Abstract: A cannula includes a first tubular member having a first longitudinal axis, a second tubular member having a second longitudinal axis, a connector that connects the first and second tubular members in series, and a rear bearing that supports the second tubular member in a three-dimensionally pivotable manner around an axis intersecting the second longitudinal axis. The first tubular member has a first through-hole into which a flexible and elongated medical treatment device is insertable, and is supported by a trocar in a state where the first tubular member extends through the trocar attached to a body wall of a patient. The second tubular member has a second through-hole into which the medical treatment device is insertable. The connector connects the first and second tubular members in a pivotable manner around an axis orthogonal to a plane including the first longitudinal axis and the second longitudinal axis.

Abstract: A surgical access device includes a cannula and a sleeve stop. The sleeve stop is configured for selective engagement with an elongated portion of the cannula, and configured to limit distal advancement of the cannula with respect to tissue. The sleeve stop is a unitary structure and includes a body portion having a first section and a second section. The first section and the second section are interconnected by a living hinge. The first section is configured to selectively engage the second section.

Abstract: An apparatus and method for providing surgical access to a body cavity of a living animal through an access port inserted in a wall of the body cavity is disclosed. The apparatus includes a collapsible volume having an opening for sealingly receiving a surgical apparatus. The apparatus also includes an access coupler disposed at a distal end of the collapsible volume, the access coupler being operably configured to sealingly couple to an opening in the access port placing the collapsible volume in fluid communication with the body cavity. The collapsible volume is operably configured to collapse to permit the surgical apparatus to be inserted through the access coupler into the body cavity.

Abstract: Various trocars and trocar supports are provided for allowing an insufflation port on the trocar to be coupled through the trocar support to an insufflation fluid. In one embodiment, the trocar includes a housing, a cannula extending through the housing, and an insufflation port projecting from the housing. A trocar support is provided having an opening that receives the insufflation port on the housing such that the insufflation port is unobtrusive during use and can be connected and disconnected rapidly.

Abstract: A clamping device of an external fixation system that has a jaw set with a passage at one end configured to hold an element from a first range of sizes and a second passage configured to hold an element from a different range of sizes. The jaw set includes a first jaw, a second jaw, and a slider interposed between the first and second jaws that moves to a first position when the first element is located in the first passage and to a second position when the second element is located in the second passage.

Abstract: A polyaxial bone anchor including a housing, a bone screw, and a retainer for pivotably coupling the head of the bone screw to the housing. The retainer is positioned into the bore of the housing and includes a plurality of alternating tabs and slots circumferentially arranged to define a cavity for receiving the head portion of the bone screw therein. The retainer is axially moveable in the housing from a first position in which the head portion is not passable through the lower opening of the retainer to a second position in which lie head portion is passable through the lower opening of the retainer.

Abstract: In some embodiments, a spinal stabilization system may be formed in a patient using quick-connect sleeve assemblies. Each quick-connect sleeve assembly can be coupled to a bone fastener assembly in a fast and intuitive way. In one embodiment, a quick-connect sleeve assembly has a detachable member and a movable member. Both members engage a collar of the bone fastener assembly. In one embodiment, the engagement can be locked via one or more locking features to facilitate screwing a bone fastener of the bone fastener assembly onto a vertebral body in a minimally invasive surgical procedure. Each quick-connect sleeve assembly has a low profile and is particularly shaped for minimally invasive entry.

Abstract: To provide a bone fixation device able to firmly fix bone elements. A bone fixation device, comprising: a base section having a first space that holds a rod; a hook formed with a second space in which a bone element is accommodated together with a art of the base section; and a sandwiching part that is installed to the base section and that sandwiches the bone element which has been accommodated in the second space together with a pail of the hook, wherein the sandwiching part is shiftable allowing attachment to the bone element.

Abstract: A pivotal bone anchor assembly includes a receiver with a base defining an internal cavity with a seating surface adjacent a bottom opening and an upper portion defining a channel configured to receive an elongate rod. The assembly also includes an anchor member having a proximal end portion with a lower contact surface slidably engageable with the seating surface to establish pivotable motion between the anchor member and the receiver, and a planar upper surface surrounding an internal drive socket. The assembly further includes an insert positionable within the channel with a lower surface engageable with the proximal end portion of the anchor member to direct a downwardly-directed force onto the proximal end portion to lock the position of the anchor member relative to the receiver, with the planar upper surface remaining spaced apart from the lower surface of the insert so as to not directly receive the downwardly-directed force therefrom.

