WO2025015144A1

WO2025015144A1 - Surgical drape cooling systems and methods

Info

Publication number: WO2025015144A1
Application number: PCT/US2024/037555
Authority: WO
Inventors: Allison GREY; Steven Manuel; Charles Swinehart; John Ryan Steger
Original assignee: Intuitive Surgical Operations, Inc.
Priority date: 2023-07-12
Filing date: 2024-07-11
Publication date: 2025-01-16

Abstract

Systems and methods provide a cooling air flow path to a surgical manipulator having a draped disposed thereover. The systems and methods can include constricting the air flow path within the drape to direct the air flow path through a fan and operating the fan to move air away from a procedural site within the drape. The system and methods can also include directing the air flow path along an exterior of a housing of the surgical manipulator within the drape and directing the air flow path into an interior of the housing of the surgical manipulator through a housing air flow inlet defined therein.

Description

SURGICAL DRAPE COOLING SYSTEMS AND METHODS

FIELD

[0001] Disclosed embodiments relate to surgical drapes for use with robotic surgical systems.

BACKGROUND

[0002] Minimally invasive medical techniques (e.g., laparoscopy) have been used to reduce the amount of extraneous tissue which may be damaged during diagnostic or surgical procedures, thereby reducing patient recovery time, discomfort, and deleterious side effects. Such techniques were traditionally performed manually via a surgeon manipulating various surgical instruments within the patient’s body but can now by implemented using teleoperated robotic systems that provide telepresence. Performing minimally invasive surgery with teleoperated robotic systems facilitates increased precision and range of motion in manipulating surgical instruments when compared to manual techniques, but also introduces new challenges. One such challenge is the need to erect a sterility barrier between certain non-sterile portions of the surgical system (e.g., portions housing the various motors, sensors, encoders, and electrical connections that cannot withstand a sterilization process) and the area immediately adjacent the patient. One solution to this particular challenge has been to cover the non-sterile portions of the system with a sterile drape, leaving a sterilized instrument to be manipulated by the system uncovered, so that it can be easily replaced by another instrument during a surgical procedure.

SUMMARY

[0003] The following presents a simplified summary of various examples described herein and is not intended to identify key or critical elements or to delineate the scope of the claims. [0004] In one aspect, a method for cooling portions of a robotically assisted surgical manipulator having a drape disposed thereover is provided that includes constricting an air flow path within the drape to direct the air flow path through a fan and operating the fan to move air in a proximal direction within the drape and relative to the surgical manipulator such that air is drawn into the drape through a sterile air flow inlet disposed distally of the fan and the air flow path has a one-way flow between the sterile air flow inlet and the fan.

[0005] In another aspect, a method for cooling portions of a robotically assisted surgical manipulator having a drape disposed thereover is provided that includes directing an air flow path along an exterior of a housing of the surgical manipulator within the drape, directing the air flow path into an interior of the housing of the surgical manipulator through a housing air flow inlet defined therein, and directing the air flow path out from the interior of the housing of the surgical manipulator through a housing air flow outlet defined therein to continue along the exterior of the housing of the surgical manipulator within the drape.

[0006] In one aspect, a method for cooling portions of a robotically assisted surgical manipulator having a drape disposed thereover is provided that includes releasably coupling an inlet cover of the drape to the surgical manipulator and constricting the drape about a portion of the surgical manipulator proximal of the instrument holder in a direction away from a procedural site to direct air flowing proximally within the drape into the surgical manipulator.

[0007] In one aspect, a surgical system is provided that includes a drape configured to form a sterility barrier between a sterile surgical field and a surgical manipulator. The drape includes a sheath having an interior cavity sized to cover at least a portion of the surgical manipulator to form the sterility barrier, a sterile air flow inlet disposed in a distal region of the sheath, and a cinch coupled to the drape proximally of the sterile air flow inlet, the cinch configured to constrict the drape around an exterior perimeter of the surgical manipulator.

[0008] In one aspect, a surgical system is provided that includes a surgical manipulator including a housing having an interior with an internal cooling channel and a drape configured to form a sterility barrier between a sterile surgical field and the surgical manipulator. When the drape is disposed over the surgical manipulator, an air flow path for the surgical manipulator includes a first portion being external to the housing of the surgical manipulator and internal to the drape and a second portion being internal to the internal cooling channel within the interior of the housing of the surgical manipulator.

[0009] In one aspect, a surgical system is provided that includes a surgical manipulator and a drape that has a proximal opening or openings and is configured to form a sterility barrier between a sterile surgical field and the surgical manipulator. A flow channel extends within the drape and has an outlet at a distal location relative to the surgical manipulator. A cooling device of the surgical system includes a fan configured to direct cooling air into the flow channel, which creates an air flow path having a one-way flow through the flow channel and back through the proximal opening or openings of the drape.

[0010] In one aspect, a surgical system is provided that includes a drape configured to form a sterility barrier between a sterile surgical field and a surgical manipulator. The drape includes a sheath having an interior cavity sized to cover at least a portion of the surgical manipulator to form the sterility barrier and an inlet cover coupled to the sheath and configured to releasably couple to the surgical manipulator, the inlet cover defining one or more openings therethrough to provide an air flow path into the sheath.

[0011] It is to be understood that both the foregoing general description and the following detailed description are illustrative and explanatory in nature and are intended to provide an understanding of the present disclosure without limiting the scope of the present disclosure. In that regard, additional aspects, features, and advantages of the present disclosure will be apparent to one skilled in the art from the following detailed description.

BRIEF DESCRIPTIONS OF THE DRAWINGS

[0012] FIG. 1 is a perspective view of a surgical system according to some embodiments.

[0013] FIG. 2 is a perspective view of an instrument manipulator carrying a surgical drape according to some embodiments.

[0014] FIG. 3. is a side view of a surgical instrument including a drive assembly.

[0015] FIG. 4 is a bottom view of the drive assembly of FIG. 3.

[0016] FIG. 5 is a perspective exploded view of a surgical drape, an instrument carriage, and an instrument holder arm.

[0017] FIG. 6 is a simplified cross-sectional view of an instrument manipulator carrying a surgical drape showing a cooling flow path according to some embodiments.

[0018] FIG. 7 is a simplified side view of a first example inlet for a surgical drape according to some embodiments.

[0019] FIG. 8 is a simplified side view of a second example inlet for a surgical drape according to some embodiments.

[0020] FIG. 9 is a simplified side view of a third example inlet for a surgical drape according to some embodiments.

[0021] FIG. 10 is a perspective view of a cover plate for a drape air flow inlet according to some embodiments.

[0022] FIG 11 is a perspective view of the cover plate of FIG. 10.

[0023] FIG. 12 is a cross-sectional view of the cover plate of FIG. 10 showing protrusions of the cover plate engaging a door of a manipulator according to some embodiments.

[0024] FIG. 13 is a simplified perspective view of an instrument manipulator carrying a surgical drape according to some embodiments. [0025] FIG. 14 is a simplified perspective view of an instrument manipulator carrying a surgical drape according to some embodiments.

[0026] FIG. 15 is a simplified top cross-sectional view of a first example cinch assembly for a surgical drape and instrument manipulator according to some embodiments.

[0027] FIG. 16 is a simplified top cross-sectional view of a second example cinch assembly for a surgical drape and instrument manipulator according to some embodiments.

[0028] FIG. 17 is a simplified top cross-sectional view of a third example cinch assembly for a surgical drape and instrument manipulator according to some embodiments.

[0029] FIG. 18 is a simplified top cross-sectional view of a fourth example cinch assembly for a surgical drape and instrument manipulator according to some embodiments.

[0030] FIG. 19 is a simplified top cross-sectional view of a fifth example cinch assembly for a surgical drape and instrument manipulator according to some embodiments.

[0031] FIG. 20 is a simplified top cross-sectional view of a sixth example cinch assembly for a surgical drape and instrument manipulator according to some embodiments.

[0032] FIG. 21 is a simplified top cross-sectional view of a seventh example cinch assembly for a surgical drape and instrument manipulator according to some embodiments.

[0033] FIG. 22 is a simplified top cross-sectional view of an eighth example cinch assembly for a surgical drape and instrument manipulator according to some embodiments.

[0034] FIG. 23 is a simplified top cross-sectional view of a ninth example cinch assembly for a surgical drape and instrument manipulator according to some embodiments.

[0035] FIG. 24 is a simplified top cross-sectional view of a tenth example cinch assembly for a surgical drape and instrument manipulator according to some embodiments.

[0036] FIG. 25 is a simplified top cross-sectional view of an eleventh example cinch assembly for a surgical drape and instrument manipulator according to some embodiments.

[0037] FIG. 26 is a perspective view of a cinch member for a twelfth example cinch assembly for a surgical drape and instrument manipulator according to some embodiments.

[0038] FIG. 27 is a simplified diagram of a cooling device according to some embodiments.

[0039] FIG. 28 is a simplified diagrammatic view of an instrument manipulator carrying a surgical drape showing a cooling flow path according to some embodiments.

[0040] FIG. 29 is a flowchart illustrating a first example method for cooling a surgical manipulator within a drape according to some embodiments. [0041] FIG. 30 is a flowchart illustrating a second example method for cooling a surgical manipulator within a drape according to some embodiments.

[0042] FIG. 31 is a flowchart illustrating a third example method for cooling a surgical manipulator within a drape according to some embodiments.

[0043] Embodiments of the present disclosure and their advantages are best understood by referring to the detailed description that follows. It should be appreciated that like reference numerals are used to identify like elements illustrated in one or more of the figures, wherein showings therein are for purposes of illustrating embodiments of the present disclosure and not for purposes of limiting the same.

DETAILED DESCRIPTION

[0044] In the following description, specific details are set forth describing some embodiments consistent with the present disclosure. Numerous specific details are set forth in order to provide a thorough understanding of the embodiments. It will be apparent, however, to one skilled in the art that some embodiments may be practiced without some or all of these specific details. The specific embodiments disclosed herein are meant to be illustrative but not limiting. One skilled in the art may realize other elements that, although not specifically described here, are within the scope and the spirit of this disclosure. In addition, to avoid unnecessary repetition, one or more features shown and described in association with one embodiment may be incorporated into other embodiments unless specifically described otherwise or if the one or more features would make an embodiment non-functional. In some instances, well known methods, procedures, components, and circuits have not been described in detail so as not to unnecessarily obscure aspects of the embodiments.

