Dynamically matching input and output shaft speeds of articulating adapter assemblies for surgical instruments

Abstract

A surgical system includes a power source, a handle housing, a motor, an adapter assembly, an end effector, and a correction unit. The motor is disposed within the handle housing and is in electrical communication with the power source. The adapter assembly is operably coupled to the handle housing and supports an input and an output shaft coupled by the universal joint. The input shaft is in mechanical communication with the motor. The end effector is coupled to the adapter assembly and is selectively articulatable relative to the adapter assembly. The correction unit is in electrical communication with the power source and the motor and is configured to adjust the input shaft speed of the input shaft to maintain a substantially constant output shaft speed of the output shaft as the end effector articulates relative to the adapter assembly.

Claims

1. A method of operating a surgical system, the method comprising: articulating an end effector relative to an adapter assembly via a universal joint rotatably disposed between the end effector and the adapter assembly; measuring an articulation angle of the universal joint; identifying a motor speed profile having a mathematical curve based on a trigonometric function stored within a memory associated with a correction unit corresponding to the measured articulation angle of the universal joint; and manipulating an output speed of a motor operably coupled to the universal joint, according to the motor speed profile, to generate a substantially constant output speed from the universal joint.

2. The method according to claim 1, further including measuring a rotational position of the universal joint.

3. The method according to claim 2, wherein identifying the motor speed profile includes identifying the motor speed profile within the memory associated with the correction unit corresponding to the measured articulation angle and measured rotational position of the universal joint.

4. The method according to claim 2, wherein measuring the rotational position of the universal joint includes measuring the rotational position of the universal joint using a rotation sensor operably coupled to the universal joint.

5. The method according to claim 4, wherein measuring the rotational position of the universal joint includes measuring the rotational position of the universal joint using a rotary encoder operably coupled to the universal joint.

6. The method according to claim 2, wherein manipulating an output speed of the motor includes identifying a location within the identified motor speed profile based on the measured rotational position of the universal joint.

7. The method according to claim 6, wherein manipulating an output speed of the motor includes starting the motor at a speed associated with the identified location within the identified motor speed profile.

8. The method according to claim 1, further including firing a plurality of fasteners from the end effector.

9. The method according to claim 8, wherein firing a plurality of fasteners includes firing a plurality of surgical staples from a cartridge assembly disposed in the end effector.

10. The method according to claim 1, wherein measuring the articulation angle of the universal joint includes measuring the articulation angle of the universal joint using an articulation sensor operably coupled to the universal joint.

11. The method according to claim 10, wherein measuring the articulation angle of the universal joint includes measuring the articulation angle of the universal joint using an encoder.

12. The method according to claim 1, wherein identifying a motor speed profile includes identifying a motor speed profile from a plurality of motor speed profiles stored within the memory associated with the correction unit.

13. A method of operating a surgical system, the method comprising: articulating an end effector relative to an adapter assembly via a universal joint rotatably disposed between the end effector and the adapter assembly; measuring an articulation angle of the universal joint; identifying a sinusoidal motor speed profile stored within a memory associated with a correction unit corresponding to the measured articulation angle of the universal joint; and manipulating an output speed of a motor operably coupled to the universal joint, according to the sinusoidal motor speed profile, to generate a substantially constant output speed from the universal joint.

14. The method according to claim 13, further including selectively measuring a rotational position of the universal joint.

15. The method according to claim 14, wherein identifying the sinusoidal motor speed profile includes identifying the sinusoidal motor speed profile within a memory associated with the correction unit corresponding to the measured articulation angle and measured rotational position of the universal joint.

16. The method according to claim 14, wherein measuring the rotational position of the universal joint includes measuring the rotational position of the universal joint using a rotation sensor operably coupled to the universal joint.

17. The method according to claim 13, further including firing a plurality of fasteners from the end effector.

18. The method according to claim 17, wherein firing a plurality of fasteners includes firing a plurality of surgical staples from a cartridge assembly disposed in the end effector.

