Vascular access robotic systems and devices including robotic arm assemblies, and methods thereof

Abstract

An apparatus for vascular access is described herein. The apparatus can comprise a manipulating device configured to releasably couple a cartridge including a needle, a catheter, and a guidewire that are coaxially disposed with respect to each other, and a robotic arm coupled to the manipulating device. The manipulation device or cartridge can include a plurality of actuation mechanisms configured to advance the needle, the catheter, and the guidewire when the manipulating device is coupled to the cartridge. The robotic arm can include a plurality of joints that are configured to rotate about a plurality of axes to position the cartridge relative to the arm of the patient such that the needle, the catheter, and the guidewire can be inserted into a target vessel of the patient.

Description

VASCULAR ACCESS ROBOTIC SYSTEMS AND DEVICES INCLUDING ROBOTIC ARM ASSEMBLIES, AND METHODS THEREOFCROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims the benefit of and priority to U.S. Provisional Patent Application No. 63 / 560,288, filed March 1, 2024, and U.S. Provisional Patent Application No. 63 / 560,552, filed March 1, 2024, the entire disclosure of each of which are incorporated herein by reference.TECHNICAL FIELD

[0002] The present disclosure relates generally to robotic systems, devices, and methods for vascular access. More specifically, the present disclosure relates to robotic systems, devices, and methods for positioning a needle, catheter, and / or guidewire into a blood vessel of a subject.BACKGROUND

[0003] Interventional medical procedure is a popular procedure that can diagnose and treat diseases in various organs of a patient. Interventional medical procedures are minimally- invasive image guided medical procedures that minimize risk to the patient in comparison to open surgeries.

[0004] In order to perform an interventional medical procedure on the vascular system, an operator may need to gain safe access to one or more blood vessels. Traditionally, sharp trocars were used to access blood vessels. Trocars can be used to create lumens through which a catheter can be eventually inserted. However, there are several drawbacks associated with trocars. For instance, improperly placed trocars can lead to various complications such as organ injury, hemorrhage, failed access, catheter malposition, infection, etc.

[0005] More recently, the Seidinger technique has been widely employed in order to gain safe access to the vascular system. The Seidinger technique involves puncturing a desired blood vessel with a needle. A guidewire is inserted through the needle such that the guidewire is placed into the blood vessel. Once the guidewire has advanced to the desired length and / or location in the blood vessel, the needle is removed. A catheter is then advanced into the bloodvessel over the guidewire. Once the catheter is in the blood vessel, the guidewire is pulled out. The Seidinger technique has fewer complications in comparison to using trocars.

[0006] However, the Seidinger technique often requires an experienced surgeon and / or operator to perform the technique on a patient. For instance, human errors made by a surgeon and / or an operator while inserting the guidewire through the needle, or advancing the guidewire to the desired location in the blood vessel can cause complications such as vessel perforation, pseudoaneurysm formation, hemorrhage, infection, etc. Therefore, human errors and inconsistencies while performing the Seidinger technique can cause failures and lead to complications.

[0007] Accordingly, there is an unmet need to provide guidance to operators while inserting a needle and / or catheter into a patient to gain safe vascular access and to improve consistency and reduce complications that may arise due to human errors.SUMMARY

[0008] In some embodiments, an apparatus a cart movable from a first location to a second location near a patient and a manipulation device configured to releasably couple to a cartridge including a needle, a catheter, and a guidewire that are coaxially disposed with respect to each other. The manipulation device and the cartridge include a plurality of actuators each configured to couple to at least one of the needle, the catheter, and the guidewire to selectively advance the needle, the catheter, and the guidewire, when the manipulation device is coupled to the cartridge. The apparatus includes a robotic arm having a first end mounted to the cart and a second end coupled to the manipulation device, the robotic arm having a plurality of segments joined together via a plurality of joints such that the robotic arm can be moved to position the manipulation device.

[0009] In some embodiments, an apparatus includes a cartridge. The cartridge includes a guidewire, a needle, and a catheter that are coaxially disposed with respect to each other. The cartridge includes a plurality of guides coupled to the guidewire, the needle, and the catheter. The apparatus includes a manipulation device configured to linearly advance and retract the plurality of guides to move the needle, the guidewire, and the catheter. The apparatus includes a plurality of actuators including at least one actuator disposed in the cartridge and at least one actuator disposed in the manipulation device. The apparatus includes a least onemotor and a clutch system configured to operably couple the at least one motor to the at least one actuator disposed in the cartridge.

[0010] In some embodiments, a method includes advancing, using a first linear actuator of a manipulation device, a tip of a needle into a target vessel, the needle being coaxially disposed with a catheter and a guidewire in a cartridge selectively coupled to the manipulation device. The method includes advancing, using a second linear actuator of the cartridge, a tip of the guidewire through a lumen of the needle such that the tip of the guidewire extends distally from the tip of the needle. The method includes, after advancing the tip of the guidewire, advancing, using a third linear actuator of the cartridge, a tip of the catheter over at least a portion of the guidewire such that the tip of the catheter extends into the target vessel, the catheter including a catheter hub that is releasable coupled to the third linear actuator via a guide. The method includes after advancing the tip of the catheter, retracting, using the first linear actuator and the second linear actuator, the needle and the guidewire form the target vessel.

[0011] In some embodiments, an apparatus includes: a cart movable to a location near a patient; a manipulation device configured to releasably couple to a cartridge including a needle, a catheter, and a guidewire, the manipulation device including one or more actuators configured to drive movement of at least one of the needle, the catheter, and the guidewire to selectively advance the at least one of the needle, the catheter, and the guidewire into a target vessel; and a robotic arm having a first end mounted to the cart and a second end coupled to the manipulation device, the robotic arm including a plurality of joints coupled to a plurality of segments that are collectively configured to move to position the manipulation device at a predetermined position and orientation relative to the patient, the plurality of joints including a ball joint configured to couple a distalmost segment of the plurality of segments to the manipulation device such that the manipulation device can rotate in multiple directions relative to the plurality of segments.

[0012] In some embodiments, a method includes: receiving, from an accelerometer associated with at least one of a robotic arm, a manipulation device, or a cartridge, accelerometer data during a procedure; determining, based on the accelerometer data, if a magnitude of the accelerometer data exceeds a predefined acceleration threshold; and based on determining that the magnitude exceeds the predefined acceleration threshold, locking a position of the robotic arm by locking at least one ball joint of the robotic arm.

[0013] In some embodiments, an apparatus includes: a cart movable to a location near a patient; a manipulation device configured to releasably couple to a cartridge including a needle, a catheter, and a guidewire, the manipulation device including one or more actuators configured to advance at least one of the needle, the catheter, and the guidewire; a robotic arm having a first end mounted to the cart and a second end coupled to the manipulation device, the robotic arm including a ball joint configured to allow the manipulation device to rotate in multiple directions relative to at least a portion of the robotic arm such that the manipulation device can be positioned near a target vessel; a processor operatively coupled to the manipulation device and the robotic arm, the processor configured to: activate during a surgical procedure the one or more actuators to advance the at least one of the needle, the catheter, and the guidewire into the target vessel; receive accelerometer data associated with the robotic arm or the manipulation device during the surgical procedure; and based on the accelerometer data, activate one or more brakes coupled to the plurality of joints to prevent movement of the robotic arm.

[0014] Other systems, processes, and features will become apparent to those skilled in the art upon examination of the following drawings and detailed description. It is intended that all such additional systems, processes, and features be included within this description, be within the scope of the present invention, and be protected by the accompanying claims.BRIEF DESCRIPTION OF THE DRAWINGS

[0015] The skilled artisan will understand that the drawings primarily are for illustrative purposes and are not intended to limit the scope of the inventive subject matter described herein. The drawings are not necessarily to scale; in some instances, various aspects of the inventive subject matter disclosed herein may be shown exaggerated or enlarged in the drawings to facilitate an understanding of different features. In the drawings, like reference characters generally refer to like features (e.g., functionally similar and / or structurally similar elements).

[0016] FIG. 1 is a block diagram that illustrates a system for facilitating vascular access, according to some embodiments.

[0017] FIG. 2 a block diagram that illustrates a system for facilitating vascular access, according to some embodiments.

[0018] FIG. 3 is a block diagram that illustrates a robotic arm of a system for facilitating vascular access, according to some embodiments.

[0019] FIG. 4 is a block diagram the illustrates a base of a system for facilitating vascular access, according to some embodiments.

[0020] FIG. 5 is a block diagram the illustrates components of a manipulation device and a cartridge assembly and interactions therebetween, according to some embodiments.

[0021] FIG. 6 is a flow diagram illustrating a method of performing a vascular access procedure, in accordance with some embodiments.

[0022] FIG. 7 is a flow diagram illustrating a method of using a vascular access system to perform the Seidinger technique, in accordance with some embodiments.

[0023] FIG. 8 is a flow diagram illustrating a method of using visual aid and / or sensor data to perform a vascular access procedure, in accordance with some embodiments.

[0024] FIG. 9 illustrates a vascular access system, in accordance with some embodiments.

[0025] FIG. 10A illustrates an example robotic system, in accordance with some embodiments.

[0026] FIG. 10B illustrates rotational motion and vertical movement for a base, in accordance with some embodiments.

[0027] FIG. 11 illustrates a manipulation device, in accordance with some embodiments.

[0028] FIG. 12 illustrates a transverse view and a longitudinal view of a blood vessel as captured by an ultrasound imaging device, in accordance with some embodiments.

[0029] FIG. 13 illustrates an example robotic system, in accordance with some embodiments.

[0030] FIG. 14A illustrates a robotic arm of the robotic system of FIG. 13 in a first configuration for storage. FIG. 14B illustrates the robotic arm in a second configuration for vascular access.

[0031] FIG. 15A-15B illustrates another example robotic system, in accordance with some embodiments.

[0032] FIG. 16 is a block diagram that illustrates a robotic arm, including a ball joint, of a system for facilitating vascular access, in accordance with some embodiments.

[0033] FIGS. 17A-17B depict a ball joint, in accordance with some embodiments.

[0034] FIG.18 depicts a method for actuating a ball joint brake, in accordance with some embodiments.

[0035] FIG. 19 illustrates another system for facilitating vascular access, in accordance with some embodiments.

[0036] FIG. 20 illustrates yet another example robotic system, in accordance with some embodiments.DETAILED DESCRIPTION

[0037] Robotic systems, devices, and methods for vascular access are described herein. In some embodiments, the robotic systems, devices, and methods described herein automate or semi-automate vascular access (e.g., the procedure of the Seidinger technique) in order to provide safe access to blood vessel(s) and / or organ(s). The blood vessel(s) can be any suitable type of blood vessel(s) such as arteries (e.g., radial artery, femoral artery, etc.), veins (e.g., brachial vein, basilic vein, cephalic vein, femoral vein, internal jugular vein, median cubital vein, median antebrachial vein, etc.).

[0038] In some embodiments, the technology described herein includes a robotic system for facilitating vascular access. The robotic system can include a manipulation device coupled to a cartridge. The manipulation device and / or the cartridge can comprise or otherwise be attached to a guidewire, a needle, and a catheter that is to be positioned in a blood vessel of a subject. The robotic system and the manipulation device can be controlled by a user (e.g., an operator, a surgeon, etc.) using one or more input / output (I / O) devices. In some embodiments, the manipulation device can include an imaging device (e.g., an ultrasound array). The imaging device can provide the user with visual aid (e.g., ultrasound images of the blood vessel) of the procedure such as the guidewire, the needle, and / or the catheter being inserted into a blood vessel. In some embodiments, the I / O device(s) can include a sensor (e.g., camera) that provides feedback (e.g., image data of the robotic system, manipulation device, and / or portion of a subject’s body) to the robotic system as the manipulation device accesses a blood vessel.The robotic system can adjust the movement, position, and / or orientation of the guidewire, needle, and / or catheter based on data from the sensor so as to automate the procedure of vascular access. In some embodiments, the user can remotely control the robotic system and / or the manipulation device to perform the procedure based on the data from the sensor and the visual aid from the imaging device. Further details of such a system are described below with reference to the figures.Vascular Access System and Components

[0039] FIG. 1 is a high-level block diagram that illustrates a system 100, according to some embodiments. System 100 can be configured to automate and / or semi-automate a medical procedure for vascular access. System 100 includes a robotic system 102 including a manipulation device 130. The robotic system 102 and / or the manipulation device 130 can be communicably coupled to one or more VO device(s) 104 (e.g., external and / or remote I / O devices). In some embodiments, the robotic system 102 and / or the manipulation device 130 can be optionally communicably coupled to one or more sensor(s) 106 (e.g., external and / or remote sensors).

[0040] In some embodiments, the robotic system 102 can be any suitable robot. For instance, the robotic system 102 can include a robotic arm that can form a part of a robotic device. The robotic device itself can be an autonomous and / or a semi-autonomous cart coupled to and / or integrated with the manipulation device. In some embodiments, the robotic device can include a base with a flat portion that is configured to support a patient on whom the medical procedure is to be performed as further described herein. Alternatively, the robotic device can be an autonomous robot with humanoid features (e.g., arms, transport elements, head, base, etc.).

[0041] The robotic system 102 can include a robotic arm with two or more segments coupled together via joints, as further detailed with reference to FIG. 3. In embodiments, the robotic arm can provide at least three, at least four, at least five, at least six, at least seven, at least eight, or at least nine degrees of freedom of movement, including values and sub-ranges therebetween. For example, the robotic arm can provide between three and six degrees of freedom. Each joint of the robotic arm can be configured to allow one or more degrees of freedom. For example, joints can provide for translation along and / or rotation of the robotic arm about one or more axes. In some embodiments, one end segment of the robotic arm can include a coupling element. The coupling element can couple the robotic arm to themanipulation device 130. The other end segment of the robotic arm can be disposed on, affixed to, mounted on, and / or integrated with at least a portion of the robotic system 102. In some embodiments, the robotic arm can include one or more joints that can be configured to allow a portion of the robotic arm to move in a plurality of directions, such as, for example, a ball joint.

