Patent Description:
<CIT> relates to grip force normalization for surgical instruments.

<CIT> relates to a clamping device with calibrated parameters and a calibration process. <CIT> relates to an active drive type medical apparatus.

Minimally invasive surgical (MIS) instruments are often preferred over traditional open surgical devices due to the reduced post-operative recovery time and minimal scarring. Laparoscopic surgery is one type of MIS procedure in which one or more small incisions are formed in the abdomen and a trocar is inserted through the incision to form a pathway that provides access to the abdominal cavity. The trocar is used to introduce various instruments and tools into the abdominal cavity, as well as to provide insufflation to elevate the abdominal wall above the organs. The instruments and tools can be used to engage and/or treat tissue in a number of ways to achieve a diagnostic or therapeutic effect. Endoscopic surgery is another type of MIS procedure in which elongate flexible shafts are introduced into the body through a natural orifice.

Although traditional minimally invasive surgical instruments and techniques have proven highly effective, newer systems may provide even further advantages. For example, traditional minimally invasive surgical instruments often deny the surgeon the flexibility of tool placement found in open surgery. Difficulty is experienced in approaching the surgical site with the instruments through the small incisions. Additionally, the added length of typical endoscopic instruments often reduces the surgeon's ability to feel forces exerted by tissues and organs on the end effector. Furthermore, coordination of the movement of the end effector of the instrument as viewed in the image on the television monitor with actual end effector movement is particularly difficult, since the movement as perceived in the image normally does not correspond intuitively with the actual end effector movement. Accordingly, lack of intuitive response to surgical instrument movement input is often experienced. Such a lack of intuitiveness, dexterity, and sensitivity of endoscopic tools has been found to be an impediment in the increased the use of minimally invasive surgery.

Over the years a variety of minimally invasive robotic systems have been developed to increase surgical dexterity as well as to permit a surgeon to operate on a patient in an intuitive manner. Telesurgery is a general term for surgical operations using systems where the surgeon uses some form of remote control, e.g., a servomechanism, or the like, to manipulate surgical instrument movements, rather than directly holding and moving the tools by hand. In such a telesurgery system, the surgeon is typically provided with an image of the surgical site on a visual display at a location remote from the patient. The surgeon can typically perform the surgical procedure at the location remote from the patient whilst viewing the end effector movement on the visual display during the surgical procedure. While viewing typically a three-dimensional image of the surgical site on the visual display, the surgeon performs the surgical procedures on the patient by manipulating master control devices at the remote location, which master control devices control motion of the remotely controlled instruments.

While significant advances have been made in the field of robotic surgery, there remains a need for improved methods, systems, and devices for use in robotic surgery.

In general, systems for resisting torque in articulating surgical tools are provided.

A surgical system is described herein that includes a surgical tool including an elongate shaft having an end effector at a distal end thereof. The surgical tool also includes a rod configured to move to selectively angularly orient the end effector at an angle relative to the elongate shaft. The movement of the rod is configured to be driven by a motor providing a torque force to the surgical tool. The surgical system also includes a controller configured to determine an amount of corrective force based on the angle and the torque force, and the controller is configured to apply the determined corrective force to the rod.

The surgical tool includes a cutting element configured to translate along the end effector to cut tissue engaged by the end effector, and the controller is configured to cause the determined corrective force to be applied to the rod during the translation of the cutting element. For another example, the surgical system can include a memory storing a lookup table therein, the lookup table can correlate each of a plurality of articulation angles and a plurality of motor torque forces to corrective forces to apply to the rod, and the controller can be configured to determine the amount of corrective force via the lookup table. For yet another example, the controller can be configured to determine the angle at which the end effector is angularly oriented relative to the elongate shaft. For another example, the end effector can be configured to pivot at a joint relative to the elongate shaft to effect the angular orientation of the end effector relative to the elongate shaft, and the rod can extend through the joint. For still another example, the controller can be included in a robotic surgical system configured to releasably couple to the surgical tool.

For another example, the surgical system can include a tool driver of a robotic surgical system that includes the motor, and the surgical tool can be configured to releasably operatively couple to the tool driver. The robotic surgical system can include the controller, and the controller cam be in operative communication with the tool driver.

A further surgical system is described herein that includes a surgical tool including an elongate shaft, an end effector coupled to a distal end of the elongate shaft, a cutting element configured to translate along the end effector to cut tissue engaged by the end effector, and a rod configured to move to articulate the end effector at an angle relative to the elongate shaft in response to a first force provided to the surgical tool by a robotic surgical system configured to releasably couple to the surgical tool. The surgical system also includes a controller configured to cause adjustment of the first force provided to the surgical tool by the robotic surgical system during the translation of the cutting element and thereby counteract a second force caused by the translation of the cutting element along the end effector.

The surgical system can have any number of variations. For example, the cutting element can be configured to translate along the end effector in response to a third force provided to the surgical tool by the robotic surgical system, and the controller can be configured to determine an amount of the adjustment of the first force based on the third force and on the angle at which the end effector is articulated relative to the elongate shaft. The surgical system can include a memory storing a lookup table therein that correlates amounts of the second force to each of a plurality of angles at which the end effector can be articulated relative to the elongate shaft and each of a plurality of third forces that can be provided to the surgical tool by the robotic surgical system to cause the translation of the cutting element, and the controller determining the amount of the adjustment of the first force can include looking up in the lookup table the angle at which the end effector is articulated relative to the elongate shaft and looking up in the lookup table the third force being provided to the surgical tool by the robotic surgical system.

For another example, the surgical system can include a memory storing a lookup table therein, and the controller can be configured to access the lookup table and thereby determine an amount of the adjustment of the first force. For yet another example, the robotic surgical system can include a motor configured to provide the first force to the surgical tool. For still another example, the controller can be included in the robotic surgical system.

