CN110478043A - Surgery arm system with the gear assembly in internal drive - Google Patents

Abstract

Example embodiment is related to robots arm's component.Robots arm's component may include Forearm, upper arm segment and elbow coupling coupling assembly.Upper arm segment includes motor.Elbow couples coupling assembly connection Forearm and upper arm segment.Elbow coupling coupling assembly includes distal side elbow connection sub-component and nearside elbow connection sub-component.Elbow connection sub-component in distal side is connected to Forearm.Elbow connection sub-component in distal side includes the gear-train system with gear stage, and the gear stage includes the first distal side elbow gear stage, the second distal side elbow gear stage, third distal side elbow gear stage and the 4th distal side elbow gear stage.First distal side elbow gear stage includes bevel gear.Second distal side elbow gear stage includes spur gear.Third distal side elbow gear stage includes bevel gear.4th distal side elbow gear stage includes planetary gear set.Nearside elbow couples sub-component and upper arm segment is connected to distal side elbow connection sub-component.

Description

Surgical arm system with internally driven gear assembly

CROSS REFERENCE TO RELATED APPLICATIONS : This application is a continuation-in-part of U.S. Application No. 16/172,408 (filed October 26, 2018), which is a continuation-in-part of U.S. Application No. 15/864,628 (filed 2018 , filed January 8, 2017), U.S. Application No. 15/864,628 is a continuation of U.S. Application No. 15/605,864 (filed May 25, 2017), U.S. Application No. 15/605,864 is :

(A) U.S. Application No. 15/340,660 (filed November 1, 2016, is a continuation-in-part of U.S. Application No. 15/044,889, a continuation-in-part of U.S. Application No. 15/044,895, and U.S. Application No. .14/693,207, a continuation-in-part of U.S. Application No. 14/693,207 claiming priority from U.S. Provisional Application No. 61/982,717);

(B) U.S. Application No. 15/340,678 (filed November 1, 2016, is a continuation-in-part of U.S. Application No. 15/044,889, a continuation-in-part of U.S. Application No. 15/044,895, and U.S. Application No. .14/693,207, a continuation-in-part of U.S. Application No. 14/693,207 claiming priority from U.S. Provisional Application No. 61/982,717);

(C) A continuation-in-part of U.S. Application No. 15/340,699 (filed November 1, 2016);

(D) a continuation-in-part of U.S. Application No. 14/693,207, filed April 22, 2015, claiming priority from U.S. Provisional Application No. 61/982,717, filed April 22, 2014;

(E) U.S. Application No. 15/044,895 (filed February 16, 2016, is a continuation-in-part of U.S. Application No. 14/693,207, which requested U.S. Provisional Application No. 61/982,717 priority of the continuation-in-part application; and

(F) U.S. Application No. 15/044,889 (filed February 16, 2016, is a continuation-in-part of U.S. Application No. 14/693,207, which requested U.S. Provisional Application No. 61/982,717 priority of the continuation in part of the application.

The contents of all aforementioned related applications are hereby expressly incorporated by reference in their entirety, including the contents and teachings of any references contained therein.

Background technique

Typically, surgical procedures performed in a patient's body cavity, such as the abdominal cavity, require one or more large access incisions to the patient for the surgical team to perform the surgical maneuvers. With the development of medical science and technology, such conventional surgical procedures have been largely replaced by minimally invasive surgery (MIS) procedures and, where applicable, natural orifice endoscopic surgery (NOTES). Recent developments in computer-assisted and/or robotic surgery have prompted the development of the fields of MIS and NOTES, including the translation of a surgeon's desired surgical action into precise movement of surgical instruments within a patient's body cavity.

Contents of the invention

Despite recent advances in modern medical science, it is recognized in this disclosure that one or more problems are encountered in modern surgical techniques and methods. For example, a typical MIS procedure requires multiple incisions in the patient to allow access through the incisions for insertion of a camera and various other laparoscopic instruments into the patient's body cavity.

As another example, surgical robotic systems are often faced with simultaneously providing a left surgical robotic arm and a right surgical robotic arm (each with a primary instrument such as a cutting or grasping instrument attached to the end of the surgical robotic arm) within a patient's cavity. instrument)) and one or more auxiliary instruments (such as graspers, retractors, suction/irrigation, and/or image capture devices).

It is also recognized in this disclosure that surgical robotic systems face the challenge of providing access to all or even most parts, regions and/or Difficulty of access to the quadrant. That is, after the surgical robotic arm has been inserted into the patient's abdominal cavity and is ready to perform a surgical maneuver, instruments attached to the surgical robotic arm are typically limited to access only certain portions, regions, and quadrants of the patient's abdominal cavity.

In yet another example, known surgical robotic systems typically only provide between one and two surgical robotic arms for each access channel or opening of a patient, such as an incision or natural orifice. In this regard, insertion of the camera and various laparoscopic instruments into the patient's abdominal cavity will require one or more additional incisions.

The present example embodiments generally relate to and/or include systems, subsystems, processors, devices, logic, and methods for solving conventional problems, including those described above.

In an exemplary embodiment, a robotic arm assembly is disclosed. The robotic arm assembly may include a forearm segment, an upper arm segment, and an elbow coupling linkage assembly. The forearm segment may be formed as an elongated structure having a proximal end and a distal end. The upper arm segment may be formed as an elongated structure having a proximal end and a distal end. The upper arm section may include a first distal motor. The first distal motor may include a first distal motor drive portion at the distal end of the upper arm segment. The first distal motor drive portion may be configured to rotate relative to the first axis. The first axis may be parallel to the central axis of the upper arm section. An elbow coupling joint assembly may connect the proximal end of the forearm segment to the distal end of the upper arm segment. The elbow coupling joint assembly may include a distal elbow joint subassembly and a proximal elbow joint subassembly. The distal elbow subassembly may be connected at the distal end to the proximal end of the forearm segment. The distal elbow joint subassembly may include a gear train system having a plurality of gear stages including a first distal toggle gear stage, a second distal toggle gear stage, a third distal toggle gear stage, and a third distal toggle gear stage. Four distal toggle gear stages. The first distal toggle gear stage may include a first distal toggle bevel gear connected to a first distal motor drive portion of the first distal motor. The first distal toggle gear may be configured to be driven to rotate about the first axis by the first distal motor. The first distal toggle gear stage may also include a second distal toggle gear drivable by the first distal toggle gear. The second distal toggle bevel gear may be configured to rotate relative to the first primary toggle axis when driven by the first distal toggle bevel gear. The first main elbow axis may be orthogonal to the first axis. The first distal toggle gear stage may also include a third distal toggle bevel gear drivable by the second distal toggle bevel gear. The third distal toggle gear may be configured to rotate relative to an axis orthogonal to the first primary toggle axis when the first distal toggle gear drives the second distal toggle gear to rotate relative to the first primary toggle axis . The second distal toggle gear stage may include a first distal toggle spur gear connected to a third distal toggle bevel gear. The first distal toggle spur gear may be configured to rotate about the same axis of rotation as the third distal toggle bevel gear when the third distal toggle bevel gear is driven in rotation. The second distal toggle gear stage may also include a second distal toggle spur gear drivable by the first distal toggle spur gear. The second distal toggle spur gear may be configured to rotate relative to a rotational axis parallel to the rotational axis of the first distal toggle spur gear when the second distal toggle spur gear is driven by the first distal toggle spur gear. The third distal toggle gear stage may include a fourth distal toggle bevel gear connected to the second distal toggle spur gear. The fourth distal toggle bevel gear may be configured to be driven by the second distal toggle spur gear to rotate about an axis of rotation that is the same as the axis of rotation of the second distal toggle spur gear. The third distal toggle gear stage may also include a fifth distal toggle gear drivable by the fourth distal toggle gear. The fifth distal toggle bevel gear may be configured to rotate relative to the second primary toggle axis when driven by the fourth distal toggle bevel gear. The second main elbow axis may be orthogonal to the first main elbow axis. The fourth distal toggle gear stage may include a distal toggle planetary gear assembly. The distal toggle planetary gear assembly may include a distal toggle sun gear configured to be driven by a fifth distal toggle bevel gear for rotation relative to the second primary toggle axis. The distal toggle planetary gear assembly may also include a distal toggle ring gear configured not to rotate relative to the second primary toggle axis. The distal elbow planetary gear assembly may also include a plurality of distal elbow planetary gears driveable by the distal elbow sun gear. The distal toggle planetary gear assembly may also include a distal toggle planetary carrier opposite at one end to the distal toggle planetary carrier when the distal toggle sun gear rotates relative to the second primary toggle axis. Connected to a plurality of distal elbow planetary gears in such a manner as to rotate about the second main elbow axis. The distal elbow planetary gear carrier may be at the other end in such a way that the distal elbow planetary gear carrier drives the forearm segment to pivot relative to the second primary elbow axis when the distal elbow sun gear is driven to rotate relative to the second primary elbow axis. Connect the proximal end of the forearm segment in such a way as to rotate. The proximal elbow subassembly may connect the distal end of the upper arm segment to the distal elbow subassembly. The proximal elbow linkage subassembly may be configurable to be driven in such a manner as to pivotally rotate the forearm segment relative to the first primary elbow axis.

In another exemplary embodiment, a robotic arm assembly is disclosed. The robotic arm assembly may include a forearm segment, an upper arm segment, and an elbow coupling linkage assembly. The forearm segment may be formed as an elongated structure having a proximal end and a distal end. The upper arm segment may be formed as an elongated structure having a proximal end and a distal end. The upper arm section may include a first distal motor. The first distal motor may include a first distal motor drive portion at the distal end of the upper arm segment. The first distal motor drive portion may be configured to rotate relative to the first axis. The first axis may be parallel to the central axis of the upper arm section. An elbow coupling joint assembly may connect the proximal end of the forearm segment to the distal end of the upper arm segment. The elbow coupling joint assembly may include a proximal elbow joint subassembly and a distal elbow joint subassembly. The proximal elbow subassembly may be coupled proximally to the distal end of the upper arm segment. The proximal toggle subassembly may include a gear train system having a plurality of gear stages including a first proximal toggle gear stage and a second proximal toggle gear stage. The first proximal toggle gear stage may include a first proximal toggle bevel gear connected to a first distal motor drive portion of the first distal motor. The first proximal toggle gear may be configured to be driven to rotate about the first axis by the first distal motor. The first proximal toggle gear stage may also include a second proximal toggle gear drivable by the first proximal toggle gear. The second proximal toggle gear may be configured to rotate relative to the first primary toggle axis when driven by the first proximal toggle gear. The first main elbow axis may be orthogonal to the first axis. The second proximal toggle gear stage may include a proximal toggle planetary gear assembly. The proximal toggle planetary gear assembly may include a proximal toggle sun gear connected to a second proximal toggle bevel gear. The proximal toggle sun gear may be configured to be driven by the second proximal toggle bevel gear for rotation relative to the first primary toggle axis. The proximal toggle planetary gear assembly may also include a proximal toggle ring gear configured not to rotate relative to the first primary toggle axis. The proximal elbow planetary gear assembly may also include a plurality of proximal elbow planetary gears driveable by the proximal elbow sun gear. The proximal toggle planetary gear assembly may also include a proximal toggle planetary carrier opposite at one end to the proximal toggle planetary carrier when the proximal toggle sun gear rotates relative to the first primary toggle axis. Connected to a plurality of proximal toggle planetary gears in such a manner as to rotate about the first main toggle axis. The distal elbow subassembly may be connected at the distal end to the proximal end of the forearm segment. The distal elbow linkage subassembly may be configurable to be driven in such a manner as to pivotally rotate the forearm segment relative to the second primary elbow axis. The second main elbow axis may be orthogonal to the first main elbow axis. The proximal elbow planetary carrier may be connected at the other end to the distal end of the upper arm section. When the proximal elbow sun gear is driven to rotate relative to the first primary elbow axis, the proximal elbow planetary gear carrier may drive the forearm segment to pivotally rotate relative to the first primary elbow axis.

In another exemplary embodiment, a robotic arm assembly is disclosed. The robotic arm assembly may include a forearm segment, an upper arm segment, and an elbow coupling linkage assembly. The forearm segment may be formed as an elongated structure having a proximal end and a distal end. The upper arm segment may be formed as an elongated structure having a proximal end and a distal end. The upper arm section may include a first distal motor. The first distal motor may include a first distal motor drive portion at the distal end of the upper arm segment. The first distal motor drive portion may be configured to rotate relative to the first axis of rotation. An elbow coupling linkage assembly may connect the proximal end of the forearm segment to the distal end of the upper arm segment via a serial arrangement of the distal elbow joint and the proximal elbow joint. The distal elbow joint may form the distal main elbow axis. The proximal elbow joint may form the proximal main elbow axis. The distal main elbow axis may be orthogonal to the proximal main elbow axis. The elbow coupling joint assembly may include a distal elbow joint subassembly and a proximal elbow joint subassembly. The distal elbow joint subassembly may include a first distal elbow bevel gear configured to be driven by a first distal motor drive portion of the first distal motor. The distal elbow joint subassembly may also include a first distal elbow integrated gear assembly. The first distal elbow integrated gear assembly may include a first integrated bevel gear portion. The first integrated bevel gear portion may be configured to be driven by the first distal toggle bevel gear when the first distal toggle bevel gear is driven by the first distal motor drive portion of the first distal motor. The first distal elbow integrated gear assembly may also include a first integrated spur gear portion. The first integrated spur gear portion may be driven in such a manner that when the first distal toggle bevel gear is driven by the first distal motor drive portion of the first distal motor, the first integrated bevel gear portion and the first integrated spur gear portion are driven to move along adjoins the first integrated bevel gear portion in such a manner that it rotates about the same axis of rotation and at the same rotational speed. The distal elbow joint subassembly may also include a second distal elbow integrated gear assembly. The second distal elbow integrated gear assembly may include a second integrated spur gear portion. The second integrated spur gear portion may be configured to be driven by the first integrated spur gear portion when the first integrated spur gear portion is driven by the first distal toggle gear. The second distal elbow integrated gear assembly may also include a second integrated bevel gear portion. The second integrated bevel gear portion can be driven in such a way that when the first distal toggle bevel gear is driven by the first distal motor drive portion of the first distal motor, the second integrated spur gear portion and the second integrated bevel gear portion are driven along the adjoins the second integrated spur gear part in such a manner that it rotates about the same axis of rotation and at the same rotational speed. The distal elbow joint subassembly may further include a second distal elbow bevel gear configured to be driven by a second integrated bevel gear portion of the second distal elbow integrated gear assembly relative to the distal Lateral main elbow axis rotation. The distal toggle subassembly may also include a distal toggle planetary gear assembly. The distal elbow planetary gear assembly may include a distal elbow sun gear. The distal elbow sun gear may be configured to be driven by the second distal toggle bevel gear for rotation relative to the distal main elbow axis. The distal elbow planetary gear assembly may also include a distal elbow ring gear configured not to rotate relative to the distal main elbow axis. The distal elbow planetary gear assembly may also include a plurality of distal elbow planetary gears driveable by the distal elbow sun gear. The distal elbow planetary gear assembly may also include a distal elbow planetary gear carrier opposite at one end to the distal elbow planetary gear carrier when the distal elbow sun gear rotates relative to the distal main toggle axis. connected to the plurality of distal elbow planetary gears in such a manner as to rotate about the distal main elbow axis. The distal elbow planetary gear carrier may be at the other end in such a manner that the distal elbow planetary gear carrier drives the forearm segment to pivot relative to the distal main elbow axis when the distal elbow sun gear is driven to rotate relative to the distal main elbow axis. Connect the proximal end of the forearm segment in such a way as to rotate. The proximal elbow subassembly may connect the distal end of the upper arm segment to the distal elbow subassembly. The proximal elbow linkage subassembly may be configurable to be driven in such a manner as to pivotally rotate the forearm segment relative to the proximal main elbow axis.

Description of drawings

For a more complete understanding of the present disclosure, example embodiments and advantages thereof, reference is now made to the following description taken in conjunction with the accompanying drawings, in which like numerals indicate like features, and:

Figure 1A is an illustration of a perspective view of an example embodiment of an external anchor;

Figure IB is another illustration of a perspective view of an example embodiment of an external anchor attached to an example embodiment of a port assembly;

2A is an illustration of a perspective view of an example embodiment of a surgical device configured in an oppositely oriented position;

2B is an illustration of a perspective view of an example embodiment of a surgical device configured in a forward-facing position;

2C is another illustration of a perspective view of an example embodiment of a surgical device configured in an oppositely oriented position;

2D is another illustration of a perspective view of an example embodiment of a surgical device configured in a forward-facing position;

3A is another illustration of a perspective view of an example embodiment of a surgical device configured in an oppositely oriented position;

3B is another illustration of a perspective view of an example embodiment of a surgical device configured in a forward-facing position;

3C is another illustration of a perspective view of an example embodiment of a surgical device configured in an oppositely oriented position;

3D is another illustration of a perspective view of an example embodiment of a surgical device configured in a forward-facing position;

Figure 4A is an illustration of a perspective exploded view of an example embodiment of a port assembly;

Figure 4B is an illustration of a side view of an example embodiment of a port assembly;

4C is an illustration of a cross-sectional view of an example embodiment of a port assembly having a first or second gate assembly in an open position;

4D is an illustration of a cross-sectional view of an example embodiment of a port assembly having a first or second gate assembly in a closed position;

Figure 5A is an illustration of a side view of an example embodiment of an instrument arm assembly;

5B is another illustration of a side view of an example embodiment of an instrument arm assembly;

Figure 5C is an illustration of a perspective view of an example embodiment of an instrument arm assembly;

Figure 5D is an illustration of a side view of an example embodiment of an end effector assembly secured to an arm assembly;

Figure 5E is an illustration of a side cross-sectional view of an example embodiment of an end effector assembly secured to an arm assembly;

Figure 5F is an illustration of a side view of an example embodiment of an end effector assembly released from an arm assembly;

5G is an illustration of a side cross-sectional view of an example embodiment of an end effector assembly released from an arm assembly;

Figure 5H is an illustration of a perspective view of an example embodiment of an end effector assembly;

Figure 51 is an illustration of a perspective view of an example embodiment of a device having an insulating portion;

Figure 5J is an illustration of a top cross-sectional view of an example embodiment of an arm assembly;

Figure 5K is an illustration of a perspective view of an example embodiment of an arm assembly;

Figure 5L is an illustration of a side view of an example embodiment of an instrument arm assembly;

5M is an illustration of a side cross-sectional view of an example embodiment of an instrument arm assembly;

Figure 5N is an illustration of a top cross-sectional view of an example embodiment of a second arm assembly;

Figure 50 is an illustration of a transparent perspective partial view of an example embodiment of an instrument arm assembly;

Figure 5P is another illustration of a side view of an example embodiment of an instrument arm assembly;

Figure 5Q is another illustration of a side view of an example embodiment of an instrument arm assembly;

Figure 5R is another illustration of a perspective view of an example embodiment of an instrument arm assembly;

Figure 5S is another illustration of a side view of an example embodiment of an instrument arm assembly;

5T is another illustration of a side cross-sectional view of an example embodiment of an instrument arm assembly;

Figure 5U is another illustration of a top cross-sectional view of an example embodiment of a second arm assembly;

5V is another illustration of a transparent perspective partial view of an example embodiment of an instrument arm assembly;

Figure 6A is an illustration of a perspective view of an example embodiment of an image capture assembly;

6B is an illustration of a cross-sectional view of another example embodiment of an image capture assembly with an internal temperature control assembly;

6C is an illustration of a perspective view of another example embodiment of an image capture assembly with an internal temperature control assembly;

Figure 6D is an illustration of a perspective view of the system including the second image capture assembly while operating in the cavity of a patient;

7 is a flowchart of an exemplary method for configuring a surgical device;

8A-8E are illustrations of side views of an example embodiment of a method of deploying a surgical device in a forward facing position;

8F-8K are illustrations of side views of an example embodiment of a method of deploying a surgical device in an oppositely oriented position;

9A is an illustration of a perspective view of an example embodiment of a surgical device system;

Figure 9B is an illustration of a perspective view of another example embodiment of a surgical device system;

Figure 10A is an illustration of a perspective view of an example embodiment of an external anchor;

Figure 10B is an illustration of a perspective view of another example embodiment of an external anchor;

11A is an illustration of a perspective view of an example embodiment of an arm assembly;

11B is an illustration of a cross-sectional side view of an example embodiment of an arm assembly;

Figure 11C is an illustration of a cross-sectional side view of an example embodiment of an arm assembly;

Figure 12A is an illustration of a perspective view of an example embodiment of an elbow coupling linkage assembly;

12B is an illustration of a side view of an example embodiment of a distal elbow planetary gear assembly;

12C is an illustration of an exploded perspective view of an example embodiment of a distal elbow planetary gear assembly;

Figure 12D is an illustration of a perspective view of an example embodiment of an elbow coupling linkage assembly;

12E is an illustration of a side view of an example embodiment of a proximal elbow planetary gear assembly;

12F is an illustration of an exploded perspective view of an example embodiment of a proximal elbow planetary gear assembly;

13A is an illustration of a perspective view of an example embodiment of a shoulder coupling linkage assembly;

13B is an illustration of a side view of an example embodiment of a distal shoulder planetary gear assembly;

13C is an illustration of an exploded perspective view of an example embodiment of a distal shoulder planetary gear assembly;

Figure 13D is an illustration of a perspective view of an example embodiment of a shoulder coupling linkage assembly;

13E is an illustration of a side view of an example embodiment of a proximal shoulder planetary gear assembly;

13F is an illustration of an exploded perspective view of an example embodiment of a proximal shoulder planetary gear assembly;

Figure 14A is an illustration of a side view of an example embodiment of an elbow coupling linkage assembly;

14B is an illustration of a cross-sectional side view of an example embodiment of an elbow coupling linkage assembly;

Figure 14C is an illustration of another side view of an example embodiment of an elbow coupling linkage assembly;

Figure 14D is an illustration of another cross-sectional side view of an example embodiment of an elbow coupling linkage assembly;

15A is an illustration of a side view of an example embodiment of a shoulder coupling linkage assembly;

15B is an illustration of a cross-sectional side view of an example embodiment of a shoulder coupling linkage assembly;

15C is an illustration of another side view of an example embodiment of a shoulder coupling linkage assembly; and

Figure 15D is an illustration of another cross-sectional side view of an example embodiment of a shoulder coupling linkage assembly.

Although, for convenience, like numerals may be used in the drawings to refer to like elements, it will be appreciated that each of the various example embodiments may be considered as entirely different variations.

Example embodiments will now be described with reference to the accompanying drawings, which form a part of this disclosure, and which illustrate example embodiments in which they may be practiced. As used in this disclosure and the appended claims, the terms "example embodiment", "exemplary embodiment" and "this embodiment" do not necessarily refer to a single embodiment, although they may, and various examples Embodiments may be easily combined and/or interchanged without departing from the scope or spirit of the example embodiments. Furthermore, the terminology, as used in this disclosure and the appended claims, is for the purpose of describing example embodiments only and is not intended to be limiting. In this regard, as used in this disclosure and the appended claims, the term "in" may include "in" and "on", and the term "a (a, an) " and "the" may include singular and plural referents. Furthermore, as used in this disclosure and the appended claims, the term "from" can also mean "from", depending on the context. Furthermore, as used in this disclosure and the appended claims, the term "if" can also mean "when" or "when", depending on the context. Furthermore, as used in this disclosure and the appended claims, the term "and/or" may refer to and encompass any and all possible combinations of one or more of the associated listed items.

Detailed ways

It is recognized in this disclosure that despite recent advances in modern medical science and technology, one or more problems are encountered in modern surgical techniques and methods, including MIS. For example, a typical MIS procedure requires multiple incisions in the patient to allow access through the incisions for insertion of a camera and various other laparoscopic instruments into the patient's abdominal cavity.

In addition to the aforementioned disadvantages associated with numerous sizable incisions, it is recognized in this disclosure that devices developed to perform robot-assisted MIS surgery, including surgical robotic arms (and the instruments attached to them), Surgical robotic systems also suffer from one or more problems. For example, it is recognized herein that a major technical challenge for surgical robotic systems is the difficulty in providing anchoring forces and/or anchoring forces that are sufficiently stable against the forces expected and/or necessary to be applied to the patient by the surgical robotic system during surgical maneuvers. reaction force. In this regard, certain surgical maneuvers with known surgical robotic systems may require significant effort and time and may not be properly performed or performed as a result of problems with insufficient anchoring forces and/or reaction forces. cannot be executed at all.

Another example of what is recognized in this disclosure as a problem that can be encountered with surgical robotic systems is the difficulty of providing instruments, such as those attached to the surgical procedure, after the surgical robotic system has been set up (or installed) and ready to perform The cutting and/or grasping instrument at the end of the robotic arm) provides access to all or even most parts, regions and quadrants of the patient's abdominal cavity. That is, after the surgical robotic arm of the system has been inserted, attached, and properly positioned in the patient's abdominal cavity and is ready to perform a surgical maneuver, the instruments attached to the end of the surgical robotic arm are generally limited to only entering the patient's Certain parts, regions, and quadrants of the abdominal cavity. It is recognized in this disclosure that such problems are primarily due to the limited number of possible degrees of freedom that known surgical robotic systems and arms can provide (more specifically, the in vivo degrees of freedom of known surgical robotic systems and arms ( That is, due to the limited number of degrees of freedom) provided within the patient's abdominal cavity. In this regard, surgical robotic systems typically only provide between 2 and 4 in vivo degrees of freedom for each surgical robotic arm.

As another example, while known surgical robotic systems have been designed to perform forward-directed surgical procedures in a patient's abdominal cavity, such systems have not been designed for situations where reverse-directed surgical procedures are required, and when Problems may be encountered when applied to these situations. For example, such known surgical robotic systems have not been designed to be deployed through a natural orifice, such as the rectum or vagina, for performing natural orifice endoscopic surgery (or NOTES), such as transvaginal gynecological surgery in women and transrectal urological surgery. Such systems may suffer from one or more problems, such as inability to access certain organs, tissues, or other surgical sites when inserted into a natural orifice.

Surgical systems, devices, and methods (including those used in MIS ) that address one or more problems of known surgical systems, devices, and methods, including those described above and in this and those in natural orifice endoscopic surgery (or NOTES). It is to be understood that the principles described in this disclosure may be applied outside the context of MIS and/or NOTES, such as in environments that are not readily accessible to humans (including in a vacuum, outside performing scientific experiments and/or surgery in space, and/or under toxic and/or dangerous conditions).

Surgical system (eg, surgical device 200)

Figures 2A, 2B, 2C, and 2D are depicted operable to pass through a single access channel or opening (e.g., a single incision, such as in or around the umbilicus region) or through the patient's natural orifice, such as A surgical device or system (e.g., surgical device or system 200) inserted into a patient's abdominal cavity for performing natural orifice endoscopic surgery (or NOTES) through the rectum or vagina, hereinafter "opening") Illustration of an example implementation. The surgical device can then be anchored to position the surgical device 200 in the opening. Surgical device 200 may include port assembly 210 and instrument arm assembly 230 . Surgical device 200 may also include other elements, such as one or more instrument arm assemblies (eg, instrument arm assembly 240 ), one or more image capture assemblies, one or more auxiliary arm assemblies, and the like.

As shown in FIGS. 1A and 1B , surgical device 200 may be provided with an external anchor 1 attachable to port assembly 210 . External anchor 1 may comprise a configurable assembly of segments 2 , 6 , 10 and 14 communicating with each other via coupling or connecting portions 4 , 8 and 12 , and an external anchor connector 16 . The external anchor 1 may be operable to securely fix the position and/or orientation of the port assembly 210 (hereinafter "position") in or around a single opening of the patient, and may also be operable to provide sufficient resistance during surgical maneuvers or An anchoring force and/or reaction force that is stabilized by the force exerted by at least one or more instruments of surgical device 200 (including instrument arm assembly 230 ) is desired or necessary during surgery. External anchor 1 , which may also be in the form of controllable rotation assembly 1000 shown in FIGS. 10A and 10B , may be operable to cooperate with port assembly 210 to provide one or more extracorporeal degrees of freedom. For example, the external anchor 1 may be configurable to provide 3 internal degrees of freedom. In an example embodiment, the one or more extracorporeal degrees of freedom may include torsional, pivotal, telescopic, and/or other movement of the port assembly 210 relative to the external anchor 1 . For example, twisting motion of port assembly 210 as indicated by arrow A in FIG. 1B may allow one or more attached instruments (including instrument arm assembly 230) to be repositioned during a surgical procedure (i.e., after setup or installation). Positioned for access to other portions, regions and/or all quadrants of the patient's abdominal cavity. As another example, pivotal movement of the port assembly 210, as shown by arrow B in FIG. Including the instrument arm assembly 230 ) is repositioned during a surgical procedure (ie, after setup or installation) to access the distal region of the patient's abdominal cavity. Other coupling portions of the external anchor 1 may also be operable to assist and/or facilitate desired movement of the port assembly 210 . The external anchor 1 may be anchored to one or more stationary or fixedly positioned objects, such as the side rails 300 of an operating table/bed as shown in FIG. 1A . 10A and 10B illustrate other example motions that provide additional extracorporeal degrees of freedom via an example embodiment of an external anchor (controllable gyration assembly) 1000 . The steerable swivel assembly 1000 is further described below in section "(1) Providing an External Anchor and Installing a Port Assembly."

