CN114340547A

CN114340547A - Sterile barrier system and method for robotic surgical system

Info

Publication number: CN114340547A
Application number: CN202080059391.8A
Authority: CN
Inventors: 佩里·A·杰诺瓦; C·C·沃尔特斯; M·E·劳特; S·W·博克曼; T·B·亨特; M·帕兹; S·A·桑科尔卡
Original assignee: Titan Medical Inc
Current assignee: Titan Medical Inc
Priority date: 2019-06-26
Filing date: 2020-06-16
Publication date: 2022-04-12
Also published as: WO2020263630A1; EP3989864A4; CA3143200A1; EP3989864A1; AU2020309050A1

Abstract

A sterile barrier system for a robotic surgical device may include a drape coupling. The drape coupling may include an outer surface configured to face a first surface of a first portion of the robotic surgical device. The drape coupler may include at least one drape coupler fastener positioned at least partially on the outer surface and configured to removably attach the drape coupler to the first surface. The drape coupling may be configured to at least partially cover the first surface. The system may include a drape made of a flexible material and coupled to a drape coupler, the drape configured to wrap around a second surface of the first portion of the robotic surgical device, the second surface being different from the first surface. The drape coupler and drape may be sterile.

Description

Sterile barrier system and method for robotic surgical system

Technical Field

The present disclosure relates generally to robotic surgical systems, and more particularly to sterile barrier systems and methods for such systems.

Background

Prevention of surgical site infection in the operating room is one of the most important goals for the surgical team. Typically, surgical teams accomplish this by creating and maintaining a sterile field, which may include environmental cleaning, sterilization, and instrument sterilization. The creation and maintenance of the sterile zone may impose a requirement that all items used within the sterile zone remain sterile. When using robotic surgical systems in an operating room, the creation and maintenance of sterile zones can present several challenges that have not been addressed by existing approaches. For example, due to size and complexity, it may not be possible to sterilize the entire robotic surgical system. In many cases, partial sterilization may not be feasible or effective. The present disclosure addresses these and other problems associated with known methods for creating and maintaining sterility of robotic surgical systems used in operating rooms.

Disclosure of Invention

A sterile barrier system (or sterile barrier) for a robotic surgical device may include a drape coupler. The drape coupling may include an outer surface configured to face a first surface of a first portion of the robotic surgical device. The drape coupler may include at least one drape coupler fastener positioned at least partially on an outer surface of the drape coupler and configured to removably attach the drape coupler to the first surface. The drape coupler may be configured to at least partially cover a first surface of a first portion of the robotic surgical device. The system may include a drape (drape) made of a flexible material and coupled to a drape coupler, the drape configured to be wrapped around a second surface of the first portion of the robotic surgical device, the second surface being different from the first surface. The drape coupler and drape may be sterile.

The system (or barrier) of any preceding paragraph and/or any system described herein can include one or more of the following features. The first portion of the robotic surgical device may include a manipulator unit. The first surface may comprise a manipulation surface of the manipulator unit. The at least one drape coupler fastener may be configured to removably attach the drape coupler to the manipulation surface of the manipulator unit. The second surface may include at least one side surface of the manipulator unit. The drape may be configured to enclose the at least one side surface of the manipulator unit. The at least one drape coupler fastener may include a ferromagnetic material configured to attach to a magnet positioned on the first surface. The at least one drape coupler fastener may include a plurality of fasteners having a ferromagnetic material and configured to attach to a plurality of magnets positioned on the first surface. The drape may be coupled to the drape coupler along a perimeter of the drape coupler. The drape may include an opening configured to expose a surgical instrument interface of a first portion of the robotic surgical device. The surgical instrument interface may be configured to cause actuation of a surgical instrument, which may be mounted on the surgical instrument interface. The drape coupler may include a sterile adapter configured to be received at the opening and removably attached to the surgical instrument interface. The sterile adapter may be configured to receive and support a surgical instrument and provide a sterile barrier between the surgical instrument interface and the surgical instrument. The sterile adapter may include a plurality of actuator caps configured to couple with a plurality of instrument actuators positioned on the surgical instrument interface. The actuator cap may be configured to be positioned in the first position prior to attaching the sterile adapter to the surgical instrument interface. The actuator cover may be aligned in the first position. The actuator cover may be centrally aligned in the first position. The actuator cap may be configured to move in at least one direction to facilitate at least one of movement or articulation of a surgical instrument supported by the sterile adapter. The drape coupling may include at least one removable protector configured to cover an opening of the drape coupling.

The system (or barrier) of any preceding paragraph and/or any system described herein can include one or more of the following features. The drape coupling may include at least one region made at least partially of a flexible material. The at least one region may be positioned adjacent to the opening and configured to collapse and expand. The at least one region may include a first region and a second region. The first region may be positioned adjacent to a first side of the opening. The second region may be positioned adjacent a second side of the opening, the second side being opposite the first side. The first region and the second region may be configured to collapse and expand in response to movement of the opening. The at least one region may include an insert at least partially made of a material that is more rigid than the material of the at least one region. The insert may be configured to cause the flexible material of the at least one region to fold when the at least one region collapses. The insert may include at least one tapered edge.

The kit may include the system (or barrier) of any of the preceding paragraphs and/or any of the systems described herein. The kit may include a sterile adapter configured to be received at (or fit into or cover) the opening and removably attached to the surgical instrument interface. The sterile adapter may be configured to provide a sterile barrier between the surgical instrument interface and the surgical instrument.

The kit of the preceding paragraph and/or any kit described herein can include one or more of the following features. The sterile adapter may include a plurality of actuator caps configured to be coupled to a plurality of instrument actuators positioned on the surgical instrument interface. The actuator cap may be configured to move in at least one direction to facilitate at least one of movement or articulation of a surgical instrument mounted to (or supported by) the surgical instrument interface. The actuator cover may be positioned in the first position prior to positioning the cover over the surgical instrument interface. The actuator cover may be configured to align in the first position. The sterile adapter may include a retainer surrounding the actuator cap. The retainer may be configured to retain the positioning of the actuator cap in the first position. The retainer may be removable to permit at least one of the actuator caps to move to a position different from the first position.

The system (or barrier) of any preceding paragraph and/or any system described herein can include one or more of the following features. The drape may include at least one drape fastener configured to removably attach the drape to the second (or third) surface of the first portion of the robotic surgical device. The at least one drape fastener may comprise a pliable material and be configured to wrap around the at least one protrusion on the second (or third) surface. The drape may include a first region having a first drape fastener and a second region having a second drape fastener. The first region may be configured to be positioned over the second region and secured to the second region by attaching the first drape fastener to the second drape fastener. The drape may include a cover made of a material that is more rigid than the flexible material of the drape. The cover may be configured to enclose a pin positioned on the second (or third) surface of the first portion of the robotic surgical device and configured to be inserted into an opening of at least one of a surgical instrument insertion device or a camera insertion device of the robotic surgical device. The cap may be configured to provide a sterile barrier between the pin and the opening. A sterile barrier may be disposed between the pin and an opening of at least one of a surgical instrument insertion device or a camera insertion device of the robotic surgical apparatus. The drape may include an insert made of a material that is more rigid than the flexible material of the drape. The insert may be configured to be positioned in an opening in a first portion of the robotic surgical device that receives a portion of an endoscopic camera of the robotic surgical device. The insert may be configured to provide a sterile barrier between the endoscopic camera and the first portion. The insert may include a first elongated side surface and a second elongated side surface, the two side surfaces being connected at one end and unconnected at an opposite end to form an opening (or slot). The opening (or slot) may be configured to be inserted into the opening of the first portion and receive the endoscopic camera.

The system (or barrier) of any preceding paragraph and/or any system described herein can include one or more of the following features. The drape may include a first pocket configured to receive and at least partially enclose a first hand of a user. The first pouch may be configured to facilitate positioning the drape over the first portion of the robotic surgical device (and/or optionally, maintaining sterility of the drape during attachment of the drape to the first portion of the robotic surgical device). The drape may include a second pocket configured to receive and at least partially enclose a second hand of the user. The second pouch may be configured to facilitate positioning the drape over the first portion of the robotic surgical device (and/or optionally, maintaining sterility of the drape during attachment of the drape to the first portion of the robotic surgical device). The second pouch may be different from the first pouch. The first and second pouches may be positioned to allow a user to lift the drape off the second surface while maintaining a sterile barrier for the first portion of the robotic surgical device. The drape coupler may be made of a material that is more rigid than the flexible material of the drape. The manipulator unit may be hexahedral in shape, and the manipulation surface of the manipulator unit may be a bottom surface of the manipulator unit.

An instrument adapter for a robotic surgical device may include a housing configured to receive and support an actuator housing of a surgical instrument. The actuator housing may include a plurality of surgical instrument actuators. The adapter may include a plurality of interface actuators configured to engage and cause movement of the plurality of instrument actuators of the actuator housing. Movement of the instrument actuator causes movement of an end effector of the surgical instrument. The adapter may include a guide configured to receive an actuator housing of the surgical instrument and allow the actuator housing to move within the housing (e.g., forward and backward, side-to-side, or otherwise from one position to another). The guide may be configured to allow the actuator housing to be positioned in the housing in a first orientation in which the interface actuator is not engaged with an instrument actuator of the surgical instrument, thereby facilitating removal of the actuator housing from the housing. The guide may include a protrusion configured to engage an opening in an actuator housing of the surgical instrument to permit installation of the actuator housing into the adapter housing. The adapter may include a fastener configured to engage an actuator housing of the surgical instrument. The fastener may be configured to transition from a first position in which the actuator housing is positioned in a first orientation to a second position in which the actuator is positioned in a second orientation in which the interface actuator is engaged with an instrument actuator of the surgical instrument. The transition of the fastener from the first position to the second position causes rotation of the actuator housing. The fastener may be configured to transition from a first position to a second position along an axis (craft axis) of a shaft of the surgical instrument to which the end effector is coupled.

The adapter of the preceding paragraph and/or any adapter described herein can include one or more of the following features. The guide may be configured to receive the actuator housing at an angle, which may be consistent with the first orientation. The plane in which the guide is oriented may be inclined relative to the plane in which the interface actuator is oriented. The interface actuator may be oriented in a horizontal plane. The fastener may include a latch configured to be locked when the fastener is in the second position. The fastener may be configured to transition from a first position to a second position to cause rotation of the actuator housing from a first orientation to a second orientation. The fastener may include a protrusion configured to engage an opening in an actuator housing of the surgical instrument and cause the actuator housing to rotate. The guide may be configured to not support the actuator instrument housing when the housing is rotated. The guide may be configured to at least partially support the actuator housing when the actuator housing is inserted into the adapter housing and not support the actuator housing when the actuator housing transitions from the first orientation to the second orientation. At least one of the interface actuators may include a distal end and a proximal end opposite the distal end. The distal end may be configured to face a corresponding instrument actuator opening. The at least one interface actuator may be tapered toward the distal end. The interface actuator may be configured to engage with an instrument actuator of a surgical instrument and move from a first position to a second position to cause the instrument actuator to correspondingly move from the first position to the second position. Movement of the instrument actuator causes movement of the end effector. The adapter may be sterile.

The adapter of any preceding paragraph and/or any adapter described herein may include one or more of the following features. The interface actuator may be positioned in a top portion of the adapter housing. The guide may be positioned in a first portion of a side of the housing. The fastener may be positioned in a second portion of the side (or side portion) of the adapter housing.

An instrument adapter for a robotic surgical device may include an adapter housing configured to receive and support an actuator housing of a surgical instrument. The actuator housing may include a plurality of instrument actuators. The adapter may include a plurality of interface actuators supported by the adapter housing. The plurality of interface actuators may be configured to engage with the plurality of instrument actuators of the actuator housing and cause movement of the instrument actuators. Movement of the instrument actuator causes movement of an end effector of the surgical instrument. The adapter may include a guide connected to the adapter housing and oriented at an angle relative to a plane in which the interface actuator is positioned. The guide may be configured to permit installation of the actuator housing of the surgical instrument into the adapter housing in a first orientation in which the interface actuator is not engaged with the instrument actuator of the surgical instrument, thereby preventing movement of the end effector of the surgical instrument.

The manipulator unit of the robotic surgical device may include a surgical instrument actuation interface configured to receive any of the instrument adapters of the preceding paragraphs and/or any of the instrument adapters described herein.

A method of positioning a surgical instrument in a robotic surgical device may include: an instrument interface is positioned on the robotic surgical device. The instrument interface may include a housing including a plurality of interface actuators configured to cover (or overlay) a plurality of instrument actuators of the robotic surgical device. The method can comprise the following steps: an actuator housing of a surgical instrument is inserted into a housing of an instrument interface. The method can comprise the following steps: rotating an actuator housing within a housing of an instrument interface to cause a plurality of instrument actuators of a surgical instrument to engage with the plurality of instrument actuators of a robotic surgical device, the plurality of instrument actuators being covered by the plurality of interface actuators of the instrument interface. Actuation of an instrument actuator of the robotic surgical device causes a corresponding actuation of the instrument actuator. Actuation of an instrument actuator of the robotic surgical device causes movement of an end effector of the surgical instrument.

The method of the preceding paragraph and/or any method described herein may include one or more of the following features. Inserting the actuator housing of the surgical instrument into the housing of the instrument interface may include: the actuator housing is inserted at an angle relative to a plane in which the interface actuator is oriented. Inserting the actuator housing at the angle may include: the actuator housing is guided through a slot of the housing that is oriented in a plane that is at the angle relative to a plane in which the interface actuator is oriented. The method can comprise the following steps: the actuator housing is guided through the slot of the housing into a portion of the housing adjacent the slot. When the actuator housing does not rotate, the plurality of instrument actuators of the robotic surgical device (which may be covered by the plurality of interface actuators of the instrument interface) may not engage with instrument actuators of the surgical instrument. The rotary actuator housing may include: operating a fastener of an instrument interface. Operating the fastener may include: moving the fastener upward and locking the fastener latch. The method can comprise the following steps: the actuator housing is removed from the housing of the instrument interface by unlocking the latch. Unlocking the latch causes the fastener to move downward and causes the actuator housing to rotate. The rotary actuator housing may include: the actuator housing is rotated about an axis that traverses a center of a shaft of the surgical instrument that connects the actuator housing to the end effector. The instrument interface may be sterile.

An instrument adapter for a robotic surgical device may include an adapter housing configured to receive and support an actuator housing of a surgical instrument. The actuator housing may include a plurality of surgical instrument actuators. The adapter may include a plurality of interface actuators configured to engage and cause movement of the instrument actuators of the actuator housing. Movement of the instrument actuator causes movement of an end effector of the surgical instrument. The instrument adapter may be configured to facilitate transitioning of an actuator housing of the surgical instrument from a first orientation in which the interface actuator is not engaged with an instrument actuator of the surgical instrument to a second orientation in which the interface actuator is engaged with the instrument actuator.

