in the first notch  246  returns the needle driver device  200  to the initial configuration shown in  FIG.  6 A , completing a full cycle of the needle driver device  200 . 
     While not illustrated in connection with  FIGS.  6 A- 6 K , the needle  208  can be provided with suture material and operation of the needle driver device  200  as discussed in connection with  FIGS.  6 A- 6 K  can secure suture material in tissue within the suturing area  222  of the C-shaped portion  206  of the needle driver device  200 . Moreover, rotation of the pulley disc  224  in the reciprocating rotational directions discussed above can be effectuated automatically, such as by a computer-controlled manipulator to which the transmission mechanism (e.g.,  110 ) of the needle driver device  200  is operably coupled, or can be performed manually, such as in exemplary embodiments in which the needle driver device is configured for use manually (e.g., such as for hand-held operation). 
     In the embodiment of  FIGS.  6 A- 6 K , the needle  208  advances approximately 180 degrees for each continuous stepwise movement of the driver link  228  from one end of the needle track  214  to the opposite end of the needle track  214  or vice versa. That is, a full rotation (360 degrees) of the needle  208  requires two 180-degree rotations in opposite directions of the pulley disc  224  and the associated movements of the driver link  228 . The 180-degree increment rotations are non-limiting, and those of ordinary skill in the art would appreciate that in other exemplary embodiments, the needle  208  can be advanced by other amounts per continuous rotational movement of the drive components by increasing the number of equally-spaced notches in the needle  208  and driving the drive components a reduced distance. 
     Referring now to  FIGS.  7 - 10   , another exemplary embodiment of a needle driver device  700  is shown. In this embodiment, each of a proximal end portion, a central portion, and a distal end portion of a needle driver link are constrained in one or more degrees of freedom to ensure the distal end portion of the needle driver link follows a needle track. Unlike the exemplary embodiment of  FIGS.  2 - 5   , in which the distal end portion of the needle driver link is free and mechanically unconstrained, the distal end portion of the needle driver link in the exemplary embodiment of  FIGS.  7 - 10    is directly constrained to follow the needle track, as discussed in more detail in connection with  FIGS.  9  and  10   . 
     Referring now to  FIGS.  7  and  8   , a needle driver device  700  is shown. Many aspects of construction and features of needle driver device  700  are similar to those of needle driver device  200  and are not discussed further. In contrast to the previously described embodiment of the needle driver device  200 , the needle driver device  700  includes a driver link  728  having a proximal end portion  732  pinned directly to a rotary drive mechanism, such as a pulley disc  724  of a pulley assembly similar to that described above with reference to  FIGS.  3 - 6   , rather than being coupled by a pin that rides in a slot of the pulley disc  224 , allowing some relative radial motion of the proximal end portion of the driver link relative to the pulley disc as in the needle driver device  200 . Thus, the proximal end portion  732  of the driver link  728  moves with the pulley disc  724  as it rotates so as to follow a circular path at a constant radial distance from a rotational axis A P  of the pulley disc  724 . In other words, the motion of the proximal end portion of the driver link  728  is rotational about the rotational axis A P . 
     The needle driver device  700  further includes a sliding guide member  742  that is free to translate within a guide member track  762 . The sliding guide member  742  includes a pin  764  (shown in hidden lines) received in a longitudinal slot  765  provided in the driver link  728 . With this configuration, the driver link  728  is rotatable about the pin  764 , which defines a pivot location that is simultaneously movable in translation along both a longitudinal axis of the driver link  728  and a longitudinal axis of the needle driver device  700  overall. 
     Referring now to  FIGS.  9  and  10   , the distal end portion  730  of the driver link  728  includes a boss  766  that is received within a driver link guide track  768  that is adjacent to, and connected with, a needle track  714 . As can be seen in the cross-sectional view of  FIG.  10   , the driver link guide track  768  and needle track  714  together have a generally “T” shaped cross section, with the horizontal portion of the “T” being the driver link guide track  768  and the vertical portion of the “T” being the needle track  714 . The driver link guide track  768  follows a circular arc having a same radius of curvature as the needle track  714 . Thus, the motion of both the distal end portion  730  and proximal end portion  732  ( FIGS.  7  and  8   ) of the driver link  728  are constrained along circular arcs, with the pinned connection at the sliding guide member  742  ( FIGS.  7  and  8   ) physically constraining the driver link  728  to rotate about a movable, generally central location on the driver link  728 , and the boss  766  physically constraining the distal end portion  730  to move along the driver link guide track  768 . The sliding guide member  742  facilitates the desired motion of each of the proximal and distal end portions of the driver link  728 , as will be discussed further below in connection with  FIGS.  11 A- 11 C . 