[0042] In some embodiments, the robotic arm can be disposed on, affixed to, mounted on, and / or integrated with a base (e.g., base of an autonomous and / or semi-autonomous cart) of the robotic system 102, as further detailed with reference to FIG. 2. In some embodiments, the base can carry the robotic arm, one or more I / O device(s) 104, and one or more sensor(s) 106. The base can be a movable base with one or more transport elements that can provide for translation along and / or rotation of the robotic system 102 along one or more axes. Additionally or alternatively, the base can be configured to be stationary. In some embodiments, the base can be configured to raise vertically so as to position the robotic arm at an appropriate height with respect to a subject (e.g., a patient on whom the medical procedure is to be performed). In some embodiments, the base can include a locking mechanism to lock the movement of the transport elements and / or the movement of the base itself.

[0043] In some embodiments, the robotic system 102 can include a communication interface to enable communication with the I / O device(s) 104 and / or the sensor(s) 106. In some embodiments, the robotic system 102 can include a control unit to control the robotic system 102 (e.g., to control the base, robotic arm, etc.).

[0044] The robotic system 102 is described as a robotic arm disposed on, affixed to, mounted on, and / or integrated with a base solely for illustrative purposes. It should be readily understood that the robotic system 102 can be any suitable robotic component (e.g., robotic cart, humanoid robot, etc.) that can be coupled to one or more manipulation devices 130. For instance, the robotic system 102 can include multiple robotic arms that form a part of the robotic system 102. Each robotic arm can be coupled to a respective manipulation device. In such a scenario, the robotic system 102 may be configured to perform the medical procedure on multiple subjects substantially simultaneously. Additionally or alternatively, the robotic system 102 may include a robotic arm without a base. Additionally or alternatively, the robotic system 102 can be an autonomous humanoid robot (e.g., a robot with humanoid features such as head, transport elements, manipulation elements, etc.) with a robotic arm for facilitating vascular access.

[0045] In some embodiments, the manipulation device 130 can be coupled to the robotic system 102 via a coupling element. The manipulation device 130 can be configured to drive movement of one or more components (e.g., a catheter, a needle, and / or a guidewire) to facilitate vascular access. The coupling element can include any type of mechanism that can couple the manipulation device 130 to the robotic system 102, such as, for example, a mechanical mechanism (e.g., a fastener, a latch, a mount, a joint), a magnetic mechanism, a friction fit, etc. The manipulation device 130 can be attached to a cartridge assembly (further described with reference to FIG. 5) that can include a needle, a catheter, and / or a guidewire to perform the medical procedure. In some embodiments, the manipulation device 130 can include one or more actuators that can actuate each of the needle, the catheter, and the guidewire. In some embodiments, one or more actuators are housed within the cartridge assembly. The actuators can enable the manipulation device 130 to perform the medical procedure. The one or more actuators can be any suitable type of actuator. For instance, the one or more actuators can include linear actuators with magnetic encoders.

[0046] In some embodiments, the robotic system 102 can include an imaging device (e.g., ultrasound array) to provide a user (e.g., an operator, a surgeon, etc.) with visual aid (e.g., ultrasound images showing transverse view and / or longitudinal view) as the medical procedure is performed (e.g., ultrasound images of the needle, the catheter, and / or the guidewire being inserted into a blood vessel of a subject). In some embodiments, the imaging device can be integrated and / or form part of the manipulation device, as further detailed with reference to FIG. 5.

[0047] The manipulation device 130 and / or the robotic system 102 can be communicably coupled to one or more I / O device(s) 104. An I / O device(s) 104 can be any suitable input device that can be configured to receive inputs from the user and / or any suitable output device that can be configured to send outputs to other devices and / or the user operating the robotic system 102. In some embodiments, the I / O device(s) 104 can be an integrated computing device that includes one or more components to both receive inputs and send outputs. Some non-limiting examples of integrated computing device that can receive inputs from the user and send outputs to the user and / or to other devices can include computers (e.g., desktops, personal computers, laptops etc.), tablets and e-readers (e.g., Apple iPad®, Samsung Galaxy® Tab, Microsoft Surface®, Amazon Kindle®, etc.), mobile devices and smart phones (e.g., Apple iPhone®, Samsung Galaxy®, Google Pixel®, etc.), etc.

[0048] In some embodiments, the I / O device(s) 104 can be a user control such as a joystick, a remote user control, keyboard, trackball, etc. that can receive input from the user. In some embodiments, the I / O device(s) 104 can be an audio device such as a microphone and / or a speaker that receives audio input from the user. In such embodiments, the I / O device(s) 104 can additionally include a display device (e.g., a display, a touch screen, etc.) that displays output to the user.

[0049] The manipulation device 130 and / or the robotic system 102 can be optionally coupled to one or more sensor(s)106. The sensor(s) 106 can be configured to capture image data of the at least a part of the robotic system 102, the manipulation device 130, and / or at least a part of the subject as the robotic system 102 performs the medical procedure on the subject. The sensor(s) 106 can be an image sensor such as visual camera, stereo camera array, etc. The sensor(s) 106 can be operable to capture two-dimensional and / or three-dimensional images of the robotic system 102, the manipulation device 130, and / or the subject. In some embodiments, the sensor(s) 106 can be operated remotely by the user. For instance, the user can be in a location away from the system 100, and the sensor(s) can be configured to be controlled remotely using one of the I / O device(s) 104. Alternatively, in some embodiments, the user can be in a location proximate to the system 100 and may not require any sensor(s) 106. In some embodiments, a user proximate to the system 100 can also operate and / or adjust one or more sensor(s) 106 of the system 100, e.g., one or more image sensors, to capture views of the environment for one or more remote users and / or for tracking / monitoring purposes.

[0050] In some embodiments, the sensor(s) 106 can be mounted on and / or can otherwise be an integral part of the I / O device(s) 104. For instance, the sensor(s) 106 can be attached to, coupled to, and / or otherwise be a part of the I / O device(s) 104. In some embodiments, the sensor(s) 106 can be mounted on the robotic system 102 itself. The sensor(s) 106 can be operable to move (e.g., rotational and / or translational motion) such that the sensor(s) 106 can capture image data from various angles. For instance, the sensor(s) 106 can be mounted on a pan / tilt mechanism to capture the image data. In some embodiments, the sensor(s) 106 can be a portable device such as a handheld computer tablet, a smartphone with camera, or a digital camera that is attached to, mounted on, and / or otherwise a part of the system 100.

[0051] In order to perform the medical procedure, the VO device(s) 104 (e.g., user control such as joystick, keyboard, remote control, trackball, etc.) can receive an input from the user. The input can be transmitted to the robotic system 102 and / or the manipulation device 130. Forinstance, the I / O device(s) 104 can receive an input to advance the needle, catheter, and / or guidewire into a blood vessel. The input can be transmitted from the I / O device(s) to the robotic system 102 via a communications interface. The robotic system 102 can cause the actuators in the manipulation device 130 to actuate the needle, catheter, and / or guidewire (e.g., included in a cartridge assembly) based on the input. The imaging device (e.g., ultrasound array) included in the manipulation device can provide a visual aid of the movement (e.g., the advancement) of the needle, catheter, and / or guidewire into the blood vessel. The visual aid (e.g., ultrasound images showing transverse view and / or longitudinal view) may be displayed on the I / O device(s) 104 (e.g., display device). Subsequent input representing subsequent movement of the manipulation device 130 or one or more components in the manipulation device 130 (e.g., actuators actuating needle, catheter, and / or guidewire) can be provided to the I / O device(s) 104 based on the visual aid. For example, if the position of the needle, catheter, and / or guidewire in the blood vessel is incorrect, the visual aid (e.g., ultrasound images showing transverse view and / or longitudinal view) can guide the user to modify the input so that such component(s) advance to an appropriate location in the blood vessel.

[0052] In some embodiments, the sensor(s) 106 (e.g., camera) can provide image data of the robotic system 102, the manipulation device 130, and the subject to the user. The user can remotely control the manipulation device 130 based on the image data. For example, the image data may include images of the portion of the body of the subject that includes the blood vessel and the orientation and / or position of the manipulation device 130 with respect to the portion of the body. If the orientation and / or position of the manipulation device 130 with respect to the portion of the body is incorrect, the user can remotely control the manipulation device 130 (e.g., by sending instructions to the robotic system 102 via the I / O device(s) 104) so as to orient and / or position the manipulation device 130 as desired.

[0053] In some embodiments, the user can control the sensor(s) 106 remotely using the I / O device(s) 104. For instance, if the captured image data does not include images of the manipulation device 130 or the portion of the body, then the sensor(s) 106 can be remotely controlled by the user such that the angle of the sensor(s) 106 can be changed so as to capture the images of both the manipulation device 130 and the portion of the body. For example, the pan / tilt mechanism on which the sensor(s) is mounted can be remotely controlled by the VO device(s) so as to capture the images as desired.

[0054] Subsequent inputs such as input to advance the needle, catheter, and / or guidewire can be provided remotely through the I / O device 104 based on the image data and the visual aid (e.g., ultrasound images) obtained from the imaging device (e.g., ultrasound array). In some embodiments, the robotic system 102 can be configured to automatically (e.g., via the control unit in the robotic system 102) adjust the position and / or orientation of the manipulation device 130 or one or more components of the manipulation device 130 based on the image data and the visual aid. In this manner, the robotic system 102 along with the manipulation device 130 can perform the vascular access procedure (e.g., the Sei dinger technique) in an automated and / or a semi-automated manner such as with the user controlling the I / O device(s) 104 that in turn controls and actuates the robotic system 102 and / or the manipulation device 130.1.0 Robotic System

[0055] FIG. 2 is a block diagram that illustrates a robotic system 202 of a vascular access system, according to some embodiments. The robotic system 202 can be functionally and / or structurally similar to other robotic systems described herein, such as, for example, robotic system 102 in FIG. 1. The robotic system 202 can include a base 203. The base 203 can be mechanically coupled to a robotic arm 220 (e.g., similar to the robotic arm as described with reference to FIG. 1) via an arm support 210. The robotic arm 220 can be coupled to and / or integrated with a manipulation device 230. In some embodiments, a cartridge assembly 240 can be attached to the manipulation device 230. In some embodiments, the cartridge assembly 240 may be a cartridge configured to access a radial vein. In some embodiments, the cartridge assembly may be configured to access a jugular vein.1.1 Base

[0056] The base 203 can be any suitable base for positioning a manipulation device 230 of the vascular access system. For example, the base 203 can be a chassis supporting the robotic arm 220 and the manipulation device 230. In such scenarios, one or more electronic components such as a control unit, a communications interface, etc. can be attached to and / or coupled to the base 203 (e.g., chassis). Alternatively, the base 203 can be a structure supporting the robotic arm 220 and the manipulation device 230 that houses one or more electronic components such as a control unit, a communications interface, etc. within the base 203. Put differently, the outer structure of the base 203 can be a housing that encloses one or more electronic components. The robotic arm 220 and the manipulation device 230 can be supported on the outer structure.In some embodiments, the base 203 can be implemented as a surgical cart, which can support the robotic arm 220 and / or other components of the vascular access system. The cart can include transport elements (e.g., wheels, swivel casters, crawlers, tracks, etc.) which can be used to move the base from a first location to a second location near a patient. In some embodiments, the base 203 can be or include a surface with a flat portion configured to support a patient on whom the medical procedure is to be performed. For example, the base 203 can be a bed or other platform configured to support the patient. Additionally or alternatively, the base 203 can include a surface (e.g., an attachable extension such as an attachable arm rest or table) that can be configured to support at least a portion of the patient (e.g., an arm of the patient). A first portion of the robotic arm 220 can be coupled to the base 203 (e.g., bed, chassis, etc.). A second portion of the robotic arm (e.g., a second portion opposite the first portion) can be coupled to the manipulation device 230. In some embodiments, the second portion of the robotic arm 220 coupled to the manipulation device 230 can be movable relative to the base 203 to position the needle, the guidewire, and the catheter for insertion into the target vessel of the patient.

[0057] FIG. 4 is a block diagram the illustrates a base 403 (e.g., structurally and / or functionally similar to base 203 in FIG. 2 and / or other bases described herein), according to some embodiments. Optionally, the bottom surface of the base 403 can include transport elements 414 that can provide for translation along and / or rotation of the robotic system (e.g., robotic system 202 in FIG. 2) along one or more axes. Transport elements 414 can be any suitable components configured for movement such as, for example, a wheel, a swivel caster, a crawler, a track, etc. Transport elements can enable the robotic system 202 to move around.

[0058] For instance, the transport elements 414 can be swivel casters (e.g., 4 swivel casters coupled to 4 corners of the base 403) that provide three degrees of freedom to the robotic system 202. The swivel casters can allow for linear translations of the robotic system 202 along two axes and rotation of the robotic system 202 along one axis. These three degrees of freedom can enable a user (e.g., a surgeon and / or an operator) to achieve planar and rotational positioning of the base 403 and thereby planar and rotational positioning of the robotic system 202 relative to a portion of a subject’s body (e.g., arm, etc., on which the medical procedure is to be performed).

[0059] Optionally, the base 403 can include vertical adjustment elements 409 to move (e.g., raise or drop) the base vertically so as to position the robotic arm 220 and the manipulationdevice 230 at an appropriate height with respect to a subject (e.g., a patient on whom the medical procedure is to be performed). This can provide the robotic system 202 with a fourth degree of freedom. In some embodiments, the vertical adjustment elements 409 can include mechanical features to lift a top surface of the base 403 and / or drop the top surface of the base 403 to a specific height. For example, the vertical adjustment elements 409 can include linear rails with recirculating balls to adjust a height of the top surface of the base 403. In some embodiments, the vertical adjustment elements 409 can include an actuator such as ball screw actuator to move the base vertically. For instance, the ball screw actuator can move the top surface of the base 403 vertically to a desired height. Once the desired height is reached, a failsafe brake can hold the position of the top surface while the linear rails with recirculating balls can constraint the movement of the base 403. In other embodiments, the top surface of the base 403 can be moved manually by manually adjusting the linear rails and the recirculating balls. In some embodiments, the base 403 may not be vertically adjustable. However, in such embodiments, an robotic arm coupled to the base 403 (such as any of the robotic arms described herein, including, for example, robotic arm 220) can be configured to translate and / or rotate about one or mor axes to adjust a position of the manipulation device and / or cartridge assembly relative to the base 403.