Abstract: A polyaxial bone screw assembly includes a threaded shank body having an integral upper portion receivable in an integral receiver, the receiver having an upper channel for receiving a longitudinal connecting member and a lower cavity cooperating with a lower opening. A down-loadable compression insert, a down-loadable friction fit split retaining ring having inner and outer tangs and an up-loadable shank upper portion cooperate to provide for pop- or snap-on assembly of the shank with the receiver either prior to or after implantation of the shank into a vertebra. The shank and receiver once assembled cannot be disassembled.

Abstract: A bone fixation system for implanting in bone, the system comprising a plurality of bone fastener assemblies that attach to bone, a pair of elongate members that attach to the plurality of bone fastener assemblies, a connector member that contacts the pair of elongate members, and a plurality of locking caps that secure the connector member and the elongate members to the plurality of bone fastener assemblies, wherein at least one of the plurality of locking caps comprises a cap portion and a hook portion, where the cap portion is adapted to rotate while the hook portion is stationary.

Abstract: Spinal stabilization implant assemblies, as well as systems, instruments and methods are provided for implanting and stabilizing adjacent vertebra in connection with a surgical procedure, particularly a spinal surgery. The implant assemblies and instruments enable controlled spinal rod insertion and reduction, and controlled rotation or de-rotation of adjacent spinal bones for optimized compression to achieve enhanced sagittal balance in a treated spine.

Abstract: Spinal surgical procedures can benefit from a rod reduction instrument with a ratchet lock-out mechanism. The instrument can include an inner shaft, an outer housing and a ratchet mechanism. The inner shaft can include a threaded proximal portion and a distal end that includes a plurality of engagement members adapted to receive a pedicle screw. The outer housing can be slidably received over the inner shaft, and include a top sleeve and a bottom sleeve. The top sleeve can include the ratchet mechanism to selectively engage the threaded proximal portion of the inner shaft and the bottom sleeve can engage a connecting rod. The ratchet mechanism can include an engagement feature to selectively engage the threaded proximal portion of the inner shaft, and a locking mechanism to selectively lock the engagement feature of the ratchet mechanism against the threaded proximal portion of the inner shaft.

Abstract: Provided is a percutaneous screw fixing rod inserting device for minimal invasive surgery, which includes: a leg unit including a plurality of support legs, each of which has a joint link provided at a lower end thereof; an aligning holder unit configured to align the plurality of support legs such that longitudinal central axes of the support legs of the leg unit are placed on one virtual plane, the aligning holder unit holding the support legs such that an angle between the longitudinal central axes of the support legs is maintained; and a rod inserting unit coupled to the aligning holder unit to rotate by a predetermined angle around a portion coupled to the aligning holder unit and configured to insert the rod into a rod insert hole provided to the joint link of the support leg, thereby eliminating the difficulty of inserting the rod caused by the misalignment of the pedicle screws and increasing the convenience or efficiency of the medical procedure.

Abstract: The present invention relates to a kit for stabilizing an implanted device. The kit komprises a composition for stabilizing an implanted device, and a syringe for introducing the composition into an implanted device. The composition is a composition comprising a solidifying fluid, an initiator adapted to exert influence on a solidifying fluid, and a mixture of a solidifying fluid and an initiator.

Abstract: An assembly includes a surgical device (10) including a distal interface member (12) and a proximal handle (14), the distal interface member (12) including a connecting element (16) for connecting to a surgical tool (18), and a K-wire (20) that passes through a central passageway of the surgical device (10) distally through the distal interface member (12) into a lumen of the surgical tool (18). A wire depth measurement tool (30) includes a handle interface member (32) that assembles to the handle (14) and one or more graduated scales (36) that extend proximally from the handle interface member (32). The graduated scales (36) include depth graduations for indicating an amount a tip of the K-wire (20) protrudes from a distal end of the surgical tool (18).

Abstract: A flowable, bioactive bone void filler is provided. This bone void filler may be a settable, hardening material having sufficient compression strength for use in bone repair techniques. The cement may be a calcium phosphate cement having incorporated therein bioactive glass, and can be used as a bone graft substitute or bone void filler for any number of applications in spine surgery and orthopedic surgery, such as for example, subchondral bone repair.