19. The method according to claim 13, wherein measuring the articulation angle of the universal joint includes measuring the articulation angle of the universal joint using an articulation sensor operably coupled to the universal joint.

20. The method according to claim 13, wherein identifying a motor speed profile includes identifying a motor speed profile from a plurality of motor speed profiles stored within the memory associated with the correction unit.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the disclosure and, together with a general description of the disclosure given above, and the detailed description of the embodiment(s) given below, serve to explain the principles of the disclosure, wherein:

(2) FIG. 1A is a perspective view of an electromechanical surgical system in accordance with the principles of the present disclosure, the electromechanical surgical system having an end effector shown in an unarticulated and clamped position;

(3) FIG. 1B is an enlarged, perspective view of the indicated area of detail shown in FIG. 1A;

(4) FIG. 2 is an enlarged, front, perspective view of a portion of the electromechanical surgical system of FIG. 1A, the end effector thereof shown in an articulated condition;

(5) FIG. 3 is a perspective view of an adapter assembly of the electromechanical surgical system of FIG. 1A;

(6) FIG. 4 is a bottom, cross-sectional view of the adapter assembly of FIG. 3, as taken along section line 4-4 of FIG. 3, illustrating an articulation assembly thereof in a first condition;

(7) FIG. 5 is a side, cross-sectional view of the adapter assembly of FIG. 3, as taken along section line 5-5 of FIG. 3;

(8) FIG. 6 is an enlarged, side, cross-sectional view of the indicated area of detail shown in FIG. 5;

(9) FIG. 7 is an enlarged, perspective view, with parts separated, of an end effector of the electromechanical surgical system of FIG. 1A;

(10) FIG. 8 is a graph of an output speed of a universal joint of the electromechanical surgical system of FIG. 1A relative to a rotational angle of the universal joint;

(11) FIG. 9 is a block diagram of a correction unit of the electromechanical surgical system of FIG. 1A;

(12) FIG. 10 is a flow chart of a method of using the electromechanical surgical system of FIG. 1A; and

(13) FIG. 11 is a schematic illustration of a medical work station and operating console in accordance with the present disclosure.

DETAILED DESCRIPTION

(14) The electromechanical surgical systems of the present disclosure include surgical devices in the form of powered handheld electromechanical instruments configured for selective attachment to different adapter assemblies having an end effector. The end effectors are each configured for actuation and manipulation by the powered handheld electromechanical surgical instrument. In particular, the adapter assemblies are configured to convert rotational motion outputted by the powered handheld electromechanical surgical instrument into linear motion to fire surgical staples, clips, or the like. One or more couplings are utilized to enable articulation of the end effector relative to the adapter while simultaneously transmitting rotational motion. As can be appreciated, couplings, such as a universal joint, introduce variations in the rotational velocity of the output of the coupling relative to the input to the coupling. These variations increase in severity with a corresponding increase in articulation angle.

(15) To combat this issue, a second coupling is typically introduced in series with the first coupling to effectively cancel out the variations in rotational velocity outputted by the coupling. However, additional couplings require additional space and introduce additional complexity to the system. The electromechanical surgical systems of the present disclosure utilize a single universal joint to transmit the rotational motion over the articulation joint. To account for variations in rotational velocity across the universal joint, a correction unit adjusts the output speed of a motor disposed within the powered handheld electromechanical instrument based on the articulation angle of the end effector and the rotational position of the universal joint. In this manner, the output speed of the motor is adjusted to increase or decrease in speed for eliminating the sinusoidal velocity profile at the output of the universal joint.

(16) Embodiments of the presently disclosed electromechanical surgical systems, surgical devices/handle assemblies, adapter assemblies, and/or end effectors/loading units are described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein, the term “distal” refers to that portion of structure farther from the user, while the term “proximal” refers to that portion of the structure closer to the user. As used herein, the term “clinician” refers to a doctor, nurse, or other care provider and may include support personnel. In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail.

