Patent Description:
The present invention, in some embodiments thereof, relates to actuation of a device including at least one surgical arm and, more particularly, but not exclusively, to a motor unit configured for actuating at least one surgical arm.

<CIT> discloses "An instrument for a surgical robot arm. The instrument, which is to be mounted on a front end of a robot arm equipped with an actuator, includes: a housing, which is coupled to the front end of the robot arm; a driving wheel, which is coupled to the housing, and which is operated by way of a driving force transferred from the actuator; and a locking part, which is coupled to the housing, and which locks the operation of the driving wheel in correspondence to the mounting and dismounting of the housing on and from the robot arm. By installing a locking part on the instrument, the locking part can be made to restrain the rotation of the driving wheels when mounting or dismounting the instrument on or from the robot arm, and the driving wheels can be automatically calibrated when the instrument is dismounted from the robot arm. Thus, the driving wheels or the manipulation part may not undergo unnecessary movements, and the driving force of the robot arm can be transferred to the instrument without having to perform a separate aligning process after mounting the instrument onto the robot arm" (abstract).

<CIT> discloses "A system for operating a catheter having a distal end adapted to be navigated in the body, and a proximal end having a handle with a translatable control and a rotatable control for acting on the distal end of the device includes a support for receiving and engaging the handle of the catheter; a translation mechanism for advancing and retracting the support to advance and retract a catheter whose handle is received in the support; a rotation mechanism for rotating the support to rotate a catheter whose handle is received in the support; a translation operator for engaging the translatable control of a catheter whose handle is received in the support and operating the translatable control to act on the distal end of the device; and a rotation operator for engaging the rotatable control of a catheter whose handle is received in the support and operating the rotatable control to act on the distal end of the device" (abstract).

<CIT> discloses a system that "uses a single entry port in a wide variety of surgeries. To insert multiple surgical instruments into a patient through a single entry port requires that the shaft of at least one of the surgical instruments be bent between the base of the surgical instrument and the point where the shaft contacts a channel in an entry guide. Each surgical instrument is positioned by an instrument manipulator positioning system so that when the shaft is inserted in a channel of the entry guide, any bending of the shaft does not damage the surgical instrument and does not inhibit proper operation of the surgical instrument" (abstract).

Additional background art includes: "<NPL>); "<NPL>;.

Further background art includes U. Patent No. <CIT>, U. Patent No. <CIT>, U. Patent No. <CIT>, U. Patent No. <CIT>, International Patent Application Publication No. <CIT>, and International Patent Application Publication No. <CIT>.

Even further prior art is disclosed in <CIT>, <CIT> and <CIT>.

According to the invention, there is provided a method for maintaining the calibration of a surgical arm during attachment of the surgical arm to a motor unit according to claim <NUM> and a surgical system according to claim <NUM>. Further exemplary embodiments disclose a mechanism for actuating movement of a shaft having two degrees of freedom, comprising: a first actuator configured to rotate the shaft around the shaft axis; a second actuator configured to bend the shaft using one or more elongated elements attached to the shaft; wherein actuation of the first actuator indirectly manipulates the elongated elements controlled by the second actuator, thereby affecting operation of the second actuator.

In some embodiments, the mechanism comprises at least one motor and at least one of the first and second actuators comprises at least one gear driven by the motor.

In some embodiments, the indirect manipulation comprises changing a position of the elongated elements in response to rotation of the shaft by the first actuator.

In some embodiments, rotation of the shaft by the first actuator tensions at least one of the elongated elements controlled by the second actuator.

In some embodiments, the elongated elements are attached to the shaft at a point distal to a flexible joint of the shaft.

In some embodiments, the second actuator is configured to respectively tension and releases the elongated elements to cause flexion and extension of the joint.

In some embodiments, one or both of the first and second actuators comprises a gear.

In some embodiments, the gear is positioned to rotate about the shaft axis.

In some embodiments, both of the actuators comprise gears and are positioned to rotate about the shaft axis.

In some embodiments, relative actuation of the first and second actuators is configured to bend the shaft.

In some embodiments, the relative actuation comprises driving the actuators at different speeds.

In some embodiments, unified actuation of the first and second actuators is configured to rotate the shaft as a single rigid body.

In some embodiments, each of the actuators is driven by a motor.

In some embodiments, a gear of the motor or one or more transmission gears driven by the motor are positioned to interfere, at least in part, with rotation of the second actuator.

In some embodiments, an amount of friction imposed on the second actuator by the interference effects a final shaft articulation actuated by the mechanism.

In some embodiments, when high friction is imposed on the second actuator, actuation of the first actuator results in simultaneous rotation and bending of the shaft; and when low or no friction is imposed on the second actuator, actuation of the first actuator results in rotation of the shaft as a rigid body.

In some embodiments, the shaft forms at least a portion of a surgical arm.

According to an aspect of some embodiments, there is provided a surgical system comprising a surgical arm comprising at least one joint; a motor unit configured to actuate articulation of the at least one joint of the surgical arm, the motor unit comprising a proximal extension of the arm; wherein the motor unit comprises at least one actuation mechanism configured for one or both of rotating at least a portion of the arm around its axis and bending the at least one joint, the actuation mechanism operably coupled to the extension of the arm.

In some embodiments, the portion of the arm which is moved by the actuation mechanism is configured proximally to the joint.

In some embodiments, the arm comprises at least one inner shaft nested within an outer shaft, the inner and outer shafts extending in a proximal direction and forming the proximal extension of the arm.

In some embodiments, the actuation mechanism comprises a first proximal gear and a second distal gear; wherein the outer shaft is operably coupled to the distal gear, and the inner nested shaft extends in a proximal direction to and through the proximal gear.

In some embodiments, each of the gears is driven directly or via a gear transmission by a motor.

In some embodiments, the arm comprises <NUM> joints actuated by <NUM> actuation mechanisms.

In some embodiments, more than one actuation mechanism is actuated to generate a selected articulation of the arm.

In some embodiments, articulation of the outer shaft is performed concurrently with articulation of the inner shaft.

In some embodiments, the actuation mechanisms are collinear.

In some embodiments, the system comprises two surgical arms and the motor unit comprises actuations mechanisms for articulating both arms.

In some embodiments, the motor unit is less than <NUM> in length and less than <NUM> in width.

In some embodiments, the motor unit comprises one or more position sensors for indicating a current angular position of the motor gear.

In some embodiments, a controller of a first motor is configured to receive input from a position sensor of a second motor and to control operation of the first motor in response to the input.

According to an aspect of some embodiments, there is provided a mechanism for linear movement of elongated elements driven by rotational movement, comprising: a gear operably coupled to a threaded screw, the gear configured to rotate the screw around the screw axis; at least two rider elements coupled to the thread of the screw; wherein a first rider element is attached to at least one first elongated element and a second rider element is attached to at least one second elongated element; wherein rotation of the screw moves the rider elements laterally in opposing directions, tensioning the first elongated element and releasing tension of the second elongated element or vice versa.

In some embodiments, rotational movement of the rider elements around the screw is limited by one or more protrusions configured on an internal face of a housing in which the screw is received.

In some embodiments, a coupling between the gear and the screw comprises a clutch. In some embodiments, the clutch comprises a spring coupled to the screw such that when torque and/or tension produced by rotation of the screw exceeds a threshold, the spring yields and further rotation of the screw is no longer effective to actuate movement of the elongated elements.

In some embodiments, the clutch comprises one or more springs attached between the rider elements and the elongated elements such that when an elongated element is tensioned above a threshold, the spring yields and further movement of the rider element is no longer effective to tension the elongate element.

In some embodiments, each of the rider elements is attached to two elongated elements.

In some embodiments, the elongated elements are each coupled at their proximal end to the respective rider element, and at their distal end to a shaft which forms at least a portion of a surgical arm.

In some embodiments, the elongated elements are coupled to the shaft at a point distal to a flexible joint of the shaft.

According to an aspect of some embodiments, there is provided a mechanism for actuating a shaft having two degrees of freedom, comprising: a tubular shaft; first and second actuators disposed at an end of the tubular shaft, the actuators collinear to the tubular shaft; wherein the first actuator is configured to actuate shaft movement of a first type, and the second actuator is configured to actuate shaft movement of a second type, the movement of a second type different than the movement of a first type.

In some embodiments, the first and second actuators are configured to move about a central axis of the tubular shaft.

In some embodiments, the first and second actuators are spaced apart from each other.

In some embodiments, the first actuator is directly coupled to the tubular shaft and the second actuator is indirectly coupled to the tubular shaft.

In some embodiments, the second actuator is coupled to the tubular shaft via one or more elongated elements extending between the second actuator and the tubular shaft.

In some embodiments, movement of a first type comprises rotation of the tubular shaft around its axis and movement of a second type comprises bending of the tubular shaft.

According to the invention, there is provided a method of maintaining calibration of a surgical arm, comprising positioning an extension of a surgical arm in a motor unit configured to actuate articulation of the surgical arm by comprising one or more gears operably coupled to the extension; during positioning, interfering with movement of the one or more gears to maintain a calibrated state of the surgical arm.

