Abstract: Described herein are systems and methods for providing personalized oral care. A system for oral care comprises an oral insert. The oral insert is sized and shaped according to a user's oral cavity, and has a plurality of fluid nozzles and an effluence conduit to channel fluid out of the user's oral cavity. Pressurized fluid provided through the nozzles are directed to, for example, the interproximal spaces between the user's teeth. In some variations, a system comprises an oral insert and an elastomeric substrate that is attached to the oral insert. In some variations, the elastomeric substrate comprises a textured surface vibrates and/or mechanically agitates and/or translates along the surface of the user's teeth. In some variations, a system for oral care comprises a microbiome collection chamber. Some variations comprise dental shim devices that are used for acquiring oral structure data and alignment between the upper and lower arches.

Abstract: A sterile adapter for coupling a surgical instrument and a surgical instrument manipulator includes a bottom component and a coupling component. The bottom component includes a bottom component opening with a bottom lip having a locking mechanism. The coupling component is rotatably coupled to the bottom component. The coupling component includes an engagement feature that engages the surgical instrument manipulator. The coupling component further includes a locking mechanism opening that engages the locking mechanism when the engagement feature has not engaged the surgical instrument manipulator. The coupling component may include a retention tab that is aligned with the keyway to insert the coupling component into the bottom component opening and then misaligned with the keyway to retain the coupling component in the bottom component opening. A ramp may be provided on a leading edge of a pocket to facilitate engaging the coupling component with the surgical instrument manipulator.

Abstract: An instrument carriage provides control of a surgical instrument coupled to the instrument carriage. The instrument carriage includes a control surface that is coupled to the surgical instrument to provide the control. A detection pin having a first distal end that extends from the control surface is coupled to the instrument carriage. A sensor fixed relative to the instrument carriage detects a position of the detection pin. A carriage controller coupled to the sensor, provides a signal that indicates at least a first state and a second state responsive to a distance between the distal end of the detection pin and the control surface. The signal may indicate if an instrument sterile adapter is coupled to the control surface of the instrument carriage. A third state of the signal may indicate if a surgical instrument is coupled to the instrument sterile adapter.

Abstract: An instrument sterile adapter couples a surgical instrument and an instrument carriage. The instrument sterile adapter includes an instrument plate that provides a first surface to receive the surgical instrument and a latch plate joined to the instrument plate. The latch plate includes a second surface to receive the instrument carriage and latch structures. Each latch structure has a carriage latch arm that extends away from the second surface of the latch plate and an instrument latch arm joined to the carriage latch arm. The instrument latch arm extends through the instrument plate and away from the first surface of the instrument plate. A connecting member flexibly connects the carriage latch arm and the instrument latch arm to a remainder of the latch plate. The connecting member may be perpendicular to the latch arms. The latch arms may engage fixed locking surfaces in the instrument carriage and the surgical instrument.

Abstract: A manipulator for articulating a surgical tool during surgery includes an instrument holder, a parallelogram linkage assembly, an offset extension link, a yaw joint, and a mounting base. The instrument holder is configured to couple with the surgical tool. The parallelogram linkage assembly produces motion of the instrument holder that is limited to rotation about a pitch axis that intersects a remote center of manipulation. The offset extension link has an offset extension link distal end and an offset extension link proximal end. The yaw joint is connected to the offset extension link proximal end and produces motion of the instrument holder that is limited to rotation about a yaw axis that intersects the remote center of manipulation. The offset extension link distal end is offset from the yaw axis. The mounting base is coupled with the yaw joint.

Abstract: Described herein are systems and methods for providing personalized oral care. A system for oral care comprises an oral insert. The oral insert is sized and shaped according to a user's oral cavity, and has a plurality of fluid nozzles and an effluence conduit to channel fluid out of the user's oral cavity. Pressurized fluid provided through the nozzles are directed to, for example, the interproximal spaces between the user's teeth. In some variations, a system comprises an oral insert and an elastomeric substrate that is attached to the oral insert. In some variations, the elastomeric substrate comprises a textured surface vibrates and/or mechanically agitates and/or translates along the surface of the user's teeth. In some variations, a system for oral care comprises a microbiome collection chamber. Some variations comprise dental shim devices that are used for acquiring oral structure data and alignment between the upper and lower arches.

