Controller for remote operation systems enabling robots

Abstract

This invention relates to a robot-enabled remotely operated system, which may include a controller and an instrument capable of being manipulated by the controller. The instrument may be a medical device. The controller may include a handle configured for actuation by an operator. The handle may be attached to a gimbal configured to allow manipulation of the handle in multiple rotational degrees of freedom. The gimbal may include a force sensor. The gimbal may be configured for impedance control. The controller may also include a positioning platform coupled to the gimbal and configured to allow manipulation of the handle in multiple positional degrees of freedom. The controller may be configured to perform admittance control based at least in part on the output signal of the force sensor in the gimbal.

Description

Technical Field

[0001] This application relates to controllers, and more specifically, to controllers for remotely operated systems (including medical systems) for robot-enabled operation. Background Technology

[0002] Medical procedures such as laparoscopic surgery may involve accessing and visualizing a patient's internal areas. During laparoscopic procedures, medical instruments can be inserted into the internal areas through a laparoscopic incision.

[0003] In some procedures, robot-enabled medical systems can be used to control the insertion and / or manipulation of instruments and their end effectors. Robot-enabled medical systems may include robotic arms or other instrument positioning devices. Robot-enabled medical systems may also include controllers for controlling the positioning of instruments during procedures. Summary of the Invention

[0004] In a first aspect, a robot-enabled remote operation system is described. The system includes a controller and a robotic tool operable by the controller. The controller includes: a handle configured for actuation by an operator; a gimbal coupled to the handle and configured to allow manipulation of the handle in multiple degrees of freedom, wherein the gimbal is configured for impedance control such that manipulation of the handle causes corresponding manipulation of the robotic tool; and a positioning platform coupled to the gimbal and configured to allow manipulation of the handle in multiple degrees of freedom. The positioning platform is configured for admittance control such that manipulation of the handle causes corresponding manipulation of the robotic tool.

[0005] The system may include one or more of the following features in any combination: (a) the robotic tool is a medical device; (b) the gimbal is coupled to the positioning platform via a rotary joint; (c) the gimbal allows manipulation of the handle in at least three rotational degrees of freedom; (d) the positioning platform allows manipulation of the handle in at least three positional degrees of freedom; (e) a robotic arm coupled to the robotic tool, wherein the robotic tool includes at least one of a catheter, endoscope, gripper, sealer, or cutter; (f) a force sensor positioned within the gimbal; (g) The admittance control of the positioning platform is based on the output signal of the force sensor; (h) the universal joint includes at least a first connector, a second connector, and a third connector, the first connector, the second connector, and the third connector being arranged from distal to proximal and connected by a joint, and the force sensor being positioned within the first connector; (i) the joint is a rotary joint; (j) the universal joint includes at least a first joint, a second joint, and a third joint, the first joint, the second joint, and the third joint being arranged from distal to proximal and connected by a connector, and the force sensor being positioned within the second joint. (k) wherein the universal joint includes at least a first connector, a second connector, and a third connector, the first connector, the second connector, and the third connector being arranged from distal to proximal and connected by joints, and wherein the force sensor is positioned within the third connector; (l) the universal joint includes at least a first joint, a second joint, and a third joint, the first joint, the second joint, and the third joint being arranged from distal to proximal and connected by connectors, and wherein the force sensor is positioned proximal to the third joint; (m) wherein the universal joint includes a cover attached to the distal end of the force sensor, the cover screen A structure located proximal to the force sensor to prevent mechanical short circuit between the distal end of the force sensor and the shielded structure; (n) a motor positioned within the universal joint for controlling a joint of the universal joint; (o) wherein the motor is connected to the joint via a cable drive; (p) wherein the motor is located proximal to the joint; (q) wherein the positioning platform includes at least one prismatic joint; (r) wherein the axis of motion of the prismatic joint is aligned with the direction of gravity; and / or (s) wherein the universal joint is coupled to the positioning platform via a joint, and wherein the axis of the joint is aligned with the direction of gravity.

[0006] On the other hand, a robot-enabled remotely operated system includes a controller and a robotic tool capable of being manipulated by the controller. The controller includes: a handle configured for actuation by an operator; a gimbal coupled to the handle and configured to allow manipulation of the handle in multiple degrees of freedom, the gimbal including force sensors, wherein motion of at least two axes of the gimbal is not based on any output signal from the force sensors; and a positioning platform coupled to the gimbal and configured to allow manipulation of the handle in multiple degrees of freedom. The handle is configured for admittance control based at least in part on the output signal from the force sensors in the gimbal.

[0007] The system may include one or more of the following features in any combination: (a) wherein the universal joint includes at least a first connector, a second connector, and a third connector, the first connector, the second connector, and the third connector being arranged from distal to proximal and connected by joints, and wherein the force sensor is positioned within the first connector; (b) a cover attached to the distal end of the force sensor, the cover shielding a structure located proximal to the force sensor to prevent mechanical short circuits between the distal end of the force sensor and the shielded structure; (c) wherein the universal joint includes at least a first joint, a second joint, and a third joint, the first joint, the second joint, and the third joint being arranged from distal to proximal and connected by connectors, and wherein the force sensor... (d) The force sensor is located distal to the second joint; wherein the universal joint includes at least a first connector, a second connector, and a third connector, the first connector, the second connector, and the third connector being arranged from distal to proximal and connected by a joint, and wherein the force sensor is located within the third connector; (e) The universal joint includes at least a first joint, a second joint, and a third joint, the first joint, the second joint, and the third joint being arranged from distal to proximal and connected by a connector, and wherein the force sensor is located proximal to the third joint; (f) A motor, the motor being located within the universal joint for controlling the joints of the universal joint; (g) The motor is connected to the joint via a cable drive; and / or (h) The motor is located proximal to the joint.

[0008] In another aspect, a method for remote operation is provided, the method involving or including: driving rotation of a controller via impedance control; driving translation of the controller via admittance control; delivering an output signal from the controller based on impedance control and / or admittance control; and driving movement of the remotely operated tool based on the output signal.

[0009] The method may include any combination of one or more of the following features: (a) wherein the output signal is based on the rotation and / or position of the handle of the controller; (b) wherein driving the rotation of the controller via impedance control includes rotating the handle of the controller; (c) wherein the handle is attached to a gimbal configured to allow manipulation of the handle in multiple degrees of freedom; (d) wherein the gimbal includes a force sensor; (e) wherein driving the translation of the controller via admittance control includes translating the handle of the controller, and wherein the admittance control is based on the output of the force sensor; (f) wherein the gimbal includes at least a first connector, a second connector, and a third connector, the first connector, the second connector, and the third connector being arranged from distal to proximal and connected by a joint, and wherein the force sensor... (g) The universal joint includes at least a first joint, a second joint, and a third joint, the first joint, the second joint, and the third joint being arranged from distal to proximal and connected by a connector, and wherein the force sensor is located distal to the second joint; (h) The universal joint includes at least a first connector, a second connector, and a third connector, the first connector, the second connector, and the third connector being arranged from distal to proximal and connected by a joint, and wherein the force sensor is located within the third connector; and / or (i) The universal joint includes at least a first joint, a second joint, and a third joint, the first joint, the second joint, and the third joint being arranged from distal to proximal and connected by a connector, and wherein the force sensor is located proximal to the third joint.

[0010] In another aspect, a method for remote operation is provided, the method comprising: manipulating a controller to induce corresponding manipulation of a remotely operated robotic tool, wherein manipulating the controller comprises: manipulating a handle of the controller in at least three rotational degrees of freedom via impedance control to induce corresponding manipulation of the remotely operated robotic tool; and manipulating the handle of the controller in at least three positional degrees of freedom via admittance control to induce corresponding manipulation of the remotely operated robotic tool.

[0011] The method may include any combination of one or more of the following features: (a) wherein manipulating the handle in the at least three rotational degrees of freedom includes manipulating a gimbal; (b) wherein manipulating the handle in the at least three rotational degrees of freedom includes manipulating the handle in at least pitch, roll, and yaw directions; (c) wherein manipulating the handle in the at least three positional degrees of freedom includes manipulating a positioning platform; and / or (d) wherein manipulating the handle in the at least three positional degrees of freedom includes manipulating the handle in at least the x, y, and z directions.

[0012] On the other hand, a robot-enabled remotely operated system includes a manipulator for manipulating a remotely operated robotic tool. The manipulator includes a plurality of joints formed by connectors, each connector including a proximal connector and a distal connector operably coupled to a post, wherein the proximal connector is positioned closer to the post than the distal connector. The system also includes a force sensor located within at least one of the connectors. A first group of the joints is located proximal to the force sensor, and a second group of the joints is located distal to the force sensor. The second group of joints includes at least one joint whose movement is not based on an output signal from the force sensor.

[0013] The system may include one or more of the following features in any combination: (a) wherein the manipulator includes a series connector manipulator; (b) wherein the manipulator includes a parallel connector manipulator; (c) wherein the manipulator includes a handle, a universal joint, and a positioning platform formed by the plurality of connectors; (d) wherein the universal joint is coupled to the positioning platform via a rotary joint; (e) wherein the first group of the plurality of joints proximal to the force sensor is part of the positioning platform; (f) wherein the manipulation of the positioning platform is based on the output of the force sensor; and / or (g) wherein the second group of the plurality of joints distal to the force sensor is part of the universal joint.

[0014] On the other hand, a robot-enabled system includes a controller comprising: a handle configured for actuation by an operator; a gimbal coupled to the handle and configured to allow manipulation of the handle in multiple degrees of freedom, wherein the gimbal is configured for impedance control; and a positioning platform coupled to the gimbal and configured to allow manipulation of the handle in multiple degrees of freedom, wherein the positioning platform is configured for admittance control. In some embodiments, the controller manipulates a remotely operated robotic tool. In some embodiments, the controller manipulates objects in a virtual environment. Attached Figure Description

[0015] The disclosed aspects will be described below in conjunction with the accompanying drawings, which are provided to illustrate and not limit the disclosed aspects, wherein similar reference numerals denote similar elements.

[0016] Figure 1 An implementation scheme of a cart-based robotic system deployed for diagnostic and / or therapeutic bronchoscopy procedures is shown.

[0017] Figure 2 Depicting Figure 1 Another aspect of robotic systems.

[0018] Figure 3 The setup for ureteroscopy is shown. Figure 1 The implementation plan for the robot system.

[0019] Figure 4 The diagram shows the arrangement used for vascular procedures. Figure 1 The implementation plan for the robot system.

[0020] Figure 5 An implementation scheme of a table-based robotic system deployed for bronchoscopy procedures is shown.