Surgical device 200 may further include one or more additional instrument arm assemblies attachable to port assembly 210 , such as second instrument arm assembly 240 shown in FIGS. 3A , 3B, 3C, and 3D. One or more of the instrument arm assemblies including the first instrument arm assembly 230, the second instrument arm assembly 240, the third instrument arm assembly (not shown), the fourth instrument arm assembly (not shown), etc. may be Attached to port assembly 210. Such an instrument arm assembly may be operable to access any and all portions, regions, and/or quadrants of a patient's abdominal cavity and perform one or more surgical procedures on any and all portions, regions, and/or quadrants . For example, surgical device 200 may be configurable to perform surgical maneuvers in a forward direction (or "forward-directed position" or "forward position") (eg, as shown in FIGS. 2B , 2D, 3B, and 3D ). Show). As another example, surgical device 200 may be configurable to perform surgical maneuvers in the opposite direction (or "opposite position" or "opposite position") (eg, as shown in FIGS. 2A , 2C, 3A, and 3C ). Show).

Surgical device 200 may also include one or more image capture components, such as image capture component 220 . Surgical device 200 may further include one or more auxiliary arm assemblies, such as retractor arm assembly 260 shown in FIGS. 2A , 2B, 3A, and 3B. In addition, surgical device 200 may include one or more other instrument arm assemblies that may be inserted into the patient's opening via port assembly 210 before, during, and/or after performing a surgical action or procedure, such as in FIGS. The aspiration/irrigation assembly 250 is shown in Figures 3A and 3B. It is understood in the present disclosure that, in an example embodiment, surgical device 200 may be configurable in a variety of configurations and arrangements, including having more or less than two instrument arms, without departing from the teachings of the present disclosure. assembly (such as the third, fourth, fifth, etc. instrument arm assembly), more than one image capture assembly (such as the second, third, etc. image capture assembly), more or less than one auxiliary arm assembly (such as the first Second, third etc. auxiliary arm assembly), and/or more or less than one other laparoscopic tool.

port assembly (eg, port assembly 210)

Example implementations of a port assembly (eg, port assembly 210 ) are illustrated in FIGS. 2A-2D , 3A-3D , 4A , 4B , 4C, and 4D. Port assembly 210 may be configurable to be inserted into or around a single opening (such as a single incision or natural orifice) of a patient and pass through at least an external anchor (such as the external anchor 1 shown in FIGS. 1A and 1B ). and the steerable swivel assembly 1000 shown in FIGS. 10A and 10B ) are held in place.

Port assembly 210 may be an elongated structure having a central access channel 210a formed through port assembly 210 . Central access channel 210a may be used to insert and remove instruments, such as one or more instrument arm assemblies 230, 240, one or more image capture assemblies 220, one or more auxiliary arm assemblies 250, 260, etc. . In an example embodiment, port assembly 210 may include a first end segment 212 and a second end segment 214 . The first end segment 212 and the second end segment 214 may be fixedly attached to each other or formed as a unitary object. Port assembly 210 may also include an intermediate segment 213 between first end segment 212 and second end segment 214 . First end segment 212, second end segment 214, and intermediate segment 213 may be fixedly attached to each other as shown in FIGS. 4A and 4B , or two or more of these segments may form for a single object. In an example embodiment, the first end section 212 may be the portion of the port assembly 210 that is secured to the external anchor 1 and the port assembly 210 may be secured at an angle of about 0 degrees to +/- relative to the single opening of the patient. 90 degrees between the positions of the angle θ. These and other elements of port assembly 210 will now be described below with reference to FIGS. 2A-2D , 3A-3D , and 4A-4D .

As shown in at least FIGS. 4A and 4B , port assembly 210 may include a first end segment 212 . The first end segment 212 may have a first end channel 212a formed therethrough. The first end channel 212a may be considered a portion of the central inlet channel 210a. The first end section 212 may also include a portion operable to be fixed to the outer anchor 1 , such as an outer portion of the first end section 212 .

As shown in FIGS. 4A , 4C, and 4D, the first end segment 212 may also include a first gate assembly 212b. The first gate assembly 212 may be configurable to control access through the first end passage 212a. For example, the first gate assembly 212b may be configurable in an open position as shown in FIG. 4C to allow access through the first end passage 212a. The first gate assembly 212b may also be configurable in a closed position as shown in FIG. 4D to prevent or restrict access through the first end passage 212a. The first gate assembly 212b may also be configurable in a partially closed (or partially open) position (not shown). The first gate assembly 212b may also be configurable to transition between a closed position and an open position.

In an example embodiment, the first gate assembly 212b may be provided within the first end section 212 in such a manner that when the first gate assembly 212b is configured in the open position as shown in FIG. 4C, The first end passage 212a is substantially or not at all obstructed by the first gate assembly 212b. When the surgeon desires to insert an instrument into (or remove an instrument from) the patient's cavity via the first end channel 212a (and the rest of the central access channel 210a), the first gate assembly 212b can be configured in the open position.

Similarly, the first gate assembly 212b may be provided within the first end section 212 in such a manner that when the first gate assembly 212b is configured in the closed position as shown in FIG. 4D, the first end The outer channel 212a is substantially or completely blocked by the first gate assembly 212b. When the surgeon desires to maintain insufflation of the patient's cavity, and/or when the surgeon does not need to insert an instrument into (or remove an instrument from) the patient's cavity via the first end channel 212a , the first gate assembly 212b may be configured in a closed position.

The first gate assembly 212b can include a first expandable portion 212b that can be configured to expand when the first gate assembly 212b is deployed to the closed position as shown in FIG. 4D. When the first gate assembly 212b is configured to the closed position, the first deployable portion 212b can be operable, among other operations, to substantially or completely block the passage of gaseous media (and/or other media) through the first end passage 212a . For example, if the patient's cavity is being insulated with a gas such as carbon dioxide (CO ₂ ), the first gate assembly 212b (ie, the first expandable portion 212b ) can be configured to substantially prevent carbon dioxide gas from passing through the first End channel 212a exits the patient's cavity.

The first expandable portion 212b may include one or more first expandable members. For example, as shown in Figures 4C and 4D, the first expandable portion 212b may include six expandable members. It is understood that the first expandable portion 212b may include more or less than six expandable members without departing from the teachings of the present disclosure. Some or all of the first expandable members may be integrated and/or in communication with each other, such as with some or all of the first expandable members being operable to receive pressure from a common or same first source 212b' (i.e. , gas medium) way. For example, when the first gate assembly 212b is configured to the closed position, the first source 212b' may be configurable to provide positive pressure (i.e., supply gas) to expand some or all of the first expandable members and block the first expandable member. An end passage 212a (eg, sealingly blocks the first end passage 212a). Similarly, when the first gate assembly 212b is configured to the open position, the first source 212b' may be configurable to provide negative pressure (ie, remove gas) so that one or more of the first expandable members (or at all) does not expand and does not block the first end channel 212a. It is understood that more than one first source 212b' may provide positive and negative pressure to the one or more expandable members without departing from the teachings of the present disclosure.

It is recognized in this disclosure that the first gate assembly 212b may include a valve (not shown) or the like in addition to or instead of the first deployable portion 212b. The valve may be configurable to perform substantially the same action of blocking the first end passage 212a when the first gate assembly 212b is configured to the closed position and not blocking the first end passage 212a when the first gate assembly 212b is configured to the open position. An end channel 212a. The valve may be any type of valve configurable to perform the actions described above and in this disclosure. The valve may include, but is not limited to, a ball valve, a gate valve, etc., as long as the valve can be configured to substantially block/unblock the first end passage 212a and prevent gaseous media from passing through the first end passage 212a.

As shown at least in FIGS. 4A and 4B , port assembly 210 may also include a second end segment 214 . The second end segment 214 may have a second end channel 214a formed therethrough. The second end channel 214a may be substantially or completely aligned with the first end channel 212a. In an example embodiment, the second end channel 214a as well as the first end channel 212a may be considered to be part of the central inlet channel 210a. The second end section 214 may also include an insufflation port (not shown) for providing insufflation to the patient's cavity.

As shown in FIGS. 4A , 4C, and 4D, the second end segment 214 may also include a second gate assembly 214b. The second gate assembly 214 may be configurable to control access through the second end passage 214a. For example, the second gate assembly 214b may be configurable in an open position as shown in FIG. 4C to allow access through the second end passage 214a. The second gate assembly 214b may also be configurable in a closed position as shown in FIG. 4D to prevent or restrict access through the second end passage 214a. The second gate assembly 214b may also be configurable in a partially closed (or partially open) position (not shown). The second gate assembly 214b may also be configurable to transition between a closed position and an open position.

In an example embodiment, the second gate assembly 214b may be provided within the second end section 212 in such a manner that when the second gate assembly 214b is configured in the open position as shown in FIG. 4C, The second end passage 214a is substantially or not at all obstructed by the second gate assembly 214b. When the surgeon desires to insert an instrument into (or remove an instrument from) the patient's cavity via the second end channel 214a (and the rest of the central access channel 210a), the second gate assembly 214b can be configured in the open position.

Similarly, the second gate assembly 214b may be provided within the second end segment 214 in such a manner that when the second gate assembly 214b is configured in the closed position as shown in FIG. 4D, the second end The upper channel 214a is substantially or completely blocked by the second gate assembly 214b. When the surgeon desires to maintain the insufflation of the patient's cavity, and/or when the surgeon does not need to insert the instrument into (or remove the instrument from) the patient's cavity via the second end channel 214a , the second gate assembly 214b may be configured in a closed position.

The second gate assembly 214b can include a second expandable portion 214b that can be configured to expand when the second gate assembly 214b is configured to the closed position as shown in FIG. 4D. When the second gate assembly 214b is configured to the closed position, the second expandable portion 214b can be operable, among other operations, to substantially or completely block the passage of gaseous media (and/or other media) through the second end passageway 214a . For example, if the patient's cavity is being insulated with a gas, such as carbon dioxide (CO ₂ ), the second gate assembly 214b (ie, second expandable portion 214b ) can be configured to substantially prevent carbon dioxide gas from passing through the second End channel 214a exits the patient's cavity.

The second expandable portion 214b may include one or more second expandable members. For example, as shown in Figures 4C and 4D, the second expandable portion may include six expandable members. It is understood that the second expandable portion 214b may include more or less than six expandable members without departing from the teachings of the present disclosure. Some or all of the second expandable members may be integrated and/or communicate with each other, such as with some or all of the second expandable members operable to receive pressure from a common or same second source 214b' (i.e. , gas medium) way. For example, when the second gate assembly 214b is configured to the closed position, the second source 214b' may be configurable to provide positive pressure (i.e., supply gas) to expand some or all of the second expandable members and block the second expandable member. Two end passages 214a (eg, sealingly blocking second end passage 214a). Similarly, when the second gate assembly 214b is configured to the open position, the second source 214b' may be configurable to provide negative pressure (ie, remove gas) so that some or all of the second expandable members do not expand (and/or retract) without blocking the second end channel 214a. It is understood that more than one second source 214b' may provide positive and negative pressures to the one or more expandable members without departing from the teachings of the present disclosure. It is also understood in this disclosure that one or more of the first source 212b' and the second source 214b' may be the same or different sources.

It is recognized in this disclosure that the second gate assembly 214b may include a valve (not shown) or the like in addition to or instead of the second deployable portion 214b. The valve may be configurable to perform substantially the same action by blocking the second end passage 214a when the second gate assembly 214b is configured to the closed position and not blocking the second end passage 214a when the second gate assembly 214b is configured to the open position. Two end channels 214a. The valve may be any type of valve configurable to perform the actions described above and in this disclosure. The valve may include, but is not limited to, a ball valve, a gate valve, etc., as long as the valve is configurable to substantially block/unblock the second end passage 214a and prevent gaseous media from passing through the second end passage 214a.

As shown in FIGS. 4A and 4B , the second end segment 214 may also include one or more anchor ports 216 . Each anchor port 216 may be operable to enable instrument arm assembly 230 or 240 , image capture assembly 220 , and/or auxiliary arm assembly 250 or 260 to be secured to and released from port assembly 210 . Each anchor port 216 may be formed as any one or more of a variety of shapes, holes, slots, depressions, protrusions, hooks, fasteners, magnets, buckles, etc., including those described above and in this disclosure. those described in . For example, as shown in FIGS. 4A and 4B , one or more of the anchor ports 216 may include one or more ports operable to allow the shoulder segment 231 of the instrument arm assembly 230 or 240 to be inserted and attached. slot etc.

In an example embodiment, as shown at least in FIGS. 4A and 4B , port assembly 210 may also include an intermediate section 213 . The middle section 213 may have a middle section channel 213a formed therethrough. The middle section 213 may have a middle section channel 213a formed therethrough. The intermediate segment channel 213a may be substantially or completely aligned with the first end channel 212a and/or the second end channel 214a. In this regard, in an example embodiment, the middle segment channel 213a and the first end channel 212a and/or the second end channel 214a may be considered to be part of the central inlet channel 210a. The intermediate section 213 may also include an insufflation port (not shown) in addition to or instead of the insufflation port of the second end section 214 . In some example embodiments, intermediate section 213 may also include an intermediate section gate assembly (not shown) similar to first gate assembly 212 and second gate assembly 214 described above and in this disclosure.

In an example embodiment, the intermediate section channel 213a may be operable to cooperate with the first gate assembly 212b and the second gate assembly 214b to function for instruments such as the instrument arm assembly 230 or 240, the image capture assembly 220, the auxiliary arm assembly 250 Or 260, etc.) the role of the isolation chamber. For example, when an instrument (such as instrument arm assembly 230) needs to be inserted into the patient's cavity via port assembly 220 (or central access channel 210a) and inflation of the patient's cavity needs to be maintained, first gate assembly 212b can be activated. Configured to an open position to allow an instrument to be inserted into the mid-section channel 213a. After the instrument (or a substantial portion thereof) passes through the first gate assembly 212b, the first gate assembly 212b may be configured to a closed position. Second gate assembly 214b may then be configured to an open position to allow further insertion of an instrument through port assembly 210 . After the instrument (or a substantial portion thereof) passes through the second gate assembly 214b, the second gate assembly 214b may be configured to a closed position.

With respect to central entry channel 210a, central entry channel 210a may include first end channel 212a, second end channel 214a, and/or mid-section channel 213a, or may consist of first end channel 212a, second end channel 214a, and /or Intermediate segment channel 213a is formed. Central access channel 210a may be operable to provide access to allow one or more instruments, such as one or more instrument arm assemblies 230 or 240, one or more image capture assemblies 220, one or more auxiliary arm assemblies 250, or 250, etc.) into (or out of) the access port (ie, access or channel).

In an example embodiment, the first end section 212, the second end section 214, and/or the intermediate section 213 may be generally cylindrical in shape. First end segment 212, second end segment 214, and/or intermediate segment 213 may also be formed in any of a variety of other shapes, sizes, and/or dimensions without departing from the teachings of the present disclosure. One.

In an example embodiment, the outer diameters of the first end segment 212, the second end segment 214 and/or the intermediate segment 213 may be between about 28 and 35 mm, the first end segment 212, the second end segment 212, the second end segment The inner diameter (unobstructed) of 214 and/or intermediate section 213 may be between about 16 to 21 mm. In an example embodiment, the outer diameter of the first end section 212, the second end section 214, and/or the intermediate section 213 may be about 33 mm, and the first end section 212, the second end section 214, and/or The inner diameter (unobstructed) of the intermediate section 213 may be approximately 19 mm. The length of the first end segment 212 may be between about 80 and 100 mm, the length of the second end segment 214 may be between about 80 and 200 mm, and the length of the intermediate segment 213 may be between about 60 and 80 mm. . The overall length of port assembly 210 may be between approximately 320 to 380 mm. It is to be understood in this disclosure that the above dimensions are illustrative of example embodiments only, and as such, these dimensions may be smaller or larger than those recited above without departing from the teachings of the present disclosure.

Port assembly 210 (comprising first end segment 212, second end segment 214, intermediate segment 213, and/or anchor port 216) may be formed using any one or more of a variety of materials, Such as surgical grade metals, high strength aluminum alloys, stainless steels (such as 304/304L, 316/316L, and 420), pure titanium, titanium alloys (such as Ti6A14V, NiTi), and cobalt chromium alloys. The first gate assembly 212b and the second gate assembly 214b may be formed using any one or more of a variety of materials, such as biocompatible materials such as silicone rubber and polyurethane. It is understood in the present disclosure that other materials may be used without departing from the teachings of the present disclosure. It is to be understood in this disclosure that the above materials are merely illustrations of example embodiments and that these and other materials and compositions may be used without departing from the teachings of the present disclosure.

Image capture component (e.g., image capture component 220)

In an example embodiment, surgical device 200 may include one or more image capture components (eg, image capture component 220 ) that may be configured to be inserted into and attached to port assembly 210 . One or more of the image capture assemblies 220 may include an image capture body 224, a flexible body 222, and an anchor portion 220a.

As shown in FIG. 6A , the image capture body 224 may include one or more cameras 227 . Each camera 227 may comprise a standard and/or high definition 2-dimensional (2D) and/or 3-dimensional (3D) camera, as described above and in this disclosure, operable to capture imaging, such as 2D and/or or stereoscopic and/or autostereoscopic 3D imaging (including images, video, and/or audio), and provide captured imaging (including images, video, and/or audio) to one or more Computing devices (or controllers or systems) of a nearby and/or remote surgical team 904. A computing device (or controller or system) may include one or more processors, one or more human-computer interfaces, one or more graphical displays (such as computer screens, television screens, portable devices, wearable devices such as glasses, etc.)) and/or other devices and/or systems, examples of which are illustrated in FIGS. 9A and 9B. The one or more nearby and/or remote surgical teams 904 may be operable to view, listen, feel, analyze, and/or control (such as panning, zooming, processing, altering, marking, changing resolution, etc.) In one or more standard and/or high-definition 2D and/or 3D graphics displays 902 (such as shown in the illustrations of FIGS. 9A and 9B ) and/or portable and/or Or imaging displayed or represented on a wearable device (not shown). The image capture body 224 may also include one or more illumination sources 229, such as LEDs, etc., operable to illuminate or sense at least one or more portions, segments, and/or quadrants of the patient's cavity, Includes instruments provided in the patient's cavity. Image capture body 224 may further include one or more internal temperature control components operable to control, such as reduce, the temperature of one or more components of image capture body 224 .

As shown in the example embodiment of FIG. 6A , one or more of the image capture assemblies 220 may include a multi-bendable body 222 attached to an image capture body 224 . The multi-flexible body 222 can be any elongated multi-flexible, multi-arcuate, multi-connectable, and/or serpentine (hereinafter "multi-flexible") body that can, among other things, be surgically The team (such as via a computing device/controller) is controlled/configured to straighten and/or bend (and maintain such straightening and/or bending) at one or more of a plurality of locations along the multi-bendable body 222 or bend), bend in one or more of a plurality of bends (and maintain such a bend), and/or straighten in one or more of a plurality of directions and/or Bend (and keep so straightened and/or bent). For example, as shown in FIG. 8H , the multi-bendable body 222 may be controllable/configurable by the surgical team (such as via a computing device/controller) to bend at two different locations 222a and 222b along the multi-bendable body 222 , and each of these curves can include any curvature in any direction. It is understood that the multi-bendable body 222 may be configurable to bend at more or fewer than two locations along the multi-bendable body 222 without departing from the teachings of the present disclosure. It is also understood that when the multi-bendable body 222 is configured to bend at any position along the multi-bendable body 222, the curve can be held and/or released (or released) by the surgical team (such as via a computing device/controller). configured as no bend, less bend or straightened).

The multi-bendable body 222 can be formed in any one or more ways known in the art. For example, the flexible body 222 may comprise a plurality of segments, each segment being linked to adjacent part. As another example, the multi-bendable body 222 may include a plurality of wires, cables, etc. distributed throughout the multi-bendable body 222 in such a manner that pull/release of one or a combination of the cables, Shortening/lengthening, tightening/loosening etc. enables the above-mentioned bending of one or more locations of the multi-bendable body 222 in one or more bending portions and in one or more directions. As another example, the multi-bendable body 222 may include a plurality of springs, gears, motors, etc. for achieving the above-mentioned bending. It is to be understood in this disclosure that the multi-bendable body 222 may also include a combination of one or more of the above-mentioned methods.

One or more internal temperature control components (not shown) may be provided for each image capture component 220 . Each internal temperature control assembly may be operable to control (such as reduce) the temperature and/or heating of the aforementioned camera(s) 227, illumination source(s) 229, and/or multi-bendable body 222 . In example embodiments, the one or more internal temperature control components may be operable to perform such temperature control using one or more gases, liquids, and/or solids. For example, gas and/or liquid may be fed, maintained and/or regulated using an external source via one or more tubes or the like. In an example embodiment, the one or more tubes for supplying, regulating and/or discharging gas and/or liquid may have a diameter of between about 0.5 mm and 3 mm, although such tubes may also be larger in size. bigger or smaller. It is understood in this disclosure that the one or more tubes (if used) and any solids (if used) may be provided through the interior of image capture assembly 220 without increasing the size of image capture assembly 220 (such as diameter) and/or affect the controllability/configurability of the multi-bendable body 222.

When the internal temperature control assembly utilizes a gas or the like, example embodiments may also be operable to provide such gas to the body lumen via one or more tubes or the like and/or exhaust or recycle such gas outside the body lumen. In example embodiments, the gas may include carbon dioxide, oxygen, and/or other gases. Such gas may further be operable to help provide and/or maintain insufflation of the patient's cavity during a surgical procedure. When internal temperature control components utilize liquids or the like, example embodiments may be operable to drain or recycle such liquids outside of the body cavity. When the internal temperature control assembly utilizes a solid, etc., such solid may possess properties that enable the surgical team to change the temperature of the solid, such as through application of electricity or other forms of energy, in order to control (such as lower) the image capture assembly 220 temperature and/or heat generation of one or more components of the In example embodiments, the internal temperature control assembly may utilize a combination of gases, liquids, solids, etc. without departing from the teachings of the present disclosure.

Image capture assembly 220 may be secured to port assembly 210 in one or more of a variety of ways, including those described above and in this disclosure with respect to instrument arm assembly 230 or 240 and/or auxiliary arm assembly 250 or 260 of those. For example, image capture assembly 220 may also include an anchor portion 220a operable to attach (or secure) image capture assembly 220 to one or more anchor ports 216 of port assembly 210 (e.g., similar to an instrument arm The fixed part 231a) of the assembly 220.

In an example embodiment, both the image capture body 224 and the multi-bendable body 222 may be generally cylindrical in shape. Image capture body 224 and flexible body 222 may also be formed in any of a variety of other shapes, sizes, and/or dimensions without departing from the teachings of the present disclosure.

In an example embodiment, the length of the multi-bendable body 222 may be between about 50 and 150 mm. In an example embodiment, the length of the multi-bendable body 222 may also be adjusted by the surgical team 904 before, during, and/or after insertion of the camera arm assembly into the patient's cavity. The outer diameter of the flexible body 222 may be between about 5 to 7 mm. It is to be understood in this disclosure that the above dimensions are illustrative of example embodiments only, and as such, these dimensions may be smaller or larger than those recited above without departing from the teachings of the present disclosure.

The multi-bendable body 222 may be formed using any one or more of a variety of materials, such as stainless steel or the like. It is understood in the present disclosure that other materials may be used without departing from the teachings of the present disclosure. It is to be understood in this disclosure that the above materials are merely illustrations of example embodiments and that these and other materials and compositions may be used without departing from the teachings of the present disclosure.

As shown in FIGS. 6B and 6C , the image capture assembly 220 may further include a gas shield 228 positioned adjacent the one or more lenses of the camera 227 . The image capture assembly 220 may further include a gas shield 228 positioned proximate to one or more of the illumination source 229 and/or any other sensors provided by the image capture assembly 220 (such as temperature sensors, pressure sensors, humidity sensors, etc.). The gas hood 228 may include one or more openings, etc., one or more external gas sources 228, and One or more tubes, channels, etc. In operation, the gas shield 228 may be operable to provide pressurized gas (and/or or liquids), such as carbon dioxide, oxygen, other gases or liquids, or combinations thereof.

The overall system may also include one or more separate image capture components, such as the separate image capture component 320 shown in Figure 6D. Separate image capture assembly 320 may be magnetically anchored by magnetic anchor 310 to the inner wall of the patient's cavity, such as via a permanent magnet, electromagnet, or the like. In some example embodiments, the magnetic anchor 310 may also be secured/held in place via an external anchor (not shown). A separate image capture assembly 320 may include one or more cameras 327 and may also include one or more illumination sources 329 .

A separate image capture component 320 may be operable to provide one or more of various views including, but not limited to, a normal view, a zoomed view, a wide angle view, and/or a panoramic view of the patient's cavity. The separate image capture component 320 may be positioned in a manner to provide the surgical team 904 with an unobstructed view of the region of interest within the patient's cavity. With regard to positioning and securing the individual image capture assembly 320 in place, as shown in FIG. Access to the desired location of the inner wall of the patient's cavity includes using surgical tools (not shown), attaching separate image capture assembly 320 to a multi-bendable body similar to that of image capture assembly 220 (not shown). Shown) (as shown in Figure 2A, Figure 2B, Figure 3A, Figure 3B and Figure 6D), and so on.

Instrument arm assemblies (eg, instrument arm assemblies 230, 240)

In an example embodiment, surgical apparatus 200 may include one or more instrument arm assemblies (e.g., first instrument arm assembly 230, second instrument arm assembly 240, third instrument arm assembly (not shown), fourth instrument arm assembly arm assemblies (not shown), etc.), each may be configured to attach to port assembly 210 . Although some of the drawings and/or descriptions provided in this disclosure may be directed to the first instrument arm assembly 230 and its components, it is understood in this disclosure that such drawings and/or descriptions may apply to other instrument arm assemblies as well. , including the second instrument arm assembly 240, the third instrument arm assembly (not shown), the fourth instrument arm assembly (not shown) and the like.