Abstract: A sterile adapter for coupling a surgical instrument and a surgical instrument manipulator includes a bottom component and a coupling component. The bottom component includes a bottom component opening with a bottom lip having a locking mechanism. The coupling component is rotatably coupled to the bottom component. The coupling component includes an engagement feature that engages the surgical instrument manipulator. The coupling component further includes a locking mechanism opening that engages the locking mechanism when the engagement feature has not engaged the surgical instrument manipulator. The coupling component may include a retention tab that is aligned with the keyway to insert the coupling component into the bottom component opening and then misaligned with the keyway to retain the coupling component in the bottom component opening. A ramp may be provided on a leading edge of a pocket to facilitate engaging the coupling component with the surgical instrument manipulator.

Abstract: Described herein are systems and methods for providing personalized oral irrigation. One variation of a system for personalized oral irrigation comprises a fluid reservoir and a customized oral insert in fluid communication with the fluid reservoir. The oral insert comprises an arrangement of fluid openings positioned based on the individual oral or dental structures of a user's teeth to provide a customized fluid flow over the user's teeth. Also described herein are methods for generating an arrangement of fluid openings in a customized oral insert.

Abstract: An instrument sterile adapter (310) couples a surgical instrument (120) and an instrument carriage (130). The instrument sterile adapter (310) includes an instrument plate (430) that provides a first surface to receive the surgical instrument (120) and a latch plate (400) joined to the instrument plate (430). The latch plate (400) includes a second surface to receive the instrument carriage (130) and latch structures. Each latch structure has a carriage latch arm (410) that extends away from the second surface of the latch plate (400) and an instrument latch arm (405) joined to the carriage latch arm (410). The instrument latch arm (405) extends through the instrument plate (430) and away from the first surface of the instrument plate (430). A connecting member (425) flexibly connects the carriage latch arm (410) and the instrument latch arm (405) to a remainder of the latch plate (400). The connecting member (425) may be perpendicular to the latch arms (405).

Abstract: Minimally invasive surgical methods employ an offset drive shaft to actuate an end effector. A minimally invasive surgical method includes introducing an end effector to an internal surgical site. The end effector includes an end effector base that is coupled to the instrument shaft via a wrist. An end effector articulation mechanism is operated to reorient the end effector base relative to the instrument shaft. A surgical task is performed by operating a motor to rotate an offset drive shaft relative to the instrument shaft to actuate the end effector.

Abstract: Mechanisms, assemblies, systems, tools, and methods include an offset drive shaft within an independently rotating member. An example method of transmitting torque through an offset drive shaft routed within a rotatable main shaft includes supporting a main shaft to rotate relative to a base so that the main shaft rotates about a main shaft rotational axis. A drive shaft is supported to rotate relative to the main shaft so that the drive shaft rotates about a drive shaft rotational axis that is offset from the main shaft rotational axis. The drive shaft is engaged with a drive feature having a drive feature rotational axis that is fixed relative to the base as the main shaft rotates. The main shaft is rotated relative to the base. The drive feature is rotated relative to the main shaft so as to rotate the drive shaft relative to the main shaft.

Abstract: An instrument carriage provides control of a surgical instrument coupled to the instrument carriage. The instrument carriage includes a control surface that is coupled to the surgical instrument to provide the control. A detection pin having a first distal end that extends from the control surface is coupled to the instrument carriage. A sensor fixed relative to the instrument carriage detects a position of the detection pin. A carriage controller coupled to the sensor, provides a signal that indicates at least a first state and a second state responsive to a distance between the distal end of the detection pin and the control surface. The signal may indicate if an instrument sterile adapter is coupled to the control surface of the instrument carriage. A third state of the signal may indicate if a surgical instrument is coupled to the instrument sterile adapter.

Abstract: An instrument sterile adapter for coupling a surgical instrument and an instrument carriage includes an adapter control surface that extends control features of a control surface of the instrument carriage and receives an instrument control surface of the surgical instrument. A shaft receiving slot is positioned in the adapter control surface to receive an elongate tube of the surgical instrument when the adapter control surface receives the instrument control surface of the surgical instrument. The elongate tube may couple a proximal control mechanism of the surgical instrument to an end effector. The instrument sterile adapter may include a convex curved surface substantially perpendicular to and facing the adapter control surface to receive a corresponding concave curved surface on the instrument control surface. A bullet portion on the convex curved surface may engage a bullet receiving feature in the corresponding concave curved surface on the instrument control surface.