Abstract: A compression fastener system includes an elongate generally rigid coupling component, a toggle anchor at the distal end of the coupling component that can pivot about 90 degrees between inline and out of line with the coupling component, and a generally cylindrical collet that is engageable with a surface of the coupling component, and having two or more legs that splay upon passage of the coupling component through the collet, at least one leg having a cutting edge along at least a portion of its length that can engage with an adjacent rigid element, such as bone, to fix the rigid coupling component, toggle anchor and collet assembly into compression with the rigid element.

Abstract: A bone screw extraction device includes a shaft extending longitudinally from a proximal end to a distal tip, a distal portion of the shaft including a tissue-receiving cavity extending proximally thereinto from the distal tip, the distal tip including a plurality of fingers configured to be received within a driving recess of a bone screw and a plurality of channels extending longitudinally along an exterior surface of the distal portion, each of the plurality of channels extending between adjacent ones of the plurality of fingers.

Abstract: Implants, guides, devices, instruments, systems and methods for fixing a joint using bone plates are disclosed. The bone fixation system includes an alignment guide with a first end and a second end, an alignment wire rotatably coupled to the first end of the alignment guide, and a coupling member slidingly engaging a first portion of the alignment guide near the first end. The plate includes a body including a first end and a second end, a plurality of lobes extending from the body, a plurality of screw holes extending through the body and each screw hole of the plurality of screw holes positioned in a lobe of the plurality of lobes, and an alignment hole positioned along a longitudinal axis of the body. A method of using a bone fixation system for fixation of at least two bones is also disclosed.

Abstract: A device for assessing the solidity of a material comprising an ancillary tool (2) having an end (2B) in the form of a point or blade, an impactor (4) for striking the ancillary tool (2), a sensor (12) and a processing unit (30). The ancillary tool (2) is placed between a material (8) and the impactor (4) and transmits the impact force generated by the impactor (4) to the material (8). The sensor (12) is capable of measuring a quantity from among the impact force and the deformation of the impactor, and of supplying a measurement signal. The processing unit (30) is suitable for calculating, from the measurement signal, an indicator representative of the solidity of the material (8). The indicator corresponds to the duration of a time window between the first peak (P1) of maximum amplitude of the measurement signal and the second peak of maximum amplitude (P2).

Abstract: Methods for stabilizing pressure within a cryogenic device include receiving a flow rate value corresponding to an expected average mass flow rate of a cryogen through a needle probe of the cryogenic device during a cryotherapy treatment cycle; determining, based on the flow rate value, a target heater power to be applied to a heater associated with the cryogenic device for a treatment cycle, wherein the heater is configured to heat the cryogen; receiving an input for the treatment cycle; causing the cryogen to flow for a period of time toward the needle probe in response to the input; and apply the target heater power to the heater during the treatment cycle so as to heat the cryogen and stabilize pressure within the cryogenic device.

Abstract: An intravascular ablation device, including a flexible elongate body; an expandable element positioned on the elongate body; a radiofrequency or electroporation treatment segment located distally of the expandable element; a cryogenic coolant source in fluid communication with an interior of the expandable element; and a radiofrequency or electroporation energy source in communication with the radiofrequency or electroporation treatment segment.

Abstract: A cryogenic device with a housing having a cryogen pathway for conducting a cryogen from a cryogen cartridge toward a needle probe, wherein the cryogen is configured to deliver cryotherapy to a target tissue via the one or more needles; an auxiliary pathway coupled to the cryogen pathway and exposed to a relatively low-pressure environment; and a movable sealing element configured to seal the cryogen pathway from the auxiliary pathway when the movable sealing element is in a closed position, and further configured to open the cryogen pathway to the auxiliary pathway so as to vent an amount of the cryogen to the relatively low-pressure environment when the movable sealing element is in an open position, wherein the movable sealing element is configured to be moved by a user-actuatable element coupled to the movable sealing element and separately configured to be moved by an automatic pressure relief mechanism.

Abstract: A cryosurgical system including a computer system programmed with software configured to perform the following steps: a) capturing at least one first view of a region of interest in a human body; b) capturing at least one second view of the region of interest; c) outlining the region of interest and at least one area outside the region of interest with the assistance of an operator; d) constructing a 3-dimensional model of the region of interest and the at least one area outside the region of interest utilizing the at least one first view and the at least one second view of the region of interest; and e) utilizing the 3-dimensional model of the region of interest and the at least one area outside the region of interest to determine at least one cryosurgical probe placement location.