One or more of the instrument arm assemblies (such as 230, 240) may include multiple instrument arm segments (or arm assemblies, such as the first arm assembly 330, the second arm assembly 360, and the Configurable or A configured series (or linear) connection arrangement, and an end instrument 340 (which has at least a wrist assembly and an instrument assembly 237, integrated into and/or connected to one or more of the instrument arm segments and/or coupling portions Instrument assembly 237 includes instrument 239 (one or more) having instrument 342 and/or instrument 344 . Although some of the figures and descriptions in this disclosure may be directed to a series connection arrangement having the end effector assembly 340 at the distal end, followed by the first arm assembly 330, followed by the elbow joint 234 (which has an elbow pitch joint portion 350', followed by elbow rocking joint 350), followed by second arm assembly 360, followed by shoulder joint assembly 232 (which has shoulder pitch joint 370, followed by shoulder rocking joint 380), then at the proximal end The instrument arm assemblies 230, 240 of the shoulder segment 231, but it is understood in this disclosure that the series connection arrangement for the instrument arm assemblies 230, 240 may also be in other orders and include (or not include) other elements. For example, the series connection arrangement may include the end effector assembly 340 at the distal end, followed by the first arm assembly 330, followed by the elbow pitch link 350', followed by the elbow rock link 350, followed by the second arm Assembly 360, followed by shoulder pitch linkage portion 370, followed by shoulder roll linkage portion 380, followed by shoulder segment 231 at the proximal end. As another example, the series connection arrangement may include end effector assembly 340 at the distal end, followed by first arm assembly 330, followed by elbow rocker link 350, followed by elbow pitch link 350', followed by The second arm assembly 360, followed by the shoulder roll link portion 380, followed by the shoulder pitch link portion 370, followed by the shoulder segment 231 at the proximal end. In yet another example, the series connection arrangement may include end effector assembly 340 at the distal end, followed by first arm assembly 330, followed by elbow pitch linkage section 350', followed by elbow roll linkage section 350, followed by is the second arm assembly 360, followed by the shoulder roll link portion 380, followed by the shoulder pitch link portion 370, followed by the shoulder segment 231 at the proximal end. As another example, the series connection arrangement may include end effector assembly 340 at the distal end, followed by first arm assembly 330, followed by elbow pitch linkage section 350', followed by elbow roll linkage section 350, followed by The second arm assembly 360, followed by the shoulder pitch link portion 370, followed by the shoulder segment 231 at the proximal end. As another example, the series connection arrangement may include end effector assembly 340 at the distal end, followed by first arm assembly 330, followed by elbow pitch linkage section 350', followed by elbow roll linkage section 350, followed by The second arm assembly 360, followed by the shoulder swing link portion 380, followed by the shoulder segment 231 at the proximal end. As another example, the series connection arrangement may include end effector assembly 340 at the distal end, followed by first arm assembly 330, followed by elbow rocker link 350, followed by elbow pitch link 350', followed by The second arm assembly 360, followed by the shoulder pitch link portion 370, followed by the shoulder segment 231 at the proximal end. As another example, the series connection arrangement may include end effector assembly 340 at the distal end, followed by first arm assembly 330, followed by elbow rocker link 350, followed by elbow pitch link 350', followed by The second arm assembly 360, followed by the shoulder swing link portion 380, followed by the shoulder segment 231 at the proximal end. In yet another example, the series connection arrangement may include the end effector assembly 340 at the distal end, followed by the first arm assembly 330, followed by the elbow rocker link 350, followed by the second arm assembly 360, followed by Shoulder pitch link 370, followed by shoulder roll link 380, followed by shoulder segment 231 at the proximal end. As another example, the series connection arrangement may include the end effector assembly 340 at the distal end, followed by the first arm assembly 330, followed by the elbow rocker link 350, followed by the second arm assembly 360, followed by the shoulder The rocking link portion 380 is followed by the shoulder pitch linking portion 370 followed by the shoulder segment 231 at the proximal end. Other series connection arrangements with more or fewer elements are also contemplated without departing from the teachings of the present disclosure.

The end effectors or instruments 239, 342, 344 may be any instruments suitable for use in surgery, such as cutting and/or grasping instruments. One or more of the instrument arm assemblies (such as 230, 240) may also include one or more illumination sources (not shown), such as LEDs, etc., operable to illuminate the end effector or instrument 239 , 342, 344, one or more portions in the instrument arm assembly and/or portions, sections and/or quadrants of the patient's abdominal cavity.

One or more of the instrument arm assemblies (such as 230, 240) may also include one or more integrated motors (e.g., integrated motors 332, 334 shown in at least FIGS. 5E, 5G, 5J, and 5K) , 336 and/or 339 and at least the integrated motors 362, 364, 366 and/or 369 shown in FIGS. 5M, 5N, 5O, 5T, 5U and 5V), each integrated motor is operable to The instrument arm assembly provides at least one degree of freedom. Each integrated motor (e.g., integrated motors 332, 334, 336, 339, 362, 364, 366, and/or 369) may be a fully and independently operating motor, except for power cables and/or control cables) are completely contained in the instrument arm section (or arm assembly, such as the first arm assembly 330, the second arm assembly 360 and/or the shoulder assembly 231) (such as the housing 331 and / or 360'). One or more of the instrument arm assemblies may also include an integrated haptic and/or force feedback subsystem (not shown) that communicates with one or more of the integrated motors and/or other sensors and/or the instrument are in communication operable (such as via a computing device/controller) to provide one or more of a plurality of feedback responses and/or measurements to the surgical team, including proximity to and/or proximity to the instrument arm assembly Those related to the component's position (including orientation), applied force, proximity, temperature, pressure, humidity, etc. For example, the surgical team 904 may be provided with a primary input device such as a manipulator, with haptic and/or force feedback, and designed to map and sense the dexterity of the surgical team 904 with high precision, high dexterity, and minimal burden. Finger twisting, wrist bending, and/or other arm/shoulder motions are incorporated into the motion of the instrument arms (such as 230, 240) while also providing feedback on contact resistance (such as tissue resistance).

When an instrument arm assembly (such as 230, 240) includes one or more illumination sources, cameras, haptic and/or force feedback instruments, and/or other sensors and/or instruments, as described above and in this disclosure, The instrument arm assembly may also include a gas shield, such as the gas shield described above with respect to image capture assembly 220 . One or more of the instrument arm assemblies (such as 230, 140) may further include one or more internal temperature control assemblies operable to control (such as lower or raise) one or more of the instrument arm assemblies. The temperature of more components.

As shown in the example embodiments of FIGS. 2A-2D , 3A-3D , 5A , 5B, 5P, and 5O, each of the instrument arm assemblies including the first instrument arm assembly 230 may include a shoulder segment 231 , second arm assembly 360 , first arm assembly 330 and end effector assembly 340 . The instrument arm assembly 230 may also include: a shoulder linkage assembly 232 having a shoulder swing linkage section 380 and/or a shoulder pitch linkage section 370; an elbow linkage assembly 234 having an elbow swing linkage section 350 and/or an elbow pitch linkage segment 350'; third coupling portion (or wrist segment) 236, which is pivotally movable relative to axis B (as shown in at least FIGS. 5D-5H ); and end effector coupling portion 238, which can Pivotally moved relative to axis A (as shown in at least Figures 5D-5H). Each of the foregoing coupling portions may be configured manually and/or via a computing device (or system) as an attached instrument arm segment (and end effector 239, end effector 239, 342, 344) provide one or more degrees of freedom within the individual. For example, shoulder link assembly 232 may be operable to provide second arm assembly 360 with one or more degrees of freedom (eg, similar to one or more degrees of freedom of a human shoulder). Specifically, the shoulder linkage assembly 232 may include a shoulder swing linkage segment 380 operable to provide movement (e.g., rotational or pivotal movement) to the second arm assembly 360 relative to the axis E (eg, as at least FIG. 5L, FIG. 5M, Figure 5S and Figure 5T). Shoulder linkage assembly 232 may include shoulder pitch linkage section 370 operable to provide movement (eg, rotational or pivotal movement) to second arm assembly 360 relative to axis D (eg, as at least FIGS. 5L , 5M, 5S and shown in Figure 5T). Axis E may be different from axis D (eg, axis E may be substantially orthogonal to axis D). As another example, elbow joint assembly 234 may be operable to provide one or more degrees of freedom to first arm assembly 330 . Specifically, the elbow linkage assembly 234 may include an elbow rocker linkage assembly 350 operable to provide movement (e.g., rotational or pivotal movement) to the first arm assembly 330 relative to the axis C (eg, at least FIG. 5L , FIG. 5M ). , shown in Figure 5S and Figure 5T). Elbow linkage assembly 234 may include elbow pitch linkage assembly 350' operable to provide movement (eg, rotational or pivotal movement) to first arm assembly 330 relative to axis C' (as shown in at least FIGS. 5S and 5T ). Show). Axis C may be different from axis C' (eg, axis C may be substantially orthogonal to axis C'). As another example, third articulation portion (or wrist segment) 236 may be operable to provide instrument assembly 237 with one or more degrees of freedom, similar to one or more degrees of freedom of a human wrist. Specifically, the third coupling portion (or wrist segment) 236 may be operable to provide movement (e.g., rotational or pivotal movement) to the instrument assembly 237 relative to the axis B (eg, at least FIGS. 5L, 5M, 5S and shown in Figure 5T). As another example, the end effector coupling portion 238 (as shown in at least FIGS. 5A-5B , 5P-5Q, 5H ) may be operable to provide an or more degrees of freedom. Specifically, the end effector coupling portion 238 may be operable to provide movement (e.g., rotational or pivotal movement) to the end effector or instrument 239, 342, 344 relative to the axis A (eg, as shown in at least FIGS. 5D-5I ). , Figures 5L-5M, Figures 5S-5T). Axis B may be different from axis A (eg, axis B may be substantially orthogonal to axis A). Accordingly, one or more of the instrument arm assemblies may be configured manually and/or via a computing device (or system) to provide seven or more in vivo degrees of freedom, and be integrated with the port assembly 210 and controllable rotation assembly 1000 (see FIGS. 10A and 10B )), one or more of the instrument arm assemblies may be configured manually and/or via a computing device (or system) to provide a total of eight to Ten or more degrees of freedom. It is recognized herein that the aforementioned at least seven in vivo degrees of freedom for the instrument arm assembly enable at least the entire range of natural motion of the surgeon's arm (via a controller/computer-human interface/manipulator/master input device such as The example shown in FIGS. 9A and 9B ) is substantially directly mapped and/or translated to the instrument arm assembly.

Each coupling portion, including coupling portions 232, 370, 380, 234, 350, 350′, 236, and/or 238, may include any one or more gears and/or gear assemblies without departing from the teachings of the present disclosure. Many more configurations, including spur gear configurations, planetary gear configurations, bevel gear configurations, spiral bevel gear configurations, hypoid gear configurations, helical gear configurations, worm gear configurations, and/or any other gear configurations. In an example embodiment, each instrument arm assembly may also include one or more internally integrated motors 332, 334, 336, 339, 362, 364, 366, 369, etc., operable to actuate ( For example, via first instrument drive portion 332a, second instrument drive portion 334a, wrist drive portion 336a, first arm assembly drive assembly 339a (which may be configured to drive first arm assembly 330 relative to axis F, as shown in at least FIG. 5K shown), elbow swing driving part 362a, elbow pitch driving part 362a', shoulder pitch driving part 364a, shoulder swing driving part 366a) each coupling part (for example, first instrument driven part 342a, second instrument driven part 344a, wrist driven portion 346a, first arm assembly driven assembly 347 (which may be configured to be driven by first arm assembly drive assembly 339a to drive first arm assembly 330 relative to axis F, as shown in at least FIG. 5K ) , elbow swing driven portion 352, elbow pitch driven portion 352′, shoulder pitch driven portion 364b, shoulder swing driven portion 366b, 366c (if desired), 366d (if desired)) and coupling portions 232, 370 , 380, 234, 350, 350', 236 and 238, and/or the gears of segments 231, 360, 330 and 340. In this regard, in example embodiments, each of the integrated motors, coupling portions, and/or segments described above and in this disclosure may be operable to communicate via wired and/or wirelessly with one or more The computing devices/controllers of a nearby and/or remotely located surgical team 904 communicate back and forth or one-way, such as receiving control commands and/or sending information. Additionally, in example embodiments, each of the integrated motors, coupling portions, and/or instrument arm segments described above and in this disclosure may be operable to receive data from an external power source and/or computing device via wired and/or wireless transmission. The device/controller receives power and/or control signals from an external power source and/or computing device/controller.

End effector assembly (e.g., end effector assembly 340)

An example embodiment of an end effector assembly (eg, end effector assembly 340 ) may include instrument assembly 237 . End effector assembly 340 may also include a wrist assembly. Instrument assembly 237 may include a first instrument assembly and a second instrument assembly. Although the drawings illustrate an end effector assembly having a first instrument and a second instrument, it is to be understood in the present disclosure that the end effector assembly may have more other instruments, or may have only the first instrument or the second instrument. The wrist assembly may include wrist coupling portion 236 and may also include wrist connector 348 .

(i) First device component

Example embodiments of a first instrument assembly may include a first instrument (eg, first instrument 342 ) for performing a surgical procedure. First instrument 342 may be any surgical instrument without departing from the teachings of the present disclosure.

In an example embodiment, the first instrument 342 may be configurable to receive an electrical current (eg, a first current) applied from a first energy source (not shown) in order to perform the action of the electrosurgical instrument. Although the first instrument may be described above and in this disclosure as receiving electrical current, it is to be understood that the first instrument may also be configurable to receive voltage potential, thermal energy, heat, cold temperature without departing from the teachings of the present disclosure. Applying, irradiating, etc. to perform the surgical procedure.

The first instrument assembly may also include a first instrument driven portion (eg, first instrument driven portion 342a). The first instrument driven part 342 a may be configurable to be driven by the first instrument driving part 332 a of the integrated motor 332 . The first instrument driven portion 342 a may be driven by the first instrument driving portion 332 a in such a manner as to move the first instrument 342 . For example, first instrument driven portion 342a may be driven to move first instrument 342 relative to a first axis (eg, axis A). In this regard, such movement of the first instrument 342 may be a rotation of the distal end of the first instrument 342 relative to the proximal end of the first instrument 342, and such a proximal end may serve as a pivot for such movement.

The first instrument driven portion 342a can be any mechanism, device, etc. that can be configured to be driven by the first instrument driven portion 332a. For example, first instrument driven portion 342a may include any one or more configurations or combinations of gears and/or gear assemblies, including spur gear configurations, planetary gear configurations, bevel gear configurations, without departing from the teachings of the present disclosure. Gear configurations, spiral bevel gear configurations, hypoid gear configurations, helical gear configurations, worm gear configurations and/or any other gear and/or mechanical configurations such as wire ropes and pulleys. Although the drawings illustrate an end effector assembly having a first instrument driven portion, it will be understood in the present disclosure that the end effector assembly may have more than one end effector assembly without departing from the teachings of the present disclosure. A driven portion of the first instrument.

In the example embodiment in which the end effector assembly 340 is detachable from the arm assembly 330 (i.e., can be released from the arm assembly 330), it is to be understood that the first instrument drive portion 332a of the integrated motor 332 may be operable to act as an end effector assembly 330 The first instrument driven portion 342a is driven when the partial effector assembly 340 is secured (ie, attached) to the arm assembly 330 . Specifically, the first instrument drive portion 332a of the integrated motor 332 may be operable to operate when the wrist connector portion 338 is secured (i.e., attached) to the wrist assembly of the end effector assembly (hereinafter and in this disclosure). Further described) (more specifically, the connector 348 of the end effector assembly 340) drives the first instrument driven portion 342a.

In example embodiments wherein the end effector assembly 340 is detachable from the arm assembly 330 (i.e., can be released from the arm assembly 330), it is understood that one or more connectable and disconnectable wires, wires A cable or the like may be provided to enable the first instrument 342 to receive electrical current from the energy source to perform the actions of the electrosurgical instrument.

The first instrument assembly may also include a first instrument insulating portion (eg, first instrument insulating portion 342b). A first instrument insulating portion 342b may be provided between the first instrument 342 and one or more portions of the end effector assembly 340 so as to separate the first instrument 342 from the one or more portions of the end effector assembly 340. Parts are electrically isolated (or electrically isolated, thermally isolated, thermally isolated, etc.). In an example embodiment, a first instrument insulating portion 342b may be provided between the first instrument 342 and the first instrument driven portion 342a so as to electrically isolate (or electrically insulate) the first instrument 342 from the first instrument driven portion 342a. , thermal isolation, thermal insulation, etc.). Such electrical isolation (or electrical isolation, thermal isolation, thermal insulation, etc.) Application, radiation, etc.) may be desired to be undesirably transmitted to the second instrument 344 via the first instrument driven portion 342a and/or other components/portions of the surgical arm assembly.

The first instrument insulating portion 342b may be formed using any one or more of a variety of materials, such as electrically insulating materials, thermally insulating materials, plastics, elastomers, ceramics, glass, and minerals. It is understood in the present disclosure that other materials may be used without departing from the teachings of the present disclosure.

The first instrument 342 may be formed using any one or more of a variety of materials, such as surgical grade metals, high strength aluminum alloys, stainless steel (such as 304/304L, 316/316L, and 420), pure titanium, titanium alloys ( Such as Ti6A14V, NiTi), cobalt chromium alloy and magnesium alloy. It is understood in the present disclosure that other materials may be used without departing from the teachings of the present disclosure. Additionally, the first instrument 342 may include an opening or the like for receiving and accommodating at least a portion of the first instrument insulating portion 342b. In an example embodiment, a first axis (eg, axis A) may be formed through the center of the opening of the first instrument 342 . Although the opening may be depicted as a circular shape in the drawings, and the corresponding outer portion of the first instrument insulating portion 342b received in the opening may be depicted as a circular shape in the drawings, it is intended in this disclosure that It is understood that openings and such corresponding outer portions may be formed in one or more other shapes without departing from the teachings of the present disclosure, including, but not limited to, square, rectangular, oval, five-sided shape etc.

(ii) Second device component

Example embodiments of a second instrument assembly may include a second instrument (eg, second instrument 344 ) for performing a surgical procedure. Second instrument 344 may be any surgical instrument without departing from the teachings of the present disclosure.

In an example embodiment, the second instrument 344 may be configurable to receive an electrical current (eg, a second electrical current) applied from a second energy source (not shown) in order to perform the action of the electrosurgical instrument. Although the second instrument may be described above and in this disclosure as receiving electrical current, it is to be understood that the second instrument may also be configurable to receive voltage potential, thermal energy, heat, cold temperature without departing from the teachings of the present disclosure. Applying, irradiating, etc. to perform the surgical procedure.

The second instrument assembly may also include a second instrument driven portion (eg, second instrument driven portion 344a). The second instrument driven portion 344a may be configurable to be driven by the second instrument driven portion 334a of the integrated motor 334 . The second instrument driven portion 344 a may be driven by the second instrument driving portion 334 a in such a manner as to move the second instrument 344 . For example, second instrument driven portion 344a may be driven to move second instrument 344 relative to a first axis (eg, axis A). In this regard, such movement of the second instrument 344 may be a rotation of the distal end of the second instrument 344 relative to the proximal end of the second instrument 344, and such a proximal end may serve as a pivot for such movement.

The second instrument driven portion 344a can be any mechanism, device, etc. that can be configured to be driven by the second instrument driven portion 334a. For example, the second instrument driven portion 344a may include any one or more configurations of gears and/or gear assemblies, including spur gear configurations, planetary gear configurations, bevel gear configurations, without departing from the teachings of the present disclosure. configuration, a spiral bevel gear configuration, a hypoid gear configuration, a helical gear configuration, a worm gear configuration, and/or any other gear and/or mechanical configuration (such as ropes and pulleys). Although the drawings illustrate an end effector assembly having a second instrument driven portion, it will be understood in the present disclosure that the end effector assembly may have more than one end effector assembly without departing from the teachings of the present disclosure. A driven portion of the second instrument.

In the example embodiment in which the end effector assembly 340 is detachable from the arm assembly 330 (i.e., can be released from the arm assembly 330), it is to be understood that the second instrument drive portion 334a of the integrated motor 334 may be operable to act as an end effector assembly 330 The second instrument driven portion 344a is driven when the actuator assembly 340 is secured (ie, attached) to the arm assembly 330 . Specifically, the second instrument drive portion 334a of the integrated motor 334 may be operable to operate when the wrist connector portion 338 is secured (i.e., attached) to the wrist assembly of the end effector assembly (hereinafter and in this disclosure). Further described) (more specifically, the connector 348 of the end effector assembly 340) drives the second instrument driven portion 344a.

In example embodiments wherein the end effector assembly 340 is detachable from the arm assembly 330 (i.e., can be released from the arm assembly 330), it is understood that one or more connectable and disconnectable wires, wires A cable or the like may be provided to enable the second instrument 344 to receive electrical current from the energy source to perform the actions of the electrosurgical instrument.

The second instrument assembly may also include a second instrument insulating portion (eg, second instrument insulating portion 344b). A second instrument insulating portion 344b may be provided between the second instrument 344 and one or more portions of the end effector assembly 340 so as to separate the second instrument 344 from the one or more portions of the end effector assembly 340. Parts are electrically isolated (or electrically isolated, thermally isolated, thermally isolated, etc.). In an example embodiment, a second instrument insulating portion 344b may be provided between the second instrument 344 and the second instrument driven portion 344a so as to electrically isolate (or electrically insulate) the second instrument 344 from the second instrument driven portion 344a. , thermal isolation, thermal insulation, etc.). Such electrical isolation (or electrical isolation, thermal isolation, thermal insulation, etc.) Application, radiation, etc.) may be desired to be undesirably delivered to the first instrument 342 via the second instrument driven portion 344a and/or other components/portions of the surgical arm assembly.

The second instrument insulating portion 342b may be formed using any one or more of a variety of materials, such as electrically insulating materials, thermally insulating materials, plastics, elastomers, ceramics, glass, and minerals. It is understood in the present disclosure that other materials may be used without departing from the teachings of the present disclosure.

The second instrument 344 may be formed using any one or more of a variety of materials, such as surgical grade metals, high strength aluminum alloys, stainless steel (such as 304/304L, 316/316L, and 420), pure titanium, titanium alloys ( Such as Ti6A14V, NiTi), cobalt chromium alloy and magnesium alloy. It is understood in the present disclosure that other materials may be used without departing from the teachings of the present disclosure. Additionally, the second instrument 344 may include an opening or the like for receiving and accommodating at least a portion of the second instrument insulating portion 344b. In an example embodiment, a first axis (eg, axis A) may be formed through the center of the opening of the second instrument 344 . Although the opening may be depicted as a circular shape in the drawings, and the corresponding outer portion of the second instrument insulating portion 344b received in the opening may be depicted as a circular shape in the drawings, it is intended in the present disclosure that It is understood that openings and such corresponding outer portions may be formed in one or more other shapes without departing from the teachings of the present disclosure, including, but not limited to, square, rectangular, oval, five-sided shape etc.

(iii) Cooperation of the first device component and the second device component

In an example embodiment, a first implement (eg, first implement 342 ) and a second implement (eg, second implement 344 ) may be selectively movable/drivable independently of each other. In example embodiments, the first implement 342 and the second implement 344 may be selectively movable/drivable in a similar or identical manner, such as simultaneously movable/drivable, movable/drivable for the same duration, Movable/drivable by the same distance, and/or with the same output power. Although the drawings illustrate an end effector assembly having a first instrument and a second instrument, it is to be understood in the present disclosure that the end effector assembly may have more other devices, or may only have the first device or the second device. For example, first instrument 342 and second instrument 344 may cooperate to form a grasper. As another example, first instrument 342 and second instrument 344 may cooperate to form scissors. As another example, first instrument 342 and second instrument 344 may cooperate to form a Maryland grasper. In the present disclosure, it is contemplated in addition to or instead of the first instrument and/or the second instrument described above and herein without departing from the teachings of the present disclosure. Or other forms and types of the first device and/or the second device.

For example, as described above, the first instrument 342 may be configurable to receive an electrical current (eg, a first current) applied from a first energy source (not shown) in order to perform the action of the electrosurgical instrument. Additionally or instead, the second instrument 344 may be configurable to receive an electrical current (eg, a second electrical current) applied from a second energy source (not shown). In example embodiments, the first current may be the same in magnitude as the second current, but opposite in direction to the second current, and in example embodiments, the first energy source and the second energy source Can be the same or different. In such embodiments where the first and second instruments cooperate to form a monopolar electrosurgical instrument or the like, when a mass (e.g., a mass of tissue) is provided between the first and second instruments 342, 344 and current When applied to either the first instrument 342 or the second instrument 344, the mass will serve to enable the applied current to pass through the mass and help cut, coagulate, dry and/or electrocautery the mass. Similarly, in embodiments where a first instrument and a second instrument cooperate to form a bipolar electrosurgical instrument, etc., when a mass (e.g., a mass of tissue) is provided between the first instrument 342 and the second instrument 344 and When electrical current is applied to the first instrument 342 and the second instrument 344, the mass will serve to enable the applied current to pass through the mass and assist in performing surgical actions, including cutting, coagulating, drying, cauterizing and/or electrocautery the mass. clumps. Although the first instrument and/or the second instrument may be described above and in this disclosure as receiving electrical current, it is to be understood that the first instrument and/or the second instrument may also be described without departing from the teachings of the present disclosure. Can be configured to receive voltage potentials, thermal energy, heat, cold application, radiation, etc. to perform the surgical action.

(iv) wrist assembly

In an example embodiment, wrist assembly may be fixable or fixed to instrument assembly 237 . The wrist assembly may include a wrist driven portion (eg, wrist driven portion 346a). The wrist assembly may further include a connector (eg, connector 348).

The wrist driven portion 346a may be configurable to be driven by the wrist driving portion 336 via the integrated motor 336 . Wrist driven portion 346a may be driven by wrist driving portion 336a in such a manner as to move instrument assembly 237 (including first instrument 342 and/or second instrument 344 ). For example, wrist driven portion 346a may be driven to pivotally move first instrument 342 relative to a second axis (eg, axis B). In this regard, such movement of the first instrument 342 may be a rotation (or pivotal movement) of the distal end of the first instrument 342 relative to a point on the second axis (e.g., axis B), and such point Can be used as a pivot for such movements. Additionally or instead, the wrist driven portion 346a may be driven by the wrist driving portion 336a in such a manner as to move the second instrument 344 . For example, wrist driven portion 346a may be driven to pivotally move second instrument 344 relative to a second axis (eg, axis B). In this regard, such movement of the second instrument 344 may be a rotation (or pivotal movement) of the distal end of the second instrument 344 relative to a point on the second axis (e.g., axis B), and such point Can be used as a pivot for such movements. In an example embodiment, the wrist driven portion 346a may be driven by the wrist driving portion 336a in such a manner that the first instrument 342 and the second instrument 344 are moved together. For example, wrist driven portion 346a may be driven to move first instrument 342 and second instrument 344 together relative to a second axis (eg, axis B). In this regard, such movement of the first instrument 342 and the second instrument 344 may be a point on the distal end of the first instrument 342 and the distal end of the second instrument 344 relative to a second axis (e.g., axis B). common rotation (or pivotal movement), and such a point can be used as a pivot for such movement. Axis B may be different from axis A (eg, axis B may be substantially orthogonal to axis A).

Wrist-driven portion 346a may be any mechanism, device, etc. that can be configured to be driven by wrist-driven portion 336a. For example, wrist driven portion 346a may include any one or more configurations or combinations of gears and/or gear assemblies, including spur gear configurations, planetary gear configurations, bevel gear configurations, without departing from the teachings of the present disclosure. configuration, a spiral bevel gear configuration, a hypoid gear configuration, a helical gear configuration, a worm gear configuration, and/or any other gear and/or mechanical configuration (such as ropes and pulleys). Although the drawings illustrate an end effector assembly having one wrist driven portion, it is to be understood in the present disclosure that an end effector assembly may have more than one wrist driven portion without departing from the teachings of the present disclosure. Wrist driven part.

Arm assemblies (eg, first arm assembly 330, second arm assembly 360)

(i) First arm assembly (eg, first arm assembly 330)

Example embodiments of the first arm assembly 330 are illustrated in at least FIGS. 5A-5C , 5L-5M, and 5S-5T. Arm assembly 330 may be fixable to end effector assembly 340 . In an example embodiment, arm assembly 330 may be fixable to and releasable (eg, detachable) from end effector assembly 340 . As shown in FIGS. 5C and 5J , the arm assembly 330 may include an arm assembly body (eg, arm assembly body 331 ), a first end 330 a (or proximal end), and a second end 330 b opposite to the first end 330 a. (or remote). Elbow pitch link portion 350' may be secured to first end 330a, and end effector assembly 340 may be secured to second end 330b. A wrist connector portion 338 may be provided at the second end 330b. The arm assembly body 331 can securely house one or more of the plurality of drive assemblies.

In an example embodiment, the arm assembly body 331 can securely house the first instrument drive assembly. The first instrument drive assembly can include a first integrated motor (eg, first integrated motor 332), and can also include a first instrument drive portion (eg, first instrument drive portion 332a). The first instrument driving portion 332a may be provided at the second end portion 330b of the arm assembly body 331 . The first instrument driving portion 332a may be controllable by the first integrated motor 332 to drive the first instrument driven portion 342a when the wrist connector portion 338 is secured to the wrist assembly. The first instrument driving portion 332a can be any mechanism, device, etc. that can be configured to drive the first instrument driven portion 342a. For example, first instrument drive portion 332a may include any one or more configurations or combinations of gears and/or gear assemblies, including spur gear configurations, planetary gear configurations, bevel gear configurations, without departing from the teachings of the present disclosure. Gear configurations, spiral bevel gear configurations, hypoid gear configurations, helical gear configurations, worm gear configurations and/or any other gear and/or mechanical configurations such as wire ropes and pulleys. Although the drawings illustrate an arm assembly having one first instrument drive portion 332a, it is to be understood in the present disclosure that an arm assembly may have more than one first instrument drive portion 332a without departing from the teachings of the present disclosure. Section 332a.