In some embodiments, interfering comprises changing a position of interfering elements to a gear-locking position using an elastic element.

In the invention, the method further comprises closing a cover door of the motor unit to release the interfering elements from the gear-locking position.

A broad aspect of some embodiments relates to actuation of a surgical arm, and more particularly, but not exclusively, to motorized actuation of a surgical arm.

An aspect of some embodiments relates to actuating movement of a shaft (e.g. a segment of the surgical arm) having two degrees of freedom using two actuators configured to interact with each other such that actuation of the first actuator indirectly manipulates one or more elongated elements attached to the shaft and controlled by the second actuator. In some embodiments, indirect manipulation comprises rotating the shaft, causing a change in a position of the elongated elements attached to the shaft.

In some embodiments, the first actuator is configured to rotate the shaft around the shaft axis. In some embodiments, the second actuator is configured to bend the shaft, for example by relative tensioning and releasing of the elongated elements attached to the shaft, for example attached at a point distal to a flexible portion of the shaft. In some embodiments, rotation of the shaft by the first actuator tensions the elongated elements, thereby affecting operation of the second actuator, which controls the elongated elements. In some embodiments, the first actuator is located between the second actuator and the attachment point of the elongated elements to the shaft, such that the elongated elements extend past the first actuator (e.g. pass from proximally to the first actuator to distally of the first actuator).

In some embodiments, the actuator comprises a gear or a gear train. In some embodiments, relative actuation of the actuators, comprising, for example, rotating the gears at different speeds and/or directions, holding one gear stationary whilst the other gear is rotated is configured to actuate a first type of movement the shaft, for example bending of the shaft. In some embodiments, unified actuation of the actuators, comprising, for example, rotating the gears at similar speeds, is configured to actuate a second type of movement of the shaft, for example rotation of the shaft as a single rigid body.

In some embodiments, one or more elements such as a gear of a motor driving the actuator are configured to interfere with free rotation of the actuator. In some embodiments, an amount of resistance imposed on the second actuator (e.g. friction due to the interfering motor gear) during actuation of the first actuator affects the type of movement produced by actuation of the first actuator. For example, if the resistance is high enough to hold the second actuator stationary whilst the first actuator is rotated, actuation of the first actuator will result in simultaneous rotation and bending of the shaft. Alternatively, if low or no friction is encountered by the second actuator, rotation of the first actuator will in turn rotate the second actuator, resulting in rotation of the controlled shaft as a single rigid body.

In some embodiments, a threshold is applied for actuating a selected movement of the shaft, for example, the gears need to be rotated at a selected minimal speed in order to rotate the shaft as a rigid, single body.

An aspect of some embodiments relates to a shaft actuation mechanism comprising two or more actuators movable about a similar rotational axis. In some embodiments, the rotational axis is the same as the rotational axis of the shaft. In some embodiments, at least one of the actuators is configured to rotate the shaft about the common rotational axis. Optionally at least one other actuator is configured to produce bending of the shaft and/or linear movement of the shaft.

An aspect of some embodiments relates to articulating a plurality of shafts that are nested, at least in part, within one another. In some embodiments, articulation of an outer shaft requires simultaneous articulation of an inner shaft positioned within the outer shaft. In an example, in order to bend an outer shaft, an inner shaft nested at least in part within the outer shaft is bent as well.

Some embodiments relate to a system comprising a motor unit configured for actuating movement of a surgical arm including a plurality of nested shafts. In some embodiments, the motor unit comprises one more actuation mechanisms, configured for articulating (e.g. bending and/or rotating) at least a segment of the surgical arm. As referred to herein, an "actuation mechanism" may include one or more actuators, such as gear or gear trains, configured for actuating movement of a joint of the surgical arm. In some embodiments, the actuation mechanism is configured for rotating an arm segment proximal to the joint around the segment's long axis, as well as bending (flexing and/or extending) the joint. In an embodiment, an actuation mechanism comprises a rotation gear configured at a distal end of the mechanism, and a bending gear configured at a proximal end of the actuation mechanism. In some embodiments, an outer shaft is operably attached to the rotation gear such that the rotation gear is configured to rotate the outer shaft around the shaft long axis. In some embodiments, an inner shaft nested within the outer shaft extends in a proximal direction to and through the bending gear, optionally continuing in the proximal direction to be operably received within a second actuation mechanism, and so forth.

In some embodiments, the bending and rotation gear are driven in different manners, for example, in some embodiments, the bending gear is rotated by a second gear driven by a motor, while the rotation gear is directly driven by a motor. Additionally or alternatively, gears of different shapes and/or sizes (e.g. having different number of teeth) are used to drive the movement actuating gears. A potential advantage of using a gear train and/or gears of different sizes may include reducing a speed of the driving motor, increasing torque and allowing for a higher degree of accuracy in control of arm movements. Additionally or alternatively, a selectable gear configured for modifying the motor speed to a selected speed is used.

In some embodiments, a certain actuation speed is selected. In some embodiments, the speed is selected in accordance with a surgical action performed by the arm, for example performed by an end-effecter at a distal end of the arm. For example, in some embodiments, for actuation of an end-effecter of the arm such as grippers configured at a distal end of the arm, when actuating fast gripper movement, e.g. during tissue dissection, a high speed is selected; when actuating gripper movement which requires a relatively high amount of force to applied by the gripper, for example when stapling tissue, separating tissue and/or other actions associated with applying of a relatively high amount of force via the grippers, a slower motor speed is selected. In some embodiments, articulation of a joint of the surgical arm involves actuating different combinations of actuators, for example, rotation of an elbow joint is obtained by a combination of <NUM> actuators, while flexion of the elbow joint is obtained by a single actuator. In some embodiments, articulation of two or more joints is performed concurrently, for example, when bending the shoulder, bending of the elbow is actuated as well so as not to limit bending of the shoulder.

In some embodiments, articulation is performed in accordance with a current position of the surgical arm. Optionally, the motor unit comprises position sensors and/or is controlled by a processor, optionally including a memory which stores commands. In some embodiments, data from position sensor/s and/or from control memory is used to infer a position of the arm portion(s). In some embodiments, the processor receives signals from an input device (e.g. a joystick) and/or from a user motion detector device, and controls activation of the motor unit based on the received signals.

In some embodiments, a long axis of the motor unit is collinear with the long axis of the surgical arm. In some embodiments, the plurality of actuation mechanisms of the motor unit are aligned concentrically with respect to each other, and/or with respect to the arm. In some embodiments, the prime actuators (e.g. motors) are shaped and sized to be disposed in parallel to the actuation mechanism, optionally beside and/or beneath the actuation mechanism, to allow for a thin motor unit.

In some embodiments, the motor unit comprises a mirrored arrangement of actuations mechanisms for actuating two surgical arms (optionally imitating left and right human arms). Alternatively, the motor unit is configured for actuating a single arm. In some embodiments, a motor unit comprising <NUM> actuation mechanisms, optionally driven by <NUM> motors, is configured to actuate a single arm, for example an arm comprising <NUM> joints.

In some embodiments, the motor unit is of small dimensions, for example a motor unit configured for actuating two arms comprises a width of less than <NUM>, less than <NUM>, less than <NUM> or intermediate, larger or smaller size, and/or a length of less than <NUM>, less than <NUM>, less than <NUM> or intermediate, larger or smaller size. In some embodiments, during use, at least a portion of the surgical arm(s) is inserted into the body (through a natural body orifice and/or through an incised port), while the motor unit remains outside the body. Alternatively, the motor unit is small enough to be inserted, at least in part, into the body.

An aspect of some embodiments relates to actuating linear movement driven by rotational movement. In some embodiments, a threaded screw is configured to be rotated about its axis, for example by a gear (e.g. a bending gear for example as described hereinabove), causing lateral movement of one or more rider elements, such as half-nuts, that fit within the grooves defined by the thread and/or fit within indentations defined by radially-inward protrusions on the housing. In some embodiments, two half nuts are used, each of the half-nuts being coupled to an elongate element, so that rotation of the screw causes one half nut to move distally and the other half nut to move proximally, thereby causing respective tensioning and releasing of the elongated elements. In some embodiments, a distal end of the elongated elements is attached to a bendable shaft at a point distal to a flexible portion defining a joint, and bending of the shaft is achieved by relative flexion and extension actuated by the linearly moved elongated elements.

In some embodiments, a coupling between the rotation gear and the threaded screw comprises a clutch. In some embodiments, the clutch comprises an elastic element such as a spring (e.g. a torsion and/or tension spring) which is coupled to the threaded screw, optionally at a distal end of the screw. Optionally, when torque and/or tension applied by the rotated screw to the spring exceeds a certain threshold, the spring yields and further rotation of the screw is no longer effective to move the elongated elements. Additionally or alternatively, the clutch comprises a spring disposed at the attachment between the elongate element and the half nut. Optionally, when a pulling force applied to the elongated element via the spring exceeds a certain threshold, the spring yields and further rotation of the screw is no longer effective to move the elongated elements. In some embodiments, the clutch is operably coupled to an encoder configured to send a signal to a driver circuit controlling a motor actuating the rotation gear, for example so that the motor is stopped in response to the signal.