The adapter of any preceding paragraph and/or any adapter described herein may include one or more of the following features. The transition of the actuator housing from the first orientation to the second orientation may include a rotation of the actuator housing. The adapter may include a guide configured to facilitate movement of the actuator housing at an angle, which may be consistent with the first orientation. The guide may be oriented in a plane that is oblique to a plane in which the interface actuator is oriented. The interface actuator may be oriented in a horizontal plane. The length of the guide may be less than the length of the actuator housing of the surgical instrument. The guide may include a protrusion configured to engage a groove in an actuator housing of the surgical instrument to permit insertion of the actuator housing into the adapter housing. The adapter may include a fastener configured to engage an actuator housing of the surgical instrument and cause the actuator housing to transition from the first orientation to the second orientation. The transition may be a rotation. The fastener may include a protrusion configured to engage a recess in an actuator housing of the surgical instrument. The engagement causes the actuator housing to rotate from the first orientation to the second orientation. The fastener may be configured to cause an actuator housing of the surgical instrument to rotatably transition from the second orientation to the first orientation. The adapter may be configured to facilitate transitioning of an actuator housing of the surgical instrument from the second orientation to the first orientation. The adapter may be sterile. The rotation of the actuator housing may be along an axis of a shaft of the surgical instrument to which the end effector is coupled.

An instrument adapter for a robotic surgical device may include an adapter housing configured to receive and support an actuator housing of a surgical instrument. The actuator housing may include a plurality of instrument actuators. The adapter may include a plurality of interface actuators supported by the adapter housing. The plurality of interface actuators may be configured to engage with the plurality of instrument actuators of the actuator housing and cause movement of the instrument actuators. Movement of the instrument actuator causes movement of an end effector of the surgical instrument. The adapter may include a guide connected to the adapter housing and oriented at an angle relative to a plane in which the interface actuator is positioned. The guide may be configured to facilitate insertion of an actuator housing of the surgical instrument into the adapter housing. The adapter may include a fastener supported by the adapter housing. The fastener may be configured to cause an actuator housing of the surgical instrument inserted into the adapter housing to transition from a first orientation in which the interface actuator is not engaged with an instrument actuator of the surgical instrument to a second orientation in which the interface actuator is engaged with the instrument actuator of the surgical instrument.

A method of preparing a robotic surgical device for a medical procedure (or a method of draping a robotic surgical device) may include: a manipulator unit of a robotic surgical device is covered with a first sterile barrier. The cover manipulator unit may include: a drape coupler of the first sterile barrier is coupled to a bottom surface of the manipulator unit. The coupling may include: attaching a drape coupler fastener positioned at least partially on an outer surface of the drape coupler to a bottom surface of the manipulator unit and covering the bottom surface of the manipulator unit with the drape coupler without covering a top surface of the manipulator unit with the drape coupler. The cover manipulator unit may include: a drape of a first sterile barrier is wrapped around the side surfaces and top surface of the manipulator unit. The drape may be coupled to the drape coupler. The drape may be made of a material that is more flexible than the material of the drape coupler. The method can comprise the following steps: covering an arm of the robotic surgical device supporting the manipulator unit with a second sterile barrier, the second sterile barrier being different from the first sterile barrier. The cover arm may include: coupling a second sterile barrier to the arm. The cover arm may include: a second sterile barrier is wrapped around the arm.

The method of any preceding paragraph and/or any method described herein may include one or more of the following features. The first and second sterile barriers may include a sterile surface configured to face away from the robotic surgical device. Covering the arm with the second sterile barrier may include: a portion of the drape of the first sterile barrier is covered with a second sterile barrier. Covering the portion of the drape of the first sterile barrier with the second sterile barrier may facilitate independent movement of the second sterile barrier without causing movement of the drape of the first sterile barrier. Covering the arm with the second sterile barrier may include: coupling at least a portion of the drape of the first sterile barrier with at least a portion of the second sterile barrier. The coupling drape coupling may include: attaching at least one fastener of the drape coupler to at least one fastener positioned on a bottom surface of the manipulator unit. Coupling the second sterile barrier may include: attaching the at least one fastener of the second sterile barrier to the at least one fastener of the arm. The at least one fastener may be positioned on a surface of the arm.

The method of any preceding paragraph and/or any method described herein may include one or more of the following features. Attaching the at least one fastener of the drape coupler to the at least one fastener positioned on the bottom surface of the manipulator unit may include causing a magnetic coupling. Attaching the at least one fastener of the second sterile barrier to the at least one fastener of the arm may include causing a magnetic coupling. The method can comprise the following steps: a sterile adapter is coupled to an instrument interface positioned on a bottom surface of the manipulator unit. The instrument interface may be configured to support and actuate an instrument. The method may include covering the pins of the manipulator unit with sterile rollers by: the roller is positioned on the pin. The pin and roller may be configured to cooperate to extend and retract the camera. The method can comprise the following steps: the first and second sterile barriers are removed. The method can comprise the following steps: covering a bedside robotic arm cart of the robotic surgical device with a third sterile barrier. The covering may include: coupling a third sterile barrier to the bedside robotic arm cart. Coupling the third sterile barrier to the bedside robotic arm cart may include: attaching at least one fastener of the third sterile barrier to the at least one fastener. The at least one fastener may be positioned on or adjacent to a surface of the bedside robotic arm car. Attaching the at least one fastener of the third sterile barrier to the at least one fastener of the bedside robotic arm cart may include causing a magnetic coupling. Wrapping the drape of the first sterile barrier around the side surfaces and the top surface of the manipulator unit may include: the drape is coupled to a top surface of the manipulator unit. Coupling the drape of the first sterile barrier to the top surface of the manipulator unit may include causing a magnetic coupling.

A method of preparing a robotic surgical device for a medical procedure (or a method of draping a robotic surgical device) may include: a first sterile barrier is positioned on a first portion of a robotic surgical device. Positioning the first sterile barrier may include: coupling a drape coupler of a first sterile barrier to a surface of a first portion of a robotic surgical device, the surface configured to support at least one surgical instrument of the robotic surgical device. The coupling may include: attaching drape coupler fasteners positioned at least partially on an outer surface of a drape coupler to and covering a surface of a first portion of a robotic surgical device with the drape coupler without covering any portion of an opposing surface of the first portion of the robotic surgical device with the drape coupler. Positioning the first sterile barrier may include: wrapping a drape of a first sterile barrier around one or more other surfaces of a first portion of a robotic surgical device. The drape may be coupled to the drape coupler. The method can comprise the following steps: a second sterile barrier, different from the first sterile barrier, is positioned on a second portion of the robotic surgical device adjacent to the first portion of the robotic surgical device. Positioning the second sterile barrier may include: coupling a second sterile barrier to the second portion. Positioning the second sterile barrier may include: a second sterile barrier is wrapped around the second portion.

The method of any preceding paragraph and/or any method described herein may include one or more of the following features. The material of the drape coupler may be more rigid than the material of the drape of the first sterile barrier. Positioning the second sterile barrier may include: a portion of the drape of the first sterile barrier is covered with a second sterile barrier. The covering may facilitate independent movement of the first and second sterile barriers. The first and second sterile barriers may include a sterile surface configured to face away from the robotic surgical device. The coupling drape coupling may include: attaching at least one fastener of the drape coupler to at least one fastener positioned on a surface of the first portion of the robotic surgical device. The coupling drape coupler may couple the second sterile barrier may include: attaching the at least one fastener of the second sterile barrier to the at least one fastener of the second portion of the robotic surgical device. The at least one fastener may be positioned on or adjacent to a surface of the second portion. The method can comprise the following steps: coupling a sterile adapter to an instrument interface positioned on a surface of a first portion of a robotic surgical device. The instrument interface may be configured to support and actuate the at least one surgical instrument. The method may include covering the pin of the first portion with a sterile cover by: a cover is positioned over the pin, the pin and the cover configured to cooperate to extend and retract the camera. The method can comprise the following steps: the first and second sterile barriers are removed. The one or more other surfaces of the first portion of the robotic surgical device may comprise opposing surfaces of the first portion of the robotic surgical device. Wrapping the drape of the first sterile barrier around the one or more other surfaces of the first portion of the robotic surgical device may include: a drape is coupled to an opposing surface of the first portion of the robotic surgical device.

The method of any preceding paragraph and/or any method described herein may include one or more of the following features. The method can comprise the following steps: a third sterile barrier is positioned on a third portion of the robotic surgical device. The positioning may include: coupling a third sterile barrier to the third portion. Coupling the third sterile barrier to the third portion may include: attaching the at least one fastener of the third sterile barrier to the at least one fastener of the third portion. The at least one fastener may be positioned on or adjacent to a surface of the third portion. Attaching the at least one fastener of the third sterile barrier to the at least one fastener of the third portion may include causing a magnetic coupling.

A sterile barrier for a robotic surgical device may include a drape made of a flexible material. The drape may include a first surface configured to face one component of the robotic surgical device, and a second surface opposite the first surface. The second surface may be sterile and configured to provide a sterile barrier for the component. The barrier may include a first pair of pockets positioned along a first edge of the second surface and configured to receive a hand of a user. The first pair of pouches may be configured to facilitate positioning of the sterile barrier on the component. The first pair of pockets may be configured to facilitate maintaining sterility of the second surface of the drape when the drape is attached to the component (and optionally when the drape is at least partially wrapped around the component).

The barrier of any preceding paragraph and/or any barrier described herein may include one or more of the following features. The barrier may include a plurality of fasteners positioned on the first surface of the drape. The fastener may be configured to removably position the drape on the component. The fastener may comprise a ferromagnetic material configured to attach to at least one magnet (and/or a plurality of magnets) positioned on (or adjacent to) a surface of the component. At least one of the fasteners may be positioned in an area of the drape that overlaps one of the pockets of the first pair of pockets. The first pair of pouches may include visual indicators, which may be positioned on the interior surfaces of the first pair of pouches. The visual indicator may be configured to guide the user to insert a hand into the first pair of pockets in the correct position. The barrier may include a second pair of pockets positioned along a first edge of the second surface and configured to receive a user's hand. The barrier may include a first fastener positioned on an exterior surface of a first pouch of the first pair of pouches. The exterior surface of the first pocket of the first pair of pockets may be a portion of the second surface of the drape. The barrier may include a second fastener positioned on an exterior surface of a second pouch of the first pair of pouches. The exterior surface of the second pocket of the first pair of pockets may be a portion of the second surface of the drape. The first and second fasteners may be configured to attach to another pair of fasteners to maintain the drape wrapped around a portion of the component.

The barrier of any preceding paragraph and/or any barrier described herein may include one or more of the following features. The barrier may include a third fastener positioned on an exterior surface of the first pouch in the second pair of pouches. The barrier may include a fourth fastener positioned on an exterior surface of a second pouch of the second pair of pouches. The third and fourth fasteners may be configured to attach to the first and second fasteners to maintain the drape wrapped around the portion of the component. The barrier may include a drape coupler made of a material that is more rigid than the flexible material of the drape, wherein the drape is coupled to the drape coupler. The barrier may include at least one fastener configured to wrap around the protrusion of the component, thereby tightening the drape around the protrusion. The barrier may include a second pouch positioned below one of the first pair of pouches. The second pocket may be configured to receive a first portion of a hand of a user to facilitate wrapping the drape at least partially around the component. The second pocket may be configured to receive only a first portion of a hand rather than the entire hand. The barrier may include a third pocket positioned along a second edge of the drape, the second edge being opposite the first edge of the drape along which the first pair of pockets are positioned. The third pocket may be configured to receive a second portion of the user's hand to facilitate wrapping the drape at least partially around the component. The third pocket may be configured to receive only a second portion of the hand instead of the entire hand.

The kit may include the first and second sterile barriers of any preceding paragraph and/or any sterile barrier described herein. The first sterile barrier may include a first drape. The second sterility may include a second drape. The first drape may be configured to cover the component. The second drape may be configured to cover a second component of the robotic surgical device adjacent to the component. The second drape may be configured to cover a portion of the first drape.

The kit of the preceding paragraph and/or any kit described herein can include one or more of the following features. The second drape may include a first fastener and a second fastener, which may be positioned on opposite sides of the second drape. The first and second fasteners may be configured to attach to one another to maintain the second drape positioned over the first drape. The kit may include at least one sterile cover configured to cover the instrument interface of the component. The instrument interface may be configured to support and actuate a surgical instrument. The kit may include at least one sterile roller configured to cover the pin of the component. The pin and roller may be configured to cooperate to extend and retract the camera. The kit may include a third sterile barrier including a third drape. The third drape may be configured to be positioned over and/or provide a sterile barrier for a third component of the robotic surgical device.

The robotic surgical device may include a component including a housing having an outer surface. The device may include a plurality of component fasteners positioned on an outer surface of the housing. The plurality of component fasteners may be configured to couple with a plurality of drape fasteners of a sterile drape. The sterile drape may be configured to cover and provide a sterile barrier to a portion of a surface of the housing. The number of component fasteners of the plurality of component fasteners may exceed the number of singulation fasteners of the plurality of singulation fasteners, thereby permitting singulation to be positioned on the housing of the component in a plurality of orientations and to cover a plurality of different portions of the surface of the housing. At least one component fastener of the plurality of component fasteners may not be coupled to any drape fastener of the plurality of drape fasteners when the drape is positioned on the housing.

The apparatus of any preceding paragraph and/or any apparatus described herein may include one or more of the following features. The component fastener may be configured to support a drape. The at least one component fastener may comprise a magnet. The outer surface of the housing may include a recess. The magnet may be configured to be positioned in the recess. The recess may be configured to receive a drape fastener. The magnet may be configured to be positioned at the bottom of the recess. The recess may include at least one wall oriented substantially perpendicular to a surface of the magnet configured to couple with the drape fastener. The apparatus may include electronic circuitry configured to detect a position and an orientation of the drape. The electronic circuitry may be configured to determine whether the drape is properly positioned and generate an indication in response to a determination that the drape is not properly positioned. The electronic circuitry may include at least one proximity sensor. The component may comprise a bedside robotic arm cart. The at least one component fastener may include indicia on a surface of the at least one component fastener. The markings may be configured to facilitate coupling of the drape fastener.

A method of preparing a robotic surgical device for a medical procedure (or a method of draping a robotic surgical device) may include: a desired location of the sterile barrier on a component of the robotic surgical device is identified from the plurality of sterile barrier locations. The method can comprise the following steps: covering at least a portion of the surface of the component with a sterile barrier by positioning the sterile barrier in a desired position. The positioning may include: a subset of the plurality of fasteners coupling the plurality of sterile barrier fasteners to the component.