[0045] This disclosure describes various instruments and portions of instruments in terms of their state in three-dimensional space. As used herein, the term “position” refers to the location of an object or a portion of an object in a three-dimensional space (e.g., three degrees of translational freedom along Cartesian x-, y-, and z-coordinates). As used herein, the term “orientation” refers to the rotational placement of an object or a portion of an object (e.g., one or more degrees of rotational freedom such as, roll, pitch, and yaw). As used herein, the term “distal” refers to a position that is closer to a procedural site and the term “proximal” refers to a position that is further from the procedural site. Accordingly, the distal portion or distal end of an instrument is closer to a procedural site than a proximal portion or proximal end of the instrument when the instrument is being used as designed to perform a procedure.

[0046] Minimally invasive surgery can be performed by inserting surgical instruments through orifices in a patient’s body (e.g., natural orifices or body-wall incisions) and controlling the surgical instruments via an interface on the outside of the body. In various embodiments of the present disclosure, the surgical instruments are teleoperated by surgeons. Thus, the surgeons do not move the instruments by direct physical contact, but instead control instrument motion from some distance away by moving a user input system. For example, using a robotically- assisted manipulator system, an operator may use the user input system to operate a manipulator assembly, such as in a leader-follower configuration of the robotic system. In the leader-follower configuration, the user input system is the leader, and the manipulator assembly is the follower of the leader-follower configuration. The operating surgeon is typically provided with a view of the actual surgical site via an image capture device (such as an endoscopic camera) that is inserted into the patient’s body and whose images/video are displayed on a visual display, so that the surgeon may remotely perform surgical motions on the user input system while viewing the surgical site. A controller of the surgical system causes the surgical instrument to be moved in accordance with movement of the user input system.

[0047] The present disclosure relates to surgical drapes for use with robotic surgical systems. The surgical drapes described herein are configured (e.g., shaped and sized) to cover one or more unsterilized portions of a surgical instrument manipulator having a robotic arm in order to inhibit or prevent contamination of a surrounding sterile surgical site. The manipulator arm contains components (e.g., motors, brakes, circuit boards, etc.) that generate heat that may be sufficient to heat surfaces of the manipulator arm adjacent thereto above a safe maximum temperature, particularly when operated with surgical drapes, which can be insulating in nature. Relying on free convection within the drape alone for cooling may result in excessive surface temperatures and, as such, a more active cooling solution may be desired.

[0048] The systems and methods described herein provide active cooling to the manipulator arm while draped, while also providing benefits in terms of drape cost, installation complexity, noise, and overall system size.

[0049] In some examples, the systems and methods provided herein have one-way air flow management from a distal region of the manipulator arm to a proximal region of the manipulator arm. An air flow path within the drape is constricted to direct the air flow path through a fan. The fan is oriented to move air proximally within the drape, such that air can be drawn into the drape through a sterile inlet disposed distally of the fan. With this configuration, the air flow path has a one-way flow between the sterile inlet and fan, effectively ensuring that air external to the system continuously flows through the drape to cool the exterior surfaces of the manipulator arm.

[0050] In some examples, the temperature of the air that is directed through the air flow path may be cooled by a cooling element. The cooling element may include one or more Peltier devices or other thermoelectric coolers, heat exchangers, liquid cooling systems, etc. In some embodiments, a plurality of cooling elements may be used. The cooling elements may be positioned near the air flow inlet (such as proximal or distal to the air flow inlet), along other positions of the air flow path, and/or at a proximal opening or openings of the drape. The elements can also be utilized to pump their heat into the air flow path to thereby cool an area surrounding the elements and push the heat downstream within the air flow path.

[0051] In additional or alternative examples, the systems and methods provided herein direct air flow externally to the manipulator arm and within an interior of the drape for a first portion of the air travel relative to the manipulator arm (i.e., between the manipulator and the drape), and direct the air flow internally to a channel within the manipulator arm for a second portion of the air travel relative to the manipulator arm. In addition, the system may direct the air flow externally to the manipulator arm and within the interior of the drape for a third portion of the air travel relative to the manipulator arm. For example, the systems and methods provided herein have an air flow path that runs between an exterior of the manipulator arm and the drape for a first portion of the air travel, into an interior portion of a housing of the manipulator arm for a second portion of the air travel, and out of the interior portion of the housing of the manipulator and back along the exterior of the manipulator arm and within the drape for a third portion of the air travel. Pursuant to this, the manipulator arm housing may include an associated housing air flow inlet and housing air flow outlet for the air flow path. To force the air flow path through the manipulator arm housing, the drape can optionally be cinched around the exterior of the manipulator arm between the inlet and outlet. Further, a fan may be disposed within the interior portion of the manipulator arm housing between the inlet and outlet to draw air through the inlet and push air through the outlet. [0052] The optional cinch for the drape, where included, can take any suitable form, such as integrated into the drape or a separate component. For functionality, the drape can be sized to be easily positioned over the manipulator arm, which results in the drape having a larger interior cross-sectional area than the manipulator arm. The cinch engages the drape and the manipulator arm to constrict the drape to direct the air flow path as desired. In one example, the cinch can constrict the drape around the exterior of the manipulator arm to direct the air flow path into an interior of the manipulator arm housing. In some examples, the cinch can locate to a particular location on the manipulator arm and/or the system can be configured to determine if the drape is properly constricted by the cinch so that the air flow path follows a desired path within the drape by ensuring air flow is properly restricted by the cinch.

[0053] FIG. 1 depicts a patient-side portion 100 of a surgical system in accordance with one or more embodiments of the present disclosure. The patient-side portion 100 is a robotic system for performing minimally invasive surgery on a patient’s body 10 positioned on an operating table 12. The patient-side portion 100 includes a support assembly 104 (e.g., a set-up structure), an instrument manipulator 112, and an instrument carriage 106. In this example, the support assembly 104 anchors the patient-side portion 100 to the operating table 12. In various embodiments, the support assembly 104 may couple the patient-side portion 100 to a base 14 of the operating table 12, to a column of the operating table 12, to a rail of the operating table 12, or to a table-top of the operating table 12. In other embodiments, however, the patient-side portion may be mounted to separate patient-side cart, to a floor via a column or the like, a wall, to the ceiling, or to other operating room equipment.

[0054] The support assembly 104 branches radially outward from the operating table 12 to couple with the instrument manipulator 112. The instrument carriage 106 is coupled to a distal end portion of the instrument manipulator 112 that includes an instrument holder arm 116. The instrument carriage 106 supports a detachable surgical instrument 108. Accordingly, the instrument carriage 106 includes various actuators and control connections for actively controlling a functionality of the surgical instrument 108 within the patient’s body 10 during a surgical procedure. For example, teleoperated actuators housed in the instrument carriage 106 can provide a number of controller motions that the surgical instrument 108 translates into a corresponding variety of movements of the instrument’s end effector. The instrument 108 includes actuation inputs that when operative coupled to outputs in the instrument carriage 106 may be driven by the actuators in the instrument carriage 106 to provide forces/torques to the instrument 108 to articulate movement of the instrument, such as articulating an end effector and/or wrist of the instrument 108, providing cutting, clamping, and other motions. In addition, the instrument carriage 106 can provide electrical signals to the instrument 108, such as for applying electrocautery to the end effector and/or transmitting data to the instrument 108. In various embodiments, a plurality of manipulators 112 may be provided (e.g., 2, 3, 4, or more manipulators) supporting a plurality of instruments 108.

[0055] An entry guide 110 (e.g., a cannula) serves as a surgical port to an orifice of the patient body 10 that receives the surgical instrument 108 to guide the instrument into the patient. The entry guide 110 may perform various other functions, such as allowing fluids and other materials to pass into or out of the body 10, and reducing trauma at the surgical site by isolating at least some motion (e.g., translating movement along an insertion axis and axial rotation of the instrument shaft) of the surgical instrument 108 from the body wall.

[0056] The term “surgical instrument” is used herein to describe a medical device for insertion into a patient's body and use in performing surgical or diagnostic procedures. A surgical instrument can include an end effector associated with one or more surgical tasks, such as forceps, a needle driver, a shears, a bipolar cauterizer, a tissue stabilizer or retractor, a clip applier, an anastomosis device, an imaging device (e.g., an endoscope or ultrasound probe), and the like. Optionally, some surgical instruments used with embodiments of the present disclosure further provide an articulated support (sometimes referred to as a “wrist”) for the end effector so that the position and orientation of the end effector can be manipulated with one or more mechanical degrees of freedom in relation to the instrument's shaft. Further, many surgical end effectors include a functional mechanical degree of freedom, such as jaws that open or close, or a knife that translates along a path. Surgical instruments may also contain stored information (e.g., on a semiconductor memory inside the instrument) that may be permanent or may be updatable by the surgical system. Accordingly, the system may provide for either one-way or two-way information communication between the instrument and one or more system components. Surgical instruments appropriate for use in one or more embodiments of the present disclosure may control their end effectors (surgical tools) with one or more rods and/or flexible cables. In some examples, rods, which may be in the form of tubes, may be combined with cables to provide a “push/pull” control of the end effector, with the cables providing flexible sections as required. A typical elongate shaft for a surgical instrument is small, perhaps five to eight millimeters in diameter. The diminutive scale of the mechanisms in the surgical instrument creates unique mechanical conditions and issues with the construction of these mechanisms that are unlike those found in similar mechanisms constructed at a larger scale, because forces and strengths of materials do not scale at the same rate as the size of the mechanisms. The rods and cables must fit within the elongate shaft and be able to control the end effector through the wrist joint.

[0057] Referring to FIGS. 1 and 2, the instrument manipulator 112 may be provided in a variety of forms that allow the surgical instrument 108 to move with one or more mechanical degrees of freedom (e.g., all six Cartesian degrees of freedom, five or fewer Cartesian degrees of freedom, etc.). Typically, the instrument manipulator 112 is controlled to move the surgical instrument 108 around a particular remote center of motion that remains stationary with reference to the patient’s body 10. This remote center of motion is typically located proximate where the surgical instrument 108 enters the patient’s body 10 (e.g., at some point along entry guide 110, such as the midpoint of the body wall).