For another example, the translation of the cutting element can be caused by applying a second amount of force to the surgical tool, and the amount of force being applied to the surgical tool can be changed based on the angle at which the end effector is articulated relative to the elongate shaft and based on the second amount of force being applied to the surgical tool. The surgical tool can be releasably and replaceably coupled to a robotic surgical system, and the robotic surgical system can apply the amount of force to the surgical tool and can apply the second amount of force to the surgical tool.

For yet another example, the surgical tool can be releasably and replaceably coupled to a robotic surgical system, and the robotic surgical system can apply the amount of force to the surgical tool and can change the amount of force being applied to the surgical tool.

Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.

Various exemplary systems, devices, and methods are provided for resisting torque in articulating surgical tools. In general, a surgical tool can include an elongate shaft having at a distal end thereof an end effector configured to engage tissue. The end effector can be configured to articulate relative to the elongate shaft, e.g., angularly orient relative to a longitudinal axis of the elongate shaft, which may help the end effector access and securely engage the tissue. The surgical tool can include a cutting element configured to translate longitudinally along the end effector to cut the engaged tissue. When the end effector is articulated, e.g., is angled at a non-zero angle relative to the shaft's longitudinal axis, the longitudinal translation of the cutting element along the end effector exerts a torque force on the end effector that urges the end effector away from its current angled orientation, e.g., urges the end effector toward a substantially zero angle position in which it is substantially aligned with the shaft's longitudinal axis. However, articulating movement of the end effector from its current angled orientation during cutting of the tissue may cause the end effector to undesirably shift in position relative to the engaged tissue such that the tissue is not cut at a proper location, and/or may cause the end effector to undesirably press against matter (e.g., an adjacent body structure, another surgical tool, etc.) in the patient's body that may cause harm to the matter and/or the end effector. The surgical tool can be configured to have a corrective tension or force applied thereto that counteracts the torque force, thereby preventing the end effector from moving from its articulated angle during the translation of the cutting element. The corrective force can be applied to the surgical tool without use of a mechanical locking mechanism that locks the end effector in its articulated position during cutting element translation, which may simplify manufacture of the surgical tool and/or may allow more space for other and/or larger tool components since a locking mechanism need not be present.

The surgical tool can be configured to releasably couple to a robotic surgical system (also referred to herein as a "surgical robot") configured to control a variety of movements and actions associated with the surgical tool. The robotic surgical system can be configured to provide the corrective force to the surgical tool. The robotic surgical system can also be configured to determine an amount of the corrective force to apply to the surgical tool in real time with the cutting element's translation, which may help ensure that the force exerted by the cutting element's movement is counteracted without over-correction or under-correction. The amount of the corrective force can be determined based on the end effector's current angle of articulation and on a force being applied to the surgical tool (e.g., applied by the robotic surgical system) to cause the cutting element's longitudinal translation along the end effector. The current angle of articulation and the force being applied to cause the cutting element translation can be correlated to predetermined corrective forces to determine the corrective force to be applied to the surgical tool.

<FIG> illustrates one embodiment of a surgical tool <NUM> that includes an elongate shaft <NUM>, an end effector <NUM>, a wrist <NUM> that couples the end effector <NUM> to the shaft <NUM> at a distal end of the shaft <NUM>, and a tool housing <NUM> coupled to a proximal end of the shaft <NUM>. The end effector <NUM> is configured to move relative to the shaft <NUM> at the wrist <NUM>, e.g., by pivoting at the wrist <NUM>, to position the end effector <NUM> at a desired location relative to a surgical site during use of the tool <NUM>. The housing <NUM> includes various components (e.g., gears and/or actuators) configured to control the operation various features associated with the end effector <NUM> (e.g., any one or more of clamping, firing, rotation, articulation, energy delivery, etc.). In at least some embodiments, the shaft <NUM>, and hence the end effector <NUM> coupled thereto, is configured to rotate about a longitudinal axis A1 of the shaft <NUM>. In such embodiments, the various components of the housing <NUM> are configured to control the rotational movement of the shaft <NUM>. In at least some embodiments, as in this illustrated embodiment, the surgical tool <NUM> is configured to releasably couple to a robotic surgical system, and the tool housing <NUM> can include coupling features configured to allow the releasable coupling of the tool <NUM> to the robotic surgical system. Each of the shaft <NUM>, end effector <NUM>, wrist <NUM>, and housing <NUM> are discussed further below.

The surgical tool <NUM> can have any of a variety of configurations. In general, the surgical tool can be configured to perform at least one surgical function and can include any of, for example, forceps, a grasper, a needle driver, scissors, an electrocautery tool that applies energy, a stapler, a clip applier, a suction tool, an irrigation tool, an imaging device (e.g., an endoscope or ultrasonic probe), etc. The surgical tool <NUM> in at least some embodiments is configured to apply energy (such as radiofrequency (RF) energy) to tissue, while in other embodiments the tool <NUM> is not configured to apply energy to tissue.

The shaft <NUM> can have any of a variety of configurations. In general, the shaft <NUM> is an elongate member extending distally from the housing <NUM> and having at least one inner lumen extending therethrough. The shaft <NUM> is fixed to the housing <NUM>, but in other embodiment the shaft <NUM> can be releasably coupled to the housing <NUM> such that the shaft <NUM> can be interchangeable with other shafts. This may allow a single housing <NUM> to be adaptable to various shafts having different end effectors.

The end effector <NUM> can have a variety of sizes, shapes, and configurations. The end effector <NUM> includes a tissue grasper having a pair of opposed jaws <NUM>, <NUM> configured to move between open and closed positions with one or both of the jaws <NUM>, <NUM> configured to pivot at the wrist <NUM> to move the end effector <NUM> between the open and closed positions. The end effector <NUM> in other embodiments can have other configurations, e.g., scissors, a babcock, a retractor, etc..