In an example embodiment, the arm assembly body 331 may also securely house a second instrument drive assembly. The second instrument drive assembly can include a second integrated motor (eg, second integrated motor 334 ), and can also include a second instrument drive portion (eg, second instrument drive portion 334 a ). A second instrument driving portion 334a may be provided at the second end 330b of the arm assembly body 331 . The second instrument driving portion 334a may be controllable by the second integrated motor 334 to drive the second instrument driven portion 344a when the wrist connector portion 338 is secured to the wrist assembly. The second instrument driving portion 334a can be any mechanism, device, etc. that can be configured to drive the second instrument driven portion 344a. For example, the second instrument drive portion 334a may include any one or more configurations or combinations of gears and/or gear assemblies, including spur gear configurations, planetary gear configurations, bevel gear configurations, without departing from the teachings of the present disclosure. Gear configurations, spiral bevel gear configurations, hypoid gear configurations, helical gear configurations, worm gear configurations and/or any other gear and/or mechanical configurations such as wire ropes and pulleys. Although the drawings illustrate an arm assembly having one second instrument drive portion 334a, it is to be understood in the present disclosure that an arm assembly may have more than one second instrument drive portion 334a without departing from the teachings of the present disclosure. Section 334a.

In an example embodiment, the arm assembly body 331 may also securely house the wrist drive assembly. The wrist drive assembly can include a third integrated motor (eg, third integrated motor 336 ), and can also include a wrist drive portion (eg, wrist drive portion 336 a ). A wrist drive portion 336a may be provided at the second end 330b of the arm assembly body 331 . Wrist drive portion 336a may be controllable by third integrated motor 336 to drive wrist driven portion 346a when wrist connector portion 338 is secured to the wrist assembly. Wrist actuating portion 336a may be any mechanism, device, etc. that may be configured to drive wrist actuated portion 346a. For example, wrist drive portion 336a may include any one or more configurations or combinations of gears and/or gear assemblies, including spur gear configurations, planetary gear configurations, bevel gear configurations, without departing from the teachings of the present disclosure. , a spiral bevel gear configuration, a hypoid gear configuration, a helical gear configuration, a worm gear configuration, and/or any other gear and/or mechanical configuration (such as wire ropes and pulleys). Although the figures illustrate an arm assembly having one wrist actuation portion 336a, it is to be understood in the present disclosure that an arm assembly may have more than one wrist actuation portion 336a without departing from the teachings of the disclosure.

In an example embodiment, the arm assembly body 331 may also securely house the first arm assembly drive assembly. The first arm assembly drive assembly may include a fourth integrated motor (eg, fourth integrated motor 339), and may also include a first arm assembly drive portion (eg, first arm assembly drive portion 339a). A first arm assembly driving portion 339 a may be provided at the first end portion 330 a of the arm assembly body 331 . The first arm assembly driving part 339a can be controlled by the fourth integrated motor 339 to drive the first arm assembly driven part 347 to drive the first arm assembly body 331 to move relative to an axis (eg, axis F shown in FIG. 5K ). Axis F may be formed by first arm assembly 330 (eg, axis F may be formed by a centerline drawn through first arm assembly body 331 ). The first arm assembly driving portion 339a may be any mechanism, device, etc. that may be configured to drive the movement of the first arm assembly body 331 relative to the first arm assembly coupling portion 350 . For example, first arm assembly drive portion 339a may include any one or more configurations or combinations of gears and/or gear assemblies, including spur gear configurations, planetary gear configurations, Bevel gear configurations, spiral bevel gear configurations, hypoid gear configurations, helical gear configurations, worm gear configurations and/or any other gear and/or mechanical configurations such as wire ropes and pulleys. Although the drawings illustrate an arm assembly having one first arm assembly drive portion 339a, it will be understood in the present disclosure that an arm assembly may have more than one first arm assembly without departing from the teachings of the present disclosure. Component drive section 339a.

Although the drawings illustrate a first integrated motor 332, a second integrated motor 334, a third integrated motor 336, a fourth integrated motor 339, a first instrument drive part 332a, a second instrument drive part 334a, a wrist drive part 336a and first arm assembly drive portion 339a, but it is to be understood that first arm assembly 330 may (or may not) include first integrated motor 332, second The integrated motor 334, the third integrated motor 336, the fourth integrated motor 339, the first instrument drive portion 332a, the second instrument drive portion 334a, the wrist drive portion 336a and/or the first arm assembly drive portion 339a, and/or can also Including other integrated motor(s) and/or other drive parts. It is also understood that first integrated motor 332, second integrated motor 334, third integrated motor 336, fourth integrated motor 339, first instrument drive portion 332a, second instrument drive Portion 334a, wrist drive portion 336a, and/or first arm assembly drive portion 339a may be partially or fully disposed in first arm assembly 330, second arm assembly 360, and/or in any other location of arm assembly 230 or in the element.

(ii) Second arm assembly (eg, second arm assembly 360)

Example embodiments of the second arm assembly 360 are illustrated in at least FIGS. 5A-5C , 5L-5M, and 5S-5T. Second arm assembly 360 may be securable to first arm assembly 330 at one end (via elbow sway link 350 and/or elbow pitch link 350 ′) and at the other end (via shoulder sway link 380 and/or shoulder pitch link 380 ′). Linking portion 370) may be secured to shoulder segment 231. When secured to shoulder segment 231, second arm assembly 360 may be configurable to move relative to shoulder segment 231 in one or more of a variety of ways, including but not limited to relative to shoulder segment 231 pitch, yaw and/or roll. In an example embodiment, the second arm assembly 360 may be fixable to and releasable (eg, detachable) from the first arm assembly 330 . As shown in FIGS. 5L-5N and 5S-5U, the second arm assembly 360 can include a second arm assembly body or housing (e.g., second arm assembly body 360'), a first end 360a (or proximal end) and a second end 360b (or distal end) opposite to the first end 360a. Either the elbow roll link portion 350 or the elbow pitch link portion 350' may be secured to the second end portion 360b. Either the shoulder pitch link portion 370 or the shoulder roll link portion 380 may be secured to the first end portion 360a. As shown in at least FIG. 5S and FIG. 5T , in an example embodiment, one end (eg, the proximal end) of the elbow rocker coupling portion 350 may be fixed to a second arm assembly 360 (eg, a distal end, such as the second end 360 b ). ), the other end (for example, the distal end) of the elbow rocking link 350 can be fixed to the elbow pitch link 350' (for example, the proximal end), and one end (for example, the distal end) of the elbow pitch link 350' can be fixed To the first arm assembly 330 (e.g., the proximal end, such as the first end 330a), one end (e.g., the distal end) of the shoulder pitch coupling portion 370 may be fixed to the second arm assembly 360 (e.g., the proximal end, such as the first end 330a). One end 360a), the other end (e.g., the proximal end) of the shoulder pitch coupling portion 370 can be fixed to a shoulder swing coupling portion 380 (e.g., the distal end), and one end (e.g., the proximal end) of the shoulder swing coupling portion 380 can be Fixed to the shoulder segment 231 (eg, distally). The second arm assembly body 360' can securely house one or more of the plurality of drive assemblies.

In an example embodiment, the second arm assembly body 360' may securely house the elbow pitch drive assembly. The elbow pitch drive assembly may include a fifth integrated motor (eg, fifth integrated motor 362 ), and may also include an elbow pitch drive portion (eg, elbow pitch drive portion 362 a ′). An elbow pitch drive portion 362 a ′ may be provided at a second end 360 b (eg, a distal end) of the second arm assembly body 360 . The elbow pitch driving part 362a' may be controllable by the fifth integrated motor 362 to drive the elbow pitch driven part 352a'. Elbow pitch driving portion 362a' may be any mechanism, device, etc. that may be configured to drive elbow pitch driven portion 352a'. In an example embodiment, elbow pitch driving portion 362a' may be configurable to drive elbow pitch driven portion 352' to pivotally move or rotate first arm assembly 330 relative to an axis (eg, axis C'). In other words, fifth integrated motor 362 may be configurable to pivotally move or rotate first arm assembly 330 relative to second arm assembly 360 and/or elbow rocker coupling portion 350 (and relative to axis C′). For example, elbow pitch drive portion 362a' may include any one or more configurations or combinations of gears and/or gear assemblies, including spur gear configurations, planetary gear configurations, bevel gear configurations, without departing from the teachings of the present disclosure. Gear configurations, spiral bevel gear configurations, hypoid gear configurations, helical gear configurations, worm gear configurations and/or any other gear and/or mechanical configurations such as wire ropes and pulleys. Although the figures illustrate a second arm assembly having one elbow pitch drive portion 362a', it is to be understood in the present disclosure that the arm assembly may have more than one elbow pitch without departing from the teachings of the present disclosure. drive portion 362a.

The second arm assembly body 360' can also securely house the elbow rocker drive assembly. The elbow rocker drive assembly can include a sixth integrated motor (eg, sixth integrated motor 369), and can also include an elbow rocker drive portion (eg, elbow rocker drive portion 362a). An elbow rocking drive portion 362a may be provided at a second end 360b (eg, a distal end) of the second arm assembly body 360 . The elbow swing driving part 362a may be controllable by the sixth integrated motor 369 to drive the elbow swing driven part 352 . The elbow rocker driving portion 362a may be any mechanism, device, etc. that may be configured to drive the elbow rocker driven portion 352 . In an example embodiment, the elbow rocker drive portion 362a may be configurable to drive the elbow rocker driven portion 352 to pivotally move or rotate the first arm assembly 330 relative to an axis (eg, axis C). In other words, the sixth integrated motor 369 may be configurable to pivotally move or rotate the elbow rocker coupling portion 350' (and thus the first arm assembly 330) relative to the second arm assembly 360 (and relative to axis C). Axis C may be different from axis C'. In an example embodiment, axis C may be substantially orthogonal to axis C'. Without departing from the teachings of the present disclosure, the toggle drive portion 362a may include any one or more configurations or combinations of gears and/or gear assemblies, including spur gear configurations, planetary gear configurations, bevel gear configurations, Spiral bevel gear configurations, hypoid gear configurations, helical gear configurations, worm gear configurations and/or any other gear and/or mechanical configurations such as wire ropes and pulleys. Although the drawings illustrate a second arm assembly having one elbow swing drive portion 362a, it will be understood in the present disclosure that the second arm assembly may have more than one elbow without departing from the teachings of the present disclosure. Swing drive portion 362a.

In an example embodiment, the second arm assembly body 360' may also securely house the shoulder pitch drive assembly. The shoulder pitch drive assembly may include a seventh integrated motor (eg, seventh integrated motor 364 ) and a shoulder pitch drive portion (eg, shoulder pitch drive portion 364 a ). A shoulder pitch drive portion 364a may be provided at the first end 360a (eg, the proximal end) of the second arm assembly 360 . The shoulder pitch driving portion 364a may be controllable by the seventh integrated motor 364 to drive the shoulder pitch driven portion 364b. Shoulder pitch driving portion 364a may be any mechanism, device, etc. that may be configured to drive shoulder pitch driven portion 364b. In an example embodiment, the shoulder pitch driving portion 364a may be configurable to drive the shoulder pitch driven portion 364b to pivotally move or rotate the second arm assembly 360 relative to an axis (eg, axis D). In other words, the seventh integrated motor 364 may be configurable to pivotally move or rotate the second arm assembly 360 relative to the shoulder swing coupling portion 380 (and/or the shoulder segment 231 ) (and relative to the axis D). For example, shoulder pitch drive portion 364a may include any one or more configurations or combinations of gears and/or gear assemblies, including spur gear configurations, planetary gear configurations, bevel gear configurations, without departing from the teachings of the present disclosure. configuration, a spiral bevel gear configuration, a hypoid gear configuration, a helical gear configuration, a worm gear configuration, and/or any other gear and/or mechanical configuration (such as ropes and pulleys). Although the drawings illustrate a second arm assembly having one shoulder pitch drive portion 364a, it will be understood in the present disclosure that the second arm assembly may have more than one shoulder without departing from the teachings of the present disclosure. Pitch drive portion 364a.

In an example embodiment, the second arm assembly body 360' can also securely house the shoulder swing drive assembly. The shoulder sway drive assembly may include an eighth integrated motor (eg, eighth integrated motor 366 ) and a shoulder sway drive portion (eg, shoulder sway drive portion 366 a ). A shoulder rocking drive portion 366a may be provided at the first end 360a (eg, the proximal end) of the second arm assembly 360 . The shoulder swing driving portion 366a may be controllable by the eighth integrated motor 366 to drive the shoulder swing driven portions 366a, 366c and/or 366d. Shoulder swing driving portion 366a may be any mechanism, device, etc. that may be configured to drive shoulder swing driven portion 366b. In an example embodiment, the shoulder swing driving portion 366a may be configurable to drive the shoulder swing driven portions 366b, 366c, and/or 366d to pivotally move or rotate the second arm assembly 360 relative to an axis (e.g., axis E). . In other words, eighth integrated motor 366 may be configurable to pivotally move or rotate shoulder pitch link portion 370 (and/or second arm assembly 360 ) relative to shoulder segment 231 (and relative to axis E). Axis E may be different from axis D. In an example embodiment, axis E may be substantially orthogonal to axis D. As shown in FIG. One or more of shoulder sway driving portion 366a, first shoulder sway driven portion 366b, second shoulder sway driven portion 366c, and third shoulder sway driven portion 366d without departing from the teachings of the present disclosure Any one or more configurations or combinations of gears and/or gear assemblies may be included, including spur gear configurations, planetary gear configurations, bevel gear configurations, spiral bevel gear configurations, hypoid gear configurations, helical gear configurations, worm gear configurations configuration and/or any other gear and/or mechanical configuration (such as wire ropes and pulleys). Although the drawings illustrate a second arm assembly having a shoulder swing driving portion 366a, a first shoulder swing driven portion 366b, a second shoulder swing driven portion 366c, a third shoulder swing driven portion 366d, It is to be understood in the present disclosure, however, that the second arm assembly may have more than one shoulder rocker drive portion 366a, more than one first shoulder rocker driven portion 366b, more than one One second shoulder swing driven portion 366c, more than one third shoulder swing driven portion 366d. Furthermore, it is to be understood within the present disclosure that the second arm assembly may or may not have the second shoulder swing driven portion 366c, and/or between the shoulder swing drive portion 366a and the third shoulder swing drive portion 366a without departing from the teachings of the present disclosure. There may or may not be one or more additional or other intermediate shoulder swing driven portions between the shoulder swing driven portions 366d.

Although the drawings illustrate a fifth integrated motor 362, a sixth integrated motor 369, a seventh integrated motor 364, an eighth integrated motor 366, an elbow pitch drive section 362a', an elbow swing drive section 362a, a shoulder pitch drive section 364a and the second arm assembly 360 of the shoulder swing drive portion 366a, but it is understood that the second arm assembly 360 may or may not include the fifth integrated motor 362, the sixth integrated motor 369 without departing from the teachings of the present disclosure. , the seventh integrated motor 364, the eighth integrated motor 366, the elbow pitch drive part 362a', the elbow swing drive part 362a, the shoulder pitch drive part 364a and/or the shoulder swing drive part 366a, and/or may also include other integrated motors (one or more) and/or other drive parts. It is also to be understood that the fifth integrated motor 362, the sixth integrated motor 369, the seventh integrated motor 364, the eighth integrated motor 366, the elbow pitch drive portion 362a′, the elbow swing drive portion 362a, shoulder pitch drive portion 364a, and shoulder sway drive portion 366a may be partially or fully disposed in first arm assembly 330, second arm assembly 360, and/or any other location or element of arm assembly 230.

Each instrument arm assembly can be secured to (and unfastened from) the anchor port 216 of the port assembly 210 via the securing portion 231a of the shoulder segment 231 . It is recognized in the present disclosure that the instrument arm assemblies 230, 240 may be secured to the anchor port 216 of the port assembly 210 in a forwardly oriented position (eg, as shown in FIGS. 2B, 2D, 3B, and 3D) and/or in the opposite direction (eg, as shown in FIGS. 2A , 2C, 3A, and 3C). Furthermore, in an example embodiment, the instrument arm assemblies 230, 240 may or may not transition between a forwardly directed position and an oppositely directed position. In an example embodiment in which the instrument arm assemblies 230, 240 are transitionable between a forwardly directed position and an oppositely directed position, such transition may be preceded by securing the shoulder segment 231 to the anchor port 216 of the port assembly 210 , during and/or after. For example, in such an embodiment, the position of the fixation portion 231a relative to the shoulder segment 231 may be adjustably changed, such as from the forward position shown in FIGS. 5A and 5P to the position shown in FIGS. 5B and 5Q. Positions in opposite directions to those shown in and vice versa.

One or more internal temperature control assemblies (not shown) may be provided for each of the one or more instrument arm assemblies 230 , 240 . Each internal temperature control assembly may be operable to control (such as reduce) the above-mentioned gears and/or gear assemblies, motors, instrument couplings (such as 232, 370, 380, 234, 236, and/or 238), and/or Temperature and or heating of instrument arm segments (such as 231 , 360 , 330 and/or 340 ). The one or more internal temperature control assemblies may also be operable to control (such as raise or lower) the temperature of the end effector 239, 342, 344 (when the end effector 239, 342, 344 is a cutting tool, etc. , this may be desired). In example embodiments, the one or more internal temperature control components may be operable to perform such temperature control using one or more gases, liquids and/or solids. For example, the gas and/or liquid may be fed, maintained and/or regulated using an external source via one or more tubes or the like. In an example embodiment, the one or more tubes for supplying, regulating and/or discharging gas and/or liquid may have a diameter of between about 0.5 mm and 3 mm, although such tubes may also be larger in diameter. bigger or smaller. It is understood in this disclosure that the one or more tubes (if used) and any solids (if used) may be provided through the interior of the instrument arm assembly without increasing the size (such as diameter) of the instrument assembly.

When the internal temperature control assembly utilizes a gas or the like, example embodiments may also be operable to provide such gas into the body cavity via one or more tubes or the like and/or exhaust or recycle such gas outside the body cavity. In example embodiments, the gas may include carbon dioxide, oxygen, and/or other gases. Such gas may further be operable to assist in providing and/or maintaining insufflation of the body cavity, such as via an opening (not shown). When internal temperature control components utilize liquids or the like, example embodiments may be operable to drain or recycle such liquids outside of the body cavity. When the internal temperature control assembly utilizes a solid state or the like, such a solid may possess properties that allow the surgical team to change the temperature of the solid, such as by applying electrical or other forms of energy, in order to control (such as lower) the instrument arm assembly 230 , temperature and/or heat generation of one or more components of 240.

In example embodiments, the internal temperature control assembly may utilize a combination of gases, liquids, solids, etc. without departing from the teachings of the present disclosure.

After the instrument arm assembly 230, 240 has been inserted and attached (or secured) to the port assembly 210, the end effector or instrument 239, 342, 344 may be manually and/or via a computing device (or system) configured to A force between approximately 0 and 20N is applied via the integrated motors 332, 334 when performing surgical maneuvers and procedures such as cutting and/or grasping maneuvers. Additionally, the end effectors or instruments 239, 342, 344 may be configured manually and/or via a computing device/controller to perform other surgical actions and procedures such as translational, twisting, pulling, and/or pushing actions via The integrated motors 332, 334, 336, 339 apply a force between approximately 0 and 10N. It is to be understood in this disclosure that the above ranges of applied force are illustrative of example embodiments only, and as such, ranges of applied force may be less than or greater than those stated above.

In an example embodiment, the instrument arm segment including shoulder segment 231, second arm assembly 360, first arm assembly 330, and/or end effector assembly 340 may be generally cylindrical in shape. The instrument arm segment including shoulder segment 231, second arm assembly 360, first arm assembly 330, and/or end effector assembly 340 may also be formed in a variety of other shapes without departing from the teachings of the present disclosure, Any of the size and/or dimensions.

As noted above, the instrument arm assemblies 230, 240 may also include one or more securing portions 231a. The fixed portion 231a may be attachable or attached to the first instrument arm section 231 , a portion of the first instrument arm section 231 , and/or form a unitary object with the first instrument arm section 231 . Such a securing portion 231a may be used to secure the instrument arm assembly 230 , 240 to the anchor port 216 . In an example embodiment, such securing portion 231a may also be used to perform or assist in performing the process of inserting and securing the instrument arm assembly 230 , 240 into the port assembly 210 .

After the instrument arm assembly 230 is inserted through the port assembly 210 into a patient's cavity (such as the vagina or rectum), the fixed portion 231a of the first instrument arm section (or shoulder section) 231 can be anchored by the anchor of the port assembly 210. tor port 216 securely accommodated.

In an example embodiment, the length of the fixed portion 231a may be between about 350 to 450 mm, the length of the shoulder segment 231 may be between about 15 to 40 mm, and the length of the second arm assembly 360 may be between about 80 to 105 mm. , the length of the first arm assembly 330 may be between about 65 and 90 mm, the length of the end effector assembly 340 may be between about 5 and 30 mm, and the total length of the combined instrument arms may be between about 165 and 265 mm. In an example embodiment, the length of the fixed portion 231a may be between about 340 to 400 mm, the length of the shoulder segment 231 may be between about 15 to 25 mm, and the length of the second arm assembly 360 may be between about 90 to 100 mm. , the length of the first arm assembly 330 may be between about 75 and 85 mm, the length of the end effector assembly 340 may be between about 15 and 25 mm, and the total length of the combined instrument arms may be between about 195 and 235 mm. In example embodiments, the length of one or more of the instrument arm segments, fixation portion 231a, and/or end effectors or instruments 239, 342, 344 may also be controlled by one or more adjacent and/or The computing device (or system) of the remote surgical team 904 adjusts before, during and/or after inserting the instrument arm assembly into the patient's cavity. One or more of the instrument arm segments may have an outer diameter of about 10 to 16 mm. In an example embodiment, one or more of the instrument arm segments may have an outer diameter of about 16 mm.

Including fixed portion 231a, shoulder segment 231, second arm assembly 360, first arm assembly 330, instrument assembly 237, end effectors or instruments 239, 342, 344, shoulder swing coupling portion 380 (or along axis E joint), shoulder pitch joint 370 (or joint along axis D), elbow pitch joint 350' (or joint along axis C), elbow roll joint 350 (or joint along axis C' coupling portion), third coupling portion 236 (or coupling portion along axis B), and/or instrument coupling 238 (or coupling portion along axis A) of the instrument arm assembly may use a variety of materials Any one or more of various forms, such as surgical grade metals, high strength aluminum alloys, stainless steels (such as 304/304L, 316/316L, and 420), pure titanium, titanium alloys (such as Ti6A14V, NiTi), and cobalt chromium alloys. It is understood in the present disclosure that other materials may be used without departing from the teachings of the present disclosure.

Other Example Embodiments of Instrument Arm Assemblies (e.g., Instrument Arm Assemblies 230, 240)

As shown in at least FIGS. 11-14 , an example embodiment of a surgical device 200 may include one or more arm assemblies (e.g., a first instrument arm assembly 230, a second instrument arm assembly 240, a third instrument arm assembly (not shown) shown), the fourth instrument arm assembly (not shown), etc.). Each arm assembly 230, 240 may be configurable to attach to (or anchor to or secure to) an example embodiment of the port assembly 210 (described above and in this disclosure). Although some of the drawings and/or descriptions provided in this disclosure may be directed to first instrument arm assembly 230 and elements thereof, it is to be understood that such drawings and/or descriptions may be made without departing from the teachings of this disclosure. Other arm assemblies illustrated and/or described above and in this disclosure may also be applicable, including second instrument arm assembly 240, third instrument arm assembly (not shown), fourth instrument arm assembly (not shown), out) etc.

The arm assemblies 230, 240 may comprise a serial (or linear) connected arrangement of arm segments. For example, as shown in the perspective view of at least FIG. 11A , arm assemblies 230, 240 may include a forearm segment (eg, forearm segment 1100), an upper arm segment (eg, upper arm segment 1140), and a shoulder segment (eg, shoulder segment 231).

The arm assemblies 230, 240 may also include coupling portions. For example, as at least the perspective view of FIG. 11A and the cross-sectional view of FIG. 11B (which is a cross-sectional view of the arm assemblies 230, 240 along line A shown in FIG. As shown in the cross-sectional view along line B) shown in FIG. 11A , the arm assemblies 230 , 240 may include an elbow-coupling linkage assembly (eg, elbow-coupling linkage assembly 1120 ). Elbow coupling joint assembly 1120 may include a distal elbow (eg, distal elbow 1120a ) and a proximal elbow (eg, proximal elbow 1120b ). Elbow coupling joint assembly 1120 may also include a distal elbow joint subassembly comprising components for driving forearm segment 1100 in rotation relative to distal elbow joint 1120a (e.g., pivotally rotating with respect to axis C', as oriented in FIG. 11C ). C'shown) one or more gears. Elbow coupling joint assembly 1120 may also include a proximal elbow joint subassembly comprising components for driving rotation of distal elbow joint 1120a (and forearm segment 1100 attached to distal elbow joint 1120a) relative to proximal elbow joint 1120b (e.g., , pivotally rotates with respect to axis C, as shown in direction C in FIG. 11B ) of one or more gears.

Additionally or alternatively, the arm assemblies 230, 240 may include a shoulder-coupling linkage assembly (eg, shoulder-coupling linkage assembly 1160). Shoulder coupling joint assembly 1160 may include a distal shoulder joint (eg, distal shoulder joint 1160a ) and a proximal shoulder joint (eg, proximal shoulder joint 1160b ). Shoulder coupling linkage assembly 1160 may also include a distal shoulder coupling subassembly comprising components for driving upper arm segment 1140 in rotation relative to distal shoulder joint 1160a (e.g., pivotally rotating with respect to axis D, as in direction D in FIG. 11C ). shown) one or more gears. Shoulder coupling linkage assembly 1160 may also include a proximal shoulder coupling subassembly comprising components for driving distal shoulder joint 1160a (and upper arm segment 1140 attached to distal shoulder joint 1160a) in rotation relative to proximal shoulder joint 1160b (e.g., , one or more gears that pivotally rotate with respect to axis E, as shown in direction E in FIG. 11B ).

The arm assemblies 230, 240 may also include an end effector assembly integrated into and/or connected to one or more of the arm segments and/or linkage portions (e.g., as described above and in this disclosure with a wrist Assembly and end effector assembly 340 of instrument assembly 237; instrument assembly 237 may include instrument 239(s) having instrument 342 and/or instrument 344). The end effectors or instruments 239, 342, 344 may be instruments suitable for use in surgery, such as cutting and/or grasping instruments.

The arm assemblies 230, 240 may also include one or more integrated motors, including those described above and in this disclosure. For example, the arm assemblies 230, 240 may include at least the integrated motors 332, 334, 336, and/or 339 shown in FIGS. 5E, 5G, 5J, and 5K. Additionally or alternatively, the arm assemblies 230, 240 may include at least the integrated motors 362, 364, 366 and/or 369 shown in FIGS. 5M-5O and 5T-5V. Additionally or alternatively, arm assemblies 230, 240 may include integrated motors 1142, 1144, 1146 and/or 1148 as shown in at least the following figures: FIGS. 12D, a perspective view of the elbow coupling assembly 1120, a perspective view of the shoulder coupling assembly 1160 of FIG. 13A, a perspective view of the shoulder coupling assembly 1160 of FIG. 13D, and a cross-sectional side of the elbow coupling assembly 1120 of FIG. 14D view.

As shown in at least FIGS. 11B and 11C , and as described above and in this disclosure, each integrated motor may include a ) and provide arm assemblies 230, 240 with at least one degree of freedom for the drive portion, etc. (e.g., drive portion 1142a for the first distal motor 1142, drive portion 1144a for the second distal motor 1144, A drive portion 1146a for the proximal motor 1146, and a drive portion 1148a) for the second proximal motor 1148). Each integrated motor may be fully housed (except for, for example, power cables and/or control cables that may be fed via a port assembly) in an arm segment (eg, arm segments 1100, 1140, and/or 231) fully Motors that operate independently and independently.

