CROSS-REFERENCE TO RELATED APPLICATION

[0001] This application claims the benefit of priority to the Singapore application no. 10202251022W filed September 15, 2022, the contents of which are hereby incorporated by reference in their entirety for all purposes.

TECHNICAL FIELD

[0002] This application relates to the handling of surgical instruments and more specifically to methods and apparatus involving the handling of surgical instruments.

BACKGROUND

[0003] Surgery is an important aspect of healthcare. A large number of surgical instruments must be cleaned, inspected, assembled, and sterilized for each surgery. However, owing to the variety and variability of the instruments in each surgical instrument set, nurses in specialized units have to manually inspect and assemble each surgical instrument set.

SUMMARY

[0004] According to one aspect, a bracket includes: a first support member, a second support member, a first receiver rod, and a second receiver rod. The first support member includes a first connecting portion and a first coupled end. The first connecting portion is spaced apart from the first coupled end. The second support member includes a second connecting portion and a second coupled end. The second connecting portion is spaced apart from the second coupled end. The second coupled end and the first coupled end are hingedly coupled together and rotatable relative to one another about a hinge joint. The first support member and the second support member are parallel to a support plane. The first receiver rod extends from the first connecting portion. The first receiver rod extends along a receiving direction that is nonparallel to the support plane. The second receiver rod extends from the second connecting portion.

[0005] In another aspect, the bracket may be used with one or more ring surgical instruments. Each ring instruments may be a first class lever formed by two shafts cooperatively forming a functional tip and including two ring sections. The bracket includes: a first support member having a first connecting portion and a first coupled end, the first connecting portion being spaced apart from the first coupled end; a second support member having a second connecting portion and a second coupled end, the second connecting portion being spaced apart from the second coupled end, the second coupled end and the first coupled end being hingedly coupled together and rotatable relative to one another about a hinge joint, the first support member and the second support member being parallel to a support plane; a first receiver rod, the first receiver rod extending from the first connecting portion, the first receiver rod extending along a receiving direction that is non-parallel to the support plane; and a second receiver rod, the second receiver rod extending from the second connecting portion, wherein the first receiving rod and the second receiving rod are in slidable engagement with respective ones of the two ring sections of any one or more of the ring instruments.

[0006] In yet another aspect, a system includes: a ring instrument inspection station and a first robotic arm. The ring instrument inspection station may be configured to inspect a plurality of ring instruments. Each of the plurality of ring instruments may be a first class lever formed by two shafts, in which each of the two shafts includes a functional tip and a respective ring section at either end. The first robotic arm may be configured to transfer a plurality of ring instruments to and from the ring instrument inspection station by transporting a bracket according to any one described above, with the plurality of ring instruments assembled thereto. [0007] In another aspect, a method includes using a first robotic arm to perform transferring of a plurality of ring instruments together before and/or after a ring instrument inspection, the first robotic arm being controllably operable to pick up and transfer the bracket according to any described above. The method includes: disengaging each one of the plurality of ring instruments in turn from the bracket before the ring instrument inspection; performing the ring instrument inspection of the plurality of ring instruments one ring instrument at a time in turn, with the one ring instrument disengaged from the bracket. The method includes: assembling the bracket with a predefined number of predefined types of the ring instruments in a predefined order. The method of inspection may further include any one or more of the following: (i) performing a non-ring inspection of a plurality of non-ring instruments and (ii) a wrapping of selected ones of the plurality of non-ring instruments.

BRIEF DESCRIPTION OF THE DRAWINGS

[0008] Various embodiments of the present disclosure are described below with reference to the following drawings:

[0009] FIG. 1A is a schematic diagram showing a partial work flow for preparation for surgical operations;

[0010] FIG. IB is a schematic diagram illustrating a system according to embodiments of the present disclosure;

[0011] FIG. 1C is a schematic workflow diagram illustrating a method executed by the system according to embodiments of the present disclosure;

[0012] FIG. 2 is a perspective view of the system according to one embodiment;

[0013] FIG. 3 A and FIG. 3B are perspective and top views of another embodiment of the system; [0014] FIG. 4A is a perspective view of a loading station according to one embodiment of the system;

[0015] FIG. 4B is a schematic top view of a partial instrument set;

[0016] FIG. 5 is a perspective view of a bracket according to an embodiment;

[0017] FIG. 6 is another perspective view of FIG. 5;

[0018] FIG. 7 is a perspective view of a bracket according to another embodiment;

[0019] FIG. 8 is another perspective view of FIG. 7;

[0020] FIG. 9 is a partial top view of a bracket according to another embodiment;

[0021] FIG. 10 is a perspective view of a bracket according to another embodiment;

[0022] FIG. 11A to 11C are images of a bracket with multiple instruments in different operating states;

[0023] FIG. 12 is a perspective view of a gripper of a robotic arm picking up a ring instrument from a bracket according to an embodiment;

[0024] FIG. 13 is a perspective view of a ring instrument inspection station and a spare ring instrument station according to an embodiment;

[0025] FIG. 14 is another perspective view of the ring instrument inspection station of FIG. 13;

[0026] FIG. 15 is a top view of FIG. 14;

[0027] FIG. 16 is a partial perspective view of the ring instrument inspection station of FIG. 15;

[0028] FIG. 17 is a partial perspective view of the ring instrument inspection station of FIG. 15;

[0029] FIG. 18A and FIG. 18B are schematic flow diagrams of a work flow for crack detection and for detecting worn out instruments, respectively; [0030] FIG. 19A and FIG. 19B are perspective and top views of a non-ring instrument inspection station, a wrapping station, and a spare non-ring instrument station according to an embodiment;

[0031] FIG. 20 is a perspective view of a non-ring instrument inspection station according to an embodiment;

[0032] FIG. 21 is a front view of FIG. 20;

[0033] FIG. 22 is a partial perspective view of the non-ring instrument inspection station of FIG. 20;

[0034] FIG. 23 is a perspective view of a wrapping station according to one embodiment;

[0035] FIG. 24 is a top view of FIG. 23;

[0036] FIG. 25 A and FIG. 25B are perspective and top views of a wrapping module according to one embodiment;

[0037] FIG. 26A and FIG. 26B are perspective and side views of a wrapping station according to another embodiment;

[0038] FIG. 27 is a perspective view of an unloading station according to one embodiment;

[0039] FIG. 28 is a partial perspective view of the unloading station of FIG. 27;

[0040] FIG. 29 is a schematic diagram of a picking method according to embodiment of the present disclosure;

[0041] FIG. 30 and FIG. 31 are schematic flow diagrams illustrating one exemplary setup process;

[0042] FIG. 32, FIG. 33, and FIG. 34 are schematic flow diagrams illustrating one exemplary inspection process for a variety of surgical instruments;

[0043] FIG. 35 is a schematic diagram illustrating an exemplary work flow of a robotic arm operating at a ring instrument inspection station; [0044] FIG. 36 is a schematic diagram illustrating an exemplary work flow of a tipinstrument inspection;

[0045] FIG. 37 is a schematic diagram illustrating an exemplary work flow of a flatinstrument inspection;

[0046] FIG. 38 is a schematic diagram illustrating an exemplary work flow of a ring instrument inspection;

[0047] FIG. 39 is a schematic diagram illustrating an exemplary printer work flow;

[0048] FIG. 40 is a schematic diagram illustrating an exemplary wrapping process;

[0049] FIG. 41 is a schematic diagram illustrating an exemplary work flow at a spare nonring instrument station;

[0050] FIG. 42 is a schematic diagram illustrating an exemplary work flow at a spare ring instrument station; and

[0051] FIG. 43 is a schematic diagram illustrating an error recovery process.

DETAILED DESCRIPTION

[0052] The following detailed description is made with reference to the accompanying drawings, showing details and embodiments of the present disclosure for the purposes of illustration. Features that are described in the context of an embodiment may correspondingly be applicable to the same or similar features in the other embodiments, even if not explicitly described in these other embodiments. Additions and/or combinations and/or alternatives as described for a feature in the context of an embodiment may correspondingly be applicable to the same or similar feature in the other embodiments.

[0053] In the context of various embodiments, the articles “a”, “an” and “the” as used with regard to a feature or element include a reference to one or more of the features or elements. [0054] In the context of various embodiments, the term “about” or “approximately” as applied to a numeric value encompasses the exact value and a reasonable variance as generally understood in the relevant technical field.

[0055] As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items.

[0056] As used herein, “comprising” means including, but not limited to, whatever follows the word “comprising”. Thus, use of the term “comprising” indicates that the listed elements are required or mandatory, but that other elements are optional and may or may not be present. [0057] To aid understanding and not to be limiting, a detailed description of various embodiments of a surgical instrument preparation system 100 with various sub-systems will be described below with reference to the appended drawings. The instrument preparation system 50 may be modular and configurable to include sub-systems or functions as required.

[0058] Instruments

[0059] Surgical instruments are essential to any surgical operation. On the average, each surgery can use two to five sets of surgical instruments. Highly complex operations may require even more sets of surgical instruments. Standard surgical procedures require sterilized surgical instruments to be provided in pre-defined sets, with each set of surgical instruments placed in a covered container (also referred to as a "box" of surgical tools or surgical instruments set). Different types of surgeries require different combinations of surgical instruments in each box, e.g., different boxes or different sets. The apparatus and processes described in the present application can be applied to various different types of surgical instrument sets with variations that do not go beyond the claimed scope. For the purpose of illustration, the following description will be made with reference to a frequently used surgical instrument set, the "GES Basic Set", that includes 24 different types of items as listed in Table 1, but it will be understood that the present bracket, system, and method of inspection and assembly may be used for other types of surgical instruments or surgical instrument sets.

Table 1. GES Basic Set

[0060] There can be various types of forceps, e.g., forceps for arteries ("Forceps Artery") and forceps for tissues ("Forceps Tissue"), in one set of instruments. In this example, there are two sizes of forceps for arteries (e.g., 180 mm and 140 mm). There are differently shaped instruments, e g., curved scissors and straight scissors. There are also instruments that are generally similar and yet different, e g., both the Crilewood needle holder and the Mayo Hegar needle holder have approximately the same dimensions (150 mm), but surgical staff would appreciate that the Crilewood needle holder is more delicate than the Mayo Hegar needle holder. For each type of instrument, there may be variations in dimensions (size), shape (e.g., profile), colors, etc., as the instruments may be sourced from different suppliers.