[0060] Optionally, the base 403 can include a locking mechanism or locking device 412 to lock the movement of the base 403. For instance, once a user positions the robotic system 202 at an appropriate position (e.g., distance and / or height) with respect to the subject, the locking mechanism can be engaged to lock the position of the base 403 and the robotic system 202. The locking mechanism 412 can lock the transport elements 414 (e.g., swivel casters) preventing the transport elements 414 from moving further. In some embodiments, the locking mechanism 412 can automatically engage a lock. For instance, the locking mechanism 412 can automatically lock the transport elements 414 as soon as the robotic system 202 is positioned at a desired location.

[0061] Optionally, the base 403 can include a communications interface 407. The communication interface 407 can be any suitable component that enables the base 403 and / or the robotic system 202 to communicate with I / O device(s) (e.g., VO device(s) 104 in FIG. 1), sensor(s) (e.g., sensor(s) 106 in FIG. 1), or other suitable devices. In some embodiments, communication interface 407 can further enable the I / O device(s) to communicate with the transport elements 414, vertical adjustment elements 409, and locking mechanism 412. In someembodiments, the I / O device(s) can include a user control 404a and / or a display 404b, as further detailed below.

[0062] In some embodiments, the base 403 can include a control unit 405 to control and / or monitor one or more components of the robotic system (e.g., robotic system 202 in FIG. 2) such as the base 403, the robotic arm (e.g., robotic arm 220 in FIG. 2), the manipulation device (e.g., manipulation device 230 in FIG. 2), the cartridge assembly (e.g., cartridge assembly 240 in FIG. 2), and / or a combination thereof. Control unit 405 can be any suitable processing device configured to run and / or execute functions associated with controlling and / or monitoring one or more components of the robotic system. Control unit 405 can include any suitable processor(s) that can be configured to execute modules, functions, and / or processes. In some embodiments, the processor(s) can be a general purpose processor, a Field Programmable Gate Array (FPGA), an Application Specific Integrated Circuit (ASIC), a Digital Signal Processor (DSP), and / or the like. In some embodiments, the control unit 405 may be communicatively coupled to or include a sensor (e.g., torque sensor, pressure sensors, ammeters, etc.) configured to monitor the operations of the robotic system.

[0063] As discussed above, the base 403 can support the robotic arm (e.g., robotic arm 220 in FIG. 2) and / or one or more I / O device(s) (e.g., VO device(s) 104 in FIG. 1). For example, the base 403 can be coupled to the robotic arm via arm support 410. One or more I / O device(s) such as, for example, user control 404a and display 404b can be communicably coupled to the base 403. In some embodiments, the display 404b can additionally be mechanically coupled to the base 403 via the display support 405a. Display support 405a can be any suitable support that can attach and / or couple display 404b to the base 403 such that the base 403 supports the display 404b. In some embodiments, display support 405a can enable adjustment s) to be made to the position and / or orientation of the display 404a. Display 404b can be any suitable display device such as touch screen, device displaying a graphical user interface, audio device (e.g., microphone, speaker, etc.), a combination thereof, and / or the like.

[0064] In some embodiments, the user control 404a can additionally be attached to and / or integrated with the base 403. For instance, user control 404a can be integrated with the base 403 such that the base 403 supports the user control 404a. User control 404a can be any suitable device that can receive input from the user such as a joystick, a remote user control, keyboard, trackball, etc.1.2 Robotic Arm

[0065] Referring back to FIG. 2, the base 203 can be coupled to the robotic arm 220. In some embodiments, the base 203 can be coupled directly to the robotic arm 220 and support the robotic arm 220 at a predefined distance above a ground surface or floor on which the base 203 is disposed. In some embodiments, an arm support 210 can be used to couple the base 203 to the robotic arm 220. The arm support 210 (similar to other arm supports described herein) can include a coupler, a stand, or other mounting device for coupling or attaching the robotic arm 220 to the base 203.

[0066] The robotic arm 220 can comprise of two or more segments coupled together via joints. One end segment can be coupled to the arm support 210 and / or base 203. The other end segment can be integrated with and / or coupled to the manipulation device 230. In some embodiments, the robotic arm 220 can be actuated by one or more motors. In some embodiments, the robotic arm 220 can include one or more sensors to measure sensory information, including information relating to the robotic arm 220. Examples of sensors include position encoders, torque and / or force sensors, touch and / or tactile sensors, etc. The sensors can be disposed on or integrated with either the segments, or the joints, or a combination of both. The sensory information can be transmitted to a control unit (e.g., control unit 405 in FIG. 4) included in or attached to the base 203. Additionally or alternatively, the sensory information can be transmitted to one or more VO device(s) (e.g., VO device(s) 104 in FIG. 1).

[0067] FIG. 3 is a block diagram the illustrates a robotic arm 320 (e.g., structurally and / or functionally similar to robotic arm 220 in FIG. 2 and / or other robotic arms described herein), according to some embodiments. In some embodiments, robotic arm 320 can be implemented as an arm that includes two segments 322 and 324. Arm support 310 (e.g., similar to arm support 210 in FIG. 2) and segment 322 can be coupled together via joint 321. Segments 322 and 324 are coupled together via joint 323. In some embodiments, the robotic arm can optionally include segment 326. Segments 326 and segment 324 can be coupled together via joints 325a and 325b. In some embodiments, the manipulation device 330 (e.g., manipulation device 230 in FIG. 2) and segment 326 can be coupled together via joint 327. In other embodiments (e.g., embodiments that may not include segment 326), the manipulation device 330 and segment 324 can be coupled together via joint 325a. In yet other embodiments, the manipulation device 330 can be integrated with segment 324 or segment 326.

[0068] In some embodiments, the robotic arm 320 can have three proximal axes. A first proximal axis can be along arm support 310 that enables vertical translation of the robotic arm 320 along the arm support 310. A second proximal axis can be along joint 321. A third proximal axis can be along joint 323. The three proximal axes can allow translation of the robotic arm 320 along the three-dimensional space. In some embodiments, the robotic arm can have three distal axes. A first distal axis can be along joint 325a, a second distal axis can be along joint 325b, and a third distal axis can be along joint 327. The three distal axes can allow rotation of the robotic arm 320 along the three-dimensional space (e.g., pitch, yaw, and roll). In this manner, the robotic arm can have six degrees of freedom. In some embodiments, the second proximal axis along joint 321, the third proximal axis along joint 323, and the first distal axis along 325a can comprise a planar Selective Compliance Articulating Robot Arm (SCARA) linkage. While three segments and five joints are depicted in FIG. 3, one of ordinary skill in the art would understand that a robotic arm can include a different number of segments and / or joints.

[0069] In some embodiments, the robotic arm 320 can include a first joint (e.g., joint 321) which is configured to allow segment 322 (and segments distal thereto) to rotate about an axis of the first joint, a second joint (e.g., joint 323) which is configured to allow segment 324 (and segments distal thereto) to rotate about an axis of the second joint, and a third joint (e.g., joint 325a) which is configured to allow segment 326 (and segments distal thereto) to rotate about an axis of the third joint. In some embodiments, the axes of the first, second and third joints can be orthogonal to each other. Therefore, the first, second and third joints can define three degrees of freedom of movement of the robotic arm. In some embodiments, the robotic arm 320 can include an additional joint (e.g., joint 327) which can be configured to attach or couple to the manipulation device 330. The additional joint can enable the manipulation device to be rotated about at least one axis. In some embodiments, the additional joint can be implemented as a ball joint and enable the manipulation device to be rotated in multiple directions (e.g., 360 degree directional movement) relative to the robotic arm. The combination of joints and segments can enable the robotic arm 320 to be reconfigured (e.g., into different positions and / or orientations) to position the manipulation device 330 (and a cartridge coupled thereto) for insertion of a catheter, needle, and / or guidewire into the patient vasculature.

[0070] In some embodiments, the robotic arm 320 can include locking mechanisms or devices for locking one or more components of the robotic arm 320. For example, the robotic arm caninclude one or more pulleys, magnets, etc. for locking one or more joints and / or a height of the robotic arm 320 relative to a base of a robotic system (e.g., base 403). The locking mechanisms can include, for example, mechanical locking devices (e.g., latches, ratchets, hydraulic locks), friction-based locking devices, electromagnetic locking devices, piezoelectric locking devices, etc. The locking mechanisms can be located at one or more joints, e.g., to lock a position of those joints and therefore the segments coupled thereto.

[0071] FIG. 16 is a block diagram that illustrates a robotic arm 4320 (e.g., functionally and / or structurally similar to the robotic arm 320 and / or the robotic arm 220 of FIG. 2 and / or other robotic arms described herein), including a ball joint 4325, of a system for facilitating vascular access, in accordance with some embodiments. The ball joint 4325 is configured to couple a manipulation device 4330 (e.g., structurally and / or functionally similar to the manipulation device 220 of FIG. 2, the manipulation device 330 of FIG. 3 and / or any of the manipulation devices described herein) to the segment 4322 (e.g., a distalmost segment of the robotic arm). The ball joint 4325 is configured to allow the manipulation device to swivel or rotate in multiple directions relative to a base (e.g., the base 203 of FIG. 2, the base 403 of FIG. 4, and / or any of the bases described herein). In some embodiments, the ball joint 4325 includes a brake that, when activated, prevents further motion and / or rotation. In some embodiments, the brake may be a friction brake, a mechanical break, an electric break, and / or the like. In some embodiments, the brake may be activated in response to an erratic motion. In some embodiments, the brake may be activate based on the manipulation device 4330 being placed in a desired position. In some embodiments, the operation of the brake of the ball joint 4325 is controlled via a control unit (e.g., functionally and / or structurally similar to the controller unit 405 of FIG. 4) associated with the base. The ball joint 4235 is further discussed in reference to FIGS. 17A-18.

[0072] In some embodiments, the ball joint 4325 is coupled to the base via a component configured to translate the ball joint. In some embodiments, the robotic arm 4320 includes one or morejoint(s) 4321 (e.g., functionally and / or structurally similar to the joints 321, 323, 325a, 325b, 327 of FIG. 3) and / or one or more segment(s) 4324 (e.g., functionally and / or structurally similar to the segments 322, 324, 326 of FIG.3). Optionally, the robotic arm 4320 can be coupled to the base via an arm support 4310 (e.g., functionally and / or structurally similar to the arm support 210 of FIG. 2, the arm support 310 of FIG. 3, and / or other arm supports described herein). While FIG. 16 depicts a particular arrangement of joints 4321 and segments 4324, one of ordinary skill in the art would understand that a robotic arm can include a differentnumber of segments and / or joints. In some embodiments, the joint(s) 4321 can be additional ball joints, functionally and / or structurally similar to the ball joint 4325. Alternatively, one or more of the joint(s) 4321 can be rotational joints that allow segments distal to the joint to rotate about an axis of the joint. In an embodiment, the robotic arm 4320 can include a first joint 4321 that is configured to allow segments 4324 that are distal to the first joint 4321 to rotate about a first axis, a second joint 4321 that is configured to allow segments 4324 that are distal to the second joint 4321 to rotate about a second axis, and a third joint 4321 that is configured to allow segments 4324 to rotate about a third axis, where the first, second, and third axes are orthogonal to each other. The ball joint 4325 can then be disposed on a distal end of the distalmost segment 4324, and be configured to couple the manipulation device 4330 to that segment (and the rest of the robotic arm).

[0073] The arm support 4310, joints 4321, and / or the segments 4324 can be included to position the robotic arm 4320 such that the manipulation device 4330 is in a desirable position for an operation. In some embodiments, the robotic arm 4320 can include sensors in one or more components configured to measure the position, the acceleration and / or the like of a portion of the robotic arm 4320. Advantageously, having the ball joint can enable the robotic system to function with lesser segments and joints in the robotic arm. However, ball joints may be more difficult to brake and / or lock compared to traditional single axis rotational joints. Therefore, it can be desirable to have an effective mechanism for braking a ball joint of a robotic system, as further described with respect to FIGS. 17A-17B.2.0 Manipulation Device and Cartridge Assembly

[0074] Referring back to FIG. 2, an end segment of the robotic arm 220 can be coupled to the manipulation device 230. The manipulation device 230 can be attached to a cartridge assembly 240. Further details of the components of an example manipulation device and an example cartridge assembly are described below.

[0075] FIG. 5 is a block diagram that illustrates a manipulation device 530 (e.g., similar to manipulation device 230 in FIG. 2 and / or other manipulation devices described herein) and a cartridge assembly 540 (e.g., similar to cartridge assembly in FIG. 2 and / or other cartridge assemblies described herein), according to some embodiments. In some embodiments, the manipulation device 530 can include a coupling mechanism 538, an imaging device 536, a portion of one or more device actuator(s) (e.g., catheter actuator 534a, needle actuator 534b,and guidewire actuator 534c), collectively referred to as device actuator(s) 534, and optionally a control unit 532. In some embodiments, one or more of the device actuator(s) 534 may be housed within the cartridge assembly 540. For example, the catheter actuator 534a and the guidewire actuator 534c may be located within the cartridge assembly 540 while the needle actuator 534b is located within the manipulation device 530. Any suitable permutation of the catheter actuator 534a, needle actuator 534b, and the guidewire actuator 534c in the manipulation device 530 and / or the cartridge assembly 540 can be possible.

[0076] While an catheter actuator 534a, a needle actuator 534b, and a guidewire actuator 534c are depicted in FIG. 5, it can be appreciated that any number or type of actuators can be used. Moreover, an actuator that is configured to actuate the needle (e.g., needle actuator 534b) can be configured to actuate other components and / or devices as well (e.g., the catheter and / or the guidewire). In an embodiment, a first actuator can be configured to move the catheter, the needle, and the guidewire (or to move the entire cartridge assembly 540), a second actuator can be configured to move the guidewire relative to the needle and the catheter, and a third actuator can be configured to move the catheter relative to the needle and the guidewire.

[0077] In some embodiments, the device actuator(s) 534 can include one or more linear actuators. Each linear actuator can include a motor, a screw shaft, and a ball screw or other follower. Alternatively, each linear actuator can include a hydraulic actuator. In some embodiments, the motors that drive movement of the screw shaft of other components of the linear actuators can be disposed in the manipulation device 530, while other components of the linear actuators (e.g., screw shaft, ball screw) can be disposed in the cartridge assembly 540.