In at least the example embodiment shown in FIGS. 11B and 11C , integrated motors 1142 and 1144 are housed in upper arm section 1140 and are used to drive elbow coupling linkage assembly 1120 . In particular, the first distal motor 1142 can be configured to drive the distal elbow joint 1120a via the distal elbow joint subassembly (as further described in this disclosure). Additionally, the second distal motor 1144 can be configured to drive the proximal elbow joint 1120b via the proximal elbow joint subassembly (as further described in this disclosure).

Additionally, integrated motors 1146 and 1148 are housed in upper arm section 1140 and are used to drive shoulder coupling linkage assembly 1160 . In particular, the second proximal motor 1148 can be configured to drive the proximal shoulder joint 1160b via the proximal shoulder linkage subassembly (as further described in this disclosure). Additionally, the first proximal motor 1146 can be configured to drive the distal shoulder joint 1160a via the distal shoulder linkage subassembly (as further described in this disclosure).

One or more of the arm assemblies 230, 240 may also include an integrated haptic and/or force feedback subsystem (not shown) that communicates with one or more of the integrated motors and/or other sensors and/or instruments. Communicating, operable (such as via a computing device/controller) to provide one or more of a plurality of feedback responses and/or measurements to the surgical team, including proximity and/or proximity to the instrument arm assembly Those related to the position (including orientation), applied force, proximity, temperature, pressure, humidity, etc. of the instrument arm assembly. For example, the surgical team 904 may be provided with a primary input device such as a manipulator, with haptic and/or force feedback, and designed to map and sense the dexterity of the surgical team 904 with high precision, high dexterity, and minimal burden. Finger twisting, wrist flexion, and/or other arm/shoulder motion into motion of the instrument arm (such as 230, 240), while also providing feedback on contact resistance (such as tissue resistance).

These and other elements of the arm assemblies 230, 240 will now be described in more detail with reference to the drawings.

End effector assembly (e.g., end effector assembly 340)

In an example embodiment, arm assemblies 230, 240 may include an end effector assembly (eg, end effector assembly 340). As described above and in this disclosure, end effector assembly 340 may include wrist assembly and instrument assembly 237 . Instrument assembly 237 may include one or more instruments 239 . As shown at least in FIGS. 5D-5H , each instrument 239 may include an instrument 342 and/or an instrument 344 . The end effectors or instruments 239, 342, 344 may be any instruments suitable for use in surgery, such as cutting and/or grasping instruments.

Forearm segment (e.g., forearm segment 1100)

An example embodiment of a forearm segment 1100 is illustrated in at least FIGS. 11A-11C . Forearm segment 1100 may be fixable to end effector assembly 340 . In an example embodiment, arm assembly 230 may be fixable to and releasable (eg, detachable) from end effector assembly 340 . Forearm segment 1100 may include a distal end 1100a and a proximal end 1100b. Distal elbow joint 1120a may be secured to proximal end 1100a, and end effector assembly 340 may be secured to distal end 1100b.

In an example embodiment, the forearm segment 1100 may be similar or identical to the first arm assembly 330 described above and in this disclosure. For example, the forearm segment 1100 may include a first integrated motor 332, a second integrated motor 334, a third integrated motor 336, a fourth integrated motor 339, a first instrument drive section 332a, a second instrument drive section 334a, a wrist drive section 336a, And/or first arm assembly drive portion 339a. It is to be understood that forearm section 1100 may (or may not) include first integrated motor 332, second integrated motor 334, third integrated motor 336, fourth integrated motor 339, first The instrument drive portion 332a, the second instrument drive portion 334a, the wrist drive portion 336a, and/or the first arm assembly drive portion 339a, and/or may also include other integrated motor(s) and/or other drive portions .

Upper arm section (e.g., upper arm section 1140)

An example embodiment of an upper arm segment 1140 is illustrated in at least FIGS. 11A-11C . Upper arm segment 1140 may include a distal end 1140a and a proximal end 1140b. The proximal elbow joint 1120b may be secured to the proximal end 1140a, and the distal shoulder joint 1160a may be secured to the distal end 1140b.

In an example embodiment, upper arm segment 1140 may securely house a first distal motor (eg, first distal motor 1142 ). The first distal motor 1142 can include a first distal motor drive portion (eg, first distal motor drive portion 1142a). A first distal motor drive portion 1142a may be provided at or near the distal end 1140a of the upper arm segment 1140 . The first distal motor drive portion 1142a can be controllable by the first distal motor 1142 to drive the distal elbow joint subassembly (which, as further described in this disclosure, can include a first distal elbow bevel gear 1124a, a second Distal toggle bevel gear 1125a, third distal toggle bevel gear 1126a, first distal toggle spur gear 1128a, second distal toggle spur gear 1129a, fourth distal toggle bevel gear 1131a, fifth distal toggle bevel gear 1132a and/or distal elbow planetary gear assembly 1133a) to rotate forearm segment 1100 relative to distal elbow joint 1120a (eg, in direction C' relative to axis C', as shown in at least FIG. 11C ).

Upper arm segment 1140 may also securely house a second distal motor (eg, second distal motor 1144 ). Second distal motor 1144 may include a second distal motor drive portion (eg, second distal motor drive portion 1144a). A second distal motor drive portion 1144a may be provided at or near the distal end 1140a of the upper arm segment 1140 . The second distal motor drive portion 1144a may be controllable by the second distal motor 1144 to drive the proximal elbow joint subassembly (which may include a first proximal elbow bevel gear 1122b, a second proximal elbow bevel gear 1123b and/or proximal elbow planetary gear assembly 1124b) to rotate distal elbow joint 1120a (and forearm segment 1100 attached to distal elbow joint 1120a) relative to proximal elbow joint 1120b (e.g., rotation in direction C relative to axis C, as shown at least in FIG. 11B ).

Upper arm segment 1140 may also securely house a first proximal motor (eg, first proximal motor 1146 ). First proximal motor 1146 may include a first proximal motor drive portion (eg, first proximal motor drive portion 1146a). A first proximal motor drive portion 1146a may be provided at or near the proximal end 1140b of the upper arm segment 1140 . The first proximal motor drive portion 1146a can be controllable by the first proximal motor 1146 to drive the distal shoulder coupling subassembly (which, as further described in this disclosure, can include a first distal shoulder bevel gear 1168a, a second Distal shoulder bevel gear 1169a and/or distal shoulder planetary gear assembly 1170a) to rotate upper arm segment 1140 relative to distal shoulder joint 1160a (e.g., in direction D relative to axis D, as shown in at least FIG. 11C ) .

Upper arm segment 1140 also securely houses a second proximal motor (eg, second proximal motor 1148 ). Second proximal motor 1148 may include a second proximal motor drive portion (eg, second proximal motor drive portion 1148a). A second proximal motor drive portion 1148a may be provided at or near the proximal end 1140b of the upper arm segment 1140 . The second proximal motor drive portion 1148a may be controllable by the second proximal motor 1148 to drive the proximal shoulder coupling subassembly (which may include a first proximal shoulder bevel gear 1163b, a second proximal shoulder bevel gear 1163b, as further described in this disclosure). Proximal shoulder bevel gear 1164b, third proximal shoulder bevel gear 1165b, first proximal shoulder bevel gear 1167b, third proximal shoulder bevel gear 1169b, fourth proximal shoulder bevel gear 1171b, fifth proximal shoulder bevel gear 1172b and/or proximal shoulder planetary gear assembly 1173b) to rotate the distal shoulder joint 1160a (and the upper arm segment 1140 attached to the distal shoulder joint 1160a) relative to the proximal shoulder joint 1160b (e.g., along the axis E The direction E is rotated, as shown in at least FIG. 11B).

Although the drawings illustrate a first distal motor 1142, a second distal motor 1144, a first proximal motor 1146, a second proximal motor 1148, a first distal motor drive portion 1142a, a second distal motor The upper arm assembly 1140 of the drive portion 1144a, the first proximal motor drive portion 1146a, and the second proximal motor drive portion 1148a, but it is to be understood that the upper arm assembly 1140 may (or may not) Including a first distal motor 1142, a second distal motor 1144, a first proximal motor 1146, a second proximal motor 1148, a first distal motor drive portion 1142a, a second distal motor drive portion 1144a, a first proximal The side motor drive portion 1146a and/or the second proximal motor drive portion 1148a, and/or may also include other integrated motor(s) and/or other drive portions. It is also to be understood that the first distal motor 1142, the second distal motor 1144, the first proximal motor 1146, the second proximal motor 1148, the first distal motor drive portion without departing from the teachings of the present disclosure 1142a, second distal motor drive portion 1144a, first proximal motor drive portion 1146a, and second proximal motor drive portion 1148a may be partially or fully disposed on upper arm assembly 1140, forearm assembly 1100, and/or arm assembly 230 , 240 in any other location or element.

Elbow coupling joint assembly (e.g., elbow coupling joint assembly 1120)

As shown in the side views of FIGS. 12A and 12D , the side views of FIGS. 14A and 14C, and the cross-sectional side views of FIGS. 1120). Elbow coupling joint assembly 1120 may include a distal elbow joint 1120a and a proximal elbow joint 1120b.

As shown at least in FIGS. 11B, 11C, 12A, 12D, and 14A-14D, the distal elbow joint 1120a can have an axis of rotation C'. Distal elbow joint 1120a may be configured to enable rotation (or pivotal rotation) of forearm segment 1100 relative to axis C'. In other words, the distal elbow joint 1120a can be configured such that the forearm segment 1100 can rotate (or pivotally rotate) relative to the distal elbow joint 1120a. Such rotation about axis C' may be driven by the first distal motor 1142 and the distal elbow linkage subassembly as described further below and in this disclosure.

The proximal elbow joint 1120b may have an axis of rotation C, as shown at least in FIGS. The proximal elbow joint 1120b may be configured such that the distal elbow joint 1120a (and the forearm segment 1100 attached to the distal elbow joint 1120a) can rotate (or pivotally rotate) relative to the axis C. In other words, the proximal elbow joint 1120b can be configured such that the distal elbow joint 1120a (and the forearm segment 1100 attached to the distal elbow joint 1120a) can rotate (or pivotally rotate) relative to the proximal elbow joint 1120b .

In other words, the proximal elbow joint 1120b can be configured such that the forearm segment 1100 can rotate (or pivotally rotate) relative to the proximal elbow joint 1120b. The axis of rotation C of the proximal elbow joint 1120b may not be parallel to the axis of rotation C' of the distal elbow joint 1120a. For example, the axis of rotation C of the proximal elbow joint 1120b may be orthogonal to the axis of rotation C' of the distal elbow joint 1120a. Such rotation about axis C may be driven by the second distal motor 1144 and the proximal elbow linkage subassembly as described further below and in this disclosure.

(i) Distal elbow subassembly

In an example embodiment, the first distal motor 1142 can drive the distal elbow joint subassembly so that the forearm segment 1100 is relative to the distal elbow joint 1120a (or as depicted in direction C' as shown in FIG. 11C , relative to Axis C') rotates (or pivotally rotates). As shown in at least FIGS. 11B, 11C, 12A, 12D, and 14A-14D, the distal elbow linkage subassembly includes a plurality of gears. More specifically, the distal elbow subassembly includes a gear train system having a plurality of gear stages.

The distal toggle subassembly may include a first distal toggle gear stage. The first distal toggle gear stage may include a first distal toggle bevel gear (eg, first distal toggle bevel gear 1124a, as shown in at least FIGS. 12A, 12D, 14A, 14C, and 14D). The distal elbow joint subassembly can also include one or more gears between the first distal motor drive portion 1142a and the first distal elbow bevel gear 1124a, such as one or more spur gears (as shown in Figures 12A and 1124a). shown in Figure 12D). The distal elbow joint subassembly may also include one or more connectors or the like between the first distal motor drive portion 1142a and the first distal elbow bevel gear 1124a, such as connector 1123a (as at least FIG. 12D).

Alternatively, as shown in at least FIGS. 14A and 14C , in an example embodiment, the first distal toggle bevel gear 1124a may be configured to be directly driven by the first distal motor drive portion 1142a (eg, without the one or more spur gears 1121a, 1122a), which is recognized in this disclosure to enable shortening the overall length of the arm assembly 230, 240.

The first distal toggle gear stage may also include a second distal toggle bevel gear (eg, second distal toggle bevel gear 1125a, as shown in at least FIGS. 12A, 12D, 14A, 14C, and 14D). The second distal toggle gear 1125a can be drivable by the first distal toggle gear 1124a for rotation relative to axis C (the second distal toggle gear 1125a can have a central axis of rotation corresponding to axis C).

The gear ratio between the first distal toggle bevel gear 1124a and the second distal toggle bevel gear 1125a may be between about 1:2 and 1:5 (eg, 1:3).

The first distal toggle gear stage may also include a third distal toggle bevel gear (eg, third distal toggle bevel gear 1126a, as shown in at least FIGS. 12A, 12D, 14A, 14C, and 14D). The third distal toggle gear 1126a can be drivable for rotation by the second distal toggle gear 1125a.

The gear ratio between the second distal toggle bevel gear 1125a and the third distal toggle bevel gear 1126a may be between about 2:1 and 5:1 (eg, 3:1).

The distal toggle subassembly may include a second distal toggle gear stage. The second distal toggle gear stage may include a first distal toggle spur gear (eg, first distal toggle spur gear 1128a, as shown in at least FIGS. 12A, 12D, 14A, 14C, and 14D). The distal elbow joint subassembly may also include one or more connectors, such as connector 1127a (as shown at least in FIGS. shown).

Alternatively, as shown in at least FIGS. 14A and 14C , in an exemplary embodiment, the first distal toggle spur gear 1128a may be directly coupled to (or connected to or fixed to) the third distal toggle bevel gear 1126a, which It is recognized in this disclosure that the overall length of the arm assemblies 230, 240 can be shortened.

The second distal toggle gear stage may also include a second distal toggle spur gear (eg, second distal toggle spur gear 1129a, as shown in at least FIGS. 12A, 14C, and 14D). The second distal toggle spur gear 1129a can be drivable for rotation by the first distal toggle spur gear 1128a.

The gear ratio between the first distal toggle spur gear 1128a and the second distal toggle spur gear 1129a may be between about 1:1 to 1:4 (eg, 1:2).

The distal toggle subassembly may include a third distal toggle gear stage. The third distal toggle gear stage may include a fourth distal toggle bevel gear (e.g., fourth distal toggle bevel gear 1131a, as shown in at least FIGS. 12A, 12D, 14A, 14B, 14C, and 14D) . The distal elbow linkage subassembly may also include one or more connectors, such as connector 1130a (as shown in at least FIG. 12A ), between the second distal elbow spur gear 1129a and the fourth distal elbow bevel gear 1131a. .

Alternatively, as shown in at least FIGS. 14B-14D , in an example embodiment, the fourth distal toggle bevel gear 1131a may be directly coupled to (or connected to or fixed to) the second distal toggle spur gear 1129a, which in It is recognized in the present disclosure that the overall length of the arm assemblies 230, 240 can be shortened.

The third distal toggle gear stage may also include a fifth distal toggle bevel gear (eg, fifth distal toggle bevel gear 1132a, as shown in at least FIG. 12A and FIGS. 14A-14D ). Fifth distal toggle gear 1132a may be drivable by fourth distal toggle gear 1131a for rotation relative to axis C' (fifth distal toggle gear 1132a may have a central axis of rotation corresponding to axis C').

The gear ratio between the fourth distal toggle bevel gear 1131a and the fifth distal toggle bevel gear 1132a may be between about 1:2 and 1:5 (eg, 1:3).

The distal toggle subassembly may include a fourth distal toggle gear stage. The fourth distal toggle gear stage may include a distal toggle planetary gear assembly (eg, distal toggle planetary gear assembly 1133a, as shown in at least FIGS. 11C, 12A, and 14A). The distal elbow joint subassembly may also include one or more connectors, etc. (e.g., connector portion 1134a), and/or the fifth distal elbow bevel gear 1132a and/or the distal elbow sun gear 1133aa may have a second The extension between the fifth distal toggle bevel gear 1132a and the distal toggle planetary gear assembly 1133a, which is recognized in this disclosure, enables improvements for routing the wiring through the toggle coupling assembly 1120 (e.g., through the fifth distal spacing between the elbow bevel gear 1132a and the distal elbow planetary gear assembly 1133a).

Alternatively, as shown in at least FIG. 11B and FIG. 12A , in an example embodiment, the fifth distal toggle bevel gear 1132a may be directly coupled to (or connected to or fixed to) the distal toggle planetary gear assembly 1133a (i.e., The fifth distal elbow bevel gear 1132a is directly coupled or connected or fixed to the distal elbow sun gear 1133aa).

Figure 12B illustrates a side view of an example embodiment of the distal elbow planetary gear assembly 1133a, and Figure 12C illustrates an exploded perspective view of the embodiment. The distal elbow planetary gear assembly 1133a can have a central axis corresponding to axis C'. The distal elbow planetary gear assembly 1133a can include a distal elbow sun gear 1133aa. The distal elbow sun gear 1133aa can be drivable for rotation relative to the axis C' by the fifth distal elbow bevel gear 1132a. The distal elbow sun gear 1133aa and/or the fifth distal elbow bevel gear 1132a may include extensions (not shown) to enable spacing therebetween and to allow wiring to extend through such spacing.

The distal elbow planet gear assembly 1133a may also include a plurality of distal elbow planet (or planet) gears 1133ab. For example, the distal elbow planetary gear assembly 1133a can include 4 or more distal elbow planetary gears 1133ab. Each of the distal toggle planetary gears 1133ab can be configured to rotate relative to its central axis. The distal elbow planet gears 1133ab can be drivable for common rotation about axis C' by the distal elbow sun gear 1133aa.

The distal toggle planetary gear assembly 1133a can also include a distal toggle ring gear 1133ac. In an example embodiment, the distal elbow ring gear 1133ac may be fixed or locked against rotation relative to the axis C' so as to enable the plurality of distal elbow planetary gears 1133ab to collectively rotate about the axis C'.

The distal toggle planetary gear assembly 1133a can also include a distal toggle planetary gear carrier 1133ad. The distal elbow planet gear carrier 1133ad may have a plurality of first ends 1133ad' connected to a plurality of distal elbow planet gears 1133ab. The distal elbow planetary carrier 1133ad may also have a second end 1133ad″ connected to a portion of the distal end 1100b of the forearm segment 1100.

In this regard, when the distal elbow sun gear 1133aa is driven by the fifth distal elbow bevel gear 1132a to rotate relative to the axis C', the distal elbow sun gear 1133aa in turn drives the plurality of distal elbow planetary gears 1133ab to rotate together about the axis C'. Such common rotation of the plurality of distal elbow planetary gears 1133ab about axis C' in turn (via connection) drives the distal elbow planetary carrier 1133ad in rotation relative to axis C'. Such rotation of the distal elbow planetary carrier 1133ad about axis C' in turn (via the connection between the second end 1133ad" of the distal elbow planetary carrier 1133ad and the distal end 1100b of the forearm segment 1100) drives the forearm segment 1100 relative to Rotate (or pivotally rotate) about axis C' (eg, in direction C', as shown in at least FIG. 11C ).

The gear ratio between the fifth distal toggle bevel gear 1132a and the distal toggle planetary gear assembly 1133a may be between about 1:2 and 1:8 (eg, 1:5).

Accordingly, the forearm segment 1100 can be driven to rotate (or pivotally rotate) relative to the axis C' (or rotate relative to the distal elbow joint 1120a) by driving the first distal motor 1142, which in turn drives the first distal toggle gear stage (which includes a first distal toggle gear 1124a, a second distal toggle gear 1125a, a third distal toggle gear 1126a), which in turn drives the second The distal toggle gear stage (which includes a first distal toggle spur gear 1128a and a second distal toggle spur gear 1129a), which in turn drives a third distal toggle gear stage (which includes a fourth distal toggle gear stage) toggle bevel gear 1131a and fifth distal toggle bevel gear 1132a), the third distal toggle gear stage in turn drives the fourth distal toggle gear stage (which includes a distal toggle planetary gear assembly 1133a having Distal toggle sun gear 1133aa, distal toggle planet gear 1133ab, distal toggle ring gear 1133ac, and distal toggle planet gear carrier 1133ad), the fourth distal toggle gear stage in turn drives forearm segment 1100 in rotation relative to axis C′.

The gear ratio or magnification ratio of the distal elbow joint assembly may be between about 1:20 to 1:50 (eg, 1:30).

The distal elbow joint assembly may be or may include any other gear arrangement for driving the forearm section 1100, including those described in this disclosure. For example, the distal elbow joint assembly may include any one or more configurations or combinations of gears and/or gear assemblies, including spur gear configurations, planetary gear configurations, bevel gear configurations, without departing from the teachings of the present disclosure. , a spiral bevel gear configuration, a hypoid gear configuration, a helical gear configuration, a worm gear configuration, and/or any other gear and/or mechanical configuration (such as wire ropes and pulleys).

(ii) Proximal Elbow Joint Subassembly

In an example embodiment, the second distal motor 1144 can drive the proximal elbow joint subassembly to make the distal elbow joint 1120a (and the forearm segment 1100 attached to the distal elbow joint 1120a) relative to the proximal elbow joint 1120b ( Or rotate (or pivotally rotate) relative to axis C) as depicted by direction C as shown in FIG. 11B .

In other words, the second distal motor 1144 can drive the proximal elbow joint subassembly so that the forearm segment 1100 (which is attached to the distal elbow joint 1120a) is relative to the proximal elbow joint 1120b (or as shown in FIG. 11B ). Depicted in direction C, rotates (or pivotally rotates) relative to axis C). As shown in at least 11B, 11C, 12A, 12D, and 14A-14D, the proximal elbow linkage subassembly includes a plurality of gears. More specifically, the proximal elbow subassembly includes a gear train system having a plurality of gear stages.

The proximal toggle subassembly may include a first proximal toggle gear stage. The first proximal toggle gear stage may include a first proximal toggle bevel gear (eg, first proximal toggle bevel gear 1122b, as shown in at least FIGS. 12D, 14C, and 14D). The proximal elbow joint subassembly may also include one or more gears, such as one or more spur gears (not shown), between the second distal motor drive portion 1144a and the first proximal elbow bevel gear 1122b . The proximal elbow joint subassembly may also include one or more connectors or the like between the second distal motor drive portion 1144a and the first proximal elbow bevel gear 1122b, such as connector 1121b (as shown in at least FIG. ).

Alternatively, as shown in at least FIGS. 14C and 14D , in an example embodiment, the first proximal toggle bevel gear 1122b may be configured to be directly driven by the second distal motor drive portion 1144a (as shown in at least FIGS. 14C and 14D ). 14D), it is recognized in this disclosure that the overall length of the arm assemblies 230, 240 can be shortened.

The first proximal toggle gear stage may also include a second proximal toggle bevel gear (eg, second proximal toggle bevel gear 1123b, as shown in at least FIGS. 12D, 14C, and 14D). The second proximal toggle gear 1123b can be drivable by the first proximal toggle gear 1122b for rotation relative to axis C (the second proximal toggle gear 1123b can have a central axis of rotation corresponding to axis C).

The gear ratio between the first proximal toggle bevel gear 1122b and the second proximal toggle bevel gear 1123b may be between about 1:2 and 1:5 (eg, 1:3).

The proximal toggle subassembly may include a second proximal toggle gear stage. The second proximal toggle gear stage may include a proximal toggle planetary gear assembly (eg, proximal toggle planetary gear assembly 1124b, as shown in at least FIGS. 11B, 12D, and 14C). The proximal elbow joint subassembly may also include one or more connectors (not shown), and/or the second proximal elbow bevel gear 1123b and/or the proximal elbow sun gear 1124ba may have The extension between the bevel gear 1123b and the proximal elbow planetary gear assembly 1124b (not shown), which is recognized in the present disclosure, enables improvements for routing the wiring through the elbow coupling coupling assembly 1120 (e.g., through the second proximal The spacing between the side toggle bevel gear 1123b and the proximal toggle planetary gear assembly 1124b).

Alternatively, as shown in FIGS. 11C , 12D and 14C, in an example embodiment, the second proximal toggle bevel gear 1123b may be directly coupled to (or connected to or fixed to) the proximal toggle planetary gear assembly 1124b (i.e. , the second proximal elbow bevel gear 1123b is directly coupled or connected or fixed to the proximal elbow sun gear 1124ba).

Figure 12E illustrates a side view of an example embodiment of the proximal elbow planetary gear assembly 1124b, and Figure 12F illustrates an exploded perspective view of the embodiment. The proximal elbow planetary gear assembly 1124b can have a central axis corresponding to axis C. The proximal elbow planetary gear assembly 1124b can include a proximal elbow sun gear 1124ba. The proximal toggle sun gear 1124ba can be drivable for rotation relative to axis C by the second proximal toggle bevel gear 1123b. The proximal toggle sun gear 1124ba and/or the second proximal toggle bevel gear 1123b may include extensions (not shown) to enable spacing therebetween and to allow wiring to run through such spacing.

The proximal toggle planet gear assembly 1124b may also include a plurality of proximal toggle planet (or planet) gears 1124bb. For example, the proximal elbow planet gear assembly 1124b can include 4 or more proximal elbow planet gears 1124bb. Each of the proximal elbow planetary gears 1124bb can be configured to rotate relative to its central axis. The proximal elbow planet gears 1124bb can be drivable for common rotation about axis C by the proximal elbow sun gear 1124ba.

The proximal toggle planetary gear assembly 1124b can also include a proximal toggle ring gear 1124bc. In an example embodiment, proximal elbow ring gear 1124bc may be fixed or locked against rotation relative to axis C so as to enable collective rotation of the plurality of proximal elbow planetary gears 1124bb about axis C.

The proximal toggle planetary gear assembly 1124b may also include a proximal toggle planetary gear carrier 1124bd. The proximal toggle planet gear carrier 1124bd can have a plurality of first ends 1124bd' connected to a plurality of proximal toggle planet gears 1124bb. The proximal elbow planetary gear carrier 1124bd may also have a second end 1124bd″ connected to a portion of the proximal end of the distal elbow joint 1120a.

In this regard, when proximal elbow sun gear 1124ba is driven to rotate relative to axis C by second proximal elbow bevel gear 1123b, proximal elbow sun gear 1124ba in turn drives the plurality of proximal elbow planetary gears 1124bb to jointly rotate with respect to axis C. Such common rotation of the plurality of proximal elbow planetary gears 1124bb about axis C is in turn (via a connection between the first end 1124bd' of the proximal elbow planetary gear carrier 1124bd and the plurality of proximal elbow planetary gears 1124bb ) drives the proximal toggle planetary carrier 1124bd in rotation relative to axis C. Such rotation of the proximal elbow planetary gear carrier 1124bd about axis C in turn drives the distal elbow joint (via the connection between the second end 1124bd″ of the proximal elbow planetary gear carrier 1124bd and the proximal end of the distal elbow joint 1120a). 1120a rotates (or pivotally rotates) relative to axis C (eg, in direction C, as shown in at least FIG. 11B ).

The gear ratio between the second proximal toggle bevel gear 1123b and the proximal toggle planetary gear assembly 1124b may be between approximately 1:2 and 1:8 (eg, 1:5).

Accordingly, the distal elbow joint 1120a (and the forearm segment 1100 attached to the distal elbow joint 1120a) can be driven to rotate (or pivotally rotate) relative to the axis C by driving the second distal motor 1144 (or relatively Rotate at the proximal elbow joint 1120b), the second distal motor 1144 in turn drives the first proximal toggle gear stage (which includes the first proximal toggle bevel gear 1122b and the second proximal toggle bevel gear 1123b), the first proximal The toggle gear stage in turn drives a second proximal toggle gear stage (which includes a proximal toggle planetary gear assembly 1124b having a proximal toggle sun gear 1124ba, a proximal toggle planetary gear 1124bb, a proximal toggle ring gear 1124bc and proximal elbow planetary gear carrier 1124bd), the second proximal toggle gear stage in turn drives the distal elbow joint 1120a (and the forearm segment 1100 attached to the distal elbow joint 1120a) in rotation relative to axis C.