     Referring to  FIGS.  11 A- 11 C , a partial use cycle of the needle driver device  700  is shown, which has similar aspects as the operation described in connection with  FIGS.  6 A- 6 K  in that a full rotation of the needle  708  is accomplished by two 180-degree rotations of the pulley disc  724 , each of the two rotations being in opposite directions. As described above in connection with  FIGS.  6 A- 6 K , however, those of ordinary skill in the art would appreciate that the 180-degree increments of rotation is non-limiting and other increments can be used by adjusting the drive components and cycling of the rotary drive mechanism accordingly. 
     In  FIG.  11 A , the needle driver device  700  is shown in an initial position similar to the position of needle driver device  200  shown in  FIG.  6 A . The driver link  728  comprises a needle engagement member  744  (shown in the cross-sectional view of  FIG.  10   ), which is similar to needle engagement member  244  associated with the embodiment of  FIGS.  2 - 5    and extends through the distal end portion  730  and the boss  766  of the driver link  728  and at least partly into the needle track  714 . As the pulley disc  724  rotates counterclockwise, force applied to the pin  764  by the driver link  728  draws the sliding guide member  742  in the proximal direction. Movement of the sliding guide member  742  in the proximal direction enables the distal end portion  730  of the needle driver link to follow a path of the driver link guide track  768 , which is along a path parallel to the needle track  714 , as best shown in  FIG.  10   . If the pin  764  were fixed in place relative to the pulley disc  724 , the distal end portion  730  of the driver link  728  would be over-constrained in terms of its degree of freedom movement by the pulley disc  724 , the pin  764 , and the boss  766  ( FIGS.  9  and  10   ). Freedom of the pin  764  to move in the distal and proximal directions, in combination with the longitudinal slot  765  of the driver link  728 , enables both the proximal end portion  732  and distal end portion  730  to follow circular arcs throughout their travel. 
     Referring now to  FIG.  11 B , as the pulley disc  724  rotates counterclockwise and the distal end portion  730  of the driver link  728  moves clockwise, it drives the needle  708  clockwise along the needle track  714 , until it exits the needle track  714  at a distal end of the C-shaped portion  706  and advances into the suturing space defined by the C-shaped portion  706 . As shown in  FIGS.  10 ,  11 A, and  11 B , the driver link  728  includes a needle engagement member  744  that functions similar to the needle engagement member  244  of the embodiment of  FIGS.  2 - 5   . 
     The pin  764  serves to constrain movement of the needle driver link  728 . While movement of the needle driver link  728  is nearly fully constrained throughout its movement solely by the constraints on the distal end portion  730  and proximal end portion  732 , when the needle driver link  728  is in the position shown in  FIG.  11 B , movement of the needle driver link  728  can become indeterminate in the absence of the pin  764 . As shown in  FIG.  11 B , the distal end portion  730  of the needle driver link  728  is at a midpoint of the driver link guide track  768  and the proximal end portion  732  of the needle driver link  728  is at a corresponding position halfway through the oscillating rotational movement of the pulley disc  724 . Thus, the distal end portion  730  and proximal end portion  732  are aligned along a longitudinal axis of the needle driver device. With continued rotation of the pulley disc  724 , for example, in the counterclockwise direction, the distal end portion  730  could either proceed clockwise through the driver link guide track  768 , counter to the rotation of the pulley disc  724 , or the distal end portion  730  could move in tandem with the proximal end portion  732 , such that both the distal end portion  730  and proximal end portion  732  proceed in a counterclockwise rotational direction. In the latter scenario, the needle driver link  728  would move purely in translation. The distal end portion  730  and the proximal end portion  732  would move in tandem until again reaching the position shown in  FIG.  11 B , at which point movement of the needle driver link  728  would again be indeterminate and the distal end portion  730  and proximal end portion  732  could either move in opposite rotational directions or continue moving in tandem. 