[0061] The instruments in a set 99 (e g., the GES Basic Set) may be generally categorized under "non-ring instruments" and "ring instruments", as well as containers, such as the gallipot and the kidney dish. The ring instruments may include forceps, holder needles, scissors, etc. In the present disclosure, the term "ring instrument" refers to any surgical instrument with rings or loops for fingers of the user to pass through and thereby manipulate the instrument between an opened state and a closed state. The ring instrument 92 is a form of a first class lever in which the two shafts of the instrument is pivotably joined (also called a box mechanism) between the load (functional tip) 950 and the force (ring section) 940. This complicates the inspection process because the opening and closing of the ring instrument has to be checked. A worn or otherwise defective ring instrument may be one with a functional tip that cannot close fully and therefore fail to hold or cut properly, etc. The box mechanism may be rusty or otherwise fail to pivot smoothly, etc. In the present disclosure, the term "non-ring instrument" refers to any other surgical instrument that when in use does not involve a scissor-like movement between its parts. Instruments such as retractors, clip towel jones and loose instruments such as handle bard parker, spear redivac, rulers, etc., as well as the containers (such as the gallipot and kidney dish) may be classified as non-ring instruments or loose instruments for the purpose of the present disclosure.

[0062] In the present disclosure, the terms "instruments", "surgical instruments", "surgical tools", "tools" and the like, may be used interchangeably, and may include items such as kidney dishes, forceps, needle holders, clips, scissors, etc., that are packed or assembled as a set, a box, or a kit of surgical instruments. The term “surgical set preparation” refers to processes performed on sets of instruments in preparation for use in surgery, including but not limited to one or more of the following: transferring, inspecting, cleaning, repairing, replacing, servicing, lubricating, assembling (into a set), wrapping, consolidating, collecting, labelling, sterilizing, etc. The proposed system 1000 can provide greater efficiency and safety in the inspection process but this does not preclude the system 1000 from performing other processes, such as maintenance or wrapping, etc., which conventional methods may require separate manual processes to execute. As schematically shown in FIG. 1A, various embodiments of the present system 1000 and method 9000 may be implemented after a step of washing (e.g., cleaning) 20 of the surgical instrument sets, and before a step of sterilization (e.g., autoclave) 30 of the surgical instrument sets.

[0063] System Overview

[0064] FIG. IB is a schematic diagram of a system 1000 according to various embodiments of the present disclosure. The system 1000 may be described in terms of interconnected or integrated modules referred to as bays or stations 1900. The system 1000 may include one or more inspection stations. The system 1000 may include a ring instrument inspection station 2000 at which various surgical instruments with rings can be inspected. In the present disclosure, the term "inspection" is used generally and may include identifying instruments in a set that need to be replaced, instruments that do not meet the cleanliness standards, instruments that are worn out, instruments that are blunt from use, instruments that may be defective or otherwise unsuitable for use in a surgical operation. In the example illustrated here, the system 1000 includes a non-ring inspection station 3000 at which various other surgical instruments can be inspected. The system 1000 may include a wrapping station 4000 at which selected non-ring instruments can be wrapped. For example, one or more clip towel jones may be collectively wrapped and labelled at the wrapping station 4000. For example, selected loose instruments may be wrapped and labelled at the wrapping station 4000. The system 1000 includes a loading station 6000 to receive instruments. The system 1000 includes an unloading station 7000 from which a user can retrieve instruments from the system 1000.

[0065] The first robotic arm 1500 and the second robotic arm 1510 may be configured to operate concurrently and independently. The transfer of the instruments (ring instruments and non-ring instruments) may be planned such that use of each of the inspection stations or stations 1900 is optimized. The system 1000 may process as many as six GES Basic Sets when fully loaded. For each set, the processing time can be as short as 15 minutes.

[0066] The system 1000 may include one or more sensing devices (e.g., cameras, proximity sensors, etc.) 1040 at each of the stations (e.g., ring inspection station 2000, non-ring inspection station 3000, wrapping station 4000, etc.) or at selected locations in the system 1000 to acquire images for inspection, control feedback, etc. For example, the instrument preparation system 1000 may include a frame 1001 with an optical system mounted to the frame 1001. The optical system may include a plurality of cameras configured to obtain two-dimensional images and/or three-dimensional volumetric data of the workspace 1006 of the system 1000. The workspace 1006 may be defined as a volumetric space defined by all sub-systems/bays of the instrument preparation system 1000 in which the surgical instruments are maneuvered, transported, inspected, maintained, assembled, etc. The computing device 1030 (e.g., a controller, a control system, etc.) may be configured to determine a position and a respective orientation of each of the surgical instruments, for example the ring instruments and the non-ring instruments, based on input from the sensing devices 1040.

[0067] In some embodiments, the system 1000 includes a first robotic arm 1500 controllable by a computing device 1030. In some embodiments, the first robotic arm 1500 is installed so that a first end-effector 1502 coupled to the first robotic arm 1500 can reach and manipulate objects in any of the bays. In some embodiments, the first robotic arm 1500 is surrounded by the various stations 1900 allowing efficient transfer of instruments from one station to another. For example, the first robotic arm 1500 may pick up and transport a ring instrument from the loading station 6000 to the ring instrument inspection station 2000 for inspection. Upon the ring instrument passing inspection, the first robotic arm 1500 may pick up and transport the ring instrument to the unloading station 7000 for assembly. Concurrent with the inspection of the ring instrument, the first robotic arm 1500 may pick up and transport a non-ring instrument from the loading station 6000 to the non-ring instrument inspection station 3000 for inspection. Upon the non-ring instrument passing inspection, the first robotic arm 1500 may pick up and transport the non-ring instrument to the wrapping station 4000 for wrapping. Thereafter, the first robotic arm 1500 may transport the wrapped non-ring instrument to the unloading station 7000 for assembly.

[0068] In some embodiments, the system 1000 may include a second robotic arm 1510 controllable by the computing device 1030. The second robotic arm 1510 may be coupled with a second end-effector 1512 for handling or manipulating objects concurrently and independently of the first robotic arm 1500.

[0069] The computing device 1003 may be configured to execute instructions stored in a computer-readable medium to perform a method 9000 involving any one or more of the stations 1900 of the system 1000. The computing device 1030 may be programmed to communicate with the sensing device or sensing devices 1040 and to controllably operate the first robotic arm 1500 and/or any one or more of the second robotic arm 1510.

[0070] For ease of installation at different sites, e.g., different hospitals and surgical centers, the system 1000 may be an integration of a plurality of stations 1900. This advantageously enables greater flexibility in accommodating any space constraints.

[0071] The method 9000 or work flow for preparation of surgical instruments for use in surgical operations may vary from hospital to hospital. Various embodiments of a system 1000 and/or a process (or method) 9000 described herein may be implemented as part of such preparations to replace the manual inspection of each instrument before each set is sterilized for the next use. Advantageously, the present system 1000 may be configured to execute an inspection process 9000 following a washing process and preceding a sterilization process. FIG. 1C schematically illustrates a work flow or method 9000 in terms of processes and/or subprocesses. The process 9000 may include a loading process 9100, a transfer subprocess 9500, an inspection (and maintenance) subprocess 9200, a wrapping subprocess 9400, an assembly process 9600, and an unloading process 9700. The system 1000 processes the surgical instruments in sets (corresponding to trays) as many hospitals currently transport, wash, and sterilize surgical instruments in sets or trays. This advantageously means that hospitals and surgical centers can implement the present system 1000 and process 9000 without disrupting their current procedures which involve washing and sterilizing surgical instruments in predefined sets. Beneficially, nurses can be relieved from the eye-straining task of manually inspecting each surgical instrument and can reduce the amount of time spent handling sharp instruments.

[0072] As illustrated schematically in FIG. 2, in some embodiments, the system 1000 may be housed in an enclosure 1002, e.g., to enable access control and/or to provide a cleaner environment for handling of the surgical instruments. The system 1000 may include indicator lights 1004 to indicate when surgical instrument sets are ready for collection, or to indicate fault or maintenance needs. The system 1000 may further include other modules, such as a printer bay 1072, a tray paper bay 1074, and an indicator dispenser and sticker tag printer 1076, etc. [0073] FIG. 3 A shows a perspective view of the system 1000 according to another embodiment of the present disclosure, and FIG. 3B shows a top view of the system 1000 of FIG. 3 A. The system 1000 includes a loading station 6000; a ring inspection station 2000; a non-ring inspection station 300; a wrapping station 4000; and an unloading station 7000. The system 1000 may include a first robotic arm 1500 and a second robotic arm 1510 as part of a transfer module. Further, the system 1000 may also include a spare ring instrument station for holding a plurality of spare ring instruments, as well as a spare non-ring instrument station for holding a plurality of spare non-ring instruments. As shown, the relative position of the stations 1900 can be varied according to space constraints at the hospital or surgical center.

[0074] Referring to FIG. 1C to FIG. 3B, the method 9000 or process includes a loading process 9100. The loading station 6000 may be a wet bay that can handle instruments 90 received from a preceding process, such as a washing process 20. In some examples, the user loads the surgical instruments 90 in trays 110 at the loading station 6000 after the instruments 90 come out of the washer. The ring instruments 92/90 are secured to one or more brackets. The various loose items (e.g., not secured by a mayo clip or by a bracket of the present disclosure) or non-ring instruments 93/90 may be disposed in the kidney dish 112/90. The transfer processes 9500 may be performed by one or more robotic arms 1500/1510. The first robotic arm 1500 may be a collaborative type of robot and the first end-effector 1502 mounted to its distal end may be a gripper suitable for pick-and-place operations of objects generally the size and weight of surgical instruments 90. The first robotic arm 1500 may be configured to pick up instruments 90 from the loading station 6000. Responsive to identifying the instrument 90 as a non-ring instrument 93, the first robotic arm 1500 may be configured to place an instrument 90 on a first processing table 3010 (Processing Table 1) before transferring the instrument 90 to the non-ring inspection station 3000. The system 1000 may include a non-ring spare station 3600 to store a range of spare non-ring instruments 93. Responsive to detecting defects with a non-ring instrument, the first controller arm 1500 may be configured to discard the defective instrument (e.g., by placing the defective instrument in a chute for rejected items) and to take another instrument 90 from the non-ring spare station 3600 as a replacement.

[0075] Upon completion of the inspection of non-ring surgical instruments 93, the first robotic arm 1500 may be configured to move selected ones of the non-ring surgical instruments 93 to the wrapping station 4000. At the wrapping station 4000, the selected non-ring instruments 93 are wrapped in a wrapper, e.g., crepe paper or a suitable alternative type of paper.

[0076] The first robotic arm 1500 may be configured to transfer the wrapped instruments from the wrapping station 4000 to the dry station or the unloading station 7000. The first robotic arm 1500 may be configured to assemble various pre-defined items in one tray 110, e.g., a steam indicator may be obtained (e.g., from an indicator dispenser and sticker tag printer 1076) and placed in the tray 110 if needed. The sticker tag printer 1072 may print a barcode tag to be included with the assembled surgical instrument set.