Abstract: An electrosurgical apparatus for generating a plasma discharge beam is provided. In one aspect, the electrosurgical apparatus includes a first fluid flow housing, a second fluid flow housing, and an electrode. A first gas is provided to the distal end of the first fluid flow housing, where the electrode is energized to ionize the first gas and generate a plasma discharge beam. A second gas is provided to the distal end of the second fluid flow housing, where the distal end of the second fluid flow housing injects the second gas into the plasma discharge beam. In another aspect, the electrosurgical apparatus includes a single fluid flow housing having an external electrode and an internal electrode. In another aspect, the electrosurgical apparatus includes a transformer assembly having a plurality of serially-connected transformers.

Abstract: Disclosed herein is an electroporation system including a catheter shaft, at least one electrode coupled to the catheter shaft at a distal end thereof, and an electroporation generator coupled in communication with the at least one electrode. The electroporation generator configured to supply a biphasic pulse signal to the at least one electrode. The biphasic pulse signal includes a first phase having a first polarity and a first pulse duration, and a second phase having a second polarity opposite to the first polarity, and a second pulse duration. Each of the first phase and second phase has a voltage amplitude of at least 500 volts and a pulse duration of less than 20 microseconds. The second phase is generated at a non-zero interval following the first phase.

Abstract: A head for electrical scalpel includes a member that is composed of a ceramic(s), and an electrode rod where at least a part thereof is positioned in the member, wherein a surface that contacts the electrode rod on the member is configured in such a manner that a skewness Rsk that is obtained from a roughness curve is positive.

Abstract: Conventional vasectomy techniques suffer from a number of disadvantages, including, for example, a substantial risk for the development of hematomas and swelling, a potential for spontaneous regeneration and undesired resumption of fertility, a need for a highly skilled surgical professional, as well as a long recovery period, accompanied by severe limitations on post-surgical activity. The vasectomy methods of the present invention eliminate the need for scrotal dissection and vas duct extraction and thereby overcome the disadvantages and deficiencies of the prior art, resulting in a rapid, reliable, non-invasive male sterilization procedure that may be readily, reliably and successfully performed by minimally skilled personnel around the world in a variety of medical settings.

Abstract: A surgical instrument including housing having a shaft extending distally therefrom, an outer sleeve disposed about the shaft and selectively translatable relative to the shaft, a first drive shaft disposed within the shaft and translatable relative to the shaft independently of the outer sleeve, a second drive shaft disposed within the first drive shaft and coupled to the outer sleeve to translate in conjunction with the outer sleeve, and a rotatable nose wheel. The rotatable nose wheel is mounted about a distal end of the housing and is rotatably coupled to each of the outer sleeve, the shaft, the first drive shaft, and the second drive shaft such that rotation of the rotatable nose wheel effects corresponding rotation of the outer sleeve, the shaft, the first drive shaft, and the second drive shaft in conjunction with one another and relative to the housing.

Abstract: An ablation probe (100; 200) suitable for insertion through the working channel of an intraluminal delivery device comprises an applicator (102; 202) arranged to apply radiation to heat surrounding tissue. The probe also comprises a feeding cable (104; 204) arranged to supply electromagnetic energy to the applicator (102; 202). The probe further comprises a first coolant flow path (106). There is also a deformable member (110; 210) arranged to move between an insertion configuration in which insertion of the probe is facilitated and a deployed configuration. A second coolant path (108), via which coolant is able to flow, is provided by the deformable member (110; 210) when in the deployed configuration. The probe further comprises a tube arranged to house a distal portion of the feeding cable, and the deformable member surrounds at least part of the tube, and the tube is formed from an elastic material.

Abstract: A medical imaging system comprising: a microwave antenna array comprising a transmitting antenna and a plurality of receiving antennae, wherein the transmitting antenna is configured to transmit microwave signals so as to illuminate a body part of a patient and the receiving antennae are configured to receive the microwave signals following scattering within the body part; a processor configured to process the scattered microwave signals and generate an output indicative of the internal structure of the body part to identify a target within the body part; and an ablation probe comprising an ablation needle movable relative to the microwave antenna array; wherein the receiving antennae are further configured to receive microwave signals scattered or emitted by the ablation needle and the processor is further configured to monitor a position of the ablation needle and to guide the ablation needle to the identified target within the body part which it can be used to perform an ablation procedure.