The wrist <NUM> can have any of a variety of configurations. Exemplary embodiments of a wrist of a surgical tool and of effecting articulation at the wrist are described in <CIT>, International Pat. No. <CIT>, <CIT> entitled "Methods, Systems, And Devices For Initializing A Surgical Tool", and US Pat. No. <CIT>, entitled "Methods, Systems, And Devices For Causing End Effector Motion With A Robotic Surgical System". In general, the wrist <NUM> can include a joint configured to allow movement of the end effector <NUM> relative to the shaft <NUM>, such as a pivot joint at which the jaws <NUM>, <NUM> are pivotally attached. In some embodiments, the pivoting motion can include pitch movement about a first axis of the wrist <NUM> (e.g., a X axis), yaw movement about a second axis of the wrist <NUM> (e.g., a Y axis), and combinations thereof to allow for <NUM>° rotational movement of the end effector <NUM> about the wrist <NUM>. In other embodiments, the pivoting motion can be limited to movement in a single plane, e.g., only pitch movement about the first axis of the wrist <NUM> or only yaw movement about the second axis of the wrist <NUM>, such that end effector <NUM> rotates in a single plane.

<FIG> illustrates degrees of freedom of a system represented by three translational or position variables, e.g., surge, heave, sway, and by three rotational or orientation variables, e.g., Euler angles or roll, pitch, yaw, that describe the position and orientation of a component of a surgical system with respect to a given reference Cartesian frame. As used herein, and as illustrated in <FIG>, the term "surge" refers to forward and backward movement, the term "heave" refers to movement up and down, and the term "sway" refers to movement left and right. With regard to the rotational terms, "roll" refers to tilting side to side, "pitch" refers to tilting forward and backward, and "yaw" refers to turning left and right.

The movement of the end effector <NUM> in this illustrated embodiment includes articulating movement of the end effector <NUM> between an unarticulated position, in which the end effector <NUM> is substantially longitudinally aligned with the shaft <NUM> (e.g., a longitudinal axis A2 of the end effector <NUM> is substantially aligned with the longitudinal axis A1 of the shaft <NUM> such that the end effector <NUM> is at a substantially zero angle relative to the shaft <NUM>), and an articulated position, in which the end effector <NUM> is angularly orientated relative to the shaft <NUM> (e.g., the longitudinal axis A2 of the end effector <NUM> is angled relative to the longitudinal axis A1 of the shaft <NUM> such that the end effector <NUM> is at a non-zero angle relative to the shaft <NUM>). A person skilled in the art will appreciate that the end effector <NUM> may not be precisely aligned with the shaft <NUM> (e.g., may not be at a precise zero angle relative thereto) but nevertheless be considered to be aligned with the shaft <NUM> (e.g., be at a substantially zero angle) due to any number of factors, such as manufacturing tolerance and precision of measurement devices. The end effector <NUM> is shown in the unarticulated positon in <FIG>. The movement of the end effector <NUM> in this illustrated embodiment also includes rotational movement of the end effector <NUM> in which the end effector <NUM> rotates about its longitudinal axis A2, either with or without corresponding rotation of the shaft <NUM> about its longitudinal axis A1.

The surgical tool <NUM> can include one or more actuation shafts configured to facilitate movement of the end effector <NUM>. Each of the one or more actuation shafts can extend along the shaft <NUM> (e.g., in an inner lumen thereof) and can be operatively coupled to the housing <NUM> and to the end effector <NUM>. In this way, a tool driver coupled to the housing <NUM> can be configured to provide input to the surgical tool <NUM> via the tool housing <NUM> and thereby actuate the one or more actuation shafts to cause movement of the end effector <NUM>.

<FIG> illustrates one embodiment of a surgical tool, such as the tool <NUM> of <FIG>, that includes one or more actuation shafts <NUM> configured to be actuated to cause movement of an end effector <NUM> (see <FIG>) operatively coupled thereto. <FIG> illustrates a distal end of the actuation shafts <NUM> extending from a wrist <NUM> located just proximal of the end effector <NUM>. The wrist <NUM> can allow for fine movements and angulation of the end effector <NUM> relative to the proximal end of an elongate shaft <NUM> to which the end effector <NUM> is coupled. In this illustrated embodiment, the wrist <NUM> includes three actuation shafts <NUM>, each in the form of a rod, that are spaced around a perimeter of the wrist <NUM>. When actuated (e.g., pushed, pulled, rotated), the actuation shafts <NUM> will cause articulation of the end effector (e.g., movement up, down, left, right, and combinations thereof) relative to the shaft <NUM>. The actuation shafts <NUM> are configured to be operatively coupled to a tool driver, via a tool housing of the surgical tool as discussed herein, to cause selective proximal and distal movement of selected one or more of the actuation shafts <NUM> to cause selected articulation of the end effector <NUM>.