[0077] In various embodiments of the present disclosure, all the ring instruments 92 are held by one or more brackets 5000 when the set of surgical instruments are fully assembled in the tray. In the case of a GES Basic Set, a bracket 5001/5000 (for convenience, referred to as the forceps bracket or the bracket holding various pairs and types of forceps) may be provided to hold twelve units of Forceps Artery Adson (curved, 180 mm) and one unit of Forceps Artery Crile (curved 140 mm). Another bracket 5002/5000 (for convenience, referred to as the mix bracket or the bracket holding a mix of various non-forceps ring instruments) may be provided to hold one unit each of two types of Holder Needles, two units each of the Forceps Tissue Littlewood and the Forceps Tissue Stilles, four units of the Forceps Tissue Babcock, one unit of the Forceps Sponge-Holding Rampley, and one unit each of the Scissors Dressing Nurses 165 mm, the Scissors Mayo 170 mm, and the Scissors Dissecting Metzenbaum 180 mm. The first robotic arm 1500 may be configured to place the bracket 5000 with ring instruments 92 on a second processing table 2010 before transferring the ring instruments 92 one at a time to the ring inspection station 4000. The system 1000 may include a ring spare station 2600 to store a range of spare ring instruments 92. Responsive to detecting defects in a ring instrument, the first controller arm 1500 may be configured to discard the defective instrument (e g., by placing the defective instrument in a chute for rejected items) and to take another instrument 90 from the ring spare station 2600 as a replacement. The manipulation of the ring instrument 92 at the second processing table 2010 and/or the ring inspection station 2000 may be carried out by a second robotic arm 1510 and a suitable end-effector 1512 coupled to the second robotic arm 1200. The ring instrument 92 may be coupled to another bracket 5000 after inspection. The bracket 5000 of inspected ring instruments 92 may then be transferred from the ring inspection station 2000 (including the second processing table 2010 to the unloading station 7000. The assembly process 9600 includes re-assembling the surgical instruments 90 back in a tray 110. The instruments 90 that came in the same set (tray) 110 at the loading station 6000 are reassembled back in one set (tray) 110, with the necessary replacements. The system 1000 may include a printer / printer bay 1072 to print a log sheet. The log sheet may be wrapped with a wrapper (e.g., crepe paper) from a tray paper station 1074 and included in the tray 110. The reassembled set 110 of instruments 90 can then be retrieved by the user from the unloading station 7000. The system 1000 may be configured to leave the re-assembled tray 110 uncovered or covered but unlocked. The user can collect the inspected instruments 90 in sets or trays 110, perform a visual check of the number and types of instruments 90 in each tray 110 (without the need to handle the instruments by hand), and lock each covered tray 110 in readiness for use in a surgical operation.

[0078] Loading

[0079] To aid understanding, physical details of various aspects of the system 1000 will be described. In some embodiments, as illustrated in FIG. 4A, the loading station 6000 may include a loading rack 6002. The loading rack 6002 may provide a plurality of drawers 6100. Each drawer 6100 may be slidably cooperative with a pair of rail elements 6200 that enable the drawer 6100 to be drawn open at an outward-facing user side 6006 by a user to load an uncovered tray 110 of washed instruments. Each drawer 6100 may be sized to hold one uncovered tray 110. The same drawer 6100 can be drawn open from an opposing inward-facing system side 6008 by the first robotic arm 1500. The first robotic arm 1500 may be configured to open each occupied drawer in turn from the system side 6008 to pick up the instruments disposed in the uncovered tray 110. Alternatively, responsive to detecting which drawers have loaded trays, the rail elements 6200 may be controllably actuated to open the drawers 6100 at the system side 6008. FIG. 4A shows an example of the loading station 6000 with six drawers 6100 such that the loading station 6000 when fully loaded can process six sets or trays 110 of surgical instruments 90 in one operational cycle. In other examples, the loading station 6000 may be constructed with different numbers of drawers 6100.

[0080] FIG. 4B is a schematic top view of an incomplete set or tray 110 of surgical instruments 90. The tray 110 may hold various surgical instruments 90 such as ring instruments 92 and non-ring instruments 93. The tray 110 may also include a gallipot 113/90 and a kidney dish 112/90 in which are disposed various loose instruments 90 such as the non-ring instruments 93. Ring instruments 92 may be stacked in a predefined order by a bracket 5000 of the present disclosure (not shown in FIG. 4B to avoid obfuscation).

[0081] Bracket

[0082] According to one aspect, various embodiments of the present disclosure includes a bracket 5000. The bracket 5000 includes a first support member 5101 and a second support member 5202 hingedly coupled or pivotably coupled to one another at respective anterior ends 5111/5112 via a hinge joint 5010, and a pair of first and second receiver rods 5201/5202 extending from the first support member 5101 and second support member 5102 respectively. Each receiver rod 5200 includes an elongated body with a support end 5220 and an opposing handle end 5210. Each first or support member 5101/5102 includes a posterior end 5120 that is spaced apart from the hinge joint 5010 along a length of the support member 5100. The posterior end 5120 of each support member 5100 is fixedly coupled to the support end 5220 of one of the receiver rods 5200. The respective handle ends 5210 of the receiver rods 5200 may be free or unengaged.

[0083] For convenient reference, each support member 5100 (e.g., the first support member 5101, the second support member 5102) may be described as being substantially disposed in a respective support plane 5131/5132. In various embodiments, the support planes 5130 of the first support member 5101 and the second support member 5102 may be coplanar or substantially coplanar, or coincident. In various embodiments, the support planes 5130 may be parallel or substantially parallel to one another.

[0084] For convenient reference, the elongated body of the first receiver rod 5201 may be described as defining a first receiver axis 5231. In some embodiments, the first receiver rod 5201 or the first receiver axis 5231 is non-parallel to the first support member 5101 or to the support plane 5130/5131 defined by the first support member 5101. In some embodiments, the first receiver rod 5201 or the first receiver axis 5231 is normal or substantially normal to the first support member 5101 or to the support plane 5130/5131 defined by the first support member 5101.

[0085] The bracket 5000 can be used with one or more ring instruments 92. In some embodiments, the bracket 5000 in use has its first receiver rod 5201 threaded through a respective ring section 940 of each of a plurality of ring instruments 92. The first receiver rod 5201 is sized to accommodate ring sections 940 of various sizes over a relatively wide range. The respective ring 940 and first receiver rod 5201 together can form a first engagement. In various embodiments, the diameter of the first receiver rod 6201 is significantly smaller than the diameter of the ring section 940 such that the first engagement forms a relatively loose slidable engagement. For example, the first engagement may be such that the ring instrument 92 can slide easily along the first receiver rod 5201. This enables one easy disengagement, assembly, or re-assembly of one or more ring instruments to the bracket 5000. The non-parallel orientation of the first and second receiver rods 5201/5202 relative to the first and second support members 5101/5102 prevent those ring instruments 92 already assembled to the bracket 5000 from easily disengaging or slipping out of the bracket 5000. When the bracket 5000 is placed "upright" or substantially upright with at least one of the support members 5100 contacting a mounting surface 2032, the effect of gravity or the weight of the ring instruments 92 would mean bring the one or more ring instruments to rest against the support members 5100 (e.g., near the support end 5220 of the receiver rod 5200), and hence be less likely to slip off the handle end 5210 of the receiver rod 5200.

[0086] In some embodiments, the bracket 5000 includes a first holder rod 5301 extending from the posterior end 5120/5121 of the first support member 5101, generally on the same side or generally in a similar direction as the first receiver rod 5201. The first holder rod 5301 may include an elongated body with a support end 5321 and an opposing handle end 5311, in which the support end 5321 is coupled to the posterior end 5120/5121 of the first support member 5101. The first holder rod 5301 extends from the first support member 5101 parallel to the first receiver rod 5201. The first holder rod 6301 is spaced apart from the first receiver rod 5201 to define a first ring slot 5401.

[0087] In some embodiments, the bracket 5000 includes a second holder rod 5302 extending from the posterior end 5120/5122 of the second support member 5102, generally on the same side or generally in a similar direction as the second receiver rod 5202. The second holder rod 5302 may include an elongated body with a support end 5322 and an opposing handle end 5312, in which the support end 5320/5322 is coupled to the posterior end 5120/5132 of the second support member 5102. The second holder rod 5302 extends from the second support member 5102 parallel to the second receiver rod 5202. The second holder rod 5302 is spaced apart from the second receiver rod 5202 to define a second ring slot 5402. [0088] In some embodiments, the bracket 5000 includes a holder 5500. The holder 5500 may define two or more limiter slots 5510. The holder 5500 may be disposed transversely relative to the two holder rods 5300, with the limiter slots 5510 oriented transversely and extending between the two holder rods 5300. Each of the first holder rod 5301 and the second holder rod 5302 may be engaged at a different limiter slot 5510. Each holder rod 5300 may slide along the limiter slot 5510. For example, one or more of the holder rods 5300 may be slidably engaged with a respective one of the two or more limiter slots 5510 such that the two holder rods 5300 may move toward or away from one another. The angular displacement (a) defined between the first support member 5101 and the second support member 5102 correspondingly becomes bigger or smaller. In some embodiments, the limiter slots 5510 serves to engage the holder rods 5300. In some embodiments, the limiter slots 5510 serves to limit the angular displacement defined between the support members 5100.

[0089] The handle ends 5310 of the holder rods 5300, e.g., the ends of the holder rods 5300 proximal to the holder 5500 or extending beyond the limiter slots 5510/holder 5500, may be held/gripped by the first robotic arm 1500 (e.g., by the end-effector 1502 of the first robotic arm 1500) and/or the second robotic arm 1510 (e.g., the end-effector 1512 of the second robotic arm 1510). This will suffice to support and/or transport the bracket 5000 with/without a full/partial assembly of one or more ring instruments 92. In some embodiments, it may suffice for the bracket 5000 to be held/gripped only by one of the holder rods 5300. In some embodiments, it may suffice for the bracket 5000 to be held/gripped only by one of the receiver rods 5200. In some embodiments, the holder 5500 may be optional.

[0090] In some embodiments, the bracket 5000 includes a first catcher rod 5601 coupled to the first support member 5101 and extending parallel or substantially parallel to the first receiver rod 5201. A first catch 5611 may be slidably engaged to the first catcher rod 5601 and releasably engageable with the first receiver rod 5201. The first catch 5611 may include a first hook 5621 that is rotationally coupled to the first catcher rod 5601 and releasable from the first receiver rod 5201.

[0091] In some embodiments, the bracket 5000 includes a second catcher rod 5602 coupled to the second support member 5102 and extending parallel or substantially parallel to the second receiver rod 5202. A second catch 5612 may be slidably engaged to the second catcher rod 5602 and releasably engageable with the second receiver rod 5202. The second catch 5612 may include a second hook 5622 that is rotationally coupled to the second catcher rod 5601 and releasable from the second receiver rod 5202.