[0078] In some embodiments, the cartridge assembly 540 can include the device(s) 544 (e.g., interventional devices) such as a catheter, a needle, and / or a guidewire. Alternatively, the manipulation device 530 can include some of the device(s) 544 while the cartridge assembly 540 can include other device(s) 544. For instance, the manipulation device 530 can include a catheter and a guidewire while the cartridge assembly 540 can include the needle. Similarly, the manipulation device 530 can include the guidewire and the needle while the cartridge assembly 540 can include the catheter. In a similar manner, any suitable permutation of the catheter, the needle, and the guidewire in the manipulation device 530 and / or the cartridge assembly 540 can be possible. In some embodiments, the guidewire, the needle, and the catheter can be arranged coaxially. For example, the guidewire can be disposed within a lumen of the needle and the needle can be disposed within a lumen of the catheter. In someembodiments, a length of the catheter can be about 40mm. In some embodiments, a length of the needle can be a little more than 40mm (40mm plus bevel length) such that the needle can extend past the catheter. In some embodiments, the guidewire can be 142mm long such that at least 50mm of the guidewire can extend past the needle tip. In some embodiments, the cartridge assembly 540 can be configured to store the guidewire in a linear state.

[0079] The imaging device 536 in the manipulation device 530 can provide the user with a visual aid of a blood vessel as the medical procedure is being performed. For example, the imaging device can be any suitable imaging device that can capture a visual representation of the blood vessel. Some non-limiting example of the imaging device 536 can include ultrasound imaging device, fluoroscopes, cameras, etc.

[0080] In some embodiments, the imaging device 536 can be an ultrasound array located on the manipulation device 230. The ultrasound array can provide two-dimensional ultrasound images along a longitudinal plane and a transverse plane. The ultrasound images with the transverse view of a blood vessel can show the radial cross section of the blood vessel and the longitudinal view of the blood vessel can show the axial cross section of the blood vessel. In some embodiments, the imaging device 536 can be configured to obtain three-dimensional ultrasound images of the blood vessel.

[0081] The manipulation device 530 and the cartridge assembly 540 can each include a portion of one or more device actuator(s) 534. The device actuator(s) 534 can be configured to actuate the needle, the catheter, and / or the guidewire. For example, the manipulation device 530 can include linear actuators to actuate the device(s) 544. The linear actuators can include a ball screw shaft supported by ball screw bearings. A motor can be coupled to each device actuator 534 to drive the movement of a ball screw nut along the shaft. A magnetic encoder coupled to the motor can sinusoidally commutate the motor. A linear circulating ball bearing can be coupled to the ball screw nut that is fixed on the ball screw shaft. For instance, the linear circulating ball bearing can be coupled to the ball screw nut on the ball screw shaft via a carriage block. As the ball screw shaft rotates (e.g., owing to the rotation of the motor’s rotor), the ball screw nut translates as it is constrained by the linear circulating ball bearing through the carriage block. The translation of the ball screw nut can in turn actuate a device(s) 544 along a linear axis. Accordingly, each of the needle, catheter, and guidewire can be actuated along a linear axis by a respective linear actuator. In some embodiments, a portion of the one or more device actuator(s) 534 are located in the manipulation device 530 and a correspondingportion of the one of more device actuator(s) 534 are located in the cartridge assembly 540. For example, a motor of a linear actuator may be located in the manipulation device 530 and a corresponding ball screw may be located in the cartridge assembly 540 and operably coupled to the motor.

[0082] In some embodiments, each of the needle, catheter, and guidewire can be attached to a respective guide that guides the device(s) 544 along the linear axis as the device(s) are being actuated by the linear actuators (e.g., device actuator(s) 534 included in manipulation device 530). In some embodiments, the guides can be included in the cartridge assembly 540 and can be attached to the respective device(s) 544. For example, a needle guide 544b included in the cartridge assembly 544 can be attached to the needle, a catheter guide 544a included in the cartridge assembly 544 can be attached to the catheter, and a guidewire guide 544c included in the cartridge assembly 544 can be attached to the guidewire. In some embodiments, the catheter guide 544a, the needle guide 544b, and the guidewire guide 544c can each include a coupling element that can couple with the coupling mechanism 538 in the manipulation device 530. Alternatively, in some embodiments, one or more of the needle, the catheter, or the guidewire may not include a guide. For example, the needle may not include a guide but can be coupled to move with the cartridge assembly 540 when the entire cartridge assembly 540 moves.

[0083] The manipulation device 530 can include coupling mechanism 538 that couples the cartridge assembly 540 (e.g., the coupling element in the cartridge assembly 540) to the manipulation device 530, such as, for example, a mechanical mechanism (e.g., a fastener, a latch, a mount, a platform, a plate, a clip, etc.), a magnetic mechanism, a friction fit, etc. In some embodiments, the manipulation device 530 and the cartridge assembly 540 are operably coupled to allow for at least a portion of the device actuator(s) 534 in the manipulation device 530 to interface with corresponding portions of device actuator(s) 534 in the cartridge assembly. For example, the manipulation device 530 may be coupled to the cartridge assembly 540 such that motors in the manipulation device 530 may operate ball screws in the cartridge assembly 540 which may operate device(s) 544. In some embodiments, the cartridge assembly 540 is coupled to the manipulation device 530 such that device actuator(s) 534 in the manipulation device 530 may translate the cartridge assembly along the manipulation device 530.

[0084] In some embodiments, the coupling mechanism 538 can be a mechanical mechanism.For example, the coupling mechanism 538 can include slots (e.g., recessed portions in themanipulation device 530) such that the catheter guide 544a, the needle guide 544b, and the guidewire guide 544c included in the cartridge assembly 540 can fit within the slots. Alternatively, the coupling mechanism 538 can include a platform or plate with features (e.g., protrusions, slots, and / or grooves) that can receive a corresponding structure of the cartridge (e.g., a mated feature) and allow the cartridge to slide onto and be secured to the platform. In some embodiments, the coupling mechanism 538 can be a combination of the magnetic mechanism and the mechanical mechanism.

[0085] In some embodiments, the coupling mechanism 538 includes an adaptor for facilitating coupling via the manipulation device 530 and the cartridge assembly 540. The adaptor may be configured to allow for the manipulation device 530 to be isolated (e.g., from potential contaminants, etc.) during operation. For example, the coupling mechanism can 538 can be or form part of a sterile interface or adapter, e.g., allowing for the cartridge assembly 540 to couple to the manipulation device 530 without compromising a sterile field. In particular, the cartridge assembly 540 can be a sterile component prior to use, while the manipulation device 530, the robotic arm, and / or other portions of the robotic system may not be sterile. Therefore, a sterile adapter (e.g., including a platform, latches, capstans, or other structure) can be configured to allow components of the cartridge assembly 540 (e.g., catheter, needle, guidewire, guide(s), and / or actuator components (e.g., screw shaft(s))) to be operatively coupled to components of the manipulation device 530 (e.g., motors, etc.). The sterile adapter can be attached to a sterile drape, which can be draped over the robotic arm, the manipulation device 530, and / or other components of the robotic system in use. In some embodiments, the coupling mechanism 538 may include a clutch mechanism between the cartridge assembly 540 and the manipulation device 530 that provides mechanical coupling while allowing for the manipulation device 530 to be isolated.

[0086] In some embodiments, the manipulation device 530 can optionally include a control unit 532 to control the actuation of the device actuator(s) 534. Control unit 532 can be any suitable processing device configured to run and / or execute functions associated with controlling the device actuator(s) 534. Control unit 532 can include any suitable processor(s) that can be configured to execute modules, functions, and / or processes. In some embodiments, the processor(s) can be a general purpose processor, a Field Programmable Gate Array (FPGA), an Application Specific Integrated Circuit (ASIC), a Digital Signal Processor (DSP), and / or the like.

[0087] Further examples of manipulation devices and cartridge assemblies are described in U.S. Patent Application No. 18 / 587,711, entitled “ROBOTIC SYSTEMS, DEVICES, AND METHODS FOR VASCULAR ACCESS,” filed February 26, 2024 and / or in PCT Patent Application No. PCT / US2023 / 085933, entitled “VASCULAR ACCESS ROBOTIC SYSTEMS AND DEVICES INCLUDING CARTRIDGE ASSEMBLIES, AND METHODS THEREOF,” filed December 26, 2023, both of which are incorporated herein by reference.Methods

[0088] FIG. 6 is a flow diagram illustrating a method 600 of performing a medical procedure (e.g., using system 100 in FIG. 1), in accordance with some embodiments. A robotic system, such as, for example, robotic system 102 in FIG. 1 and / or any of the other robotic systems described herein, can perform the medical procedure (e.g., vascular access procedure) in an automated and / or semi-automated manner. At 602, a base (e.g., base 203 in FIG. 2 or base 403 in FIG. 4) can be moved to a location next to a subject (e.g., a patient). As discussed above, the base can include transport elements (e.g., swivel casters) that can allow for translational and rotational movement of the robotic system. The base can be moved to a suitable position from the subject such that the medical procedure can be performed on the subject. For example, the base can be moved to a position that allows a robotic arm (e.g., robotic arm 220 in FIG. 2 or robotic arm 320 in FIG. 3) access a portion of the subject’s body (e.g., patient’s arm on which the medical procedure is to be performed). In some embodiments, the base can be moved to position the robotic arm such that at least a portion of the manipulation device and / or the cartridge assembly touches the skin of the subject. In some embodiments, an I / O device (e.g., I / O device(s) 104 in FIG. 1 or user control 404a in FIG. 4) communicably coupled to the base and / or communicably coupled to the transport elements included in the base can transmit instructions to move the base. For example, the I / O device can be configured to transmit instructions to an actuator controlling the movements of the swivel caster. In other embodiments, the base can be moved manually by a user.

[0089] In some embodiments, the base can optionally be raised up or dropped down in a vertical manner so as to position the base and / or the robotic arm suitably in order to perform the medical procedure. As discussed above, the base can include vertical adjustment element(s) (e.g., vertical adjustment element(s) 409 in FIG. 4) to adjust a height of a top surface of the base. In some embodiments, an I / O device (e.g., I / O device(s) 104 in FIG. 1 or user control 404a in FIG. 4) communicably coupled to the base and / or communicably coupled to the verticaladjustment element(s) can transmit instructions to adjust the height of the top surface of the base. For example, the I / O device can be configured to transmit instructions to an actuator controlling the vertical adjustment element(s). In other embodiments, the vertical adjustment element(s) can be manipulated manually by a user so as to adjust the height of the top surface of the base. Once the base is moved to a suitable location from the subject (e.g., suitable distance and / or suitable height), the base can be locked (e.g., using locking mechanism(s) 412 in FIG. 4) to lock the location of the base (at 603 in FIG. 6). In some embodiments, the base may not include a vertical adjustment element; however, the robotic arm can be configured to move to change a position and / or orientation of the manipulation device and / or cartridge relative to a ground or floor.

[0090] At 604, a cartridge assembly (e.g., cartridge assembly 240 in FIG. 2 or cartridge assembly 540 in FIG. 5) can be attached to a manipulation device (e.g., manipulation device 130 in FIG. 1, manipulation device 230 in FIG. 2, manipulation device 330 in FIG. 3, or manipulation device 530 in FIG. 5). The manipulation device can be coupled to or otherwise be a part of the robotic arm. In some embodiments, the manipulation device can include coupling mechanism(s) (e.g., coupling mechanism(s) 538 in FIG. 5) to couple the cartridge assembly to the manipulation device. For example, the manipulation device can include a permanent electromagnet that magnetically couples the manipulation device to the cartridge assembly. A coupling element (e.g., puck) in the cartridge assembly can comprise a magnetic portion (e.g., an embedded stainless-steel disk) that can close a magnetic circuit with the magnet (e.g., permanent electromagnet). Alternatively, or additionally, the coupling mechanism(s) can include mechanical components that latch into or fit into other mechanical components to lock to a cartridge assembly. For example, the coupling mechanism(s) may include latches, tracks, clamps, slots, or other mechanical elements configured to couple the cartridge assembly to the manipulation device. In some embodiments, the coupling mechanism(s) can include a clutch that is configured to allow for mechanical force or power transfer between the manipulation device and the cartridge assembly. In this manner, the cartridge assembly can be attached to the manipulation device. Additionally or alternatively, the manipulation device can include recessed portions (e.g., slots) to receive portions of the cartridge assembly. For instance, the device(s) (e.g., device(s) 544 in FIG. 5) along with guide(s) (e.g., device actuator(s) 534 in FIG. 5) can be configured to fit within the recessed portions of the manipulation device. In this manner, the cartridge assembly can be mechanicallycoupled to the manipulation device. In some embodiments, an adaptor is used to drape all components of the robotic system 102 from the cartridge assembly and potential contaminants.

[0091] In some embodiments, the robotic arm can include locking mechanisms to lock and unlock the robotic arm. Locking the robotic arm can prevent further movement of the robotic arm. Unlocking the robotic arm can enable the robotic arm to move as desired. In some embodiments, at 605, the method 600 can include unlocking the robotic arm if the robotic arm is in locked position.

[0092] At 606, the method 600 can include moving the robotic arm to position the manipulation device and / or cartridge assembly at target site. While 606 is shown after 604 in FIG. 6, it can be appreciated that the robotic arm can first be unlocked and positioned so that the manipulation device is positioned near the target site. More specifically, the robotic arm can be positioned so that the manipulation device is positioned / oriented for insertion of the interventional devices (e.g., catheter, guidewire, needle) into a target vessel before the cartridge is attached to the manipulation device. The target site can be a portion of a subject’s body on which the medical procedure is to be performed. For example, the target site can be an arm of a patient’s body on which the Seidinger technique is to be performed. Moving the robotic arm can include positioning the manipulation device and / or cartridge assembly at a desired location relative to the target site. For instance, the manipulation device and / or cartridge assembly can be positioned at an angle with respect to a blood vessel in the target site (e.g., patient’s arm). In some embodiments, the angle can be between about 0 degrees and about 90 degrees, between about 10 degrees and about 80 degrees, between about 20 degrees and about 70 degrees, between about 30 degrees and about 60 degrees, between about 40 degrees and about 50 degrees with respect to the blood vessel. In some embodiments, the angle can be between about 20 degrees and about 60 degrees. Additionally or alternatively, the manipulation device and / or cartridge assembly can be positioned at a specific distance from the blood vessel. In some embodiments, the robotic arm can be moved to position the manipulation device such that at least a portion of the manipulation device (e.g., the imaging device such as an ultrasound array) touches the skin of the subject. In some embodiments, moving the robotic arm can include transmitting instructions from an I / O device to the robotic system and / or the robotic arm. For instance, a user can transmit instructions to move the robotic arm via an input device such as joystick, mouse, keyboard, buttons, etc. Once the robotic arm is moved to position the cartridge assembly at the target site, at 607, the robotic arm can be locked to prevent further movement.