The wrist <NUM> also includes an upper rotary driver <NUM> that when actuated can cause a pair of jaws of the end effector <NUM> to close. The upper rotary driver <NUM> is configured to be operatively coupled to the tool driver, via the tool housing, to cause rotation of the upper rotary driver <NUM> and hence closure of the end effector <NUM>. The wrist <NUM> also includes a lower rotary driver <NUM> that when actuated can cause movement of a sled relative the end effector <NUM>, e.g., can cause the sled to longitudinally translate along the end effector <NUM>. The sled translating along the end effector <NUM> can cause a cutting element to translate along the end effector <NUM> to cut tissue engaged by the end effector <NUM>, as discussed further below. The lower rotary driver <NUM> is configured to be operatively coupled to the tool driver, via the tool housing, to cause rotation of the lower rotary driver <NUM> and hence translation of the sled along the end effector <NUM>. The wrist <NUM> can also include at least one linear pull cable <NUM> that when actuated moves linearly in a proximal direction to cause rapid close of the end effector <NUM>, e.g., rapid closure of the jaws. The at least one linear pull cable <NUM> is configured to be operatively coupled to the tool driver, via the tool housing, to cause the proximal movement thereof. Exemplary embodiments of the tool driver and operatively coupling the tool driver to actuation members such as the actuation shafts <NUM>, rotary drivers <NUM>, <NUM>, and linear pull cables <NUM> are further described in US Pat. No. <CIT>, entitled "Methods, Systems, And Devices For Causing End Effector Motion With A Robotic Surgical System".

<FIG> illustrates a portion of the end effector <NUM>, which has a cutting element actuation assembly <NUM> that includes a drive member <NUM>, a cutting element <NUM> in the form of a knife, a sled <NUM>, and the lower rotary driver <NUM>. The drive member <NUM> includes internal threads that are threadably coupled with the lower rotary driver <NUM>, which is in the form of a lead screw in this illustrated embodiment. Such coupling can allow drive member <NUM> to move along the lower rotary driver <NUM> when the lower rotary driver <NUM> is rotated. As discussed above, the lower rotary driver <NUM> can be actuated, e.g., via input from a tool driver coupled to the tool's housing, thereby causing rotation of the lower rotary driver <NUM> and linear movement of the sled <NUM> along the lower rotary driver <NUM>. The cutting element actuation assembly <NUM> is configured to orient the cutting element <NUM> in a cutting position when the drive member <NUM> pushes the sled <NUM> distally along the lower rotary driver <NUM> and to stow the cutting element <NUM> when the drive member <NUM> is moved proximally relative to the sled <NUM>. In operation, the lower rotary driver <NUM> can be rotated to advance the drive member <NUM> distally along the lower rotary driver <NUM>, thereby pushing the sled <NUM> in a distal direction and angularly orienting the cutting element <NUM> in the cutting position. At the end of the distal movement of the assembly <NUM>, the direction of rotation of the lower rotary driver <NUM> is reversed to retract the drive member <NUM> proximally relative to the sled <NUM>, thereby causing the cutting element <NUM> to rotate down into the stowed position, such as via interaction between an interface feature <NUM> and the cutting element <NUM>.

In at least some embodiments, the surgical tool <NUM> of <FIG> can be a stapler, as mentioned above. <FIG> illustrates a distal portion of one embodiment of a surgical stapling tool. The stapler includes an elongate shaft <NUM> and an end effector at a distal end of the shaft <NUM>. A tool housing (not shown) is at a proximal end of the shaft <NUM>, as discussed herein. The end effector in this illustrated embodiment includes opposed lower and upper jaws <NUM>,<NUM>. The lower jaw <NUM> includes a staple channel configured to support a staple cartridge <NUM>, and the upper jaw <NUM> has an anvil surface <NUM> that faces the lower jaw <NUM> and is configured to operate as an anvil to help deploy staples of the staple cartridge <NUM> (the staples are obscured in <FIG>). At least one of the lower and upper jaws <NUM>, <NUM> is moveable relative to the other of the lower and upper jaws <NUM>, <NUM> to clamp tissue and/or other objects disposed therebetween. In at least some embodiments, one of the lower and upper jaws <NUM>, <NUM> can be fixed or otherwise immovable. In some other embodiments, both of the lower and upper jaws <NUM>, <NUM> be movable. Components of a firing system can be configured to pass through at least a portion of the end effector to eject the staples into the clamped tissue. A cutting element <NUM> (see <FIG>), which is a knife blade in this illustrated embodiment, can be associated with the firing system to cut tissue during a stapling procedure.

In this illustrated embodiment, the lower jaw <NUM> serves as a cartridge assembly or carrier, and the upper jaw <NUM> serves as an anvil. The staple cartridge <NUM>, having a plurality of staples therein, is supported in a staple tray <NUM>, which in turn is supported within a cartridge channel <NUM> of the lower jaw <NUM>. The upper jaw <NUM> has a plurality of staple forming pockets (not shown), each of which is positioned above a corresponding staple from the plurality of staples contained within the staple cartridge <NUM>. The upper jaw <NUM> can be connected to the lower jaw <NUM> in a variety of ways. In the illustrated implementation the upper jaw <NUM> has a proximal pivoting end 52p that is pivotally received within a proximal end 60p of the staple channel <NUM>, just distal to its engagement to the shaft <NUM>. When the upper jaw <NUM> is pivoted downwardly, the upper jaw <NUM> moves the anvil surface <NUM> and the staple forming pockets formed thereon move toward the opposing staple cartridge <NUM>.

Various clamping components can be used to effect opening and closing of the jaws <NUM>, <NUM> to selectively clamp tissue therebetween. As illustrated, the pivoting end 52p of the upper jaw <NUM> includes a closure feature 52c distal to its pivotal attachment with the cartridge channel <NUM>. Thus, a closure tube <NUM>, whose distal end includes a horseshoe aperture 62a that engages the closure feature 52c, selectively imparts an opening motion to the upper jaw <NUM> during proximal longitudinal motion and a closing motion to the upper jaw <NUM> during distal longitudinal motion of the closure tube <NUM> in response to input from the tool driver operatively coupled thereto. As mentioned above, the opening and closure of the end effector may be effected by relative motion of the lower jaw <NUM> with respect to the upper jaw <NUM>, relative motion of the upper jaw <NUM> with respect to the lower jaw <NUM>, or by motion of both jaws <NUM>, <NUM> with respect to one another.