The method of any preceding paragraph and/or any method described herein may include one or more of the following features. The number of fasteners of the component may exceed the number of sterile barrier fasteners. Positioning the sterile barrier may include: at least one fastener that does not couple any sterile barrier fasteners to the component. The method can comprise the following steps: removing the sterile barrier by decoupling the plurality of sterile barrier fasteners from the subset of the plurality of fasteners of the component. The method can comprise the following steps: verifying that the sterile barrier is properly positioned based on an output of the electronic circuitry of the robotic surgical device. The electronic circuitry may be configured to detect whether the sterile barrier is properly positioned in the desired position and output an indication that the sterile barrier is not properly positioned.

The robotic surgical device may include a component including a housing having an outer surface. The device may include a component fastener positioned on an outer surface of the housing. The component fastener may be configured to couple with a drape fastener of a sterile drape. The sterile drape may be configured to cover and provide a sterile barrier to a portion of a surface of the housing. At least one dimension of the component fastener may exceed at least one corresponding dimension of the drape fastener, thereby permitting the drape to be positioned on the housing of the component in multiple orientations and to cover multiple different portions of the surface of the housing. The component fastener may be configured to support a drape.

The apparatus of any preceding paragraph and/or any apparatus described herein may include one or more of the following features. The at least one dimension may include a length. The component fastener may be configured to support a drape.

A method of preparing a robotic surgical device for a medical procedure (or a method of draping a robotic surgical device) may include: a desired location of the sterile barrier on a component of the robotic surgical device is identified from the plurality of sterile barrier locations. The method can comprise the following steps: covering at least a portion of the surface of the component with a sterile barrier by positioning the sterile barrier in a desired position. The positioning may include: a component fastener coupling the sterile barrier fastener to the component. At least one dimension of the component fastener may exceed at least one corresponding dimension of the drape fastener.

The method of any preceding paragraph and/or any method described herein may include one or more of the following features. The at least one dimension of the component fastener exceeding the at least one corresponding dimension of the drape fastener may permit the drape to be positioned in a plurality of orientations and to cover a plurality of different portions of the surface of the component. The at least one dimension may include a length. The component fastener may be configured to support a drape.

Any of the sterile barriers and/or adapters described in any of the preceding paragraphs and/or below may be used with any of the robotic surgical system components.

In some cases, a robotic surgical system as described and/or illustrated is provided. In some cases, one or more sterility barriers as described and/or illustrated are provided. In some cases, one or more sterile adapters as described and/or illustrated are provided. In some cases, one or more kits as described and/or illustrated are provided.

In some cases, a method of using and/or operating a robotic surgical system as described and/or illustrated, or any component thereof, is provided. In some cases, methods of preparing a robotic surgical device for a medical procedure as described and/or illustrated are provided. Any such method may include: one or more sterile barriers and/or adapters are positioned on (or cover) any component of the robotic surgical system as described and/or illustrated.

Any of the preceding paragraphs and/or any of the methods described herein may be used with any sterile barrier, adapter, kit, and/or robotic surgical system.

Drawings

Embodiments of the present disclosure will now be described, by way of example only, with reference to the accompanying drawings, in which:

fig. 1A-1D illustrate a robotic surgical system;

fig. 2A-2G illustrate a sterile barrier for a robotic surgical system;

3A-3F illustrate a sterile barrier for a manipulator unit of a robotic surgical system;

fig. 4A-4O illustrate a sterile adapter for a surgical instrument;

FIG. 5 illustrates a sterile barrier for the lifting link assembly of the robotic surgical system;

FIG. 6A illustrates a sterile barrier for a boom assembly of a robotic surgical system;

FIG. 6B illustrates various orientations of the sterile barrier of FIG. 6A;

fig. 7A to 7C illustrate a tag;

8A-8W illustrate covering components of a robotic surgical system with one or more sterile barriers;

FIG. 9 illustrates a fastener of the robotic surgical system;

fig. 10 illustrates a sterile barrier kit;

fig. 11 illustrates the positioning of the sterile barrier on a robotic surgical system component.

Detailed Description

Overview of a robotic surgical System

Use of a robotic surgical system in an operating room may require placement of one or more components of the system within a sterile field in the operating room while placing other components of the system outside of the sterile field. Creating and maintaining a sterile field in an operating room can be challenging when components of a robotic surgical system are present. For example, non-sterile components of the system (such as a workstation as described herein) may be placed outside the sterile field, and it is important to ensure that such components, or connections between non-sterile components and sterile components, do not contaminate the sterile items, personnel, or patients within the sterile field. As another example, due to the size and complexity of the one or more components, it may be impractical to sterilize the one or more components of the system positioned within the sterile zone. As described herein, one or more sterile barriers covering one or more components of the system can be utilized to create and maintain a sterile zone.

Referring to fig. 1A, a robotic surgical system is shown generally at 1000. In some embodiments, robotic surgical system 1000 may be configured to facilitate a medical procedure (e.g., surgery) performed via one or more incisions. For a single incision, a single access port may be inserted into the incision to provide access to one or more instruments (sometimes referred to as surgical instruments, tools, or surgical tools) or cameras (or other non-tissue manipulation equipment, including advanced visualization equipment).

The system 1000 may include a workstation 102 and a bedside robotic arm cart (bedside cart) 104. One or more of the bedside robot car 104 or the workstation 102 may be movable. The bedside robotic arm cart 104 may include a manipulator unit or central unit 400 to which one or more instrument insertion and visualization devices 108 may be attached or mounted. The central unit 400 may be supported by a lifting link assembly 300 (sometimes referred to as an arm) that is connected to a boom assembly 200 (sometimes referred to as a post) of the bedside robotic arm car. The central unit 400 may be movable (such as in three dimensions) to facilitate desired positioning of one or more surgical instruments or cameras. Movement of the central unit 400 may be facilitated by one or more of the arms 300 and the posts 200. For example, the column 200 may facilitate vertical positioning of the central unit 400, and the arm 300 may facilitate further vertical positioning of the central unit 400 (supplemental lateral movement and rotation).

The instrument insertion and visualization device 108 (which may be removably mounted to the central unit 400) may support at least one surgical instrument and one or more cameras (not shown) that image a site of interest, such as a surgical site. The instrument insertion and visualization device 108 may support two or more instruments (not shown). The one or more cameras may include a primary camera and at least one secondary camera. The primary and secondary cameras may provide different perspectives, perform different functions, and/or produce different images. At least one of the primary camera and the secondary camera may be a two-dimensional (2D) or three-dimensional (3D) camera.

The workstation 102 may include an input device 112 that receives operator input and generates input signals, and may also be configured to generate feedback to an operator or user. The feedback may be visual, auditory, tactile, etc. For example, the input device 112 may be implemented using a haptic interface available from Force Dimension, switzerland. The operator may be a surgeon.

The workstation 102 may further include electronic circuitry 114 in communication with the input device for receiving input signals and generating control signals for controlling the robotic surgical system, which may be transmitted to the bedside robotic arm cart 104 via an interface cable 116. In some cases, the data transmission may be wireless, and the interface cable 116 may not be present. The electronic circuitry 114 may include one or more processors or controllers. The electronic circuit 114 may serve as a master device (master) for controlling movement of one or more surgical instruments or cameras mounted to the bedside robotic arm cart 104. The bedside robotic arm cart may include electronic circuitry 118, which may include one or more processors or controllers. The electronic circuitry 118 may act as a slave device and be controlled by the electronic circuitry 114. The communication between the electronic circuitry 114 of the workstation 102 and the electronic circuitry 118 of the bedside robotic arm cart 104 may be wired (such as via a cable 116) or wireless. The workstation 102 may be located remotely from the bedside robotic arm cart 104, such as outside the operating room or in a non-sterile area of the operating room.

The input devices may include a right input device 132 and a left input device 112 for controlling respective right and left instruments (not shown). The right input device 132 may include a right hand control 122 (sometimes referred to as a handle or handpiece), and the left input device 112 may include a left hand control 124. The right hand controller 122 and the left hand controller 124 may be mechanically and/or electrically coupled to the

respective input devices

132 and 112. Alternatively, the right hand controller 122 and the left hand controller 124 may be wirelessly coupled to the

respective input devices

132 and 112, or may be directly wirelessly coupled to the workstation 102. The right hand control 122 and the left hand control 124 may be grasped by the operator's hand and moved to generate input signals at the

respective input devices

132 and 112.

In some cases, when there are two instruments at the bedside robotic arm cart 104, the right hand controller 122 and the left hand controller 124 may control the two instruments, respectively. In some cases, when there are more than two instruments, right hand control 122 and left hand control 124 may be used to select which of a plurality of instruments the operator wishes to use at any given time. In some cases, when there is only one instrument, one of the right hand control 122 and the left hand control 124 may be used to select a single instrument.

Input devices

132 and 112 may generate input signals indicative of the position of hand controls 122 and 124 within an input device workspace (not shown). In some cases where the

input devices

132 and 112 are directly and wirelessly coupled to the workstation, they will include the necessary sensors to allow wireless control, such as accelerometers, gyroscopes, and/or magnetometers. In other cases, the wireless connection of the

input devices

132 and 112 to the workstation 102 may be accomplished using a camera system, alone or in combination with the described sensors. Such sensors for wireless functionality may also be placed in each handpiece for use in conjunction with the

input devices

132 and 112 to independently verify input device data. The electronic circuitry 114 may be in communication with the

input devices

132 and 112 for receiving input signals.

The electronic circuitry 118 of the bedside robotic arm cart 104 may receive control signals from the electronic circuitry 114 and generate slave control signals operable to control the instrument insertion and visualization device 108 and one or more instruments (and their respective end effectors) and/or cameras during a surgical procedure. The one or more instruments may include smart tools such as clamps, needle drivers, staplers, dissectors, cutters, hooks, graspers, scissors, coagulators, irrigators, and suction devices for performing surgical procedures, such as laparoscopic surgical procedures. Although both master electronic circuit 114 and slave electronic circuit 118 are illustrated, in some cases a single electronic circuit may be used to perform both master and slave functions.

The workstation 102 may also include a user interface, such as a display 120 in communication with the electronic circuitry 114 for displaying information (such as body cavity images) and other information of a region or site of interest (e.g., surgical site, body cavity, etc.) to the operator. The display 120 may display real-time images or other graphical depictions of the surgical site generated by one or more cameras of the visualization device (not shown) and/or one or more cameras of the instrument insertion and visualization device 108. The workstation 102 may include right and left graphical depictions (not shown) displayed on the display 120 for right and left instruments (not shown), respectively. These graphical depictions may be displayed at peripheral regions of the display 120 to prevent occlusion of live views of the surgical workspace that are also displayed on the display. The display 120 may be further operable to provide other visual feedback or instructions to the user.

The workstation 102 may include a second auxiliary display 123 to display auxiliary surgical information to the user, such as patient medical records, pre-operative images, and surgical data. In some cases, the secondary display 123 may be a touch display, and may also be configured to display graphics representing additional inputs for controlling the workstation 102, the bedside robotic arm cart 104, and/or specific functions thereof.

The workstation 102 may also include one or more controllers (such as one or more foot pedals or pedals 126) for controlling the robotic surgical system. For example, one or more pedals 126 may include a clutch pedal that allows repositioning of hand controls 122 or 124 without corresponding movement of the respective associated instrument. The clutch pedal 126 may provide an input signal to the electronic circuit 114, and the electronic circuit may inhibit movement of the associated instrument while the foot switch 126 is depressed.

Fig. 1B illustrates a close-up front perspective view of a portion of the bedside robotic arm cart 104. The illustrated portion includes a central unit 400 (which may be shaped as a hexahedron), arms 300, and an upper portion of the column 200. Fig. 1C illustrates a close-up rear perspective view of the portion of the bedside robotic arm cart 104 illustrated in fig. 1B. The central unit 400 may include one or more attachments or

fasteners

302 and 304 that may be positioned around the perimeter or circumference of the central unit (such as on opposite sides) and/or around the perimeter or circumference of the lower portion of the arms 300 (in close proximity to where the central unit 400 is attached, mounted, connected, or otherwise coupled to the arms) as illustrated. The arm 300 may include one or more attachments or

fasteners

402, 404, and 406, which may be positioned around the circumference or circumference of the arm as illustrated. The fastener 402 may be positioned in the middle (e.g., in line or substantially in line with the center of the central unit 400).

Fasteners

404 and 406 may be positioned on each side. The column 200 may include one or more attachments or

fasteners

202, 204, 206, and 208 that may be positioned around the circumference or circumference of the column on opposite sides (or otherwise spaced apart, e.g., equally spaced apart) as illustrated. As described herein, the one or more attachments may be configured to facilitate attachment (such as a removable attachment) of one or more sterile barriers (such as a drape) to cover (or enclose) the one or more components of the bedside robotic arm car 104. For example, any fastener may include a magnetic material for removably attaching or affixing a sterile barrier (such as a drape). The attachment may be formed when an attachment portion of the drape comprising ferromagnetic material is brought into proximity or contact with the fastener. Any fasteners of the robotic surgical system components and/or sterile barrier may be circular, rectangular, square, etc. In some cases, one or more of the fasteners may be three-dimensionally shaped in addition to having a shape. In some cases, the attachment portion of the drape comprising ferromagnetic material may be three-dimensionally shaped. In some cases, the fasteners positioned on the one or more of the

components

400, 300, and 200 may be more or less than the fasteners illustrated in fig. 1B-1C. In some cases, one or more fasteners may be positioned in different locations (locations). In some cases, one or more fasteners may be positioned on or adjacent to a surface of a robotic surgical system component.

Fig. 1D illustrates an instrument insertion and visualization device 108. The instrument insertion and visualization device 108 may include an insertion device 210 and a visualization device 220. The insertion device 210 may include a housing 212, and a plurality of passageways, lumens or channels 214 for inserting and guiding one or more instruments or cameras. The plurality of channels 214 may be enclosed in another housing, as illustrated in fig. 1D. As shown, two housings may be connected. The plurality of channels 214 may also permit insertion of a primary camera 224. The primary camera is an endoscope or an endoscopic camera. The distal end 224B of the primary camera 224 may extend beyond the housing that includes the plurality of channels 214. At least a portion of distal end 224B may be positioned near or within the region of interest (such as to provide image data of the region of interest). One or more cameras (such as an imaging component including one or more lenses) may be positioned at the distal end 224B. The primary camera 224 may also include a proximal end 224A.

The visualization device 220 may include a housing 222 to which a proximal end 224A of the primary camera may be attached (removably or non-removably). The housing 222 may include an opening in which one or more sterile drivers, such as at least one of 232A or 232B (individually or collectively 232), may be positioned. The one or more drivers 232 may contact or grip the primary camera 224 and move the primary camera through the opening in the housing 222 and one of the plurality of channels 214 such that the distal end 224B extends away from one or more of the

housings

212 or 222 or retracts back toward or into one or more of the

housings

212 or 222. The camera tube 225 of the primary camera 224 may form a ring around at least a portion of the housing 222. The diameter of the annulus may increase as distal end 224B is retracted toward or into one or more of

housings

212 or 222, and the diameter of the annulus may decrease as distal end 224B extends away from one or more of

housings

212 or 222. In some cases, visualization device 220 may be coupled to another portion of insertion device 210. In some cases, the visualization device may not be coupled to the insertion device 210, but to another portion of the central unit 400. In some cases, the primary camera 224 may not include a loop, but rather is inserted linearly through the insertion device 210, but otherwise causes the distal end 224B of the primary camera 224 to function as described above.