An aspect of some embodiments relates to temporarily fixating a surgical arm at a selected position, for example maintaining a calibrated state of the surgical arm during attachment of the arm to a motor unit. In some embodiments, movement of one or more movement actuating gears (e.g. bending and/or rotation gears) is limited or prevented, for example by elements configured to interfere with movement of the gear. In some embodiments, completion of the attachment process such as by closing a cover door of the motor unit releases the interfering elements, allowing the gears to rotate again.

An aspect of some embodiments relates to safety of a device comprising one or more surgical arms. In some embodiments, the motor unit comprises one or more mechanisms for reducing risk during a power outage, for example: a solenoid lock which locks a cover of the motor unit during power outage; a manual mode in which the motor unit can be operated manually, for example by the surgeon; and/or other mechanisms configured for limiting manipulation of the arm and/or for limiting user access, for example during power outage.

In some embodiments, the motor unit comprise one or more mechanisms for reducing risk of human error during operation, for example, a relay that prevents power delivery to an electrocautery instrument when the instrument is mistakenly attached to the wrong device arm (e.g.in a device comprising two arms, the electrocautery instrument being attached to the arm defined as the left arm instead of the arm defined as the right arm or vice versa).

In some embodiments, the motor unit comprises one or more mechanisms for self-controlled operation, for example: cross-control of the motors in which a safety sensor of a first motor is controlled by a driver circuit controlling a second motor; selective delivery of monopolar or bipolar energy to the end effecter using, for example, a slip ring, and/or other energy delivery control mechanisms.

In some embodiments, mechanisms and/or systems and/or methods for example as described herein are used in robot-assisted surgeries and/or computer assisted surgeries. Robot-assisted surgeries may include, for example, minimally invasive surgeries (e.g. surgeries in which a less than <NUM> incision is made, a less than <NUM> incision is made, a less than <NUM> incision or intermediate, larger or smaller incision is made); open surgical procedures; single port procedures; multi-port procedures and/or other types of surgeries.

In some embodiments, mechanisms and/or systems for example as described herein are configured to be controlled remotely. In some embodiments, the robot (comprising the one or more surgical arms for example as described herein) is positioned on and/or below and/or otherwise adjacent the operating table. In some embodiments, control of the one or more surgical arms for example as described herein (e.g. arms as shown in <FIG> and/or <FIG> and/or <FIG> and/or <FIG> and/or <FIG> and/or other figures described), is provided via a console which may be located in the operating room, optionally adjacent the operating table and the surgical arms. Additionally or alternatively, control of the one or more surgical arms is performed from a distance.

A "robot" as referred to herein may include, in accordance with some embodiments, an electromechanical machine comprising one more surgical arms for example as described herein, which are controlled by circuitry, for example controlled by a computer. In some embodiments, movement of the at least one surgical arm such as rotation of at least a portion of the arm; bending of the arm; axial movement of the arm (e.g. back and forth movement of the arm) and/or or other movements and/or articulations for example as described herein are driven by one or more motors operably coupled to the surgical arm.

In some embodiments, the robot is configured to carry out movements associated with surgery, for example movements that would have been otherwise performed by a surgeon. In some embodiments, the robot is configured to control operation of surgical instruments inside and/or outside the patient body, e.g. to actuate movement of an end effecter such as a gripper.

Referring now to the drawings, <FIG> is a simplified schematic side view of a device <NUM> (e.g. surgical device) including a plurality of arms, according to some embodiments of the invention.

In some embodiments, the device includes a first arm <NUM> and a second arm <NUM>.

In some embodiments each arm <NUM>, <NUM> includes a support segment <NUM>, <NUM>, coupled to a first segment <NUM>, <NUM> by a first connecting section <NUM>, <NUM>, where first segment <NUM>, <NUM> is coupled to a second segment <NUM>, <NUM> by a second connecting section <NUM>, <NUM>, and a third segment <NUM>, <NUM> coupled to second segment <NUM>, <NUM> by a third connecting section <NUM>, <NUM>.

In some embodiments, one or more of support segments <NUM>, <NUM> are rigid. In some embodiments one or more of support segments <NUM>, <NUM> are flexible or include a flexible portion.

In some embodiments, support segments <NUM>, <NUM> are coupled, e.g. by a cover 102a. In some embodiments, support segments are coupled at only a portion of the torso length or are not coupled: <FIG> is a simplified schematic of a device <NUM> including a plurality of arms <NUM>, <NUM>, according to some embodiments of the invention.

In some embodiments, one or more arm includes a humanoid like structure. For clarity, in some portions of this document, device segments and connecting sections are referred to by anatomical names: Support segments <NUM>, <NUM> are also termed first torso <NUM> and second torso <NUM>, first connecting sections <NUM>, <NUM> are also termed first shoulder joint <NUM>, second shoulder joint <NUM>, first segments, <NUM>, <NUM> are also termed first humerus <NUM> and second humerus <NUM>, second connecting sections <NUM>, <NUM> are also termed first elbow joint <NUM>, and second elbow joint <NUM>, second segments <NUM>, <NUM> are also termed first radius <NUM> and second radius <NUM> and third segments <NUM> and <NUM> are also termed first hand tool <NUM> and second hand tool <NUM>.

In some embodiments, one or more connecting section includes a hinge. In some embodiments, one or more connecting section is flexible and/or includes a flexible portion. In an exemplary embodiment, a device arm includes an elbow joint and a shoulder joint where bending of the joint is distributed along the joint in a direction of a joint long axis.

In some embodiments, torsos <NUM>, <NUM> are close together, for example, a long axis of first torso <NUM> and a long axis of second torso <NUM> are within <NUM>, or <NUM>, or <NUM> of each other. Alternatively, torsos <NUM>, <NUM> are spaced apart from each other. Additionally or alternatively, torsos <NUM>, <NUM> are configured to converge or to diverge relative to each other. Optionally, a torso is curved.

In some embodiments, one or more device segment has a substantially cylindrical external shape (e.g. radius, humerus). In some embodiments, joints have circular long axis cross-section. Alternatively, in some embodiments, one or more device segment and/or joint has non-circular cross section external shape, for example, oval, square, rectangular, irregular shapes.

In some embodiments, a surgical arm includes one or more short and/or adjustable segment. In some embodiments, flexible portions are directly connected.

In some embodiments, a flexible portion comprises a plurality of stacked links.

<FIG>are simplified schematic side views of surgical arms, according to some embodiments of the invention. <FIG> illustrates an exemplary embodiment where a humerus segment <NUM> is short, for example, the segment including a long axis length, J of <NUM>-<NUM>, or <NUM>-<NUM>, or <NUM>-<NUM>, or approximately <NUM> or lower or higher or intermediate ranges or lengths.

In some embodiments, a user selects arm/s including desired segment lengths, where for example, selection is based on patient anatomy and/or a procedure to be performed. For example, when treating a child, a user, in some embodiments, selects one or more arm with one or more short segment (e.g. as illustrated by <FIG>). For example, when treating an obese patient, a user, in some embodiments, selects an arm with one or more a long segment for example, a standard arm with a long humerus segment (e.g. as illustrated by <FIG>) (e.g. humerus segment length, J' is <NUM>-<NUM>, or <NUM>-<NUM>, or <NUM>-<NUM>, or lower or higher or intermediate ranges or lengths).

In some embodiments, a device includes a kit with different structured arms (e.g. different segment lengths, e.g. different arm sizes).

Alternatively or additionally, in some embodiments, one or more segment length is adjustable, e.g. during a treatment and/or during set-up of the device. For example, in some embodiments, the arm illustrated in <FIG> is adjustable (e.g. by telescoping of humerus segment <NUM>) is adjustable to the configuration illustrated in <FIG>.

In some embodiments, extension and/or retraction of one or more segment is effected by a portion connected to the segment (e.g. a segment extension) being moved with respect to other portions of a surgical arm. For example, in some embodiments, a segment extension is moved (e.g. by a motor located in a motor unit) to increase a length of a segment. In some embodiments, a motor uses a screw mechanism to move the segment extension.

In some embodiments, a device arm has at least the freedom of movement of human arms. Generally, segments of human limbs (e.g. arms, legs) move by flexion and extension from a proximal segment joint, and rotation around the proximal segment joint. For example, a human radius flexes and extends at the elbow and rotates around the elbow.

The term proximal joint herein refers to the joint which is least removed from the torso to which a segment is coupled, e.g. a hand proximal joint is the wrist, a radius proximal joint is the elbow joint, a humerus proximal joint is the shoulder joint.

The term proximal segment herein refers to the segment which is least removed from the torso to which a segment is coupled (e.g. by a proximal segment joint). For example, a hand proximal segment is the radius, a radius proximal segment is the humerus, and a humerus proximal segment is the torso.