The firing components of the illustrated embodiment includes a firing bar <NUM>, shown in <FIG> and <FIG>, which has an E-beam <NUM> on a distal end thereof. The firing bar <NUM> is flexible in at least a distal portion thereof to facilitate bending of the firing bar <NUM> at the joint where the end effector is articulated. The firing bar <NUM> is disposed within the shaft <NUM>, for example in a longitudinal firing bar slot <NUM> of the shaft <NUM>, and guided by a firing input received by the stapler from a tool driver coupled thereto. The firing input can cause distal motion of the E-beam <NUM> through at least a portion of the end effector to thereby cause the firing of staples contained within the staple cartridge <NUM>. As in this illustrated embodiment, guides <NUM> projecting from a distal end of the E-Beam <NUM> can engage a sled <NUM>, which in turn can push staple drivers <NUM> upwardly through staple cavities <NUM> formed in the staple cartridge <NUM>. Upward movement of the staple drivers <NUM> applies an upward force on each of the plurality of staples within the cartridge <NUM> to thereby push the staples upwardly against the anvil surface <NUM> of the upper jaw <NUM> and create formed staples.

In addition to causing the firing of staples, the E-beam <NUM> can be configured to facilitate closure of the jaws <NUM>, <NUM>, spacing of the upper jaw <NUM> from the staple cartridge <NUM>, and/or cutting of tissue captured between the jaws <NUM>, <NUM>. In particular, a pair of top pins <NUM> and a pair of bottom pins <NUM> (one of the bottom pins <NUM> is obscured in <FIG>) can engage one or both of the upper and lower jaws <NUM>, <NUM> to compress the jaws <NUM>, <NUM> toward one another as the firing bar <NUM> advances distally through the end effector. Simultaneously, the cutting element <NUM> can be configured to cut tissue captured between the jaws <NUM>, <NUM>.

The systems, devices, and methods disclosed herein can be implemented using a robotic surgical system. As will be appreciated by a person skilled in the art, electronic communication between various components of a robotic surgical system can be wired or wireless. A person skilled in the art will also appreciate that all electronic communication in the robotic surgical system can be wired, all electronic communication in the robotic surgical system can be wireless, or some portions of the robotic surgical system can be in wired communication and other portions of the system can be in wireless communication.

<FIG> is a perspective view of one embodiment of a robotic surgical system <NUM> that includes a patient-side portion <NUM> that is positioned adjacent to a patient <NUM>. and a user-side portion <NUM> that is located a distance from the patient, either in the same room and/or in a remote location. The patient-side portion <NUM> generally includes one or more robotic arms <NUM> and one or more tool assemblies <NUM> that are configured to releasably couple to a robotic arm <NUM>. The user-side portion <NUM> generally includes a vision system <NUM> for viewing the patient <NUM> and/or surgical site, and a control system <NUM> for controlling the movement of the robotic arms <NUM> and each tool assembly <NUM> during a surgical procedure.

The control system <NUM> can have a variety of configurations and can be located adjacent to the patient (e.g., in the operating room), remote from the patient (e.g., in a separate control room), or distributed at two or more locations (e.g., the operating room and/or separate control room(s)). As an example of a distributed system, a dedicated system control console can be located in the operating room, and a separate console can be located in a remote location. The control system <NUM> can include components that enable a user to view a surgical site of the patient <NUM> being operated on by the patient-side portion <NUM> and/or to control one or more parts of the patient-side portion <NUM> (e.g., to perform a surgical procedure at the surgical site). In some embodiments, the control system <NUM> can also include one or more manually-operated input devices, such as a joystick, exoskeletal glove, a powered and gravity-compensated manipulator, or the like. The one or more input devices can control teleoperated motors which, in turn, control the movement of the surgical system, including the robotic arms <NUM> and tool assemblies <NUM>.

The patient-side portion <NUM> can have a variety of configurations. As illustrated in <FIG>, the patient-side portion <NUM> can couple to an operating table <NUM>. However, in other embodiments, the patient-side portion <NUM> can be mounted to a wall, to the ceiling, to the floor, or to other operating room equipment. Further, while the patient-side portion <NUM> is shown as including two robotic arms <NUM>, more or fewer robotic arms <NUM> may be included. Furthermore, the patient-side portion <NUM> can include separate robotic arms <NUM> mounted in various positions, such as relative to the surgical table <NUM> (as shown in <FIG>). Alternatively, the patient-side portion <NUM> can include a single assembly that includes one or more robotic arms <NUM> extending therefrom.

<FIG> illustrates another embodiment of a robotic arm <NUM> and the surgical tool <NUM> of <FIG> releasably and replaceably coupled to the robotic arm <NUM>. Other surgical instruments can instead be coupled to the arm <NUM>, as discussed herein. The robotic arm <NUM> is configured to support and move the associated tool <NUM> along one or more degrees of freedom (e.g., all six Cartesian degrees of freedom, five or fewer Cartesian degrees of freedom, etc..

The robotic arm <NUM> can include a tool driver <NUM> at a distal end of the robotic arm <NUM>, which can assist with controlling features associated with the tool <NUM>. The robotic arm <NUM> can also include an entry guide <NUM> (e.g., a cannula mount, cannula, etc.) that can be a part of or releasably and replaceably coupled to the robotic arm <NUM>, as shown in <FIG>. A shaft of a tool assembly can be inserted through the entry guide <NUM> for insertion into a patient, as shown in <FIG> in which the shaft <NUM> of the tool <NUM> of <FIG> is shown inserted through the entry guide <NUM>.