Abstract: A medical image processing apparatus according to a first embodiment includes processing circuitry. The processing circuitry is configured to generate information related to temperature by using a first image obtained by imaging one or more observation regions prior to treatment and at least one second image obtained by imaging the one or more observation regions during the treatment, generate alert information on a basis of the information related to temperature, and cause a display to output the alert information together with the information related to temperature.

Abstract: A surgical instrument includes a handle assembly and a shaft assembly extending distally from the handle assembly and having a distal end sized to be inserted into the nasal cavity of a patient. The shaft assembly includes a cutting member configured to cut tissue within the nasal cavity, and a translating member slidably disposed over the cutting member. A navigation sensor is disposed within the distal end of the shaft assembly and is operable to generate a signal corresponding to a position of the distal end within the patient.

Abstract: A method of applying RF energy includes using an RF energy applicator assembly to apply RF energy to a tissue. The RF energy applicator assembly includes a housing, and RF electrodes coupled to an RF energy source and movably mounted in the housing. The RF electrodes have a retracted position, in which the RF electrodes are retracted inside the housing, and deployed positions in which the RF electrodes protrude out of the housing at different protrusion lengths. An actuator is coupled to the RF electrodes and configured to move the RF electrodes from the retracted position to any one of the deployed positions.

Abstract: A method of applying RF energy includes using an RF energy applicator assembly to apply RF energy to a tissue. The RF energy applicator assembly includes a housing, and RF electrodes coupled to an RF energy source and movably mounted in the housing. The RF electrodes have a retracted position, in which the RF electrodes are retracted inside the housing, and deployed positions in which the RF electrodes protrude out of the housing at different protrusion lengths. An actuator is coupled to the RF electrodes and configured to move the RF electrodes from the retracted position to any one of the deployed positions.

Abstract: A medical apparatus includes a probe configured for insertion into a body of a patient. The probe includes a plurality of electrodes configured to contact tissue within the body. The medical apparatus further includes an electrical signal generator configured to apply between one or more pairs of the electrodes signals of first and second types in alternation. The signals of the first type include a sequence of bipolar pulses having an amplitude sufficient to cause irreversible electrophoresis (IRE) in the tissue contacted by the electrodes. The signals of the second type include a radio-frequency (RF) signal having a power sufficient to thermally ablate the tissue contacted by the electrodes.

Abstract: A medical apparatus for performing ablation. The apparatus comprising a probe configured for insertion into a body of a patient and comprising an array of electrodes disposed along the probe and configured to contact tissue within the body, and an electrical signal generator configured to apply during a first period of time while the probe contacts the tissue, between each electrode among a plurality of the electrodes in the array and a first neighboring electrode on a first side of the electrode in the array, a first sequence of bipolar pulses between each electrode and the first neighboring electrode, and to apply during a second period of time while the probe remains in contact with the tissue, between each electrode among the plurality of the electrodes in the array and a second neighboring electrode on a second side of the electrode, opposite the first side, in the array, a second sequence of the bipolar pulses between the electrode and the second neighboring electrode.

Abstract: An intravascular catheter for peri-vascular and/or peri-urethral tissue ablation includes multiple penetrators advanced through supported guide tubes which expand around a central axis to engage the interior surface of the wall of the renal artery or other vessel of a human body allowing the injection an ablative fluid for ablating tissue, nerve sensing, nerve stimulation, or ablation by application of energy. The catheter can include a proximal handle for the advancement of guide tubes and penetrators.

Abstract: A microwave antenna apparatus comprises an electrically conductive ground element defining an aperture, an electrically conductive elongated element extending through the aperture and terminating at a distal end, and one or more dielectric elements. The one or more of the dielectric elements electrically insulate the elongated element and the ground element from one another. The microwave antenna apparatus may be configured for use in radiating microwave energy into surface tissue of a uterine cervix so as to provide a therapeutic effect in one or more regions of the uterine cervix, such as one or more regions of the cervix infected with human papillomavirus (HPV) and/or diagnosed with cervical intraepithelial neoplasia (CIN) or so as to create the correct biological response in one or more such regions.