(17) With reference to FIGS. 1A-2, an electromechanical surgical system is provided in accordance with the present disclosure and generally identified by reference numeral 10. The electromechanical surgical system 10 includes a surgical device 100, an adapter assembly 200, and a surgical loading unit (e.g., multiple or single-use loading unit) or end effector 300. The surgical device 100 is configured for selective connection with the adapter assembly 200 and, in turn, the adapter assembly 200 is configured for selective connection with the end effector 300. In embodiments, the surgical device 100 and the adapter assembly 200 may cooperate to actuate the end effector 300.

(18) The surgical device 100 of the electromechanical surgical system 10 includes a handle housing 102 having a circuit board (not shown) and one or more motors 112 situated therein. The circuit board is configured to control the various operations of the surgical device 100. The handle housing 102 defines a cavity therein (not shown) configured to removably receive a power source such as a rechargeable battery 110 therein. The battery 110 is configured to supply power to any of the electrical components of the surgical device 100. In some embodiments, the surgical device 100 may couple to an external power source such as an AC outlet or generator. For an example of a generator, reference can be made to U.S. Pat. No. 8,784,410 to Dunning, the entire disclosure of which is incorporated by reference herein.

(19) The handle housing 102 of the surgical device 100 provides a housing in which the one or more motors 112 are situated. Each motor 112 is configured to drive one or more shafts and/or gear components in order to perform the various operations of the surgical device 100. In particular, the one or more motors 112 of the surgical device 100 are configured: to drive the various shafts and/or gear components in order to selectively articulate the end effector 300 of the electromechanical surgical system 10 about a longitudinal axis “X” and relative to a distal end portion of the adapter assembly 200 of the electromechanical surgical system 10; to selectively rotate the end effector 300 about the longitudinal axis “X” and relative to the handle housing 102 of the surgical device 100; to selectively move, approximate, or separate an anvil assembly 310 and a cartridge assembly 320 of the end effector 300 relative to one another; and/or to fire a stapling and cutting cartridge (not shown) disposed within the cartridge assembly 320 of the end effector 300.

(20) As best illustrated in FIG. 1A, the handle housing 102 of the surgical device 100 defines a connection portion 104 configured to accept a proximal portion of the adapter assembly 200 of the electromechanical surgical system 10. The connection portion 104 of the surgical device 100 houses a trigger contact surface 105 that is in electrical communication with the circuit board and a plurality of rotatable drive shafts or connectors 106 of the surgical device 100. Each rotatable drive shaft of the plurality of rotatable drive shafts 106 can be independently and/or dependently actuatable and rotatable by the one or more motors 112 housed within the housing handle 102 of the surgical device 100. In embodiments, the plurality of rotatable drive shafts 106 includes rotatable drive shafts 106a, 106b, 106c, 106d, and 106e. Although generally illustrated as arranged in a common plane or in line with one another, it is contemplated that the plurality of rotatable drive shafts 106 may be arranged in any suitable configuration such as a quadrant or matrix, for example. The one or more motors 112 of the surgical device 100 may be configured to selectively drive one drive shaft of the plurality of drive shafts 106 at any given time.

(21) With continued reference to FIG. 1A, the handle housing 102 of the surgical device 100 supports a plurality of finger-actuated control buttons, rocker devices, and the like for activating various functions of the surgical device 100. For example, the handle housing 102 supports a plurality of actuators including, for example, an articulating pad such as articulating pad 108, to effectuate articulation of the end effector 300. The articulating pad 108 of the handle housing 102 is configured to contact a plurality of sensors 108a that cooperate with the articulating pad 108 to enable omni-directional articulation of the end effector 300 relative to the adapter assembly 200 of the electromechanical surgical system 10. In embodiments, one or more of the plurality of sensors 108a of the surgical device 100 may correspond to different yaw and/or pitch angles relative to the longitudinal axis “X,” to which the end effector 300 may be moved upon activation of one or more of the plurality of sensors 108a.