In order to provide a sterile operation area while using the surgical system, a barrier <NUM> can be placed between the actuating portion of the surgical system (e.g., the robotic arm <NUM>) and the surgical instruments coupled thereto (e.g., the tool <NUM>, etc.). A sterile component, such as an instrument sterile adapter (ISA), can also be placed at the connecting interface between the tool <NUM> and the robotic arm <NUM>. The placement of an ISA between the tool <NUM> and the robotic arm <NUM> can ensure a sterile coupling point for the tool <NUM> and the robotic arm <NUM>. This permits removal of surgical instruments from the robotic arm <NUM> to exchange with other surgical instruments during the course of a surgery without compromising the sterile surgical field.

<FIG> illustrates the tool driver <NUM> in more detail. As shown, the tool driver <NUM> includes one or more motors, e.g., five motors <NUM> are shown, that control a variety of movements and actions associated with the tool <NUM> coupled to the arm <NUM>. For example, each motor <NUM> can couple to and/or interact with an activation feature (e.g., gear) associated with the tool <NUM> for controlling one or more actions and movements that can be performed by the tool <NUM>, such as for assisting with performing a surgical operation. The motors <NUM> are accessible on the upper surface of the tool driver <NUM>, and thus the tool <NUM> (e.g., the housing <NUM> thereof) is configured to mount on top of the tool driver <NUM> to couple thereto. Exemplary embodiments of motor operation and components of a tool housing (also referred to as a "puck") configured to controlled by tool driver motors are further described in previously mentioned International Patent Publication No. <CIT> and International Patent Publication No. <CIT>, U. No. <CIT> entitled "Methods, Systems, And Devices For Initializing A Surgical Tool", and in US Pat. No. <CIT>, entitled "Methods, Systems, And Devices For Controlling A Motor Of A Robotic Surgical System".

The tool driver <NUM> also includes a shaft-receiving channel <NUM> formed in a sidewall thereof for receiving the shaft <NUM> of the tool <NUM>. In other embodiments, the shaft <NUM> can extend through on opening in the tool driver <NUM>, or the two components can mate in various other configurations.

As mentioned above, a surgical tool, such as the tool <NUM> of <FIG>, the tool of <FIG>, the tool of <FIG>, or other surgical tool, can be configured to have a corrective force applied thereto that counteracts a torque force experienced by the end effector due to translation of a cutting element therealong. As also mentioned above, a robotic surgical system, such as the robotic surgical system <NUM> of <FIG> or other robotic surgical system, coupled to the surgical tool can be configured to deliver the corrective force to the surgical tool, e.g., a tool driver of the robotic surgical system providing a force to a tool housing of the surgical tool. The robotic surgical system (e.g., a control system thereof that includes a controller and/or a computer system including a controller) can be configured to determine an amount of the corrective force to apply.

<FIG> illustrates one embodiment of a method <NUM> of applying a corrective force to a surgical tool during cutting element translation. The method <NUM> is described for ease of description with reference to the robotic surgical system <NUM> of <FIG> and a surgical tool of <FIG> but can be similarly implemented using other embodiments of robotic surgical systems and surgical tools. The surgical tool of <FIG> is, for purposes of the description of the method <NUM>, releasably coupled to the robotic surgical system, e.g., a tool housing (not shown) of the surgical tool is releasably coupled to the tool driver <NUM>.

An end effector <NUM> of the surgical tool can be articulated <NUM> to be positioned at a non-zero angle α relative to a longitudinal axis <NUM> of an elongate shaft <NUM> having the end effector <NUM> at a distal end thereof. The illustrated angle α is an example angle, with the end effector <NUM> being configured to articulate at other angles greater than and less than the illustrated angle α. <FIG> shows the end effector <NUM> articulated at the non-zero angle α. The end effector's articulation can be effected in a variety of ways, as discussed herein, such as by the robotic surgical system <NUM> driving one or more actuation shafts of the surgical tool that are operatively coupled to the end effector <NUM> and the tool driver <NUM>. The end effector <NUM> is coupled to the shaft <NUM> at a wrist or joint <NUM>, at which the end effector <NUM> is angled relative to the shaft <NUM>. The end effector <NUM> includes opposed upper and lower jaws <NUM>, <NUM> configured open and close similar to other embodiments of jaws described herein.

The robotic surgical system <NUM> can determine <NUM> the articulation angle α in any of a variety of ways. For example, the robotic surgical system <NUM>, e.g., the control system <NUM> thereof, can include a computer system with a memory having stored therein data correlating articulation forces with articulation angles. The amount of articulation force delivered to the surgical tool to articulate the end effector <NUM> is known by the robotic surgical system <NUM>, and the robotic surgical system <NUM> (e.g., a controller of the control system <NUM>) can use the stored data to look up the articulation angle corresponding to the delivered amount of force, which is the angle α. For another example, the surgical tool can include at least one position sensor configured to sense a position of the end effector <NUM> that is indicative of the angle α. The at least one position sensor can be configured to communicate the sensed position to the robotic surgical system <NUM> (e.g., to the control system <NUM>) via the tool driver <NUM>.

With the end effector <NUM> articulated at the angle α, a cutting element (obscured in <FIG>) can be translated <NUM> along the end effector <NUM> in a distal direction to cut tissue (not shown) engaged by the end effector <NUM>, e.g., tissue clamped between the jaws <NUM>, <NUM>. In this illustrated embodiment, a firing bar <NUM> having the cutting element thereon, similar to the firing bar <NUM> and cutting element <NUM> of <FIG>, is translated <NUM> distally along the end effector <NUM> to cut the tissue. The firing bar <NUM> is bent at the wrist <NUM> during the translation of the cutting element, as shown in <FIG>, and exerts a torque force in a distal direction, which is shown by arrow F1 in <FIG>. The torque force urges the end effector <NUM> from its articulated angle α, as discussed above.