[0021] Figure 6 Provided Figure 5 An alternative view of the robotic system.

[0022] Figure 7 An exemplary system configured to retract a robotic arm is shown.

[0023] Figure 8 An implementation scheme of a table-based robotic system constructed for ureteroscopy procedures is shown.

[0024] Figure 9 An implementation scheme of a table-based robotic system constructed for laparoscopic procedures is shown.

[0025] Figure 10 It shows a pitch or tilt adjustment. Figures 5-9 Implementation plan for platform-based robot system.

[0026] Figure 11 Provided Figures 5-10 A detailed diagram of the interface between the platform and the column of a platform-based robot system.

[0027] Figure 12 An exemplary device driver is shown.

[0028] Figure 13 An exemplary medical device with paired instrument drivers is shown.

[0029] Figure 14 An alternative design of the instrument actuator and the instrument is shown, wherein the axis of the actuator is parallel to the axis of the slender axis of the instrument.

[0030] Figure 15 A block diagram illustrating a positioning system according to an exemplary embodiment is depicted, the positioning system estimating Figures 1-10 The location of one or more components of a robotic system, such as Figure 13 and Figure 14 The location of the instruments.

[0031] Figure 16A This is a block diagram illustrating an implementation of a robot-enabled medical system, which includes a controller for robot-enabled medical devices.

[0032] Figure 16B It is shown Figure 16A A block diagram of an implementation of a controller that can be configured for hybrid impedance and admittance control.

[0033] Figure 16C It is an isometric view of an implementation of a controller that includes two universal brackets and a positioning platform.

[0034] Figure 17 This is an isometric view of an implementation scheme for a universal bracket used in a controller.

[0035] Figure 18 It is an isometric sectional view of a first embodiment of a universal bracket including a force sensor in a first position.

[0036] Figure 19A This is an isometric sectional view of a second embodiment of a universal joint including a force sensor in a second position.

[0037] Figure 19B yes Figure 19A An isometric view of the second embodiment is shown, which has a transparent cover to illustrate the embodiment of the cable drive system.

[0038] Figure 20A An example of a mechanical short circuit is shown.

[0039] Figure 20B An example of a cover for a gimbal is shown, which is configured to reduce the possibility of mechanical short circuits.

[0040] Figure 20C An embodiment is shown. Figure 18 The first embodiment of the universal bracket includes a cover that can be accessed without causing a mechanical short circuit.

[0041] Figure 20D An embodiment is shown. Figure 19A and Figure 19B The second embodiment of the universal bracket includes a cover that can be accessed without causing a mechanical short circuit.

[0042] Figure 21 This is a flowchart illustrating an implementation scheme of the controller method.

[0043] Figure 22 This is a flowchart illustrating another implementation of the controller method. Detailed Implementation

[0044] 1. Overview .

[0045] The aspects of this disclosure can be integrated into robot-enabled medical systems capable of performing a variety of medical procedures, including minimally invasive procedures such as laparoscopy and non-invasive procedures such as endoscopy. In endoscopic procedures, the system may be able to perform bronchoscopy, ureteroscopy, gastroscopy, etc.

[0046] In addition to executing a wide range of procedures, the system can provide additional benefits such as enhanced imaging and guidance to assist physicians. Furthermore, the system allows physicians to execute procedures from an ergonomic orientation, eliminating the need for cumbersome arm movements and positioning. Additionally, the system provides physicians with improved ease of use, enabling one or more instruments within the system to be controlled by a single user.

[0047] For illustrative purposes, various embodiments will be described below in conjunction with the accompanying drawings. It should be understood that many other embodiments of the disclosed concepts are possible, and various advantages can be achieved using the disclosed embodiments. Headings are included herein for reference and to aid in locating the various sections. These headings are not intended to limit the scope of the concepts described therein. Such concepts may be applicable throughout the specification.

[0048] A. Robotic System – Cart .

[0049] Robot-enabled medical systems can be constructed in a variety of ways, depending on specific procedures. Figure 1 An embodiment of a cart-based, robot-enabled system 10 arranged for diagnostic and / or therapeutic bronchoscopy procedures is illustrated. During bronchoscopy, system 10 may include a cart 11 having one or more robotic arms 12 to deliver medical instruments, such as a manipulable endoscope 13 (which may be a procedure-specific bronchoscope for bronchoscopy), to a natural orifice entry point (i.e., the patient's mouth positioned on the table in this example) to deliver diagnostic and / or therapeutic tools. As shown, cart 11 may be positioned near the patient's upper torso to provide access to the entry point. Similarly, robotic arms 12 may be actuated to position the bronchoscope relative to the entry point. This can also be utilized when performing GI procedures with a gastroscope (a dedicated endoscope for gastrointestinal (GI) procedures). Figure 1 The layout within. Figure 2 An exemplary implementation of the cart is described in more detail.

[0050] Continue to refer to Figure 1 Once the trolley 11 is correctly positioned, the robotic arm 12 can robotically, manually, or in combination thereof insert the steerable endoscope 13 into the patient. As shown, the steerable endoscope 13 may include at least two telescopic portions, such as an inner guide portion and an outer sheath portion, each coupled to a separate instrument actuator from a set of instrument actuators 28, each instrument actuator coupled to the distal end of a separate robotic arm. This linear arrangement of the instrument actuators 28, which facilitates coaxial alignment of the guide portion and the sheath portion, creates a “virtual track” 29, which can be repositioned in space by manipulating one or more robotic arms 12 to different angles and / or orientations. The virtual track described herein is depicted using dashed lines in the accompanying drawings, and therefore the dashed lines do not depict any physical structure of the system. Translation of the instrument actuators 28 along the virtual track 29 causes the inner guide portion to extend or retract relative to the outer sheath portion, or to advance or retract the endoscope 13 from the patient. The angle of the virtual track 29 can be adjusted, translated, and pivoted based on clinical application or physician preference. For example, in bronchoscopy, the angle and orientation of the virtual track 29 shown in the figure represent a trade-off between providing the physician with access to the endoscope 13 and minimizing friction caused by the endoscope 13 bending into the patient's mouth.

[0051] After insertion, endoscope 13 can be guided downwards through the patient's trachea and lungs using precise commands from the robotic system until the target destination or surgical site is reached. To enhance navigation through the patient's lung network and / or reach the desired target, endoscope 13 can be manipulated to telescopically extend the inner guide portion from the outer sheath portion to achieve enhanced joint movement and a larger radius of flexion. The use of separate instrument actuators 28 also allows the guide portion and sheath portion to be driven independently of each other.

[0052] For example, endoscope 13 can be guided to deliver a biopsy needle to a target, such as a lesion or nodule in a patient's lung. The needle can be deployed downwards along the working channel, which extends the length of the endoscope to obtain a tissue sample to be analyzed by a pathologist. Depending on the pathological findings, additional tools can be deployed downwards along the working channel of the endoscope for additional biopsies. After the nodule is identified as malignant, endoscope 13 can be used to deliver endoscopic tools to remove potentially cancerous tissue. In some cases, diagnostic and therapeutic procedures may need to be delivered in a separate procedure. In these cases, endoscope 13 can also be used to deliver a reference point to “mark” the location of the target nodule. In other cases, diagnostic and therapeutic procedures can be delivered during the same procedure.

[0053] System 10 may also include a movable tower 30, which can be connected to the cart 11 via support cables to provide control, electronic, fluid, optical, sensor, and / or electrical support to the cart 11. Placing such functionality in the tower 30 allows for easier adjustment and / or repositioning of the smaller form factor of the cart 11 by the operating physician and his / her staff. Additionally, the division between the cart / table and the support tower 30 reduces operating room clutter and facilitates improved clinical workflow. While the cart 11 can be positioned close to the patient, the tower 30 can be stowed in a remote location to avoid obstructing the path during procedures.

[0054] To support the aforementioned robotic system, tower 30 may include components of a computer-based control system that stores computer program instructions in a non-transitory computer-readable storage medium such as a permanent magnet memory drive, a solid-state drive, etc. Whether execution occurs within tower 30 or cart 11, the execution of these instructions can control the entire system or its subsystems. For example, when executed by the processor of the computer system, the instructions can cause components of the robotic system to actuate relevant brackets and arm mounts, actuate the robotic arm, and control medical devices. For instance, in response to receiving a control signal, motors in the joints of the robotic arm can position the arm into a specific posture.

[0055] Tower 30 may also include pumps, flow meters, valve controllers, and / or fluid passages to provide controlled flushing and suction capabilities to a system that can be deployed via endoscope 13. These components may also be controlled using a computer system of tower 30. In some embodiments, flushing and suction capabilities may be delivered directly to endoscope 13 via separate cables.

[0056] Tower 30 may include voltage and surge protectors designed to provide filtered and protected power to trolley 11, thereby avoiding the need to place power transformers and other auxiliary power components in trolley 11, resulting in a smaller and more portable trolley 11.

[0057] Tower 30 may also include support devices for sensors deployed throughout the robotic system 10. For example, tower 30 may include optoelectronic devices for detecting, receiving, and processing data received from optical sensors or cameras throughout the robotic system 10. In conjunction with a control system, such optoelectronic devices can be used to generate real-time images for display in any number of consoles deployed throughout the system (including displays within tower 30). Similarly, tower 30 may also include electronic subsystems for receiving and processing signals received from deployed electromagnetic (EM) sensors. Tower 30 may also be used to house and position EM field generators for detection by EM sensors in or on a medical device.

[0058] In addition to other consoles available in the rest of the system (e.g., a console mounted on top of a cart), tower 30 may also include console 31. Console 31 may include a user interface and display, such as a touchscreen, for physician operators. Consoles in system 10 are generally designed to provide both robot control and preoperative and real-time information for procedures, such as navigation and positioning information for endoscope 13. When console 31 is not the only console available to the physician, it may be used by a second operator (such as a nurse) to monitor the patient's health or vital signs and system operation, as well as to provide procedure-specific data, such as navigation and positioning information. In other embodiments, console 30 is housed in a separate body from tower 30.

[0059] Tower 30 can be coupled to cart 11 and endoscope 13 via one or more cables or connectors (not shown). In some embodiments, support functionality from tower 30 can be provided to cart 11 via a single cable, thereby simplifying the operating room and eliminating clutter. In other embodiments, specific functions can be coupled in separate wiring and connections. For example, while power to the cart can be provided via a single cable, support for control, optics, fluid, and / or navigation can also be provided via separate cables.