[0092] FIGS. 5 to 8 illustrate an embodiment of a ring surgical instrument holder or a bracket 5000 that can be used to hold a plurality and a variety of ring instruments 92, such as but not limited to needle holders, forceps, scissors, etc. The bracket 5000 may hold ring instruments 92 with different dimensions (e.g., lengths, widths, and ring sizes/shapes). The bracket 5000 is configured to enable transport of the bracket 5000 (with any ring instrument 92 assembled thereto) by gripping only one of the holder rods 5300/receiver rods 5200 proximal to the handle end 5310/5210. The bracket 5000 allows easy transportation of multiple ring instruments 92 held by the bracket 5000, as well as easy pick-up and handling of the ring instruments 92 by an end effector 1502/1512 of a robotic arm 1500/1510, such as a gripper end effector, providing a user-friendly and a robot-friendly bracket 5000. The bracket 5000 may be made from a relatively corrosion resistant and heat resistant material, such as 304 stainless steel.

[0093] In some embodiments, the bracket 5000 may include a first support member 5101 coupled to a second support member 5102. In some examples, the first support member 5101 is hingedly coupled to the second support member 5102 or, in other words, coupled to one other via a hinge joint 5010. The hinge joint 5010 may be disposed on respective ends of the support members 5100. The first support member 5101 and the second support member 5102 may be pivotable relative to one other in a support plane 5130. In some embodiments, the first support member 5101 forms an angle (a) with the second support member 5102. The angle (a) is variable or changeable as the first support member 5101 and the second support member 5102 rotationally displace relative to one other. In some embodiments, a mounting slot 5140 may be formed in each of the respective first support member 5101 and second support member 5102. The first and second mounting slots 5141/5142 in the first and support members 5101/5102 may be coupleable with mounting pins 2034 extending in a perpendicular or substantially perpendicular direction from a mounting surface 2032, for example the holding stage or holding table 2030. The mounting pins 2034 may slide within the mounting slots 5140 when the angle (a) of the bracket is varied while the bracket 5000 remains secured to the mounting surface 2032.

[0094] In some embodiments, the bracket 5000 includes a first support member 5101 that includes a pair of first extensions (corresponding to the first receiver rod 5201 and the first holder rod 5301), extending from the first support member 5101 away from the first support plane 5131. The pair of first extensions form a first ring slot 5401 therebetween, extending along respective lengths of the first extensions 5201/5301. The bracket 5000 includes a second support member 5102 that includes a pair of spaced apart second extensions (corresponding to the second receiver rod 5202 and the second holder rod 5302), extending from the second support member 5102 away from the support plane 5130. The pair of second extensions 5202/5302 form a second ring slot 5402 therebetween, extending along respective lengths of the second extensions 5202/5302. The first ring slot 5401 may receive a first ring section 941 of the ring instrument 92, and the second ring slot 5402 may receive a second ring section 942 of the ring instrument 92. The first ring slot 5401 and the second ring slot 5402 may be sized to receive a variety of ring instruments 92, such that the bracket 5000 may hold a range or a variety of ring instruments 92. In some embodiments, the variety of ring instruments 92 received by the first ring slot 5401 and the second ring slot 5402 are held in a common orientation. In other words, the respective functional tips 950 of the ring 92 are held collectively facing a common direction.

[0095] In some embodiments, the pair of first extensions 5201/5301 may extend parallel to one another, thereby forming the first ring slot 5401 with a uniform gap width (Wl). The first extensions 5201/5301 extend along the first receiving axis 5231 for receiving the ring instruments 92. Alternatively, in some embodiments, the pair of first extensions 5201/5301 may extend oblique to one another, forming a first ring slot 5401 with a non-uniform gap width (Wl), for example an increasing gap width Wl along the respective lengths of the first extensions 5201/5301. Similarly, the pair of second extensions 5202/5302 may extend parallel to one another, forming the second ring slot 5402 with a uniform or substantially uniform gap width (W2). The second extensions extend along a second receiving axis 5232 for receiving the ring instruments 92. Alternatively, in some embodiments, the pair of second extensions 5202/5302 may extend obliquely to each other forming a second ring slot 5402 with a non- uniform gap width (W2), for example, an increasing gap width (W2) along the respective lengths of the second extensions 5202/5302. In some embodiments, the first receiving axis 5232 and the second receiving axis 5202 are parallel to one another. In various embodiments, the first receiving axis 5231 and the second receiving axis 5232 are substantially normal or normal to the support plane 5130.

[0096] As illustrated in FIGS. 5 and 6, by pivoting the first support member 5101 relative to the second support member 5102 alters the ring instrument 92 held by the bracket 5000 between an opened state and a closed state. A plurality and/or a variety of ring instruments 92 may be received by the bracket 5000. The bracket 5000 enables handling (including transporting and/or opening/closing) the ring instruments 92 collectively. For example, responsive to pivoting the first support member 5101 relative to the second support member 5102, the plurality or variety of ring instruments 92 assembled to or received by the first ring slot 5401 and the second ring slot 5402 are collectively alterable between an opened state and a closed state. Controllable operation to provide the collection or assembly of ring instruments 92 in various intermediates states therebetween is also enabled by the present bracket 5000.

[0097] Referring to FIGS. 7 and 8, the bracket 5000 may include a first lock 5701 coupled to respective handle ends 5210/5310 of the pair of first extensions 5201/5301 and a second lock 5702 coupled to respective handle ends 5210/5310 of the pair of second extensions 5202/5302. The first lock5 701 may releasably close the first ring slot 5401 such that the respective first ring sections 941 of the ring instruments 92 are retained in the first ring slot 5401. Similarly, the second lock 5702 may releasably close the second ring slot 5402 such that the respective second ring sections 942 of the ring instruments 92 are retained in the second ring slot 5402. It may be appreciated that by closing at least one of the first ring slot 5401 or second ring slot 5402 retains the ring instrument 92 within the bracket 5000. When the first lock 5701 and second lock 5702 are collectively released, the first ring slot 5401 is opened for receiving or releasing the respective first ring sections 941 of the ring instruments 92 and the second ring slot 5402 is opened for receiving or releasing the respective second ring sections 942 of the ring instruments 92.

[0098] In some embodiments, the bracket 5000 may further include a grip element or tab 5710 acting as an object for the robotic arms 1500/1510 to grip or hold. The tab 5710 may extend from one or both of the holder rods 5300 and may be disposed spaced apart from and generally between the first support member 5101 and the second support member 5102. The tab 5710 may also be disposed between the first extensions 5201/5301 and the second extensions 5202/5302. For example, the one or more tabs 5710 may be coupled proximal to the handle end 5210/5310 of the first extensions 5201/5301 and/or the handle end 5210/5310 of the second extensions 5202/5302. The tab 5710 may be configured as a panel with a pair of opposing planar faces to facilitate gripping by the end-effector of the first robotic arm 1500 and/or the second robotic arm 1510.

[0099] In some embodiments, the holder 5500 may include limiter slots 5510 coupled to the respective first holder rod 5301 and second holder rod 5302. The limiter slots 5510 may also act as a limiter of the angle (a) formed by the first support member 5101 and the second support member 5102. The limiter slots 5510 may limit the angle (a) to a maximum angle. In some embodiments, the limiter slots 5510 may limit the angle (a) within a range of angles (a) corresponding to the operational requirements. In some examples, the range of angles (a) may include a maximum angle and a minimum angle, and intermediate angles (a) therebetween. In some embodiments as illustrated in FIG. 9, a second limiter 5520 may be formed on or coupled to the respective first support member 5101 and second support member 5102 as protrusions towards each other, to operatively limit the angle (a) to a minimum angle, formed by the first support member 5101 and the second support member 5102.

[00100] FIG. 10 illustrates other embodiments of the bracket 5000. The bracket 5000 may include a first support member 5101 pivotably coupled to a second support member 5102. The first support member 5101 and the second support member 5102 may be pivotable relative to each other in a support plane 5130 to form a variable/alterable angle (a) therebetween. The first support member 101 includes a pair of spaced apart first extensions 5201/5301 extending from the first support member 5101 away from the support plane 5130. The pair of first extensions 5101 form a first ring slot 5401 therebetween extending along respective lengths of the first extensions 5201/5301. Further, the second support member 5102 includes a pair of spaced apart second extensions 5202/5302 extending from the second support member 5102 away from the support plane 5130. The pair of second extensions 5202/5302 form a second ring slot 5402 therebetween extending along respective lengths of the second extensions 5202/5302. The first ring slot 5401 may receive a first ring section 941 of the ring instrument 92, and the second ring slot 5402 may receive a second ring section 942 of the same ring instrument 92.

[00101] Still referring to FIG. 10, the bracket 5000 may further include a first lock 5701 coupled to respective "free" ends 5211/5311 of the pair of first extensions 5201/5301, and a second lock 5702 coupled to respective "free" ends 5212/5312 of the pair of second extensions 5202/5302. The first lock 5701 may releasably close the first ring slot 5401 such that the respective first ring sections 941 of the ring instruments 92 are retained in the first ring slot 5401. Similarly, the second lock 5702 may releasably close the second ring slot 5402 such that the respective second ring sections 942 of the ring instruments 92 are retained in the second ring slot 5402. Further, a first tab 5711 may be integrally formed with the first lock 5701, and a second tab 5712 may be integrally formed with the second lock 5702. The tabs 5710 may be configured as respective panels to facilitate gripping by the robotic arms 1500/1510.

[00102] FIGS. 11A to 11C illustrate examples of the bracket 5000 holding multiple ring instruments 92 in various states forming different angles (a). The bracket 5000 may be utilized during the various stages of: cleaning / washing 20, inspection and packing 9000, as well as disinfection / sterilization 30 of the ring instruments 92. As illustrated in FIG. 11 A, during cleaning / washing, the ring instruments 92 may collectively be in the opened state and laid down on a side such that every edge or corner of the instruments 90 may be thoroughly washed. FIG. 1 IB illustrates the bracket 5000 during inspection, where the ring instruments 92 stand in line for easy transportation, and it allows robotic arm 1500/1510 or gripper 1502/1512 to pick up the ring instruments 92 one by one. During final sterilization stage 30 after leaving the system 1000, as illustrated in FIG. 11C, the bracket 5000 may cause the ring instruments 92 to be in the closed state and laid down for space saving as the instrument set will be disposed in a covered container/tray 110. [00103] FIG. 12 illustrates an example of the end-effector or gripper 1512 of the second robotic arm 1510 that can be used for picking up and/or translating ring instruments 92 one at a time out from the bracket 5000. The gripper 1512 picks up the ring instrument 92 along a gripper axis 1520 which is parallel or substantially parallel to the receiver rod of the bracket 5000. In some embodiments, the gripper 1512 may include a gripping edge 1530 that is controllably translatable along a translational axis 1540. The gripping edge 1530 acts as a claw to hook or grip onto the ring instrument 92. In some examples, the gripper 520 may be pneumatically actuated using air pistons and a control valves, which have been verified to provide a suitably quick response time suitable for the proposed robotic operations. In other examples, the gripper 520 may be mechanically actuated (such as using of gears or cams), electrically actuated (such as using linear motors), and/or hydraulically actuated using hydraulic pistons.