(22) For a detailed description of various internal components of and operation of exemplary electromechanical surgical systems, the components of which are combinable and/or interchangeable with one or more components of the electromechanical surgical systems 10 described herein, reference may be made to World Intellectual Property Publication No. WO 2009/039506, filed Sep. 22, 2008, and U.S Patent Application Publication No. 2011/0121049, filed on Nov. 20, 2009, the entire disclosures of each of which are hereby incorporated by reference.

(23) Turning now to FIGS. 3 and 4, the adapter assembly 200 of the electromechanical surgical system 10 includes a housing 202 at a proximal end portion thereof and an outer tube 204 that extends distally from the housing 202 to a distal end portion 204a thereof. The housing 202 of the adapter assembly 200 includes a proximal housing 202a that is configured for selective engagement with a distal end portion of the handle housing 102. The housing 202 includes an articulation assembly 230 and a firing assembly 270 that are individually actuatable using the articulating pad 108 (FIG. 1A). A proximal portion of each of the articulation assembly 230 and the firing assembly 270 of the housing 202 are selectively engageable with a distal portion of a corresponding rotatable drive shaft 106 of the handle housing 102 when the adapter assembly 200 of the electromechanical surgical system 10 is coupled to the handle housing 102 of the surgical device 100 of the electromechanical surgical system 10. The articulation assembly 230 of the housing 202 is configured to effectuate articulation of the end effector 300 relative to the adapter assembly 200. The firing assembly 270 is configured to fire the stapling and cutting cartridge disposed within the cartridge assembly 320 of the end effector 300 (FIG. 1B). For a detailed description of an exemplary articulation assembly capable of use with the electromechanical surgical systems 10 described herein, reference may be made to U.S. Patent Application Publication No. 2015/0297199, filed on Apr. 21, 2014, the entire disclosure of which is incorporated by reference herein.

(24) With reference to FIGS. 1A and 4-6, the firing assembly 270 of the electromechanical surgical system 10 is rotatably supported within the housing 202 and outer tube 204 of the adapter assembly 200. The firing assembly 270 includes an input socket 272 adapted to couple to a rotatable drive shaft 106 (FIG. 1A) of the housing handle 102, a proximal firing shaft 274 that extends distally from the input socket 272, a distal firing shaft 276 that extends distally from the proximal firing shaft 274, and a pin 278 that secures the proximal and distal firing shafts 274, 276 to one another. The proximal firing shaft 274, the distal firing shaft 276, and the pin 278 cooperate to define a universal joint 280 capable of transmitting rotational force from the corresponding rotatable drive shaft 106 of the surgical device 100 to the end effector 300 regardless of the articulation angle “a” of the end effector 300 with respect to the adapter assembly 200 (FIG. 2). For a detailed description of an exemplary firing assembly 270 capable of use with the electromechanical surgical system 10 described herein, reference may be made to U.S. Patent Application Publication No. 2015/0297199, previously incorporated by reference hereinabove.

(25) In general, during normal operation of a standard universal joint, the rotational output speed of an output shaft of a universal joint is approximately equal to the rotational input speed of an input shaft of the universal joint when the universal joint is in an unarticulated orientation as the universal joint is rotated about a longitudinal axis thereof. As the output shaft of the universal joint is articulated relative to the input shaft of the universal joint, the output shaft speed of the universal joint becomes mismatched with the input shaft speed of the universal joint.