In some embodiments, one or more joint is uni-directionally bendable and extendable. In some embodiments, segment rotation around a segment proximal joint is achieved by rotation of a proximal segment around a proximal segment long axis. For example, rotation of the hand around the wrist joint is by rotation of the radius around a radius long axis.

Generally, human freedom of movement for arms includes limits to the angles of rotation and flexion. Optionally, in some embodiments, the device is restricted to human freedom of movements e.g. during one or more control mode. Alternatively, the device is configured to allow movement having additional degrees of freedom relative to human arm movement.

<FIG> is a simplified schematic of a device <NUM>, held by a support <NUM>, according to some embodiments of the invention.

In some embodiments, support <NUM> attaches to a portion of a patient operating surface, e.g. rail <NUM>. In some embodiments, position of attachment of support <NUM> on rail <NUM> is adjustable, for example enabling linear adjustment of position of attachment of the support to the patient operating surface. Optionally, the adjustment is performed manually.

In some embodiments, support <NUM> is attached to port <NUM> of a motor unit <NUM>, device <NUM> being supported by attachment to motor unit <NUM>.

In some embodiments, port <NUM> is placed at an opening to the patient's body, for example at an incision and/or at a natural body orifice such as the vagina and/or anus and/or mouth. In some embodiments, port <NUM> is attached to the patient's body using sutures and/or other attachment means. Additionally or alternatively, port <NUM> is fixated to the operating surface <NUM>.

In some embodiments, support <NUM> includes a plurality of articulations where angles between segments and/or segment lengths are adjustable, for example, enabling adjustment of position and/or angle of a device <NUM> including surgical arms and/or a port <NUM> and/or motor unit <NUM> (e.g. which actuate device <NUM> arm/s).

In some embodiments, one or more motor is used to move device <NUM>, with respect to one or more portions of the system (e.g. with respect to port <NUM> and/or motor unit <NUM>), for example, into and/or out of a patient. In some embodiments, motor unit <NUM> includes one or more motors for movement of one or more device arms with respect to the motor unit, where, for example, one or more support segment positions is changed with respect to the motor unit. In some embodiments, movement of device <NUM> is controlled by a user, optionally using input object control and/or a user interface.

<FIG> is a simplified schematic view of a system <NUM> where a device <NUM> is held by a support <NUM>, according to some embodiments of the invention.

In some embodiments, a device <NUM> is coupled to a bed <NUM>. In some embodiments, a patient <NUM> lies on bed <NUM> for surgical procedures using device <NUM>. In some embodiments, one or more components of the device, for example one or more parts of device control (e.g. motors) are located underneath bed <NUM>, e.g. in a housing <NUM>. In some embodiments, support <NUM> connects device <NUM> to housing <NUM>. Optionally, other components, for example transformers, connectivity to other components e.g. the display, are located in housing <NUM>.

In an exemplary embodiment, a main motor unit for control of movement of the device is located in housing <NUM>, where for example, in some embodiments, torque transfer element/s transfer torque from motor/s within housing <NUM> to device <NUM> and/or elongated elements for effecting flexion of device joints are coupled to motors within housing <NUM>.

In some embodiments, control of movement of the device above the bed, using a motor unit underneath the bed is via an orientation controller, for example using a parallelogram linkage, e.g. as described in International Patent Application Publication No. <CIT>.

A potential benefit of one or more components being located underneath a bed (e.g. inside housing <NUM>), is reduced footprint of the system in an operating room. A further potential benefit of components being located underneath a bed as opposed to above and/or around the bed is potentially improved access to a patient (e.g. in an emergency situation).

A potential benefit of the device being coupled to a bed is the ability to move and/or change an angle of the bed, for example, during surgery, while the device remains in the same position relative to the bed and/or patient. Alternatively, or additionally, in some embodiments, a device position with respect to the patient and/or the bed is adjustable, for example, before treatment with the device and/or during surgery.

Optionally, in some embodiments, support <NUM> moves device <NUM> into position for surgery. In some embodiments, support <NUM> moves device <NUM> into a desired position for insertion into patient <NUM>. In some embodiments, support <NUM> moves device <NUM> vertically, and/or horizontally, and/or laterally, and/or inserts device <NUM> into a patient <NUM> and/or withdraws device <NUM> from the patient.

In the embodiment illustrated by <FIG>, support arm <NUM> and housing <NUM> are located at the foot end of bed <NUM>. A potential benefit of this location is ease of surgery through a patient's undercarriage, for example, through the vagina. In <FIG>, patient <NUM> is illustrated in a suitable position for insertion of the device into the vagina, the patient's legs are elevated and apart (e.g. held by stirrups which are not shown).

<FIG> is a simplified schematic view of a system <NUM> where a device <NUM> is held by a support <NUM>, according to some embodiments of the invention. In the embodiment illustrated by <FIG>, support arm <NUM> and housing <NUM> are located at a long axis center of the bed <NUM>. A potential benefit of this location is ease of abdominal and/or thoracic surgery using the device.

In some embodiments, a housing position underneath the bed and/or a position around the bed from where the arm meets the housing are adjustable. For example, the arm and/or housing are moved for different surgeries.

<FIG> is a simplified schematic cross sectional view of an arm <NUM> with nested segment extensions, according to some embodiments of the invention. <FIG> is a simplified schematic of a side view of a portion of an arm, according to some embodiments of the invention. Dashed lines illustrate the portion of the arm illustrated in <FIG> illustrated by <FIG>.

In some embodiments, arm <NUM> includes a hand tool <NUM> coupled to a radius <NUM> at a wrist joint <NUM>.

In some embodiments, radius <NUM> is coupled to a radius extension including two torque transfer portions; an elbow torque transfer portion 416ETT disposed inside an elbow joint <NUM> and a shoulder torque transfer portion 416STT disposed inside a shoulder joint <NUM>. In some embodiments, radius <NUM> is coupled to a humerus <NUM> by a connector 416C. In some embodiments, portion 416C connects radius <NUM> to humerus <NUM> whilst allowing free rotation of humerus <NUM>. In some embodiments, at region A of <FIG>, protrusion/s on radius portion <NUM> fit into indentation/s on portion 416C. In an exemplary embodiment, a ring shaped protrusion on radius portion <NUM> (e.g. a ring of material connected (e.g. welded) to radius portion <NUM>) fits into an indentation on portion 416C. Similarly, in some embodiments, portions 412C and <NUM> are connected by matching protrusion/s and indentation/s (e.g. a ring protrusion on portion <NUM> fitting into a matching indention in portion 412C).

In some embodiments, a "connecting section" includes a connector and a joint, for example shoulder joint <NUM> and connector 412C, and for example elbow joint <NUM> and connector 416C.

<FIG> is a simplified schematic cross sectional view of a portion of an arm, according to some embodiments of the invention. In some embodiments, for example, a portion includes a ring protrusion which fits into an indentation on portion 416C.

In some embodiments, portion 416C provides anchoring to one or more elongated elements: for example, where elongated element/s (e.g. a cable, a wire, a tape) are connected/coupled to portion 416Canc.

In some embodiments, one or more connectors couple portions whilst allowing one portion to rotate within the connector about the portion's long axis. For example connecting portion 416C allows radius <NUM> to rotate within connecting portion 416C about a radius long axis.

In some embodiments, humerus <NUM> is coupled to a humerus extension including one torque transfer portion, a shoulder torque transfer portion 412STT disposed inside shoulder joint <NUM>. In some embodiments, the humerus is coupled to a torso <NUM> by a connector 412C.

In some embodiments, a surgical arm includes a first and a second flexible portion (e.g. elbow joint and shoulder joint) which are coupled together with a short connecting segment (e.g. a humerus section coupling a shoulder and elbow joint is short). In some embodiments, coupling between the flexible portions is a point connection (e.g. a shoulder and elbow joint are directly connected).

In some embodiments, a rigid anchoring portion (e.g. portion 416C) connects two flexible portions, where the anchoring portion provides anchoring of elongated elements which control flexion and extension of the joint which is, for example, proximal to the elongated portion. In some embodiments, anchoring is provided by a portion of one of the joints, e.g. a distal portion of the proximal joint.

In some embodiments, one or more shafts (or portions thereof) of the surgical arm are rigid. In some embodiments, a flexible shaft is nested within a rigid outer shaft. In some embodiments, the outer shaft is flexible to a lower extent than the inner shaft.

<FIG> schematically illustrates actuation of a surgical arm <NUM>, according to some embodiments.