[0093] At 610, the method 600 can include controlling the manipulation device to perform a vascular access procedure, e.g., the Seidinger technique. In some embodiments, an I / O device (e.g., I / O device(s) 104 in FIG. 1 or user control 404a in FIG. 4) communicably coupled to the robotic system can transmit instructions to the robotic system (e.g., a control unit included in the robotic system) so as to control the movement of the robotic arm. For instance, a control unit (e.g., control unit 405 in FIG. 4) included in the robotic system (e.g., control unit in the base, control unit in the robotic arm, etc.) can process instructions (e.g., instructions from the I / O device) to control the manipulation device. For example, the needle, the catheter, and / or the guidewire can be actuated based on the instructions. Feedback from sensor(s) (e.g., sensor(s) 106 in FIG. 1) and / or imaging device (e.g., imaging device 536 in FIG. 5) can be used for further subsequent control of the manipulation device. For instance, subsequent control of the actuation of the needle, the catheter, and / or the guidewire can be based on feedback from sensor(s) and / or the imaging device.

[0094] FIG. 7 is a flow diagram illustrating a method 700 of gaining vascular access, for example, by performing the Seidinger technique (e.g., using system 100 in FIG. 1 or any of the other systems and / or components described herein), in accordance with some embodiments. At 712, the method 700 can include receiving user input to access a blood vessel. For instance, the user input can include instructions to perform arterial insertion. In some embodiments, a user can transmit an input to perform the arterial insertion to a robotic system (e.g., robotic system 102 in FIG. 1, robotic system 202 in FIG. 2, etc.) via an VO device (e.g., I / O device(s) 104 in FIG. 1 or user control 404a in FIG. 4) that is communicably coupled to the robotic system. The robotic system can be controlled based on the input so as to position and / or orient the robotic system to perform the arterial insertion. For example, the base (e.g., base 203 in FIG. 2), the manipulation device (e.g., manipulation device 230 in FIG. 2), and / or the cartridge assembly (e.g., cartridge assembly 240 in FIG. 2) can be positioned and / or oriented based on the user input such that the cartridge assembly is at a specific distance and / or orientation from the desired artery. While certain steps of the method 700 are described in reference to user inputs, certain steps can receive signals that allow for one or more of the steps of the method 700 to be executed automatically.

[0095] At 714, the method 700 can include activating an actuator (e.g., needle actuator of the device actuator(s) 534 in FIG. 5) to move a needle to puncture the artery. In some embodiments, the needle can be included in the cartridge assembly. In some embodiments, the needle can becoupled to a needle guide (e.g., a portion of the needle actuator included in the cartridge assembly) that can include a coupling element such as an adaptor. A cavity in the cartridge device can be configured to fit the needle guide along with the needle. The cartridge assembly can be attached to the manipulation device via an adaptor (e.g., coupling mechanism 538 in FIG. 5). The cartridge assembly can also be attached to the manipulation device via a fastener configured to operably couple the cartridge assembly and the manipulation device.

[0096] In response to the input from the user (e.g., via an I / O device) to perform arterial insertion, a linear actuator can be activated. The linear actuator can move along a linear axis. This in turn can cause the cartridge assembly or a portion thereof to move, thereby causing at least the needle to move into the artery. Accordingly, the needle can be moved and positioned so as to puncture the desired artery. In some embodiments, the needle, the guidewire, and the catheter can be advanced together into the artery. For example, the tip of the needle, the tip of the guidewire, and the tip of the catheter can be aligned with respect to one another, and the entire cartridge (or portion thereof) can be advanced to advance the tip of the three devices into the artery.

[0097] In some embodiments, the user can visualize the movement of the needle using visual aid (e.g., ultrasound images) captured by an imaging device (e.g., imaging device 536 in FIG. 5). For example, a longitudinal view and / or transverse view of the artery can be shown, which can show the tip of the needle (and / or the tip of the catheter and guidewire) as they are advanced into the artery. The visual aid can provide the user with information on the movement of the needle. In some embodiments, the user can visualize the movement of the robotic arm, manipulation device, and / or the cartridge assembly as the needle is being actuated using sensor data obtained from sensor(s) (e.g., sensor(s) 106 in FIG. 1). The user can modify the input to perform arterial insertion based on the visual aid and / or the sensor data.

[0098] At 716, the method 700 can include receiving user input (e.g., via an I / O device) to advance the guidewire into the artery. Once the artery has been punctured and the needle positioned in the artery, the user can transmit instructions (e.g., similar to step 712) to advance the guidewire into the artery.

[0099] At 718, in response to the instructions at 716, the method 700 can include activating an actuator (e.g., guidewire actuator of the device actuator(s) 534 in FIG. 5) to advance the guidewire distal to the tip of the needle. Similar to the needle, the guidewire can be included inthe cartridge assembly. In some embodiments, the guidewire can be coupled to a guidewire guide (e.g., a portion of the guidewire actuator included in the cartridge assembly), which can be attached to the manipulation device via a fastener or an interface, such as a clutch. Additionally and / or alternatively, the guidewire may not be attached to a guidewire guide.

[0100] In response to the user input (e.g., via an I / O device) to advance the guidewire, a linear actuator (e.g., portion of the guidewire actuator included in the manipulation device and / or the cartridge assembly) to actuate the guidewire can be activated. The linear actuator can cause movement along a linear axis. This in turn can cause the guidewire guide and / or guidewire to move along the linear axis. Accordingly, the guidewire can be advanced distal to the needle and to the desired location in the artery. The needle and the catheter can be held stationary as the guidewire is advanced into the artery. In some embodiments, the user can visualize the movement of the guidewire using visual aid captured by the imaging device. In some embodiments, the user can visualize the movement of the robotic arm, manipulation device, and / or the cartridge assembly as the guidewire is being advanced using sensor data obtained from the sensor(s). The user can modify the input to advance the guidewire based on the visual aid and / or the sensor data.

[0101] At 720, the method 700 can include receiving user input (e.g., via an I / O device) to advance the catheter into the artery. In some embodiments, the user can transmit instructions (e.g., similar to step 712) to advance the catheter into the artery.

[0102] At 722, in response to the instructions at 720, the method 700 can include activating an actuator (e.g., catheter actuator of the device actuator(s) 534 in FIG. 5) to advance the catheter over the guidewire and distal to the tip of the needle. Similar to the needle, the catheter can be included in the cartridge assembly. In some embodiments, the catheter can be coupled to a catheter guide (e.g., a portion of the catheter actuator included in the cartridge assembly) and can be attached to the manipulation device via a fastener or an interface, such as a clutch. Additionally and / or alternatively, the catheter may not be attached to a catheter guide.

[0103] In response to the user input (e.g., via an I / O device) to advance the catheter, a linear actuator (e.g., portion of the catheter actuator included in the manipulation device and / or the cartridge assembly) to actuate the catheter can be activated. The linear actuator can cause movement along a linear axis. This in turn can cause the catheter guide and / or the catheter to move along the linear axis. Accordingly, the catheter can be advanced to the desired locationin the artery. In some embodiments, the user can visualize the movement of the catheter using visual aid captured by the imaging device. In some embodiments, the user can visualize the movement of the robotic arm, manipulation device, and / or the cartridge assembly as the catheter is being advanced using sensor data obtained from the sensor(s). The user can modify the input to advance the catheter based on the visual aid and / or the sensor data.

[0104] At 724, the method 700 can include receiving user input (e.g., via an I / O device) to retract the needle and the guidewire. At 726, in response to the instructions at 724, the method 700 can include activating the actuator(s) to retract the needle and the guidewire. For example, at least one linear actuator can be activated to retract the needle and the guidewire along the linear axis. In some embodiments, a first linear actuator configured to retract the entire cartridge assembly can be activated so that the needle and the guidewire can be retracted, while a second linear actuator can be actuated to maintain a position of the catheter while the entire cartridge is being retracted. In some embodiments, the user can visualize the movement of the retraction of the needle and the guidewire using visual aid captured by the imaging device. In some embodiments, the user can visualize the movement of the robotic arm, manipulation device, and / or the cartridge assembly as the needle and / or the guidewire is being retracted using sensor data obtained from the sensor(s). The user can modify the input to retract the needle and / or the guidewire based on the visual aid and / or the sensor data.

[0105] At 728, the method 700 can include decoupling the catheter from the cartridge assembly. In some embodiments, the catheter can be detached from the catheter guide without releasing the catheter guide from the cartridge assembly. For example, the user can manually decouple the catheter from the catheter guide without decoupling the catheter guide from the cartridge assembly. For example, the catheter may be attached to the catheter guide via a pin assembly and the catheter may be decoupled from the cartridge by removing the at least one pin. The user can wait to detach the catheter until after the needle and the guidewire have been retracted.

[0106] Although in FIG. 7, the sequence of steps to gain access to a blood vessel is described as activating an actuator to advance the needle followed by activating an actuator to advance the guidewire and subsequently activating an actuator to advance the catheter, it should be readily understood that the sequence of steps to gain access to a blood vessel using the system and methods described herein can be performed in any suitable permutations and combinations. For example, in some embodiments, one or more actuators can be activated to advance theneedle, the catheter, and the guidewire simultaneously. Once the needle punctures the desired blood vessel (e.g., artery), the guidewire can be advanced distal to the needle to a desired position in the blood vessel. The catheter can then be advanced over the guidewire to the desired position in the blood vessel. In some embodiments, after advancing the guidewire but before advancing the catheter to the desired position in the blood vessel, the needle can be retracted slightly (e.g., moved proximal by a small distance) so that advancing the catheter may be atraumatic to the subject. Alternatively, one or more actuators can be activated to align the needle tip and the distal end of the catheter. The needle and the catheter can be advanced simultaneously to a desired blood vessel. Once the needle punctures the desired blood vessel, the guidewire can be advanced through the puncture to a desired position in the blood vessel. The catheter can then be further advanced to the desired position in the blood vessel. As discussed above, these are a few examples to illustrate various permutations and combinations for accessing a blood vessel using the systems and methods described herein.

[0107] In some embodiments, if the size of the blood vessel is large (e.g., central vein), a second catheter can be advanced over the first catheter in order to perform the medical procedure. Put differently, one or more actuators can advance the needle, the guidewire, and the catheter to a desired position in the desired blood vessel. Then, the needle and the guidewire can be retracted from the blood vessel. Another guidewire can be advanced (e.g., manually and / or autonomously) through the catheter already positioned in the desired location. A second catheter that is bigger in size than the already positioned catheter can be advanced through the guidewire. In this manner, the second larger catheter can be positioned through the first catheter in order to perform the medical procedure. In some embodiments, one or more dilators can be used before positioning either the first catheter (e.g., catheter advanced using actuator(s) in the manipulation device and / or cartridge assembly) and / or the second catheter (e.g., catheter that is larger than the first catheter and is advanced through the first catheter) during the medical procedure.

[0108] In some embodiments, method 700 as described herein can be performed autonomously and / or semi-autonomously. Accordingly, one or more steps of receiving user input (e.g., 712, 716, 720, 724) can be optional, and systems and devices described herein can be configured to automatically proceed from actuating one component to the next based on confirmation that a first step has been completed. Such confirmation can be determined via sensor data (e.g., via sensor(s) 106) and / or imaging data (e.g., via imaging device 536). In some embodiments, oneor more steps may be performed without user input while other steps may be performed with user input.

[0109] FIG. 8 is a flow diagram illustrating a method 800 of using visual aid and / or sensor data to perform a medical procedure (e.g., using system 100 in FIG. 1), in accordance with some embodiments. At 812, the method 800 can include receiving user input to perform a step of the medical procedure (e.g., vascular access procedure). For example, the user input can include instructions to perform arterial insertion (e.g., step 712 in FIG. 7), advance a guidewire into a blood vessel (e.g., step 716 in FIG. 7), advance a catheter into a blood vessel (e.g., step 720 in FIG. 7), and / or retract a needle and the guidewire from the blood vessel (e.g., step 724 in FIG. 7).

[0110] At 814, the method 800 can include activating actuators to move medical instruments based on the user input. For example, activating actuators can include activating actuators within a robotic system (e.g., robotic system 202 in FIG. 2 and / or other robotic systems described herein) to move transport elements (e.g., transport element 414 in FIG. 4) and / or vertical adjustment elements (e.g., vertical adjustment element(s) 409 in FIG. 4) included in the robotic system based on the user input. This in turn can cause a robotic arm (e.g., robotic arm 220 in FIG. 2 and / or other robotic arms described herein), a manipulation device (e.g., manipulation device 230 in FIG. 2 and / or other manipulation devices described herein), and / or a cartridge assembly (e.g., cartridge assembly 240 in FIG. 2 and / or other cartridge assemblies described herein) to be positioned at a desired location from a target site (e.g., subject’s body part such as arm). In some embodiments, activating actuators can include activating device actuators (e.g., device actuator(s) 534 in FIG. 5) to advance (e.g., steps 714, 718, and 722 in FIG. 7) and / or retract (e.g., step 726 in FIG. 7) the needle, the catheter, and / or the guidewire into / from a blood vessel based on the user input.[OHl] At 816, the method 800 can include capturing visual aid and / or sensor data as the step of the vascular access procedure is being performed. For example, the manipulation device can include an imaging device (e.g., imaging device 536 in FIG. 5) to capture visual aid (e.g., ultrasound images) of the needle, the catheter, and / or the guidewire (collectively device(s) 544 in FIG. 5) as the device(s) are being advanced into and / or retracted from the blood vessel. In some embodiments, the robotic system can be communicably coupled to a sensor (e.g., sensor(s) 106 in FIG. 1) such as a camera to capture images of the robotic system, themanipulation device, and / or the cartridge assembly as the step of the vascular access procedure is being performed.