[0058] In this example, the instrument manipulator 112 includes a plurality of manipulator links 118, joints 114 situated between adjacent manipulator links 118, and an elongated instrument holder arm 116. The instrument holder arm 116 carries and supports the instrument carriage 106 and the entry guide 110. The instrument carriage 106 is optionally mounted to ride along the length of the instrument holder arm 116, while the entry guide 110 is held fixed by a connector 131 at the distal end of the instrument holder arm 116. Movement of the instrument carriage 106 effects translating movement of the surgical instrument 108 through the stationary entry guide 110 along an insertion axis relative to the patient’s body 10.

[0059] The joints 114 of the manipulator 112 facilitate the articulated movement of the manipulator links 118 to locate the surgical instrument 108 at a desired pose (position and orientation) with multiple degrees of freedom (e.g., yaw, pitch, and roll) about the remote center of motion. Furthermore, as described above, the translating movement of the instrument carriage 106 along the instrument holder arm 116 locates the surgical instrument 108 at a desired insertion point through the remote center of motion. Thus, the various teleoperated actuators of the instrument manipulator 112 move the surgical instrument 108 as a whole, while the actuators housed within the instrument carriage 106 move only the instrument’s end effector or other individual instrument components. In some examples, movement of the joints 114 is constrained to maintain the remote center of motion of the manipulator 112 by mechanically constrained links and/or mechanically fixed intersecting axes (hardware-centering). In some other examples, movement of the joints 114 is constrained by software-controlled motors (software-centering). As noted above, implementations employing the software-centering motor-driven joints may especially benefit from embodiments described below that enhance heat dissipation along the instrument manipulator 112.

[0060] In FIGS. 1-2, the manipulator 112 depicted includes three manipulator links 118, including a distal manipulator link, an intermediate manipulator link, and a proximal manipulator link, connected by two joints 114. One or more of the manipulator links 118 can include inner and outer telescoping housings 118a, 118b, such as the intermediate manipulator link 118 as shown, to provide a translation along the longitudinal axis of the link 118. However, the manipulator 112 shown in FIGS. 1-2 is by way of example only and it should be appreciated that other linkage designs are possible.

[0061] Referring now to FIGS. 3 and 4, the surgical instrument 108 includes a distal portion 120 and a drive assembly 122 coupled to one another by an elongate shaft 124 defining an internal bore. The drive assembly 122 includes a housing 125 supporting an input device 126. The input device 126 includes an instrument drive interface 127. The input device 126 facilitates controlled adjustment of the instrument’s end effector via one or more drive cables extending along the internal bore of the elongate instrument shaft 124.

[0062] The drive interface 127 provides mechanical and/or electrical connections to the other control features of the surgical instrument 108. During use, the instrument drive interface 127 couples to a complementary drive interface of the instrument carriage 106 (e.g., manipulator drive interface 134 shown in FIG. 5) optionally through an adaptor (e.g., adaptor 220), which allows the instrument carriage 106 to control the surgical instrument 108 in the manner generally described above. The distal portion 120 of the surgical instrument 108 may provide any of a variety of surgical tools, such as the forceps 128 shown, a needle driver, a cautery device, a cutting tool, an imaging device (e.g., an endoscope or ultrasound probe), or a multipart device that includes a combination of two or more various tools and imaging devices. Further, in the illustrated embodiment, the forceps 128 are coupled to the elongate shaft 124 by an optional wrist joint 130, which allows the orientation of the forceps 128 to be manipulated with reference to the elongate shaft 124.

[0063] The bottom view of surgical instrument 108 shown in FIG. 4 illustrates the instrument drive interface 127. As shown, the drive interface 127 includes a set of five steering inputs 132, each of which governs a different aspect of movement by the wrist joint 130 and the forceps 128. Of course, more or fewer steering inputs 132 can be provided in different implementations. When the drive interface 127 is coupled to the instrument carriage 106, each of steering inputs 132 interfaces with an actuator that drives the respective steering input. The instrument carriage 106 and/or the drive assembly 122 may optionally include configurations for power transmission (e.g., mechanical couplings including speed and/or torque converters, fluid couplings, and/or electrical couplings). Each of the steering inputs 132 may be operatively coupled to a drive shaft in the housing 125 (not shown) that operates a drive cable (not shown) controlling movement of the forceps 128, wrist mechanisms (when present), etc.

[0064] As shown in FIG. 2, the patient-side portion 100 further includes a surgical drape 200 covering at least a portion of the manipulator 112, including the joints 11 , the instrument holder arm 116, the distal manipulator link 118, the intermediate manipulator link 118, and at least a portion of the proximal manipulator link 118, for example. The surgical drape 200 forms a sterility barrier between a sterile surgical field and the unsterilized instrument manipulator 112. If desired, in addition to the manipulator 112, the drape 200 can cover a portion of the support assembly 104, extending the sterility barrier to partially shield this component from the sterile field as well. The present disclosure, however, is not limited to any particular configuration in this regard. In any event, components of patient- side portion 100 that are not covered by drape 200 (e.g., surgical instrument 108, entry guide 110, and part of instrument carriage 106) will generally be sterile. In some examples, one or more of these sterile components are capable of being sterilized and re-used. In some examples, one or more of these components are single-use disposable elements, provided in hermetically sealed packages (e.g., peel-open pouches or sterilization wraps).

[0065] As shown in FIG. 2, the surgical drape 200 includes a sheath 201 that is a flexible, bag-like object having a proximal opening or one or more openings 202 that leads to an interior cavity 203. The interior cavity 203 is configured (e.g., sized and shaped) to be disposed over and receive the manipulator 112 within the interior cavity 203. The sheath 201 is an impervious structure having an interior (i.e., innermost) surface and an exterior (i.e., outermost) surface. During use, the exterior surface of the sheath 201 is exposed to the sterile surgical field, and, therefore, is provided in a sterile state. The sheath 201 may be formed from a suitable plastic material (e.g., thermoplastic polyurethane) or any other flexible material capable of withstanding a sterilization process. As such, in some implementations, the surgical drape 200 may be re-used over multiple surgical procedures following sterilizations. In other implementations, however, the surgical drape 200 is adapted to be sterilized for a single use (e.g., by gamma irradiation). [0066] As shown in FIG. 5, the surgical drape 200 further includes an adaptor 220 coupled to an end portion of sheath 201. In this example, the adaptor 220 is permanently bonded to the sheath 201, but other physical attachment mechanisms are also contemplated. For example, the adaptor 220 may be fixed to the sheath 201 by mechanical fasteners, adhesives, etc. The adaptor 220 provides physical connection point for the drape 200, the instrument holder arm 116, and the surgical instrument 108. This connection point secures the sheath 201 in place covering the manipulator 112 during a surgical procedure. In this example, the adaptor 220 is provided in the form of a relatively thin plate-like body having two opposite substantially planar faces. A first face of the adaptor 220 includes an instrument interface 218, and a second face includes a manipulator interface 222. When the various components are assembled, the adaptor 220 is sandwiched between the instrument carriage 106 and the drive assembly 122 of the surgical instrument 108. In the assembled condition, the adaptor’s manipulator interface 222 engages a drive interface 134 of the instrument carriage 106, and the adaptor’s instrument interface 218 engages the drive interface 127 of the instrument drive assembly 122. The respective interfaces 218, 222 of the adaptor 220 arc configured to transfer torque and power from the actuators of the instrument carriage 106 to the steering inputs 132 of the drive interface 127.

[0067] Turning now to FIG. 6, a cooling air flow pathway P is shown for the surgical manipulator 112 within the drape 200. The cooling air flow pathway P conveys cooling air within the interior cavity 203 of the sheath 201 to transfer heat generated by one or more components of the manipulator 112 (e.g., the motor-driven joints 114).

[0068] As shown, the drape 200 includes one or more sterile air flow inlets 230 disposed in the sheath 201. In one example, the drape 200 includes a sterile air flow inlet 230 in a distal region of the sheath 201. For example, the sterile air flow inlet 230 can be disposed in an area of the sheath 201 covering the instrument holder arm 116, covering the distal manipulator link 118, or the distal joint 11 . The air flow pathway P starts at the sterile air flow inlet 230 and proceeds in a proximal direction to cool the manipulator 112. In some embodiments described herein, the air flow pathway P has a one-way air flow from the sterile air flow inlet 230 to the proximal opening 202 of the drape 200, which ensures that a consistent supply of cooling air is provided to the manipulator 112 and also ensures that air heated by the manipulator 112 is exhausted through the proximal opening 202 of the drape 200. As set forth above and used herein, the term “distal” refers to a position that is closer to a procedural site and the term “proximal” refers to a position that is further from the procedural site. Accordingly, with regal'd to the air flow pathway P, the air flows from a distal location (e.g., the sterile air flow inlet 230) to a proximal location (e.g., the proximal opening 202 of the drape 200).

[0069] One or more fans 300 can be disposed within the drape 200 to pull and direct air along the air flow path P. For example, the fans 300 can be oriented to blow air proximally within the drape 200. The fans 300 may be utilized external to the manipulator 112 between the manipulator 112 and the drape 200 and/or internal to the manipulator 112, such as within a housing thereof described in more detail below.

[0070] To increase the influence of the fan 300 on the air flow path P, in some examples, the drape 200 can be constricted to direct the air flow path P into the fan 300. For example, the drape 200 can be constricted around at least a portion of the manipulator 112 to restrict air flow between the interior cavity 203 of the drape 200 and an exterior of the manipulator 112. If a fan is external to the manipulator 112, the drape 200 can be constricted around a perimeter of the fan 300 in addition to being constricted around the manipulator 112. If a fan is internal to the manipulator 112, the drape 200 can be constricted around an entire external perimeter of the manipulator 112. In some examples, the drape 200 can be constricted via manipulation of a cinch 302 coupled to the drape 200, described in more detail below.

[0071] With this configuration, operation of the fan 300 moves air along the air flow path P in a proximal direction within the drape 200 and relative to the surgical manipulator 112. Further, this air flow causes air to be drawn into the drape 200 through the sterile air flow inlet 230 disposed distally of the fan 300 and results in the air flow path P having a one-way flow between the sterile air flow inlet 230 and the fan 300.