     The pin  764  forces rotation of the driver link  728  as the pulley disc  724  rotates to advance the driver link  728  from the position shown in  FIG.  11 B , thereby ensuring the distal end portion  730  and proximal end portion  732  rotate counter to one another. For example, referring now to  FIG.  11 C , as the pulley disc  724  is rotated counterclockwise further from the position of  FIG.  11 B , force of the driver link  728  in the angled position shown against the pin  764  pushes the sliding guide member  742  in the distal direction. The needle engagement member  744  engages with and drives the needle  708  further through the needle track  714  until the distal end portion of the needle driver link  728  reaches the position along the driver link guide track  768  opposite its initial position. In this position, the tip  709  of the needle  708  re-enters the needle track  714  at the position of the needle track  714  opposite to where the distal end portion of the needle driver link  728  is located. Further operation of the needle driver device  700  generally follows the sequence shown in connection with  FIGS.  6 A- 6 K  in terms of rotation of the pulley disc  724  and engagement/disengagement of the needle engagement member  744  with the needle  208 . The guide member  742  moves proximally from the distal position shown in  FIG.  11 C  as the needle driver link  728  moves from the position in shown in  FIG.  11 C  back to the position illustrated in  FIG.  11 A . 
     As the needle driver link  728  moves in the manner discussed above, at all points in the range of motion of the needle driver link except for the position shown in  FIG.  11 B , the movement of the needle driver link  728  is fully constrained by the pulley disc  724  and the boss  766  in the needle driver link guide track  768 . Further, movement of the needle driver link  728  through the desired range of motion includes simultaneous translation and rotation of the needle driver link  728 . The sliding arrangement of the guide member  742  inhibits binding between the driver link  728  and the pinned connection that could otherwise occur if the pinned connection was fixed in place at either the housing or along the driver link  728 . That is, because the needle driver link  728  is constrained to follow a circular arc at both the proximal and distal ends, a pinned connection in the center of the needle driver link  728  fixed relative to either the needle driver link  728  or the housing would over-constrain the needle driver link  728  and the needle driver link  728  would be unable to move in the desired motion due to binding of the driver link  728  against the pinned connection. The sliding guide member  742  enables translation of the needle driver link  728  while also forcing rotation of the needle driver link  728  at the point in the range of motion at which the movement of the driver link  728  is indeterminate. 
     While embodiments of the disclosure discuss rotation of drive components (such as the pulleys  224 ,  724 ), portions of the needle driver link, and the needle in clockwise and counterclockwise directions, the particular directions of rotation could be reversed and a person having ordinary skill in the art would understand how such alterations could be accomplished. 
     Embodiments of the present disclosure provide needle driver devices occupy a relatively small space for a given needle size. Further, embodiments of the disclosure feature fewer parts and potentially greater reliability as compared to conventional designs. 
     Embodiments described herein may be used, for example, with remotely operated, computer-assisted systems (such, for example, teleoperated surgical systems) such as those described in, for example, U.S. Pat. No. 9,358,074 (filed May 31, 2013) to Schena et al., entitled “Multi-Port Surgical Robotic System Architecture”, U.S. Pat. No. 9,295,524 (filed May 31, 2013) to Schena et al., entitled “Redundant Axis and Degree of Freedom for Hardware-Constrained Remote Center Robotic Manipulator”, and U.S. Pat. No. 8,852,208 (filed Aug. 12, 2010) to Gomez et al., entitled “Surgical System Instrument Mounting”, each of which is hereby incorporated by reference in its entirety. Further, embodiments described herein may be used, for example, with a da Vinci® Surgical System, such as the da Vinci Si® Surgical System (model number IS3000) or the da Vinci Xi® Surgical System, both with or without Single-Site® single orifice surgery technology, all commercialized by Intuitive Surgical, Inc., of Sunnyvale, Calif. Although various embodiments described herein are discussed in connection with a manipulating system of a teleoperated surgical system, the present disclosure is not limited to use with a teleoperated surgical system. Various embodiments described herein can optionally be used in conjunction with hand-held, manual instruments. 