Abstract: An imaging sensor includes a radiation sensor. An imaging controller is configured to: (i) generate an imaging-datastream based on the sensed phenomena and (ii) transmit, to a central controller, the imaging-datastream. The central controller is configured to: receive the imaging-datastream; generate, from the imaging-datastream, a high-contrast videostream in which surgical tools and vascular tissue is represented with a dark color and in which surrounding tissue is represented with a light color, the dark color being darker than the light color; and transmit, to an augmented-reality controller, the high-contrast videostream. The augmented-reality controller is configured to: (i) receive the high-contrast videostream and (ii) instruct a head-worn display to render the high-contrast videostream such that the surgical tools and vascular tissue is rendered with the dark color.

Abstract: The invention relates to a method of determining the sagittal rotation of a patient's pelvis based on a standard anterior posterior X-ray-image with known image parameters and a calibration of the image, for example by using at least one King-Mark calibration object. The angle of the pelvic rotation is determined between a pelvic plane which is orthogonal to the midsagittal plane of the pelvis, and the image plane of the X-ray-image. Assuming the patient's position shown on the X-ray-image represents a standard neutral position, the X-ray-image plane can be used as a functional reference plane for further calculations, for example during hip-replacement surgery. The present invention further relates to a corresponding computer program and system.

Abstract: Systems and methods enabling a personalized solution for allowing more efficient access to the carotid artery (or vertebral arteries) m patients needing endovascular/neurointervention procedures using catheter systems.

Abstract: A device, a system, and a method for carrying out an endoscopic procedure in a patient's body using an endoscopic device comprising (a) a tube with a proximal end and a distal end, the distal end coupled to a handle and a proximal end configured to enter into the patient's body, (b) an ultrasound probe on the proximal end of the tube, positioned to emit sound waves to create a visual image of a target site inside the patient's body, and (c) a needle that is configured to be housed inside the tube, wherein the tube includes an internal cavity for a development of the needle.

Abstract: A system and method for providing image guidance for placement of one or more medical devices at a target location. The system can determine one or more intersections between a medical device and an image region based at least in part on first emplacement data and second emplacement data. Using the determined intersections, the system can cause one or more displays to display perspective views of image guidance cues, including an intersection indicator in a virtual 3D space.

Abstract: A system and method for providing image guidance for placement of one or more medical devices at a target location. The system can be used to determine one or more affected regions corresponding to the operation of one or more medical devices and display at least a portion of the one or more affected regions. The affected regions can correspond to predicted affected regions and/or dynamic affected regions and can be based at least in part on a variance parameter of the medical device.

Abstract: A surgical instrument comprises a first member including a drive engageable with a first mating surface of a bone fastener. A second member is rotatable relative to the first member and includes an engagement element connectable with a second mating surface of the bone fastener. A part is disposed with the first member and being alternately connectable with an actuator and an adaptor attachable with an image guide. Systems, surgical adaptors, spinal implants and methods are disclosed.

Abstract: Systems and methods for electromagnetic field generator alignment are disclosed. In one aspect, the system includes an electromagnetic (EM) sensor configured to generate, when positioned in a working volume of the EM field, one or more EM sensor signals based on detection of the EM field, the EM sensor configured for placement on a patient. The system may also include a processor and a memory storing computer-executable instructions to cause the processor to: determine a position of the EM sensor with respect to the field generator based on the one or more EM sensor signals, encode a representation of the position of the EM sensor with respect to the working volume of the EM field, and provide the encoded representation of the position to a display configured to render encoded data.

Abstract: A computerized system and method of endoscope navigation is provided that includes receiving an endoscope image from the endoscope in a body lumen, determining from the endoscope image a proximate wall of the body lumen, determining a movement vector directing away from the proximate wall, and applying a mechanical motion to the endoscope, according to the movement vector, to move the endoscope away from the proximate wall.

Abstract: A foot pedal assembly for controlling a robotic surgical system. The foot pedal assembly including a foot pedal base, a foot pedal and a sensor. The foot pedal moves relative to the foot pedal base and has a contact surface extending from a distal end to a proximal end of the foot pedal. The contact surface is to come into contact with a foot of a user during use of the foot pedal assembly for controlling the robotic surgical system and the distal end is farther away from a heel of the foot than the proximal end during use of the assembly for controlling the robotic surgical system.