[00104] Ring Instrument Inspection

[00105] FIG. 13 shows embodiments of a ring inspection station 2000 together with the spare ring instrument station 2600. A second processing table 2010 may be disposed with one or more holding stages 2030 configured to temporarily hold or support a bracket 5000 with ring instrument(s) 92 mounted to the bracket 5000. The spare ring instrument station 2600 may be configured to hold multiple spare ring instruments such that when a defect is detected during inspection by the ring instrument inspection station 2000, spare ring instruments may be provided as replacement. In some embodiments, a second robotic arm 1510, such as a UR5 gripper, may be provided for transferring the ring instruments 92 from the bracket 5000 to the ring instrument inspection station 2000 and vice versa. Further, the second robotic arm 1510 may also assist in picking up and handling the spare ring instruments 92 from the spare ring instrument station 2600 if a replacement instrument is needed. [00106] FIGS. 14 to 17 illustrate a ring instrument inspection station 2000 according to various embodiments. The ring instrument inspection station 2000 is configured to inspect a variety of ring instruments 92 or instruments with ring handles, such as needle holders, forceps, scissors, etc. The ring instrument inspection station 2000 may include a frame 2002 with an optical defect inspection module. The optical defect inspection module may include a plurality of cameras 2040 coupled/mounted to the frame 2002. The cameras 2040 are disposed in multiple different locations, facing, or pointing at an inspection zone of the ring instrument inspection station 2000. Background lightings may be provided to the inspection zone for illumination of the instrument 90 undergoing inspection. As each camera 2040 captures at least a 2D image comprising a surface/area information or in some instances, 3D volumetric information, the inspection zone is broadly understood as an area or volume for inspecting the ring instruments 92.

[00107] The ring instrument inspection station 2000 may further include a rotating stage 2100 rotatable about an actuating axis 2102. The rotating stage 2100 may extend laterally forming two mounting ends 2200 opposite to each other relative to the actuating axis 2102. Each mounting end 2200 may be configured to hold onto a respective ring instrument 92, and in some instances, the mounting ends 2200 are able actuate the ring instruments 92, such as forceps or scissors, between an opened and closed state. Upon rotation of the rotating stage 2100, each of the mounting ends 2200 is moveable between a loading end 2202 and an inspection end 2204. It may be appreciated that the mounting ends 2200 may interchange between being the loading end 2202 and the inspection end 2204 with half a revolution of the rotating stage 2100. Ring instruments 92 may be received on the loading end 2202 by use of the second robotic arm 1510 picking up each ring instrument 92 from the bracket 5000 and transferring it to the loading end

2202. [00108] Referring to FIG. 17, a ring instrument 92a / 92 may be loaded at the loading end 2202 awaiting inspection and another ring instrument 92b / 92 disposed at the inspection end 2204 undergoing inspection. Upon completion of the inspection, the rotating stage 2100 may be rotated 2101 about the actuating axis 2102, transferring the ring instrument 92a from the loading end 2202 to the inspection end 2204, and concurrently transferring the ring instrument 92b from the inspection end 2204 to the loading end 2202. The ring instrument 92b transferred to the loading end 2204 may then be picked up by the second robotic arm 1510 and transferred to a second bracket (not shown) at the holding stage 2030.

[00109] In some embodiments, the ring instrument 92b / 92 at the inspection end 2204 may undergo inspection from the multiple cameras 2040 for determining any physical defects on the ring instrument 92, such as surface cleanliness, stain, rust, crack, misalignment, deformation, discoloration, and locking function. It may be appreciated that both the loading end 2202 and the inspection end 2204 of the rotating stage 2100 may be disposed in the inspection zone 25300. Therefore, inspection of the instrument 90 need not be performed on at the inspection end 2204 and may instead be performed at any intermediate position between the loading end 2202 and the inspection end 2204.

[00110] In some embodiments as shown in FIG. 17, a cutting module 2400 may be provided at the inspection end 2204 for performing a cutting test to determine if a sharpness of the ring instrument 92, such as a scissors, is sufficient. The sharpness testing station 2400 may translate 2401 or move relative to the inspection end 2204 to bring a testing material 2440, such as a roll of paper or tissue, into the vicinity of the inspection end 2204 for performing the cutting test. Beneficially, moving the cutting module 2400 away from the inspection end 2204 before or after the cutting test, avoids the cutting module 2400 blocking a field of view of one or more cameras 2040. In some embodiments, the ring instruments 92 may be lubricated at the mounting end 2200, the inspection end 2204 or any intermediate positions between the loading end 2202 and the inspection end 2204 by a lubrication module. As examples, a lubricant dispenser may be provided to apply targeted lubrication on the ring instruments 92.

[00111] During operation, each ring instrument 92 are picked up by the second robotic arm 1510 sequentially from a first bracket 5000 and mounted on the loading end 2202 of the rotating stage 2100 for inspection. The rotating stage 2100 then rotates to bring the ring instrument 92 to the inspection end 2202 for defect inspection. Upon completion of inspection, the same ring instrument 92 will be lubricated and picked up again by the second robotic arm 1510 at the loading end 2202 and placed in a second bracket 5000 to be held. When the optical defect inspection module 2040 detects a defect on the ring instrument 92 and/or the cutting module 2400 detects insufficient sharpness in the ring instrument 92, the second robotic arm 1510 will discard/dispose the defective ring instrument 92, and obtain a replacement ring instrument, which is of the same type as the discarded defect ring instrument, from the spare ring instrument station 2600 and placed on the second bracket 5000. The inspection process continues until all ring instruments 92 from the first bracket 5000 are inspected or replaced, and placed on the second bracket 5000.

[00112] Crack Detection

[00113] An exemplary workflow of a crack defect inspection process 9002 which may be performed at the ring inspection station 2000 and the non-ring inspection station 3000 is illustrated schematically by FIG. 18 A. Alternatively, a crack defect inspection station may be shared by the ring instruments 92 and the non-ring instruments 93. The surgical instrument 90 is inspected for cracks on the surfaces at the box lock region and also on other surfaces of the surgical instrument 92. In one example, a top positioned Basler camera 1040 may be used to focus on the surgical instrument 90 placed on a tool holder. The tool holder may be releasably coupled to each of the two rings of the ring surgical instrument 92. The tool holder couplers may be moved apart. As a result, the box lock area can be visible for imaging and/or inspection. An initial image may be captured by focusing the tool from a top view. A Region of Interest (ROI) can then be defined in such a way box lock area is in focus.

[00114] Next, a segmentation process may follow to isolate the surgical instrument 90 from the background. The surgical instrument 90 is masked based on its color, e g., remove the background. This process also highlighted the cracks on surface of the surgical instrument and helped in identification of defects in the surgical instrument. Finally for classification purposes, the preprocessed images are trained using Faster RCNN Inception Resnet v2 object detection model with the help of TensorFlow deep learning platform. This model may be chosen for its good precision average (mAP) of 37.7 among other object detection models. Both good and defective samples were labelled and trained with the above-mentioned model.

[00115] Worn Out Defect

[00116] A worn out inspection process 9004 may be provided as part of the ring instrument inspection station 2000 or as a separate station 1900. Selected surgical instruments may be inspected for worn out parts, e g., the Tungsten Carbide tips of some surgical instruments tend to wear out with time. A Basler camera 1040 may be used to focus the surgical instrument placed on the same holder. The camera 1040 is focused on the tips of surgical instruments 90 with the background illuminated. Viewed against a strong back light, if the tips are worn out, the tips will not meet well, e.g., light can pass through between the tips. Images may be labelled and trained using Faster RCNN Inception Resnet v2 object detection model and TensorFlow platform.

[00117] Non-Ring Instrument Inspection

[00118] FIGS. 19A and 19B illustrate embodiments of the non-ring instrument inspection station 3000 for inspecting non-ring instruments 93, and the wrapping station 4000 for wrapping the non-ring instruments 93. The non-ring instrument station 3000 may further include a flipping module 3400 for flipping or changing an orientation or facing of the non-ring instrument 93. A holding stage 3030 may be provided to temporarily hold a non-ring instrument 93 awaiting inspection or after inspection. A spare non-ring instrument station 3600 may also be provided to hold multiple spare non-ring instruments such that when a defect is detected during inspection by the non-ring instrument inspection station 3000, spare ring instruments may be provided as replacement.

[00119] FIGS. 20 to 22 illustrate a non-ring instrument inspection station 3000 according to various embodiments. The non-ring instrument inspection station 3000 is configured to inspect a variety of non-ring instruments 93 or instruments 90 without ring handles, such as ball parker, retractors, ruler, towel clip jones, etc. The non-ring instrument inspection station 3000 may include a frame 3002 and a second optical defect inspection module mounted to the frame 3002. The second optical defect inspection module may include a plurality of cameras 3040 coupled/mounted to the frame 3002. The cameras 3040 are disposed in multiple different locations, facing, or pointing at an inspection zone of the non-ring instrument inspection station 3000. Background lightings may be provided to the inspection zone for illumination of the non- ring instruments 93 undergoing inspection. As each camera 3040 captures at least a 2D image comprising a surface/area information or in some instances, 3D volumetric information, the inspection zone is broadly understood as an area or volume for inspecting the non-ring instruments 93.

[00120] In some embodiments, the non-ring instrument inspection station 3000 may include a conveyor module 3200 mounted to the frame 3002. The conveyor module 3200 may include a pair of conveyor belts 3220 actuatable to transport the non-ring instruments 90. The pair of conveyor belts 3220 may form a belt gap 3240 therebetween. The pair of conveyor belts 3220 may define on one end, a loading zone 3206 for receiving or releasing the non-ring instrument 93, and on the other end, the inspection zone 3204. In some embodiments, the inspection zone 3204 may be disposed on an intermediate position between the two ends of the conveyor belts 3220. In some embodiments, a width (WB) formed by the pair of conveyor belts 3220 may be adjustable or changeable, to accommodate supporting and transporting non-ring instruments 93 of different lengths. The conveyor module 3200 transports the non-ring instrument 93 from the loading zone 3206 of the conveyor belts 3220 to the inspection end 3204 of the conveyor belts 3202 for inspection by the cameras 3040.

[00121] The non-ring instrument inspection station 3000 may include a flipping module 3400 for flipping or changing an orientation of the non-ring instrument 93 on the conveyor belts 3220. The flipping module 3400 may include a rotation actuator 3100, such as a motor, coupled to frame 3002. An output from the rotation actuator 3100 may be coupled to a gripper 3120 for flipping the non-ring instrument 93. In some embodiments, the gripper 3120 may include a pair of fingers actuatable towards each other to grip onto the non-ring instrument 93. Upon lowering the flipping module 3100 into the belt gap 3240 to grip the non-ring instrument 93, the rotation actuator 3100 rotates 3140 the non-ring instrument 93 to flip the non-ring instrument 93 before placing the non-ring instrument 90 back onto the conveyor belt 3220.