[0060] Figure 2 Provided from Figure 1 The illustration shows a detailed implementation of a cart-based robot-enabled system. The cart 11 typically includes an elongated support structure 14 (often referred to as a "post"), a cart base 15, and a console 16 at the top of the post 14. The post 14 may include one or more brackets, such as those for supporting one or more robotic arms 12. Figure 2 The bracket 17 (or alternatively, "arm support") is deployed in three configurations. The bracket 17 may include a separately configurable arm mount that rotates along a vertical axis to adjust the base of the robotic arm 12 for better positioning relative to the patient. The bracket 17 also includes a bracket interface 19 that allows the bracket 17 to translate vertically along the post 14.

[0061] The bracket interface 19 is connected to the column 14 via a slot, such as slot 20, positioned on the opposite side of the column 14 to guide the vertical translation of the bracket 17. Slot 20 includes a vertical translation interface to position and hold the bracket relative to the trolley base 15 at various vertical heights. The vertical translation of the bracket 17 allows the trolley 11 to adjust the reach of the robotic arm 12 to accommodate various table heights, patient sizes, and physician preferences. Similarly, separately configurable arm mounts on the bracket 17 allow the robotic arm base 21 of the robotic arm 12 to be angled in various configurations.

[0062] In some embodiments, slot 20 may be supplemented with a slot cover flush and parallel to the slot surface to prevent dust and fluid from entering the internal cavity of column 14 and the vertical translation interface during the vertical translation of bracket 17. The slot cover can be deployed via a pair of spring reels positioned near the vertical top and bottom of slot 20. The cover is coiled within the reels until it is deployed to extend and retract from its coiled state during the vertical up-and-down translation of bracket 17. The spring loading of the reels provides a force to retract the cover into the reels as bracket 17 translates toward the reels, while maintaining a tight seal as bracket 17 translates away from the reels. The cover can be attached to bracket 17 using, for example, a bracket in bracket interface 19, to ensure proper extension and retraction of the cover during the translation of bracket 17.

[0063] The column 14 may internally include mechanisms such as gears and motors, which are designed to mechanically translate the bracket 17 using vertically aligned lead screws in response to control signals generated in response to user input (e.g., input from the console 16).

[0064] A robotic arm 12 typically includes a robotic arm base 21 and an end effector 22 separated by a series of links 23 connected by a series of joints 24, each joint including an independent actuator, and each actuator including an independently controllable motor. Each independently controllable joint represents an independent degree of freedom available to the robotic arm. Each arm in the arm 12 has seven joints and thus provides seven degrees of freedom. Multiple joints result in multiple degrees of freedom, thus allowing for “redundant” degrees of freedom. Redundant degrees of freedom allow the robotic arm 12 to position its corresponding end effector 22 in a specific orientation, orientation, and trajectory in space using different link orientations and joint angles. This allows the system to locate and guide medical devices from desired points in space, while allowing physicians to move the arm joints away from the patient to a clinically advantageous orientation for greater proximity while avoiding arm collisions.

[0065] The trolley base 15 balances the weight of the column 14, bracket 17, and arm 12 on the floor. Therefore, the trolley base 15 houses heavier components such as electronics, motors, power supplies, and components that enable the trolley to move and / or be secured. For example, the trolley base 15 includes rollable wheel-shaped casters 25 that allow the trolley to be easily moved around the room before the procedure. Once in the correct position, the casters 25 can be secured using wheel locks to hold the trolley 11 in the correct position during the procedure.

[0066] The console 16, positioned at the vertical end of column 14, allows both a user interface for receiving user input and a display screen (or dual-purpose device, such as touchscreen 26) to provide both preoperative and intraoperative data to the physician user. Potential preoperative data on touchscreen 26 may include preoperative planning, navigation, and mapping data derived from preoperative computed tomography (CT) scans and / or records from preoperative patient interviews. Intraoperative data on the display screen may include optical information from tools and sensors, coordinate information from sensors, and important patient statistics such as respiration, heart rate, and / or pulse. The console 16 can be positioned and tilted to allow the physician to access it from the side of column 14 opposite to bracket 17. From this orientation, the physician can operate the console 16 from behind cart 11 while observing the console 16, robotic arm 12, and patient. As shown, the console 16 also includes a handle 27 to aid in manipulating and stabilizing cart 11.

[0067] Figure 3 An embodiment of a robot-enabled system 10 arranged for ureteroscopy is shown. In a ureteroscopy procedure, a trolley 11 is positioned to deliver a ureteroscope 32 (a procedure-specific endoscope designed to traverse the patient's urethra and ureter) to the patient's lower abdominal region. During ureteroscopy, it is desirable to align the ureteroscope 32 directly with the patient's urethra to reduce friction and force on sensitive anatomical structures in that region. As shown, the trolley 11 can be aligned at the foot of the table to allow the robotic arm 12 to position the ureteroscope 32 for direct linear access into the patient's urethra. The robotic arm 12 can insert the ureteroscope 32 directly into the patient's lower abdomen through the urethra from the foot of the table along a virtual track 33.

[0068] After insertion into the urethra, using control techniques similar to those used in bronchoscopy, the ureteroscope 32 can be navigated to the bladder, ureter, and / or kidney for diagnostic and / or therapeutic applications. For example, the ureteroscope 32 can be guided into the ureter and kidney to break up accumulated kidney stones using a laser or ultrasonic lithotripsy device deployed downwards along the working channel of the ureteroscope 32. After lithotripsy is complete, the resulting stone fragments can be removed using a basket deployed downwards along the ureteroscope 32.

[0069] Figure 4A similar implementation of a robot-enabled system for vascular procedures is shown. In vascular procedures, system 10 can be configured such that a trolley 11 delivers a medical device 34 (such as a manipulable catheter) to an entry point in the femoral artery in the patient's leg. The femoral artery presents both a relatively large diameter for navigation and a relatively less circuitous and tortuous path to the patient's heart, which simplifies navigation. As in ureteroscopy procedures, trolley 11 can be positioned toward the patient's leg and lower abdomen to allow robotic arm 12 to provide a virtual track 35 for direct linear access to the femoral artery entry point in the patient's thigh / hip region. After insertion into the artery, the medical device 34 can be guided and inserted via translational device actuator 28. Alternatively, the trolley can be positioned around the patient's upper abdomen to reach alternative vascular entry points, such as the carotid and brachial arteries near the shoulder and wrist.

[0070] B. Robot System – Unit .

[0071] Implementation plans for robot-enabled medical systems can also incorporate patient-integrated tables. Integrating tables reduces the amount of capital equipment in the operating room by removing trolleys, allowing for greater accessibility to the patient. Figure 5 An embodiment of such a robot-enabled system arranged for a bronchoscopy procedure is shown. System 36 includes a support structure or column 37 for supporting a platform 38 (shown as a "table" or "bed") on a floor. Much like a trolley-based system, the end effector of the robotic arm 39 of system 36 includes an instrument actuator 42, which is designed to manipulate elongated medical instruments, such as… Figure 5 The bronchoscope 40 is used in the bronchoscopy. In practice, the C-arm used to provide fluorescence imaging can be positioned above the patient's upper abdominal region by placing the transmitter and detector around the stage 38.

[0072] Figure 6An alternative view of system 36 without a patient and medical devices is provided for discussion purposes. As shown, column 37 may include one or more brackets 43, shown as annular in system 36, upon which one or more robotic arms 39 may be based. The brackets 43 may translate along a vertical column interface 44 extending along the length of column 37 to provide different vantage points from which the robotic arms 39 may be positioned to reach the patient. The brackets 43 may be rotated about column 37 using mechanical motors positioned within column 37 to allow the robotic arms 39 to access multiple sides of table 38, such as both sides of the patient. In embodiments with multiple brackets, the brackets may be individually positioned on the column and may translate and / or rotate independently of the other brackets. While the brackets 43 need not be circular or even circular around column 37, the annular shape shown facilitates rotation of the brackets 43 around column 37 while maintaining structural balance. Rotation and translation of the brackets 43 allow the system to align medical devices such as endoscopes and laparoscopes to different access points on the patient. In other embodiments (not shown), system 36 may include a patient examination table or bed with an adjustable arm support, which takes the form of a rod or rail extending beside the patient examination table or bed. One or more robotic arms 39 (e.g., via a shoulder with an elbow joint) may be attached to the adjustable arm support, which can be vertically adjusted. By providing vertical adjustment, the robotic arms 39 can advantageously be compactly stored under the patient examination table or bed and subsequently raised during procedures.

[0073] Arm 39 can be mounted on a bracket via a set of arm mounts 45 comprising a series of joints that can be individually rotated and / or telescopically extended to provide additional constructability to the robotic arm 39. Additionally, the arm mounts 45 can be positioned on the bracket 43 such that, when the bracket 43 is properly rotated, the arm mounts 45 are positioned on the same side of the platform 38 (e.g., ...). Figure 6 As shown), on the opposite side of platform 38 (as shown) Figure 9 (as shown) or on the adjacent side of platform 38 (not shown).

[0074] Column 37 structurally supports platform 38 and provides a path for the vertical translation of the bracket. Internally, column 37 may be equipped with a lead screw for guiding the vertical translation of the bracket, and a motor for mechanizing the translation of the bracket based on the lead screw. Column 37 may also transmit power and control signals to bracket 43 and robotic arm 39 mounted thereon.

[0075] Platform base 46 has with Figure 2The trolley base 15 in the illustrated trolley 11 serves a similar function, accommodating heavier components to balance the table / bed 38, column 37, bracket 43, and robotic arm 39. The table base 46 may also incorporate rigid casters to provide stability during operation. Casters deployed from the bottom of the table base 46 can extend in opposite directions on either side of the base 46 and retract when the system 36 needs to be moved.

[0076] continue Figure 6 System 36 may also include a tower (not shown) that divides the functionality of system 36 between the table and the tower to reduce the form factor and volume of the table. As in previously disclosed embodiments, the tower may provide the table with various support functions such as processing, computing and control capabilities, electrical, fluid and / or optical, and sensor processing. The tower may also be movable to be positioned away from the patient, thereby improving physician accessibility and eliminating clutter in the operating room. Additionally, placing components in the tower allows for more storage space in the base of the table for potential retraction of the robotic arm. The tower may also include a main controller or console that provides both a user interface (such as a keyboard and / or hooks) for user input and a display screen (or touchscreen) for preoperative and intraoperative information (such as real-time imaging, navigation, and tracking information). In some embodiments, the tower may also include a gripper for a gas canister to be used for inflatation.