At least a portion of the primary camera tube 225 may be flexible or substantially flexible so as to form a loop and/or be directed through the one or more openings and/or channels as described herein. In some cases, at least a portion of the primary camera tube 225 may be flexible or substantially flexible in order to facilitate manipulation of the primary camera at the site of interest, e.g., to provide a desired camera view to an operator. In some cases, looping (looping) the camera 224 up around at least the portion of the housing 222 as described may permit the primary camera to have sufficient length to reach near and/or into the site of interest while eliminating or reducing the risk of the primary camera 224 (or at least a desired portion thereof) coming into contact with non-sterile objects, such as a floor or a portion of the system 1000 that is not covered or protected by a sterile barrier.

One or more cables 240 may be used to transmit control signals and data (such as analog or digital image data provided by the one or more cameras positioned at the distal end 224B or in the insertion device 210) to the bedside robotic arm car 104 and/or the workstation 102. In some cases, the transmission may be wireless, and one or more cables 240 may not be present.

Insertion device 210 may include one or more instrument channels for positioning one or more surgical instruments. The one or more instruments may be loaded (into the instrument channel) through one or more openings 340 formed in the rear of the housing 212 of the insertion device 210. In some cases, one or more auxiliary cameras may be integrated or removably positioned in the insertion device 210.

In operation, the insertion device 210 and the visualization device 220 may be attached to each other. For example, the

housings

220 and 210 may be attached to each other. The attachment may be removable, and may facilitate insertion and movement of the primary camera 224 (such as the distal end 224B) through the

housings

220 and 210 and the one of the plurality of channels 214. In some cases, the insertion device 210 may be attached to a first portion of the central unit 400, while the visualization device 220 may be attached to a second portion of the central unit, thereby facilitating entry of the primary camera 224 into and through the insertion device from a range of angles/orientations.

Fig. 1A-1D illustrate examples of robotic surgical systems and their components, and certain elements may be removed, other elements added, two or more elements combined, or an element may be split into multiple elements, depending on the specifications and requirements of the robotic surgical system.

Additional details of the robotic surgical system 1000 and its components (including one or more insertion devices, visualization devices, or cameras) are described in each of the following: U.S. patent application No. 16/156,651 filed on 10/2018, U.S. patent application No. 16/156,625 filed on 10/2018, U.S. patent application No. 16/174,646 filed on 30/10/2018, U.S. patent application No. 16/299,834 filed on 12/3/2019, U.S. patent application No. 16/419,743 filed on 22/5/2019, and U.S. patent application No. 16/419,696 filed on 22/5/2019, the entire disclosure of each of which is incorporated by reference and should be considered part of this specification.

Overview of sterile Barrier

To establish and maintain sterility of one or more components of a robotic surgical system (such as system 1000), one or more sterile barriers (such as a drape) may be utilized. Such a method may be more practical, efficient, and/or effective for sterilizing the one or more components of the robotic surgical system (such as sterilizing an outer surface and/or other portions of the one or more components). Attaching or positioning such a barrier on the one or more components of a robotic surgical system is illustrated in fig. 2A-2G. As illustrated, one or more sterile barriers may be removably attached or positioned to cover one or more components of the bedside robotic arm cart 104, which may be positioned at least partially in the sterile zone.

The sterile barrier may help mitigate the risk of sterile objects or sterile personnel (such as sterile nurses, surgeons, etc.) coming into contact with non-sterile surfaces or objects. The sterile barrier may additionally or alternatively protect components of the robotic surgical system from contact with fluids or tissue during a medical procedure.

Fig. 2A illustrates an interface 500 of the central unit 400. Interface 500 (which may be referred to as a mounting interface) may be configured to support instrument insertion and visualization device 108, which may include insertion device 210 and visualization device 220. The insertion device 210 may include the plurality of channels 214 for facilitating positioning of one or more surgical instruments and one or more cameras (including the primary camera 224) adjacent to or within the site of interest. The visualization device 220 may facilitate positioning the primary camera 224 adjacent to or within the location of interest. In some cases, the primary camera 224 may have a length selected to at least allow the distal portion 224B of the primary camera to advance toward or into the site of interest and retract away from the site of interest (such as toward or into a channel of the visualization device 220). As described herein, the primary camera 224 may include a camera tube 225 (flexible or substantially flexible portion) that forms a loop around a portion of the visualization device 220, such as the housing 222. The looper portion of the primary camera may shorten when the primary camera is advanced and lengthen when the primary camera is retracted.

The mounting interface may include an opening or slot 504 for receiving a loop portion of the primary camera. The interface 500 may include one or more struts or pins 510 configured to actuate one or more drivers 232 for advancing the main camera 224 toward or into a site of interest and/or retracting the main camera. The interface 500 may include a sterile cover 550 that may be attached to cover one or more additional posts or pins of the mounting interface 500. The one or more pins may be configured to support one or more of an insertion device or a visualization device.

The one or more drivers 232 and the cap 550 may be sterile and form part of a sterile barrier for the central unit 400. It may be desirable to provide a sterile barrier between the mounting interface 500 of the non-sterile surface of the central unit 400 and one or more of a sterile insertion device or a sterile visualization device that may be removably attached to or mounted on the interface 500. It may be desirable for the insertion device 210 and visualization device 220 to be sterile (e.g., to maintain sterility of one or more surgical instruments and/or cameras mounted to or positioned in the insertion device and visualization device) in order to protect the site of interest from infection. It may be advantageous to provide a sterile barrier for non-sterile parts of the central unit 400 that may come into contact with the insertion device and the visualization device. For example, the primary camera 224 may be advanced or retracted by the one or more sterile drivers 232, which may rotate to advance or retract the camera, as described in more detail in U.S. patent application No. 16/156,651 filed on 10/2018 and U.S. patent application No. 16/156,625 filed on 10/2018. As described herein, a sterile insert (e.g., insert 640) positioned in the slot 504 may be utilized to maintain sterility of the looped portion of the primary camera positioned in the slot 504. The sterility cap 550 can advantageously maintain the sterility of the one or more of the insertion device or visualization device mounted onto the one or more pins covered by the cap 550.

Fig. 2B illustrates covering (such as enclosing) the central unit 400 with a sterile barrier 650, which may include a drape 600 and a drape coupler 610. Fig. 2C illustrates a portion (part) of the arm 300 being covered (such as enclosed) with a sterile barrier (such as a sterile drape 700). As described herein, the drape 700 may overlap a portion of the drape 600 of the sterile barrier 650. In some cases, a portion of the drape 700 may be attached, connected, or otherwise coupled to a portion of the drape 600 by using one or more of any of the fasteners described herein.

After (or in some cases before) covering the central unit 400 with the sterile drape 600, one or more of the insertion device 210 or visualization device 220 may be attached to the central unit, such as mounted on the mounting interface 500. As illustrated in fig. 2D, the visualization device 220 may be mounted to the mounting interface 500. As shown, the visualization device 220 can be positioned over the one or more pins 510 covered by the one or more drivers 232 and the one or more pins (such as the top two pins) covered by the cover 500 to maintain sterility of the visualization device (and the main camera attached to the visualization device). After the visualization device 220 has been mounted to the mounting interface 500 (or in some cases before), the insertion device 210 may be mounted to the mounting interface, as illustrated in fig. 2E. The insertion device 210 may be mounted on the one or more pins (such as the bottom two pins) covered by the cover 500.

As shown in fig. 2F, a bottom surface 410 of the central unit 400 may include one or more instrument interfaces 420 configured to support and actuate one or more surgical instruments (as illustrated, for example, in fig. 4E). Each instrument interface 420 may include a plurality of actuators 422 configured to interface with (e.g., mate with) a plurality of actuators of a surgical instrument attached to the instrument interface (e.g., actuators 322 of the surgical instrument illustrated in fig. 4G-4H). For example, the protrusion of the actuator 422 may interface with (e.g., mate with) an opening in an actuator 322 of a surgical instrument (sometimes referred to as a surgical instrument actuator). Movement of the actuator 422, such as movement to the left and down (or up and down, or otherwise from one point to another), causes corresponding movement of the actuator of the surgical instrument. This may cause the end effector portion of the instrument (which may be located at the distal end of the instrument) to articulate or move (e.g., in three dimensions), change orientation (e.g., in three dimensions including rotation), and/or actuate or perform a function as required for performing a medical procedure (such as opening or closing jaws of a grasper).

To maintain sterility of the one or more surgical instruments, one or more sterile interfaces 680 (sometimes referred to as caps, interfaces, shrouds, or adapters) may be attached to or positioned on instrument interfaces 420, which may not be sterile (e.g., due to particular difficulties in sterilizing the plurality of actuators 422). As described herein, one or more sterile adapters 680 may be removably attached to the instrument interface 420, and when the sterile adapter(s) 680 are installed on the instrument interface 420, the instrument may be placed or positioned in contact with the sterile adapter(s). For example, when attached to the instrument interface 420 using a single sterile adapter 680, the sterile adapter may be configured (e.g., sized and shaped) to coincide or substantially coincide with the size and shape of the instrument interface 420. The sterile adaptor 680 may have the same or substantially similar length and width as the instrument interface 420.

Referring to fig. 4A and 4D, sterile adaptor 680 may include a plurality of actuator caps 622 corresponding in size and shape to the plurality of actuators 422. The plurality of actuators 422 may be covered by the actuator cover 622 (e.g., enclosed by the actuator cover 622 or received therein). Actuator cover 622 is also illustrated in fig. 8N (which illustrates adapter 680 in a perspective bottom view).

Although the actuators 422 are illustrated as protrusions (such as male connectors), in some cases, one or more of the actuators 422 may include an opening or slot (such as a female connector) configured (e.g., sized and shaped) to receive a protrusion of a corresponding surgical instrument actuator. In this case, the one or more actuator covers 622 may be configured (e.g., sized and shaped) to correspond to the size and shape of the actuator 422. Additional details of mounting and actuating surgical instruments are disclosed in U.S. patent No. 9,629,688, the entire disclosure of which is incorporated by reference and is to be considered part of this specification.

Fig. 2G illustrates covering a portion (or all) of the column 200 with a sterile barrier (illustrated as a drape 800). The drape 800 may facilitate maintaining sterility of the sterile barrier of the central unit 400, such as the

drapes

600 and 700, if the central unit 400 is moved into contact with the column 200 (or another sterile object or person is in contact with the column 200). As described herein, the drape 800 may be removably attached to the post 200 in one or more different locations or in one or more different orientations. This may facilitate protecting the post 200 from contact with blood, fluids, tissue, etc. during a medical procedure.

Sterile barrier for a central unit

Fig. 3A illustrates a sterile barrier 650 for the central unit. The sterile barrier 650 may include a drape 600 and a drape coupler 610 (which may sometimes be referred to as a tray). Both the drape 600 and the drape coupler 610 may be sterile. As described herein, the drape coupler 610 may be removably attached to at least one surface of the central unit 400, such as the bottom surface 410. The drape coupler 610 may be configured (e.g., sized and shaped) to match the size and shape of the bottom surface 410 of the central unit 400. The drape coupling 610 may be rigid or substantially rigid. The drape coupling 610 may include one or more rigid or substantially rigid materials, such as plastic, metal, and the like.

The drape 600 may be flexible or substantially flexible. The drape may include one or more flexible or substantially flexible materials, such as Polyethylene (PE) (e.g., low density polyethylene), Polyurethane (PU), polyvinyl chloride (PVC), and the like. Although shown as separate components in fig. 3A, the drape coupler 610 and the drape 600 may be attached to or otherwise integrated with one another. For example, the drape 600 may be attached to the drape coupler 610 along the perimeter of the drape coupler. Referring to fig. 3B, in some cases, the drape 600 may be attached along a perimeter outlined by 612. For example, the drape 600 may be adhered to the portion of the drape coupler 610 positioned between the edge and the perimeter outlined by 612. Due to, for example, preventing the drape (which may be flexible) from collapsing, the drape coupler 610 may facilitate covering (e.g., enclosing) the central unit 400 with the drape 600, thereby holding the drape in a position around the perimeter of the central unit or the like (see, e.g., fig. 8B and 8C).

The cap 550 illustrated in fig. 3A may be integrated into the sterility barrier 650. For example, the cover 550 may be attached to the drape 600, such as in the area 606 (see also fig. 3D). For example, the cover 550 may be attached through an opening or hole (such as four holes) illustrated in the area 606. This is illustrated in fig. 3E-3F, which illustrate sterility barrier 650 in perspective front and bottom views, respectively. The attachment may be by means of an adhesive, heat sealing or the like.

An insert 640 (which may sometimes be referred to as a shell) may be positioned in the slot 504 of the central unit 400. The insert 640 may have a concave shape that matches the slot 504 in size and shape. The insert 640 may have side surfaces that are connected at one end (such as at the bottom) and unconnected at an opposite end (such as at the top) to form an opening. As described herein, the looped portion of the main camera tube 225 may be positioned in the slot 504. The slot 504 may be covered by an insert 640, and the looped portion of the main camera tube 225 may be positioned in the insert 640. The insert 640 may be rigid or substantially rigid, which may facilitate the retention of the insert within the slit 504. The insert may comprise one or more materials that are more rigid than the one or more materials of the drape. For example, the insert 640 may include one or more of a plastic material, such as High Density Polyethylene (HDPE), Acrylonitrile Butadiene Styrene (ABS), metal, or the like.

Insert 640 may be integrated into sterility barrier 650. For example, as illustrated in fig. 3E-3F, the insert 640 may be attached to the drape 600, such as in the area 604 (see also fig. 3D). The attachment may be by means of an adhesive, heat sealing or the like.

The cover 550 may comprise one or more rigid or substantially rigid materials, such as any of the materials described herein. For example, the cover 550 may comprise one or more plastic materials. The one or more materials of the cover 550 may be more rigid than the one or more materials of the insert 640. This may be due to the following reasons: the cover 550 provides support for the insertion device 210 and/or visualization device 220, and the insert 640 is substantially flexible to facilitate insertion into the slit 504.

Fig. 3B illustrates the drape coupling 610 as viewed from a side configured to face the bottom surface 410 of the central unit 400 (e.g., an inward facing side or upper surface of the pallet illustrated in fig. 3A). The drape coupler 610 may include one or more attachments or fasteners 614 configured to facilitate mounting the drape coupler 610 to the bottom surface 410 of the central unit 400. The drape coupler 610 may be removably mounted to the bottom surface 410. In some cases, the fasteners 614 may include metal (or another ferromagnetic material) for attachment to the one or more attachments or fasteners (which may be similar to one or more of the fasteners illustrated in fig. 1B-1C) positioned on the bottom surface 410. For example, the fasteners 614 may be metal washers, and the one or more fasteners positioned on the bottom surface 410 may include a magnetic material. The bottom surface 410 may include the same number of fasteners (e.g., four) as the fasteners on the drape coupler 610 to help promote proper alignment between the drape coupler and the bottom surface of the central unit 400.