[0072] In some examples, it may be advantageous to direct the air flow path P into a housing 140 of one or more of the manipulator links 118. Accordingly, the systems and methods described herein can include directing the air flow path P along an exterior of the manipulator 112 and within the drape 200, and directing the air flow path P into an interior 142 of the housing 140 of the manipulator link 118 through a housing air flow inlet 144 defined in the housing 140. In the illustrated example, the housing air flow inlet 144 provides radial access into the housing interior 142. Additionally or alternatively, the manipulator 112 may include housing air flow inlets 144 in the instrument holder arm 116, the carriage 106, the adaptor 220, a distal link 118, and/or a proximal link 118. The housing air flow inlets 144 may reside in a naturally open state to allow air flow into the manipulator or may movable between opened and closed states for air flow passage. For example, the housing air flow inlets 144 may be biased closed and opened to allow air flow passage, such as by portions of the drape that open the manipulator openings as described with reference to FIG. 12. One or more of the housing air flow inlets 144 may be aligned with an inlet of the drape 200 according to any of the examples described herein, such that air flow directly from an exterior of the drape 200 through the housing air flow inlet 144 and into a portion of the manipulator 112.

[0073] If desired, the systems and methods described herein can further include directing the air flow path P out from the interior 142 of the housing 140 of the manipulator 112 through a housing air flow outlet 146 defined in the housing to continue along the exterior of the housing 140 of the manipulator 112 and within the drape 200.

[0074] In some examples, the housing 140 of the manipulator link 118 can include or define an internal air flow cooling channel 148 extending within the housing interior 142. The cooling channel 148 can have any desired orientation and configuration within the housing 140. For example, the cooling channel 148 can extend longitudinally within a portion or an entire length of the housing 140. The housing air flow inlet and outlet 144, 146 can access the cooling channel 148 through an exterior wall of the housing 140 as shown.

[0075] With the above configuration, when the drape 200 is disposed over the manipulator 112, the air flow path P can include both exterior and interior portions. For example, the air flow path P includes a first portion Pl external to the housing 140 of the manipulator 112 and internal to the drape 200 and a second portion P2 internal to the cooling channel 148 within the interior 142 of the housing 140 of the manipulator 112. In some examples, the air flow path P can further include a third portion P3 external to the housing 140 of the manipulator 112 and internal to the drape 200. [0076] The fan 300, described above can be disposed within the housing interior 142 within the second portion P2 of the air flow path P. For example, the fan 300 can extend across the cooling channel 148 so that all air within the air flow path P flows through the fan 300. This configuration allows the fan 300 to pull air into the housing interior 142 through the housing air flow inlet 144 and, if included, push air out from the housing interior 142 through the housing air flow outlet 146. Stated another way, the fan 300 can be disposed within the housing interior 142 longitudinally between the housing air flow inlet 144 and the housing air flow outlet 146 with the fan 300 proximal to the housing air flow inlet 144 and distal to the housing air flow outlet 146. Operation of the fan 300 thus moves air in the proximal direction within the drape 200 to direct the air flow path P into and out of the interior 142 of the housing 140.

[0077] As will be appreciated, a plurality of fans 300 can be spaced from one another along a length of the manipulator 112 within the drape 200. One or more fans 300 can be disposed within adjacent or spaced manipulator links 118, the same manipulator link 118, and/or be disposed external to a manipulator link 118. For example, a first fan 300 can have a relatively distal position and a second fan 300 can have a position proximal to the first fan 300 and be positioned along the air flow path P to move air in the proximal direction within the drape 200 and relative to the manipulator 112. By constricting the drape 200 to direct air through the fans 300, the air flow path P has a one-way flow between the sterile air flow inlet 230, the first fan 300 and the second fan 300, and/or the second fan 300 and the drape proximal opening 202.

[0078] In some examples, chilled air may optionally be supplied to the system to aid with cooling of the manipulator 112. For example, the temperature of the air that is directed through the air flow path P may be cooled by a cooling device. The cooling device may include one or more Peltier devices or other thermoelectric coolers, heat exchangers, or liquid cooling systems. In some embodiments, a plurality of cooling devices/elements may be used. In some examples, one or more cooling devices may be positioned near the air flow inlet 230 (such as proximal or distal to the air flow inlet 230) and/or along other positions of the air flow path P, such as within a manipulator link housing interior 142 or along an exterior of the manipulator 112. If desired, one or more cinches can be utilized similar to the above-described examples. In other examples, chilled air may be introduced into the drape 200 or the manipulator 112 at a proximal end of the drape 200 or manipulator 112, such as through the proximal opening 202, circulated distally within the drape 200 and/or manipulator 112 (e.g., to the instrument holder arm 116, to a manipulator link 1 18, and so forth), and then back to the proximal end. In some examples, the circulation of the chilled air may be aided or forced through the system via a fan or blower. The fan or blower in these examples may be configured as set for above.

[0079] An example Peltier device 400 configured for the systems described herein is shown in FIG. 27. Although a Peltier device is illustrated, the configuration can be suitable for other devices having a hot side 402 and a cold side 404. Each side 402, 404 is connected to a respective heat sink 406. The heat sink 406 on the hot side 402 spreads out heat, while the heat sink 406 on the cold side 404 spreads out cold. As shown, the device 400 further includes a fan 408 coupled to the heat sink 406 on the cold side 404 to force air away from the heat sink 406 and into the drape 200. Optionally, the device 400 can further include a second fan 410 coupled to the heat sink 406 on the hot side 402 to manage built up heat and help the heat sink 406 cool more effectively.

[0080] Pursuant to the above and as shown in FIG. 28, the system can include the cooling device 400 configured to output a flow of cooled air into the drape interior 203. In some examples, the drape 200 can include a flow channel 412 that extends from the proximal opening 202 to a distal location within the drape 200 (e.g., the instrument holder arm 116, a manipulator link 118, and so forth) and the cooling device 400 can be positioned to output the flow of cooled air into the flow channel 412. The flow channel 412 can be defined by material coupled to the sheath 201 to separate the flow channel 412 from the rest of the sheath interior cavity 203 or can be a tube separate from the sheath 201.

[0081] Cold air output from the device 400 can be aligned with the flow channel 412 or an end of the flow channel 412 can be fitted around the fan or associated device housing. When operating, the forced air from the fan 408 would flow distally within the drape 200 through the flow channel 412 and subsequently flow back proximally within the drape 200 after exiting the flow channel 412. This distal-to-proximal one-way flow outside of the flow channel 412 can function as described with the above examples. In some examples, the device 400 can be located on or adjacent to the support assembly 104, underneath the operating table 12, and so forth. [0082] Alternatively, one or more devices 400 can be installed within or integrated into one of the manipulator links 118 and/or support assembly 104 and the manipulator 112 can include an internal flow channel 414 having an outlet at a distal portion thereof. In this example, the air flow would subsequently flow back proximally within the drape 200 after exiting the internal flow channel 414. For example, the device 400 may force chilled air in a proximal to distal direction through the internal flow channel 414 within the manipulator 112. The internal flow channel 414 can include one or more air flow outlets at a distal portion of the manipulator 112, wherein the air flow outlets are defined in the housing of the manipulator and allow the air flow to move to an exterior of the housing of the manipulator. The air flow would then be positioned between the manipulator housing and within the drape 200. The air flow would then subsequently flow back in a distal to proximal direction as described previously.

[0083] The device(s) 400 and/or any fans (e.g., fans 300) can be operated continuously during a procedure or can be operated as needed to cool one or more components in the manipulator 112. A control system (e.g., control system 152 described below) can monitor temperatures at one or more locations of the manipulator 112 and turn on active cooling when a temperature threshold is exceeded. For example, the system can include one or more thermocouples or other temperature sensors. If desired, the system can vary an output of cooling air depending on the measured temperature of the manipulator 112. Additionally, the control system can reference known poses or movements that generate heat that could benefit from active cooling (e.g., poses or movements requiring a threshold level of torque on the motor).

[0084] In some examples as discussed above, one or more of the manipulator links 118 can include inner and outer telescoping housings 118a, 118b. If movement of the inner and outer telescoping housing 118a, 118b relative to one another can cover the housing air flow outlet 146 defined in the inner telescoping housing 118a, the outer telescoping housing 118b can include one or more openings 150 extending therethrough. The openings 150 allow air flow passing through the housing air flow outlet 146 to also pass through the outer telescoping housing 118b when the outer telescoping housing 118b is disposed radially outwardly of the housing air flow outlet 146 to return to the air flow path P external to the manipulator 112.

[0085] Example sterile air flow inlets 230 are shown in FIGS. 7-9. In a first example in FIG. 7, the sterile air flow inlet 230 can be coplanar with the drape 200. Accordingly, the inlet 230 is an air permeable portion 234 of the drape 200 in the distal region thereof. The air permeable portion 234 can be a material that is bonded, adhered, welded, or otherwise coupled to the drape 200 over one or more opening 232 defined therein in the distal region. In a second example in FIG. 8, the inlet 230 is a cap 236 configured to be coupled to drape 200 to extend over the one or more openings 232 defined therein. As shown, the cap 236 can include a downwardly depending skirt 237 to engage complementary structure on the drape 200, such as a recess or lip (not shown). In a third example in FIG. 9, the inlet 230 is an inlet housing 238 coupled to the drape 200 over the one or more openings 232 defined therein. The inlet housing 238 defines a circuitous inlet path 240 without a direct linear inlet path. For example, the inlet path 240 can include a plurality of turns, overlapping walls, etc.

[0086] As set forth above, the drape 200 can be constricted around the manipulator 112 by one or more cinches 302 coupled thereto. In embodiments with multiple cinches 302, the cinches 302 can be spaced from one another along a length of the manipulator 112. For example, the system can include the same number of cinches 302 and fans 300, which each cinch 302 constricting the drape 200 to direct the air flow path P through the associated fan 300 as discussed herein.

[0087] Each cinch 302 may have any suitable form that sufficiently constricts the drape 200 (e.g., bunching and/or overlapping portions of the drape 200) to reduce or prevent air flow between the drape 200 and an adjacent interior structure, such as an exterior of the manipulator 112 (e.g., a manipulator link 118), an exterior of a fan 300, and so forth. For example, the cinch 302 can include portions that move relative to one another, compress the drape 200 into an opening or recess, and/or tighten around the manipulator 112. The cinch 302 can be utilized, for example, to direct the air flow path P into the fan 300 and/or the manipulator housing 140.