In some embodiments, a proximally extending shaft extension <NUM> (e.g. an extension of a torso <NUM>) of arm <NUM> is attached to a motor unit <NUM>. In some embodiments, proximal shaft extensions of arm segments that are nested within extension <NUM> (e.g. a proximal shaft extension <NUM> of humerus <NUM>, a proximal shaft extension <NUM> of radius <NUM> that is nested within humerus extension <NUM>, a proximal shaft extension <NUM> of a hand portion <NUM> that is nested within radius extension <NUM>, and so forth) are actuated by a plurality of actuation mechanisms of the motor unit, such as <NUM> actuation mechanisms <NUM>, <NUM> and <NUM>. In some embodiments, the number of actuation mechanisms is set in accordance with the number of joints of the arm, for example, as shown herein, an arm including <NUM> joints (e.g. shoulder, elbow and wrist joints) is actuated by <NUM> actuation mechanisms, an arm including <NUM> joints is actuated by <NUM> actuation mechanisms, an arm including <NUM> joints is actuated by <NUM> actuation mechanisms, an arm including <NUM> joint is actuated by a single actuation mechanism.

In some embodiments, an actuation mechanism <NUM> (shown in the enlarged view) is configured to move at least a segment of arm <NUM>, for example rotate the segment and/or bend the segment and/or otherwise move the segment. In some embodiments, an actuation mechanism comprises one or more actuators, for example <NUM>, <NUM>, <NUM>, <NUM>, <NUM> and/or <NUM> actuators. In some embodiments, the actuators are independently operable, yet, in some embodiments, a shaft manipulation (e.g. rotation, bending) obtained by a first actuator effects control of one or more other actuators.

In some embodiments, actuators of the same actuation mechanism are actuated together. Additionally or alternatively, actuators of different actuation mechanisms are actuated together, for example to provide for articulation of a proximal arm segment, a distal arm segment (which is at least partially nested within the proximal arm segment) needs to be moved as well. In an example, to provide for flexion of the shoulder, a bending actuator of an elbow is actuated as well.

In some embodiments, for example as shown herein, shaft extensions <NUM> and <NUM> (which is nested, in part, within shaft extension <NUM>) are received within actuation mechanism <NUM>. In some embodiments, actuation mechanism <NUM> comprises a first actuator <NUM>, and a second actuator <NUM>. In some embodiments, first actuator <NUM> is configured to rotate an arm portion, such as rotate the torso by rotating shaft extension <NUM> around its axis. In some embodiments, second actuator <NUM> is configured to bend an arm portion, such as bend a shoulder joint at a distal end of the torso (not shown herein). Optionally, bending is achieved by respective linear movement of elongate elements <NUM> and <NUM>, which extend from actuator <NUM> and are connected distally to the joint.

In some embodiments, a prime mover of an actuator such as <NUM> and/or <NUM> comprises a motor <NUM>. In some embodiments, a speed of motor <NUM> ranges between, for example, <NUM>-<NUM> rpm, such as <NUM> rpm, <NUM> rpm, <NUM> rpm, <NUM> rpm or intermediate, higher or lower speeds. In some embodiments, motor <NUM> is configured to apply a torque between <NUM> N*M to <NUM> N*m, such as <NUM> N*m, <NUM> N*m, <NUM> N*m or intermediate, higher or lower values. In some embodiments, motor <NUM> is a continuous rotation motor.

Additionally or alternatively, a prime mover of an actuator comprises a linear motor. Additionally or alternatively, a prime mover of an actuator comprises a pulley. In some embodiments, the prime mover of an actuator is manually operated, for example comprising one or more cables that are pulled on to actuate movement of the gear.

In some embodiments, a single motor is configured to move more than one actuator (e.g. rotate both the bending and rotation gears). In some embodiments, dual-actuation is enabled by use of a locking mechanism and another motor configured for switching between the actuators, based on the selected articulation (e.g. bending or rotation).

In some embodiments, motor <NUM> is positioned parallel to the shaft extension, for example underlying the shaft extension, overlying the extension and/or positioned beside the extension. Alternatively, motor <NUM> is disposed within an internal lumen of the shaft extension. Alternatively, the shaft extension is configured as a part of the motor, for example contained within an external housing of motor <NUM>.

In some embodiments, an actuator comprises a single gear or a gear train. In some embodiments, the gear train is configured to amplify the input torque generated by motor <NUM>. Alternatively, the gear train is configured to reduce the input torque generated by motor <NUM>. In some embodiments, the gear train is configured to reduce the rotation speed generated by the motor. In an example, the motor speed is <NUM>,<NUM> RPM, and the gear or gear train reduces the speed by a ratio of, for example, <NUM>:<NUM>, <NUM>:<NUM>, <NUM>:<NUM> and/or intermediate, higher or lower ratios. In an example, a gear or gear train actuating movement of an end-effecter of the arm such as grippers is configured to reduce the speed by a ratio of <NUM>:<NUM> , enabling fast opening and closure of the gripper. This may be advantageous, for example, when dissecting tissue using the gripper.

Alternatively, in some embodiments, the gear train is configured to increase the output speed generated by the motor. In an example, the output speed of the motor is increased for autonomous electrical ablation of tissue.

In some embodiments, actuators of an actuation mechanism comprise gears or gear trains that are different from each other. In some embodiments, the motors of the two actuators are rotated at similar speeds, but the "final" movement manipulating gears of each actuator are rotated at different speeds. In an example, actuator <NUM> comprises a gear transmission while actuator <NUM> is driven directly by the motor. In another example, the actuators each comprise a single gear, but the gears are of different sizes and/or shapes (e.g. comprising different numbers of teeth).

In an example, actuator <NUM> comprises a gear that is configured to rotate shaft extension <NUM> directly, rotating at a speed, of, for example, <NUM> RPM; actuator <NUM> comprises a gear that is configured to actuate bending by linearly moving elongated elements <NUM> and <NUM>, optionally by rotation of a threaded screw coupled to the elements for example as described hereinbelow, and due to this additional transmission the gear of actuator <NUM> needs to be rotated faster than gear of actuator <NUM>, for example rotated at a speed of <NUM> RPM.

In another example, an actuator that actuates an end-effecter such as a gripper is configured to rotate at a relatively fast speed, for example <NUM> RPM for enabling fast movement.

Alternatively, in some embodiments, it is desired to actuate an end-effecter at a relatively low speed, for example for action requiring applying of relatively large force via the end-effecter, such as separating tissue, stapling tissue, and/or other actions.

In some embodiments, actuators <NUM> and <NUM> are rotated on a single rotational axis <NUM>. In some embodiments, axis <NUM> is also the rotational axis of shaft extensions <NUM> and <NUM>.

In some embodiments, actuation mechanisms <NUM>, <NUM>, <NUM> of the motor unit are collinear.

In some embodiments, the motor unit includes one or more position sensors <NUM>.

In some embodiments, position sensor <NUM> is placed adjacent the motor for sensing a current rotation angle of the motor.

In some embodiments, the position sensor is magnetically operated, using a magnet placed on the motor gear and sensing the magnetic flux to determine a current position of the motor gear.

In some embodiments, the motor unit is controlled by a processor <NUM> including a memory which stores commands.

In some embodiments, data from position sensor/s and/or from control memory is used to infer a position of the device portion/s.

In some embodiments, the motor unit is controlled by a processor configured in the user's input device.

In some embodiments, motor unit <NUM> includes structure (e.g. including electrical contact/s), for example, for delivery of monopolar and/or bipolar energy to the device (e.g. to a device end effecter), for example as further described in <FIG>.

<FIG> is a simplified schematic side view of a motor unit <NUM> for actuation of a device including surgical arms, according to some embodiments of the invention. In some embodiments, a device including a first surgical arm <NUM> and a second surgical arm <NUM> are controlled by motor unit <NUM>.

<FIG> is a detailed view of the motor unit <NUM>, according to some embodiments.

In some embodiments, a first actuation mechanism 601a, including first rotation gear 602a and first bending gear 606a, drives flexion/extension and rotation of a shoulder joint. Referring now to <FIG>, for example, in some embodiments, first actuation mechanism 601a rotates the shoulder joint by rotating torso <NUM> and effects flexion and extension of shoulder joint <NUM> by movement of elongated elements attached to connector 412C.

In some embodiments, a second actuation mechanism 601b, including second rotation gear 602b and second bending gear 606b, drives flexion/extension and rotation of an elbow joint.

In some embodiments, one or more driving gears coupled to a motor <NUM> is disposed underneath motor unit <NUM>. For example, in some embodiments, a gear which drives second bending gear 606b, which gear is coupled to a motor is disposed on an underside of motor unit <NUM>. For example, gear <NUM> drives a second actuation mechanism corresponding to second surgical arm <NUM>. Referring now to <FIG>, for example, in some embodiments, second actuation mechanism 601b rotates the elbow joint by rotating humerus <NUM> and effects flexion and extension of elbow joint <NUM> by movement of elongated elements attached to portion 416C.

In some embodiments, a third actuation mechanism 601c, including third rotation gear 602c and third bending gear 606c, actuates an end effecter (e.g. opens and closes a gripper) and drives rotation of a wrist joint. Referring to <FIG>, in some embodiments, rotation gear 602c rotates radius <NUM> and bending gear 606c actuates hand tool <NUM>; For example, in some embodiments, rotation of third bending gear 606c opens and closes an end effecter.