The robotic surgical system <NUM>, e.g., the controller of the control system <NUM>, can determine <NUM> an amount of corrective force to deliver to the end effector <NUM>, e.g., deliver via the tool driver <NUM> to the tool housing, to correct for the torque force. The corrective force can be determined <NUM> in any of a variety of ways. <FIG> illustrates one embodiment of a determination process <NUM> that the robotic surgical system <NUM> (e.g., the controller of the control system <NUM>) can implement to determine <NUM> the amount of corrective force. The process <NUM> can be stored at the robotic surgical system <NUM> (e.g., in the memory of the control system <NUM>) for execution thereby (e.g., by the control system's controller).

An amount of torque force applied by the robotic surgical system <NUM> to the surgical tool to cause the cutting element translation (e.g., firing bar <NUM> translation) is a first input <NUM> to the process <NUM>, and the determined <NUM> articulation angle α is a second input <NUM> to the process <NUM>. The amount of torque force applied by the robotic surgical system <NUM> to the surgical tool to cause the cutting element translation can be determined in any of a variety of ways. For example, the torque force can be measured via motor torque, e.g., torque of the motor at the tool driver <NUM> providing the force to the surgical tool's tool housing. For another example, the robotic surgical system <NUM> can include at least one force sensor (e.g., at the tool driver <NUM> adjacent a motor thereat) configured to sense the torque force.

The first input <NUM> is used to determine <NUM> a force that the cutting element (e.g., the firing bar <NUM>) is exerting on the end effector <NUM>. The determination <NUM> can be made, for example, by the robotic surgical system <NUM> (e.g., the controller of the control system <NUM>) using a lookup table that correlates each torque force that the robotic surgical system can deliver to a force that the torque force causes to be exerted on the end effector <NUM>. The lookup table can be stored at the robotic surgical system <NUM> (e.g., in the memory of the control system <NUM>). The determined <NUM> force is input into a <NUM>-D lookup table <NUM>. The second input <NUM> is also input into the <NUM>-D lookup table <NUM>. The robotic surgical system <NUM> (e.g., the controller of the control system <NUM>) uses the <NUM>-D lookup table <NUM> and the two inputs thereto to determine a torque force at the wrist <NUM>. In other words, the <NUM>-D lookup table <NUM> can correlate torque forces at the wrist <NUM> to different end effector articulation angles and different torque forces exerted on the end effector, with a one of the torque forces matching the two inputs to the <NUM>-D lookup table <NUM> being the output of the lookup table <NUM> function that is indicative of the torque force at the wrist <NUM>. The data (e.g., predetermined forces) in the lookup table <NUM> can be gathered, for example, through experiments and/or through historical use of the surgical tool.

The robotic surgical system <NUM> (e.g., the controller of the control system <NUM>) also calculates <NUM> an inverse tangent (arc tangent or atan) of the second input <NUM>.

The robotic surgical system <NUM> (e.g., the controller of the control system <NUM>) divides <NUM> the torque force at the wrist <NUM>, e.g., the output from the lookup table <NUM>, by the calculated <NUM> inverse tangent to obtain a result <NUM>. The result <NUM> is the amount of corrective force for the robotic surgical system <NUM> to apply to the end effector <NUM> to counteract the torque force, e.g., the force shown by arrow F1 in <FIG>.

Having determined <NUM> the amount of corrective force, the robotic surgical system <NUM> delivers <NUM> the corrective force to the surgical tool, e.g., by the tool driver <NUM> imparting torque to one or more actuation shafts of the surgical tool. The corrective force is in an opposite direction to the torque force. In others words, the torque force is in the distal direction, as shown by arrow F1, and the corrective force is in a proximal direction, as shown by arrow F2 in <FIG>. The corrective force may thus substantially cancel out the urging of the end effector's movement caused by the cutting element's translation along the end effector <NUM> to maintain the end effector <NUM> at the articulation angle α during the cutting element's translation. A person skilled in the art will appreciate that the corrective force may not precisely cancel out the torque force exerted during cutting element translation but nevertheless be configured to substantially cancel out the torque force due to any number of factors, such as sensitivity of measurement equipment.

As in this illustrated embodiment, throughout the cutting element's translation the robotic surgical system <NUM> can repeatedly determine <NUM> the amount of corrective force and deliver <NUM> the determined <NUM> amount in an iterative process. This iterative process may help account for changes in applied motor torque that may occur during the cutting element's translation, such as if motor torque is increased to help move the cutting element through thicker and/or tougher tissue. In other embodiments, the process <NUM> may end after the corrective force <NUM> is delivered <NUM> once, which may help conserve processing resources.

The systems, devices, and methods disclosed herein can be implemented using one or more computer systems, which may also be referred to herein as digital data processing systems and programmable systems.

The programmable system or computer system may include clients and servers.

The computer programs, which can also be referred to as programs, software, software applications, applications, components, or code, include machine instructions for a programmable processor, and can be implemented in a high-level procedural language, an object-oriented programming language, a functional programming language, a logical programming language, and/or in assembly/machine language.

To provide for interaction with a user, one or more aspects or features of the subject matter described herein can be implemented on a computer having a display device, such as for example a cathode ray tube (CRT) or a liquid crystal display (LCD) or a light emitting diode (LED) monitor for displaying information to the user and a keyboard and a pointing device, e.g., a mouse, a trackball, etc., by which the user may provide input to the computer. For example, feedback provided to the user can be any form of sensory feedback, such as for example visual feedback, auditory feedback, or tactile feedback; and input from the user may be received in any form, including, but not limited to, acoustic, speech, or tactile input. Other possible input devices include, but are not limited to, touch screens or other touch-sensitive devices such as single or multi-point resistive or capacitive trackpads, voice recognition hardware and software, optical scanners, optical pointers, digital image capture devices and associated interpretation software, and the like.