In other words, the forearm segment 1100 (which is attached to the distal elbow joint 1120a) can be driven to rotate (or pivotally rotate) relative to the axis C by driving the second distal motor 1144 (or relative to the proximal elbow joint 1120b rotates), the second distal motor 1144 in turn drives the first proximal toggle gear stage (which includes a first proximal toggle bevel gear 1122b and a second proximal shaft bevel gear 1123b), the first proximal toggle gear stage This in turn drives a second proximal toggle gear stage (which includes a proximal toggle planetary gear assembly 1124b having a proximal toggle sun gear 1124ba, a proximal toggle planetary gear 1124bb, a proximal toggle ring gear 1124bc, and a proximal toggle planetary gear assembly 1124b). side toggle planetary gear carrier 1124bd), the second proximal toggle gear stage in turn drives the forearm segment 1100 (which is attached to the distal elbow joint 1120a) in rotation relative to axis C.

The gear ratio or magnification ratio of the proximal elbow joint assembly may be between approximately 1:10 and 1:30 (eg, 1:20).

The proximal elbow joint assembly may be or include any other gear arrangement for driving the forearm section 1100, including those described in this disclosure. For example, the proximal elbow joint assembly may include any one or more configurations or combinations of gears and/or gear assemblies, including spur gear configurations, planetary gear configurations, bevel gear configurations, without departing from the teachings of the present disclosure. , a spiral bevel gear configuration, a hypoid gear configuration, a helical gear configuration, a worm gear configuration, and/or any other gear and/or mechanical configuration (such as wire ropes and pulleys).

Shoulder coupling assembly (e.g., shoulder coupling assembly 1160)

13A and 13D, the side views of FIGS. 15A and 15C, and the cross-sectional side views of FIGS. 1160). The shoulder coupling assembly 1160 may include a distal shoulder joint 1160a and a proximal shoulder joint 1160b.

As shown at least in FIGS. 11B , 11C , 13A , 13D , and 15A-15D , the distal shoulder joint 1160a can have an axis of rotation D . Distal shoulder joint 1160a may be configured to enable rotation of upper arm segment 1140 relative to axis D (or pivotal rotation). In other words, the distal shoulder joint 1160a can be configured such that the upper arm segment 1140 can rotate (or pivotally rotate) relative to the distal shoulder joint 1160a. Such rotation about axis D may be driven by first proximal motor 1146 and the distal shoulder coupling subassembly as described further below and in this disclosure.

As shown at least in FIGS. 11B , 11C , 13A , 13D and 15A-15D , the proximal shoulder joint 1160b may have an axis of rotation E. The proximal shoulder joint 1160b can be configured such that the distal shoulder joint 1160a (and the upper arm segment 1140 attached to the distal shoulder joint 1160a) can rotate (or pivotally rotate) relative to the axis E. In other words, the proximal shoulder joint 1160b can be configured such that the distal shoulder joint 1160a (and the upper arm segment 1140 attached to the distal shoulder joint 1160a) can rotate (or pivotally rotate) relative to the proximal shoulder joint 1160b .

In other words, proximal shoulder joint 1160b can be configured such that upper arm segment 1140 can rotate (or pivotally rotate) relative to proximal shoulder joint 1160b. The axis of rotation E of the proximal shoulder joint 1160b may not be parallel to the axis of rotation D of the distal shoulder joint 1160a. For example, the axis of rotation E of the proximal shoulder joint 1160b may be orthogonal to the axis of rotation D of the distal shoulder joint 1160a. Such rotation relative to axis E may be driven by the second proximal motor 1148 and the proximal shoulder coupling subassembly as described further below and in this disclosure.

(i) Distal shoulder articulation subassembly

In an example embodiment, the first proximal motor 1146 can drive the distal shoulder linkage subassembly so that the upper arm segment 1140 is positioned relative to the distal shoulder joint 1160a (or as depicted in direction D as shown in FIG. 11C , relative to the axis D) Rotate (or pivotally rotate). As shown in at least FIGS. 11B, 11C, 13A, 13D, and 15A-15D, the distal shoulder coupling subassembly includes a plurality of gears. More specifically, the distal shoulder coupling subassembly includes a gear train system having a plurality of gear stages.

The distal shoulder link subassembly may include a first distal shoulder gear stage. The first distal shoulder gear stage can include a first distal shoulder bevel gear (eg, first distal shoulder bevel gear 1168a, as shown in at least FIGS. 13A, 13D, 15C, and 15D). The distal shoulder coupling subassembly may also include one or more gears between the first proximal motor drive portion 1146a and the first distal shoulder bevel gear 1168a, such as one or more spur gears 1164a, 1165a, 1166a . Alternatively, the distal shoulder coupling subassembly may be directly driven by the first proximal motor drive portion 1146a to the first distal shoulder bevel gear 1168a (e.g., without the one or more spur gears 1164a, 1165a, and 1166a) configured in such a way. The distal shoulder coupling subassembly may also include one or more connectors or the like, such as connectors 1162a, 1163a, 1167a (eg, at least Figure 13D).

Alternatively, as shown in at least FIGS. 15C and 15D , in an exemplary embodiment, the first distal shoulder bevel gear 1168a may be configured to be more directly driven by the first proximal motor drive portion 1146a, which is described in the present disclosure. is recognized so that the overall length of the arm assemblies 230, 240 can be shortened. For example, as shown in at least FIG. 15C, the spur gear 1166a can be directly coupled to the first distal shoulder bevel gear 1168a (eg, without the connector 1167a).

The first distal shoulder gear stage may also include a second distal shoulder bevel gear (eg, second distal shoulder bevel gear 1169a, as shown in at least FIGS. 13D, 15C, and 15D). The second distal bevel gear 1169a can be drivable by the first distal bevel gear 1168a for rotation relative to the axis D (the second distal bevel gear 1169a can have a central axis of rotation corresponding to the axis D).

The gear ratio between the first distal shoulder bevel gear 1168a and the second distal shoulder bevel gear 1169a may be between about 1:2 and 1:5 (eg, 1:3).

The distal shoulder link subassembly may include a second distal shoulder gear stage. The second distal shoulder gear stage may include a distal shoulder planetary gear assembly (eg, distal shoulder planetary gear assembly 1170a, as shown in at least FIGS. 11C, 13D, and 15C). The distal shoulder coupling subassembly may also include one or more connectors (not shown), and/or the second distal shoulder bevel gear 1169a and/or the distal shoulder sun gear 1170aa may have The extension between the bevel gear 1169a and the distal shoulder planetary gear assembly 1170a, which is recognized in this disclosure, enables improvements for routing the wiring through the shoulder coupling coupling assembly 1160 (e.g., through the second distal shoulder bevel gear 1169a and distal shoulder planetary gear assembly 1170a).

Alternatively, as shown in FIGS. 11B, 13D and 15C, in an exemplary embodiment, the second distal shoulder bevel gear 1169a may be directly coupled to (or connected to or fixed to) the distal shoulder planetary gear assembly 1170a (i.e. , the second distal shoulder bevel gear 1169a is directly coupled or connected or fixed to the distal shoulder sun gear 1170aa).

Figure 13E illustrates a side view of an example embodiment of a distal shoulder planetary gear assembly 1170a, and Figure 13F illustrates an exploded perspective view of the embodiment. Distal shoulder planetary gear assembly 1170a can have a central axis corresponding to axis D. The distal shoulder planetary gear assembly 1170a can include a distal shoulder sun gear 1170aa. The distal shoulder sun gear 1170aa can be drivable for rotation relative to the axis D by the second distal shoulder bevel gear 1170a. The distal shoulder sun gear 1170aa and/or the second distal shoulder bevel gear 1169a may include extensions (not shown) to enable spacing between each other and to allow routing of wiring through such spacing.

The distal shoulder planetary gear assembly 1170a may also include a plurality of distal shoulder planetary (or planetary) gears 1170ab. For example, the distal shoulder planetary gear assembly 1170a can include 4 or more distal shoulder planetary gears 1170ab. Each of the distal shoulder planet gears 1170ab can be configured to rotate relative to its central axis. Distal shoulder planet gears 1170ab may be drivable for common rotation about axis D by distal shoulder sun gear 1170aa.

The distal shoulder planetary gear assembly 1170a may also include a distal shoulder ring gear 1170ac. In an example embodiment, the distal shoulder ring gear 1170ac may be fixed or locked against rotation relative to the axis D such that the plurality of distal shoulder planetary gears 1170ab can collectively rotate about the axis D.

The distal shoulder planetary gear assembly 1170a may also include a distal shoulder planetary gear carrier 1170ad. The distal shoulder planetary gear carrier 1170ad can have a plurality of first ends 1170ad' connected to a plurality of proximal elbow planetary gears 1170ab. The distal shoulder planetary carrier 1170ad may also have a second end 1170ad ″ connected to a portion of the proximal end 1140b of the upper arm segment 1140 .

In this regard, when the distal shoulder sun gear 1170aa is driven to rotate relative to axis D by the second distal shoulder bevel gear 1169a, the distal shoulder sun gear 1170aa in turn drives the plurality of distal shoulder planetary gears 1170ab to jointly rotate about the axis D. Such common rotation of the plurality of distal shoulder planet gears 1170ab about axis D is in turn (via the connection between the first end 1170ad' of the distal shoulder planet gear carrier 1170ad and the plurality of distal shoulder planet gears 1170ab ) drives the distal shoulder planetary gear carrier 1170ad in rotation relative to axis D. Such rotation of distal shoulder planetary gear carrier 1170ad about axis C in turn drives upper arm section 1140 relative to Axis D rotates (or pivotally rotates) (eg, in direction D, as shown in at least FIG. 11C ).

The gear ratio between the second distal shoulder bevel gear 1169a and the distal shoulder planetary gear assembly 1170a may be between about 1:2 and 1:8 (eg, 1:5).

Accordingly, upper arm segment 1140 may be driven to rotate (or pivotally rotate) relative to axis D (or rotate relative to distal shoulder joint 1160b) by driving first proximal motor 1146, which in turn drives A first distal shoulder gear stage (which includes a first distal shoulder bevel gear 1168a and a second distal shoulder bevel gear 1169a), which in turn drives a second distal shoulder gear stage (which includes a distal Shoulder planetary gear assembly 1170a, distal shoulder planetary gear assembly 1170a has distal shoulder sun gear 1170aa, distal shoulder planetary gear 1170ab, distal shoulder ring gear 1170ac, and distal shoulder planetary gear carrier 1170ad), a second distal shoulder gear The stages in turn drive the upper arm section 1140 in rotation relative to the axis D.

The gear ratio or magnification ratio of the distal shoulder link assembly may be between about 1:20 to 1:50 (eg, 1:30).

The distal shoulder link assembly may be or include any other gear arrangement for driving upper arm segment 1140, including those described in this disclosure. For example, the distal shoulder coupling assembly may include any one or more configurations or combinations of gears and/or gear assemblies, including spur gear configurations, planetary gear configurations, bevel gear configurations, without departing from the teachings of the present disclosure. , a spiral bevel gear configuration, a hypoid gear configuration, a helical gear configuration, a worm gear configuration, and/or any other gear and/or mechanical configuration (such as wire ropes and pulleys).

(ii) Proximal Shoulder Link Assembly

In an example embodiment, the second proximal motor 1148 can drive the proximal shoulder joint subassembly so that the distal shoulder joint 1160a (and the upper arm segment 1140 attached to the distal shoulder joint 1160a) is relative to the proximal shoulder joint 1160b ( Or rotate (or pivotally rotate) relative to axis E) as depicted by direction E as shown in FIG. 11B .

In other words, the second proximal motor 1148 can drive the proximal shoulder joint subassembly so that the upper arm segment 1140 (which is attached to the distal shoulder joint 1160a) is positioned relative to the proximal shoulder joint 1160b (or as shown in FIG. 11B ). Rotation (or pivotal rotation) relative to axis E) depicted in direction E. As shown in at least 11B, 11C, 13A, 13D, and 15A-15D, the proximal shoulder coupling subassembly includes a plurality of gears. More specifically, the proximal shoulder coupling subassembly includes a gear train system having multiple gear stages.

The proximal shoulder link subassembly may include a first proximal shoulder gear stage. The first proximal shoulder gear stage can include a first proximal shoulder bevel gear (eg, first proximal shoulder bevel gear 1163b, as shown in at least FIGS. 13A, 15A, 15A, and 15D). The proximal shoulder coupling subassembly may also include one or more gears, such as one or more spur gears (not shown), between the second proximal motor drive portion 1148a and the first proximal shoulder bevel gear 1163ba. . The proximal shoulder coupling subassembly may also include one or more connectors or the like between the second proximal motor drive portion 1148a and the first proximal shoulder bevel gear 1163b, such as connectors 1161b, 1162b (as at least FIG. 13A shown).

Alternatively, as shown in at least FIGS. 15A and 15C , in an example embodiment, the first proximal bevel gear 1163 a may be configured to be directly driven by the second proximal motor drive portion 1148 a (as shown in at least FIGS. 15C and 1148 a ). 15D), which is recognized in the present disclosure to enable the overall length of the arm assemblies 230, 240 to be shortened.

The first proximal shoulder gear stage may also include a second proximal shoulder bevel gear (eg, second proximal shoulder bevel gear 1164b, as shown in at least FIGS. 13A, 13D, 15A, 15C, and 15D). The second proximal bevel gear 1164b can be drivable by the first proximal bevel gear 1163b for rotation relative to the axis D (the second proximal bevel gear 1164b can have a central axis of rotation corresponding to the axis D).

The gear ratio between the first proximal shoulder bevel gear 1163b and the second proximal shoulder bevel gear 1164b may be between about 1:2 and 1:5 (eg, 1:3).

The first proximal shoulder gear can also include a third proximal shoulder bevel gear (eg, third proximal shoulder bevel gear 1165b, as shown in at least FIGS. 13A, 15A, 15C, and 15D). The third proximal bevel gear 1165b can be drivable for rotation by the second proximal bevel gear 1164b.

The gear ratio between the second proximal shoulder bevel gear 1164b and the third proximal shoulder bevel gear 1165b may be between about 2:1 and 5:1 (eg, 3:1).

The proximal shoulder link subassembly may include a second proximal shoulder gear stage. The second proximal shoulder gear stage can include a first proximal shoulder spur gear (eg, first proximal shoulder spur gear 1167b, as shown in at least FIGS. 13A, 15A, 15C, and 15D). The proximal shoulder coupling subassembly may also include one or more connectors between the third proximal shoulder bevel gear 1165b and the first proximal shoulder spur gear 1167b, such as connector 1166b (as shown in at least FIG. 13A ). .

Alternatively, as shown in at least FIG. 15A and FIG. 15C, in an exemplary embodiment, the first proximal shoulder spur gear 1167b may be directly coupled to (or connected to or fixed to) the third proximal shoulder bevel gear 1165b, which It is recognized in this disclosure that the overall length of the arm assemblies 230, 240 can be shortened.

The second proximal shoulder gear stage may also include a second proximal shoulder spur gear (eg, second proximal shoulder spur gear 1168b, as shown in at least FIGS. 13A, 15C, and 15D). The second proximal shoulder spur gear 1168b can be drivable for rotation by the first proximal shoulder spur gear 1167b.

The gear ratio between the first proximal shoulder spur gear 1167b and the second proximal shoulder spur gear 1168b may be between about 1:1 and 1:4 (eg, 1:2).

The second proximal shoulder gear stage may also include a third proximal shoulder spur gear (eg, third proximal shoulder spur gear 1169b, as shown in at least FIG. 13A ). The third proximal shoulder spur gear 1169b can be drivable for rotation by the second proximal shoulder spur gear 1168b.

The gear ratio between the second proximal shoulder spur gear 1168b and the third proximal shoulder spur gear 1169b may be between about 1:1 and 1:4 (eg, 1:2).

The proximal shoulder link subassembly may include a third proximal shoulder gear stage. The third proximal shoulder gear stage can include a fourth proximal shoulder bevel gear (eg, fourth proximal shoulder bevel gear 1171b, as shown in at least FIGS. 13A, 15A, 15B, 15C, and 15D). The proximal shoulder coupling subassembly may also include one or more connectors between the third proximal shoulder spur gear 1169b and the fourth proximal shoulder bevel gear 1171b, such as connector 1170b (as shown in at least FIG. 13A ). .

Alternatively, as shown in at least FIGS. 15B-15D , in an example embodiment, the fourth proximal shoulder bevel gear 1171b may be directly coupled to (or connected to or fixed to) the third proximal shoulder spur gear 1169b, which in It is recognized in the present disclosure that the overall length of the arm assemblies 230, 240 can be shortened.

The third proximal shoulder gear stage may also include a fifth proximal shoulder bevel gear (eg, fifth proximal shoulder bevel gear 1172b, as shown in at least FIG. 13A and FIGS. 15A-15D ). Fifth proximal bevel gear 1172b may be drivable by fourth proximal bevel gear 1171b for rotation relative to axis E (fifth proximal bevel gear 1172b may have a central axis of rotation corresponding to axis E).

The gear ratio between the fourth proximal bevel gear 1171b and the fifth proximal bevel gear 1172b may be between about 1:2 and 1:5 (eg, 1:3).

The proximal shoulder link subassembly may include a fourth proximal shoulder gear stage. The fourth proximal shoulder gear stage may include a proximal shoulder planetary gear assembly (eg, proximal shoulder planetary gear assembly 1173b, as shown in at least FIGS. 11B, 13A, and 15A). The proximal shoulder coupling subassembly may also include one or more connectors, etc. (not shown), and/or the fifth proximal shoulder bevel gear 1172b and/or the proximal shoulder sun gear 1173ba may have The extension between the shoulder bevel gear 1172b and the proximal shoulder planetary gear assembly 1173b, which is recognized in this disclosure, enables improvements for routing the wiring through the shoulder coupling coupling assembly 1160 (e.g., through the fifth proximal shoulder bevel gear 1172b and proximal shoulder planetary gear assembly 1173b).

Alternatively, as shown in at least FIG. 11C and FIG. 13A , in an example embodiment, fifth proximal shoulder bevel gear 1172b may be directly coupled to (or connected to or fixed to) proximal shoulder planetary gear assembly 1173b (i.e., The fifth proximal shoulder bevel gear 1172b is directly coupled or connected or secured to the proximal shoulder sun gear 1173ba).

Figure 13B illustrates a side view of an example embodiment of a proximal shoulder planetary gear assembly 1173b, and Figure 13C illustrates an exploded perspective view of that embodiment. Proximal shoulder planetary gear assembly 1173b may have a central axis corresponding to axis E. The proximal shoulder planetary gear assembly 1173b can include a proximal shoulder sun gear 1173ba. Proximal shoulder sun gear 1173ba can be driven for rotation relative to axis E by fifth proximal shoulder bevel gear 1172b. The proximal shoulder sun gear 1173ba and/or the fifth proximal shoulder bevel gear 1172b may include extensions (not shown) to enable spacing therebetween and to allow wiring to run through such spacing.

The proximal shoulder planet gear assembly 1173b may also include a plurality of proximal shoulder planet (or planetary) gears 1173bb. For example, the proximal shoulder planetary gear assembly 1173b can include 4 or more proximal shoulder planetary gears 1173bb. Each of the proximal shoulder planet gears 1173bb can be configured to rotate relative to its central axis. The proximal shoulder planet gears 1173bb can be drivable for common rotation about axis E by the proximal shoulder sun gear 1173ba.

The proximal shoulder planetary gear assembly 1173b may also include a proximal shoulder ring gear 1173bc. In an example embodiment, the proximal shoulder ring gear 1173bc may be fixed or locked against rotation relative to the axis E so as to enable collective rotation of the plurality of proximal shoulder planetary gears 1173bb about the axis E.

The proximal shoulder planetary gear assembly 1173b may also include a proximal shoulder planetary gear carrier 1173bd. The proximal shoulder planet gear carrier 1173bd can have a plurality of first ends 1173bd' connected to a plurality of proximal shoulder planet gears 1173bb. The proximal shoulder planetary gear carrier 1173bd may also have a second end 1173bd″ connected to a portion of the proximal end of the distal shoulder joint 1160a.

In this regard, when proximal shoulder sun gear 1173ba is driven to rotate relative to axis E by fifth proximal shoulder bevel gear 1172b, proximal shoulder sun gear 1173ba in turn drives the plurality of proximal shoulder planetary gears 1173bb to jointly rotate about the axis E. Such common rotation of the plurality of proximal shoulder planet gears 1173bb about axis E is in turn (via the connection between the first end 1173bd' of the proximal shoulder planet gear carrier 1173bd and the plurality of proximal shoulder planet gears 1173bb ) drives the proximal shoulder planetary gear carrier 1173bd in rotation relative to the axis E. Such rotation of the proximal shoulder planetary gear carrier 1173bd about the axis E in turn (via the connection between the second end 1173bd″ of the proximal shoulder planetary gear carrier 1173bd and the proximal end of the distal shoulder joint 1140) drives the distal shoulder joint 1160a (and upper arm segment 1140 attached to distal shoulder joint 1160a) rotates (or pivotally rotates) relative to axis E (eg, in direction E, as shown in at least FIG. 11B ).

The gear ratio between fifth proximal shoulder bevel gear 1172b and proximal shoulder planetary gear assembly 1173b may be between approximately 1:2 and 1:8 (eg, 1:5).

Thus, the distal shoulder joint 1160a (and the upper arm segment 1140 attached to the distal shoulder joint 1160a) can be driven to rotate relative to the axis E (or relative to the proximal shoulder joint 1160b) by driving the second proximal motor 1148 (or pivotally rotate), the second proximal motor 1148 in turn drives the first proximal shoulder gear stage (which includes a first proximal shoulder bevel gear 1163b, a second proximal shoulder bevel gear 1164b, a third proximal shoulder bevel gear gear 1165b), the first proximal shoulder gear stage in turn drives the second proximal shoulder gear stage (which includes a first proximal shoulder spur gear 1167b, a second proximal shoulder spur gear 1168b, and a third proximal shoulder spur gear 1169b) , the second proximal shoulder gear stage in turn drives the third proximal shoulder gear stage (which includes a fourth proximal shoulder bevel gear 1171b and a fifth proximal shoulder bevel gear 1172b), which in turn drives the fourth proximal shoulder gear stage The proximal shoulder gear stage (which includes a proximal shoulder planetary gear assembly 1173b having a proximal shoulder sun gear 1173ba, a proximal shoulder planetary gear 1173bb, a proximal shoulder ring gear 1173bc and a proximal shoulder planetary gear Carrier 1173bd), the fourth proximal shoulder gear stage in turn drives the distal shoulder joint 1160a (and the upper arm segment 1140 attached to the distal shoulder joint 1160a) in rotation relative to the axis E.

In other words, upper arm segment 1140 (which is attached to distal shoulder joint 1160a) can be driven to rotate (or pivot) relative to axis E (or relative to proximal shoulder joint 1160b) by driving second proximal motor 1148. ground rotation), the second proximal motor 1148 in turn drives the first proximal shoulder gear stage (which includes a first proximal shoulder bevel gear 1163b, a second proximal shoulder bevel gear 1164b, a third proximal shoulder bevel gear 1165b) , the first proximal shoulder gear stage in turn drives the second proximal shoulder gear stage (which includes a first proximal shoulder spur gear 1167b, a second proximal shoulder spur gear 1168b, and a third proximal shoulder spur gear 1169b), the second The proximal shoulder gear stage in turn drives a third proximal shoulder gear stage (which includes a fourth proximal shoulder bevel gear 1171b and a fifth proximal shoulder bevel gear 1172b), which in turn drives a fourth proximal shoulder gear stage gear stage (which includes a proximal shoulder planetary gear assembly 1173b having a proximal shoulder sun gear 1173ba, a proximal shoulder planetary gear 1173bb, a proximal shoulder ring gear 1173bc and a proximal shoulder planetary gear carrier 1173bd) , the fourth proximal shoulder gear stage in turn drives upper arm segment 1140 (which is attached to distal shoulder joint 1160a) in rotation relative to axis E.

The gear ratio or magnification ratio of the proximal shoulder link assembly may be between about 1:20 to 1:50 (eg, 1:30).

The proximal shoulder linkage assembly may be or may include any other gear arrangement for driving upper arm segment 1140 , including those described in this disclosure. For example, the proximal shoulder coupling assembly may include any one or more configurations or combinations of gears and/or gear assemblies, including spur gear configurations, planetary gear configurations, bevel gear configurations, without departing from the teachings of the present disclosure. , a spiral bevel gear configuration, a hypoid gear configuration, a helical gear configuration, a worm gear configuration, and/or any other gear and/or mechanical configuration (such as wire ropes and pulleys).

Shoulder section (eg, Shoulder section 231)

Exemplary embodiments of shoulder segment 231 are illustrated in at least FIGS. 11A-11C . The distal end of shoulder segment 231 may be fixable to shoulder coupling link assembly 1160 . The proximal end of shoulder 231 may be securable to port assembly 210 . In an example embodiment, shoulder segment 231 may be securable to port assembly 210 and releasable (eg, detachable) from port assembly 210 .

In an example embodiment, the shoulder section 231 may be similar or identical to the shoulder section 231 described above and in this disclosure.

Auxiliary arm assemblies (eg, auxiliary arm assemblies 250, 260)

In an example embodiment, surgical device 200 may include one or more accessory arm assemblies (eg, accessory arm assemblies 250 or 260 ) that may be configured to be inserted into and attached to port assembly 210 . As shown in Figures 2A, 2B, 3A and 3B, one or more of the auxiliary arm assemblies may be a suction/irrigation assembly 250, or an auxiliary instrument arm assembly such as a retractor arm assembly 260, each Each may include a multi-bendable body 252 or 262, respectively, and each include an anchor portion (eg, similar to the multi-bendable body 222 and anchor portion 220a of the image capture assembly 220).

As shown in Figures 2A, 2B, 3A and 3B, the suction/irrigation assembly 250 can include an end with a suction port 259 for applying a fluid that can be used to remove fluid from the patient's cavity. (eg, blood, etc.) suction or negative pressure. Regarding the auxiliary instrument arm assembly 260, the auxiliary instrument arm assembly 260 can include an end with an instrument 269 (such as a grasper, retractor, cutter, needle, etc.) that can be used to assist the one or more The instrument arm assemblies 230 and/or 240 perform surgical actions.

As shown in the example embodiments of FIGS. 2A , 2B, 3A and 3B, auxiliary arm assemblies 250 and/or 260 may each include a removable arm attached to their end (suction port or instrument, respectively). Multiple curved bodies 252 and/or 262 . The multi-bendable body 252 or 262 can be any elongated multi-bendable body similar to the multi-bendable body of the image capture assembly 220 described above and in this disclosure, which can be manipulated by the surgical team 904 (such as via a computing device). /controller/manipulator/master input device) is controlled/configured to, among other things, straighten and/or bend at one or more of a plurality of locations along the multi-bendable body 252 or 262 (and maintain such straightening and/or bending), bend in one or more of a plurality of curved portions (and maintain such a curved portion), and/or in one or more of a plurality of directions Straighten and/or bend in multiple directions (and remain so straightened and/or bent). It will be appreciated that when the multi-bendable body 252 or 262 is configured to bend at any position along the multi-bendable body 252 or 262, the curve can be manipulated by the surgical team 904 (such as via a computing device/controller/manipulator/master input device) hold and/or release (or be configured to not bend, less bend, or straighten).

The multi-bendable body 252 or 262 may be formed in any one or more ways known in the art. For example, the multi-bendable body 252 or 262 may be a unitary or substantially unitary elongated body having a plurality of wires, cables, etc. throughout the multi-bendable body 252 or 262 Distribute/extend in such a way that the pulling/releasing, shortening/lengthening, tightening/loosening, etc. of one or a combination of such wires, cables, etc. And the above-mentioned bending of one or more positions of the multi-bendable body 252 or 262 is achieved in one or more directions. As another example, the multi-bendable body 252 or 262 may comprise a plurality of segments, each segment may be controlled/configured to be pivotally positioned in a plurality of positions relative to adjacent segments in such a manner Link to adjacent segments. As another example, the multi-bendable body 252 or 262 may include features for achieving one or more positions of the multi-bendable body 252 or 262 in one or more curved portions and in one or more directions. The above mentioned curved multiple springs, gears, motors etc. It is understood in this disclosure that the multi-bendable body 252 or 262 may also include a combination of one or more of the above mentioned methods.