In some embodiments, similarly, second surgical arm <NUM> is actuated by three actuation mechanisms, including, for example, <NUM> motors. In an exemplary embodiment, a device for insertion into the body includes two surgical arms, actuated by <NUM> motors.

In some embodiments, one or more additional motors (e.g. a 13th motor) moves the device arms towards and/or away from the motor unit. For example, in some embodiments, a position of attachment of the motor unit (e.g. to a support and/or to a patient support surface) is changed e.g. by a motor.

In some embodiments, the device comprises a single arm actuated by a motor unit comprising <NUM> motors (e.g. <NUM> motors per each actuation mechanism). In some embodiments, a <NUM>th motor is used for linearly moving the arm, for example towards and/or away from the motor unit and/or from the patient's body.

In some embodiments, one or more additional motors (e.g. an <NUM>th motor, a <NUM>th motor) are used. Optionally, the additional motor(s) actuate movement of an end-effecter of the arm around a pivot point (fulcrum movement), for example around the incision.

For example, referring to <FIG>, in some embodiments, a position of attachment of support <NUM> with respect to rail <NUM> is changed (e.g. by a motor located on support <NUM>). For example, in some embodiments, a position of attachment of motor unit <NUM> with respect to support <NUM> is changed (e.g. by a motor located on support <NUM>), for example, for moving the device into and/or out of a patient body e.g. when the motor unit is supported in a fixed configuration and/or to automate movement of the device into the patient. In some embodiments, a motor located within motor unit <NUM> moves the device arms into and/or out of a patient.

In some embodiments, for example, so that rotation of a joint also causes rotation of joints distal of the rotated joint, more than one actuation mechanism is driven in rotation of the joint. For example, in some embodiments, for rotation of the shoulder joint, gears 602a, 606a, 602b, 606b, 602c, and 606c are rotated in the same direction. For example, in some embodiments, for rotation of the elbow joint, gears 602b, 606b, 602c, and 606c are rotated in the same direction. For example, in some embodiments, for rotation of the end effecter, gears 602c and 606c are rotated in the same direction.

In some embodiments, concurrent rotation of nested portions with outer portions prevents stress on and/or tangling of internal elongated elements (e.g. elongated element/s which are used to effect flexion/extension, e.g. elongated element/s providing power supply).

In some embodiments, one or more actuation mechanisms is used to flex/extend a joint. For example, in some embodiments, to bend a shoulder joint, elongated elements for bending of both the shoulder joint and elbow joint are moved, for example by actuating bending gear 606a and bending gear 606b.

In some embodiments, if elongated elements for the elbow are not moved and/or released, tension in the elongated elements associated with the elbow joint resist movement of the shoulder joint.

In some embodiments, a motor unit is small, for example having a long axis length <NUM> of between <NUM>-<NUM>, or <NUM>-<NUM>, or <NUM>-<NUM>, or <NUM>-<NUM>, or intermediate, longer or shorter lengths. In some embodiments, a width <NUM> of the motor unit (e.g. as measured perpendicular to the long axis) is between <NUM>-<NUM>, or <NUM>-<NUM>, or <NUM>-<NUM>, or intermediate, longer or shorter widths.

In some embodiments, motor <NUM> is cylindrical. Optionally, a diameter of motor <NUM> is less than <NUM>, less than <NUM>, less than <NUM> or intermediate, larger or smaller diameters. A potential advantage of disposing a motor of a relatively small diameter in a parallel position relative to the arm may include maintaining the dimensions of the motor unit small.

Alternatively, the motor is not cylindrical, for example rectangular. In some embodiments, the motor comprises a hollow shaft. A potential advantage of a hollow shaft may include reducing the footprint of the system in the operating room.

In some embodiments, electric power is supplied through wires to the motor unit, for example, in some embodiments, contacts <NUM> are connected to an electric power supply. The electric power supply may include a battery (optionally rechargeable) and/or a generator and/or connection to the electrical network via a wall socket and/or a combination thereof. In some embodiments, the power range is between <NUM>-300W, for example 150W, 200W, 250W or intermediate, higher or lower ranges. In some embodiments, an uninterruptible power supply source is used to protect from power interruptions.

In some embodiments, a motor unit drives more than two surgical arms and/or drives additional device elements. For example, in some embodiments, a motor unit drives two device arms and a camera.

<FIG> is a cross-section of the motor unit along the length of the unit, showing actuation mechanisms of a single surgical arm, according to some embodiments. In some embodiments, the motor unit comprises a motherboard <NUM>, optionally underlying the actuation mechanisms. In some embodiments, one or more driver circuits <NUM> are operably coupled to motherboard <NUM> for controlling operation of the motor unit. In some embodiments, each driver circuit is configured to control activation of one of the motors (e.g. one of the <NUM> motors described hereinabove). In some embodiments, cross-control of the motors is provided. In an example, a position sensor of a first motor is controlled by a controller of a second motor. Optionally, in such a configuration, upon malfunctioning of the first motor, position sensor associated with the first motor and/or driver controlling the first motor can be detected by the controller of the second motor.

In some embodiments, an external housing <NUM> of the motor unit comprises a handle <NUM> for attaching and/or releasing arm <NUM> from a distal end face <NUM> of the motor unit.

In some embodiments, one or more latches <NUM> are configured on external housing. Optionally, latch <NUM> is configured to release a gear fixation mechanism used, for example, during attachment of the surgical arm to the motor unit to maintain calibration of the motor unit, for example as further described herein.

<FIG> is a cross section of the motor unit along an axis perpendicular to the long axis, according to some embodiments.

In some embodiments, the motor unit is configured to actuate two surgical arms; in this example, one surgical arm <NUM> (an extension of which) is shown to be received within a first side of the motor unit, while the second opposing side is shown in a configuration suitable for receiving a second arm, for example within internal lumen <NUM>.

It is noted that in some embodiments a motor unit configured for actuating a single arm is comprised of only of one of the sides of the motor unit shown herein, including, for example, <NUM> actuation mechanisms.

In some embodiments, for example as shown herein, actuation gears <NUM> and <NUM> of motors <NUM> and <NUM> respectively are each configured to drive a gear of an actuation mechanism, for example actuation gear <NUM> of motor <NUM> is configured to drive rotation gear or bending gear <NUM> (such as gear 602a or 606a or 602b or 606b or 602c or 606c).

In some embodiments, latch <NUM> configured at the first side of the motor unit in which the arm is received is shown at a closed position, which releases a fixation mechanism of gear <NUM>, allowing it to rotate freely; a second latch <NUM> configured at the second side of the motor unit, shown without an arm, is shown at an open, lifted position.

In some embodiments, a motor such as <NUM> is disposed such that it does not extend to a distance <NUM> longer than <NUM>, <NUM>, <NUM> or intermediate, longer or shorter distances relative to a central long axis of an actuation mechanism, for example passing through a center <NUM> of rotation/bending gear. A potential advantage of a motor disposed adjacent an actuation mechanism, optionally in parallel to the actuation mechanism such that it substantially does not protrude outwardly or protrudes outwardly to a short distance only, may include reducing bulkiness of the motor unit, potentially allowing insertion of the surgical arm(s) as well as the motor unit into the body during operation.

In some embodiments, the motor unit is coupled to a linear unit <NUM>, configured for actuating linear movement of the motor unit (and thereby of the arm(s)), for example to actuate advancement and/or retraction of the device to and/or from the patient body. In some embodiments, linear unit <NUM> comprises a rail <NUM> on which a sliding element <NUM> coupled to the motor unit can be moved linearly. In some embodiments, movement (e.g. sliding) of the motor unit on the rail of the linear unit is actuated by a motor.

Alternatively, in some embodiments, the linear unit is an integral component of the motor unit.

In some embodiments, the linear unit comprises one or more sensors, such as microswitches, for detecting movement of the motor unit. In some embodiments, the linear unit comprises one or more actuation buttons configured to provide for a user (e.g. nurse) to move the motor unit according to the need. In some embodiments, the motor driving the linear movement (not shown herein) comprises an electro-magnetic break. Optionally, the brake is configured to avoid unwanted movement (e.g. slipping) of the motor unit, for example during a power outage.

<FIG> is a flowchart of exemplary operation of an actuation mechanism comprising a rotation gear and a bending gear, according to some embodiments.

In some embodiments, actuation of a gear comprises actively rotating the gear at a certain speed and/or direction, for example by the motor. In some embodiments, actuation of the bending gear (<NUM>) generates bending of the joint (<NUM>), for example by simultaneous flexion and extension. Optionally, simultaneous flexion and extension is obtained by relative tensioning and releasing of elongated elements extending along the arm segment being moved and connected at a point distal to the joint (e.g. flexible segment).

In some embodiments, an articulation actuated by rotation gear (<NUM>) depends on movement of the bending gear. In some embodiments, for example when the arm is placed in the motor unit, free rotation of the bending gear is resisted at least in part by a gear that drives the bending gear, for example in some embodiments the motor gear or a second gear driven by the motor gear. Optionally, in such a situation, actuation of the rotation gear whilst the bending gear is held stationary generates rotation of an arm segment proximal to the joint as well as bending of the joint (<NUM>).