(26) As best illustrated in FIG. 8, the output shaft speed of the universal joint while the universal joint is in an articulated position follows a sinusoidal profile (e.g., the output shaft speed increases and decreases relative to the input shaft speed over an angle of rotation of the universal joint) that increases in amplitude as the articulation angle of the output shaft of the universal joint is increased with respect to the input shaft of the universal joint. For example, when the output shaft of the universal joint is positioned at a first articulation angle “α.sub.1” of 15 degrees, a first curve 290 is defined through a single revolution (360 degrees) of the input shaft that minimally affects the output shaft speed of the universal joint. As the articulation angle “a” is increased, the amplitude of the sinusoidal profile correspondingly increases. Specifically, with reference to a second curve 292 corresponding to a second articulation angle “α.sub.2” of 30 degrees, a third curve 294 corresponding to a third articulation angle “α.sub.3” of 45 degrees, and a fourth curve 296 corresponding to a fourth articulation angle “α.sub.4” of 60 degrees, the output shaft speed of the universal joint increases or decreases at a corresponding increase in amplitude with respect to the input shaft speed of the universal joint (e.g., the output speed varies a greater amount as the articulation angle “α” increases). As can be appreciated, the first through fourth curves 290, 292, 294, 294 are illustrative of the effect of articulation angle on the output shaft speed of the universal joint. In particular, a curve is developed for each possible articulation angle “α” in which the universal joint is capable of being positioned. These curves may be generated by experimentation or may be generated using mathematical relationships such as interpolation, extrapolation or the like.

(27) Turning to FIGS. 1B and 7, the end effector 300 of the electromechanical surgical system 10 includes an anvil 310 and a cartridge assembly 320 that are movable between a first, open position, and a second, approximated or closed position. The anvil 310 and the cartridge assembly 320 of the end effector 300 cooperate to apply a plurality of linear rows of fasteners “F” (e.g., staples) to tissue. The cartridge assembly 320 is in mechanical communication with the distal firing shaft 276 (FIG. 6) of the firing assembly 270 such that actuation of the firing assembly 270 effectuates firing of the fasteners “F” from the cartridge assembly 320. For a detailed description of an exemplary end effector 300 capable of use with the electromechanical surgical systems 10 described herein, reference may be made to U.S. Patent Application Publication No. 2015/0297199, previously incorporated by reference hereinabove.

(28) To prevent the non-uniform rotational output shaft speed of the universal joint 280, the electromechanical surgical system 10 includes a correction unit 400 (FIG. 9). Although generally illustrated as being disposed within a portion of the handle assembly 102 (FIG. 1A) of the surgical device 100, the correction unit 400 may be partially or wholly disposed in the adapter assembly 200. The correction unit 400 may be in electrical communication with the circuit board (not shown) via the trigger contact surface 105 (FIG. 1A) or any other suitable mechanical or electrical structure for transmitting electrical signals. The correction unit 400 may be integrated within the circuit board or in embodiments, may be an integrated circuit.

(29) The correction unit 400 of the electromechanical surgical system 10 includes a memory 402, a processor 404 associated with the memory 402, a counter 406 in electrical communication with the processor 404, and a measuring unit 408 for measuring articulation angle “α” of the end effector 300 relative to the adapter assembly 200. The memory 402 of the correction unit 400 may include any non-transitory computer-readable storage media for storing data and/or software that is executable by the processor 404 of the correction unit 400 (e.g., solid-state, volatile, non-volatile, removable, and/or non-removable). The memory 402 includes information stored therein that, when executed by the processor 404, causes the one or more motors 112 of the surgical device 100 to adjust its output speed.

(30) An articulation angle “α” of the end effector 300 of the electromechanical surgical system 10 relative to the adapter 200 of the electromechanical surgical system 10 may be measured using an articulation sensor 298 (FIG. 4), which may be any suitable device capable of measuring an angle of one component relative to another, such as an accelerometer, counter mechanism coupled to the articulation assembly 230 of the adapter 200 (e.g., rotary encoder, optical encoder, magnetic encoder, linear encoder, hall effect sensor, linear variable differential transformer (LVDT), inertial measurement unit (IMU), micromechanical system (MEMS), gyroscope, etc., or combinations thereof). The articulation sensor 298 may be supported, for example, within the housing 202 or outer tube 204 of the adapter assembly 200.