[0088] In some examples, it may be helpful to an operator to easily position the cinch 302 at a desired location on the manipulator 112. Pursuant to this, the manipulator 112 may define a coupling structure (e.g., an opening, such as an aperture or recess, a tab, a snap-fit coupling, a hook, a hook-and-loop fastener, magnet/magnetic member, and so forth) and the cinch 302 may have a corresponding coupling structure (e.g., an opening, such as an aperture or recess, a tab, a snap-fit coupling, a hook, a hook-and-loop fastener, magnet/magnetic member, and so forth) configured to secure to the coupling structure of the manipulator 112. The coupling structures can be secured together after the drape 200 has been mounted to the manipulator 112, which ensures that the cinch 302 is located at the correct longitudinal location along the manipulator 112 (e.g., between the housing air How inlet and outlet 144, 146) to provide a desired air How pathway P.

[0089] The system may also include a control system 152, which may include processing circuitry that implements the some or all of the methods or functionality discussed herein. The control system 152 may include at least one memory and at least one processor for controlling the operations of the manipulator 112, the surgical instrument 108, and so forth. The control system 152 may include instructions (e.g., a non-transitory machine-readable medium storing the instructions) that when executed by the at least one processor, configures the one or more processors to implement some or all of the methods or functionality discussed herein. While the control system 152 is shown as a single block in FIG. 6, the control system 152 may include two or more separate data processing circuits with one portion of the processing being performed at one or more of the components of the system (e.g., at the manipulator 112). In some examples, the control system 152 may include other types of processing circuitry, such as applicationspecific integrated circuits (ASICs) and/or field-programmable gate array (FPGAs). The control system 152 may be implemented using hardware, firmware, software, or a combination thereof. [0090] To provide additional confirmation that the system is properly configured for a surgical procedure, the control system 152 may be operably coupled to one or more sensors 154 associated with the cinch 302 and the sensor(s) 154 may be configured to provide data allowing the control system 152 to determine that the cinch 302 properly constricted the drape 200. The sensor(s) 154 can be any suitable type and have any suitable data configuration to provide data associated with the cinch 302 being manipulated to a constricted position. For example, the sensor 154 can be optical sensors, acoustic sensors, pressure sensors, and so forth. In some examples, the sensor 154 can be an electrical switch.

[0091] Another example air flow inlet 230 is shown in FIGS. 10-12. In this example, the air flow inlet 230 includes a cover plate or inlet cover 242 that is configured to be sealingly coupled to the drape 200 by any suitable method, such as adhesive, welding, heating, etc. The cover plate 242 releasably mounts to structure of the manipulator 112. For example, the cover plate 242 can releasably mount to the instrument holder 116 of the manipulator 112 by any suitable configuration, such as by snap-fit connectors, hook-and-loop fasteners, tongue-and-groove connectors, adhesive, and so forth. As shown in the example of FIGS 10 and 11, the cover plate 242 includes arms 244 that extend rearwardly relative to a front face of the cover plate 242 to engage the manipulator 112. Ends 246 of the arms 244 define channels 248 to receive an edge or ridge of the manipulator 112 therein to thereby couple the cover plate 242 to the manipulator 112. [0092] The cover plate 242 defines one or more openings 250 therein to provide an air flow path P into the drape 200 through the opening 250. To ensure a sterile inlet, the one or more openings 250 can have a configuration that defines a circuitous path (e.g., without a direct linear inlet path), such as that described above. The circuitous path prevents incidental contact of fluids from entering the drape 200 through the one or more openings 250. Alternatively or in addition thereto, the air flow inlet 230 of this example includes a filter 252 coupled over the one or more openings 250 defined in the cover plate 242 so that the air flow path P passes through the filter 252 and filtered air enters the drape 200.

[0093] As shown in FIGS. 10 and 11, the cover plate 242 can define one or more secondary openings 254 to provide access to one or more locations on the manipulator 112 through the cover plate 242. For example, the secondary openings 254 can be utilized to provide access to buttons or other inputs on the manipulator 112, show displays on the manipulator 112, and so forth.

[0094] Furthermore, the secondary openings 254 can be utilized to easily locate the cover plate 242 onto the manipulator 112 (e.g., the instrument holder 116) during initial installation of the drape 200. The secondary openings 254 can couple to/around or align with complementary structure 256 on the manipulator 112. For example, the manipulator 112 can include a projection 256 that extends into the opening 254 when the cover plate 242 is mounted to the manipulator 112 in an intended orientation/position. Other shapes and structures can also or alternatively be utilized.

[0095] In some examples, the manipulator 112 includes a housing 150 having a door 152 biased to close over one or more openings 154 into the housing 150 by a biasing mechanism 156 (e.g., spring, rubber or other elastic or resilient material, etc.). With this configuration, the opening 154 is normally covered by the door 152 to prevent undesired materials from entering the manipulator housing 150. As shown in the example of FIG. 12, the cover plate 242 includes one or more protrusions 258 that extend outwardly adjacent to the one or more openings 250. When the cover plate 242 is mounted to the manipulator 112, the protrusions 258 abut and push the door 152 to pivot against the force of the biasing mechanism 156 to at least partially expose the one or more openings 154 for the air flow path P to enter the housing 150. Although shown as separate structures, the protrusions 258 could alternatively be incorporated into the arms 244 or other structure used to mount the cover plate 242 to the manipulator 112. [0096] Turning now to FIGS. 13 and 14, two example cooling system configurations are shown for the manipulator 112 and drape 200 having the air flow inlet 230 in a distal portion of the drape 200. In some examples, the drape 200 includes the cover plate 242 for the air flow inlet 230, with the cover plate 242 configured to couple to the instrument holder 116 of the manipulator 112. The systems further include drape constrictions 260 (e.g., constricted by one of the cinches 302 described herein).

[0097] Each cinch 302 may have any suitable form that sufficiently constricts the drape 200 (e.g., bunching and/or overlapping portions of the drape 200) to reduce or prevent air flow between the drape 200 and an adjacent interior structure, such as an exterior of the manipulator 112 (e.g., a manipulator link 118), an exterior of a fan 300, and so forth. For example, the cinch 302 can include portions that move relative to one another, compress the drape 200 into an opening or recess, and/or tighten around the manipulator 112. The cinch 302 can be utilized, for example, to direct the air flow path P into the fan 300 and/or the manipulator housing 140.

[0098] In a first example shown in FIG. 13, the drape constriction 260 is disposed around a distal link 118 of the manipulator 112 adjacent to the instrument holder 116. In a second example shown in FIG. 14, the drape constriction 260 is disposed around an intermediate or proximal link 118 spaced from the instrument holder 116 by one or more links 118. The systems further include one or more fans 300 disposed within the manipulator 112 to direct airflow within the manipulator 112.

[0099] An air flow pathway P enters the drape 200 at the sterile air flow inlet 230 and proceeds in a proximal direction (e.g., along the manipulator 112 to an end thereof opposite a procedural site) to cool the manipulator 112. As set forth above and used herein, the term “distal” refers to a position that is closer to a procedural site and the term “proximal” refers to a position that is further from the procedural site. Accordingly, with regard to the air flow pathway P, the air flows from a distal location (e.g., the sterile air flow inlet 230) to a proximal location (e.g., the proximal opening 202 of the drape 200).

[0100] As shown, the systems include one or more fans 300 disposed within the manipulator 112. In systems having more than one fan 300, each link 118 of the manipulator 112 can have one fan 300 disposed therein. In other examples, one or more links 118 can be provided without a fan 300. [0101] In the examples shown, the manipulator 1 12 includes a fan 300 disposed in a distal link 118 adjacent to the instrument holder arm 116. The drape constriction 260 can be disposed distal to the fan 300 around the distal link 118 as shown in FIG. 13 or can be disposed proximal to the fan 300 as shown in FIG. 14, such as around the intermediate link 118. Alternatively, the system of FIG. 14 could locate the drape constriction 260 around the distal link 118 proximal to the fan 300. If desired, for increased air flow into the manipulator 112, the manipulator housing 140 can define a housing air flow inlet 144 aligned with or adjacent to the fan 300 in the distal link 118.

[0102] The systems can also include one or more secondary or proximal fans 300 disposed in intermediary and/or proximal links 118 of the manipulator 112 to aid in directing air proximally within the manipulator 112. In both systems, the proximal fans 300 are located proximally to the drape constriction 260.

[0103] The fans 300 can have any desired orientation relative to a longitudinal axis of each link 118 of the manipulator 112. For example, the distal fan 300 can be oriented to direct air therethrough transverse (e.g., perpendicular) to the longitudinal axis of the distal link 118, while the proximal fans 300 can be oriented to direct air generally along the longitudinal axes of the intermediate and/or proximal links 118.

[0104] With these configurations, the air flow path P flows through the air flow inlet 230 with at least a portion that flows along an exterior of the manipulator 112 until the drape constriction 260, including along the instrument holder arm 116 and portions of one or more links 118. While there can be dedicated openings into the manipulator housing 140 as discussed herein, the assembly of the manipulator 112 can also define openings between adjacent components, such as due to clearance or tolerance requirements, that allow the air flow path P to enter the manipulator instrument holder arm 116, links 118, and/or other components. Accordingly, after the drape constriction 260, the air flow path P flows within the manipulator 112. Operation of the one or more fans 300 aids the proximal air flow within the manipulator 112, as discussed herein.

[0105] With further reference to FIGS. 13-14, additionally or alternatively, one or more air flow inlets may be provided that create dedicated openings into the manipulator housing 140 for the air flow path P to enter into the manipulator. For example, the manipulator may include dedicated openings in the instrument holder arm 116, the carriage 116, the adaptor 220, a distal link 1 18, and/or a proximal link 118. The openings in the manipulator may reside in a naturally open state to allow air flow into the manipulator or may movable between opened and closed states for air flow passage. For example, the openings in the manipulator may be biased closed and opened to allow air flow passage, such as by portions of the drape that open the manipulator openings as described with reference to FIG. 12.

[0106] As set forth above, the systems of these examples, can also define a coupling structure (e.g., an opening, such as an aperture or recess, a tab, a snap-fit coupling, a hook, a hook-and-loop fastener, magnet/magnetic member, and so forth) for the cinch 302. The systems may also include a control system 152, similar to that described above, that is operably coupled to one or more sensors 154 associated with the cinch 302 and the sensor(s) 154 may be configured to provide data allowing the control system 152 to determine that the cinch 302 properly constricted the drape 200. In some examples, chilled air may optionally be supplied to the system to aid with cooling of the manipulator 112, such as with the device(s) 400. The fans (e.g., fans 300) and/or device(s) 400 can be operated continuously during a procedure or can be operated as needed to cool one or more components in the manipulator 112.