[00122] In some embodiments, the flipping module 3100 is configured to flip the orientation of the non-ring instrument 93 at the inspection zone 3204. In other embodiments, the flipping module 3100 changes the orientation of the non-ring instrument 93 at any intermediate position between the loading zone 3206 and the inspection zone 3204. In some embodiments, the flipping module 3100 picks up and flips the non-ring instrument 93 at the inspection zone 2304 and places it back on the conveyor belt 3220 at an intermediate position. When the second optical defect inspection module detects a defect on the non-ring instrument 93, the conveyor belts 3220 discards/disposes the defective non-ring instrument 93 into defect bin 3300, and obtain a replacement non-ring instrument, which is of the same type as the discarded defect non-ring instrument, from the spare non-ring instrument station 305. [00123] In some embodiments, some of the non-ring instruments 93, such as retractors, passing inspection will be transported to the unloading station 7000, while other non-ring instruments 93 passing inspection will be transported to the wrapping station 4000 for wrapping Wrapping of the non-ring instruments 93 keeps the non-ring instruments tidy while maintaining steam penetration during sterilization. In some examples, multiple non-ring instruments 93 of the same type, for example j ones towel clips, are transported to the wrapping station to be wrapped in a single bundle. In some examples, multiple non-ring instruments 93 of different types, for example bard parker handles, needle holders, a spear redivac and a ruler, are transported to the wrapping station to be wrapped in another single bundle. In some examples, flat-tip non-ring instruments 93 are wrapped in a bundle, while non-flat-tip non-ring instruments 93 are wrapped in another bundle. In some examples, a log sheet including details of the instrument sets is printed and wrapped in a wrapper (e g., crepe paper 421) to prevent any chemical ink leakage.

[00124] Wrapping

[00125] FIGS. 23 to 26B illustrate embodiments of a wrapping station 4000. In the example of a GES Basic Set, the wrapping station 4000 may be configured to wrap the six units of the Clip Tower Jones into one wrapped package. For the GES Basic Set, another package may be wrapped to contain two units of the Handle Bard Parker, one unit of the Holder Needle Crilewood, one unit of the Holder Needle Mayo Hegar, one unit of the Spear Redivac, and one unit of the Ruler. The retractors of the GES Basic Set do not need to be wrapped.

[00126] FIG. 23 to FIG. 25B illustrate the wrapping station 4000 according to some embodiments of the present disclosure. The wrapping station 4000 includes a wrapping module 4100 and a wrapper (e.g., crepe paper) dispenser 4200. In some embodiments, the wrapper dispenser 4200 holds crepe paper 4210 and dispenses the crepe paper 4210 to the wrapping module 4100 for wrapping the non-ring instruments 93. The wrapper dispenser 4200 may dispense the crepe paper 4210 via a roller, a suction pad, etc. In some embodiments, the wrapping module 4100 may receive the crepe paper 4210 from the wrapper dispenser 4200 along a paper receiving direction 4220. The wrapping module 4100 may include a pair of clamps 4300 symmetrically disposed on opposing sides of the wrapping module 4100. The pair of clamps 4300 may each clamp onto opposing edges of the received crepe paper, and may collectively rotate 4320 the crepe paper 4210 with a common direction and a common rotational speed. The wrapping module 4100 may also include guiding rods 4400 for guiding the crepe paper 4210 along the paper receiving direction 4220, as well as a pair of folding plates 4500 symmetrically disposed for folding the sides of the crepe paper 4210.

[00127] Upon receiving the crepe paper 4210 guided by the guiding rods 4400, one or more non-ring instruments 93 are placed on the crepe paper 4210 with a length of the non-ring instrument transverse or substantially lateral to the paper receiving direction 4220. The pair of clamps 4300 collective rotate or roll the crepe paper 4210 to fold the crepe paper 4210 and the non-ring instruments 93 into an elongated bundle. The folding plates 4500 are then actuated to fold 4520 the ends of the elongated bundle. Thereafter, a taping module dispenses a tape to be adhered or stuck to the crepe paper 4210 to robustly hold the bundle to complete the wrapping process.

[00128] FIG. 26A and FIG. 26B schematically illustrate the wrapping station 4000 according to other embodiments of the present disclosure. The wrapping station 4000 may include a wrapper (e.g., crepe paper) dispenser 4200, a wrapping module 4100, a taping mechanism 4600, and a collection area 4700. The wrapper dispenser 4200 can be refilled with crepe papers 4210 or other suitable sheets of paper or fabric-like material.

[00129] In operation, in some examples, a roller or a suction pad 4202 dispenses one sheet of crepe paper 4210 onto the working surface of the wrapping module 4100. The surgical instruments 90 may be sorted into three different groups, such as Flat-Tips, Non-Flat Tips, and Retractors. Responsive to detecting that a complete set of either the group of flat-tips instruments or the group of non-flat tip instruments, the complete group of instruments 90 will be placed on the crepe paper 4210 that is located above the wrapping module 4100. The wrapping module 4100 is operable by one or more motors 4102 configured to perform at least a fold or folding action 4520. The folding action 4520 may be configured as a rotational motion of a section of the crepe paper 4210 about a fold line or as a rotational motion to wind crepe paper 4210 around the instruments 90.

[00130] Alternatively described, a primary folding 4521 may be first executed by bringing a first comer of the crepe paper 4210 over the instruments 90. Pneumatic actuators or motors 4102 may then be activated, causing shafts gripping opposing second and third corners of the crepe paper 4210 to rotate (e.g., in an anti-clockwise motion from the view of FIG. 26B) which results in a rolling motion that turns the half-wrapped package by a predefined number of turns (e.g., two turns). The rolling motion winds the crepe paper 4210 around the instruments 90. The second comer and the third corner of the crepe paper 4210 may be folded towards the center of the package. The fourth corner may be folded towards the center and taped down.to the rest of the package.

[00131] The taping mechanism 4700 may be configured to dispense a suitable length of tape 4702. In some embodiments, the crepe paper 4210 and the tape 4702 are in a coordinated rolling motion together.

[00132] In some embodiments, a micro linear actuator 4704 with a blade mounted on its end may be actuated to cut off excess tape 4702 from the package.

[00133] In some embodiments, the motor 4102 that is mounted to the linkages may be operated to move the package to an initial position of the instruments in the wrapping station 4000. A conveyor belt may be raised to lift and transport the wrapped package to the collection area 4700 where the first robotic arm 1500 will pick it up and transfer it to the unloading station

7000.

[00134] Unloading

[00135] FIGS. 27 and 28 illustrate an unloading station 7000 according to various embodiments. The unloading station 7000 may include a plurality of slidable drawers 7100 configured to slide between an unloading position extending outwardly away from the system 1000 and an assembling position extending inwardly towards the robotic arm 1500. The drawers 7100 of the unloading station 7000 may be configured similarly to the drawers 6100 of the loading station 600 to enable opening and closing manually or automatically from either a user side or an opposing system side. A tray 110 may be disposed on/in each of the slidable drawers 7100. At the assembling position, surgical instruments 90 such as ring instruments 92, non-ring instruments 93, kidney dish 112, gallipot 113, etc., which were previously inspected and maintained, are assembled in the tray 110. In some embodiments, upon completion of the assembly of all the surgical instruments, the drawers 7100 may slide towards the interior of the unloading station 7000 such that an indicator dispenser 7300 may drop a steam indicator into the tray 110. In some embodiments, one or more flipping modules 7400 may be provided to the unloading station 700 to flip the instruments, for example a gallipot 113 as illustrated in FIG. 24. This allows the orientation of the instruments 90 to be corrected prior to being assembled in the tray 110. Upon completion of assembly, the slidable drawers 7100 slide towards the unloading position to be picked up from the user side for sterilization.

[00136] Vision-Based Pick-and-Place

[00137] Automated handling of surgical instruments 90 is challenging, especially taking into consideration that every surface of the surgical instrument 90 must be exposed for inspection, and the fact that the surgical instruments 90 come in various shapes and sizes. The environment in which the robotic arm gripper has to pick up the object of interest is relatively cluttered. For example, the tray 110 may be made of stainless steel with a plurality of through holes (to allow for passage of steam in a subsequent sterilization process), the surgical instruments 90 may be disposed in various random orientations in the relatively limited space in the tray 110.

[00138] According to one embodiment, the method 9000 includes a bounding box -based method to detect a surgical instrument and estimate picking coordinates (position and orientation). Images collected may be labelled with many details like type of surgical instrument, and a fixed picking angle and orientation (front or side). Labelling may follow the format of toolname_fixedangle_orientation. A plurality of images may be labelled in such manner. Eight angles may be fixed or predetermined for use in the labelling (e.g., 0 degrees, 45 degrees, 90 degrees, 135 degrees, 180 degrees, 225 degrees, 270 degrees, and 315 degrees). Based on the shape and size of the tips of the surgical instruments 90, a fixed angle can be labelled for each image. The labelled images may be trained with Faster RCNN Inception Resnet v2 object detection model with the help of TensorFlow deep learning platform. The training model may be extracted for detection test and experiments. For picking coordinates, a center (U, V) of bounding box may be defined and used as a picking position and a fixed angle may be used as an orientation angle.

[00139] Alternatively, according to another embodiment, the method 9000 includes a masking-based method to detect a surgical instrument 90 and estimate picking coordinates (position and orientation). This approach may follow a labelling format of toolname_orientation and a plurality of images may be labelled in the same manner. Labelled images may be trained with Mask RCNN Inception Resnet v2 object detection model with the help of TensorFlow deep learning platform. The position of each surgical instrument 90 may be calculated using a center of detected mask points. Determining the centroid of mask points enables estimation of the position of surgical instruments 90. To determine the orientation angle, an image processing method based on a minimum rectangle may be used to evaluate a precise angle for picking each tool. A bounding rectangle around the mask with minimum area may be drawn along the rotation of mask. The minimum rectangle method returns a structure containing a center, a width, a height, and an angle of rotation. When the width of the rectangle is smaller than the height, the angle returned from the function may be assigned for picking. When the width is greater than the height, an angle + 90 is assigned for picking.

[00140] Once surgical instruments 90 are detected by any of the above approaches, the controller 1030 or the vision system checks for tools inside a processing table 2010/3010 which are isolated and not in overlapping condition with other instruments. The system 1000 can be configured to only check for surgical instruments 90 inside a processing table 2010/3010 by providing markers (e.g., Aruco markers) placed on each edge of the processing table 2010/3010. This helps the controller 1030 or the vision system to direct a trained model to process detection on specified boundary. The controller 1030 or the vision system may trigger the robotic arm 1500/1510 to first pick isolated surgical instruments 90. Next, the vision system may look for surgical instruments 90 which are disposed on their edges. To isolate such instruments, the robot arm 1500/1510 may move the selected surgical instrument 90 away from other surgical instruments 90 in a horizontal direction or a vertical direction (based on the relative positions of other surgical instruments and/or table boundary).