(31) The correction unit 400 of the electromechanical surgical system 10 may be further configured to identify the rotational position of the universal joint 280 of the adapter assembly 200. The rotational position of the universal joint 280 dictates the difference between the output shaft speed and the input shaft speed of the universal joint 280 (see FIG. 8). For instance, if the articulation angle “α” of the output shaft of the universal joint 280 is 60 degrees, e.g., the fourth curve 296 and articulation angle “α.sub.4,” at a first position, the output shaft speed is 0.5 of the input shaft speed. As the universal joint 280 rotates, the difference in shaft speed increases until the output shaft speed difference reaches a peak of 2 times the input shaft speed at 90 degrees. The output shaft speed follows this sinusoidal profile throughout the 360 degree revolution of the universal joint 280. Accordingly, in order to compensate for the difference in output shaft speed of the universal joint 280, the rotational position of the universal joint 280 must be known. In this manner, the rotational position of the universal joint 280 may be measured using any suitable device capable of measuring rotational position, such as a counter, encoder, gyroscope, etc., or combinations thereof. In one non-limiting embodiment, the rotational position of the universal joint 280 may be measured using a rotary encoder 410 (FIG. 4) operably coupled to the firing shaft 274 of the firing assembly 270. In some embodiments, the rotary encoder 410 may be coupled to the motor 112 of the surgical device 100 or any other rotating component associated with the firing assembly 270 of the adapter assembly 200.

(32) In order to ensure that the output shaft speed of the universal joint 280 of the adapter assembly 200 is maintained at a constant or substantially constant speed, data pertaining to the relationship between the output speed of the motor 112 of the surgical device 100 and the output shaft speed of the universal joint 280 is stored in the memory 402 of the correction unit 400. The output speed of the motor 112 is manipulated through each complete rotation thereof, the amount of which is dependent upon the articulation angle “α” of the output shaft of the universal joint 280. In embodiments, a constant output speed may have a tolerance of +/−2% as compared to the input speed and a substantially constant output speed may have a tolerance of +/−5% as compared to the input speed.

(33) A unique motor speed profile 412 may be generated and stored in the memory 402 of the correction unit 400. The motor speed profile 412 can correspond to a known sinusoidal profile of the output shaft speed of the universal joint 280 at a specific articulation angle “α.” The motor speed profile 412 can function to increase or decrease the output speed of the motor 112 in order to compensate for the natural increase or decrease in output shaft speed of the universal joint 280 as it completes each revolution. The motor speed profile 412 may vary the voltage applied to the motor 112 to increase or decrease the motor 112 speed using any suitable electrical structure, such as a potentiometer, pulse width modulation, etc., or combinations thereof. The processor 404 of the correction unit 400 is configured to receive a signal (e.g., electrical) or data indicative of the articulation angle “α” of the output shaft of the universal joint 280 and is configured to associate the articulation angle “α” data with a particular motor speed profile 412. In embodiments, the motor speed profile 412 may be stored in a look-up table or other reference source for quickly correlating the articulation angle “α” data with a corresponding motor speed profile 412 (and its data or information). In embodiments, the correction unit 400 may continuously and/or dynamically change the motor speed profile 412 in response to changes in the articulation angle “α” of the end effector 300 during firing of the fasteners “F” of the end effector 300.

(34) With reference to FIG. 10, in use, after the clinician has clamped target tissue, in step S502, the articulation angle “α” of the universal joint 280 is measured using the articulation sensor 298 of the adapter assembly 200. The articulation angle “α” of the universal joint 280 may be continuously monitored by the articulation sensor 298. In step S504, the correction unit 400 is configured to identify a motor speed profile 412 corresponding to the measured articulation angle “α.” Once the motor speed profile 412 is identified, the rotational position of the universal joint 280 can be measured using the rotary encoder 410 or the like in step S506. In step S508, the rotational position of the universal joint 280 is configured to enable the correction unit 400 to identify a position on the motor speed profile 412 at which to start the motor 112. The output shaft speed of the universal joint 280 is configured to remain constant or substantially constant if the motor 112 is started at the correct location on the motor speed profile 412. In step S510, voltage may be applied to the motor 112 so that the speed of the motor 112 can be varied according to the selected motor speed profile 412. The voltage may be applied to the motor 112 until all of the fasteners “F” within the cartridge assembly 320 are formed, at which point, the motor 112 may be reversed and positioned in a home position in step S512. This method may be repeated as many times as the clinician desires or can depend upon the particular needs of the procedure being performed.