Abstract: A medical device includes an instrument sterile adapter (ISA) that includes a first plate and a second plate. The first plate includes a mounting surface and a plurality of landing pads. The mounting surface provides a first datum plane for mounting the ISA on a carriage that includes actuators. The plurality of landing pads extend through the second plate and provide a second datum plane for a surgical instrument coupled to the ISA such that the first datum plane and the second datum plane are parallel surfaces separated by a fixed distance. The medical device may include a plastic sheet having opposing first and second sides with the first plate located on the first side and the second plate located on the second side. The instrument sterile drape may include a pouch shaped to fit around the carriage with the ISA capturing the pouch between the top and bottom plates.

Abstract: A robotic surgery system includes an orienting platform, a support linkage movably supporting the orienting platform, a plurality of surgical instrument manipulators, and a plurality of set-up linkages. Each of the manipulators includes an instrument holder and is operable to rotate the instrument holder around a remote center of manipulation (RC). At least one of the manipulators includes a reorientation mechanism that when actuated moves the attached manipulator through a motion that maintains the associated RC in a fixed position.

Abstract: A surgical system includes a manipulator, a surgical tool and a control system. The manipulator includes a manipulator mounting base, a pitch mechanism, a roll mechanism and a redundant rotation mechanism. The surgical tool is supported by the manipulator and has a tool shaft axis. The pitch mechanism rotates the surgical tool around a pitch axis. The roll mechanism rotates the surgical tool around a roll axis transverse to the pitch axis. The redundant rotation mechanism rotates the surgical tool around a redundant rotation axis. Each of the tool shaft axis, the pitch axis and the roll axis intersect at a remote center. The control system is configured to electronically communicate with and control operation of the manipulator to articulate the surgical tool during surgery.

Abstract: An instrument sterile adapter for coupling a surgical instrument and an instrument carriage includes an adapter control surface that extends control features of a control surface of the instrument carriage and receives an instrument control surface of the surgical instrument. A curved surface extends from the adapter control surface. The curved surface receives a corresponding curved surface on the instrument control surface. A bullet portion on the curved surface may engage a bullet receiving feature in the corresponding curved surface on the instrument control surface. A locating pin or slot on the adapter control surface may engage a locating slot or pin on the instrument control surface. The instrument control surface may be supported by landing pads on the adapter control surface. Latch arms on the adapter control surface may engage latch receptacles on the instrument control surface.

Abstract: A medical robotic assembly configured to support, insert, retract, and actuate a surgical instrument. The medical robotic assembly includes a surgical instrument carriage configured for detachably mounting a surgical instrument to the surgical instrument carriage. The surgical instrument carriage includes a motor housing, a first output assembly in the motor housing, a second output assembly in the motor housing, a first sensor assembly configured to sense a rotational orientation of a first output drive coupling, and a second sensor assembly configured to sense a rotational orientation of a second output drive coupling.

Abstract: An instrument sterile drape includes a plastic sheet and an instrument sterile adapter (ISA) coupled to the plastic sheet. The ISA includes a bottom plate located on a first side of the plastic sheet and a top plate located on a second side of the plastic sheet and joined to the bottom plate. The bottom plate includes a mounting surface that provides a first datum plane for mounting the ISA on a carriage that includes actuators and a plurality of landing pads that extend through the top plate to provide a second datum plane for a surgical instrument coupled to the ISA such that a distance between the carriage and the surgical instrument is controlled only by the bottom plate. The instrument sterile drape may include a pouch shaped to fit around the carriage with the ISA capturing the pouch between the top and bottom plates.

Abstract: An instrument sterile drape includes a plastic sheet and a pouch sealed to a first opening in the plastic sheet. The pouch is shaped to fit around a carriage that includes actuators and may be shaped to provide a loose form fit around the carriage. A stiffener is coupled to the pouch around a second opening in the pouch to provide an area that is less elastic than the remainder of the pouch. An instrument sterile adapter (ISA) may be coupled to the second opening in the pouch. The ISA may include a bottom plate and a top plate located on opposite sides of the pouch and joined together. Portions of the bottom plate may project through the top plate to provide a datum plane to receive a surgical instrument. The ISA may contain loose pins that depress sensing pins in the carriage when a surgical instrument is mounted.