[0107] Each cinch 302 functions to bunch and/or overlap portions of the drape 200, so that the drape 200 is constricted to a desired interior perimeter that corresponds to an external perimeter of structure within the drape 200 (e.g., the manipulator 112 and/or fan 300). Some example cinches 302 are shown in FIGS. 15-26.

[0108] In a first example shown in FIG. 15, the cinch 302 includes a cinch member 304 having an elongate body with opposite lateral ends 306. The manipulator 112, such as a housing of a manipulator link 118, includes recesses 308 disposed on opposite sides of the manipulator 112. The recesses 308 are sized to receive the ends 306 of the cinch member 304 therein. The dimensions of the ends 306 and recesses 308 are sized so that a sufficient amount of the drape 200 is wrapped within the cinch-manipulator connection to pull the drape 200 against an exterior of the manipulator 112. In some examples, the ends 306 of the cinch member 304 can be enlarged, as shown, and the recesses 308 can have a corresponding configuration. In one form, the body of the cinch member 304 is flexible such that the body can be bent around a perimeter of the manipulator 112. In another form, the body of the cinch member 304 can have a shape (e.g., curve) corresponding to an external perimeter of the manipulator 112. [0109] In a second example shown in FIG. 16, the cinch 302 includes first and second bodies 310, 312 that arc pivotable with respect to one another and coupled to the drape 200. For example, the first and second bodies 310, 312 can have a hinge therebetween or can be coupled to the drape 200 adjacent to one another so that the drape 200 between the bodies 310, 312 can be utilized as a hinge. With the drape 200 coupled to the bodies 310, 312, pivoting the second body 312 to extend along the first body 310 causes the drape 200 to overlap and pivoting the stacked bodies 310, 312 to extend along the manipulator 112 causes the drape 200 to overlap again. The bodies 310, 312 have a shape (e.g., curve) corresponding to an exterior perimeter of the manipulator 112, such that the bodies 310, 312 can be stacked on one another and extend along the manipulator 112 as shown. The cinch 302 of this form can further include a connector 314 that holds the cinch 302 in a constricted configuration relative to the manipulator 112. The connector 314 can have any suitable form. For example, the connector 314 can be a magnet, snap-fit, clip, and so forth.

[0110] In a third example shown in FIG. 17, the cinch 302 includes a recess 316 defined in the manipulator 112 that is sized to receive a predetermined amount of the drape 200. The predetermined amount of drape 200 is sufficient to pull the remaining perimeter of the drape 200 around the manipulator, while also compressing the drape 200 within the recess 316 to frictionally hold the drape 200 in a constricted state.

[0111] In fourth and fifth examples shown in FIGS. 18 and 19, the cinch 302 is provided by arms 318, 320 that are pivotably attached to the manipulator 112. Pivoting of the arms 318, 320 cause the drape 200 to overlap and constrict around the manipulator 112. As shown, one or both of the arms 318, 320 can include a corresponding connector 322 that secures the drape 200 adjacent to the pivot of the corresponding arm 318, 320 to maximize the constriction of the drape 200 caused by pivoting the respective arm 318, 320. In the fourth example, the arms 318, 320 are spaced from one another with a pivoting range that does not overlap and distal ends of the arms 318, 320 spaced from one another in the pivoted position. In the fifth example, the pivoting range of the arms 318, 320 overlap one another. In this example, the arms 318, 320 can include an inner arm having a shorter length relative to an outer arm to allow for an easier overlap. The connectors 322 can have any suitable form. For example, the connector 322 can be a magnet, snap-fit, clip, and so forth. [0112] In a sixth example shown in FIG. 20, the cinch 302 includes two connectors 324, 326 each having one portion coupled to the drape 200 and another portion coupled to the manipulator 112. As shown, the connectors 324, 326 require that the drape 200 be overlapped when connected. The first connector 324 provides a first, direct connection between the portions thereof and the second connector 326 has an indirection connection with the drape 200 extending between the portions thereof due to the first connector 324 passing over the second connector 326 when being secured. The connectors 324, 326 can have any suitable form. For example, the connectors 324, 326 can be magnets, snap-fits, clips, and so forth.

[0113] In a seventh example shown in FIG. 21, the cinch 302 includes a plug 328 coupled to the drape 200 and an opening 330 (e.g., an aperture or cavity) defined in the manipulator 112 sized to receive the plug 328. Insertion of the plug 328 into the opening 330 causes the drape 200 to bunch up behind the plug 328 to constrict around the manipulator 112. As such, the plug 328 and opening 330 can be sized for sufficient insertion depth to allow a desired amount of constriction. Insertion of the plug 328 into the manipulator 112 can be manual or a grasping/suction mechanism (not shown) can engage the plug 328 and pull the plug 328 inwardly into the manipulator 112.

[0114] In an eighth example shown in FIG. 22, the cinch 302 includes a mount 332 rotatably coupled to the manipulator 112 and a connector 334 coupled to the drape 200. The connector 334 can be secured to the mount 332, which is then driven to wrap the drape 200 therearound causing the drape 200 to constrict around the manipulator 112. Rotation of the mount 332 can be done manually with a releasable ratcheting mechanism to hold a desired constriction or can be driven by a motor or other suitable drive.

[0115] In a ninth example shown in FIG. 23, the cinch 302 includes two connectors 336, 338 coupled to the drape 200. The connectors 336, 338 releasably couple together and are spaced from one another a sufficient distance such that bringing the connectors 336, 338 together overlaps and bunches the drape 200 beneath the connectors 336, 338 and causes the drape 200 to constrict around the manipulator 112.

[0116] In a tenth example shown in FIG. 24, the cinch 302 includes a housing 340 coupled to the drape 200. The housing 340 has a connector 342 configured to couple the housing 340 to the manipulator 112. The connector 342 can have any suitable form. For example, the connector 342 can be a magnet, snap-fit, clip, and so forth. A tie 344 is connected to the drape 200 at a location spaced from the housing 340. The tie 344 extends through or along the housing 340 and movement of the tic 344 relative to the housing 340 is restricted by a releasable stop 346, which can be a biased mechanism to engage the tie 344, for example. With this configuration, an operator can pull the tie 344, which bunches the drape 200 up between the housing and tie connections. The stop 346 restricts the tie 344 from releasing, thus holding the drape 200 in a constricted configuration.

[0117] In an eleventh example shown in FIG. 25, the cinch 302 is a clamp having two members 348 that capture a portion of the drape 200 therebetween. The members can be pivotably coupled together or be separate components that connect together. The members 348 are sized to capture a sufficient portion of the drape 200 to constrict the drape 200 around the manipulator 112. The cinch 302 of this form can be a separate component or can be coupled to the drape 200 for easier location.

[0118] In a twelfth example shown in FIG. 26, the cinch 302 has an elongate flexible body opposite ends that connect to one another. In the illustrated form, the proximal end includes a channel 352 defined by opposing upstanding walls 354 and the distal end includes a pin-shaped portion 356 sized to be frictionally held within the channel 352. The length of the cinch body is sized to flexibly wrap around the manipulator 112 and the drape 200, such that when the ends are coupled together, the drape 200 is constricted around the manipulator 112. If desired, the cinch body can be at least partially elastic to be stretched around the manipulator 112.

[0119] FIG. 29 illustrates a method 500 for cooling a surgical manipulator (e.g., surgical manipulator 112) having a drape (e.g., drape 200) disposed thereover according to some embodiments. The method 500 is illustrated as a set of operations or processes 502 through 506. Not all of the illustrated processes may be performed in all embodiments of method 500.

Additionally, one or more processes that are not expressly illustrated in FIG. 29 may be included before, after, in between, or as part of the processes 502 through 506. Processes may also be performed in different orders. In some embodiments, one or more of the processes 502 through 506 may be implemented, at least in part, in the form of executable code stored on non- transitory, tangible, machine-readable media that when run by one or more processors (e.g., the processors of a controller) may cause the one or more processors to perform one or more of the processes. In one or more embodiments, the processes 502 through 406 may be performed by a controller (e.g., control system 152). [0120] In process 502, an air flow path (e.g., air flow path P) within the drape is constricted to direct the air flow path through a fan (c.g., fan 300). In process 504, the fan is operated to move air in a proximal direction within the drape and relative to the manipulator such that air is drawn into the drape through a sterile air flow inlet (e.g., sterile air flow inlet 230) disposed distally of the fan and the air flow path has a one-way flow between the sterile air flow inlet and the fan. In optional process 506, air is directed to flow in the proximal direction within the drape and relative to the surgical manipulator through a proximal opening (e.g., proximal opening 202) in the drape.

[0121] FIG. 30 illustrates a method 600 for cooling a surgical manipulator (e.g., manipulator 112) having a drape (e.g., drape 200) disposed thereover according to some embodiments. The method 600 is illustrated as a set of operations or processes 602 through 614. Not all of the illustrated processes may be performed in all embodiments of method 600. Additionally, one or more processes that are not expressly illustrated in FIG. 30 may be included before, after, in between, or as part of the processes 602 through 614. Processes may also be performed in different orders. In some embodiments, one or more of the processes 602 through 614 may be implemented, at least in part, in the form of executable code stored on non-transitory, tangible, machine-readable media that when run by one or more processors (e.g., the processors of a controller) may cause the one or more processors to perform one or more of the processes. In one or more embodiments, the processes 602 through 614 may be performed by a controller (e.g., control system 152).

[0122] In process 602, a cinch (e.g., cinch 302) is secured to a coupling of the manipulator to locate the cinch at a desired location on the manipulator. In optional process 604, a sensor (e.g., sensor 154) senses manipulation of the cinch to constrict the drape around the manipulator. In optional process 606, the control system determines that a satisfactory constriction of the drape around the manipulator occurred based on data from the sensor.

[0123] In process 608, a fan (e.g., fan 300) disposed within an interior of a housing (e.g., housing 140) of the manipulator is operated between a housing air flow inlet (e.g., housing air flow inlet 144) and a housing air flow outlet (e.g., housing air flow outlet 146).