[0077] In some implementations, the base can be retracted and stored when not in use. Figure 7 A system 47 for retracting a robotic arm is illustrated in an embodiment of a platform-based system. In system 47, a bracket 48 can be vertically translated into a base 49 to retract the robotic arm 50, arm mount 51, and bracket 48 within the base 49. A base cover 52 can be translated and retracted to open to deploy the bracket 48, arm mount 51, and arm 50 around a post 53, and to close to retract the bracket 48, arm mount 51, and arm 50 for protection when not in use. The base cover 52 can be sealed along the edges of its opening with a membrane 54 to prevent dust and fluid from entering when closed.

[0078] Figure 8An embodiment of a robot-enabled table-based system configured for a ureteroscopy procedure is illustrated. During ureteroscopy, table 38 may include a rotating portion 55 for positioning the patient at an angle to the column 37 and table base 46. The rotating portion 55 may rotate or pivot about a pivot point (e.g., below the patient's head) to position the lower portion of the rotating portion 55 away from the column 37. For example, pivoting the rotating portion 55 allows a C-arm (not shown) to be positioned above the patient's lower abdomen without competing for space with the column (not shown) below table 38. By rotating a bracket 35 (not shown) about the column 37, a robotic arm 39 can insert a ureteroscope 56 directly into the patient's groin region along a virtual track 57 to reach the urethra. During ureteroscopy, stirrups 58 may also be fixed to the rotating portion 55 of table 38 to support the orientation of the patient's legs during the procedure and allow full access to the patient's groin region.

[0079] In laparoscopic procedures, minimally invasive instruments are inserted into the patient's anatomical structures through a small incision in the abdominal wall. In some implementations, the instruments include elongated, rigid components, such as shafts, for accessing the patient's anatomy. After the abdominal cavity is inflated, the instruments can be guided to perform surgical or medical tasks, such as grasping, cutting, ablation, and suturing. In some implementations, the instruments may include endoscopes, such as laparoscopes. Figure 9 An implementation scheme of a robot-enabled platform-based system constructed for laparoscopic procedures is shown. For example... Figure 9 As shown, the bracket 43 of system 36 can be rotated and vertically adjusted to position the pair of robotic arms 39 on opposite sides of table 38, so that the instrument 59 can be positioned through the smallest incision on both sides of the patient to reach his / her abdominal cavity using arm mount 45.

[0080] To accommodate laparoscopic procedures, the robot-enabled platform system can also tilt the platform to the desired angle. Figure 10 An implementation scheme for a robot-enabled medical system with pitch or tilt adjustment is shown. For example... Figure 10 As shown, system 36 can adapt to the tilt of platform 38 to position one part of the platform at a greater distance from the ground than the other part. Additionally, arm mount 45 can rotate to match the tilt, ensuring that arm 39 maintains the same planar relationship with platform 38. To accommodate steeper angles, column 37 may also include a telescopic section 60 that allows vertical extension of column 37 to prevent platform 38 from contacting the floor or colliding with base 46.

[0081] Figure 11Detailed illustrations are provided of the interface between platform 38 and column 37. The pitch-rotation mechanism 61 can be configured to change the pitch angle of platform 38 relative to column 37 in multiple degrees of freedom. The pitch-rotation mechanism 61 can be implemented by positioning orthogonal axes 1 and 2 at the column interface, each axis being actuated by separate motors 3 and 4 in response to electrical pitch angle commands. Rotation along one screw 5 enables tilt adjustment along axis 1, while rotation along another screw 6 enables tilt adjustment along another axis 2. In some embodiments, ball joints can be used to change the pitch angle of platform 38 relative to column 37 in multiple degrees of freedom.

[0082] For example, pitch adjustment is particularly useful when attempting to position the table in a head-down, feet-up position (i.e., positioning the patient's lower abdomen higher than the floor) for lower abdominal surgery. The head-down, feet-up position causes the patient's internal organs to slide down to his / her upper abdomen by gravity, clearing the abdominal cavity to allow minimally invasive instruments to enter and perform lower abdominal surgical or medical procedures, such as laparoscopic prostatectomy.

[0083] C. Instrument drivers and interfaces .

[0084] The end effector of the system's robotic arm includes: (i) an instrument actuator (alternatively referred to as an "instrument drive mechanism" or "instrument device manipulator"), which incorporates electromechanical devices for actuating the medical device; and (ii) a removable or detachable medical device, which may lack any electromechanical components such as motors. This dichotomy may be driven by the need for sterilization of medical devices used in medical procedures, and the inability to adequately sterilize expensive capital equipment due to its complex mechanical components and sensitive electronics. Therefore, the medical device can be designed to be detached, removed, and interchanged from the instrument actuator (and thus from the system) for individual sterilization or disposal by a physician or physician staff. In contrast, the instrument actuator does not need to be altered or sterilized and can be covered for protection.

[0085] Figure 12 An exemplary instrument actuator is illustrated. The instrument actuator 62, positioned at the distal end of a robotic arm, includes one or more drive units 63 arranged parallel to the axis to provide controlled torque to a medical device via a drive shaft 64. Each drive unit 63 includes a separate drive shaft 64 for interacting with the device, a gear head 65 for converting motor shaft rotation into desired torque, a motor 66 for generating drive torque, an encoder 67 for measuring the speed of the motor shaft and providing feedback to control circuitry, and control circuitry 68 for receiving control signals and actuating the drive unit. Each drive unit 63 is independently controlled and motorized, and the instrument actuator 62 can provide multiple (e.g., ...) to the medical device. Figure 12Four independent drive outputs are shown. In operation, the control circuit 68 receives control signals, transmits motor signals to the motor 66, compares the motor speed measured by the encoder 67 with the desired speed, and modulates the motor signals to generate the desired torque.

[0086] For procedures requiring a sterile environment, the robotic system can incorporate a drive interface, such as a sterile adapter connected to a sterile cover, positioned between the instrument actuator and the medical device. The primary purpose of the sterile adapter is to transmit angular motion from the drive shaft of the instrument actuator to the drive input of the device, while maintaining physical separation between the drive shaft and the drive input, and thus maintaining sterility. Therefore, an exemplary sterile adapter may include a series of rotary inputs and outputs designed to mate with the drive shaft of the instrument actuator and the drive input on the device. The sterile cover, composed of a thin, flexible material (such as transparent or translucent plastic), is designed to cover capital devices, such as instrument actuators, robotic arms, and trolleys (in trolley-based systems) or tables (in table-based systems). The use of the cover allows the capital device to be positioned near the patient while still within an area that does not require sterilization (i.e., a non-sterile area). On the other side of the sterile cover, the medical device can dock with the patient in an area that requires sterilization (i.e., a sterile area).

[0087] D. Medical devices .

[0088] Figure 13 An exemplary medical device with paired instrument actuators is shown. Similar to other devices designed for use with robotic systems, the medical device 70 includes an elongated shaft 71 (or elongated body) and an instrument base 72. The instrument base 72, also referred to as the “instrument handle” due to its intended design for manual interaction by a physician, typically includes a rotatable drive input 73 (e.g., a socket, pulley, or reel) designed to engage a drive output 74 on a drive interface extending through the distal end of a robotic arm 76. When physically connected, latched, and / or coupled, the engaging drive input 73 of the instrument base 72 may share a rotational axis with the drive output 74 in the instrument driver 75 to allow torque to be transmitted from the drive output 74 to the drive input 73. In some embodiments, the drive output 74 may include a spline designed to engage a socket on the drive input 73.

[0089] The elongated shaft 71 is designed to be delivered through an anatomical opening or cavity (e.g., as in endoscopy) or through a minimally invasive incision (e.g., as in laparoscopy). The elongated shaft 71 can be flexible (e.g., having endoscope-like properties) or rigid (e.g., having laparoscopy-like properties), or a customized combination of both flexible and rigid portions. When designed for laparoscopy, the distal end of the rigid elongated shaft can be connected to an end effector extending from an articulated wrist and surgical tool or medical instrument (e.g., a gripper or scissors) formed by a connecting fork having at least one degree of freedom, which can be actuated based on forces from a tendon when the drive input rotates in response to torque received from the drive output 74 of the instrument actuator 75. When designed for endoscopy, the distal end of the flexible elongated shaft can include a manipulable or controllable flexure segment that articulates and flexes based on torque received from the drive output 74 of the instrument actuator 75.

[0090] Torque from the instrument actuator 75 is transmitted along the elongated shaft 71 using tendons along the shaft 71. These individual tendons (e.g., drawstrings) may be individually anchored to a separate drive input 73 within the instrument handle 72. From the handle 72, the tendons are guided downward along one or more traction chambers of the elongated shaft 71 and anchored at the distal portion of the elongated shaft 71, or at the wrist at the distal portion of the elongated shaft. During surgical procedures such as laparoscopic, endoscopic, or hybrid procedures, these tendons may be coupled to a distally mounted end effector, such as a wrist, gripper, or scissors. In such an arrangement, torque applied to the drive input 73 transmits tension to the tendons, thereby causing the end effector to actuate in a certain way. In some embodiments, during surgery, the tendons may cause the joint to rotate about the axis, thereby causing the end effector to move in one direction or the other. Alternatively, the tendons may be connected to one or more jaws of a gripper at the distal end of the elongated shaft 71, wherein tension from the tendons causes the gripper to close.

[0091] During endoscopy, tendons can be coupled via adhesives, control rings, or other mechanical fasteners to flexural or articulated segments positioned along an elongated axis 71 (e.g., at the distal end). When fixedly attached to the distal end of a flexural segment, torque applied to drive input 73 is transmitted down the tendon, causing the softer flexural segment (sometimes referred to as an articulated segment or region) to flex or articulate. Along non-flexural segments, it can be advantageous to helve or coil individual traction cavities that guide individual tendons along the wall (or inside) of the endoscope axis to balance radial forces caused by tension in the traction lines. For specific purposes, the angle of the helices and / or the spacing between them can be varied or designed, with tighter helices exhibiting less axial compression under load, while lower helical amounts cause greater axial compression under load but also exhibit restricted flexion. Alternatively, traction cavities can be guided parallel to the longitudinal axis of the elongated axis 71 to allow controlled articulation within the desired flexural or articulated segment.

[0092] In endoscopic procedures, the elongated shaft 71 houses multiple components to assist in robotic procedures. The shaft may include, at its distal end, a working channel for deploying surgical instruments (or medical devices), rinsing and / or aspirating the surgical area. The shaft 71 may also house wires and / or optical fibers to transmit signals to / from optical components at its distal end, which may include an optical camera. The shaft 71 may also house optical fibers to carry light from a proximal light source (e.g., a light-emitting diode) to the distal end of the shaft.