The instrument interface 420 (and attached surgical instrument (s)) of the central unit 400 may be configured to move (such as linearly) toward and away from a site of interest (such as a surgical site). For example, after mounting a surgical instrument to a respective instrument interface 420 (using, for example, sterile adapter 680), the instrument may need to be advanced forward into the surgical site. To accomplish this movement, the instrument interface 420 may slide forward along one or more grooves on the bottom surface 410 (see, e.g., fig. 2F), which causes the surgical instrument to advance forward accordingly. When the surgical instrument may need to be repositioned or removed, the surgical instrument may need to be retracted away from the surgical site. To accomplish this movement, the instrument interface 420 may be slid rearward along the one or more grooves (such as into the position illustrated in fig. 2F, for example), which may cause the surgical instrument to correspondingly retract away from the surgical site.

As shown in fig. 3B, the drape coupling 610 may include one or more openings (sometimes referred to as windows) to expose the one or more instrument interfaces 420 of the central unit 400. The openings (also illustrated as 624A and 624B in fig. 3C) may be movable to facilitate movement of the one or more instrument interfaces 420 as described herein. To maintain the sterility of the one or more surgical instruments (such as to prevent any portions of the surgical instruments from contacting the non-sterile bottom surface 410 of the central unit 400), the openings may include fixtures or

frames

616A and 616B that may slide forward and backward within the slots or grooves of the drape coupling 610. The

frames

616A and 616B may be rigid or substantially rigid. The frame may comprise a rigid or substantially rigid material, which may comprise any one or more of the rigid or substantially rigid materials described herein. The recess for facilitating movement of the

frames

616A and 616B may be formed, for example, by a structure 608 (illustrated as a frame in fig. 3C) positioned on a side of the drape coupling 610 opposite the side in fig. 3B. The frame 608 may include any one or more of the rigid or substantially rigid materials described herein. A groove may be formed between the frame 608 and another frame positioned on the inward facing side of the tray 610 shown in fig. 3B. The other frame may be rigid (e.g., comprising any one or more of the rigid or substantially rigid materials described herein).

One or more of the windows (624A and 624B) or the frames (616A and 616B) may be configured (e.g., sized and shaped) to match the size and shape of the instrument interface 420. The window may have a substantially similar length and width as the corresponding instrument interface 420.

The

frames

616A and 616B may be attached or connected to one or more flexible or substantially flexible regions or

sections

620A and 620B, which may comprise any of the flexible or substantially flexible materials described herein. The flexible section may collapse and/or expand when the opening is moved, for example, forward and/or backward. This may facilitate maintaining a sterile barrier between the non-central unit 400 (such as the bottom surface 410 thereof) and one or more surgical instruments. As illustrated in fig. 3C, a similar flexible segment (such as segment 621B) may be positioned and connected to the top of

frames

616A and 616B. In fig. 3B, the bottom

flexible sections

620A and 620B are shown in an expanded position or configuration (such as a fully expanded configuration), while the top section is shown in a collapsed position or configuration (such as a fully collapsed configuration). The location (or position) of the opening shown in fig. 3B may correspond to a default location for mounting the drape coupler 610 to the bottom surface 410 of the central unit 400. The site may correspond to a default (or docked) position or site of the instrument interface 420 (such as when the robotic surgical system is being prepared for a medical procedure). The removable opening may be held in a default position by one or more removable fasteners, for example, attached to the edges of the

frames

616A and 616B and one or more surrounding surfaces of the drape coupler 610. For example, an adhesive tear tab may be used as a fastener.

As shown, bottom

flexible sections

620A and 620B (and similar top sections) may include one or more dividers or inserts 618A and 618B. Such inserts may be rigid or substantially rigid. The insert may comprise one or more materials that are more rigid than the one or more materials of

sections

620A and 620B, such as any rigid or substantially rigid material described herein.

Inserts

618A and 618B may facilitate expansion and collapse of

flexible segments

620A and 620B, respectively.

Inserts

618A and 618B may be configured to allow one or more flexible portions of

sections

620A and 620B, respectively, to wrap around, fold, or be received overlapping a respective section when

sections

620A and 620B are collapsing. One or more flexible portions of

segments

620A and 620B may be wrapped around or folded onto

respective inserts

618A and 618B. As illustrated in fig. 3C, the insert 618A may be tapered. For example, the insert 618A includes one or more tapered sides or edges 623A. The insert 619B may be tapered. For example, the insert 619B includes one or more tapered sides or edges 625B. The sides or edges may be tapered toward the one or more flexible portions of the

respective sections

620A and 620B. The tapered shape of the one or

more inserts

618A and 619B may facilitate wrapping or folding the flexible material of the

segments

620A and 620B, respectively, or facilitate the respective segments overlapping each other as the segments are collapsing. For example, the taper may facilitate lifting (or clasping) and folding the flexible material edge while the one or

more sections

620A and 620B are collapsing.

Fig. 3C illustrates the tray 610 viewed from a side opposite the side shown in fig. 3B, such as from an outward facing side (or surface) of the tray. In fig. 3C, the left opening 624A is illustrated in the same location as in fig. 3B, while the right opening 624B is illustrated in a different location. The right opening 624B is illustrated as moving downward (which may correspond to forward movement of the right instrument interface 420 and the mounted surgical instrument, causing the surgical instrument to move toward the site of interest). The right bottom flexible section 620B is illustrated in a collapsed configuration (such as a fully collapsed configuration). The top flexible section 621B is illustrated in an expanded configuration (such as a fully expanded configuration). Flexible segment 621B may include an insert 619B, which may be similar to

inserts

618A and 618B described herein. A flexible segment similar to 621B may be positioned adjacent to a top portion of left window 624A. The flexible section is shown in a collapsed configuration (such as a fully collapsed configuration).

In some cases, when a particular flexible section is in a fully collapsed configuration, the opening is positioned at a maximum distance where it is configured to move in that direction. For example, fig. 3B illustrates the opening retracted to the maximum distance. As another example, fig. 3C illustrates opening 624B moved forward to a maximum distance. The maximum distance associated with movement of the

openings

624A and 624B may correspond to a range of movement of the instrument interface 420.

Although the illustrated central unit 400 and sterile barrier 650 are configured to facilitate attachment of two surgical instruments to the central unit, the central unit 400 and sterile barrier 650 may be configured to facilitate attachment of a single surgical instrument or more than two surgical instruments.

Any of the one or more windows (624A and 624B) may be covered by a cover (sometimes referred to as a protector). The protector may be removable. For example, the protector may be attached or affixed to the bottom surface of the drape coupler 610 (see fig. 3F). Referring to fig. 3A, as shown, a protector 655 may be attached. The protector 655 may cover the entire (or substantially the entire) bottom surface of the drape coupling 610 or a portion of that surface. For example, the protector may be attached with an adhesive. In some cases, the protector may include one or more sections that are independently removable. For example, the protector may include two sections that cover

windows

624A and 624B.

Fig. 3D illustrates the drape 600 in an expanded configuration. The drape 600 is illustrated as being separate from the drape coupler 610. As described herein, the drape 600 may be attached to the drape coupler 610 and in a folded configuration to form an enclosure configured (e.g., sized and shaped) to enclose the central unit 400 (see, e.g., fig. 3A). One or more dimensions of the drape 600 may correspond to (or be larger than) the one or more dimensions of the central unit 400.

The drape 600 may include one or more compartments (sometimes referred to as pockets or pouches) illustrated as 672, 674, 676, and 678. The outer surface (sometimes referred to as the outer side, outer-facing surface, or outwardly-facing side) of the drape 600 may be configured to maintain sterility during a medical procedure. The opposite inner side (sometimes referred to as the inner side, inner facing surface, or inward facing side) of the drape 600 may be in contact with one or more non-sterile surfaces of the central unit 400 and, thus, may not remain sterile (even though the entire sterile barrier 650 may be sterile when packaged). The pouch may help maintain the sterility of the exterior surface of the drape 600 when a user, such as a sterile nurse (e.g., a surgical assistant nurse), covers the central unit 400 with the drape 600. For example, when the drape is attached or affixed to the central unit 400, the pouch may prevent the user's hand from touching any non-sterile surfaces. Any of the pouches described herein can facilitate maintaining sterility of a sterile barrier attached to cover one component of a robotic surgical system.

Any pocket may be configured (such as sized and shaped) to at least partially enclose a user's hand or a portion of a user's hand (such as a finger or fingers). One or more of the

pockets

672, 674, 676, and 678 may be positioned on an exterior surface of the drape 600 (or, in some cases, on an interior facing surface of the drape). Any of the pouches described herein can be formed by attaching a flexible or substantially flexible material to a drape (such as by heat sealing, adhering, etc.), or by causing a portion of the drape material to fold and then heat sealing certain portions to form one or more pouches, with the area of the folded drape that does not require a pouch or enclosure optionally being removed. The material attached to the drape may be the same as or similar to the one or more materials of the drape, which may be any of the flexible materials described herein. One or more of the

pockets

672, 674, 676, and 678 may be configured to enclose a user's hand.

For example, the pouches may be marked with

labels

666, 667, 668, and 669, respectively. Any label may include an indication (or indicia) of which hand (left or right) or which portion of the hand should be inserted into the pouch. For example, as illustrated in fig. 7B, the label 910 may guide the user to insert the right hand into the pocket and the label 912 may guide the user to insert the left hand into the pocket. The hand shape in tab 910 corresponds to the shape of the right hand (thumb on the left side when the palm of the right hand is facing the page). The hand shape in tab 912 corresponds to the shape of the left hand (thumb on the right side when the palm of the left hand is facing the page). Any label may additionally or alternatively guide the user in which direction to insert a particular hand. Referring to fig. 7B, the label 912 may guide the user's insertion into the right hand with the palm facing the central unit 400 because this orientation of the right hand will match the right hand contour depicted in the label (such as when the label is attached to the front or back interior surface of the pocket, the pocket may be positioned on the exterior facing surface of the drape). Similarly, the label 912 may guide the user to insert the left hand with the palm facing the central unit 400, as this orientation of the left hand will match the left hand contour depicted in the label (such as when the label is attached to the rear surface of the pouch). Any of the labels described herein may be attached to the interior or exterior surface of the pouch and/or other surfaces of the drape.

In some cases,

tabs

666 and 667 can guide the user through the right hand and

tabs

668 and 669 can guide the user through the left hand. The pockets may be paired according to the steps of the process for covering the central unit 400 with the drape 600. When two pouches are paired, the user can insert the right and left hands into the respective pouches of the pair to perform a particular step. These tags may provide an indication of pairing. For example, as illustrated in fig. 7C, tags 920 (right hand) and 922 (left hand) include a number "1" indicating that the two tags are paired. The indication of pairing may also correspond to an order of the processes. For example, a number of "1" may indicate an earlier (such as a first) step in a process than one or more tags with subsequent numbers (such as "2", "3", etc.). In some cases, letters, images, etc. may be used instead of or in addition to numbers.

The drape 600 may include one or more attachments or

fasteners

652 and 662. The fasteners 652 may be positioned in the area of the drape that is covered by (or overlaps with) the pocket 672. The fasteners 662 may be positioned in the area of the drape covered by the pocket 678. As described herein, one or more of the

fasteners

652 and 662 may include a ferromagnetic material (such as a metal washer) configured to attach to an attachment or fastener of the central unit, such as one or more of the fasteners 302 and 304 (e.g., by contacting or approaching the ferromagnetic material to the one or more fasteners 302 and 304). Either of the

fasteners

652 and 662 may be positioned on or adjacent to an inner facing surface of the drape 600 that is configured to contact the central unit 400.

In some cases, pockets 672 and 678 may be paired. For example, labels 666 and 669 associated with

pockets

652 and 662, respectively, may correspond to

labels

920 and 922 illustrated in fig. 7C. As shown in fig. 8B-8D, the user may be guided to insert the right hand into the pocket 672 and the left hand into the pocket 678 (or vice versa). Subsequently, the drape 600 may be lifted and attached to the central unit 400 (e.g., by forming magnetic attachments between the

fasteners

652 and 662 and the fasteners 302 and 304). The

pockets

672 and 678 may facilitate maintaining sterility of the exterior-facing surface of the drape 600 as it is attached to the central unit 400. When the drape 600 is in the folded configuration as illustrated in fig. 3A, the

pockets

672 and 678 may be positioned adjacent to one another (see, e.g., fig. 8B-8D).

The drape 600 may include attachments or

fasteners

654, 656, 658, and 660, which may not be attached to the central unit 400. The drape may include fasteners similar to

fasteners

654, 656, 658 and 660 positioned in the same or similar areas as previously described fasteners 652 and 662 (which may be attached to the fasteners of central unit 400, as described herein). For example, the

fasteners

652 and 662 may be positioned on or adjacent to an inner facing surface of the drape, while other fasteners may be positioned on or adjacent to an opposite outer facing surface of the drape (such as on the outer surfaces of the pockets 672 and 678). Because the regions illustrated as 652 and 662 may include multiple fasteners, for simplicity, the fasteners positioned in the same or similar regions as previously described

fasteners

652 and 662 may be referred to as

second fasteners

652 and 662. The

fasteners

654, 656, 658 and 660 and the

second fasteners

652 and 662 may facilitate covering (such as enclosing) the central unit with the drape 600 and maintaining the drape in a desired position during a medical procedure. As described herein, these fasteners may be attached (or connected) to each other. Any of these fasteners may provide removable attachment, and may include hook and loop fasteners (e.g.,

brand fasteners), adhesive fasteners, button fasteners, magnetic fasteners, zippers, and the like.

The

second fasteners

652 and 662 may be positioned in the area of the drape covered by the

pockets

672 and 678, respectively. As described herein,

second fasteners

652 and 662 may be mated to (or configured to attach to)

fasteners

656 and 658, respectively, for example.

Second fasteners

652 and 662 may be removably attached to

fasteners

656 and 658, respectively. In some cases, the

second fasteners

652 and 662 may be VELCRO fasteners.