<FIG> illustrates one exemplary embodiment of a computer system <NUM>. As shown, the computer system <NUM> includes one or more processors <NUM> which can control the operation of the computer system <NUM>. "Processors" are also referred to herein as "controllers. " The processor(s) <NUM> can include any type of microprocessor or central processing unit (CPU), including programmable general-purpose or special-purpose microprocessors and/or any one of a variety of proprietary or commercially available single or multi-processor systems. The computer system <NUM> can also include one or more memories <NUM>, which can provide temporary storage for code to be executed by the processor(s) <NUM> or for data acquired from one or more users, storage devices, and/or databases. The memory <NUM> can include read-only memory (ROM), flash memory, one or more varieties of random access memory (RAM) (e.g., static RAM (SRAM), dynamic RAM (DRAM), or synchronous DRAM (SDRAM)), and/or a combination of memory technologies.

The various elements of the computer system <NUM> can be coupled to a bus system <NUM>. The illustrated bus system <NUM> is an abstraction that represents any one or more separate physical busses, communication lines/interfaces, and/or multi-drop or point-to-point connections, connected by appropriate bridges, adapters, and/or controllers. The computer system <NUM> can also include one or more network interface(s) <NUM>, one or more input/output (IO) interface(s) <NUM>, and one or more storage device(s) <NUM>.

The network interface(s) <NUM> can enable the computer system <NUM> to communicate with remote devices, e.g., other computer systems, over a network, and can be, for non-limiting example, remote desktop connection interfaces, Ethernet adapters, and/or other local area network (LAN) adapters. The IO interface(s) <NUM> can include one or more interface components to connect the computer system <NUM> with other electronic equipment. For non-limiting example, the IO interface(s) <NUM> can include high speed data ports, such as universal serial bus (USB) ports, <NUM> ports, Wi-Fi, Bluetooth, etc. Additionally, the computer system <NUM> can be accessible to a human user, and thus the IO interface(s) <NUM> can include displays, speakers, keyboards, pointing devices, and/or various other video, audio, or alphanumeric interfaces. The storage device(s) <NUM> can include any conventional medium for storing data in a non-volatile and/or non-transient manner. The storage device(s) <NUM> can thus hold data and/or instructions in a persistent state, i.e., the value(s) are retained despite interruption of power to the computer system <NUM>. The storage device(s) <NUM> can include one or more hard disk drives, flash drives, USB drives, optical drives, various media cards, diskettes, compact discs, and/or any combination thereof and can be directly connected to the computer system <NUM> or remotely connected thereto, such as over a network. In an exemplary embodiment, the storage device(s) can include a tangible or non-transitory computer readable medium configured to store data, e.g., a hard disk drive, a flash drive, a USB drive, an optical drive, a media card, a diskette, a compact disc, etc..

The elements illustrated in <FIG> can be some or all of the elements of a single physical machine. In addition, not all of the illustrated elements need to be located on or in the same physical machine. Exemplary computer systems include conventional desktop computers, workstations, minicomputers, laptop computers, tablet computers, personal digital assistants (PDAs), mobile phones, and the like.

The computer system <NUM> can include a web browser for retrieving web pages or other markup language streams, presenting those pages and/or streams (visually, aurally, or otherwise), executing scripts, controls and other code on those pages/streams, accepting user input with respect to those pages/streams (e.g., for purposes of completing input fields), issuing HyperText Transfer Protocol (HTTP) requests with respect to those pages/streams or otherwise (e.g., for submitting to a server information from the completed input fields), and so forth. The web pages or other markup language can be in HyperText Markup Language (HTML) or other conventional forms, including embedded Extensible Markup Language (XML), scripts, controls, and so forth. The computer system <NUM> can also include a web server for generating and/or delivering the web pages to client computer systems.

In an exemplary embodiment, the computer system <NUM> can be provided as a single unit, e.g., as a single server, as a single tower, contained within a single housing, etc. The single unit can be modular such that various aspects thereof can be swapped in and out as needed for, e.g., upgrade, replacement, maintenance, etc., without interrupting functionality of any other aspects of the system. The single unit can thus also be scalable with the ability to be added to as additional modules and/or additional functionality of existing modules are desired and/or improved upon.

A computer system can also include any of a variety of other software and/or hardware components, including by way of non-limiting example, operating systems and database management systems. Although an exemplary computer system is depicted and described herein, it will be appreciated that this is for sake of generality and convenience. In other embodiments, the computer system may differ in architecture and operation from that shown and described here.

Preferably, components of the invention described herein will be processed before use. First, a new or used instrument is obtained and if necessary cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument are then placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility.

Typically, the device is sterilized. This can be done by any number of ways known to those skilled in the art including beta or gamma radiation, ethylene oxide, steam, and a liquid bath (e.g., cold soak). An exemplary embodiment of sterilizing a device including internal circuitry is described in more detail in <CIT> and entitled "System And Method Of Sterilizing An Implantable Medical Device. " It is preferred that device, if implanted, is hermetically sealed. This can be done by any number of ways known to those skilled in the art.

Claim 1:
A surgical system, comprising:
a surgical tool (<NUM>) including an elongate shaft (<NUM>) having an end effector (<NUM>) at a distal end thereof, the surgical tool including a cutting element configured to translate along the end effector to cut tissue engaged by the end effector, wherein a torque force is applied to the surgical tool to cause the cutting element translation, and a rod configured to move to articulate the end effector at an angle relative to the elongate shaft, the movement of the rod being configured to be driven by a motor (<NUM>); and
a controller configured to determine an amount of corrective force based on the angle and the torque force, and the controller being configured to apply the determined corrective force to the rod during the translation of the cutting element.