In some embodiments, when no resistance is imposed on the bending gear, actuation of the rotation gear will bring about rotation of the bending gear, resulting in rigid "single body" rotation of the arm (<NUM>).

In some embodiments, both gears are actuated together.

In some embodiments, relative actuation of the gears (<NUM>), including, for example: holding the bending gear stationary and rotating the rotation gear; rotating the gears at different speeds and/or directions generates bending (<NUM>).

In some embodiments, unified actuation of both gears (<NUM>), i.e. rotating the bending gear and the rotation gear at the same speed and direction generates "single body" rotation (<NUM>), in which the actuated arm segment moves as a whole.

In some embodiments, bending gears and/or rotation gears of more than one actuation mechanism (e.g. <NUM>, <NUM>, <NUM>) are actuated simultaneously. Optionally, actuation of more distal, nested arm portion(s) is performed so as to allow movement of a more proximal arm portion. For example, when bending the shoulder joint, bending gears of both the shoulder and the elbow are actuated (e.g. 606a, 606b) so as to release tension from the elongate element operating the elbow which will in turn allow for bending of the shoulder. In an example, if 606a was to be solely rotated to bend the shoulder, a tensioned elongate element operating the elbow may tear.

<FIG> is a simplified schematic side view of an actuation mechanism for control of a surgical arm joint, according to some embodiments of the invention.

In some embodiments, a rotation gear <NUM> is coupled to a shaft <NUM>, where shaft <NUM> is coupled to an extension (e.g. to torso <NUM>, <FIG>). In some embodiments, rotation of rotation gear <NUM> causes rotation of shaft <NUM> which in turn rotates the distal extension coupled to the shaft.

In some embodiments, a shaft <NUM> which is nested, at least in part, within shaft <NUM> extends in the proximal direction to a bending gear <NUM>.

In some embodiments, bending gear <NUM> is coupled to a portion including screw threading, referred to herein as threaded screw <NUM>. In some embodiments, a threading on screw <NUM> comprises a double thread. In some embodiments, rotation of the double thread in one direction achieves bidirectional lateral movement of one or more rider elements, such as half-nuts referred to hereinbelow, coupled to the screw.

In some embodiments, a pitch <NUM> of the screw thread is selected according to the use of the arm. For example, a small thread pitch is more advantageous when the arm is configured to operate large loads, for example a load of <NUM> grams, <NUM> grams, <NUM> grams or intermediate, larger or smaller loads at a low speed (e.g. <NUM> rounds per second, <NUM> round per second, <NUM> rounds per second). Alternatively, a large thread pitch is more advantageous when the arm is configured to operate small loads, for example <NUM> grams, <NUM> grams, <NUM> grams or intermediate, larger or smaller loads at a higher speed (e.g. <NUM> rounds per second, <NUM> rounds per second, <NUM> rounds per second).

In some embodiments, rotation of the bending gear <NUM> causes rotation of threaded screw <NUM>. In some embodiments, a first half nut <NUM> and a second half nut <NUM> are coupled to screw threaded screw <NUM> such that rotation of the screw threading generates linear movement of half-nuts parallel to a long axis <NUM> of central shaft <NUM>, where first half-nut <NUM> and second half-nut <NUM> move in different directions.

In some embodiments, each of the half-nuts is limited to movement in a single direction, for example a right handed half-nut and a left handed half-nut. In some embodiments, movement of the half-nuts is limited by one or more protrusions, for example protrusions extending radially inward from an inner wall of housing <NUM>, for example as further described herein.

In some embodiments, first half nut <NUM> and second half nut <NUM> are connected to elongated elements 810ee and 812ee respectively, where linear movement of the nuts pulls one elongated element whilst releasing and/or pushing on the other, generating flexion/extension of the joint. In some embodiments, a distance <NUM> between the half-nuts, measured along an axis perpendicular to the long axis, defines the distance between the elongated elements. In some embodiments, distance <NUM> between the elongated elements remains constant. In some embodiments, first nut <NUM> is configured remain in line with elongated element 810ee, and second nut <NUM> is configured to remain in line with elongated element 812ee.

In some embodiments, an elongated element such as 810ee and/or 812ee comprises a wire, cable, ribbon, tape and/or any other element which can be tensioned and released to provide for bending of the joint.

It is noted that in some embodiments, only one elongated element is used. In an example, the mechanism comprises one elongated element and an elastic element such as a spring. Optionally, the spring is configured to move relative to the elongated element, for example if the elongated element is flexed, the spring is extended and vice versa. It is also noted that in some embodiments, more than two elongated elements (e.g. <NUM>, <NUM>, <NUM>, <NUM>) may be used.

In some embodiments, actuation of the rotation gear rotates the arm segment and thereby pulls on the elongated elements, moving the half-nuts. If the bending gear is held stationary (e.g. by the motor gear), the threaded screw will not rotate, generating simultaneous rotation and bending of the arm segment. If the bending gear is free to rotate, pulling on the elongated elements will in turn move the half-nuts, rotating the threaded screw. Friction at interface <NUM> between a head of the threaded screw and bending gear <NUM> will in turn rotate the bending gear, generating rotation of the arm segment as one piece.

In some embodiments, one or both of the elongated elements is coupled to an elastic element such as a spring. Optionally, the spring is configured to limit tensioning of the elongated element(s), yielding in response to a force (e.g. torque and/or pulling force) above a certain threshold.

<FIG>are cross section views of the actuation mechanism along the long axis (8B) and along an axis perpendicular to the long axis (8C). <FIG> shows housing <NUM> extending between rotation gear <NUM> and bending gear <NUM>. Threaded screw <NUM> and half-nuts <NUM> and <NUM> are shown at a cross section. <FIG>, viewed from a proximal to distal direction, shows radially inward protrusions <NUM> which are configured to limit rotational movement of the nuts, for example so as to keep a constant cross-distance between the half-nuts, for example during rotation of threaded screw <NUM>.

In some embodiments, elongated elements 810ee and/or 812ee are positioned within designated elongated grooves <NUM> configured in housing <NUM> (see <FIG>) such that actuation of rotation gear <NUM> does not twist the elongated elements about the long axis of the actuation mechanism. Optionally, a cross-wise position of the elongated elements relative to each other is maintained constant.

In some embodiments, housing <NUM> covers the central shaft, screw threading and nuts, for example, potentially preventing debris or other material from entering the mechanism. In some embodiments, housing <NUM> is cylindrical.

In some embodiments, each mechanical device joint is coupled to an actuation mechanism as described above (e.g. by an extension coupled to the joint). For example, in some embodiments, each extension portion (e.g. as describe above) is coupled to a central shaft, and elongated portions for control of flexion and extension (e.g. as described above) are coupled to half-nuts of the actuation mechanism.

In some embodiments, actuation mechanisms for a single surgical arm are arranged linearly, with central shafts disposed in a nested configuration, the inner central shafts protruding for control by the gears.

<FIG>schematically illustrates, at a cross section, different layers of a structure of the actuation mechanism for articulating nested arm segments, according to some embodiments. In <FIG>, an extension <NUM> of the shoulder (e.g. a torso <NUM>, for example as shown in <FIG>) is operably received within a rotation gear <NUM> of a first actuation mechanism <NUM>, according to some embodiments. <FIG> illustrates elongated elements <NUM> and <NUM> for actuating bending of the shoulder in response to rotation of threaded screw <NUM>, according to some embodiments. In <FIG>, an extension <NUM> of the elbow (e.g. an extension of a humerus <NUM>, for example as shown in <FIG>), which is nested, at least in part, inside extension <NUM> of the shoulder, is received within an internal lumen of threaded screw <NUM>. In some embodiments, elbow extension <NUM> is freely received within threaded screw <NUM> such that rotation of the screw does not affect rotation of elbow extension <NUM>. <FIG> illustrates a proximal portion of elbow extension <NUM> operably received within a rotation gear <NUM> of a second actuation mechanism <NUM>, aligned proximally (and, in some embodiments, linearly) relative to first actuation mechanism <NUM>. Optionally, in this manner, additional nested extensions (e.g. a wrist extension such as radius <NUM>) are freely received within a more proximal actuation mechanism and operably received within a more distal actuation mechanism.

<FIG>illustrates a clutch mechanism, according to some embodiments of the invention.

In some embodiments, an elastic element such as a spring is used for setting a minimal and/or maximal actuation force, according to some embodiments.

In some embodiments, as shown for example in <FIG>, threaded screw <NUM> is coupled to a central spring <NUM>. In some embodiments, rotation of screw <NUM> applies torque and/or tension to spring <NUM>. Optionally, when the applied force tensions (e.g. linearly pulls and/or twists) spring <NUM> beyond its elastic limit, the spring yields and further rotation of screw <NUM> is no longer effective to move elongated elements <NUM> and <NUM> (shown in <FIG>).