[0093] At the distal end of the instrument 70, the distal end may further include an opening for delivering tools for diagnosis and / or treatment, and for a working channel for rinsing and aspirating the surgical site. The distal end may also include a port for a camera (such as a fiberoptic endoscope or digital camera) to capture images of the internal anatomical space. Relatedly, the distal end may also include a port for a light source used to illuminate the anatomical space when the camera is used.

[0094] exist Figure 13 In the example, the drive shaft axis, and therefore the drive input axis, is orthogonal to the axis of the slender shaft. However, this arrangement complicates the rolling capability of the slender shaft 71. Rolling the slender shaft 71 along its axis while keeping the drive input 73 stationary can cause undesirable tangling of the tendon as it extends from the drive input 73 and enters the traction cavity within the slender shaft 71. Such tendon tangling can disrupt any control algorithms designed to predict the movement of the flexible slender shaft during endoscopic procedures.

[0095] Figure 14An alternative design of the instrument actuator and instrument is shown, wherein the axis of the drive unit is parallel to the axis of the slender axis of the instrument. As shown, the circular instrument actuator 80 includes four drive units whose drive outputs 81 are aligned parallel to each other at the end of the robot arm 82. The drive units and their respective drive outputs 81 are housed in a rotating assembly 83 of the instrument actuator 80, driven by one of the drive units within assembly 83. In response to torque provided by the rotating drive unit, the rotating assembly 83 rotates along a circular bearing that connects the rotating assembly 83 to the non-rotating portion 84 of the instrument actuator. Electrical and control signals can be transmitted from the non-rotating portion 84 of the instrument actuator 80 to the rotating assembly 83 via electrical contacts, which can be maintained by rotation of a brush slip ring connection (not shown). In other embodiments, the rotating assembly 83 may be responsive to a separate drive unit integrated into the non-rotating portion 84 and therefore not parallel to the other drive units. The rotation mechanism 83 allows the instrument actuator 80 to allow the drive units and their respective drive outputs 81 to rotate as a single unit about the instrument actuator axis 85.

[0096] Similar to previously disclosed embodiments, the instrument 86 may include an elongated shaft portion 88 and an instrument base 87 (shown for discussion purposes as having a transparent outer surface), the instrument base including a plurality of drive inputs 89 (such as sockets, pulleys, and reels) configured to receive drive outputs 81 in the instrument driver 80. Unlike previously disclosed embodiments, the instrument shaft 88 extends from the center of the instrument base 87, and the axis of the instrument base is substantially parallel to the axes of the drive inputs 89, rather than as... Figure 13 It is orthogonal as in the design.

[0097] When coupled to the rotating assembly 83 of the instrument driver 80, the medical device 86, including the instrument base 87 and the instrument shaft 88, rotates in combination with the rotating assembly 83 about the instrument driver axis 85. Since the instrument shaft 88 is positioned at the center of the instrument base 87, it is coaxial with the instrument driver axis 85 when attached. Therefore, rotation of the rotating assembly 83 causes the instrument shaft 88 to rotate about its own longitudinal axis. Furthermore, when the instrument base 87 rotates together with the instrument shaft 88, any tendons connected to the drive input 89 in the instrument base 87 do not become entangled during rotation. Therefore, the parallelism of the axes of the drive output 81, the drive input 89, and the instrument shaft 88 allows the shaft to rotate without causing any control tendons to become entangled.

[0098] E. Navigation and Control .

[0099] Traditional endoscopy can involve the use of fluoroscopy (e.g., delivered via a C-arm) and other forms of radiation-based imaging modalities to provide intracavitary guidance to the operating physician. In contrast, the robotic system envisioned in this disclosure can provide radiation-free navigation and positioning, reducing physician exposure to radiation and the amount of equipment required in the operating room. As used herein, the term "positioning" can refer to determining and / or monitoring the orientation of an object in a reference coordinate system. Techniques such as preoperative mapping, computer vision, real-time EM tracking, and robot command data can be used individually or in combination to achieve a radiation-free operating environment. In other cases where radiation-based imaging modalities are still used, preoperative mapping, computer vision, real-time EM tracking, and robot command data can be used individually or in combination to improve upon information obtained solely through radiation-based imaging modalities.

[0100] Figure 15 This is a block diagram illustrating a positioning system 90 for estimating the position of one or more components of a robotic system (such as the position of a machine) according to an example embodiment. The positioning system 90 may be one or more computer devices configured to execute one or more instructions. The computer devices may be embodied by a processor (or multiple processors) and computer-readable storage among the components discussed above. By way of example and not limitation, the computer devices may be located in... Figure 1 Tower 30 shown Figures 1-4 The trolley shown Figures 5-10 The bed, etc. shown.

[0101] like Figure 15 As shown, the positioning system 90 may include a positioning module 95 that processes input data 91-94 to generate position data 96 for the distal end of a medical device. The position data 96 may be data or logic representing the position and / or orientation of the distal end of the device relative to a reference frame. The reference frame may be relative to a patient's anatomy or a known object (such as an EM field generator) (see the discussion of EM field generators below).

[0102] The various input data are now described in more detail 91-94. Preoperative mapping can be accomplished using a collection of low-dose CT scans. The preoperative CT scans are reconstructed into three-dimensional images, which are visualized, for example, as “slices” of cross-sectional views of the patient’s internal anatomy. When analyzed in whole, image-based models of the anatomical cavities, spaces, and structures of the patient’s anatomical structures, such as the patient’s lung network, can be generated. Techniques such as centerline geometry can be determined and approximated from CT images to form a three-dimensional volume of the patient’s anatomy, which is referred to as model data 91 (also referred to as “preoperative model data” when generated using only preoperative CT scans). The use of centerline geometry is discussed in U.S. Patent Application 14 / 523,760, the contents of which are incorporated herein by reference in their entirety. Network topology models can also be derived from CT images and are particularly well-suited for bronchoscopy.

[0103] In some implementations, the device may be equipped with a camera to provide visual data 92. The positioning module 95 can process the visual data to enable one or more vision-based position tracking methods. For example, preoperative model data can be used in conjunction with visual data 92 to enable computer vision-based tracking of a medical device (e.g., an endoscope or an instrument propelled through the working channel of an endoscope). For example, using preoperative model data 91, the robotic system can generate a library of expected endoscope images based on the model, with each image linked to a location within the model, based on the expected path of the endoscope's movement. In operation, the robotic system can refer to this library to compare real-time images captured at a camera (e.g., a camera at the distal end of the endoscope) with those images in the image library to aid in positioning.

[0104] Other computer vision-based tracking techniques use feature tracking to determine camera motion, and thus, endoscope motion. Some features of the localization module 95 can identify circular geometries corresponding to anatomical cavities in the preoperative model data 91 and track changes in those geometries to determine which anatomical cavity has been selected, as well as track the relative rotation and / or translational motion of the camera. The use of a topology map can further enhance vision-based algorithms or techniques.

[0105] Optical flow (another computer vision-based technique) can analyze the displacement and translation of image pixels in a video sequence within visual data 92 to infer camera movement. Examples of optical flow techniques can include motion detection, object segmentation calculation, brightness, motion compensation coding, stereo parallax measurement, and more. Through multiple iterations and comparisons of multiple frames, the movement and position of the camera (and therefore the endoscope) can be determined.

[0106] The positioning module 95 can use real-time EM tracking to generate the real-time position of the endoscope in a global coordinate system that can be registered to the patient's anatomy represented by a preoperative model. In EM tracking, an EM sensor (or tracker), including one or more sensor coils embedded in one or more locations and orientations within the medical instrument (e.g., an endoscopic tool), measures changes in the EM field generated by one or more static EM field generators positioned at known locations. The positional information detected by the EM sensor is stored as EM data 93. The EM field generator (or transmitter) can be placed close to the patient to generate a low-intensity magnetic field detectable by the embedded sensor. The magnetic field induces a small current in the sensor coil of the EM sensor, which can be analyzed to determine the distance and angle between the EM sensor and the EM field generator. These distances and orientations can be "registered" to the patient's anatomy (e.g., a preoperative model) during surgery to determine the geometric transformations that align a single location in the coordinate system with its orientation in the preoperative model of the patient's anatomy. Once registered, an embedded EM tracker in one or more orientations of the medical device (e.g., the distal end of an endoscope) can provide real-time indication of the medical device’s progress through the patient’s anatomy.

[0107] Robot commands and kinematic data 94 can also be used by the positioning module 95 to provide orientation data 96 for the robotic system. Device pitch and yaw from joint movement commands can be determined during preoperative calibration. During surgery, these calibration measurements can be combined with known insertion depth information to estimate the instrument's orientation. Alternatively, these calculations can be analyzed in conjunction with EM, vision, and / or topology modeling to estimate the medical device's orientation within the network.

[0108] like Figure 15 As shown, the positioning module 95 can use multiple other input data. For example, although in Figure 15 Not shown, but an instrument using shape sensing fibers can provide shape data that a positioning module 95 can use to determine the position and shape of the instrument.

[0109] The localization module 95 can use the input data 91-94 in combination. In some cases, such combination can use a probabilistic method, where the localization module 95 assigns confidence weights to the location determined based on each of the input data 91-94. Therefore, in cases where the EM data may be unreliable (e.g., in the presence of EM interference), the confidence of the location determined by the EM data 93 may be reduced, and the localization module 95 may rely more heavily on the visual data 92 and / or robot commands and kinematic data 94.

[0110] As discussed above, the robotic systems discussed in this paper can be designed as a combination of one or more of the technologies mentioned above. The computer-based control system of a robotic system located in a tower, bed, and / or trolley can store computer program instructions in, for example, a non-transitory computer-readable storage medium (such as a permanent magnetic storage drive, a solid-state drive, etc.). When executed, these computer program instructions cause the system to receive and analyze sensor data and user commands, generate control signals for the entire system, and display navigation and positioning data, such as the instrument's orientation in a global coordinate system and anatomical diagrams.

[0111] 2. Controller for a system for enabling remote operation of robots

[0112] Robot-enabled remotely operated systems (such as those described above) may include input devices or controllers configured to allow an operator (e.g., a physician performing a robot-enabled medical procedure) to manipulate and control one or more instruments. In some embodiments, the robot-enabled remotely operated system includes a controller for operating one or more medical instruments. Those skilled in the art will appreciate that the controllers described herein can also be applied in non-medical environments. For example, the controller may be used to manipulate tools involving hazardous substances. Furthermore, in some embodiments, the controllers described herein may be used to grasp objects in physical and / or virtual environments. In some embodiments, the controller may be self-contained as a service robot that interacts with a human operator. In some embodiments, the controller may be coupled to an instrument (e.g., communicative ground, electronic ground, electrical ground, wireless ground, and / or mechanical ground) such that manipulation of the controller causes corresponding manipulation of the instrument. In some embodiments, the controller and instrument are arranged as a master-slave pair. In some embodiments, the controller may be referred to as a manipulator, simulator, master device, interface, etc. In some embodiments, the controller may include multiple connectors assembled in parallel or series.