In some cases, the

pockets

674 and 676 may be paired. For example, the

labels

668 and 667 associated with the

pockets

674 and 676, respectively, may correspond to the

labels

922 and 920 illustrated in fig. 7C (except that the number "1" in the two labels is replaced with, for example, the number "2" indicating a step subsequent to the step indicated by the number "1"). The user may be guided to insert the right hand into the pocket 676 and the left hand into the pocket 674 (or vice versa). The fasteners 656 may be positioned in the area of the drape 600 covered by the pocket 674. The fasteners 658 may be positioned in the area of the drape 600 covered by the pockets 676. The fastener 656 may mate with or be coupled to the second fastener 652. Fastener 658 can be mated with or connected to second fastener 662. As illustrated in fig. 8E-8F, fastener 656 may be removably attached to second fastener 652, and fastener 658 may be attached to second fastener 662. In some cases, the

fasteners

656 and 658 may be VELCRO fasteners. The

pockets

674 and 676 can facilitate maintaining sterility of the outer-facing surface of the drape 600 as the user attaches the

fasteners

656 and 658 to the

second fasteners

652 and 662, respectively. As illustrated in fig. 3A, the

pouches

674 and 676 may be positioned adjacent to one another (see also, e.g., fig. 8E-8F). The

pockets

674 and 676 may be positioned opposite the

pockets

672 and 678 when the drape 600 is in the folded configuration (see, e.g., fig. 8B-8F).

The drape 600 may include

fasteners

654 and 660. These fasteners may be mated.

Fasteners

654 and 660 may be attached (e.g., removably attached) to one another, as illustrated in fig. 8G. In some cases,

fasteners

654 and 660 may be VELCRO fasteners. The

fasteners

654 and 660 may be connected to each other to tighten the drape 600 around the central unit 400, as illustrated in fig. 8G. For example, the

fasteners

654 and 660 may be positioned in a portion of the drape 600 configured to cover a rear portion of the central unit 400. One or more pouches may not be needed to attach

fasteners

654 and 660, for example, due to the low or no risk of a user touching or otherwise contacting any non-sterile surfaces of central unit 400. For example, there may be a fold on the outward facing surface of the drape where

fasteners

654 and 660 are located. The user may grasp or pinch these folds to connect

fasteners

654 and 660 without risk of touching any non-sterile surfaces of central unit 400.

In fig. 3D, all of the pockets and fasteners are illustrated as being positioned near the top edge of the drape. Such positioning may be appropriate because the underside of the drape 600 may be attached to the drape coupler 610. As described herein, the drape coupler may be attached to the bottom surface 410 of the central unit 400, which may eliminate the need to separately attach the bottom portion of the drape 600 to the central unit 400 (and thus include one or more pockets or fasteners). In some cases, any of the pouches, fasteners, or labels may be positioned in different locations (including on different surfaces) or removed. Additional pouches, fasteners or label fasteners may be added.

Sterile adapter for surgical instrument interface

Fig. 4A-4D illustrate sterile adaptor 680 in front perspective, side, rear, and top perspective views, respectively. Sterile adapter 680 (or a plurality of sterile adapters as shown in fig. 2F) may be part of a sterile barrier 650 for central unit 400. The adapter 680 may attach to the instrument interface 420 and provide a sterile barrier between the instrument interface and the surgical instrument. The illustrated adapter 680 can be a sterile barrier for the left (see "L" in front of the adapter, as shown at 683) instrument interface 420 (see, e.g., fig. 3B-3C) of the central unit 400. The right instrument interface 420 may be covered with a similar sterile adapter.

The adapter 680 may include a housing configured to support a surgical instrument (see, e.g., fig. 4G-4H). The adapter 680 may be removably attached to the instrument interface. As illustrated in fig. 4A, the closure 690 may be configured to attach the adapter 680 (such as a front portion of the adapter) to the instrument interface 420. As illustrated in fig. 4D, the closure 690 may include a release mechanism (e.g., handle) 692. Referring to fig. 8L, the closure 690 may be releasably attached to (or mated with) the opening 428 of the instrument interface 420. As shown in fig. 4B-4C and 8L, the closure 690 may include a protrusion or latch 691 configured (such as sized and shaped) to be inserted into the opening 428 when the adapter 680 is attached to the instrument interface 420. The latch 691 may be positioned on the rear of the closure 690 (such as on or adjacent to the rear of the handle 692). The handle 692 may move or flex to release the latch 691, which causes the latch 691 to disengage the opening 428 in the instrument interface 420. For example, a user may pull handle 692 to release adapter 680. In some cases, the user may push handle 692 to release adapter 680.

The latch 691 may comprise a plurality of latches. Such latches may be shorter and may not extend along the entire length of the closure member 690 (see fig. 4C). For example, two latches may be positioned on opposite sides of the closure member 690. As another example, three latches may be positioned as follows: two on opposite sides of the closure member 690 and one in the middle of the closure member 690. In some cases, other combinations and/or locations of latches may be present.

As illustrated in fig. 4B-4D, the adapter 680 can include one or more protrusions 682 (sometimes referred to as tabs or hooks) positioned on a side (such as a back side) of the adapter 680 opposite the closure member 690. The protrusion 682 may be configured to attach (such as removably attach) a rear portion of the adapter 680 to the instrument interface 420. Referring to fig. 8K-8L, the protrusions 682 may connect to holes or openings 426 positioned in the rear portion of the instrument interface 420 (such as in the direction illustrated by the arrow in fig. 8K). The projections 682 may be shaped as hooks configured to attach to the corresponding openings 426, as shown by the arrows in fig. 8K. The protrusion 682 may contact (e.g., hook) a surface of the opening 426, such as an edge of the opening. This attachment may be removable because moving the adapter 680 downward (such as at an angle) may release the back portion of the adapter. Fig. 8M illustrates adapter 680 attached or attached to instrument interface 420.

Referring to fig. 4D and 8K-8M, one or more protrusions or plates 689 on each side of adapter 680 may facilitate one or more of the following: attaching the adapter to the instrument interface 420, removing the adapter from the instrument interface, and supporting the adapter by the instrument interface. The plate 689 may contact a side portion of the instrument interface 420, as illustrated in fig. 8M.

As described herein, the adapter 680 can include a plurality of actuator covers 622 (see, e.g., fig. 4D) configured to receive the plurality of actuators 422 of the central unit 400. Actuator cap 622 may provide a sterile interface between actuator 422 of instrument interface 420 and an actuator of a surgical instrument (such as actuator 322 of a surgical instrument, such as instrument 364 illustrated in fig. 4F). Movement of the actuator 422 may be transmitted to the actuator 322 of the surgical instrument through actuator covers 622, which may be configured to move with (e.g., side-to-side) the actuator 422. This causes articulation or movement of an end effector portion of the instrument, such as end effector 366 of instrument 364 illustrated in fig. 4F.

It may be advantageous to facilitate removal of the surgical instrument(s) 364 from the site of interest if the robotic surgical system (or any component thereof) malfunctions, loses power, is in an emergency, etc. Actuator cap 622 is illustrated in fig. 4A-4D as being positioned or aligned (such as centrally aligned), which may correspond to a default position or alignment of actuator 422 (such as for loading surgical instruments; see, e.g., fig. 8L). During performance of a medical procedure, the actuators 422 (and actuator caps 622), which may be configured to move independently of one another, may no longer be in a default (aligned) position due to manipulation of the end effector portion of the surgical instrument. Due to misalignment, it may not be possible to remove the instrument by simply pulling the surgical instrument out of sterile adapter 680. Sterile adapter 680 may be configured to allow removal of a surgical instrument while the robotic surgical system is in use by rotating the surgical instrument to disengage actuator 322 of the surgical instrument from actuator 422 covered by actuator cap 622. This design may promote safety, simplicity and efficiency, among other advantages.

Referring to fig. 4A and 4B, the adapter 680 may include a groove or guide 684 (sometimes referred to as a slot) configured (such as sized and shaped) to receive a housing of a surgical instrument (see, e.g., fig. 4F-4H). The guide 684 may have a width 686 that matches a width of a surgical instrument housing (e.g., housing 365, which is shaped as a rectangular box, as shown in fig. 4F-4H). The guide 684 may facilitate loading (or removal) of the surgical instrument housing. The guide 684 may include a protrusion 687 (such as a rib or rail) configured (such as sized and shaped) to guide the surgical instrument housing into the adapter 680. The surgical instrument housing may include an opening or recess (such as recess 370 illustrated in fig. 4F) configured to receive the protrusion. The groove may be positioned on a side of the housing of the surgical instrument (such as the left side for a left instrument, as illustrated in fig. 4F).

The guide 684 may be configured to guide the surgical instrument housing into the adapter 680. As illustrated in fig. 4A, the guide 684 may be oriented at an angle relative to a horizontal plane in which the actuator 422 and actuator cover 622 may be oriented. The plane of the guide 684 may be inclined relative to the plane of the actuator cap 622. This may facilitate loading (or removing) the surgical instrument housing at an angle. The angle may be 5 degrees (or less or greater), 8 degrees, 10 degrees (or less or greater), 12 degrees (or less or greater), 15 degrees (or less or greater), 20 degrees (or less or greater), and the like. The angle may be less than 5 degrees or greater than 20 degrees. When a surgical instrument is loaded through the guide 684, the surgical instrument actuator 322 may not engage (or be coupled to) the actuator 422 covered by the actuator cap 622.

The surgical instrument housing 365 may be rotated within the adapter 680 to facilitate engagement of the surgical instrument actuator 322 with the actuator 422 (covered by the actuator cover 622). As illustrated in fig. 4A-4B, the fastener 694 (sometimes referred to as a clasp) can be configured to do one or more of the following actions: a housing supporting the surgical instrument housing and a rotation housing within adapter 680. The fastener 694 can include a protrusion 695 (sometimes referred to as a rib or rail) configured (e.g., sized and shaped) to engage the surgical device housing. For example, the rails 695 of the fastener 694 can engage an opening or recess (such as the recess 370 illustrated in fig. 4F) positioned on a side of the surgical device housing 365. The rails 687 of the guides 684 and the rails 695 of the fasteners 694 can be horizontal or substantially horizontal (see, e.g., fig. 4B), and the grooves can be the same grooves described herein in connection with the rails 687.

The fastener 694 can include (e.g., be connected to) a handle or lever 696. The user may move the lever in one or more directions, such as up and down. When the lever 696 is moved upward (e.g., due to a user pushing the lever upward), the fastener 694 and the rail 695 can be moved upward. This causes the surgical instrument housing to rotate. For example, rotation may be due to the rail 695 moving upward and causing the side of the instrument on which the groove 370 is located to move upward. In some cases, the lever 696 may be pulled downward and/or to one side to cause rotation of the surgical device housing 365.

Referring to fig. 4G, surgical instrument housing 365 is illustrated positioned in adapter 680, which is shown positioned upside down. Unlike normal operation, the surgical instrument housing 365 is positioned upside down in the adapter to illustrate the actuator 322. The user may move the lever 696 downward (or upward when the adapter 680 is properly positioned), as illustrated by arrow 442. This causes the surgical device housing 365 to rotate in the direction of arrow 444. The rotation may be in a clockwise direction. In some cases, the rotation may be in a counterclockwise direction. The position of the rotated surgical instrument housing 365 is illustrated in fig. 4H (which also shows the adapter and the inverted surgical instrument housing).

The lever 696 may be locked into position such that the surgical instrument housing 365 remains in a rotated position in which the surgical instrument actuator 322 is engaged with the actuator 422 (covered by the actuator cover 622). By locking (or unlocking) the closure (such as a latch) of the lever, the lever can be locked into place (or unlocked during removal of the surgical instrument). The user may lock the lever 696 in place by, for example, moving the lever 696 outward (or in a direction away from the adapter 680). Unlocking the lever 696 may be performed by moving the lever in the opposite direction.

Referring to fig. 4E, a rear view illustrates the central unit 400 with surgical instruments 364 attached to the instrument interface 420 (or loaded). Referring to fig. 4F, instrument 364 may include a surgical instrument housing 365, a shaft 368 connected to the housing, and an end effector 366 connected to the shaft. As illustrated in fig. 4E, the shaft 368 and end effector 366 may be loaded through an opening 340 formed in the rear of the housing 212 of the insertion device 210. The surgical instrument housing 365 may rotate (or pivot) about an axis 440 that traverses along the center of the shaft of the surgical instrument. The axis 440 may coincide with an axis that traverses along the center of the end effector 366. The surgical instrument housing 365 may rotate about an axis that traverses along a center of the end effector 366. The axis 440 may coincide with an axis that traverses along the center of the opening 340 in the insertion device 210 through which the end effector and the shaft of the surgical instrument are inserted during loading. The surgical instrument housing 365 may rotate about an axis that traverses along (or through) the center of the opening 340.

To load the surgical instrument 364, the user may move the surgical instrument housing 365 through the guide 684 (at an angle, as described herein). Referring to fig. 4B and 4F, the length 685 of the guide 684 may be shorter than the length of the surgical instrument housing 365. Once a portion (or all) of the surgical device housing 365 passes through the guide 684, it may engage the rail 695, as described herein. In some cases, surgical instrument housing 365 may engage with a slot 688 positioned at the top of adapter 680, as shown in fig. 4A. The surgical device housing 365 may be supported by one or more of the rails 695 or the slots 688. In some cases, as illustrated, adapter 680 does not include a bottom. Referring to fig. 4B and 4F, the length 685 of the portion of the adapter adjacent to the guide 695 may be sufficient to receive the entire surgical instrument housing 365. The length 681 of this portion may match the length of the surgical device housing 365, such as being the same as, substantially the same as, or greater than the length of the surgical device housing. Once loaded, the surgical instrument housing 365 may be rotated (and optionally locked) into position in which the surgical instrument actuator 322 is engaged with the actuator 422 (covered by the actuator cover 622).

As illustrated in fig. 4A-4D, the guide 684 may be positioned on or in a first side portion of the housing of the adapter 680. The fastener 694 (and the rail 695) can be positioned on or in the second side portion of the housing of the adapter 680. The first side portion and the second side portion may be positioned on the same side of the housing (e.g., the left side if an adapter for a left instrument). The first side portion and the second side portion may not be connected. For example, the first side portion and the second side portion may be separated by a gap as shown in fig. 4B. In some cases, the guide 684 and the fastener 694 may be positioned in the same side portion.

In some cases, any of the actuators 422 may be tapered, as illustrated in fig. 8K-8L. The base (or proximal portion) of the respective actuator 422 may be wider than the end (or distal portion) of the actuator. Any actuator cap 622 may similarly be tapered. The tapered shape may facilitate engagement with the surgical instrument actuator 322 as the surgical instrument housing is rotated.

To remove instrument 364, the user may perform the steps opposite those performed during unloading of the instrument. For example, the lever 696 may be unlocked. The latch may be unlocked (such as by moving the lever 696 inward). This causes the fastener 694 and the rail 695 to move downward, which causes the surgical device housing 365 to rotate. The surgical instrument actuator 322 may be disengaged from the actuator 422 (covered by the actuator cover 622). The instrument may be removed from adapter 680.

The fastener 694 can include a resilient element, such as a spring. For example, the rails 695 may be biased by a resilient material or element into a position (such as a downward position) in which the surgical device housing 365 does not rotate. To rotate the surgical device housing 365, the user may move the lever 696 upward, which causes compression of the resilient material. When the user releases the lever 696, the resilient material may decompress, causing the rail 695 to move downward. This may facilitate easier removal of the surgical instrument.