(35) Although described in connection with a stapling device, the presently disclosed electromechanical surgical devices can be any suitable electromechanical instrument such as forceps, tack applier, clip applier, etc.

(36) The various embodiments disclosed herein may also be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery.” Such systems employ various robotic elements to assist the clinician and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the clinician during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.

(37) The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of clinicians may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another clinician (or group of clinicians) remotely control the instruments via the robotic surgical system. As can be appreciated, a highly skilled clinician may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.

(38) The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the clinician to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc.) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the clinician. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s).

(39) The master handles may include various sensors to provide feedback to the clinician relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the clinician with enhanced tactile feedback simulating actual operating conditions. The master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the clinician's ability to mimic actual operating conditions.

(40) Referring also to FIG. 11, a medical work station is shown generally as work station 1000 and generally may include a plurality of robot arms 1002, 1003; a control device 1004; and an operating console 1005 coupled with the control device 1004. The operating console 1005 may include a display device 1006, which may be set up in particular to display three-dimensional images; and manual input devices 1007, 1008, by means of which a person (not shown), for example a clinician, may be able to telemanipulate the robot arms 1002, 1003 in a first operating mode.

(41) Each of the robot arms 1002, 1003 may include a plurality of members, which are connected through joints, and an attaching device 1009, 1011, to which may be attached, for example, a surgical tool “ST” supporting an end effector 1100 (e.g., a pair of jaw members).

(42) The robot arms 1002, 1003 may be driven by electric drives (not shown) that are connected to the control device 1004. The control device 1004 (e.g., a computer) may be set up to activate the drives, in particular by means of a computer program, in such a way that the robot arms 1002, 1003, their attaching devices 1009, 1011 and thus the surgical tool (including the end effector 1100) execute a desired movement according to a movement defined by means of the manual input devices 1007, 1008. The control device 1004 may also be set up in such a way that it regulates the movement of the robot arms 1002, 1003 and/or of the drives. The correction unit 400 may be in electrical communication with the control device 1004 and, in embodiments, may be integrated therein.

(43) The medical work station 1000 may be configured for use on a patient “P” lying on a patient table 1012 to be treated in a minimally invasive manner by means of the end effector 1100. The medical work station 1000 may also include more than two robot arms 1002, 1003, the additional robot arms likewise connected to the control device 1004 and telemanipulatable by means of the operating console 1005. A surgical system, such as the presently disclosed surgical system, may also be attached to the additional robot arm. The medical work station 1000 may include a database 1014 coupled with the control device 1004. In some embodiments, pre-operative data from patient/living being “P” and/or anatomical atlases may be stored in the database 1014. For a more detailed description of exemplary medical work stations and/or components thereof, reference may be made to U.S. Patent Application Publication No. 2012/0116416, filed on Nov. 3, 2011, entitled “Medical Workstation” and PCT Application Publication No. WO2016/025132, filed on Jul. 21, 2015, entitled “Robotically Controlling Mechanical Advantage Gripping, the entire contents of each of which are incorporated by reference herein.

(44) Persons skilled in the art will understand that the structures and methods specifically described herein and shown in the accompanying figures are non-limiting exemplary embodiments, and that the description, disclosure, and figures should be construed merely as exemplary of particular embodiments. It is to be understood, therefore, that the present disclosure is not limited to the precise embodiments described, and that various other changes and modifications may be effected by one skilled in the art without departing from the scope or spirit of the disclosure. Additionally, the elements and features shown or described in connection with certain embodiments may be combined with the elements and features of certain other embodiments without departing from the scope of the present disclosure, and that such modifications and variations are also included within the scope of the present disclosure. Accordingly, the subject matter of the present disclosure is not limited by what has been particularly shown and described.