[0124] In process 610, the air flow path is directed along an exterior of the housing of the manipulator within the drape, in process 612, the air flow path is directed into the interior of the housing of the manipulator through the housing air flow inlet defined therein, and, in optional process 614, the air flow path is directed out from the interior of the housing of the manipulator through the housing air flow outlet defined therein to continue along the exterior of the housing of the manipulator within the drape.

[0125] FIG. 31 illustrates a method 700 for cooling a surgical manipulator (e.g., manipulator 112) having a drape (e.g., drape 200) disposed thereover according to some embodiments. The method 700 is illustrated as a set of operations or processes 702 through 710. Not all of the illustrated processes may be performed in all embodiments of method 700. Additionally, one or more processes that are not expressly illustrated in FIG. 31 may be included before, after, in between, or as part of the processes 702 through 710. Processes may also be performed in different orders. In some embodiments, one or more of the processes 702 through 710 may be implemented, at least in part, in the form of executable code stored on non-transitory, tangible, machine-readable media that when run by one or more processors (e.g., the processors of a controller) may cause the one or more processors to perform one or more of the processes. In one or more embodiments, the processes 702 through 710 may be performed by a controller (e.g., control system 152).

[0126] In process 702, an inlet cover (e.g., inlet cover 242) of the drape to an instrument holder (e.g., instrument holder arm 116) of the surgical manipulator. In process 704, the drape is constricted about a portion of the surgical manipulator proximal of the instrument holder in a direction away from a procedural site to direct air flowing proximally within the drape into the surgical manipulator.

[0127] In process 706, air entering the drape is filtered with a filter (e.g., filter 252) coupled over one or more openings (e.g., openings 250) in the inlet cover. In process 708, a fan (e.g., fan 300) disposed within the surgical manipulator is operated, the fan located proximally to the portion of the surgical manipulator having the drape constricted therearound. In process 710, a second fan (e.g., fan 300) disposed within the surgical manipulator is operated, the second fan located distally to the portion of the surgical manipulator having the drape constricted therearound.

[0128] One or more components of the embodiments discussed in this disclosure, such as control system 152, may be implemented in software for execution on one or more processors of a computer system. The software may include code that when executed by the one or more processors, configures the one or more processors to perform various functionalities as discussed herein. The code may be stored in a non-transitory computer readable storage medium (e.g., a memory, magnetic storage, optical storage, solid-state storage, etc.). The computer readable storage medium may be part of a computer readable storage device, such as an electronic circuit, a semiconductor device, a semiconductor memory device, a read only memory (ROM), a flash memory, an erasable programmable read only memory (EPROM); a floppy diskette, a CD-ROM, an optical disk, a hard disk, or other storage device. The code may be downloaded via computer networks such as the Internet, Intranet, etc. for storage on the computer readable storage medium. The code may be executed by any of a wide variety of centralized or distributed data processing architectures. The programmed instructions of the code may be implemented as a number of separate programs or subroutines, or they may be integrated into a number of other aspects of the systems described herein. The components of the computing systems discussed herein may be connected using wired and/or wireless connections. In some examples, the wireless connections may use wireless communication protocols such as Bluetooth, near-field communication (NFC), Infrared Data Association (IrDA), home radio frequency (HomeRF), IEEE 802.11, Digital Enhanced Cordless Telecommunications (DECT), and wireless medical telemetry service (WMTS).

[0129] Various general-purpose computer systems may be used to perform one or more processes, methods, or functionalities described herein. Additionally or alternatively, various specialized computer systems may be used to perform one or more processes, methods, or functionalities described herein. In addition, a variety of programming languages may be used to implement one or more of the processes, methods, or functionalities described herein.

[0130] While certain embodiments and examples have been described above and shown in the accompanying drawings, it is to be understood that such embodiments and examples are merely illustrative and are not limited to the specific constructions and arrangements shown and described, since various other alternatives, modifications, and equivalents will be appreciated by those with ordinary skill in the art.

Claims

What is claimed is:

1. A method for cooling portions of a robotically assisted surgical manipulator having a drape disposed thereover, the method comprising: releasably coupling an inlet cover of the drape to the surgical manipulator; and constricting the drape about a portion of the surgical manipulator proximal of the inlet cover in a direction away from a procedural site to direct air flowing proximally within the drape into the surgical manipulator.

2. The method of claim 1, wherein releasably coupling the inlet cover of the drape to the surgical manipulator comprises releasably coupling the inlet cover of the drape to an instrument holder of the surgical manipulator, and wherein the inlet cover comprises one or more openings to provide an air flow path into the manipulator.

3. The method of claim 1, wherein releasably coupling the inlet cover of the drape to the surgical manipulator comprises snap-fitting the inlet cover to structure of the surgical manipulator.

4. The method of claim 1, wherein releasably coupling the inlet cover of the drape to the surgical manipulator further comprises deflecting a biased door of the instrument holder to enlarge an air flow path through the inlet cover into the manipulator.

5. The method of claim 1, further comprising filtering air entering the drape through the inlet cover with a filter coupled over one or more openings in the inlet cover.

6. The method of any one of claims 1 to 5, further comprising operating a fan disposed within the surgical manipulator, the fan located proximally or distally to the portion of the surgical manipulator having the drape constricted therearound.

7. The method of claim 6, wherein operating the fan comprises drawing air into the surgical manipulator through a housing air flow inlet located adjacent or proximally to the fan.

8. The method of claim 6, wherein the fan is located proximally to the portion of the surgical manipulator having the drape constricted thcrcaround, and further comprising operating a second fan disposed within the surgical manipulator, the second fan located distally to the portion of the surgical manipulator having the drape constricted therearound.

9. The method of any one of claims 1 to 5, wherein constricting the drape about the portion of the surgical manipulator comprises manipulating a cinch coupled to the drape to constrict the drape around the surgical manipulator.

10. The method of claim 9, wherein manipulating the cinch comprises inserting a portion of the cinch into an opening defined by the surgical manipulator.

11. The method of claim 9, wherein manipulating the cinch comprises moving one or more portions of the cinch to at least one of bunch or overlap portions of the drape.

12. The method of claim 9, further comprising securing the cinch to a coupling of the surgical manipulator to locate the cinch at a desired location on the surgical manipulator.

13. The method of claim 9, further comprising: sensing manipulation of the cinch to constrict the drape around the surgical manipulator with a sensor; and determining that a satisfactory constriction of the drape around the surgical manipulator occurred with a control system based on data from the sensor.

14. A surgical system comprising: a drape configured to form a sterility barrier between a sterile surgical field and a surgical manipulator, the drape comprising: a sheath having an interior cavity sized to cover at least a portion of the surgical manipulator to form the sterility barrier; and an inlet cover coupled to the sheath and configured to releasahly couple to the surgical manipulator, the inlet cover defining one or more openings therethrough to provide an air flow path into the sheath.

15. The surgical system of claim 14, wherein the inlet cover further comprises a filter disposed over the one or more openings.

16. The surgical system of claim 14, wherein the inlet cover further comprises protrusions extending inwardly adjacent to the one or more openings to engage the surgical manipulator and open an air flow pathway into the manipulator.

17. The surgical system of claim 14, wherein the inlet cover comprises arms on opposite sides thereof, the arms configured to releasahly connect to complementary structure on the surgical manipulator.

18. The surgical system of claim 14, wherein the inlet cover is configured to releasahly couple to an instrument holder of the surgical manipulator, and wherein the one or more openings of the inlet cover provide an air flow path into the manipulator.

19. The surgical system of any one of claims 14 to 18, further comprising a cinch coupled to the drape and configured to constrict the drape around an exterior perimeter of the surgical manipulator.

20. The surgical system of claim 19, further comprising: a surgical manipulator, the drape disposed over at least a portion of the surgical manipulator to form the sterility barrier; and a fan disposed within the surgical manipulator, the fan located proximally or distally of the cinch in a direction away from a procedural site.

21 . The surgical system of claim 20, wherein the fan is located proximally to the portion of the surgical manipulator having the drape constricted thcrcaround, and further comprising a second fan disposed within the surgical manipulator, the second fan disposed distally of the cinch.

22. The surgical system of claim 20, wherein a housing of the surgical manipulator defines a housing air flow inlet into an interior thereof located adjacent or proximally to the fan.

23. The surgical system of claim 20, further comprising one or more secondary fans disposed within the surgical manipulator located at least one of proximally or distally to the fan, the secondary fans configured to move air away from a procedural site within the drape and relative to the surgical manipulator.

24. The surgical system of claim 20, wherein the surgical manipulator comprises a coupling to receive a portion of the cinch disposing the cinch on the surgical manipulator at a desired location.

25. The surgical system of claim 20, further comprising: a sensor configured to monitor the cinch; and a control system configured to determine whether the cinch properly constricted the drape around the exterior perimeter of the surgical manipulator based on data from the sensor.

26. A method for cooling portions of a robotically assisted surgical manipulator having a drape disposed thereover, the method comprising: constricting an air flow path within the drape to direct the air flow path through a fan; and operating the fan to move air in a direction away from a procedural site within the drape and relative to the surgical manipulator such that air is drawn into the drape through a sterile air flow inlet disposed distally of the fan and the air flow path has a one-way flow between the sterile air flow inlet and the fan.

27. The method of claim 26, wherein constricting the air flow path within the drape comprises manipulating a cinch coupled to the drape to constrict the drape around the surgical manipulator.

28. The method of claim 27, wherein manipulating the cinch comprises inserting a portion of the cinch into an opening defined by the surgical manipulator.

29. The method of claim 27, wherein manipulating the cinch comprises moving one or more portions of the cinch to at least one of bunch or overlap portions of the drape.

30. The method of claim 27, further comprising securing the cinch to a coupling of the surgical manipulator to locate the cinch at a desired location on the surgical manipulator.

31. The method of claim 27, further comprising: sensing manipulation of the cinch to constrict the drape around the surgical manipulator with a sensor; and determining that a satisfactory constriction of the drape around the surgical manipulator occurred with a control system based on data from the sensor.

32. The method of any one of claims 26 to 31, wherein the sterile air flow inlet comprises an inlet portion coplanar with and coupled to the drape, a cap coupled to the drape over an opening defined therein, or a circuitous path leading to an opening defined in the drape.