Referring to FIG. 4I, an adapter 680' is illustrated. The adapter 680' may be similar to the adapter 680 (or vice versa). The adapter 680 'can include a plurality of rail sections 695' (e.g., two as shown), which can operate similar to the rails 695. In some cases, more than two rail sections 695' may be included. The rail sections 695' may be separated by one or more gaps. The lever 696' may operate similar to the rail 696. The rail 696' may be shorter than the lever 696. The lever 696 'may be integrated into a side of the housing of the adapter 680'.

Referring to fig. 4J, a combination 1300 of the adapter 1315 and the surgical instrument housing 365 is illustrated. The adapter 1315 may be similar to the adapter 680 (or vice versa). The cover 1302 may be positioned on the surgical device housing 365. The cover 1302 may be connected to (e.g., removably connected to) the surgical instrument housing 365. The cover 1302 may include one or more protrusions 1304 (sometimes referred to as teeth). The housing of the adapter 1315 may include one or more openings 1306 configured to receive the protrusions 1304 of the cover 1302. As the surgical device housing 365 is rotated, the protrusion 1304 may engage the opening 1306. This may maintain the surgical instrument housing 365 in a rotated position. The surgical instrument housing 365 may be manually rotated (e.g., moved downward or upward) by a user.

The release mechanism 1312 may be positioned on or in the housing of the adapter 1315. The release mechanism 1312 may be a latch, such as a latch with an elastic material (e.g., a spring). The release mechanism 1312 may be operated by a user (e.g., moved to the right or left) to release the engagement of the protrusion 1304 with the opening 1306. This causes the surgical device housing 365 to be released. The release mechanism 1312 may control one or more release members 1308 positioned in the housing of the adapter 1315. Each release member 1308 may release the engagement of a corresponding pair of protrusions 1304 and openings 1306. For example, the release member 1308 may be moved upward to push the protrusion 1304 upward and disengage the protrusion 1306 from the opening 1306.

Referring to fig. 4K, cover 1302' may include a release mechanism 1332. The cover 1302' may be similar to the cover 1302 (or vice versa). The release mechanism 1332 may be a latch, such as a latch with a resilient material (e.g., a spring). The release mechanism 1332 may operate similar to the release mechanism 1312. The adapter 1315' may be similar to the adapter 1315 (or vice versa). The adapter 1315' may not include one or more of the release mechanism 1312 and/or the release member 1308.

Referring to fig. 4L-4O, the adapter 1340 may include a support or retainer 1342 configured to support the surgical instrument housing 365. Holder 1342 may support the bottom of surgical instrument 364. Holder 1342 may be similar to either cover 1302 or 1302', but may be integrated with adapter 1340. Holder 1342 may be rotated to cause surgical instrument 364 to rotate. For example, retainer 1342 may rotate counterclockwise. The retainer 1342 may operate as a lever or lever arm. The release mechanism 1352 may be operated by a user (e.g., moved to the right or left) to cause the retainer 1342 to rotate (e.g., in the opposite direction, such as clockwise) and the surgical instrument housing 365 to be released. The release mechanism 1352 may be a latch, such as a latch having a resilient material (e.g., a spring). Retainer 1342 may be rotated manually by a user or by operating release mechanism 1352, as described herein.

In some cases, a shaft of the surgical instrument (such as shaft 368) may be flexible or substantially flexible. The surgical instrument housing may be rotated by flexing a shaft of the instrument. For example, referring to fig. 4E, the shaft 368 may be loaded into the instrument channel through the opening 340. The surgical instrument housing 365 may be rotated by flexing the shaft 368 to facilitate engagement of the surgical instrument actuator 322 with the actuator 422 (covered by the actuator cap 622).

In some cases, any instrument channel may be wider at an end closer to the central unit 400 (such as an end proximal to the opening 340). This may allow the shaft 368 to move within the instrument channel. The surgical instrument may be loaded and rotated at an angle to facilitate engagement of the surgical instrument actuator 322 with the actuator 422 (covered by the actuator cap 622). The shaft may be moved through a wider portion of the instrument channel to facilitate rotation.

In some cases, in addition to or instead of rotation, any of the adapters described herein may be configured to facilitate any movement or transition of a surgical instrument from a first position or orientation in which surgical instrument actuator 322 is disengaged from actuator 422 (covered by actuator cover 622) to a second position or orientation in which instrument actuator 322 is engaged with actuator 422. Surgical instruments may be loaded and unloaded by moving forward and backward in or within the adapter, moving side-to-side in or within the adapter, or more generally moving from one location to another in or within the adapter.

In some cases, some or all of the adapters described herein may not be used. The one or more instrument interfaces 420 can be sterilized prior to loading the one or more instruments. The one or more instrument interfaces 420 may be configured to allow the one or more instruments to rotate (or transition) using any of the methods described herein.

Sterile barrier for arm

Fig. 5 illustrates a drape 700 for the arm 300 in an expanded configuration. The drape 700 may be positioned (e.g., removably attached) on the arm 300. The drape 700 may enclose at least a portion of the arm 300 (see, e.g., fig. 8O-8U). Similar to the drape 600, the drape 700 may be flexible or substantially flexible.

As described herein in connection with the drape 600, the drape 700 may include one or

more pouches

720 and 722. These pockets may be similar to any of the pockets described herein, such as any of the

pockets

672, 674, 676, and 678 of the drape 600. The

pouches

720 and 722 may be positioned on the outward facing surface of the drape 700, which may provide a sterile barrier, as described herein.

Pouches

720 and 722 may be marked, for example, with

labels

728 and 730, respectively. The

labels

728 and 730 may be similar to any of the labels described herein, such as any of the

labels

666, 667, 668, and 669 of the drape 600. As described herein, the

labels

728 and 730 may include instructions that guide the user to insert a particular hand (or portion of a hand) into the pocket. The tab 728 may guide the user to insert the left hand (or a portion of the left hand) into the pocket 720. The label 730 may guide the user to insert the right hand (or a portion of the right hand) into the pocket 722. The

pockets

720 and 722 may be paired as described herein with respect to the drape 600. The label may provide an indication of pairing, such as including the number "1" as described herein (e.g., representing an earlier or first step in the process for covering the arm 300 with the drape 700).

The drape 700 may include one or more attachments or

fasteners

710, 712, and 714, which may be similar to any of the

fasteners

652 and 662 of the drape 600. The fasteners 710 may be positioned in the area of the drape that is covered by (or overlaps) the pocket 720. The fasteners 714 may be positioned in the area of the drape 700 covered by the pocket 722. The fasteners 712 may be positioned in an area of the drape 700 that is not overlapped by the pocket (such as in the middle). As described herein, for example, in connection with

fasteners

652 and 662, one or more of the

fasteners

710, 712, and 714 may include a ferromagnetic material (such as a metal washer) configured to be attached to an attachment or fastener of the arm 300. As described herein, any of the

fasteners

710, 712, and 714 may be positioned on or adjacent to an inward facing surface of the drape 700, which may be configured to contact the arm 300.

As described herein in connection with the pocket of the drape 600, the

pockets

720 and 722 may facilitate maintaining sterility of the outer surface of the drape when a user attaches one or

more fasteners

710, 712, and 714 to the fasteners of the arm 300 (as shown, for example, in fig. 8O-8P). As illustrated in fig. 5 and 8O-8P, a pocket may not be needed to facilitate attachment of the fastener 712, as the use of

pockets

720 and 722 may be sufficient for attaching the fastener 712. For example, because the fastener 712 may be positioned in a middle portion of the drape 700, it will contact or be proximate to the fastener 402 positioned in the middle of the arm 300. In some cases, a pocket may be provided that overlaps fastener 712. In some cases, when such a pocket is provided, any one or more of

pockets

720 or 722 may be omitted.

The drape 700 may include a pocket 724 that may be positioned over the flap 760 on the right side of the drape. Pouch 724 may be similar to any pouch described herein. The bladder 724 may be positioned on an outward facing surface of the drape 700. The pocket 724 may be configured to enclose a portion of a user's hand (such as the left hand) to facilitate enclosing a portion of the arm 300 with the drape (such as wrapping the drape 700 around the arm; see, e.g., fig. 8Q-8U). In some cases, pouch 724 may be smaller than either of

pouches

720 or 722. For example, the capsular bag 724 may be configured (e.g., sized and shaped) to enclose a portion of a user's hand, such as completely or partially enclosing four fingers in addition to a thumb (see, e.g., fig. 8R). In some cases, pouch 724 may be configured to enclose less than four fingers. The drape 700 may include a label 729, which may be similar to any of the labels described herein. Label 729 may guide the user to insert a portion of the left hand into pouch 724. The label 729 can include instructions for steps in the process of covering the arm 300. Such a step may be subsequent to the step of attaching the

fasteners

710, 712, and 714 to the arm 300 (and attaching the top portion of the drape to the arm). For example, label 729 may include the number "2," as described herein. The capsular bag 724 may facilitate one or more of the following: maintaining sterility of the outwardly facing surface of the drape as the drape is positioned over the arm 300 (such as wrapped around the arm), facilitating wrapping of the drape 700 around the arm 300 (e.g., by providing an anchor or level to the user), and the like. Pouch 724 may not be paired with another pouch.

The pocket 724 may be used to facilitate wrapping the drape 700 around the arm 300. Referring to fig. 8Q, the user may separate the tab 760 from the drape (such as a middle portion of the drape adjacent to the tab 760). For example, a user may remove or break a tearable tab or another removable or separable closure or attachment. Referring to fig. 8R, the user may wrap the flap 760 (and in some cases, other portions of the drape) around the arm 300. For example, a user may wrap the flap around one or more of the sides or back of the arm 300 to cover those portions of the arm. The illustrated arrow may indicate a direction (such as counterclockwise) for wrapping the drape 700 around the arm 300. The user may wrap the drape by using a hand (such as the left hand) positioned in the pouch 724.

Referring to fig. 5, the drape may include one or

more fasteners

740, 742, 744, 746, 748, and 750, which may be similar to any of the fasteners described herein (such as

fasteners

654, 656, 658, and 660 of drape 600). For example,

fasteners

740, 742, 744, 746, 748, and 750 may be VELCRO fasteners. As described herein, the fasteners may be mated. For example, the pairing may be: 740 and 742, 748 and 750, and 744 and 746. The mated fasteners may be attached to one another to facilitate covering the arm 300 with the drape 700 (such as wrapping the drape around the arm). The

fasteners

740, 744, and 748 may be positioned on the flap 762 (on the left side of the drape), such as on the inward facing surface (or on the outward facing surface) of the flap. The

fasteners

742, 746, and 750 may be positioned on the flap 760 (on the right side of the drape), such as on the surface opposite the mated

fasteners

740, 748, and 744 (e.g., on the outward facing surface). In some cases,

fasteners

742, 746, and 750 may be positioned on the same surface as the mated

fasteners

740, 744, and 748.

Referring to fig. 8S, the drape 700 is illustrated wrapped around the arm 300 (such as after the flap 760 is wrapped around the arm). A user's hand (such as the left hand) may be left in the capsular bag 724. The user may wrap the flap 762 (and, in some cases, other portions of the drape) around the portion of the drape wrapped around the arm (such as flap 760) with the other hand (such as the right hand). The user may also attach the paired

fasteners

740 and 742 to each other, as illustrated in fig. 8T.

The user may touch or grasp tab 762 as illustrated without risk of touching (or with low risk of) a surface that has been in contact with any non-sterile surface of arm 300. This risk may not be present (or may be low) because the flap 762 may be attached to the drape (such as to an intermediate portion of the drape adjacent the flap 762), as described in connection with the flap 760. The user may separate the flap 762, for example, by removing or breaking a tearable tab or another removable or separable closure or attachment. The user may wrap the flap 762 around the flap 760 as illustrated by the arrow in fig. 8T. The attachment of

fasteners

740 and 742 may secure the top portion of the drape 700 around the arm 300. The attachment of mated

fasteners

748 and 750 may similarly facilitate securing the medial portion of the drape about arm 300.

As illustrated in fig. 5, the capsular bag 724 may be positioned adjacent to (or overlapping) the fastener 742. This can facilitate attachment of the fastener 742 to the fastener 740. In some cases, one or more bladders (which may be similar to bladder 724) may be positioned on flap 762. For example, a pocket similar to pocket 724 may be positioned adjacent to (or overlapping) fastener 740. One or more pouches may be positioned adjacent to (or overlapping with) one or more of the

fasteners

746, 748, and 750.

Drape 700 may include a bladder 726, which may be similar to bladder 724. The pockets 726 may be positioned in a bottom portion of the drape, such as in a bottom portion of the flap 762. Label 731 (which may be similar to any of the labels described herein) may guide a user to insert a hand (or a portion of a hand), such as the right hand, into pouch 726. Label 731 may include an indication of the steps in the process of covering the arm after attaching

fasteners

740 and 742. For example, label 729 may include the number "3" as described herein. The pocket 726 may not be paired with another pocket.

As illustrated in fig. 8U, pocket 726 may facilitate attachment of

fasteners

744 and 746. For example, fasteners 744 may be positioned on the outward facing surface of the bladder 726. Referring to fig. 5, pocket 726 may overlap fastener 744. This may provide an anchor or lever to the user for facilitating attachment of

fasteners

744 and 746.

The attachment of the

fasteners

740 and 742 may secure (or tighten) the bottom portion of the drape 700 around the arm 300. As illustrated in fig. 8U, the bottom portion of the drape 700 may partially overlap the top portion of the drape 600. The

tiles

600 or 700 may be moved independently of one another, for example, due to the tiles being separate (or modular). Movement of one drape may not cause movement of another drape. This modularity and independence of the drape provides advantages over existing unitary drapes that are large and cumbersome and require multiple users for installation. Some advantages include: facilitating securing and close fitting of the drape around different robotic surgical system components having different shapes and sizes (such as the central unit 400 and the arm 300), facilitating easier and more efficient management and installation of the drape (e.g., facilitating installation by a single user (such as a sterile nurse), facilitating faster installation, and increasing safety by reducing the risk of loss of sterility during installation (e.g., due to the sterile surface of the drape contacting a non-sterile surface of the system components).

In some cases, the

tiles

600 and 700 may be coupled. For example, the

tiles

600 and 700 may be attached to each other using any of the one or more fasteners described herein.