Accessory arm assembly 250 or 260 may be secured to port assembly 210 in one or more of a variety of ways, including those described above and in this disclosure with respect to instrument arm assemblies 230, 240 and/or image capture assembly 220. Those ones. For example, auxiliary arm assembly 250 or 260 may also include an anchor portion (e.g., similar to anchor portion 220 of image capture assembly 220 and/or fixation portion 231a of instrument arm assembly 220, respectively) operable to Accessory arm assembly 250 or 260 is attached (or secured) to one or more anchor ports 216 of port assembly 210 .

In an example embodiment, each of the multi-bendable bodies 252 or 262 may be generally cylindrical in shape. The multi-bendable body 252 or 262 may also be formed in any of a variety of other shapes, sizes, and/or dimensions without departing from the teachings of the present disclosure.

In an example embodiment, the length of the multi-bendable body 252 or 262 may be between about 170 to 270 mm. In an example embodiment, the length of the multi-bendable body 252 or 262 may also be adjusted by the surgical team 904 before, during, and/or after insertion of the camera arm assembly into the patient's cavity. The outer diameter of the flexible body 252 or 262 may be between about 5 and 7 mm. It is to be understood in this disclosure that the above dimensions are illustrative of example embodiments only, and as such, these dimensions may be smaller or larger than those recited above without departing from the teachings of the present disclosure.

controller

In an example embodiment, a surgical system may include a controller (or computing device, manipulator, and/or primary input device). The controller may be configurable to perform one or more of a number of operations in and on surgical system 200 . For example, the controller may be configurable to interface with one or more elements of the surgical system 200, such as the external anchor 1 or 1000, the port assembly 210, the instrument arm assembly 230 or 240, the image capture assembly 220, and/or the auxiliary arm component 250 or 260) to communicate and/or control these elements. The controller may be accessed and/or controlled by the surgical team 904, which may be able to communicate with and/or control the configuration and/or operation of one or more elements of the surgical system 200. For example, the controller may be configurable to control the movement and action of some or all of the instrument arm assembly 230 or 240, the first gate assembly 212b, the second gate assembly 214b, the movement of some or all of the image capture assembly 220, and Motion (including image capture, temperature control, etc.), movement and movement of some or all portions of the multi-flexible body 222 of the image capture assembly 220, motion of some or all portions of the multi-flexible body 252 or 262 of the auxiliary arm assembly, and movement, movement and action of some or all portions of the auxiliary arm assembly 250 or 260, and the like.

Method of Positioning Surgical Device 200 in a Forwardly Directed Position (e.g., Method 700)

As shown in FIGS. 7 and 8A-8E , an example embodiment of a surgical device 200 may be configurable to perform forward-directed surgical maneuvers or procedures in one of a variety of ways. In an example embodiment, an external anchor 1 may be provided and mounted/anchored to a stationary object. A port assembly 210 can be provided (eg, act 702), and an instrument arm assembly can be provided (eg, act 704). A second instrument arm assembly may be provided, along with any of the required image capture assemblies 220 and/or 320 and auxiliary arm assemblies 250 and/or 260 . Port assembly 210 may be inserted (eg, act 706) into the patient's opening (and cavity) and anchored in place (eg, act 708) using external anchor 1 , and the workable volume in the cavity The /space may be formed such as via insufflation using _CO2 and/or other gases, vacuum suction means and/or retractable hook means. In an example embodiment, a controllable swivel assembly 1000 may also be used. For example, the patient may be provided with a workable abdominal cavity at a height of approximately 10-12 cm. Thereafter, one or more image capture assemblies 220, one or more auxiliary arm assemblies (eg, act 710), and/or one or more auxiliary arm assemblies 250 or 260 (if If desired) is inserted into port assembly 210, secured to anchor port 216, and deployed in the patient's cavity. Surgical maneuvers or procedures may then be performed in any portion, region, and/or quadrant of the patient's cavity using the surgical device 200 . These processes will now be described below with reference to at least FIG. 7 , FIGS. 8A-8E , FIG. 9B and FIG. 10B .

(1) Provide external anchors and install port assemblies

In an example embodiment, as shown in FIGS. 1A and 1B , an external anchor 1 may be provided and mounted/anchored to one or more stationary objects, such as side rails 300 of a surgical table/bed. One or more segments 2, 6, 10, and 14 of the external anchor 1 may cooperate using one or more couplings 4, 8, 12, and 16 of the external anchor 1 to position the port assembly 210 ( including orientation) in or around the patient's opening.

In an example embodiment, as shown in FIGS. 10A and 10B , the external anchor 1 may include a controllable swivel assembly 1000 operable to provide one or more additional extracorporeal degrees of freedom, such as via a first swivel portion 1002 . , the second turning portion 1004 and/or the third turning portion 1006 . The controllable swivel assembly 1000 may further include a motor 1002a for the first swivel portion 1002, a motor 1004a for the second swivel portion 1004, a motor 1006a for the third swivel portion 1006, one or more support arms 1008, and One or more locks 1010.

First swivel portion 1002 may be operable to provide translational movement of port assembly 210 as indicated by arrow A along an axis defined by the elongated length of port assembly 210 as one of the extracorporeal degrees of freedom. In an example embodiment, the translational motion provided by the first swivel portion 1002 as indicated by arrow A may be between about 0 and 50 mm.

Controllable swivel assembly 1000 may further include a second swivel portion 1004 operable to provide torsional or rotational motion of port assembly 210 about an axis described by axis Y as another of the extracorporeal degrees of freedom. In an example embodiment, the twisting or rotational motion provided by the second swivel portion 1004 as indicated by arrow B may be between about +/- 180 degrees.

Controllable swivel assembly 1000 may also include a third swivel portion 1006 operable to provide, as another of the extracorporeal degrees of freedom, port assembly 210 about an axis perpendicular to the Y-axis, such as the axis depicted by axis Z (which exits page)) pivoting or rotational movement. In an example embodiment, the Z axis or center of rotation may be located around the patient's opening, such as at a midpoint in the abdominal wall. In an example embodiment, the pivotal or rotational motion provided by the third swivel portion 1006 as indicated by arrow C may be between about +/- 80 degrees.

It is recognized in this disclosure that, in example embodiments, the controllable swivel assembly 1000 may include a first swivel portion 1002 , a second swivel portion 1004 , and/or a third swivel portion 1006 . When more than three degrees of freedom outside the body and/or motion/rotation in addition to those that may be provided by the first portion of revolution 1002, the second portion of revolution 1004, and the third portion of revolution 1006 are desired and/or required, the The control swivel assembly 1000 may further include other swivel parts (not shown).

Controllable swivel assembly 1000 including first swivel portion 1002, second swivel portion 1004, and/or third swivel portion 1006 may be controllable locally or remotely by the surgical team.

In an example embodiment, port assembly 210 may be installed and secured to external anchor 1 or 1000 . As shown in FIGS. 8A-8E , the second end 214 of the port assembly 210 can be inserted into the patient's opening into the patient's cavity, and the first end 212 of the port assembly 210 can be secured to an external anchor. device 1 or 1000. Thereafter, a workable volume/space in the lumen may be created in the patient's lumen, such as via insufflation using CO ₂ and/or other gases, a vacuum suction tool, and/or a retractable hook tool. By doing so, the first gate assembly 212b and the second gate assembly 214b can be deployed to the closed position. Insufflation of the cavity can be accomplished in one or more of a variety of ways. For example, an insufflation port of port assembly 210 may be used to provide the required insufflation.

(2) Insert and attach the image capture unit

After the workable volume/space in the cavity has been created and port assembly 210 secured in place, as shown in FIG. 8A , image capture assembly 220 may be inserted through central access channel 210a and secured to the anchor of port assembly 210 Setter port 216. To do so while maintaining workable volume/space, the first gate assembly 212b may be configured to the open position at the same time as the second gate assembly 214b is configured to the closed position. Once the first gate assembly 212b is in the open position, the image capture assembly 220 may be inserted into the intermediate section 213 . The first gate assembly 212b may then be configured to the closed position after the image capture assembly 220 passes the first gate assembly 212b. The second gate assembly 214b may then be deployed to the open position. It is recognized in this disclosure that the workable volume/space in the cavity is maintained via gas injection since the first gate assembly 212b is deployed to the closed position. Once second gate assembly 214b is in the open position, image capture assembly 220 may be inserted into the patient's cavity and anchor portion 220a secured to anchor port 216 . Second gate assembly 214b may then be configured to the closed position after image capture assembly 220 passes second gate assembly 214b. The multi-bendable body 222 of the image capture assembly 220 can then be configured/controlled to bend at one or more locations along the multi-bendable body 222 such that the image capture assembly 220 can be oriented towards a forwardly oriented position (e.g. Figure 2B and Figure 3B).

A separate image capture assembly 320 may also be inserted through port assembly 210 in a similar manner as described above. Once inserted through port assembly 210 into the patient's cavity, separate image capture assembly 320 may then be attached/fixed via magnetic anchor 310 to the inner wall of the patient's cavity.

(3) Insert and attach the first instrument arm assembly

Instrument arm assembly 230 may be inserted through central access channel 210a and secured to anchor port 216 of port assembly 210 . To do so while maintaining a workable volume/space, the first gate assembly 212b may again be configured to the open position at the same time as the second gate assembly 214b is configured to the closed position. Once the first gate assembly 212b is in the open position, the instrument arm assembly 230 may be inserted into the intermediate section 213, as shown in FIG. 8B. As shown in FIG. 8C , the first gate assembly 212b may then be configured to the closed position after the instrument arm assembly 230 enters the intermediate section 213 through the first gate assembly 212b. As shown in FIG. 8D, the second gate assembly 214b may then be deployed to an open position. As shown in FIG. 8E , once the second gate assembly 214b is in the open position, the instrument arm assembly 230 may be inserted into the patient's cavity and the securing portion 231a secured to the anchor port 216 . Second gate assembly 214b may then be deployed to the closed position after instrument arm assembly 230 passes second gate assembly 214b.

(5) Insert and attach one or more additional instrument arm assemblies, one or more auxiliary arm assemblies, and/or one or more additional camera arm assemblies

One or more additional instrument arm assemblies 240, one or more auxiliary arm assemblies 250 or 260, and/or one or more additional image capture assemblies (not shown) may also be configured in the same manner as above for image capture. Assembly 220 and instrument arm assembly 230 are inserted into port assembly 210 via central access channel 210a in the same manner as described.

(6) Disassemble and remove the instrument arm assembly, image capture assembly and auxiliary arm assembly

The instrument arm assembly 230, the image capture assembly 220, the other instrument arm assembly 240 (if provided), the other image capture assembly (if provided), and one or more other auxiliary arm assemblies 250 or 260 (if provided) may is detached (or loosened) from the anchor port 216 via the central access channel 210a of the port assembly 210 and removed from the patient's cavity in substantially the opposite manner to that described above for insertion and attachment.

Method of Positioning Surgical Device 200 in Opposite Direction (e.g., Method 700)

As shown in FIGS. 7 and 8F-8K, an example embodiment of a surgical device 200 may be configurable to perform oppositely directed surgical maneuvers or procedures in one of a variety of ways. In an example embodiment, an external anchor 1 may be provided and mounted/anchored to a stationary object in a manner similar to that described above and in this disclosure. A port assembly 210 can be provided (eg, act 702), and an instrument arm assembly can be provided (eg, act 704). A second instrument arm assembly may be provided, along with any of the required image capture assemblies 220 and/or 320 and auxiliary arm assemblies 250 and/or 260 . Port assembly 210 may be inserted (eg, act 706) into the patient's opening (and cavity) and anchored in place (eg, act 708) using external anchor 1 , and the workable volume in the cavity The /space may be formed such as via insufflation using _CO2 and/or other gases, vacuum suction means and/or retractable hook means. In an example embodiment, a controllable swivel assembly 1000 may also be used. For example, a patient may be provided with a workable abdominal cavity at a height of approximately 10-12. Thereafter, one or more image capture assemblies 220, one or more auxiliary arm assemblies (e.g., act 710), and one or more auxiliary arm assemblies 250 or 260 (if desired) can be moved via central access channel 210a. ) is inserted into port assembly 210, secured to anchor port 216, and deployed in the patient's cavity. For insertion, each of image capture assembly 220, instrument arm assemblies 230 and/or 240, and auxiliary arm assemblies 250 and/or 260 is inserted into a forward position compared to the orientation described above and in this disclosure. in the opposite direction. Surgical maneuvers or procedures may then be performed in any portion, region, and/or quadrant of the patient's cavity using the surgical device 200 . These processes will now be described below with reference to at least FIG. 7 , FIGS. 8F-8K , FIG. 9B and FIG. 10B .

(1) Provide external anchors and install port assemblies

In an example embodiment, port assembly 210 may be installed and secured to external anchor 1 or 1000 . As shown in FIGS. 8A-8E , the second end 214 of the port assembly 210 is inserted into the patient's opening into the patient's cavity, and the first end 212 of the port assembly 210 is secured to the external anchor 1 or 1000. Thereafter, a workable volume/space in the lumen may be created in the patient's lumen, such as via insufflation using CO ₂ and/or other gases, a vacuum suction tool, and/or a retractable hook tool. By doing so, the first gate assembly 212b and the second gate assembly 214b can be deployed to the closed position. Insufflation of the cavity can be accomplished in one or more of a variety of ways. For example, an insufflation port of port assembly 210 may be used to provide the required insufflation.

(2) Insert and attach the image capture unit

After the workable volume/space in the cavity has been created and the port assembly 210 is secured in place, as shown in FIG. Anchor port 216 secured to port assembly 210 . To do so while maintaining a workable volume/space, the first gate assembly 212b may be configured to the open position at the same time as the second gate assembly 214b is configured to the closed position. Once the first gate assembly 212b is in the open position, the image capture assembly 220 may be inserted into the intermediate section 213 . The first gate assembly 212b may then be configured to the closed position after the image capture assembly 220 passes the first gate assembly 212b. The second gate assembly 214b may then be deployed to the open position. It is recognized in this disclosure that the workable volume/space in the cavity is maintained via gas injection since the first gate assembly 212b is deployed to the closed position. Once the second gate assembly 214b is in the open position, the image capture assembly 220 can be fully inserted into the patient's cavity with the image capture body 224 closest to the anchor port 216 . The multi-bendable body 222 of the image capture assembly 220 can then be configured/controlled to bend at one or more locations along the multi-bendable body 222 so that the image capture assembly 220 can be oriented outwardly next to the port assembly 210. The direction of the surface is opposite to the position (as shown in Figure 2A and Figure 3A). Image capture assembly 220 may then be provided adjacent to the outer surface of port assembly 210 such that anchor portion 220a of image capture assembly 220 is adjacent to anchor port 216 . Anchor portion 220a of image capture assembly 220 may then be secured to anchor port 216 . Second gate assembly 214b may be configured to a closed position after image capture assembly 220 passes second gate assembly 214b.

A separate image capture assembly 320 may also be inserted through port assembly 210 in a similar manner as described above. Once inserted through port assembly 210 into the patient's cavity, separate image capture assembly 320 may then be attached/fixed via magnetic anchor 310 to the inner wall of the patient's cavity.

(3) Insert and attach the first instrument arm assembly

In order to insert the instrument arm assembly 230 through the central access channel 210a and secure it to the anchor port 216 of the port assembly 210 while maintaining a workable volume/space, the first gate assembly 212b may again be locked within the second gate assembly 214b. Configured to the closed position is simultaneously configured to the open position. As shown in FIG. 8G , once the first gate assembly 212b is in the open position, the instrument arm assembly 230 may be inserted, with the end effectors 239 , 342 , 344 finally inserted into the intermediate section 213 . As shown in FIG. 8H , first gate assembly 212b may then be configured to the closed position after instrument arm assembly 230 enters intermediate section 213 through first gate assembly 212b. As shown in FIG. 8I, the second gate assembly 214b may then be deployed to an open position. As shown in Figure 8J, once the second gate assembly 214b is in the open position, the instrument arm assembly 230 can be fully inserted into the patient's cavity with the end effectors 239, 342, 344 closest to the anchor port 216. The instrument arm assembly 230 can then be rotated 180 degrees (if desired) and/or moved so that the instrument arm assembly 230 can abut the outer surface of the port assembly 210 . The instrument arm assembly 230 may then be drawn adjacent the outer surface of the port assembly 210 such that the fixed portion 231a of the shoulder segment 231 of the instrument arm assembly 230 is adjacent the anchor port 216 . The fixed portion 231a of the instrument arm assembly 230 may then be fixed to the anchor port 216 as shown in FIG. 8K . Second gate assembly 214b may be configured to the closed position after at least end effector 230 of instrument arm assembly 230 passes second gate assembly 214b.

(5) Insert and attach one or more additional instrument arm assemblies, one or more auxiliary arm assemblies, and/or one or more additional camera arm assemblies

One or more additional instrument arm assemblies 240, one or more auxiliary arm assemblies 250 or 260, and/or one or more additional image capture assemblies (not shown) may also be configured in the same manner as above for image capture. Assembly 220 and instrument arm assembly 230 are inserted and mounted in opposite directions via central access channel 210a of port assembly 210 in the same manner as described.

(6) Disassemble and remove the instrument arm assembly, image capture assembly and auxiliary arm assembly

The instrument arm assembly 230, the image capture assembly 220, the other instrument arm assembly 240 (if provided), the other image capture assembly (if provided), and one or more other auxiliary arm assemblies 250 or 260 (if provided) may is detached (or loosened) from the anchor port 216 via the central access channel 210a of the port assembly 210 and from the patient's cavity in a substantially opposite manner to that described above for insertion and attachment, in a reverse direction. remove.

While various embodiments in accordance with the disclosed principles have been described above, it should be understood that they have been presented by way of illustration only, and not limitation. Thus, the breadth and scope of example embodiments described in this disclosure should not be limited by any of the above-described exemplary embodiments, but should be defined only in accordance with the claims issuing from this disclosure and their equivalents. Furthermore, the above advantages and features are provided in described embodiments, but should not limit the application of such issued claims to processes and structures which achieve any or all of the above advantages.

For example, "component," "means," "portion," "section," "member," "body," or other similar terms should generally be construed broadly to include one part or multiple components attached or connected together. in one part.

Various terms used herein have specific meanings within the technical field. Whether a particular term should be considered such a "technical term" depends on the context in which the term is used. "connected", "connected", "attached", "attached", "anchored", "anchored", "in communication with", "in communication with", "in connection with. "Associated", "associated with" or other similar terms should generally be construed broadly to include instances where the attachment, connection and anchoring are direct between the referenced elements, Or between the referenced elements through one or more intermediaries. These and other terms are to be interpreted according to the context in which they are used in this disclosure, and are to be interpreted as would be understood by one of ordinary skill in the art in the context of the disclosure. The above definitions do not exclude other meanings that may be assigned to those terms based on the disclosed context.

As referred to in this disclosure, a computing device, processor, and/or system may be a virtual machine, computer, node, instance, host, and/or machine in a networked or non-networked computing environment. A networked computing environment can be a collection of devices connected by a communication channel that facilitates communication between the devices and allows the devices to share resources. Also as mentioned in this disclosure, a computing device may be a device deployed to execute a program operating as a socket listener, and may include software instances.

Resources may include any type of resource used to run an instance, including hardware (e.g., servers, clients, mainframe computers, networks, network storage, data sources, memory, central processing unit time, scientific instruments, and other computing equipment) and Software, software licenses, available network services, and other non-hardware resources, or combinations thereof.

Networked computing environments may include, but are not limited to, computing grid systems, distributed computing environments, cloud computing environments, and the like. Such networked computing environments include hardware and software infrastructure configured to form a virtual organization comprising multiple resources, which may be geographically dispersed across multiple locations.

In addition, the coverage of this application and any patents issued from this application may extend to one or more communication protocols, including TCP/IP.

Terms of comparison, measurement and timing, such as "at this time", "equivalent", "during", "completely", etc., should be understood to mean "substantially at this time", "substantially equivalents", "substantially during", "substantially completely", etc., where "substantially" means that such comparisons, measures and Timing is practical.

In addition, the paragraph headings of this text are provided to be consistent with the recommendations of 37 CFR 1.77 or to provide structural clues to the text. These headings shall not limit or characterize the invention or inventions that may be set forth in any claims that may issue from this disclosure. Specifically and by way of example, although a heading refers to a "technical field," the claims should not be limited by the language chosen under that heading to describing the so-called technical field. Further, a description of technology in the "Background" is not to be read as an admission that that technology is prior art to any one or more inventions in this disclosure. Nor is the "Summary of the Invention" intended to be construed as a description of the one or more inventions that are set forth in the issued claims. In addition, any reference to "invention" in the singular in this disclosure should not be used to demonstrate that there is only a single point of novelty in this disclosure. A number of inventions may be set forth according to the definition of the multiple claims issuing from this disclosure, and these claims accordingly define the invention or inventions protected thereby, and their equivalents. In all instances, the scope of these claims should be read on their own merits in light of this disclosure, and not by the headings herein.

Claims (28)