[0113] The controller can serve as an input device for an operator to control the movement of a medical device (such as an endoscopic, endoscopic, laparoscopic, or open surgical instrument). Movement of the controller by the operator can guide movement of the medical device. For example, when the operator translates the controller in three-dimensional space (e.g., up, down, left, right, back, forward), the system can cause a corresponding translation of the medical device. Similarly, if the operator rotates the controller (e.g., about any one of three orthogonal axes), the system can cause a corresponding rotational movement of the medical device. The controller may also include inputs that allow the operator to actuate the medical device. For example, if the medical device includes a gripper, the controller may include inputs that allow the operator to open and close the gripper.

[0114] The controller can also provide tactile feedback to the operator. For example, in some embodiments, the force or torque applied to the medical device can be transmitted back to the operator via the controller. In some embodiments, providing tactile feedback to the operator via the controller offers the user an improved operating, control, or actuation experience. In some embodiments, clear tactile cues can be provided to make it easier for the operator to interact with and operate the controller.

[0115] In some implementations, the controller is also used, for example, to align the operator's hand with the orientation of the medical device when switching medical devices. For instance, if a medical device is positioned inside a patient during a medical procedure, it is important that the device is not accidentally or unintentionally moved. Therefore, when the operator wishes to control a medical device already positioned inside the body, the controller can first move to match the orientation of the medical device, while the device remains in place. With the controller correctly oriented to match the orientation of the medical device, the operator can then use the controller to manipulate the medical device.

[0116] In some embodiments, the robot-enabled medical system includes a controller with seven degrees of freedom (DOFs) that follow the movements of an operator's hand. These seven DDFs include three positional DDFs (e.g., translational motion in x, y, z space), three rotational DDFs (e.g., rotational motion about pitch, roll, and yaw axes), and one (or more) instrument actuation DDFs (e.g., angular DDFs). In some embodiments, the instrument actuation DDFs control the opening and closing of end effectors (such as grippers or graspers) of the medical device to hold an object. In some embodiments, the instrument actuation DDFs may be omitted. In some embodiments, the controller may include more or fewer DDFs. For example, in some embodiments, the controller may include more than three positional DDFs or more than three rotational DDFs to provide one or more redundant DDFs. In some embodiments, redundant DDFs may provide the controller with additional mechanical flexibility, for example, to avoid singularities caused by the controller's mechanical structure.

[0117] Figure 16A A block diagram of an embodiment of a robot-enabled medical system 100 is shown, including schematic diagrams of an embodiment of a controller 102 and an embodiment of an embodiment of a robot-enabled medical device 310. As briefly described above, the controller 102 can be coupled to the robot-enabled medical device 310 such that manipulation of the controller 102 causes substantially corresponding movement of the robot-enabled medical device 310, and forces applied to the robot-enabled medical device 310 can be transmitted back to the controller and tactilely transmitted to the operator. In some embodiments, the controller 102 and the robot-enabled medical device 310 are arranged in a master-slave configuration.

[0118] In an exemplary embodiment of system 100, controller 102 includes a handle 104, a gimbal 106, and a positioning platform 108. The handle 104 may be configured to be gripped by an operator. As shown, in some embodiments, the handle 104 is coupled to the gimbal 106 and the positioning platform 108. As described above, the handle 104 may include one or more degrees of freedom to actuate the device. The gimbal 106 may be configured to provide one or more rotational degrees of freedom to allow an operator to rotate the handle 104. In some embodiments, the gimbal 106 is configured to provide at least three rotational degrees of freedom. For example, the gimbal 106 may be configured to allow an operator to rotate the handle 104 about a pitch axis, a roll axis, and a yaw axis. An exemplary gimbal 106 is shown in... Figures 17-19B The positioning platform 108 is shown in the diagram and described in more detail below. The positioning platform 108 may be configured to provide one or more translational (also referred to herein as positional) degrees of freedom to allow an operator to translate the handle 104. In some embodiments, the positioning platform 108 is configured to provide at least three positional degrees of freedom. For example, the positioning platform 108 may be configured to allow an operator to translate the handle 104 in three-dimensional space (e.g., the x, y, and z directions). An exemplary positioning platform 108 can be seen in… Figure 16C The details are described below. The gimbal 106 and the positioning platform 108 together enable the user to manipulate the handle 104.

[0119] In the illustrated embodiment, the robot-enabled medical device 310 includes an instrument or tool 312 (which may include an end effector), an instrument actuator 314, and a robotic arm 316 (or other instrument positioning device). The medical tool 312 may be, for example, the above... Figure 9 The laparoscopic instrument 59 shown, as well as other types of endoscopic or laparoscopic medical devices as described throughout this application and which will be apparent to those skilled in the art, are included. Medical tool 312 may include one or more end effectors. The end effector may be positioned at the distal end of the medical tool 312. The end effector may be configured for insertion into a patient. In some embodiments, the end effector may be a grasper, clamp, cutter, bushing device, or scissors, etc. In some embodiments, medical tool 312 may include a mirror or camera.

[0120] Medical tool 312 may be attached to instrument actuator 314. Instrument actuator 314 may be configured to actuate medical tool 312 as described above. For example, instrument actuator 314 may be configured to pull one or more pull wires of medical tool 312 to actuate medical tool 312. In some embodiments, instrument actuator 314 may be an instrument drive mechanism as described above. Instrument actuator 314 may be attached to robotic arm 316, for example, as... Figure 13As shown. The robotic arm 316 can be configured to perform joint movements or motions to further manipulate and position the medical instrument 312. Exemplary medical devices / tools, instrument actuators, and robotic arms are described above. Figures 1-15 The system is shown.

[0121] The controller 102 can be coupled to the robot-enabled medical device 310, such that manipulation of the handle 104 causes substantially corresponding movement of the medical tool 312, and the force applied to the medical tool 312 can be tactilely transmitted to the operator via the handle 104. Manipulation of the handle 104 can be measured or determined by measuring the force and movement of the gimbal 106 and the positioning platform 108. Movement of the medical tool 312 can be caused by joint movements and movements of the device actuator 314 and / or the robotic arm 316. Therefore, by manipulating the handle 104, the operator can control the medical tool 312.

[0122] In many cases, it is desirable for the controller 102 to be easy for the operator to manipulate, enabling the operator to exercise fine and precise control over the medical tool 312, and to use the controller 102 without becoming overly fatigued. One metric for measuring the ease of manipulation of the controller is the system's perceived inertia and / or perceived mass. In some embodiments, the system's perceived inertia is the mass of the system that the user feels as if it were a point mass when manipulating the handle 104. Generally, a controller 102 with lower perceived inertia is easier to manipulate. In other embodiments, perceived inertia includes the moment of inertia felt by the user when manipulating the handle 104.

[0123] As described below, the controller described in this patent application includes several novel and non-obvious features that provide advantages over existing systems. In some embodiments, the controller described herein is advantageously configured to operate using both admittance control and impedance control. As described below, a hybrid controller including both admittance control and impedance control can provide an improved user experience. In some embodiments, a hybrid controller including both admittance control and impedance control can advantageously provide lower or reduced perceived inertia compared to other controllers. In some embodiments, the hybrid controller can provide improved haptic feedback and response. Furthermore, as described below, in some embodiments, the controller described herein can prevent or reduce the likelihood of mechanical short circuits (described below) that can cause unstable and unpredictable movement. These and other features and advantages of the controller described in this patent application are further discussed in the following sections.

[0124] A. Hybrid Controller

[0125] Figure 16BThis is a block diagram of an embodiment of a controller 102 configured to operate using both impedance control and admittance control. Such a controller 102 may be referred to as a hybrid controller.

[0126] Impedance control and admittance control are two control schemes used to control robotic systems. Under impedance control, the system measures displacement (e.g., changes in position and velocity) and outputs force. For example, with impedance control, the system can measure the distance or velocity by which an operator moves the controller and, based on this measurement, generate a force on the instrument (e.g., via an actuating motor). Under impedance control, the operator's movement of the controller can reverse-drive multiple parts of the instrument. In many cases, using impedance control can result in large perceived inertia. This may be because, for example, impedance control relies on the operator moving the controller. Under impedance control, the operator may have to overcome the controller's perceived mass or inertia to move it, making the controller feel heavy. With impedance control, the operator must physically overcome most or all of the inertia in the system to move the controller. Other controllers rely solely on impedance control, which can result in a system with higher perceived inertia or mass compared to the controller described herein. Due to this higher perceived inertia, the operator may experience excessive fatigue when using such other controllers.

[0127] Under admittance control, the system measures the force and / or torque applied to the controller by the operator and outputs the corresponding velocity and / or position of the controller. In some respects, admittance control is the opposite of impedance control. In some implementations, the use of admittance control can advantageously reduce the perceived inertia or mass of the system. Admittance control can be used to alter the dynamics of a controller perceived as having a large mass or inertia. In some cases, by using admittance control, the operator does not need to overcome the full inertia of the system to move the controller. For example, under admittance control, when a user applies a force to the controller, the system can measure that force and assist the user in moving the controller by driving one or more motors associated with the controller, thereby obtaining the desired velocity and / or position of the controller. In other words, for admittance control, a force sensor or force measurement sensor measures the force applied to the controller by the operator and moves the controller and the coupled robot-enabled medical device 310 in a perceivedly light manner. Admittance control can feel lighter than impedance control because, under admittance control, the perceived inertia of the controller can be hidden, as the motors in the controller can help accelerate the mass. In contrast, with impedance control, the user is responsible for all or almost all of the mass acceleration.

[0128] like Figure 16BAs illustrated in the embodiment, the controller 102 includes a handle 104, a gimbal 106, and a positioning platform 108. As described above, the gimbal 106 may be configured to provide one or more rotational degrees of freedom (e.g., three or four), and the positioning platform 108 may be configured to provide one or more rotational degrees of freedom (e.g., three or four). The gimbal 106 and positioning platform 108 allow a user to move the handle 104 in three-dimensional space and rotate the handle 104 about pitch, roll, and yaw axes. Manipulation of the handle 104 causes movement of the corresponding medical device. Furthermore, the handle 104, gimbal 106, and positioning platform 108 may be configured to provide the operator with tactile feedback representing the force applied to the medical device.