Additionally or alternatively, one or both of the elongated elements are coupled to an elastic element such as a spring <NUM>, for example attached between a proximal end of the elongate element and the half-nut <NUM>. In some embodiments, rotation of screw <NUM> actuates linear movement of the elongated elements, for example pulling elongated element <NUM>. Optionally, when an elongate element such as <NUM> is tensioned above a certain threshold, spring <NUM> yields and rotation of the screw is no longer effective to move (e.g. pull proximally) the elongate element.

<FIG>illustrate various configurations of an actuation mechanism, according to some embodiments.

<FIG> illustrates a configuration in which three actuators <NUM> are configured to manipulate a shaft <NUM> (or a distal extension thereof). In some embodiments, actuators <NUM> include, for example, a rotation actuator, a bending actuator, a linear actuator configured to move the shaft back and forth, or combinations thereof (for example, two bending actuators and one rotation actuator, etc).

<FIG> shows a telescopic configuration in which, for example, an actuator <NUM> is configured to extend shaft portions distally and/or approximate shaft portions proximally, for example using elongated elements <NUM> attached to a protruding end of a shaft <NUM>.

In some embodiments, an actuator <NUM> is shaped and/or sized such that the shaft or only some portions thereof are slidably received in it, for example the shaft or a portion thereof can be moved back and forth through the actuator.

<FIG> is a flowchart of a method for maintaining calibration of a surgical arm, according to the invention.

In some embodiments, surgical device arms are initialized to a straight position, in which segment long axes are parallel (e.g. collinear), for example as shown in <FIG>. Optionally, a direction of bending <NUM> of first arm segment <NUM> is lined with a direction of bending <NUM> of second arm segment <NUM>.

In some embodiments, surgical device arms are provided in a straight position e.g. factory calibrated to a straight position. In some embodiments, a jig is used to straighten surgical device arm/s.

In some embodiments, a configuration of the actuation mechanism(s) is set in accordance with the calibrated configuration of the arm, for example, the gears are rotated to a position in which all arm portions are straightened relative to each other.

In some embodiments, one or more mechanisms are provided for maintaining a calibrated position of the arm, for example during insertion of the arm (or extensions thereof) to the motor unit <NUM>, for example as shown in <FIG>. In some cases, arm extensions may be unintentionally rotated, for example when moved against the motor gear <NUM> during insertion. In some embodiments, one or more mechanisms are provided to prevent such movement.

Optionally, during insertion, motor gear <NUM> is allowed to move (for example so as not to interfere with advancement of the arm (or extensions thereof) proximally), and once the arm is seated in position, the motor gear is locked until further activation. In some embodiments, motor gear locking and/or releasing is electrically controlled by a micro-switch connected to the motor.

In the exemplary mechanism described herein, actuation mechanism(s) of the arm are temporarily fixated (<NUM>). In some embodiments, temporary fixation is achieved by one or more elements configured to interfere with rotation of the gears (e.g. rotation and/or bending gears).

In some embodiments, for example once the arm is fully received within the motor unit, the temporary fixation of the gears is released (<NUM>). Optionally, fixation is released in response to manual operation by the user, for example closure of a cover door of the motor unit. In some embodiments, the interfering elements are moved away from the gears, for example using spring-based actuation.

In some embodiments, the motor unit comprises one or more calibration discs, configured for indicating whether a gear has moved, for example during insertion of the arm.

<FIG>illustrate a mechanism for maintaining calibration of a surgical arm, according to some embodiments.

In some embodiments, for example during insertion of arm <NUM> to the motor unit <NUM>, interfering elements <NUM> are moved to a position in which they lock gears of the actuation mechanism (e.g. gears <NUM>, <NUM>), preventing the gears from rotating, for example as shown in <FIG>. Optionally, the interfering elements are moved to the locking position by a spring and/or other elastic element <NUM> (positioned behind interfering element <NUM>).

In some embodiments, a lever <NUM> is coupled to the interfering elements. Optionally, when lever <NUM> is pushed on, for example as shown in <FIG>, the interfering elements are moved to a position in which they no longer interfere with rotation of the gears.

In some embodiments, lever <NUM> is pushed on (and/or elevated) in response to closure of a cover door <NUM> of the motor unit, for example as shown in <FIG>. Optionally, locking of latches <NUM> (optionally manually, e.g. by a physician or a nurse) applies pressure onto lever <NUM>, releasing the interfering elements from the gears to provide for articulation of the arm.

<FIG> shows an interfering element comprising an elastic element <NUM> which springs into a locked or released position.

<FIG> is a view of the motor unit <NUM> showing an exposed inner portion of the motor unit, according to some embodiments. <FIG> shows an outer view of the motor unit in which a cover door of the motor unit is open.

In some embodiments, a user (e.g. physician and/or nurse) is provided with internal access to the motor unit. In some embodiments, for example during a power outage, manual override by the physician is enabled. Optionally, the user can access the motor(s), for example to manually operate the motor gear <NUM>. In some embodiments, one or more directing arrows <NUM> are marked on the motor unit housing, optionally indicating a rotation direction in which the gears need to be rotated in order to straighten the arm.

In some embodiments, the cover door <NUM> of the motor unit, see <FIG>, is configured to automatically lock, for example during power outage. Optionally, a solenoid bolt <NUM> locks the cover door. Optionally, the solenoid lock mechanism can be manually overridden, for example by opening the cover door to allow access to at least some of the internal components of the motor unit.

In some embodiments, the solenoid lock mechanism is configured to prevent unintended removal of the arm(s) from the motor unit. In an example, cover door <NUM> cannot be opened until solenoid bolt <NUM> is released, for example by the physician, optionally via the user input device.

In some embodiments, control of arm insertion and/or removal is limited to a user, for example only the physician can control opening and/or locking of the solenoid lock mechanism, for example via the user input device.

In some embodiments, for example during a power outage, power supply is provided by a battery.

<FIG>are examples of safety-related electrical components of the motor unit, according to some embodiments.

Referring to <FIG>, in some embodiments, cross-control over motor activation is provided. In some embodiments, a safety sensor <NUM> is operably coupled to a first motor <NUM>. In some embodiments, control over safety sensor <NUM> (e.g. on/off activation) is performed by a controller of a second motor, for example motor <NUM>. Optionally, the controller detects malfunction of the first motor.

Referring to <FIG>, in some embodiments, power delivery to the arm (e.g. to an electrocautery instrument attached at a distal end of the arm) is controlled with the aid of a relay <NUM>. Optionally, relay <NUM> restricts current delivery when the electrocautery instrument is mistakenly attached to an arm, for example attached to the left arm instead of the right arm or vice versa. In an example, a physician defines (optionally via the user input device) that monopolar energy is delivered to an arm defined as the right arm, and bipolar energy is delivered to an arm defined as the left arm. Optionally, relay <NUM> is configured to detect a mismatch, for example that the bipolar electrocautery tip was attached to the arm defined as the right arm instead of the arm defined as the left arm, and the electric current is ceased.

<FIG> is a simplified side view of a portion of a motor unit including elements for supplying electric power to an end effecter of the surgical arm, according to some embodiments of the invention. In some embodiments, one or more mechanisms are incorporated in the motor unit for ensuring that the electric power supply is not affected by an arm position. Alternatively, the electric power supply is affected by an arm position.

In some embodiments, portion <NUM> is coupled to an end effecter such that, when portion <NUM> is rotated, it rotates an end effecter, for example, portion <NUM> is coupled to hand tool <NUM> of <FIG>. In some embodiments, gear <NUM> actuates the end effecter, for example, rotation of gear <NUM> opens and/or closes jaws of a grasper end effecter. In some embodiments, contacts <NUM> and <NUM> provide electric power to ring portions <NUM> and <NUM> respectively. In some embodiments, one of contacts <NUM>, <NUM> provides positive voltage and the other provides negative voltage, providing a bipolar power supply. In some embodiments, each of ring portions <NUM> and <NUM> is electrically connected (e.g. through wires running through portion <NUM>) to an end effecter, where one of the ring portions is coupled to one side of a grasper and the other to the other side of a grasper.

Claim 1:
A method for maintaining calibration of a surgical arm during attachment of the surgical arm to a motor unit, comprising:
providing a surgical arm (<NUM>) which comprises actuation gears (<NUM>, <NUM>); attaching (<NUM>) a portion of said surgical arm (<NUM>) which includes said actuation gears into a motor unit (<NUM>) while said actuation gears are maintained in a calibrated state by a gear fixation mechanism which prevents said actuation gears from rotating during attachment;
wherein said gear fixation mechanism includes one or more interfering elements (<NUM>) positioned to prevent rotation of said actuation gears (<NUM>, <NUM>);
wherein throughout said attaching, said actuation gears are locked, preventing said actuating gears from rotating;
and characterized in that
said method further comprises closing a cover door (<NUM>) of said motor unit (<NUM>) to activate releasing (<NUM>) of said interfering elements (<NUM>) from said gear-locking position, thereby allowing said actuation gears (<NUM>, <NUM>) to rotate.