1. A robotic arm assembly comprising: a forearm segment formed as an elongated structure having a proximal end and a distal end; an upper arm segment formed as an elongated structure having a proximal end and a distal end, the upper arm segment having: a first distal motor having a first distal motor drive portion at the distal end of the upper arm segment, the first distal motor drive portion being configured relative to a first axis rotate, the first axis being parallel to the central axis of the upper arm section; and an elbow coupling assembly connecting the proximal end of the forearm segment to the distal end of the upper arm segment, the elbow coupling assembly having: a distal elbow joint subassembly connected at a distal end to the proximal end of the forearm segment, the distal elbow joint subassembly comprising a gear train system having a plurality of gear stages, the The multiple gear stages described include: a first distal toggle gear stage having: a first distal toggle gear configured to be driven by the first distal motor drive portion of the first distal motor for rotation relative to the first axis; A second distal toggle gear, said second distal toggle gear being drivable by said first distal toggle gear, said second distal toggle gear being configured to be the toggle bevel gear rotates when driven relative to a first primary toggle axis, said primary primary toggle axis being normal to said first axis; and A third distal toggle bevel gear driveable by the second distal toggle bevel gear, the third distal toggle bevel gear being configured to the bevel gear drives the second distal toggle bevel gear to rotate relative to an axis orthogonal to the first primary toggle axis when rotated relative to the first primary toggle axis; a second distal toggle gear stage having: A first distal toggle spur gear connected to the third distal toggle bevel gear, the first distal toggle spur gear being configured to the gear is driven to rotate about an axis of rotation that is the same as the axis of rotation of the third distal toggle bevel gear; and A second distal toggle spur gear drivable by the first distal toggle spur gear, the second distal toggle spur gear being configured to a spur gear rotates when driven by said first distal toggle spur gear relative to an axis of rotation parallel to said axis of rotation of said first distal toggle spur gear; a third distal toggle gear stage having: a fourth distal toggle bevel gear connected to the second distal toggle spur gear, the fourth distal toggle bevel gear being configured to be gear driven to rotate about the same axis of rotation as the axis of rotation of the second distal toggle spur gear; and a fifth distal toggle gear, the fifth distal toggle gear being drivable by the fourth distal toggle gear configured to be driven by the fourth distal toggle gear the toggle bevel gear rotates when driven relative to a second primary toggle axis, said second primary toggle axis being orthogonal to said first primary toggle axis; and a fourth distal toggle gear stage having a distal toggle planetary gear assembly having: a distal elbow sun gear configured to be driven by the fifth distal elbow bevel gear for rotation relative to the second primary elbow axis; a distal toggle ring gear configured not to rotate relative to the second primary toggle axis; a plurality of distal elbow planetary gears drivable by the distal elbow sun gear; and a distal toggle planetary carrier at one end such that when the distal toggle sun gear rotates relative to the second main toggle axis, the distal toggle planetary carrier is positioned relative to the The second main elbow axis is connected to the plurality of distal elbow planetary gears in such a way that the distal elbow planetary gear carrier is at the other end so that when the distal elbow sun gear is driven relative to the The distal elbow planetary gear carrier is connected to the proximal end of the forearm section in such a way that when the second main elbow axis rotates, the forearm section drives the forearm section to pivotally rotate relative to the second main elbow axis ; a proximal elbow joint subassembly that connects the distal end of the upper arm segment to the distal elbow joint subassembly, the proximal elbow joint subassembly being configurable such that all The forearm section is driven in such a manner that it pivotally rotates relative to the first main elbow axis. 2. The robotic arm assembly of claim 1, wherein the upper arm section further comprises: a second distal motor having a second distal motor drive portion at the distal end of the upper arm segment, the second distal motor drive portion being configured relative to a second axis rotation, the second axis is parallel to the first axis. 3. The robotic arm assembly of claim 2, wherein the proximal elbow joint subassembly comprises a gear train system having a plurality of gear stages, the plurality of gear stages comprising: a first proximal elbow stage, the first proximal elbow stage having: a first proximal toggle gear configured to be driven by the second distal motor drive portion of the second distal motor to rotate relative to the second axis; and A second proximal toggle bevel gear driveable by the first proximal toggle bevel gear configured to be driven by the first proximal toggle bevel gear the toggle bevel gear is driven to rotate relative to said first primary toggle axis; and a second proximal elbow stage having a proximal elbow planetary gear assembly having: a proximal elbow sun gear configured to be driven by the second proximal elbow bevel gear for rotation relative to the first primary elbow axis; a proximal toggle ring gear configured not to rotate relative to the first primary toggle axis; a plurality of proximal elbow planetary gears drivable by the proximal elbow sun gear; and a proximal elbow planetary carrier at one end such that when the proximal elbow sun gear rotates relative to the first primary toggle axis, the proximal elbow planetary carrier relative to the The first main elbow axis is rotationally connected to the plurality of proximal elbow planetary gears in such a manner that the proximal elbow planetary gear carrier is at the other end to when the proximal elbow sun gear is driven relative to the The proximal elbow planetary gear carrier is connected to the distal end of the upper arm section in such a way that when the first main elbow axis rotates, the forearm section is driven to pivotally rotate relative to the first main elbow axis . 4. The robotic arm assembly of claim 1, wherein the distal end of the forearm segment is fixable to an end effector assembly via a wrist joint. 5. The robotic arm assembly of claim 1, further comprising a shoulder segment having a proximal end and a distal end. 6. The robotic arm assembly of claim 5, further comprising: a shoulder coupling assembly connecting the proximal end of the upper arm segment to the distal end of the shoulder segment; Wherein the upper arm section further comprises one or more of the following: a first proximal motor having a first proximal motor drive portion at the proximal end of the upper arm segment, the first proximal motor drive portion being configured relative to a third axis rotate, said third axis is parallel to said first axis; and/or a second proximal motor having a second proximal motor drive portion at the proximal end of the upper arm segment, the second proximal motor drive portion being configured relative to a fourth axis rotation, the fourth axis is parallel to the first axis. 7. The robotic arm assembly of claim 6, wherein the shoulder coupling link assembly comprises: a distal shoulder linkage subassembly connected distally to the proximal end of the upper arm segment, the distal shoulder linkage subassembly comprising a gear train system having a plurality of gear stages, the The multiple gear stages described include: a first distal shoulder stage having: a first distal bevel gear configured to be driven by the first proximal motor drive portion of the first proximal motor to rotate relative to the third axis; and A second distal shoulder bevel gear driveable by the first distal shoulder bevel gear, the second distal shoulder bevel gear being configured to be the shoulder bevel gear is driven to rotate relative to a first main shoulder axis, said first main shoulder axis being normal to said third axis; and a second distal shoulder stage having a distal shoulder planetary gear assembly having: a distal shoulder sun gear configured to be driven by the second distal shoulder bevel gear for rotation relative to the first main shoulder axis; a distal shoulder ring gear configured not to rotate relative to the first primary shoulder axis; a plurality of distal shoulder planetary gears drivable by the distal shoulder sun gear; and a distal shoulder planet carrier at one end such that when the distal shoulder sun gear rotates relative to the first main shoulder axis, the distal shoulder planet carrier is positioned relative to the The first main shoulder axis is rotationally connected to the plurality of distal shoulder planetary gears in such a manner that the distal shoulder planetary gear carrier is at the other end to when the distal shoulder sun gear is driven relative to the The distal shoulder planetary gear carrier is connected to the proximal end of the upper arm section in such a way that upon rotation of the first main shoulder axis the upper arm section pivotally rotates relative to the first main shoulder axis ;as well as A proximal shoulder linkage subassembly connects the distal end of the shoulder segment to the distal shoulder linkage subassembly. 8. The robotic arm assembly of claim 6, wherein the shoulder coupling link assembly comprises: a distal shoulder linkage subassembly connected at a distal end to the proximal end of the upper arm segment, the distal shoulder linkage subassembly being configurable such that the upper arm segment is a main shoulder axis pivotally driven in such a manner that said first main shoulder axis is orthogonal to said fourth axis; a proximal shoulder coupling subassembly that connects the distal end of the shoulder segment to the distal shoulder coupling subassembly, the proximal shoulder coupling subassembly comprising a plurality of gear stages A gear train system, the plurality of gear stages comprising: a first proximal shoulder gear stage having: a first proximal bevel gear configured to be driven by the second proximal motor drive portion of the second proximal motor to rotate relative to the fourth axis; A second proximal bevel gear driveable by the first proximal bevel gear, the second proximal bevel gear being configured to the shoulder bevel gear is driven to rotate relative to said first primary shoulder axis; and A third proximal shoulder bevel gear driveable by the second proximal shoulder bevel gear, the third proximal shoulder bevel gear being configured to the bevel gear drives the second proximal shoulder bevel gear to rotate relative to an axis orthogonal to the first main shoulder axis when rotated relative to the first main shoulder axis; a second proximal shoulder gear stage having: A first proximal shoulder spur gear connected to the third proximal shoulder bevel gear, the first proximal shoulder bevel gear being configured to the gear is driven to rotate about the same axis of rotation as the axis of rotation of the third proximal shoulder bevel gear; and A second proximal shoulder spur gear drivable by the first proximal shoulder spur gear, the second proximal shoulder spur gear being configured to a spur gear rotates relative to an axis of rotation parallel to said axis of rotation of said first proximal shoulder spur gear when driven by said first proximal shoulder spur gear; a third proximal shoulder gear stage having: a fourth proximal shoulder bevel gear connected to the second proximal shoulder bevel gear, the fourth proximal shoulder bevel gear being configured to be gear driven to rotate about the same axis of rotation as the axis of rotation of the second proximal shoulder spur gear; and a fifth proximal shoulder bevel gear drivable by the fourth proximal shoulder bevel gear, the fifth proximal shoulder bevel gear configured to be the shoulder bevel gear rotates when driven relative to a second main shoulder axis, said second main shoulder axis being normal to said first main shoulder axis; and a fourth proximal shoulder gear stage having a proximal shoulder planetary gear assembly having: a proximal shoulder sun gear connected to the fifth proximal shoulder bevel gear, the proximal shoulder sun gear being configured to be driven by the fifth proximal shoulder bevel gear relative to the Rotation of the second main shoulder axis; a proximal shoulder ring gear configured not to rotate relative to the second primary shoulder axis; a plurality of proximal shoulder planet gears drivable by the proximal shoulder sun gear; and a proximal shoulder planetary carrier at one end such that when the proximal shoulder sun gear rotates relative to the second main shoulder axis, the proximal shoulder planetary carrier is positioned relative to the The second main shoulder axis is connected to the plurality of proximal shoulder planetary gears in such a way that the proximal shoulder planetary gear carrier is at the other end so that when the proximal shoulder sun gear is driven relative to the The proximal shoulder planetary gear carrier is connected to the distal end of the shoulder segment in such a way that upon rotation of the second main shoulder axis the upper arm segment pivotally rotates relative to the second main shoulder axis . 9. The robotic arm assembly of claim 1, wherein one or more of the following applies: The first distal toggle spur gear and the third distal toggle bevel gear are connected to each other in such a manner that a portion of the first distal toggle spur gear is fixed to a portion of the third distal toggle bevel gear direct connection; and/or The second distal toggle spur gear and the fourth distal toggle bevel gear are fixed in such a way that a portion of the second distal toggle spur gear is directly fixed to a portion of the fourth distal toggle bevel gear directly connected to each other; and/or said distal elbow sun gear and said fifth distal elbow bevel gear are directly connected to each other in such a manner that a portion of said distal elbow sun gear is fixed to a portion of said fifth distal elbow bevel gear; and /or The first distal toggle gear is controlled via one or more spur gears provided between the first distal toggle gear and the first distal motor drive portion of the first distal motor. The first distal motor drive portion of the first distal motor is driven to rotate relative to the first axis. 10. The robotic arm assembly of claim 1, wherein one or more of the following applies: The first distal toggle spur gear and the third distal toggle bevel gear are connected to each other via a first common elongated member connected at one end to the first distal toggle spur gear , and connected at the other end to the third distal toggle bevel gear, the first distal toggle spur gear, the third distal toggle bevel gear, and the first common elongated member have a common center of rotation axis; and/or The second distal toggle spur gear and the fourth distal toggle bevel gear are connected to each other via a second common elongated member connected at one end to the second distal toggle spur gear , and connected at the other end to the fourth distal toggle bevel gear, the second distal toggle spur gear, the fourth distal toggle bevel gear, and the second common elongated member have a common center of rotation axis; and/or The distal elbow sun gear and the fifth distal elbow bevel gear are connected to each other via a third common elongated member connected at one end to the distal elbow sun gear and at the other end Connected at one end to the fifth distal toggle bevel gear, the distal toggle sun gear, the fifth distal toggle bevel gear, and the third common elongated member have a common central axis of rotation. 11. A robotic arm assembly comprising: a forearm segment formed as an elongated structure having a proximal end and a distal end; an upper arm segment formed as an elongated structure having a proximal end and a distal end, the upper arm segment having: a first distal motor having a first distal motor drive portion at the distal end of the upper arm segment, the first distal motor drive portion being configured relative to a first axis rotate, the first axis being parallel to the central axis of the upper arm section; an elbow coupling assembly connecting the proximal end of the forearm segment to the distal end of the upper arm segment, the elbow coupling assembly having: a proximal elbow joint subassembly connected at a proximal end to the distal end of the upper arm segment, the proximal elbow joint subassembly comprising a gear train system having a plurality of gear stages, the The multiple gear stages described include: a first proximal toggle gear stage having: a first proximal toggle gear configured to be driven by the first distal motor drive portion of the first distal motor to rotate relative to the first axis; and A second proximal toggle bevel gear driveable by the first proximal toggle bevel gear configured to be driven by the first proximal toggle bevel gear the toggle bevel gear rotates when driven relative to a first primary toggle axis, said primary primary toggle axis being normal to said first axis; and a second proximal toggle gear stage having a proximal toggle planetary gear assembly having: a proximal elbow sun gear connected to the second proximal elbow bevel gear, the proximal elbow sun gear being configured to be driven by the second proximal elbow bevel gear relative to the The rotation of the first main elbow axis; a proximal toggle ring gear configured not to rotate relative to the first primary toggle axis; a plurality of proximal elbow planetary gears drivable by the proximal elbow sun gear; and a proximal elbow planetary carrier at one end such that when the proximal elbow sun gear rotates relative to the first primary toggle axis, the proximal elbow planetary carrier relative to the the first main toggle axis is rotationally connected to the plurality of proximal toggle planetary gears; and a distal elbow articulation subassembly connected at a distal end to the proximal end of the forearm segment, the distal elbow articulation subassembly being configurable such that the forearm segment is driven in such a manner that two main elbow axes are pivotally rotated, said second main elbow axis being orthogonal to said first main elbow axis; wherein the proximal elbow planetary gear carrier is connected at the other end to the distal end of the upper arm segment, and wherein when the proximal elbow sun gear is driven to rotate relative to the first primary elbow axis, the The proximal elbow planetary gear carrier drives the forearm segment to pivotally rotate relative to the first primary elbow axis. 12. The robotic arm assembly of claim 11, wherein the upper arm section further comprises: a second distal motor having a second distal motor drive portion at the distal end of the upper arm segment, the second distal motor drive portion being configured relative to a second axis rotation, the second axis is parallel to the first axis. 13. The robotic arm assembly of claim 12, wherein the distal elbow linkage subassembly comprises a gear train system having a plurality of gear stages, the plurality of gear stages comprising: a first distal toggle gear stage having: a first distal toggle gear configured to be driven by the second distal motor drive portion of the second distal motor to rotate relative to the second axis; A second distal toggle gear, said second distal toggle gear being drivable by said first distal toggle gear, said second distal toggle gear being configured to be the toggle bevel gear is driven to rotate relative to said first primary toggle axis; and A third distal toggle bevel gear driveable by the second distal toggle bevel gear, the third distal toggle bevel gear being configured to the bevel gear drives the second distal toggle bevel gear to rotate relative to an axis orthogonal to the first primary toggle axis when rotated relative to the first primary toggle axis; a second distal toggle gear stage having: A first distal toggle spur gear connected to the third distal toggle bevel gear, the first distal toggle spur gear being configured to the gear is driven to rotate about an axis of rotation that is the same as the axis of rotation of the third distal toggle bevel gear; and A second distal toggle spur gear drivable by the first distal toggle spur gear, the second distal toggle spur gear being configured to a spur gear rotates when driven by said first distal toggle spur gear relative to an axis of rotation parallel to said axis of rotation of said first distal toggle spur gear; a third distal toggle gear stage having: a fourth distal toggle bevel gear connected to the second distal toggle spur gear, the fourth distal toggle bevel gear being configured to be gear driven to rotate about the same axis of rotation as the axis of rotation of the second distal toggle spur gear; and a fifth distal toggle gear, the fifth distal toggle gear being drivable by the fourth distal toggle gear configured to be driven by the fourth distal toggle gear the toggle bevel gear is driven to rotate relative to said second primary toggle axis; and a fourth distal toggle gear stage having a distal toggle planetary gear assembly having: a distal elbow sun gear connected to the fifth distal elbow bevel gear, the distal elbow sun gear being configured to be driven by the fifth distal elbow bevel gear relative to the The rotation of the second main elbow axis; a distal toggle ring gear configured not to rotate relative to the second primary toggle axis; a plurality of distal elbow planetary gears drivable by the distal elbow sun gear; and a distal toggle planetary carrier at one end such that when the distal toggle sun gear rotates relative to the second main toggle axis, the distal toggle planetary carrier is positioned relative to the The second main elbow axis is connected to the plurality of distal elbow planetary gears in such a way that the distal elbow planetary gear carrier is at the other end so that when the distal elbow sun gear is driven relative to the The distal elbow planetary gear carrier is connected to the proximal end of the forearm section in such a way that when the second main elbow axis rotates, the forearm section drives the forearm section to pivotally rotate relative to the second main elbow axis . 14. The robotic arm assembly of claim 13, wherein one or more of the following applies: The first distal toggle spur gear and the third distal toggle bevel gear are connected to each other in such a manner that a portion of the first distal toggle spur gear is fixed to a portion of the third distal toggle bevel gear direct connection; and/or The second distal toggle spur gear and the fourth distal toggle bevel gear are fixed in such a way that a portion of the second distal toggle spur gear is directly fixed to a portion of the fourth distal toggle bevel gear directly connected to each other; and/or said distal elbow sun gear and said fifth distal elbow bevel gear are directly connected to each other in such a manner that a portion of said distal elbow sun gear is fixed to a portion of said fifth distal elbow bevel gear; and /or The first proximal toggle gear is controlled via one or more spur gears provided between the first proximal toggle gear and the first distal motor drive portion of the first distal motor. The first distal motor drive portion of the first distal motor is driven to rotate relative to the first axis. 15. The robotic arm assembly of claim 13, wherein one or more of the following applies: The first distal toggle spur gear and the third distal toggle bevel gear are connected to each other via a first common elongated member connected at one end to the first distal toggle spur gear , and connected at the other end to the third distal toggle bevel gear, the first distal toggle spur gear, the third distal toggle bevel gear, and the first common elongated member have a common center of rotation axis; and/or The second distal toggle spur gear and the fourth distal toggle bevel gear are connected to each other via a second common elongated member connected at one end to the second distal toggle spur gear , and connected at the other end to the fourth distal toggle bevel gear, the second distal toggle spur gear, the fourth distal toggle bevel gear, and the second common elongated member have a common center of rotation axis; and/or The distal elbow sun gear and the fifth distal elbow bevel gear are connected to each other via a third common elongated member connected at one end to the distal elbow sun gear and at the other end Connected at one end to the fifth distal toggle bevel gear, the distal toggle sun gear, the fifth distal toggle bevel gear, and the third common elongated member have a common central axis of rotation. 16. The robotic arm assembly of claim 11, wherein the distal end of the forearm segment is fixable to an end effector assembly via a wrist joint. 17. The robotic arm assembly of claim 11, further comprising a shoulder segment having a proximal end and a distal end. 18. The robotic arm assembly of claim 17, further comprising: a shoulder coupling assembly connecting the proximal end of the upper arm segment to the distal end of the shoulder segment; Wherein the upper arm section further comprises one or more of the following: a first proximal motor having a first proximal motor drive portion at the proximal end of the upper arm segment, the first proximal motor drive portion being configured relative to a third axis rotate, said third axis is parallel to said first axis; and/or a second proximal motor having a second proximal motor drive portion at the proximal end of the upper arm segment, the second proximal motor drive portion being configured relative to a fourth axis rotation, the fourth axis is parallel to the first axis. 19. The robotic arm assembly of claim 18, wherein the shoulder coupling link assembly comprises: a distal shoulder linkage subassembly connected distally to the proximal end of the upper arm segment, the distal shoulder linkage subassembly comprising a gear train system having a plurality of gear stages, the The multiple gear stages described include: a first distal shoulder stage having: a first distal bevel gear configured to be driven by the first proximal motor drive portion of the first proximal motor to rotate relative to the third axis; and A second distal shoulder bevel gear driveable by the first distal shoulder bevel gear, the second distal shoulder bevel gear being configured to be the shoulder bevel gear is driven to rotate relative to a first main shoulder axis, said first main shoulder axis being normal to said third axis; and a second distal shoulder stage having a distal shoulder planetary gear assembly having: a distal shoulder sun gear connected to the second distal shoulder bevel gear, the distal shoulder sun gear being configured to be driven by the second distal shoulder bevel gear relative to the Rotation of the first main shoulder axis; a distal shoulder ring gear configured not to rotate relative to the first primary shoulder axis; a plurality of distal shoulder planetary gears drivable by the distal shoulder sun gear; and a distal shoulder planet carrier at one end such that when the distal shoulder sun gear rotates relative to the first main shoulder axis, the distal shoulder planet carrier is positioned relative to the The first main shoulder axis is rotationally connected to the plurality of distal shoulder planetary gears in such a manner that the distal shoulder planetary gear carrier is at the other end to when the distal shoulder sun gear is driven relative to the The distal shoulder planetary gear carrier is connected to the proximal end of the upper arm section in such a way that upon rotation of the first main shoulder axis the upper arm section pivotally rotates relative to the first main shoulder axis ;as well as A proximal shoulder linkage subassembly connects the distal end of the shoulder segment to the distal shoulder linkage subassembly. 20. The robotic arm assembly of claim 18, wherein the shoulder coupling link assembly comprises: a distal shoulder linkage subassembly connected at a distal end to the proximal end of the upper arm segment, the distal shoulder linkage subassembly being configurable such that the upper arm segment is a main shoulder axis pivotally driven in such a manner that said first main shoulder axis is orthogonal to said fourth axis; a proximal shoulder coupling subassembly that connects the distal end of the shoulder segment to the distal shoulder coupling subassembly, the proximal shoulder coupling subassembly comprising a plurality of gear stages A gear train system, the plurality of gear stages comprising: a first proximal shoulder gear stage having: a first proximal bevel gear configured to be driven by the second proximal motor drive portion of the second proximal motor to rotate relative to the fourth axis; A second proximal bevel gear driveable by the first proximal bevel gear, the second proximal bevel gear being configured to the shoulder bevel gear is driven to rotate relative to said first primary shoulder axis; and A third proximal shoulder bevel gear driveable by the second proximal shoulder bevel gear, the third proximal shoulder bevel gear being configured to the bevel gear drives the second proximal shoulder bevel gear to rotate relative to an axis orthogonal to the first main shoulder axis when rotated relative to the first main shoulder axis; a second proximal shoulder gear stage having: A first proximal shoulder spur gear connected to the third proximal shoulder bevel gear, the first proximal shoulder bevel gear being configured to the gear is driven to rotate about the same axis of rotation as the axis of rotation of the third proximal shoulder bevel gear; and A second proximal shoulder spur gear drivable by the first proximal shoulder spur gear, the second proximal shoulder spur gear being configured to a spur gear rotates relative to an axis of rotation parallel to said axis of rotation of said first proximal shoulder spur gear when driven by said first proximal shoulder spur gear; a third proximal shoulder gear stage having: a fourth proximal shoulder bevel gear connected to the second proximal shoulder bevel gear, the fourth proximal shoulder bevel gear being configured to be gear driven to rotate about the same axis of rotation as the axis of rotation of the second proximal shoulder spur gear; and a fifth proximal shoulder bevel gear drivable by the fourth proximal shoulder bevel gear, the fifth proximal shoulder bevel gear configured to be the shoulder bevel gear rotates when driven relative to a second main shoulder axis, said second main shoulder axis being normal to said first main shoulder axis; and a fourth proximal shoulder gear stage having a proximal shoulder planetary gear assembly having: a proximal shoulder sun gear connected to the fifth proximal shoulder bevel gear, the proximal shoulder sun gear being configured to be driven by the fifth proximal shoulder bevel gear relative to the Rotation of the second main shoulder axis; a proximal shoulder ring gear configured not to rotate relative to the second primary shoulder axis; a plurality of proximal shoulder planet gears drivable by the proximal shoulder sun gear; and a proximal shoulder planetary carrier at one end such that when the proximal shoulder sun gear rotates relative to the second main shoulder axis, the proximal shoulder planetary carrier is positioned relative to the The second main shoulder axis is connected to the plurality of proximal shoulder planetary gears in such a way that the proximal shoulder planetary gear carrier is at the other end so that when the proximal shoulder sun gear is driven relative to the The proximal shoulder planetary gear carrier is connected to the distal end of the shoulder segment in such a way that upon rotation of the second main shoulder axis the upper arm segment pivotally rotates relative to the second main shoulder axis . 21. A robotic arm assembly comprising: a forearm segment formed as an elongated structure having a proximal end and a distal end; an upper arm segment formed as an elongated structure having a proximal end and a distal end, the upper arm segment having: A first distal motor having a first distal motor drive portion at the distal end of the upper arm section configured to rotate relative to a first axis rotation; and an elbow coupling joint assembly that connects the proximal end of the forearm segment to the distal end of the upper arm segment via a serial arrangement of a distal elbow joint and a proximal elbow joint, the distal an elbow joint forming a distal main elbow axis, said proximal elbow joint forming a proximal main elbow axis, said distal main elbow axis being orthogonal to said proximal main elbow axis, said elbow coupling joint assembly having: a distal elbow subassembly having: a first distal toggle gear configured to be driven by the first distal motor drive portion of the first distal motor; A first distal elbow integrated gear assembly having: a first integrated bevel gear portion configured to be driven by the first distal toggle bevel gear when the first distal toggle bevel gear is driven by the first distal motor drive portion of the first distal motor said first distal elbow bevel gear drive; and a first integrated spur gear portion configured to, when the first distal toggle bevel gear is driven by the first distal motor drive portion of the first distal motor, the first an integrated bevel gear portion and said first integrated spur gear portion are driven to rotate along the same axis of rotation and at the same rotational speed adjacent to said first integrated bevel gear portion; A second distal elbow integrated gear assembly having: a second integrated spur gear section configured to be driven by the first integrated spur gear section when the first integrated spur gear section is driven by the first distal toggle gear; and a second integrated bevel gear portion configured to, when the first distal toggle bevel gear is driven by the first distal motor drive portion of the first distal motor, the first adjoining said second integrated spur gear portion in such a manner that the two integrated spur gear portions and said second integrated bevel gear portion are driven to rotate along the same axis of rotation and at the same rotational speed; A second distal elbow bevel gear configured to be driven by the second integrated bevel gear portion of the second distal elbow integrated gear assembly relative to the distal main elbow axis rotation; a distal elbow planetary gear assembly having: a distal elbow sun gear configured to be driven by the second distal elbow bevel gear for rotation relative to the distal main elbow axis; a distal toggle ring gear configured not to rotate relative to the distal main toggle axis; a plurality of distal elbow planetary gears drivable by the distal elbow sun gear; and a distal elbow planetary carrier at one end such that when the distal elbow sun gear rotates relative to the distal main toggle axis, the distal elbow planetary carrier relative to the The distal main elbow axis is connected to the plurality of distal elbow planetary gears in such a way that the distal elbow planetary gear carrier is at the other end so that when the distal elbow sun gear is driven relative to the The distal elbow planetary gear carrier is connected to the proximal end of the forearm section in such a way that upon rotation of the distal main elbow axis, the forearm section drives the forearm section to pivotally rotate relative to the distal main elbow axis ; a proximal elbow joint subassembly that connects the distal end of the upper arm segment to the distal elbow joint subassembly, the proximal elbow joint subassembly being configurable such that all The forearm segment is driven in such a manner that it pivotally rotates relative to the proximal main elbow axis. 22. The robotic arm assembly of claim 21, wherein the upper arm section further comprises: A second distal motor having a second distal motor drive portion at the distal end of the upper arm section configured to rotate relative to a second axis of rotation, the second axis of rotation being parallel to the first axis of rotation. 23. The robotic arm assembly of claim 22, wherein the proximal elbow joint subassembly comprises: a first proximal elbow stage, the first proximal elbow stage having: a first proximal toggle gear configured to be driven by the second distal motor drive portion of the second distal motor to rotate relative to the second axis of rotation; as well as A second proximal toggle bevel gear driveable by the first proximal toggle bevel gear configured to be driven by the first proximal toggle bevel gear the elbow bevel gear rotates relative to the proximal main elbow axis when driven; and a second proximal elbow stage having a proximal elbow planetary gear assembly having: a proximal elbow sun gear connected to the second proximal elbow bevel gear, the proximal elbow sun gear being configured to be driven by the second proximal elbow bevel gear relative to the Rotation of the proximal main elbow axis; a proximal elbow ring gear configured not to rotate relative to the proximal main elbow axis; a plurality of proximal elbow planetary gears drivable by the proximal elbow sun gear; and a proximal elbow planetary carrier at one end such that when the proximal elbow sun rotates relative to the proximal main toggle axis, the proximal elbow planetary carrier The proximal main elbow axis is rotationally connected to the plurality of proximal elbow planetary gears in such a manner that the proximal elbow planetary gear carrier is at the other end to when the proximal elbow sun gear is driven relative to the The proximal elbow planetary gear carrier is connected to the distal end of the upper arm section in such a way that the forearm section pivotally rotates relative to the proximal main elbow axis when the proximal main elbow axis rotates . 24. The robotic arm assembly of claim 21, wherein the distal end of the forearm segment is fixable to an end effector assembly via a wrist joint. 25. The robotic arm assembly of claim 21, further comprising a shoulder segment having a proximal end and a distal end. 26. The robotic arm assembly of claim 25, further comprising: a shoulder coupling link assembly that connects the proximal end of the upper arm segment to the distal end of the shoulder segment via a serial arrangement of a distal shoulder joint and a proximal shoulder joint, the distal a shoulder joint forming a distal main shoulder axis, said proximal shoulder joint forming a proximal main shoulder axis, said distal main shoulder axis being orthogonal to said proximal main shoulder axis; Wherein the upper arm section further comprises one or more of the following: a first proximal motor having a first proximal motor drive portion at the proximal end of the upper arm segment, the first proximal motor drive portion being configured to rotate relative to a third axis of rotation, said third axis of rotation being parallel to said first axis of rotation; and/or A second proximal motor having a second proximal motor drive portion at the proximal end of the upper arm segment, the second proximal motor drive portion being configured to rotate relative to a fourth axis of rotation, the fourth axis of rotation is parallel to the first axis of rotation. 27. The robotic arm assembly of claim 26, wherein said shoulder coupling link assembly comprises: a distal shoulder linkage subassembly connected distally to the proximal end of the upper arm segment, the distal shoulder linkage subassembly comprising a gear train system having a plurality of gear stages, the The multiple gear stages described include: a first distal shoulder gear stage having: a first distal bevel gear configured to be driven by the first proximal motor drive portion of the first proximal motor to rotate relative to the third axis of rotation; as well as A second distal shoulder bevel gear driveable by the first distal shoulder bevel gear, the second distal shoulder bevel gear being configured to be the shoulder bevel gear rotates relative to the distal main shoulder axis when driven, the distal main shoulder axis being normal to the third axis; and a second distal shoulder gear stage having a distal shoulder planetary gear assembly having: a distal shoulder sun gear connected to the second distal shoulder bevel gear, the distal shoulder sun gear being configured to be driven by the second distal shoulder bevel gear relative to the Rotation of the distal main shoulder axis; a distal shoulder ring gear configured not to rotate relative to the distal main shoulder axis; a plurality of distal shoulder planetary gears drivable by the distal shoulder sun gear; and a distal shoulder planetary carrier at one end such that when the distal shoulder sun gear rotates relative to the distal main shoulder axis, the distal shoulder planetary carrier is positioned relative to the The distal main shoulder axis is rotationally connected to the plurality of distal shoulder planetary gears, wherein the distal shoulder planetary gear carrier is at the other end to when the distal shoulder sun gear is driven relative to the The distal shoulder planetary gear carrier is connected to the proximal end of the upper arm section in such a way that upon rotation of the distal main shoulder axis the upper arm section pivotally rotates relative to the distal main shoulder axis ;as well as A proximal shoulder linkage subassembly connects the distal end of the shoulder segment to the distal shoulder linkage subassembly. 28. The robotic arm assembly of claim 26, wherein said shoulder coupling link assembly comprises: a distal shoulder linkage subassembly connected at a distal end to the proximal end of the upper arm segment, the distal shoulder linkage subassembly being configurable such that the upper arm segment is said distal main shoulder axis is driven in such a way that said distal main shoulder axis is pivotally rotated, said distal main shoulder axis being orthogonal to said fourth axis; a proximal shoulder coupling subassembly that connects the distal end of the shoulder segment to the distal shoulder coupling subassembly, the proximal shoulder coupling subassembly comprising a plurality of gear stages A gear train system, the plurality of gear stages comprising: a first proximal shoulder bevel gear configured to be driven by the second proximal motor drive portion of the second proximal motor; a first proximal shoulder integrated gear assembly having: A third integrated bevel gear portion configured to be driven by the second proximal motor drive portion of the second proximal motor when the first proximal shoulder bevel gear is driven by the third integrated bevel gear portion. said first proximal shoulder bevel gear drive; and a third integrated spur gear portion configured to, when the first proximal shoulder bevel gear is driven by the second proximal motor drive portion of the second proximal motor, the first proximal bevel gear three integrated bevel gear sections and said third integrated spur gear section are driven to rotate along the same axis of rotation and at the same rotational speed adjacent to said third integrated bevel gear section; a second proximal shoulder integrated gear assembly having: a fourth integrated spur gear section configured to be driven by the third integrated spur gear section when the third integrated spur gear section is driven by the first proximal shoulder bevel gear; and a fourth integrated bevel gear portion configured to, when the first proximal shoulder bevel gear is driven by the second proximal motor drive portion of the second proximal motor, the first four integrated spur gear sections and said fourth integrated bevel gear section are driven to rotate along the same axis of rotation and at the same rotational speed adjoining said fourth integrated spur gear section; a second proximal shoulder bevel gear configured to be driven by the fourth integrated bevel gear portion of the second proximal shoulder integrated gear assembly relative to the proximal main shoulder axis rotation; a proximal shoulder planetary gear assembly having: a proximal shoulder sun gear configured to be driven by the second proximal shoulder bevel gear for rotation relative to the primary proximal shoulder axis; a proximal shoulder ring gear configured not to rotate relative to the proximal primary shoulder axis; a plurality of proximal shoulder planet gears drivable by the proximal shoulder sun gear; and a proximal shoulder planetary carrier at one end such that when the proximal shoulder sun gear rotates relative to the proximal main shoulder axis, the proximal shoulder planetary carrier relative to the The proximal main shoulder axis is rotationally connected to the plurality of proximal shoulder planetary gears, wherein the proximal shoulder planetary gear carrier is at the other end to when the proximal shoulder sun gear is driven relative to the The proximal shoulder planetary gear carrier is connected to the proximal end of the forearm segment in such a way that upon rotation of the proximal main shoulder axis the upper arm segment pivotally rotates relative to the proximal main shoulder axis .