[00141] A rotating mechanism may be installed at any of the plurality of processing tables 2010/3010 to separate various surgical instruments 90 from each other. The rotating mechanism may be configured to rotate in response to successive failures to transfer a surgical instrument 90. FIG. 29 schematically illustrates an example of the process. The pick-and-place or transfer process have been experimentally verified to work.

[00142] Process - Setup

[00143] The computing device 1030 may be configured to execute a set-up protocol on powering up of the system 1000, in accordance with instructions and data stored in a computer- readable medium. Referring to the schematic process flowcharts of FIGS. 30 and 31, the set-up process may include a plurality of checks to determine if consumables have been replaced or topped-up. The sequence of the checks may vary from the example illustrated in FIG. 15. Selected checks may alternatively be performed concurrently. The system 1000 may be configured to conduct any one or more of the following: (i) detecting whether spare ring instruments are loaded; (ii) detecting whether spare non-ring instruments are loaded; (iii) detecting whether at least one spare bracket 5000 is loaded; (iv) detecting whether a first paper tray (e.g., 50 cm x 30 cm paper) is loaded with paper; (iv) detecting whether a second paper tray (e.g., 30 cm x 30 cm) is loaded with paper; (v) detecting whether a wrapping sealer (e g., steam indicator tape available from 3M) is loaded; (vi) detecting whether wrapping paper (e.g., 30 cm x 30 cm) is loaded; (vii) detecting whether printer paper (e.g., A4 size paper) is loaded; (viii) detecting whether stream indicators are loaded; (xi) detecting whether sticker printer paper is loaded. If any of the detection indicates a missing item or insufficient items, the system 1000 is alerted to an incomplete set-up so that the missing items can be loaded. If it is determined that the system 1000 has adequate consumables loaded, the system 1000 is ready to receive a new batch of instruments for inspection.

[00144] The method includes conducting a check at the loading station 6000. For example, the system 1000 may detect whether the trays 110 are loaded to the loading station 6000, and whether the tray si 10 are loaded with instruments 90. The system 1000 may check if the cover of the tray is loaded. The tray 110 may be checked for the presence of the containers. The system 1000 may load Magil's Tubes if these are determined to be missing.

[00145] Upon completion of the set-up process, the system 1000 may determine whether a "Start Process" instruction has been received, e.g., if a "start process" button at a control panel (user interface) has been selected/pressed. Responsive to the "Start Process" instructions and completion of the set-up protocol, the system 1000 may be configured to initiate the inspection and assembly process.

[00146] Main Flow A

[00147] The system 1000 is configured to operate as an integrated whole as will be evident from the following description of an exemplary work flow or method 9000. If not specifically described herein, movement of the various parts of the stations 1900 and/or surgical instruments 90 may be effected by pneumatically and/or electrically operated actuators and/or by a robotic arm. The surgical instruments 90 are processed one tray 110 after another in sequence until all loaded trays have been processed. All the instruments 90 in one tray 110 are processed before the system 1000 moves on to process another tray 110 of instruments 90. All similar instruments at the same inspection station are inspected until all have undergone inspection. For the sake of brevity, the following may not describe each iteration of similar processes.

[00148] Referring to FIG. 32, FIG. 33, and FIG. 34, according to some embodiments of the present disclosure, the system 1000 may be configured to activate a wet bay blower at the loading station (wet bay) 6000. The drawer 6100 of the loading station 6000 is opened at the system side 6008. The two brackets 5000 (forceps bracket and mix bracket) are transferred directly from the loading station 6000 to the second processing table (Processing Table 2) 2010. The first robotic arm 1500 may be activated to process the non-ring instruments processing (Process B).

[00149] The first robotic arm 1500 is configured to perform the following: (i) pick up the kidney dish 112 and empty all instruments 90 on the first processing table (Processing Table 1) 3010; (ii) place the kidney dish 112 on the first processing table 3010; pick up the gallipot 113 from the loading station 6000 and place it on the first processing table 3010 ; transfer the retractors to the non-ring inspection station 3000. [00150] The system 1000 is configured to start the retractors' inspection; pick up tray paper from the tray paper dispenser 1074 and put the tray paper 1074 on the loading station 6000. The drawer 6100 of the loading station 6000 holding the tray 110 is extended or opened at the system side 6008. The first robotic arm 1500 transfers the tray 110 from the loading station 6000 to the unloading station (dry bay) 7000. The drawer 6100 of the loading station is retracted or closed. The first robotic arm 1500 is configured to transfer a steam indicator from the indicator dispenser 7300 to the tray 110 (now disposed at the unloading station 7000).

[00151] Responsive to the completion of the inspection of the retractors, the first robotic arm 1500 is configured to: (i) transfer the retractors from the non-ring inspection station 3000 to the unloading station 7000; (ii) transfer the towel clip jones from the first processing table 3010 to the non-ring inspection station 3000 one by one in turn for inspection until the non-ring inspection station 3000 has completed inspection of all the towel clip jones. If any of the non- ring instrument is found to be faulty, a replacement process is performed for the faulty instrument.

[00152] The first robotic arm 1500 is configured to: (i) transfer the gallipot 113 from the first processing table 3010 to the unloading station 7000; (ii) transfer the kidney dish 112 from the first processing table 3010 to the unloading station 7000; (iii) transfer the rest of the non-ring instruments 93 from the first processing table 3010 to the non-ring inspection station 3000 in turn. The non-ring inspection station 3000 is configured to start inspection of the non-ring instruments 93 one at a time. Responsive to completion of the inspection of all non-ring instruments 93, the Magil's suction tube and stillet are dispensed to the tray 110. If any of the non-ring instrument is found to be faulty, a replacement process is performed for the faulty instrument. Responsive to the assembly of a first bracket (temporary bracket) 5000, the first robotic arm 1500 is configured to transfer the first bracket 5000 from the second processing table (processing table 2) 2010 to the tray 110 at the unloading station 7000. Responsive to the assembly of the second bracket 5000, the first robotic arm 1500 is configured to transfer the second bracket 5000 from the second processing table 2010 to the tray 110 at the unloading station 7000.

[00153] The first robotic arm 1500 is configured to transfer: (i) the second wrapped package (wrapped package 2) from the wrapping station (wrapping bay) 4000 to the tray 110 at the unloading station 7000; (ii) the first wrapped package (wrapped package 1) from the wrapping station (wrapping bay) 4000 to the tray 110 at the unloading station 7000; transfer the wrapped printed list from the printer bay 1072 to the tray 110 at the unloading station 7000; transfer the sticker tag from the sticker printer 1076 to the tray 110 at the unloading station 7000. The drawer 7100 holding the tray 110 is retracted.

[00154] The system 1000 continues to process each of the trays loaded at the loading station in turn in like manner until all loaded trays have been processed.

[00155] Referring to FIG. 35, in the context of the ring inspection station 2000, the second robotic arm 1510 is configured to perform the following: responsive to each of the forceps bracket 5000 and the mix bracket 5000 being received at the ring inspection station 2000, the ring surgical instruments are transferred one after another to the shuttle for the execution of the ring inspection process or to a temporary bracket 5000 if the shuttle is not available, and to subsequently transfer the inspected instrument back to assembly on the respective brackets 5000.

[00156] Referring to FIG. 36, in the context of a tip inspection process, responsive to a surgical instrument 90 being not in a preferred orientation, the orientation of the surgical instrument 90 is adjusted or corrected. The instrument 90 is inspected for the presence of any crack and any stain. Responsive to the presence of any crack or any stain, the instrument is rejected (e.g. transferred to the rejected item area and the system 1000 is alerted to the type of instrument rejected). [00157] If the instrument 90 is a retractor, the instrument 90 is transferred to undergo an alignment test. If the instrument 90 fails the alignment test, the instrument 90 is rejected. If the instrument 90 passes the alignment test, the instrument 90 is transferred to a next belt and subsequently to the wrapping station 4000 for wrapping.

[00158] Referring to FIG. 37, and in the context of a flat instrument inspection process, the system 1000 is configured such that, responsive to an instrument 90 being identifed as a spear or a parker, the instrument 90 is first subjected to a tip inspection process before it is subjected to an inspection of a first face (top face 1 inspection). For other flat instruments 90, the tip inspection process may be skipped and the instrument 90 may proceed to the inspection of the first face. The first face is inspected for any crack or any stain. Any cracked and/or stained instrument is rejected (as described above). The instrument 90 that passes inspection of the first face is flipped over for the second face to be inspected for any crack or any stain. Upon completion of the flat instrument inspection, the surgical instrument 90 is transferred to the wrapping station 4000.

[00159] Referring to FIG. 38, in the context of the inspection of ring instruments 92, the system 1000 is configured to perform the following. The ring instrument 92 is releasably coupled to a moving base and moved to the oiling station. Oiling and maintenance is performed based on the instrument's hinge position. The ring instrument 92 is moved to the tip inspection station and both faces of the ring instrument 92 are inspected. If any crack or any stain is detected, the ring instrument 92 is rejected. If the instrument passes both the crack inspection and the stain inspection, the moving base closes the hinge of the ring instrument 92 and the ring instrument 92 undergoes tip alignment inspection. If the ring instrument 92 fails the tip alignment inspection, the ring instrument 92 is rejected. If the ring instrument 92 passes the tip alignment inspection, the moving base is operated to open the hinge of the ring instrument 92. The ring instrument 92 is subjected to the box mechanism test to inspect the hinge joint of the ring instrument 92. If the ring instrument 92 fails the box mechanism test, the ring instrument 92 is rejected. If the ring instrument 92 passes box mechanism test, and if the ring instrument 92 is a pair of scissors, the ring instrument 92 is subjected to a sharpness test. If the pair of scissors fails the sharpness test, the pair of scissors is rejected, ring instrument 92 that pass the box mechanism test are subjected to the ring inspection test. The moving base releases the ring instrument 92 and the second robotic arm (station gripper) pickes up the ring instrument 92 to inspect both surfaces of the rings. If any crack or stain is detected, the ring instrument 92 is rejected. Otherwise, the ring instrument 92 is transferred back to the moving base and delivered to the drop off location.

[00160] Referring to FIG. 39, the printer station 1072 is configured to dispense a wrapping paper (e.g., crepe paper) 4210, print a list, activate the paper roller to transfer the printed list to the paper holder, activate a first folder (folder 1) to make the first fold, retract the first folder, activate a second folder (folder 2) to make the second fold, wait for the wrapped printed list collection, and retract the second folder upon collection of the wrapped printed list.

[00161] In some embodiments, the printer station 1072 may be configured to print a log sheet containing details of the instrument set and the wrapping station 4000 may be configured to wrap the log sheet with the supplied crepe paper 4210 to prevent the printed ink from contaminating the instruments 90.

[00162] In some embodiments, the sticker tag printer 1076 may be configured to print a tag that contains one or more barcodes for identification purposes. The printed materials may be collected by the first robotic arm and transferred to the unloading station 7000.