[0129] like Figure 16B As shown by the dashed box, in controller 102, gimbal 106 is configured for impedance control, and positioning platform 108 is configured for admittance control. Therefore, in some embodiments, the translational or positional degrees of freedom of positioning platform 108 depends on admittance control, while the rotational degrees of freedom of gimbal 106 depends on impedance control. This type of hybrid controller 102 can have several advantages, as further described below. In other embodiments (not shown), gimbal 106 is configured for admittance control, and positioning platform 108 is configured for impedance control. In some embodiments, both gimbal 106 and positioning platform can be configured for admittance control, or both can be configured for impedance control.

[0130] To utilize admittance control, controller 102 includes at least one force sensor or force measurement sensor 112. Force sensor 112 is configured to measure the force applied to controller 102 by an operator (generally, the force applied to handle 104). The output signal (a measure of force) of force sensor 112 is used to provide control signals for controlling the movement of controller 102, such as positioning platform 108. Robot-enabled medical device 310 will follow the movement of handle 104 (e.g., by activating one or more motors in device actuator 314 or robotic arm 316). In some embodiments, force sensor 112 may be a force sensor measuring three degrees of freedom of force in three directions.

[0131] In the illustrated embodiment, the force sensor 112 is positioned within the universal joint 106. (The following is a description of the embodiment.) Figure 18 and Figure 19ATwo different embodiments are shown where the force sensor 112 can be positioned within the gimbal 106. Other locations for the force sensor 112 are also possible. In some embodiments, the force sensor 112 is positioned within the positioning platform 108. In some embodiments, more than one force sensor 112 (e.g., two, three, four, or more force sensors) may be included, which can be positioned within the handle 104, the gimbal 106, and / or the positioning platform 108.

[0132] In some embodiments, the force sensor 112 is advantageously positioned on the distal side of the controller 102 (closer to the handle 104). This is because, in some embodiments, admittance control can be used to conceal the sensing quality of multiple portions of the controller 102 located near the force sensor 112 (e.g., multiple portions of the controller 102 located on the side of the force sensor 112 opposite to the handle 104).

[0133] Figure 16C This is a perspective view of an embodiment of controller 102. In the illustrated embodiment, controller 102 is configured to allow manipulation of one or more medical devices. As shown, controller 102 may include a pair of handles 104. In some embodiments, the pair of handles 104 manipulate a single device, while in other embodiments, each handle in the pair of handles 104 manipulates its own corresponding device. Each handle 104 is connected to a universal joint 106. Each universal joint is connected to a positioning platform 108. In some embodiments, the handle 104 is considered to be distal to the universal joint 106, which is considered to be distal to the positioning platform 108. The handles 104 and the universal joint 106 are... Figure 17 This is shown in more detail below, and will be described in more detail below.

[0134] like Figure 16C As shown, in the illustrated embodiment, each positioning platform 108 includes a SCARA (Selective Compliant Assembly Robotic Arm) 118 with multiple connectors coupled to a post 114 via prism joints 116. The prism joints 116 are configured to translate along the post 114 (e.g., along guide rail 117) to allow the handle 104 to translate in the z-direction, thus providing a first degree of freedom. The SCARA arm 118 is configured to allow the handle 104 to move in the xy-plane, thus providing two additional degrees of freedom. Therefore, Figure 16C Each of the positioning platforms 108 shown is configured to provide three positional or translational degrees of freedom and allows the operator to position the handle 104 at any location in three-dimensional (e.g., x, y, z) space (within the reach of the positioning platform).

[0135] In some embodiments, the column 114 (and guide rail 117) extends along an axis aligned with the vertical direction of the workspace (e.g., the z-direction as shown in the figure), which may be aligned with the direction of gravity. The advantage of this positioning platform 108 is that it provides gravity compensation. In other words, the prism joint 116 of the positioning platform 108 maintains a constant orientation of the gimbal 106 relative to gravity.

[0136] In some implementations, the positioning platform 108 may have other configurations. For example, in all implementations, the positioning platform 108 does not need to include prism joints and / or SCARA arms.

[0137] In some implementations, a force sensor 112 may be provided in a portion of the controller 102 (e.g., in the gimbal 106). Figure 16C (Not shown in the diagram). Adding a force sensor 112 enables the controller to have admittance control in addition to impedance control. Under admittance control, the sensed inertia of the controller 102 can be reduced. This is because the mass of the gimbal 106 and / or the positioning platform can be hidden via the force sensor 112. This is likely because the force sensor 112 can measure the force applied to the controller and can be used to provide the output to drive the motor in the controller 102 to assist in the movement of the controller 102. The amount of hidden mass depends on the location of the force sensor 112. In some embodiments, the mass proximal to the force sensor 112 can be partially or substantially hidden, while the mass distal to the force sensor 112 will not be hidden.

[0138] In some implementations, the force sensor 112 is positioned distally on the controller 102 (e.g., in...). Figure 16CIn the gimbal 106 shown, the mass of the gimbal 106 can be partially or substantially hidden when operating the controller 102. Similarly, the mass of the positioning platform 108 (which has a relatively higher mass than the gimbal 106) can also be partially or substantially hidden when operating the controller 102. Hiding the mass advantageously results in lower perceived inertia for the clinician. Without the force sensor 112, in order to move the handle 104 in the z-direction, the operator would have to apply sufficient force to the handle 104 to lift the handle 104, the gimbal 106, and the SCARA arm 118 upwards. Furthermore, it is conceivable that a smaller force would be required to move the handle in the xy-plane compared to movement in the z-direction. This difference could lead to an uneven operating experience for the operator, making the controller 102 difficult to use. Therefore, by including the force sensor 112, as described herein, the controller 102 assists the user in translating the handle 104 in the x, y, and z directions and provides a more uniform and controlled operating experience. In some implementations, the force sensor 112 enables the positioning platform 108 to operate substantially or entirely under admittance control. The gimbal 106 can have a relatively low moment of inertia compared to the positioning platform 108. This is likely because the gimbal 106 is typically much smaller than the positioning platform 108. Therefore, at least some portions of the gimbal 106 can be adapted for impedance control.

[0139] One advantage of the hybrid impedance / admittance controller 102 described herein is that the perceived inertia of the system can be relatively lower than that of a system relying solely on impedance control. Furthermore, the mechanical structure of the hybrid controller 102 can be simpler because admittance control can be used to supplement and smooth the movement of the system. In contrast, the mechanical structure of impedance-only systems is typically very complex in an attempt to normalize the forces required to move the system in different directions and minimize the perceived inertia.

[0140] In some implementations, by using a hybrid controller 102 as described herein, it is possible that the mass and inertia of the gimbal 106 can actually be increased relative to the gimbal of a controller with only impedance, because too much of the total mass and inertia of the controller 102 can be hidden by the admittance control of the positioning platform. In some implementations, increasing the size of the gimbal may allow the use of a larger motor, which may allow the controller to provide stronger tactile feedback compared to other systems that require the use of lightweight gimbals and motors to avoid increasing the total mass and inertia.

[0141] like Figure 16CAs shown, the hybrid controller 102 can be viewed as a series of connectors and joints, for example, as a series connector manipulator. The handle 104, the universal joint 106, and the positioning platform 108 each include one or more connectors operatively coupled, wherein the nearest connector is adjacent to the post 114 of the positioning platform 108, and the farthest connector is part of the handle 104 itself. In some embodiments, one or more force sensors 112 ( Figure 16C (Not shown) is inserted into controller 102 to provide admittance control over at least some portions of controller 102. Other portions of controller 102 can be controlled by a clinician or operator via impedance control (or, in some cases, passive control). In some embodiments, connectors and joints proximal to force sensor 112 may be directly or indirectly affected by force sensor 112. Therefore, manipulation of these proximal connectors and joints can be aided by admittance control. In some embodiments, connectors and joints distal to force sensor 112 may not be directly or indirectly affected by force sensor 112. Therefore, manipulation of these distal connectors and joints can be aided by impedance control. For example, in Figure 19A In the implementation scheme (discussed in more detail below), the force sensor 112 is positioned in the universal joint 106, such that the distal joints 128, 130, 132 ( Figure 17 The joints (as shown) may not be directly or indirectly affected by the force sensor 112. In other words, manipulation of the axis of the gimbal 106 at these joints is not directly or indirectly based on the output of the force sensor 112. These distal connectors and joints can be moved via impedance control. In contrast, connectors and joints located proximal to the force sensor 112 (such as those in the positioning platform 108) may be directly or indirectly affected by the force sensor 112. In other words, manipulation of the axis at these joints is directly or indirectly based on the output of the force sensor 112. These proximal connectors and joints can be moved via admittance control.

[0142] B. Example of force sensor positioning

[0143] As described above, in some embodiments, the force sensor 112 (or force sensor) is positioned within the gimbal 106. In some embodiments, the gimbal 106 provides rotational degrees of freedom for a controller 102 with impedance control, while the positioning platform 108 may provide positional degrees of freedom for the controller 102 with admittance control (e.g., based on the output of the force sensor 112 positioned within the gimbal 106). Numerous ways exist to position the force sensor 112 within the gimbal 106. The degree of reduction in the sense inertia of the controller 102 can be based in part on the position of the force sensor 112 within the gimbal 106. Two exemplary embodiments are described in this section, illustrating force sensors 112 positioned in two different portions of the gimbal 106. Other embodiments are also possible.

[0144] Figure 17 This is an isometric view of an embodiment of the universal joint 106. As shown, in some embodiments, the universal joint 106 is positioned at the distal end of the positioning platform 108. Figure 17 Only the last connector of the positioning platform 108 is shown in the image. As used in this patent application, in the context of controller 102, the term "far side" refers to the direction toward the handle 104 (e.g., the handle 104 is the farthest part of controller 102), and the term "proximal side" refers to the opposite direction (e.g., toward the post 114, see [link]). Figure 16C Therefore, the proximal end of the universal bracket 106 can be attached to the distal end of the positioning platform 108. Therefore, the handle 104 can be positioned at the distal end of the universal bracket 106.

[0145] In some embodiments, the handle 104 is configured to be gripped by an operator. The handle 104 may be configured to simulate or mimic a medical device controlled by the controller 102. In some embodiments, the handle includes a gripper handle (e.g., a radially symmetrical gripper handle), a stylus, a paddle handle, etc. In an illustrated embodiment, the handle 104 includes two actuator arms 120 configured to provide the instrument actuation degrees of freedom discussed above. While gripping the handle 104, the operator can adjust the angle between the actuator arms 120 to control a corresponding angle associated with the controlled medical device. For example, in the case of a gripper, scissors, etc., the angle between the actuator arms 120 can be used to control the angle between the two jaws of the gripper.