33. The method of any one of claims 26 to 31, wherein the fan is disposed within a housing of the surgical manipulator; and operating the fan to move air away from the procedural site within the drape comprises drawing air into the housing of the surgical manipulator through a housing air flow inlet along the air flow path.

34. The method of claim 33, wherein operating the fan to move air away from the procedural site within the drape further comprises directing air out from the housing of the surgical manipulator through a housing air flow outlet along the air flow path.

35. The method of claim 34, wherein constricting the air flow path within the drape comprises manipulating a cinch coupled to the drape to constrict the drape around the surgical manipulator between the housing air flow inlet and the housing air flow outlet.

36. The method of claim 34, wherein the housing of the surgical manipulator comprises an inner telescoping housing movable relative to an outer telescoping housing; and directing air out from the housing of the surgical manipulator further comprises directing air out through one or more openings extending through the outer telescoping housing.

37. The method of any one of claims 26 to 31, further comprising operating a second fan proximal to the fan and positioned along the air flow path to move air away from the procedural site within the drape and relative to the surgical manipulator such that the air flow path has a one-way flow between the fan and the second fan.

38. The method of claim 37, further comprising constricting the air flow path within the drape at a second location adjacent to the second fan to direct the air flow path through the second fan.

39. The method of any one of claims 26 to 31, further comprising directing the air flow path along the one-way flow within the drape through an outlet of the drape, the fan being positioned distal to the outlet of the drape.

40. A method for cooling portions of a robotically assisted surgical manipulator having a drape disposed thereover, the method comprising: directing an air flow path along an exterior of a housing of the surgical manipulator within the drape for a first portion of the air flow path; and directing the air flow path into an interior of the housing of the surgical manipulator through a housing air flow inlet defined therein for a second portion of the air flow path.

41. The method of claim 40, further comprising directing the air flow path out from the interior of the housing of the surgical manipulator through a housing air flow outlet defined therein to continue along the exterior of the housing of the surgical manipulator within the drape for a third portion of the air flow path.

42. The method of claim 40, wherein directing the air flow path into the interior of the housing of the surgical manipulator through the housing air flow inlet comprises manipulating a cinch coupled to the drape to constrict the drape around the housing.

43. The method of claim 42, wherein manipulating the cinch comprises inserting a portion of the cinch into an opening defined in the housing of the surgical manipulator.

44. The method of claim 42, wherein manipulating the cinch comprises moving one or more portions of the cinch to at least one of bunch or overlap portions of the drape.

45. The method of claim 42, further comprising securing the cinch to a coupling of the surgical manipulator to locate the cinch at a desired location on the surgical manipulator.

46. The method of claim 42, further comprising: sensing manipulation of the cinch to constrict the drape around the surgical manipulator with a sensor; and determining that a satisfactory constriction of the drape around the surgical manipulator occurred with a control system based on data from the sensor.

47. The method of claim 42, further comprising manipulating a second cinch coupled to the drape to constrict the drape around the surgical manipulator at a location spaced from the cinch.

48. The method of any one of claims 40 to 47, further comprising operating a fan disposed within the interior of the housing of the surgical manipulator between the housing air flow inlet and the housing air flow outlet, operation of the fan moving air away from a procedural site within the drape to direct the air flow path into the interior of the housing of the surgical manipulator through the housing air flow inlet.

49. The method of claim 48, further comprising operating a second fan disposed proximal to the fan to move air away from the procedural site within the drape and relative to the surgical manipulator such that the air flow path has a one-way flow between the fan and the second fan.

50. The method of claim 48, wherein operating the fan comprises drawing air into the drape through a sterile air flow inlet disposed distally of the fan, such that the air flow path has a oneway flow between the sterile air flow inlet and the fan.

51. The method of claim 50, wherein the sterile air flow inlet comprises an inlet portion coplanar with and coupled to the drape, a cap coupled to the drape over an opening defined therein, or a circuitous path leading to an opening defined in the drape.

52. The method of any one of claims 40 to 47, wherein the housing of the surgical manipulator comprises an inner telescoping housing movable relative to an outer telescoping housing; and directing the air flow path out from the interior of the housing of the surgical manipulator through the housing air flow outlet further comprises directing the air flow path through one or more openings extending through the outer telescoping housing.

53. The method of any one of claims 40 to 47, wherein the housing of the surgical manipulator comprises an air flow channel in the interior thereof, and directing the air flow path into the interior of the housing of the surgical manipulator comprises directing the air flow path into and through the air flow channel.

54. A surgical system comprising: a drape configured to form a sterility barrier between a sterile surgical field and a surgical manipulator, the drape comprising: a sheath having an interior cavity sized to cover at least a portion of the surgical manipulator to form the sterility barrier; a sterile air flow inlet disposed in a distal region of the sheath; a cinch coupled to the drape and configured to constrict the drape around an exterior perimeter of the surgical manipulator.

55. The surgical system of claim 54, wherein the sterile air flow inlet comprises an inlet portion coplanar with and coupled to the drape, a cap coupled to the drape over an opening defined therein, or a circuitous path leading to an opening defined in the drape.

56. The surgical system of claim 54 or 55, further comprising: a surgical manipulator, the drape disposed over at least a portion of the surgical manipulator to form the sterility barrier; and a fan configured to move air away from a procedural site within the drape and relative to the surgical manipulator such that air is drawn into the drape through the sterile air flow inlet disposed distally of the fan to create an air flow path having a one-way flow between the sterile air flow inlet and the fan.

57. The surgical system of claim 56, wherein a housing of the surgical manipulator defines a housing air flow inlet into an interior thereof; and the fan is disposed within the interior of the housing.

58. The surgical system of claim 57, wherein the housing of the surgical manipulator further defines a housing air flow outlet; and the cinch is configured to constrict the drape to the exterior perimeter of the surgical manipulator between the housing air flow inlet and the housing air flow outlet.

59. The surgical system of claim 58, wherein the housing comprises an inner telescoping housing, the surgical manipulator further comprises an outer telescoping housing defining one or more openings extending therethrough, and the inner and outer telescoping housings are movable relative to one another, such that air flow through the housing air flow outlet passes through the one or more openings of the outer telescoping housing when the outer telescoping housing is disposed radially outwardly of the housing air flow outlet.

60. The surgical system of claim 56, further comprising a second fan disposed proximal to the fan, the second fan configured to move air away from a procedural site within the drape and relative to the surgical manipulator such that the air flow path has a one-way flow between the fan and the second fan.

61. The surgical system of claim 60, further comprising a second cinch constricting the air flow path within the drape at a second location adjacent to the second fan to direct the air flow path through the second fan.

62. The surgical system of claim 56, wherein the air flow path has a one-way flow within the drape from the sterile air flow inlet through an outlet of the drape.

63. The surgical system of claim 56, wherein the surgical manipulator comprises a coupling to receive a portion of the cinch disposing the cinch on the surgical manipulator at a desired location.

64. The surgical system of claim 54 or 55, further comprising: a sensor configured to monitor the cinch; and a control system configured to determine whether the cinch properly constricted the drape around the exterior perimeter of the surgical manipulator based on data from the sensor.

65. A surgical system comprising: a surgical manipulator including a housing having an interior with an internal cooling channel; and a drape configured to form a sterility barrier between a sterile surgical field and the surgical manipulator; wherein, when the drape is disposed over the surgical manipulator, an air flow path for the surgical manipulator includes a first portion being external to the housing of the surgical manipulator and internal to the drape and a second portion being internal to the internal cooling channel within the interior of the housing of the surgical manipulator.

66. The surgical system of claim 65, wherein, when the drape is disposed over the surgical manipulator, the air flow path for the surgical manipulator further includes a third portion being external to the housing of the surgical manipulator and internal to the drape.

67. The surgical system of claim 65 or 66, wherein the drape comprises a sheath having an interior cavity, and a sterile air flow inlet for the air flow path disposed in a distal region of the sheath.

68. The surgical system of claim 67, further comprising a cinch coupled to the drape and configured to constrict the drape around an exterior perimeter of the housing of the surgical manipulator.

69. The surgical system of claim 68, wherein the cinch includes a portion secured to the drape.

70. The surgical system of claim 68, wherein the surgical manipulator comprises a coupling to receive a portion of the cinch disposing the cinch on the surgical manipulator at a desired location.

71. The surgical system of claim 68, further comprising: a sensor configured to monitor the cinch; and a control system configured to determine whether the cinch properly constricted the drape around the exterior perimeter of the housing of the surgical manipulator based on data from the sensor.

72. The surgical system of claim 68, further comprising a fan configured to move air away from a procedural site within the drape and relative to the surgical manipulator such that air is drawn into the drape through the sterile air flow inlet disposed distally of the fan so that the air flow path has a one-way flow between the sterile air flow inlet and the fan.

73. The surgical system of claim 72, wherein the fan is disposed within the interior of the housing of the surgical manipulator within the second portion of the air flow path.

74. The surgical system of claim 72, further comprising a second fan disposed proximal to the fan, the second fan configured to move air away from a procedural site within the drape and relative to the surgical manipulator such that the air flow path has a one-way flow between the fan and the second fan.

75. The surgical system of claim 74, further comprising a second cinch configured to constrict the air flow path within the drape to direct the air flow path through the second fan.

76. The surgical system of claim 67, wherein the sterile air flow inlet comprises an inlet portion coplanar with and coupled to the drape, a cap coupled to the drape over an opening defined therein, or a circuitous path leading to an opening defined in the drape.

77. The surgical system of claim 67, wherein the air flow path has a one-way flow away from a procedural site within the drape from the sterile air flow inlet through an outlet of the drape.

78. A surgical system comprising: a surgical manipulator; a drape configured to form a sterility barrier between a sterile surgical field and the surgical manipulator, the drape having a proximal opening; a flow channel extending within the drape with an outlet at a distal location relative to the surgical manipulator; and a cooling device including a fan configured to direct cooling air into the flow channel creating an air flow path having a one-way flow through the flow channel and back through the proximal opening of the drape.

79. The surgical system of claim 78, wherein the flow channel is coupled to the drape.

80. The surgical system of claim 78, wherein the cooling device is disposed at or adjacent to the proximal opening of the drape.

81 . The surgical system of claim 78, wherein the flow channel is defined in an interior of the surgical manipulator; and the cooling device is disposed within the interior of the surgical manipulator.

82. The surgical system of any one of claims 78 to 81, wherein the cooling device comprises a thermoelectric cooler.