In some cases, any of the pouches, fasteners, or labels illustrated in fig. 5 may be positioned in different locations (including on different surfaces) or removed. Additional pouches, fasteners or label fasteners may be added. In some cases, the drape 700 may include additional drape areas or portions (e.g., shown as 770 in fig. 8Q-8T) positioned over one or more of the

pockets

720 and 722. The additional drape portion may include a more rigid material (than the material of drape 700) in order to cause the additional drape portion to remain upright during the medical procedure. In some cases, the additional drape portion may alternatively or additionally include a support (such as a support membrane) configured to hold the additional drape portion upright. The inclusion of additional drape portions may be useful when a sterile barrier is needed over the point or area securing the drape 700 to or on the robotic surgical system. The inclusion of additional drape portions may additionally or alternatively be useful to facilitate a user (such as a sterile nurse) of average height to secure the drape 700 to the arm 300 without otherwise being supported (e.g., by using a ladder) to reach the fasteners on the arm 300, while providing sufficient sterile barrier coverage of the arm over the fasteners.

Sterile barrier for columns

Fig. 6A illustrates the drape 800 in an expanded configuration. The drape 800 may be positioned on the post 200 (e.g., removably attached). The drape 800 may cover at least a portion of the post 200 (see, e.g., fig. 8V-8W). Similar to either of the

drape

600 or 700, the drape 800 may be flexible or substantially flexible.

As described herein in connection with either of the

drape

600 or 700, the drape 800 may include one or

more pouches

820 and 822. The pockets may be similar to any of the pockets described herein, such as any of the

pockets

672, 674, 676, and 678 of the drape 600 or any of the

pockets

720 and 722 of the drape 700. The

pouches

820 and 822 may be positioned on the outward facing surface of the drape 800, which may provide a sterile barrier, as described herein. The

pockets

820 and 822 may be marked, for example, with

labels

828 and 830, respectively. The

labels

828 and 830 may be similar to any of the labels described herein, such as any of the

labels

666, 667, 668, and 669 of the drape 600 or any of the

labels

728 and 730 of the drape 700. As described herein, the

tabs

828 and 830 may include instructions that guide the user to insert a particular hand (or portion of a hand) into the pocket. The tab 828 may guide the user to insert the left hand (or a portion of the left hand) into the pocket 820. The tab 830 may guide the user to insert the right hand (or a portion of the right hand) into the pocket 822. The

pouches

820 and 822 may be paired as described herein with respect to the

drape

600 or 700. The label may provide an indication of pairing, such as including the number "1" as described herein (e.g., representing an earlier or first step in the process for covering the post 200 with the drape 800).

The drape 800 may include one or more attachments or

fasteners

810, 812, and 814, which may be similar to any of the

fasteners

652 and 662 of the drape 600 or the

fasteners

710, 712, and 714 of the drape 700. The fasteners 810 may be positioned in the area of the drape that is covered by (or overlaps with) the pocket 820. The fasteners 814 may be positioned in the area of the drape covered by the pocket 822. The fasteners 812 may be positioned in an area of the drape that is not overlapped by the pocket (such as in the middle). As described herein, for example, in connection with the

fasteners

652 and 662 of the drape 600 or the

fasteners

710, 712, and 714 of the drape 700, one or more of the

fasteners

810, 812, and 814 may include a ferromagnetic material (such as a metal washer) configured to attach to an attachment or fastener of the post 200. As described herein, any of the

fasteners

810, 812, and 814 can be positioned on or adjacent to an inner facing surface of the drape 800, which can be configured to contact the post 200.

As described herein in connection with the pouch of the

drape

600 or 700, the

pouches

820 and 822 can facilitate maintaining sterility of the outer surface of the drape when a user attaches one or

more fasteners

810, 812, and 814 to the fasteners of the post 200 (as shown, for example, in fig. 8V-8W). As illustrated in fig. 6A and 8V-8W, a pocket may not be needed to facilitate attachment of the fastener 812, as the use of

pockets

820 and 822 may be sufficient for attaching the fastener 812 (similar to the drape 700). For example, because the fastener 812 may be positioned in a middle portion of the drape 800, it will contact or be proximate to the

fasteners

202, 204, 206, or 208 positioned on the post 200. In some cases, a pocket may be provided that overlaps the fastener 812. In some cases, when such a pouch is provided, any one or more of the

pouches

820 or 822 may be omitted.

Providing a sterile barrier for the column may be advantageous if the central unit 400 (which may be movable) is in contact with the column 200, another sterile object (such as an instrument) is in contact with the column, a sterile user is in contact with the column, etc. In some cases, the drape 800 may not be configured (such as sized and shaped) to wrap around the post 200 or a portion of the post, as it may be sufficient to protect a portion of the post 200 (e.g., the portion facing the central unit 400 and/or the patient during a medical procedure). In some cases, the drape 800 may be configured to wrap around the post 200 (or a portion thereof) as described herein in connection with one or more of the

drapes

600 or 700.

The drape 800 may be positioned in different orientations (or in different locations) to cover different portions of the post 200. Referring to fig. 1B-1C, four

fasteners

202, 204, 206, and 208 may be positioned on the post 200. The drape 800 may include three

fasteners

810, 812, and 814. Because the number of fasteners of the column 200 may exceed the number of fasteners of the drape 800, the drape 800 may be positioned in different orientations to cover the column 200.

Positioning the drape in different orientations may provide a sterile barrier and/or facilitate protecting the column 200 from contact with blood, fluids, tissue, etc. during a medical procedure. The orientation of the drape 800 may be selected based on the location of the post 200 relative to the patient, the type of medical procedure, and the like. For example, the bedside robotic arm cart 104 (which may be mobile) may be positioned in different locations in the operating room. Depending on the location of the bedside robotic arm car 104, the particular orientation of the drape 800 may be selected to provide a sterile barrier to particular portions of the column 200 and/or to protect particular portions of the column 200 from being splashed, soiled, etc. during a medical procedure.

Fig. 6B illustrates the positioning of the fastener on the post 200. For example, the fastener 202 may be positioned in a front portion of the column, which may face the central unit 400 (see also fig. 1B). The drape 800 may be positioned on, affixed to, or attached to the post 200 in one or more of the following orientations:

front (attached to

fasteners

208, 202 and 204),

left (attached to

fasteners

202, 208 and 206),

right (attached to

fasteners

202, 204, and 206), or

Post (attached to

fasteners

208, 206, and 204).

Any of the

fasteners

810, 812, and 814 of the drape 800 may be attached to (or coupled with) any of the

fasteners

202, 204, 206, and 208 of the post 200. Referring to fig. 8V-8W, positioning of the drape 800 on the post 200 is illustrated. As illustrated in fig. 8V, the fastener 812 of the drape 800 may be attached to any of the

fasteners

202, 204, 206, and 208 of the post 200.

The drape 800 may include additional drape portions 870 (shown, for example, in fig. 8V). The additional drape portion 870 may be the same as or similar to the additional drape portion 770 described herein.

In general, any robotic surgical system component may include more fasteners than a sterile barrier configured to cover the component. This may facilitate positioning or attaching the sterility barrier in different orientations to cover different portions of the part. In some cases, more or fewer fasteners than described herein may be positioned on any robotic surgical system component to facilitate a greater or fewer number of orientations of the sterile barrier covering the component. In some cases, more or fewer fasteners than described herein may be positioned on any sterile barrier to facilitate a fewer or greater number of orientations.

In some cases, the fasteners of the robotic surgical system component may have at least one dimension that is different from a corresponding dimension of the fasteners of the sterile barrier. This may facilitate positioning or attaching the sterility barrier in different orientations to cover different portions of the part. Referring to fig. 11, sterile barrier 1400 may include fasteners 1402. Robotic surgical system component 1450 may include fasteners 1452. The length of fastener 1452 can exceed or be longer than the length of fastener 1402, thereby permitting sterile barrier 1400 to be positioned in various orientations to cover at least a portion of part 1450. In some cases, the length of the fastener 1402 can be longer than the length of the fastener 1452 while permitting the same or similar objectives to be achieved. The excess portion of the sterile barrier 1400 not attached to the fasteners 1452 can be removed or folded.

The

fasteners

1402 and 1452 can include any one or more of the fasteners described herein, such as ferromagnetic and magnetic materials, VELCRO, adhesives, buttons, zippers, and the like. For example,

fasteners

1402 and 1452 may include continuous ferromagnetic and magnetic portions. As another example,

fasteners

1402 and 1452 can include discontinuous ferromagnetic and magnetic sections to facilitate positioning of the sterile barrier in several fixed orientations.

Label (R)

Fig. 7A illustrates a tag 902 that may indicate the location of any fastener of a component of the robotic surgical system, such as any of the

fasteners

202, 204, 206, and 208 of the

posts

200, 302, and 304 and 402, 404, and 406 of the arm 300 of the central unit 400. The label 902 may be attached to, over, or adjacent to any fastener. The tag 902 may match the size of the fastener. The label 902 may indicate the location of any fasteners of the

drape

600, 700, and 800 that are configured to attach to any fasteners of a component of the robotic surgical system, such as any of the

fasteners

652 and 662 of the drape 600, any of the

fasteners

710, 712, and 714 of the drape 700, and any of the

fasteners

810, 812, and 814 of the drape 800. The label 902 may provide a visual cue to the user where a particular fastener is located and/or what action is to be taken, such as affixing a particular fastener to another fastener.

Referring to fig. 7B, the

tabs

910 and 912 may guide the insertion of the right and left hands into any pocket of the

drape

600, 700, and 800, respectively, as described herein. Referring to fig. 7C,

tabs

920 and 922 may be similar to

tabs

910 and 912, but with indicia (such as a "1") added to indicate the pairing of the tabs (such as a left-hand tab and a right-hand tab) or one or more of the specific steps in the process for covering components with a sterile barrier, as described herein. Arrows in

labels

910, 912, 920, and 922 may indicate directions for hand insertion.

In some cases, any of

Claims

1. A sterile barrier system for a robotic surgical device, the system comprising:

a drape coupling, the drape coupling comprising:

an outer surface configured to face a first surface of a first portion of the robotic surgical device, an

At least one drape coupler fastener positioned at least partially on the outer surface and configured to removably attach the drape coupler to the first surface, the drape coupler configured to at least partially cover the first surface; and

a drape made of a flexible material and coupled to the drape coupler, the drape configured to wrap around a second surface of the first portion of the robotic surgical device, the second surface being different from the first surface.

2. The system of any one of the preceding claims, wherein:

the first portion of the robotic surgical device includes a manipulator unit;

the first surface comprises a manipulation surface of the manipulator unit;

the at least one drape coupler fastener is configured to removably attach the drape coupler to a handling surface of the manipulator unit;

the second surface comprises at least one side surface of the manipulator unit; and is

The drape is configured to enclose the at least one side surface of the manipulator unit.

3. The system of any one of the preceding claims, wherein the at least one drape coupler fastener comprises a ferromagnetic material configured to attach to a magnet positioned on the first surface.

4. The system of any one of the preceding claims, wherein the at least one drape coupler fastener comprises a plurality of fasteners having ferromagnetic material and configured to attach to a plurality of magnets positioned on the first surface.

5. The system of any one of the preceding claims, wherein the drape is coupled to the drape coupler along a perimeter of the drape coupler.

6. The system of any one of the preceding claims, wherein the drape coupling further comprises an opening configured to expose a surgical instrument interface of the first portion of the robotic surgical device, the surgical instrument interface configured to cause actuation of a surgical instrument.

7. The system of claim 6, wherein the drape coupling further comprises at least one removable protector configured to cover an opening of the drape coupling.

8. The system of any one of claims 6 or 7, wherein the drape coupling further comprises at least one region at least partially made of a flexible material positioned adjacent to the opening and configured to collapse and expand.

9. The system of claim 8, wherein the at least one region comprises a first region and a second region, the first region positioned adjacent a first side of the opening and the second region positioned adjacent a second side of the opening, the second side opposite the first side, the first and second regions configured to collapse and expand in response to movement of the opening.

10. The system of any one of claims 8 or 9, wherein at least one region comprises an insert at least partially made of a material that is more rigid than the material of the at least one region, the insert configured to cause the flexible material of the at least one region to fold when the at least one region collapses.

11. The system of claim 10, wherein the insert comprises at least one tapered edge.

12. The system of any one of the preceding claims, wherein the drape includes at least one drape fastener configured to removably attach the drape to the second surface of the first portion of the robotic surgical device.

13. The system of claim 12, wherein the at least one drape fastener comprises a bendable material and is configured to wrap around at least one protrusion on the second surface.

14. The system of any one of the preceding claims, wherein the drape includes a first region having a first drape fastener and a second region having a second drape fastener, the first region configured to be positioned over the second region and fastened thereto by attaching the first drape fastener to the second drape fastener.

15. The system of any one of the preceding claims, wherein the drape includes a cover made of a more rigid material than the flexible material of the drape, the cover configured to enclose a pin positioned on the second surface and configured to be inserted into an opening of at least one of a surgical instrument insertion device or a camera insertion device of the robotic surgical device, the cover configured to provide a sterile barrier between the pin and the opening.

16. The system of any one of the preceding claims, wherein the drape includes an insert made of a material that is more rigid than the flexible material of the drape, the insert configured to be positioned in an opening in a first portion of the robotic surgical device, the opening receiving a portion of an endoscopic camera of the robotic surgical device, the insert configured to provide a sterile barrier between the endoscopic camera and the first portion.

17. The system of claim 16, wherein the insert comprises a first elongated side surface and a second elongated side surface, the two side surfaces connected at one end and unconnected at an opposite end to form a slot configured to be inserted into the opening of the first portion and receive the endoscopic camera.

18. The system of any one of the preceding claims, wherein the drape includes a first pocket configured to receive and at least partially enclose a first hand of a user, the first pocket configured to facilitate positioning of the drape over a first portion of the robotic surgical device.

19. The system of claim 18, wherein the drape further comprises a second pocket configured to receive and at least partially enclose a second hand of a user, the second pocket configured to facilitate positioning of the drape over the first portion of the robotic surgical device.

20. The system of claim 19, wherein the first and second bladders are positioned to allow a user to lift the drape off the second surface while maintaining a sterile barrier for the first portion of the robotic surgical device.

21. The system of any one of the preceding claims, wherein the drape coupling is made of a material that is more rigid than the flexible material of the drape.

22. A kit comprising the system of claim 6 and a sterile adaptor configured to be received at the opening and removably attached to the surgical instrument interface, the sterile adaptor configured to provide a sterile barrier between the surgical instrument interface and a surgical instrument.

23. The kit of claim 22, wherein the sterile adapter comprises a plurality of actuator covers configured to be coupled to a plurality of instrument actuators positioned on the surgical instrument interface, the actuator covers configured to move in at least one direction to facilitate at least one of movement or articulation of a surgical instrument mounted to the surgical instrument interface.

24. The kit of claim 23, wherein the actuator cover is positioned in a first position prior to positioning the cover on the surgical instrument interface, the actuator cover configured to align in the first position.

25. The kit of claim 24, wherein the sterile adapter comprises a retainer surrounding the actuator cap, the retainer configured to retain the actuator cap in position in the first position.

26. The kit of claim 25, wherein the retainer is removable to permit at least one of the actuator caps to move to a position different from the first position.