[0112] At 818, the visual aid and / or the sensor data can be displayed on an I / O device (e.g., I / O device(s) 104 in FIG. 1 or user control 404a in FIG. 4). For example, ultrasound images and / or images from cameras can be displayed on a display. At 822, if a user input to stop performing the step of the medical procedure is received (e.g., at step 820), the method 800 can include activating the actuators to remove the medical instruments from the target site. For example, the needle, the catheter, and / or the guidewire can be retracted from the blood vessel by activating the device actuators. Additionally or alternatively, the robotic system, the manipulation device and / or the cartridge assembly can be moved away from the subject by activating the actuators coupled to the transport elements and / or the vertical adjustment elements. In some embodiments, the cartridge assembly can be detached from the manipulation device.

[0113] At 824, the method 800 can include indicating to the user that the step of the vascular access procedure is complete. For example, the display can output visual, audio, and / or haptic outputs to represent that the step of the medical procedure is complete. In some embodiments, the display can also prompt the user to initiate the next step thereby repeating the steps of method 800. If the user input to stop performing the step of the medical procedure is not received at step 820, the method 800 can include at 824 indicating to the user that the step of the vascular access procedure is complete and prompting the user to initiate the next step of the vascular access procedure.

[0114] FIG. 18 depicts a method 450 for locking a robotic arm (e.g., functionally and / or structurally similar to the robotic arms described herein, including the robotic arm 320 of FIG. 3 or the robotic arm 4320 of FIG. 16), in accordance with some embodiments. In some embodiments, the ball joint (e.g., functionally and / or structurally similar to the ball joint 4325 of FIG. 16 and / or the ball joint 4425 of FIGS. 17A-17B) is controlled via a control unit (e.g., structurally and / or functionally similar to the control unit 405 of FIG. 4) during locking of the robotic arm. The method 450 can be operating while the robotic arm is being used during a procedure to decrease the likelihood of the robotic arm 4320 causing undesirable tissue damage during any erratic or unexpected motion of the robotic arm 4320, e.g., due to a collision, a drop due to physician release, an unintentional fast movement of the robotic arm, etc.

[0115] At 451, the method 450 includes receiving initial accelerometer data. The initial accelerometer data can be from a sensor on at least a portion of the robotic arm. For example, the sensor can be located on manipulation device. In some embodiments, the initial accelerometer data can be preprocessed (e.g., filtered, normalized, etc.) At 452, based on the initial accelerometer data, an initial acceleration vector is defined. The initial acceleration vector can be stored for use as a reference. In some embodiments, the initial accelerometer data is associated with the data when the robotic arm is in a first position, an initial position, a zero position, an inactive position, and / or the like.

[0116] At 453, the method 450 includes receiving updated accelerometer data after a predetermined period of time. In some embodiments, the predetermined period of time is 0.001 second, 0.01 seconds, 0.1 second, 1 second, 5 seconds, or 10 seconds, inclusive of all ranges and values therebetween. In some embodiments, the updated accelerometer data can be preprocessed. At 454, based on the updated accelerometer data, an updated acceleration vector is defined. The updated acceleration vector can correspond to the acceleration of the robotic arm during operation.

[0117] At 454, the method 450 includes determining whether the updated acceleration vector magnitude exceeds a predefined acceleration threshold. In some embodiments, the predefined acceleration threshold is between about 0.1g and about 3 g, including, for example, 0.1 g, 0.2 g, 0.3 g, 0.4 g, 0.5 g, 1 g, 2 g, 3 g, inclusive of all ranges and values therebetween. The predefined acceleration threshold may be associated with an acceleration that may indicate that the robotic system is moving in an undesired manner, e.g., engaging in unexpected movement. If the updated acceleration vector magnitude is not greater than the predefined acceleration threshold, the method 450 returns to 453, wherein additional accelerometer data is received after the predetermined period of time. If the updated acceleration vector magnitude is greater than the predefined acceleration threshold, the method 450 continues to 456.

[0118] At 456, the method 450 includes actuating brakes to lock the position of the robotic arm. Locking the position of the robotic arm can decrease or prevent the likelihood of the robotic arm impacting the patient and / or the surrounding space. In some embodiments, locking the robotic arm includes actuating or energizing a braking assembly (e.g., as described above with respect to FIGS. 17A and 17B) in a ball joint to lock the ball joint in place. In some embodiments, locking the robotic arm includes actuating or energizing a mechanical and / orelectrical brake at one or more translational and / or rotational (e.g., revolute) joints, such as, for example, a servo braking mechanism.

[0119] At 457, a notification is generated indicating that the brakes are actuated. The notification can be sent to a user so that the user can be aware of a potential issue and to indicate that the system is locked. In some embodiments, 457 is optional. As in 458, the brakes may be locked for a predetermined amount of time. In some embodiments, the brakes may unlock after the predetermined amount of time. In some embodiments, 458 is optional. At 459, the method 450 optionally includes unlocking the brakes, in response to receiving a user signal. For example, if a user indicates on an input that the issue has been resolved and that the operation may proceed, the brakes may be unlocked.Example Embodiments

[0120] FIG. 9 illustrates a vascular access system 900A (e.g., structurally and / or functionally similar to system 100 in FIG. 1), in accordance with some embodiments. The vascular system can include a robotic system that can include a base 903 (e.g., structurally and / or functionally similar to base 203 in FIG. 2), robotic arm 920 (e.g., structurally and / or functionally similar to robotic arm 220 in FIG. 2), and manipulation device 930 (e.g., structurally and / or functionally similar to manipulation device 230 in FIG. 2).

[0121] The base 903 can be a movable base. For example, the base 903 can include transport elements 914 (e.g., structurally and / or functionally similar to transport elements 414 in FIG. 4). In some embodiments, the transport elements 914 can be swivel casters with lockable wheels. The swivel casters can provide the base 903 with three degrees of freedom. For example, the swivel casters can provide translations along the U coordinate axis and the V coordinate axis shown in FIG. 9. The planar and rotational movement can enable the base 903 to be positioned relative to a subject’s (e.g., patient on whom the medical procedure is to be performed) arm. In some embodiments, a locking mechanism (e.g., locking mechanism 412 in FIG. 4) for the transport elements 914 can lock a position of the base 903 during the medical procedure. For example, in some embodiments, locks may be engaged automatically during a step of the medical procedure such as upon the base being positioned at an appropriate position relative to the arm of a patient on whom the medical procedure is to be performed.

[0122] In some embodiments, the base 903 can include vertical adjustment element(s) 909 (e.g., structurally and / or functionally similar to vertical adjustment element(s) 409 in FIG. 4) which can provide a fourth degree of freedom to the base 903. The vertical adjustment element(s) can raise and / or drop the base vertically, thereby providing the base 903 with a fourth degree of freedom. In some embodiments, the vertical adjustment element(s) 909 can lift a top surface 946 of the base 903 to position the robotic arm 920 at an appropriate height with respect to the patient on whom the medical procedure is to be performed. In some embodiments, the vertical adjustment element(s) 909 can be motorized. For example, the vertical adjustment element(s) 909 can include a ball screw actuator. A fail-safe brake can hold the position of the top surface 946 of the base 903. Linear rails with recirculating balls can constraint the movement of the base 903.

[0123] In some embodiments, the top surface 946 of the base 903 can be attached to, integrated with, and / or otherwise coupled to one or more I / O device(s). For example, a display 904b (e.g., structurally and / or functionally similar to display 404b in FIG. 4) can be mechanically coupled to the top surface 946 of the base via a display support. The display 904b can provide visual aid and / or visual feedback including longitudinal and transverse ultrasound views of a blood vessel of the subject. In some embodiments, the display 904b can provide state and status information on the task being performed during the medical procedure. Some examples of state information can include the state of one or more actuators during each step of the medical procedure as seen in Table 1.Table 1

[0124] In some embodiments, a user control 904a (e.g., structurally and / or functionally similar to user control 404a in FIG. 4) can be attached to and / or integrated with the top surface 946 of the base 903. For example, ajoystick 904a as shown in FIG. 9 can be used to control the robotic system. For instance, the joystick 904a may control the three degrees of freedom (e.g., translation and rotation) and / or four degrees of freedom (e.g., translation, rotation, and / or vertical drop or raise) of the base 903. The joystick 904a can be any suitable type of joystick such as digital joysticks, paddle joysticks, analog joysticks, Pc analog joysticks, and / or the like.

[0125] Additionally or alternatively, a handheld pendant (e.g., handheld pendant 1104a in FIG. 10A further described below) can be used to control the robotic system. In addition to controlling the three and / or four degrees of freedom of the base 903, the handheld pendant can additionally control the needle actuator, guidewire actuator, and / or catheter actuator prior to, during, and / or after each step of the Seidinger technique based on the states shown in Table 1. For example, the handheld pendant can change the state of the needle actuator and the catheter actuator from dynamic to static after arterial insertion but before advancing the guidewire into the artery.

[0126] In some embodiments, the top surface 946 of the base 903 can be attached to, integrated with, and / or otherwise coupled to the robotic arm 920. In some embodiments, the top surface 946 of the base 903 can optionally include an arm restraint 948 to constrict the arm of a subject during the medical procedure. The arm restraint 948 can be an elastic band that can restraint an arm of any size. Alternatively, the base 903 can include an arm rest, platform, table, or other supporting structure configured to support an arm of a user. The arm rest can be positioned relative to the ground at a level suitable for placing a patient’s arm on the arm rest. The arm rest can optionally include an arm restraint 948.

[0127] The sensor 906 can be configured to be controlled remotely using one or more I / O devices. For instance, the sensor 906 can be controlled by an I / O device that is communicably coupled to the robotic system and / or base 903. A user controlling the sensor 906 can be at a location remote to the system 900B. For example, the sensor 906 can be controlled via anintegrated computing device such as computers (e.g., desktops, personal computers, laptops etc.), tablets and e-readers (e.g., Apple iPad®, Samsung Galaxy® Tab, Microsoft Surface®, Amazon Kindle®, etc.), mobile devices and smart phones (e.g., Apple iPhone®, Samsung Galaxy®, Google Pixel®, etc.), etc. that is communicably coupled to the robotic system and / or base 903. In some embodiments, the user control 904a can enable a user in proximity and / or within the vicinity of the system 900B to control the sensor 906.

[0128] The sensor 906 can capture a view of the environment for the remote user. Controlling the pan / tilt mechanism can allow the sensor 906 to capture image data from various angles. A user can change the view of the environment as desired by controlling the pan / tilt mechanism. The image data can be used as feedback by the user to control the robotic system in order to perform the medical procedure. In some embodiments, instead of a user controlling the pan / tilt mechanism via an I / O device such as user control 904a, the entire system (e.g., system 900A in FIG. 9A and / or system 900B in FIG. 9B) can be autonomous. For instance, a control unit within the system can control the user control 904a and / or pan / tilt mechanism 966 by taking into account the feedback from image data and / or visual aid (e.g., ultrasound data) as the robotic system performs the medical procedure. Put differently, the system 900A and / or 900B can perform the medical procedure in an autonomous manner.

[0129] In some embodiments, the system may include an additional image sensor such as stereo camera (not shown in FIG. 9) to enable precise motion of the robotic arm 920 and / or manipulation device 930. The additional image sensor can allow precise targeting and / or access of the vascular portion. For instance, the feedback from the additional image sensor can control the manipulation device 930 and / or the robotic arm 920 in a more precise manner. In some embodiments, proximity sensor(s) may be attached to, coupled to, and / or otherwise mounted on the base 903 to enable previse motion and targeting.

[0130] In some embodiments, when the manipulation device 930 contact the skin of the subject, the feedback can be switched from sensor 906 feedback to visual aid from an imaging device such as ultrasound array. For example, a user remote to the system can switch the feedback to ultrasound using an VO device. As discussed above, in some embodiments, the robotic arm 920 can be motorized. The motorized arm can be controlled (e.g., via an I / O device) to achieve a desired view of a target vascular portion of the subject in the ultrasound array.

[0131] In some embodiments, the robotic arm 920 can include sensors to measure force and / or torque in order to perform the medical procedure in a safe manner. For instance, a needle penetration force that is greater than a threshold value can cause damage to the skin, blood vessel, and / or neighboring tissues. Accordingly, measuring the force and / or torque during the medical procedure can ensure the needle penetration force is below the threshold value. For example, for a 25G needle the maximum penetration force that can be applied by the needle to puncture a forearm vein is 2.5N. Similarly, maximum penetration force can be determined for 18G needle, 22G needle, etc. If the penetration force measured by the sensors exceed the identified maximum penetration value, in some embodiments, the system 900A and / or 900B can be automatically shut down. For example, in response to the penetration force exceeding the penetration value a control unit (e.g., structurally and / or functionally similar to control unit 405 in FIG. 4) can automatically shut down the system. In some embodiment, the measured force can also be an indicator of whether or not the needle may have penetrated into a tissue of the subject. For example, when the needle penetrates the tissue, the penetration force can drop. In such scenarios, a user can be notified via a display (e.g., structurally and / or functionally similar to display 404b in FIG. 4) that the needle has penetrated the tissue. In some embodiments, the robotic arm 920 can include collision sensing skin sensors to identify whether the manipulation device 930 is in contact with the skin of the subject prior to performing the medical procedure.

[0132] FIG. 10A illustrates a robotic system 1102A (e.g., structurally and / or functionally similar to robotic system 202 in FIG. 2), according to some embodiments. The robotic system 1102A includes a base 1103. A user control 1104a can be attached to, coupled to, and / or integrated with the base 1103. In some embodiments, the user control 1104a can be a handheld pendant. The handheld pendant 1104a can be coupled to the base 1103 via a spiral cord. As discussed above, the handheld pendant 1104a can control the linear motion, rotational motion, and / or vertical movement of the base 1103. Additionally, the handheld pendant 1104a can change the state of the system itself or otherwise one or more components of the system (e.g., needle actuator, catheter actuator, guidewire actuator, etc.) from one step of the medical procedure (e.g., the Sei dinger technique) to the next step of the medical procedure. Some nonlimiting examples of the state of some components for each step of the Seidinger technique is shown in table 1. For example, the handheld pendant 1104a can be used to change the state of the guidewire actuator from dynamic to static and the state of the catheter actuator from staticto dynamic after advancing the guidewire into the artery of a subject but before advancing the catheter into the artery of the subject.