     As discussed above, in accordance with various embodiments, surgical instruments of the present disclosure are configured for use in teleoperated, computer-assisted surgical systems employing robotic technology (sometimes referred to as robotic surgical systems). Referring now to  FIG.  12   , an embodiment of a manipulator system  1200  of a computer-assisted surgical system, to which surgical instruments are configured to be mounted for use, is shown. Such a surgical system may further include a user control system, such as a surgeon console (not shown) for receiving input from a user to control instruments coupled to the manipulator system  1200 , as well as an auxiliary system, such as auxiliary systems associated with the DA VINCI SI® and DA VINCI XI®, Da Vinci SP, and Ion systems noted above. 
     As shown in the embodiment of  FIG.  12   , a manipulator system  1200  includes a base  1220 , a main column  1240 , and a main boom  1260  connected to main column  1240 . Manipulator system  1200  also includes a plurality of manipulator arms  1210 ,  1211 ,  1212 ,  1213 , which are each connected to main boom  1260 . Manipulator arms  1210 ,  1211 ,  1212 ,  1213  each include an instrument mount portion  1222  to which an instrument  1230  may be mounted, which is illustrated as being attached to manipulator arm  1210 . 
     Instrument mount portion  1222  comprises a drive assembly  1223  and a cannula mount  1224 , with a transmission mechanism  1234  (which may generally correspond to the transmission mechanism  110  discussed in connection with  FIG.  1   ) of the instrument  1230  connecting with the drive assembly  1223 , according to an embodiment. Cannula mount  1224  is configured to hold a cannula  1236  through which a shaft  1232  of instrument  1230  may extend to a surgery site during a surgical procedure. Drive assembly  1223  contains a variety of drive and other mechanisms that are controlled to respond to input commands at the surgeon console and transmit forces to the transmission mechanism  1234  to actuate the instrument  1230 . Although the embodiment of  FIG.  12    shows an instrument  1230  attached to only manipulator arm  1210  for ease of viewing, an instrument may be attached to any and each of manipulator arms  1210 ,  1211 ,  1212 ,  1213 . 
     Other configurations of surgical systems, such as surgical systems configured for single-port surgery, are also contemplated. For example, with reference now to  FIG.  13   , a portion of an embodiment of a manipulator arm  2140  of a manipulator system with two surgical instruments  2300 ,  2310  in an installed position is shown. The surgical instruments  2300 ,  2310  can generally correspond to instruments discussed above, such as needle driver device  100  disclosed in connection with  FIG.  1 A . For example, the embodiments described herein may be used with a DA VINCI SP® Surgical System, commercialized by Intuitive Surgical, Inc. of Sunnyvale, Calif. The schematic illustration of  FIG.  13    depicts only two surgical instruments for simplicity, but more than two surgical instruments may be mounted in an installed position at a manipulator system as those having ordinary skill in the art are familiar with. Each surgical instrument  2300 ,  2310  includes a shaft  2320 ,  2330  that at a distal end has a moveable end effector or an endoscope, camera, or other sensing device, and may or may not include a wrist mechanism (not shown) to control the movement of the distal end. 
     In the embodiment of  FIG.  13   , the distal end portions of the surgical instruments  2300 ,  2310  are received through a single port structure  2380  to be introduced into the patient. As shown, the port structure includes a cannula and an instrument entry guide inserted into the cannula. Individual instruments are inserted into the entry guide to reach a surgical site. 
     Other configurations of manipulator systems that can be used in conjunction with the present disclosure can use several individual manipulator arms. In addition, individual manipulator arms may include a single instrument or a plurality of instruments. Further, as discussed above, an instrument may be a surgical instrument with an end effector or may be a camera instrument or other sensing instrument utilized during a surgical procedure to provide information, (e.g., visualization, electrophysiological activity, pressure, fluid flow, and/or other sensed data) of a remote surgical site. 