[00163] Referring to FIG. 40, the wrapping station 4000 is configured to perform the following if the instrument 90 is not a retractor: dispense a wrapping paper (e.g., crepe paper) 4210 and wait for all instruments 90 belonging to the same set to arrive at the wrapping station 4000. Responsive to all instruments 90 being ready at the wrapping station 4000, the wrapping station 4000 is configured to perform the first flip of the wrapping paper 4210 over the instruments 90 disposed in the center of the wrapping paper 4210. The wrapping station 4000 is configured to: fold the wrapping paper 4210 at the two sides, flip the package three times, activate the taping machine (taping mechanism) 4600 to tape the package, and send the taped package and other items to a waiting area/collection area 4700.

[00164] Referring to FIG. 41, the system 1000 is configured to perform the following processes at the non-ring spare instrument station 3600 or at the non-ring inspection station 3000: (i) determine the type of instrument 90 needed for replacement; (ii) determine if the non- ring spare instrument station (spare bay) 3600 has the required spare instrument; (iii) activiate the first robotic arm (UR10) 1500 to retrieve the selected spare instrument; (iv) place the selected spare instrument at the non-ring inspection station (inspection bay input area) 3000; (v) alert the non-ring inspection station 3000 not to inspect the selected spare instrument; (vi) alert the wrapping station (wrapping bay) 4000 to wait for the selected spare instrument; (vii) wait for the selected spare instrument to be transferred to the wrapping station 4000; (viii) determine that the selected spare instrument has reached the wrapping station. Responsive to the non-ring spare instrument station 3600 lacking the appropriate spare instrument, an error recovery process may be triggered.

[00165] Still referring to FIG. 42, the system 1000 is configured to perform the following processes at the ring spare instrument station 2600 or at the ring inspection station 2000: (i) determine the type of instrument 90 needed for replacement; (ii) determine if the ring spare instrument station (spare bay) 2600 has the required spare instrument; (iii) activiate the second robotic arm (UR5) 1510 to retrieve the selected spare instrument; (iv) determine if the temporary bracket assembly has been completed; (v) responsive to the temporary bracket assembly being incomplete, transfer the selected spare instrument to the temporary bracket 5000; (vi) responsive to the temporary bracket assembly being complete, transfer the selected spare instrument to the second bracket 5000; (vii) wait for the selected spare instrument to be transferred to the temporary bracket or the second bracket 5000, as the case may be; (vii) determine that the selected spare instrument has reached the temporary bracket or the second bracket 5000, as the case may be. Responsive to the ring spare instrument station 2600 lacking the appropriate spare instrument, an error recovery process may be triggered.

[00166] Referring to FIG. 42, the system 1000 is configured to execute an error recovery process so that any errors can be resolved. The system 1000 is configured to perform the following processes: (JI) responsive to an instrument 90 being dropped (error type 1, e.g., in the process of being transferred), if the system 1000 can determine the location of the dropped instrument (dropping location) and if the system 1000 can reach the dropped instrument, one of the robotic arms is controllably operated to pick up the dropped instrument.

[00167] According to one aspect, various embodiments of the present disclosure includes a bracket 5000. The bracket 5000 includes: a first support member, a second support member, a first receiver rod, and a second receiver rod. The first support member includes a first connecting portion and a first coupled end. The first connecting portion is spaced apart from the first coupled end. The second support member includes a second connecting portion and a second coupled end. The second connecting portion is spaced apart from the second coupled end. The second coupled end and the first coupled end are hingedly coupled together and rotatable relative to one another about a hinge joint. The first support member and the second support member are parallel to a support plane. The first receiver rod extends from the first connecting portion. The first receiver rod extends along a receiving direction that is non-parallel to the support plane. The second receiver rod extends from the second connecting portion.

[00168] The bracket 5000 may include a first holder rod. The first holder rod may extend from the first connecting portion parallel to the first receiver rod. The first holder rod may be spaced apart from the first receiver rod to define a first ring slot. [00169] The bracker 5000 may include a second holder rod. The second holder rod may extend from the second connecting portion parallel to the second receiver rod. The second holder rod may be spaced apart from the second receiver rod to define a second ring slot. The second receiver rod may be parallel to the first receiver rod. The first receiver rod may be normal to the support plane.

[00170] The bracket 5000 may include a holder. The holder may define two or more limiter slots. Each of the first holder rod and the second holder rod may be slidably engaged with a respective one of the two or more limiter slots to limit an angular displacement defined betwen the first support member and the second support member.

[00171] The bracket 5000 may include a first catcher rod coupled to the first support member and extending parallel to the first receiver rod. The bracket 5000 may include a first catch slidably engaged to the first catcher rod, in which the first catch is releasably engageable with the first receiver rod. An engagement between the first catch and the first receiver rod may include a first hook. The first hook may be rotationally coupled to the first catcher rod and releasable from the first receiver rod.

[00172] The bracket 5000 may include a second catcher rod coupled to the second support member and extending parallel to the second receiver rod, in which the second catch is slidably engaged to the second catcher rod, and in which the second catch is releasably engageable with the second receiver rod. An engagement between the second catch and the second receiver rod comprises a second hook, the second hook being rotationally coupled to the second catcher rod and releasable from the second receiver rod.

[00173] In another aspect, the bracket 5000 may be used with one or more ring surgical instruments. Each ring instruments may be a first class lever formed by two shafts cooperatively forming a functional tip and including two ring sections. The bracket 5000 includes: a first support member having a first connecting portion and a first coupled end, the first connecting portion being spaced apart from the first coupled end; a second support member having a second connecting portion and a second coupled end, the second connecting portion being spaced apart from the second coupled end, the second coupled end and the first coupled end being hingedly coupled together and rotatable relative to one another about a hinge joint, the first support member and the second support member being parallel to a support plane; a first receiver rod, the first receiver rod extending from the first connecting portion, the first receiver rod extending along a receiving direction that is non-parallel to the support plane; and a second receiver rod, the second receiver rod extending from the second connecting portion, wherein the first receiving rod and the second receiving rod are in slidable engagement with respective ones of the two ring sections of any one or more of the ring instruments.

[00174] The bracket 5000 may include: a first holder rod, the first holder rod extending from the first connecting portion parallel to the first receiver rod, in which the first holder rod is spaced apart from the first receiver rod to define a first ring slot, and in which the first ring slot is sized to receive one of the two ring sections. The bracket 5000 may include: a second holder rod, the second holder rod extending from the second connecting portion parallel to the second receiver rod, in which the second holder rod is spaced apart from the second receiver rod to define a second ring slot, and in which the second ring slot is sized to receive another of the two ring sections.

[00175] The bracket 5000 may include: a holder, the holder defining two or more limiter slots, in which each of the first holder rod and the second holder rod is in slidable engagement with a respective one of the two or more limiter slots, and in which the slidable engagement limits an angle defined between the first support member and the second support member. The two or more limiter slots may define a minimum value and a maximum value for the angle.

[00176] The bracket 5000 may include: a first catcher rod coupled to the first support member and extending parallel to the first receiver rod; and a first catch slidably engaged to the first catcher rod, in which the first catch is releasably engageable with the first receiver rod to prevent any of the one or more ring instruments from sliding off the first receiver rod. The first catch may releasably close the first ring slot to retain the respective first ring sections of the one or more ring instruments in the first ring slot.

[00177] The bracket 5000 may include: a gripping member pivotably coupled to the first holder member, the gripping member including a hook to releasably hook the first holder member, in which the gripping member includes a transversely extending tab to enable gripping by an end-effector.

[00178] Responsive to the first support member pivoting relative to the second support member, the one or more ring instruments received by the first ring slot and the second ring slot may be collectively alterable between an opened state and a closed state.

[00179] The plurality of the ring instruments of various dimensions may be receivable by the first ring slot and the second ring slot and held in a common orientation.

[00180] According to another aspect, a system 1000 includes: a ring instrument inspection station and a first robotic arm. The ring instrument inspection station may be configured to inspect a plurality of ring instruments. Each of the plurality of ring instruments may be a first class lever formed by two shafts, in which each of the two shafts includes a functional tip and a respective ring section at either end. The first robotic arm may be configured to transfer a plurality of ring instruments to and from the ring instrument inspection station by transporting a bracket 5000 according to any one described above, with the plurality of ring instruments assembled thereto.

[00181] The system 1000 may include a second robotic arm. The second robotic arm may be configured to: disengage each of the plurality of ring instruments from the bracket 5000 in turn to undergo non-ring inspection; and bring each of the plurality of ring instruments into engagement with the bracket 5000 to assemble the plurality of ring instruments in a predefined order.

[00182] The ring instrument inspection station may be configured to perform any one or more of the following: an optical inspection for any defect; a cutting test to test a sharpness of the functional tip; replacement of each rejected one of the plurality of ring instruments, and lubricate the box mechanism.

[00183] The system 1000 may include a loading station configured to receive one or more sets of instruments prior to processing by the system 1000, in which each of the sets of instruments includes: the plurality of ring instruments assembled to the bracket 5000; and an unloading station configured to hold the one or more sets of reassembled instruments after the processing by the system 1000.

[00184] The system 1000 may include: a non-ring instrument inspection station configured to inspect the plurality of non-ring instruments, in which each of the one or more sets of instruments further includes a plurality of non-ring instruments .

[00185] The non-ring instrument inspection station may be configured to inspect each of the plurality of non-ring instruments in turn for any defect. The non-ring instrument inspection station may include: a conveyor module; replacement of each rejected one of the plurality of non-ring instruments, and a flipping module configured to change an orientation of each of the plurality of non-ring instruments. The system 1000 may include: an optical system and a controller for determining a respective position and a respective orientation of each of the plurality of ring instruments and each of the plurality of non-ring instruments.

[00186] The system 1000 may include: a wrapping station configured to wrap selected ones of the plurality of non-ring instruments in a wrapper.

[00187] The system 1000 may include at least one spare instruments station for holding a plurality of spare ring instruments and/or a plurality of spare non-ring instruments. [00188] According to another aspect, a method of inspection includes: using a first robotic arm to perform transferring of a plurality of ring instruments together before and/or after a ring instrument inspection, the first robotic arm being controllably operable to pick up and transfer the bracket 5000 according to any described above. The method includes: disengaging each one of the plurality of ring instruments in turn from the bracket 5000 before the ring instrument inspection; performing the ring instrument inspection of the plurality of ring instruments one ring instrument at a time in turn, with the one ring instrument disengaged from the bracket 5000. The method includes: assembling the bracket 5000 with a predefined number of predefined types of the ring instruments in a predefined order. The method of inspection may further include any one or more of the following: (i) performing a non-ring inspection of a plurality of non-ring instruments and (ii) a wrapping of selected ones of the plurality of non-ring instruments.

[00189] All examples described herein, whether of apparatus, methods, materials, or products, are presented for the purpose of illustration and to aid understanding, and are not intended to be limiting or exhaustive. Modifications may be made by one of ordinary skill in the art without departing from the scope of the invention as claimed.