[0133] In some embodiments, a display 1104b can be attached to, coupled to, and / or integrated with the base 1103. The display 1104b can display visual aid (e.g., transverse view and longitudinal view of ultrasound images), image data (e.g., images captured from a sensor such as camera), status, and state of the task being performed. In some embodiments, a robotic arm 1120 can be attached to, coupled to, and / or integrated with the base 1103. In some embodiments, the robotic arm 1120 can be motorized. In some embodiments, an end segment of the robotic arm 1120 can be coupled to a manipulation device 1130. The manipulation device can be attached to a cartridge assembly.

[0134] In some embodiments, the base 1103 can include transport elements 1114 such as swivel wheels. The transport elements 1114 can provide three degrees of freedom to the base 1103. FIG. 10B illustrates rotational motion and vertical movement for a base 1103, according to some embodiments. The transport elements 1114 can allow the base 1103 to rotate along 1186a. Additionally, the transport elements 1114 can allow the base 1103 to move linearly along two perpendicular axes, thereby providing three degrees of freedom. Additionally, the base 1103 can include vertical elements to raise and / or drop the base 1103 along 1186b. This can provide a fourth degree of freedom to the base.

[0135] FIGS. 13-14B illustrate another example of a robotic system 3202, according to some embodiments. The robotic system 3202 can be structurally and / or functionally similar to other robotic systems described herein, including, for example, robotic system 202, robotic system 1102, etc.

[0136] FIG. 13 illustrates a perspective view of the robotic system 3202, in accordance with some embodiments. As shown, the robotic system 3202 can include a base 3203 (e.g., functionally and / or structurally similar to the base 1103 of FIG. 10A). The base 3203 can include transport elements 3214 (e.g., structurally and / or functionally similar to the transport elements 1114 off FIG. 10A). The transport elements 3214 vary from the transport elements 1114 by only providing two degrees of freedom (e.g., allow the robotic system 3202 to move around a surface). The vertical height of the base 3203 is fixed to a predetermined height.

[0137] The base 3203 may be coupled to a user control interface 3204a. The user control interface 3204a includes a touchpad and a joystick to control the operations of the robotic system 3202. In some embodiments, the base 3203 is coupled to a robotic arm 3220 (e.g., structurally and / or functionally similar to the robotic arm 1120 of FIG. 10A). The user control interface 3204a may be utilized to control the functionality of the robotic arm 3220. For example, the touchpad may be utilized to alter or activate operations of the robotic arm 3220, while the joystick may be utilized to control the position of the robotic arm 3220. The base 3203 attached to, coupled to, and / or integrated with a display 3204b which may display information display visual aid (e.g., transverse view and longitudinal view of ultrasound images), image data (e.g., images captured from a sensor such as camera), status, and state of the task being performed.

[0138] The base 3203 may include an arm support stand 3203a. In some embodiments, the arm support stand 3203a couples to the base 3203 via a rail. In some embodiments, the base 3203 includes multiple rails for attaching the arm support stand 3203a. In some embodiments, the arm support stand 3203a may be removed, folded, or otherwise repositioned relative to the base 3203.

[0139] FIG. 14A illustrates a robotic arm 3220 of the robotic system 3202 of FIG. 13 in a first configuration for storage. In the first configuration, the robotic arm 3220 is positioned so that the robotic arm 3220 folds into a compact shape. The first configuration may reduce the likelihood that the robotic arm 3220 is damaged when not in use. In some embodiments, the robotic arm 3220 may include a locking mechanism that locks the robotic arm 3220 in the first configuration. FIG. 14B illustrates the robotic arm in a second configuration for vascular access. In the second configuration, the robotic arm is deployed and prepared for performing a vascular access procedure.

[0140] FIG. 11 illustrates a manipulation device 3030 (e.g., structurally and / or functionally similar to other manipulation devices described herein, including the manipulation device 230 in FIG. 2), in accordance with some embodiments. The manipulation device 3030 includes a body 3060 and a cartridge motor assembly 3050. The body 3060 and the cartridge motor assembly 3050 provide components that drive the needle, catheter, and / or guidewire. The manipulation device 3030 is coupled to a cartridge assembly 3040 (e.g., structurally and / or functionally similar to other cartridge assemblies described herein, including the cartridge assembly 540 in FIG. 5). The cartridge assembly 3040 can be attached to the manipulationdevice 3030 by engaging the cartridge assembly 3040 with the cartridge motor assembly 3050 such that the actuators within the cartridge assembly 3040 are operably coupled to the motors in the cartridge motor assembly 3050. In some embodiments, one or more mechanical engagement features between the cartridge assembly 3040 and the manipulation device 3030 can mechanically couple the cartridge assembly 3040 to the manipulation device 3030. For example, the housing of the cartridge assembly 3040 can include features such as tabs that fit within slots in the housing of the manipulation device 3030. The cartridge assembly 3040 may be coupled to and / or supported by a translation plate 3031 (e.g., similar to other plates or platforms described herein) of the manipulation device 3030. The translation plate 3031 is configured to slide along the body 3060 and translates both the cartridge assembly 3040 and the cartridge motor assembly 3050 during operation.

[0141] The manipulation device 3030 can include an imaging device 3036 (e.g., structurally and / or functionally similar to imaging device 536 in FIG. 5) that can provide a user with a visual aid of a vascular portion (e.g., blood vessel) as the medical procedure is being performed. In some embodiments, the imaging device 3036 can be an ultrasound imaging device that captures a visual representation of a blood vessel. In some embodiments, the imaging device 3036 can be an ultrasound array located on the manipulation device 1430. The ultrasound array can provide two-dimensional ultrasound images along a longitudinal plane 1443b and a transverse plane 1443a. FIG. 12 illustrates a transverse view 1543a and a longitudinal view 1543b of a blood vessel as captured by an ultrasound imaging device.

[0142] As seen in FIG. 12, the transverse view 3043 a of the blood vessel shows a radial cross section of the blood vessel while the longitudinal view 3043b of the blood vessel shows an axial cross section of the blood vessel. As discussed above, the ultrasound array can provide a visual aid of the movement of the needle, catheter, and / or guidewire into the blood vessel. Subsequent movement of the manipulation device can be controlled based on the feedback from the visual aid.

[0143] As the needle advances into the field of view of the ultrasound array, the tip of the needle may remain in a central longitudinal plane (e.g., longitudinal plane 3043b in FIG. 11) of the ultrasound array and the manipulation device because the ultrasound array and the manipulation device and / or the robotic arm are physically connected to each other. However, as the tip of the needle advances into the blood vessel, the transverse plane of the needle maynot remain in the transverse plane (e.g., transverse plane 3043a in FIG. 11) of the ultrasound array.

[0144] In some embodiments, a position encoder on the needle actuator (e.g., needle actuator 534b in FIG. 5) and a limit switch can be used to determine the absolute position of the needle tip. The absolute position of the needle tip can be used to determine which transverse plane to display as a visual aid to the user.

[0145] FIG. 15A-15B illustrates another example robotic system 3702 (e.g., structurally and / or functionally similar to the robotic system 2020 of FIG. 2), in accordance with some embodiments. The robotic system 3702 includes a base 3703, a robotic arm 3720, and a manipulation device 2730. The robotic arm 3720 is coupled to the base 3702 such that the robotic arm 3720 can translate along an X-axis, a Y-axis, and a Z-axis as seen in FIG. 15 A. In some embodiments, the robotic arm 3720 is coupled to the base 3702 via a rail. The position of the robotic arm 3720 can reduce the hanging weight of the robotic arm 3720 and make it more stable during operation. The robotic arm 3720 ss coupled to the manipulation device 3730 via a ball joint 3725 (e.g., structurally and / or functionally similar to the ball joint 4325 of FIG. 16) that is configured to provide the manipulation device 3730 with yaw rotation, pitch rotation, and roll rotation. The ball joint 3725 can be configured to include a braking system configured to lock the manipulation device 3730 in a specific position and / or orientation.

[0146] The translation and rotation of the robotic arm 3720 allows the for the manipulation device 3730 to be positioned in space to a desired position and orientation while holding the manipulation device 3730 stationary. In some embodiments, the robotic arm 3720 can be motorized and controlled by a human interface (e.g., controller, joystick, etc.). In some embodiments, once the robotic arm 3720 positions the manipulation device 3730 in a desired position, the robotic arm 3720 can be locked into place with integrated joint brakes. In some embodiments, information related to operation of the robotic arm 3720 is shown on a display.

[0147] As described above, robotic systems disclosed herein can include one or more ball joints, which can be configured to enable a portion of a robotic arm (e.g., one or more segments and / or joints of a robotic arm) distal to the ball joint to move within a range of motion (e.g., along a plurality of directions) relative to the base and / or other portions of the robotic system. A ball j oint can be desirable, as it can enable movement in multiple degrees of freedom, thereby reducing the need for several rotary joints that allow for rotation about a single axis (e.g.,revolute joints). However, as noted above, ball joints can present challenges when it comes to braking and / or locking the movement of such joints. Therefore, systems and devices described herein can be equipped with braking and / or locking elements that are uniquely adapted for ball joints.

[0148] Referring generally to FIGS. 17A-17B, FIGS. 17A-17B depict a ball joint 4425 including a braking assembly, in accordance with some embodiments. In some embodiments, the ball joint 4425 is structurally and / or functionally similar to other ball joints described herein, including, for example, the ball joint 4325 of FIG. 16. The ball joint 4425 can include a braking assembly, which can transition between a de-energized or deactivated state and an energized or activated state. In the de-energized state, the ball joint 4425 can enable rotate in multiple directions about itself. In the energized state, the ball joint 4425 can lock its movement, e.g., via a high friction lock. In use, the braking assembly of the ball joint 4425 can switch between the energized and de-energized states in response to user control (e.g., a user pressing a button or other actuator to release the ball joint and / or lock the ball joint) and / or automatic locking (e.g., in response to certain conditions, such that unexpected movement). In some embodiments, the ball joint 4425 may be electrically, magnetically, and / or communicably coupled to a control unit, such as the control unit 405 of FIG. 4.

[0149] In an embodiment, the ball joint 4425 can include the components as depicted in FIGS. 17A and 17B. Specifically, the ball joint 4425 can include a frame 4425a, fasteners 4425b, a ball 4425c, an arm 4425d, a socket 4425g, and a braking assembly. The braking assembly can include a movable element 4425e (e.g., a translating element), a magnet 4425f, and an electromagnetic brake 4425h. The braking assembly can be configured to generate high frictional forces between the ball 4425c and the movable element 4425e and / or socket 4425g, when the braking assembly is activated. While the braking assembly is depicted in FIGS. 17A and 17B as including a movable element 4425e, a magnet 4425f, and an electromagnet brake 4425h, in some embodiments, the braking assembly may not include a magnet or electromagnet and instead include a mechanical and / or electrical actuator that is configured to move the movable element 4425e to create the high frictional forces. For example, the braking assembly can include a lever, a spring or other compression device, a pneumatic device, a linear actuator or other type of electrically powered actuator, etc., which can be configured to move (e.g., translate and / or rotate) the movable element 4425e to cause it to press the ball 4425c against the socket 4425g such that high frictional forces are generated.

[0150] The frame 4425a is configured to house or support the movable element 4425e and / or other components of the ball joint 4425. In some embodiments, the frame 4425a can be formed of a single part, while in other embodiments, the frame 4425a can be formed of multiple components and coupled together, e.g., via fasteners, adhesive, and / or other coupling mechanisms.

[0151] The ball 4425c can be disposed within a socket 4425g. When the braking assembly is not energized (e.g., in a de-energized or deactivated state), the ball 4425 can be configured to rotate within the socket 4425g in multiple directions (e.g., all directions). The ball 4425c can be coupled to or integrally formed with an arm or extension 4425d, which can be configured to couple or attach to another portion of the robotic system, e.g., a segment of a robotic arm (e.g., functionally and / or structurally similar to robotic arms described herein such as the robotic arm 4320 of FIG. 16), a manipulation device (e.g., functionally and / or structurally similar to the manipulation devices described herein such as the manipulation device 4330 of FIG. 16), etc. As such, when the ball 4425c can freely move within the socket 4425g, the ball 4425c can enable that portion of the robotic system (e.g., segment of the robotic arm, manipulation device) to rotate in multiple directions relative to other portions of the robotic system. In other words, the rotation of the ball 4425 can allow for the position of the arm 4425d, and therefore component(s) coupled thereto, to be selectively positioned. In some embodiments, the arm 4425d can have any shape including a linear shape and / or a shape having one or more bends or curves.

[0152] The magnet 4425f is attached to the movable element 4425e, e.g., via fastener(s) 4425k. The fastener(s) 4425k can include a bolt, a screw, a nail, or other type of mechanical fastener. Alternatively, the magnet 4425f can be attached to the movable element 4425e via adhesive, welding, or other type of coupling. In some embodiments, the movable element 4425e itself can include or be formed of a magnetic or ferromagnetic material, such that a separate magnet 4425f is not needed. In such embodiments, the movable element 4425e itself can be attracted toward the electromagnetic brake 4425h when the electromagnetic brake 4425h is energized.

[0153] The electromagnetic brake 4425h can include one or more electromagnets that, when energized or activated, can create a magnetic field, which can pull or attract the magnet 4425f (and movable element 4425e attached thereto) toward it. This can cause the moveable element 4425e to be pulled toward the socket 4425g, such that the movable element 4425e presses the ball 4425c against the socket 4425g. When the ball 4425c is pressed against the socket 4425gby the movable element 4425e, high frictional forces (e.g., high static friction) holds or locks the ball 4425c in place, preventing the ball 4425c and therefore arm 4425d attached thereto from being repositioned. In some embodiments, the electromagnetic brake 4425h is activated when electromagnets are energized. For example, each electromagnet can include a coil, that when energized with an electric current, can produce a magnetic field that causes the magnet 4425f to be pulled toward it. The electromagnetic brake 4425h can be coupled to the frame 4425a, e.g., via fastener(s) 4425b (e.g., screw, bolt, nail, etc.), adhesive, welding, etc.