     Transmission mechanisms  2385 ,  2390  (which may generally correspond to force transmission mechanism  110  disclosed in connection with  FIG.  1   ) are disposed at a proximal end of each shaft  2320 ,  2330  and connect through a sterile adaptor  2400 ,  2410  with drive assemblies  2420 ,  2430 . Drive assemblies  2420 ,  2430  contain a variety of internal mechanisms (not shown) that are controlled by a controller (e.g., at a control cart of a surgical system) to respond to input commands at a surgeon side console of a surgical system to transmit forces to the force transmission mechanisms  2385 ,  2390  to actuate surgical instruments  2300 ,  2310 . 
     The embodiments described herein are not limited to the embodiments of  FIG.  12    and  FIG.  13   , and various other teleoperated, computer-assisted surgical system configurations may be used with the embodiments described herein. The diameter or diameters of an instrument shaft and end effector are generally selected according to the size of the cannula with which the instrument will be used and depending on the surgical procedures being performed. 
     This description and the accompanying drawings that illustrate various embodiments should not be taken as limiting. Various mechanical, compositional, structural, electrical, and operational changes may be made without departing from the scope of this description and the invention as claimed, including equivalents. In some instances, well-known structures and techniques have not been shown or described in detail so as not to obscure the disclosure. Like numbers in two or more figures represent the same or similar elements. Furthermore, elements and their associated features that are described in detail with reference to one embodiment may, whenever practical, be included in other embodiments in which they are not specifically shown or described. For example, if an element is described in detail with reference to one embodiment and is not described with reference to another embodiment, the element may nevertheless be claimed as included in the other embodiment. 
     For the purposes of this specification and appended claims, unless otherwise indicated, all numbers expressing quantities, percentages, or proportions, and other numerical values used in the specification and claims, are to be understood as being modified in all instances by the term “about,” to the extent they are not already so modified. Accordingly, unless indicated to the contrary, the numerical parameters set forth in the following specification and attached claims are approximations that may vary depending upon the desired properties sought to be obtained. At the very least, and not as an attempt to limit the application of the doctrine of equivalents to the scope of the claims, each numerical parameter should at least be construed in light of the number of reported significant digits and by applying ordinary rounding techniques. 
     It is noted that, as used in this specification and the appended claims, the singular forms “a,” “an,” and “the,” and any singular use of any word, include plural referents unless expressly and unequivocally limited to one referent. As used herein, the term “include” and its grammatical variants are intended to be non-limiting, such that recitation of items in a list is not to the exclusion of other like items that can be substituted or added to the listed items. 
     Further, this description&#39;s terminology is not intended to limit the invention. For example, spatially relative terms—such as “beneath”, “below”, “lower”, “above”, “upper”, “proximal”, “distal”, and the like—may be used to describe one element&#39;s or feature&#39;s relationship to another element or feature as illustrated in the figures. These spatially relative terms are intended to encompass different positions (i.e., locations) and orientations (i.e., rotational placements) of a device in use or operation in addition to the position and orientation shown in the figures. For example, if a device in the figures is turned over, elements described as “below” or “beneath” other elements or features would then be “above” or “over” the other elements or features. Thus, the exemplary term “below” can encompass both positions and orientations of above and below. A device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. 
     Further modifications and alternative embodiments will be apparent to those of ordinary skill in the art in view of the disclosure herein. For example, the devices and methods may include additional components or steps that were omitted from the diagrams and description for clarity of operation. Accordingly, this description is to be construed as illustrative only and is for the purpose of teaching those skilled in the art the general manner of carrying out the present teachings. It is to be understood that the various embodiments shown and described herein are to be taken as exemplary. Elements and materials, and arrangements of those elements and materials, may be substituted for those illustrated and described herein, parts and processes may be reversed, and certain features of the present teachings may be utilized independently, all as would be apparent to one skilled in the art after having the benefit of the description herein. Changes may be made in the elements described herein without departing from the spirit and scope of the present teachings and following claims. 
     It is to be understood that the particular examples and embodiments set forth herein are non-limiting, and modifications to structure, dimensions, materials, and methodologies may be made without departing from the scope of the present teachings. 
     Other embodiments in accordance with the present disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, with the following claims being entitled to their fullest breadth, including equivalents, under the applicable law.