[0154] FIG. 19 illustrates another system 3830 for facilitating vascular access, in accordance with some embodiments. The system 3830 is a handheld device configured to be positioned by a user. The system 3830 can be reusable, able to be draped, and can be quick to use as the components necessary for operation can be integrated into the system 3830. The system 3830 can be structurally and / or functionally similar to other systems for facilitating vascular access described herein, including, for example, system 100, and can include components that are structurally and / or functionally similar to other components of vascular access systems described herein. For example, the system 3830 can include a manipulation device 3802, a cartridge 3840, and an imaging device 3836, which can be similar to other manipulation devices, cartridges, and imaging devices described herein, respectively.

[0155] The manipulation device 3802 can be coupled to a handle 3861, the cartridge 3840, and the imaging device 3836. The manipulation device 3802 includes motors configured to actuate actuators in the cartridge 3840. The handle 3861 is shaped so that a user can hold the handle 3861 to position and control the operation of the system 3830. The handle includes a set of buttons 3804a configured to be pressed by the user. Each button corresponds to an action of the manipulation device 3802. For example, a first button 3804a can correspond to advancing a needle, a second button 3804a can correspond to advancing a guidewire, and a third button 3804a can correspond to advancing a catheter. The handle 3861 includes a slot for a battery 3805. The battery 3805 can be removable so that the battery can be swapped and / or recharged. In some embodiments, the battery 3805 is integral to the manipulation device 3802. A display 3804b is further coupled to the handle 3861. The display 3804b displaying information from the imaging device 3836.

[0156] FIG. 20 illustrates yet another example robotic system 3902 (e.g., structurally and / or functionally similar to the robotic system 202 of FIG. 2), in accordance with some embodiments. The robotic system 3902 is configured to be used with a handheld device 3930,similar to the handheld system 3830 of FIG. 38, thus allowing for the handheld device 3930 to be used either as a handheld device or as part of the robotic system 3902. For example, the system 3930 can be used as a handheld device for easy-to-reach vessels and as part of the robotic system 3902 when steady positioning and / or optimal imaging is desired such as for harder-to-reach vessels.

[0157] The robotic system 3902 includes a base 3903, an input / output device 3904c coupled to the base 3903, a display 3904d coupled to the base 3903, a robotic arm 3920 coupled to the base 3903, and the handheld device 3930. The robotic arm 3220 includes a first coupling device 3926a that selectively couples to a second coupling device 3926b on the manipulation device 3930. When the manipulation device 3930 is coupled to the robotic arm 3920, the manipulation device 3930 can be controlled by the input / output device 3904c (e.g., controllerjoystick, etc.) and the output from the imaging device of the manipulation device 3930 can be shown on the display 3904d. The robotic arm 3220 can be used to position the manipulation device of the handheld device 3930 to a desired position and / or orientation. In some embodiments, the robotic arm 3920 can be used to support the manipulation device of the handheld device 3930 while still being positioned manually. In some embodiments, the handle of the device 3930 can be removed when the device 3930 is coupled to the robotic arm 3920.

[0158] While various inventive embodiments have been described and illustrated herein, those of ordinary skill in the art will readily envision a variety of other means and / or structures for performing the function and / or obtaining the results and / or one or more of the advantages described herein, and each of such variations and / or modifications is deemed to be within the scope of the inventive embodiments described herein. More generally, those skilled in the art will readily appreciate that all parameters, dimensions, materials, and configurations described herein are meant to be exemplary and that the actual parameters, dimensions, materials, and / or configurations will depend upon the specific application or applications for which the inventive teachings is / are used. Those skilled in the art will recognize or be able to ascertain using no more than routine experimentation, many equivalents to the specific inventive embodiments described herein. It is, therefore, to be understood that the foregoing embodiments are presented by way of example only and that, within the scope of the appended claims and equivalents thereto; inventive embodiments may be practiced otherwise than as specifically described and claimed. Inventive embodiments of the present disclosure are directed to each individual feature, system, article, material, kit, and / or method described herein. In addition,any combination of two or more such features, systems, articles, materials, kits, and / or methods, if such features, systems, articles, materials, kits, and / or methods are not mutually inconsistent, is included within the inventive scope of the present disclosure.

[0159] As used herein, the terms “about” and / or “approximately” when used in conjunction with numerical values and / or ranges generally refer to those numerical values and / or ranges near to a recited numerical value and / or range. In some instances, the terms “about” and “approximately” may mean within ± 10% of the recited value. For example, in some instances, “about 100 [units]” may mean within ± 10% of 100 (e.g., from 90 to 110). The terms “about” and “approximately” may be used interchangeably.

[0160] Also, various inventive concepts may be embodied as one or more methods, of which an example has been provided. The acts performed as part of the method may be ordered in any suitable way. Accordingly, embodiments may be constructed in which acts are performed in an order different than illustrated, which may include performing some acts simultaneously, even though shown as sequential acts in illustrative embodiments.

[0161] Some embodiments and / or methods described herein can be performed by a different software (executed on hardware), hardware, or a combination thereof. Hardware modules may include, for example, a general-purpose processor, a field programmable gate array (FPGA), and / or an application specific integrated circuit (ASIC). Software modules (executed on hardware) can be expressed in a variety of software languages (e.g., computer code), including C, C++, Java™, Ruby, Visual Basic™, and / or other object-oriented, procedural, or other programming language and development tools. Examples of computer code include, but are not limited to, micro-code or micro-instructions, machine instructions, such as produced by a compiler, code used to produce a web service, and files containing higher-level instructions that are executed by a computer using an interpreter. For example, embodiments may be implemented using imperative programming languages (e.g., C, Fortran, etc.), functional programming languages (Haskell, Erlang, etc.), logical programming languages (e.g., Prolog), object-oriented programming languages (e.g., Java, C++, etc.) or other suitable programming languages and / or development tools. Additional examples of computer code include, but are not limited to, control signals, encrypted code, and compressed code.

[0162] It will be understood that, although the terms first, second, third, etc. may be used herein to describe various elements, these elements should not be limited by these terms. These termsare only used to distinguish one element from another element. Thus, a first element discussed below could be termed a second element without departing from the teachings of the present disclosure.

[0163] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. As used herein, the singular forms “a”, “an”, and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and / or “comprising” or “includes” and / or “including” when used in this specification, specify the presence of stated features, regions, integers, steps, operations, elements, and / or components, but do not preclude the presence or addition of one or more other features, regions, integers, steps, operations, elements, components, and / or groups thereof.

Claims

What is claimed is:

1. An apparatus, comprising: a cart movable to a location near a patient; a manipulation device configured to releasably couple to a cartridge including a needle, a catheter, and a guidewire, the manipulation device including one or more actuators configured to drive movement of at least one of the needle, the catheter, and the guidewire to selectively advance the at least one of the needle, the catheter, and the guidewire into a target vessel; and a robotic arm having a first end mounted to the cart and a second end coupled to the manipulation device, the robotic arm including a plurality of joints coupled to a plurality of segments that are collectively configured to move to position the manipulation device at a predetermined position and orientation relative to the patient, the plurality of joints including a ball joint configured to couple a distalmost segment of the plurality of segments to the manipulation device such that the manipulation device can rotate in multiple directions relative to the plurality of segments.

2. The apparatus of claim 1, further comprising an imaging system coupled to a distal end portion of the manipulation device, the imaging system configured to capture a transverse view and a longitudinal view each including the target vessel.

3. The apparatus of claim 2, wherein the imaging system is configured to change the transverse view as a tip of the needle is advanced into the target vessel to show the transverse view that corresponds to a transverse plane of the tip of the needle.

4. The apparatus of claim 2, wherein the imaging system includes an ultrasound array.

5. The apparatus of claim 1, further comprising the cartridge, the cartridge including at least one linear actuator, the at least one linear actuator configured to advance at least one of the catheter or the guidewire.

6. The apparatus of claim 5, wherein the manipulation device a linear actuator configured to drive movement of at least two of the needle, the catheter, and the guidewire.

7. The apparatus of claim 6, wherein the manipulation device further includes a plurality of motors each configured to couple to a screw shaft disposed in the cartridge to drive linear movement of at least one of the needle, the catheter, and the guidewire.

8. The apparatus of claim 7, wherein each motor of the plurality of motors is configured to couple to the respective screw shaft via a clutch system.

9. The apparatus of claim 1, further comprising an adaptor configured to couple to the manipulation device and the cartridge such that the one or more actuators of the manipulation device are operably coupled to the at least one of the needle, the catheter, and the guidewire.

10. The apparatus of claim 9, wherein the adaptor is coupleable to a drape, the drape configured to cover at least a portion of the manipulation device and the robotic arm to establish a sterile barrier between the patient and the manipulation device and the robotic arm.

11. The apparatus of claim 1, wherein the ball joint is configured to allow an orientation of the manipulation device to be adjusted such that an angle of insertion of the needle, the catheter, and the guidewire into the target vessel can be adjusted to be between about 10 and about 80 degrees relative to a longitudinal length of the target vessel.

12. The apparatus of claim 1, wherein the ball joint includes an electromagnetic braking assembly, the electromagnetic braking assembly configured to transition from an unenergized state to an energized state to lock the ball joint.

13. The apparatus of claim 12, wherein the electromagnetic braking assembly including a movable element and an electromagnet, the electromagnet configured to be energized to generate a magnetic field that can pull the movable element toward a socket of the ball joint such that a ball of the ball joint is held against the socket.

14. The apparatus of claim 13, wherein the movable component is coupled to a magnet that is configured to be attracted toward the electromagnet when the electromagnet is energized.

15. The apparatus of claim 13, further comprising an extension coupled to or integrated with the ball of the ball joint and configured to attach to the manipulation device, the extension having at least one bend along its length.

16. A method, comprising: receiving, from an accelerometer associated with at least one of a robotic arm, a manipulation device, or a cartridge, accelerometer data during a procedure; determining, based on the accelerometer data, if a magnitude of the accelerometer data exceeds a predefined acceleration threshold; and based on determining that the magnitude exceeds the predefined acceleration threshold, locking a position of the robotic arm by locking at least one ball joint of the robotic arm.

17. The method of claim 16, further comprising: defining, based on the accelerometer data, an acceleration vector, wherein the magnitude is the magnitude of the acceleration vector.

18. The method of claim 16, further comprising: based on determining that the magnitude does not exceed the predefined acceleration threshold, receiving an updated accelerometer data; determining, based on the updated accelerometer data, if an updated magnitude of the updated accelerometer data exceeds the predefined acceleration threshold; and based on determining that the updated magnitude exceeds the predefined acceleration threshold, locking the position of the robotic arm.

19. The method of claim 16, further comprising: generating a notification indicating that the position of the robotic arm is locked.

20. The method of claim 16, wherein the position of the robotic arm is locked for a predetermined amount of time.

21. The method of claim 20, further comprising: subsequent to the robotic arm being locked for the predetermined amount of time, unlocking the robotic arm.

22. The method of claim 16, further comprising: in response to receiving an unlock signal, unlocking the robotic arm.

23. The method of claim 16, wherein locking the ball joint includes energizing an electromagnetic braking assembly of the ball joint.

24. The method of claim 23, wherein energizing the electromagnetic braking assembly includes: energizing an electromagnet of the braking assembly such that the electromagnet generates a magnetic field that causes a movable element to be driven toward the electromagnet.

25. The method of claim 24, wherein, when the movable element is driven toward the electromagnet, a ball of the ball joint is held against a socket of the ball joint.

26. An apparatus, comprising: a cart movable to a location near a patient; a manipulation device configured to releasably couple to a cartridge including a needle, a catheter, and a guidewire, the manipulation device including one or more actuators configured to advance at least one of the needle, the catheter, and the guidewire; a robotic arm having a first end mounted to the cart and a second end coupled to the manipulation device, the robotic arm including a ball j oint configured to allow the manipulation device to rotate in multiple directions relative to at least a portion of the robotic arm such that the manipulation device can be positioned near a target vessel; a processor operatively coupled to the manipulation device and the robotic arm, the processor configured to: activate during a surgical procedure the one or more actuators to advance the at least one of the needle, the catheter, and the guidewire into the target vessel; receive accelerometer data associated with the robotic arm or the manipulation device during the surgical procedure; and based on the accelerometer data, activate one or more brakes coupled to the plurality of joints to prevent movement of the robotic arm.

27. The apparatus of claim 26, wherein the processor is configured to activate one or more brakes based on the accelerometer data by: determining, based on the accelerometer data, if a magnitude of the accelerometer data exceeds a predefined acceleration threshold; and based on determining that the magnitude exceeds the predefined acceleration threshold, activate the one or more brakes.

28. The apparatus of claim 27, wherein the processor is further configured to: define, based on the accelerometer data, an acceleration vector, wherein the magnitude is the magnitude of the acceleration vector.

29. The apparatus of claim 28, further comprising: based on determining that the magnitude does not exceed the predefined acceleration threshold, receive an updated accelerometer data; determine, based on the updated accelerometer data, if an updated magnitude of the updated accelerometer data exceeds the predefined acceleration threshold; and based on determining that the updated magnitude exceeds the predefined acceleration threshold, lock the position of the robotic arm.

30. The apparatus of claim 26, wherein the processor is further configured to: generate a notification indicating that the one or more brakes have been activated.

31. The apparatus of claim 26, wherein the one or more brakes are activated for a predetermined amount of time.

32. The apparatus of claim 31, wherein the processor is further configured to: subsequent to the one or more brakes being activated for the predetermined amount of time, deactivate the one or more brakes such that the robotic arm can be moved again.

33. The apparatus of claim 26, wherein the processor is further configured to: receive an unlock signal; and in response to receiving an unlock signal, deactivate the one or more brakes.

34. The apparatus of claim 26, wherein the processor is configured to activate the one or more brakes by activating an electromagnetic brake associated with the ball joint.

35. The apparatus of claim 34, wherein the processor is configured to activate the electromagnetic brake by energizing one or more electromagnets to cause a ball of the ball j oint to be pressed against a socket of the ball joint to prevent movement of the ball relative to the socket.

Images