[0146] In the illustrated embodiment, the universal joint 106 includes three arms or connectors articulated together. Arranged from distal to proximal and as shown... Figure 17 As shown, the universal bracket 106 includes a first connector 122, a second connector 124, and a third connector 126. They are arranged from the distal side to the proximal side and as shown... Figure 17As shown, the universal joint 106 also includes a first joint 128, a second joint 130, a third joint 132, and a fourth joint 134. These joints allow various connectors to rotate, thereby providing the universal joint 106 with the rotational degrees of freedom discussed above.

[0147] The handle 104 is connected to the distal end of the first connector 122 via a first joint 128. The first joint 128 may be configured to allow the handle 104 to rotate relative to the first connector 122. In an illustrated embodiment, the first joint 128 allows the handle 104 to rotate about a roll axis 136. In some embodiments, the roll axis 136 is aligned with the longitudinal axis of the handle 104. The first joint 128 may be a rotary joint.

[0148] The proximal end of the first connector 122 is connected to the distal end of the second connector 124 via a second joint 130. The second joint 130 may be configured to allow rotation of the handle 104 and the first connector 122 relative to the second connector 124. In an illustrated embodiment, the second joint 130 allows rotation of the handle 104 and the first connector 122 about a yaw axis 138. In some embodiments, the yaw axis 138 extends through the second joint 130 and intersects the roll axis 136 at the center point of the handle 104. The second joint 130 may be a rotary joint. As shown, in some embodiments, the first connector 122 includes an L-shape. In some embodiments, the first connector 122 is configured to have a groove formed therein for receiving the second connector 124 and allowing rotation of the second connector 124 relative to the first connector 122.

[0149] The proximal end of the second connector 124 is connected to the distal end of the third connector 126 via a third joint 132. The third joint 132 may be configured to allow rotation of the handle 104, the first connector 122, and the second connector 124 relative to the third connector 126. In an illustrated embodiment, the third joint 132 allows rotation of the handle 104, the first connector 122, and the second connector 124 about a pitch axis 140. In some embodiments, the pitch axis 140 extends through the third joint 132 and intersects the roll axis 136 and the yaw axis 138 at the center point of the handle 104. The third joint 132 may be a rotary joint. As shown, in some embodiments, the second connector 124 includes an L-shape. In some embodiments, the L-shaped second connector 124 is received in a recess in the L-shaped first connector 122 (e.g., Figure 17 (As shown). In other embodiments, the L-shaped first connector 122 may be received in the groove of the L-shaped second connector 124.

[0150] In the illustrated embodiment, the first joint 128, the first connector 122, the second joint 130, the second connector 124, and the third joint 132 provide three rotational degrees of freedom, thereby allowing adjustment of the rotation of the handle 104 in pitch, roll, and yaw. In the illustrated embodiment, the gimbal 106 also includes a third connector 126 and a fourth joint 134 providing redundant rotational degrees of freedom. This is not required in all embodiments but provides greater mechanical flexibility to the gimbal 106.

[0151] As shown, the distal end of the third connector 126 is connected to the proximal end of the second connector 124 via a third joint 132. The proximal end of the third connector 126 is connected to the distal end of the positioning platform 108 via a fourth joint 134. The fourth joint 134 may be configured to allow rotation of the handle 104, the first connector 122, the second connector 124, and the third connector 126 relative to the positioning platform 108. In an illustrated embodiment, the fourth joint 134 allows rotation of the handle 104, the first connector 122, the second connector 124, and the third connector 126 about an axis 142. In some embodiments, the axis 142 is parallel to the yaw axis 138. In some embodiments, the yaw axis 138 and the axis 142 are coaxial, but this is not necessarily the case in all embodiments, as shown. The axis 142 (and the yaw axis 138) may be parallel to the direction of gravity to maintain the orientation of the gimbal relative to the direction of gravity, as described above. The fourth joint 134 may be a rotary joint. As shown in the figure, in some implementation schemes, the third connector 126 includes an L-shape.

[0152] Figure 18 and Figure 19A Two embodiments of the gimbal 106 are shown, illustrated in cross-sectional views of the connectors of the gimbal 106 to show some of the internal structure of the gimbal 106. As will be described in more detail below, these two embodiments provide examples of locations within the gimbal 106 where a force sensor 112 can be positioned. Although two examples are shown, other arrangements of the force sensor 112 are possible. In some embodiments, the term force sensor 112 may encompass a single force sensor or multiple sub-force sensors.

[0153] Figure 18A cross-sectional view of a first embodiment of the gimbal 106 is shown. As shown, in the first embodiment, a force sensor 112 is positioned in the first connector 122. In other words, the force sensor 112 is positioned between the first joint 128 and the second joint 130. In the first embodiment of the gimbal 106, the force sensor 112 is positioned near the distal end of the controller 102. Specifically, in this embodiment, the force sensor 112 is positioned in the distal connector of the gimbal 106, which is the last connector of the gimbal 106 before the handle 104. Due to the distal positioning of the force sensor 112, there is a very small mass distal to the force sensor 112 in this embodiment. Therefore, the sensing inertia of the controller 102 in this embodiment, including the gimbal 106, can be greatly reduced.

[0154] exist Figure 18 In the illustrated embodiments, the motors associated with the joints are visible. For example, as shown, a first motor 144 is positioned within a first joint 128, a second motor 146 is positioned within a second joint 130, a third motor 148 is positioned within a third joint 132, and a fourth motor 150 is positioned within a fourth joint 134. In some embodiments, the motors can be used to provide tactile feedback via the gimbal 106. In some embodiments, an encoder co-positioned with the motors can be configured to provide measurements of joint movement (e.g., displacement and position) for impedance control of the gimbal 106.

[0155] like Figure 18 As shown, the second motor 146, the third motor 148, and the fourth motor 150 are all positioned proximal to the force sensor 112. Therefore, in some embodiments, the mass of these motors can be concealed, thereby reducing perceived inertia. In some embodiments, this allows for the use of larger motors, which can provide stronger haptic feedback via the gimbal 106.

[0156] Figure 19A A cross-sectional view of a second embodiment of the universal joint 106 is shown. As shown, in the second embodiment, a force sensor 112 is positioned in a third connector 126. In other words, the force sensor 112 is positioned between a third joint 132 and a fourth joint 134. This is in contrast to the first embodiment of the universal joint 106. Figure 18In contrast, in the second embodiment, the force sensor 112 is positioned closer to the source. Therefore, in the second embodiment, there is more mass (e.g., the mass of the handle 104, the first connector 122, and the second connector 124) on the distal side of the force sensor 112, which contributes to higher sensing inertia throughout the system, and thus, the controller 102 of the second embodiment, including the gimbal 106, can be sensed more effectively than the controller 102 of the first embodiment, which includes the gimbal 106. Figure 18 Heavier (higher perceived inertia). However, because the second embodiment of the gimbal 106 can be included on the hybrid controller 102 as described above, an overall reduction in perceived inertia is still achieved compared to other controllers that rely entirely on impedance control. Additionally, the second embodiment of the gimbal 106 offers several unique advantages in some respects. For example, the second embodiment of the gimbal 106 reduces the rotational inertia of the gimbal 106 by positioning the force sensor 112 in the third connector 126. In the hybrid controller, because the gimbal 106 can be impedance-controlled, the operator will feel all the rotational inertia of the gimbal 106. Therefore, maintaining low inertia can be beneficial for the user experience. Furthermore, when... Figure 18 Compared to the first embodiment, the second embodiment of the universal bracket 106 can provide a reduced risk of mechanical short circuits, as discussed in the following sections.

[0157] exist Figure 19A In the illustrated embodiment, the motors associated with the joints are visible. For example, as shown, a first motor 144 is located within a first joint 128, a third motor 146 is located within a third joint 132, and a fourth motor 150 is located within a fourth joint 134. The gimbal 106 also includes a second motor 148 associated with rotation of the second joint 130; however, as Figure 19A As shown, the second motor 148 is not located at the second joint 130. Instead, the second motor 148 may be located in the third joint 132 and mechanically connected to the second joint 130. This is in Figure 19B It is most clearly seen in the middle.

[0158] Figure 19B An additional view of a second embodiment of the gimbal 106 is provided. In this view, the cover of the connector is shown as transparent to expose some internal components of the gimbal 106. As shown, a second motor 148 is positioned in a third joint 132 and connected to the second joint 130 via a novel cable drive system 152. The cable drive system 152 advantageously acts as a transmission between the second joint 130 and the second motor 148. The cable drive system may include one or more cables guided through one or more cable pulleys in the second connector 124 of the gimbal 106.

[0159] In this embodiment, the gimbal 106 has the additional advantage of allowing the second joint 130 to be controlled by a remotely positioned second motor 148. The advantage of the remotely positioned second motor 148 is that it can be placed near the proximal portion of the gimbal 106, rather than near the second joint 130 itself. Positioning the second motor 146 within the third connector 126 (opposite to the second connector 124) reduces the rotational inertia of the gimbal. As mentioned above, reducing rotational inertia can be beneficial because the gimbal 106 is impedance-controlled, thus requiring the user to overcome the inertia of the gimbal 106 to operate the controller.

[0160] As previously mentioned, a motor can be used to provide tactile feedback via the gimbal 106. Furthermore, in some embodiments, the motor can be configured to provide measurements of joint movement (e.g., displacement and position) for impedance control of the gimbal 106.

[0161] Although it has been referenced Figures 17-19B Two embodiments of the gimbal 106 including force sensors 112 have been described, but other embodiments are also possible. In other embodiments, the gimbal 106 may include two or more force sensors 112.

[0162] C. Reduce mechanical short circuits

[0163] While the use of a hybrid controller 102, incorporating both impedance control and admittance control, offers several significant advantages as discussed above (including reduced perceived inertia of the controller and improved operating experience), in some embodiments, the use of admittance control involves using a force sensor 112 to measure force. When implementing embodiments including the force sensor 112, the risk of mechanical short circuits should be considered. Mechanical short circuits can occur when the operator's hand, wrist, arm, or any combination thereof forms a rigid or physical bridge between a portion of the controller proximal to the force sensor 112 and a portion of the controller distal to the force sensor 112. The effects of a mechanical short circuit may include unintentional movements that are difficult for the operator to control.

[0164] Figure 20A This is an image illustrating an example of a mechanical short circuit. In the illustrated example, the operator is holding a handle 104 located distal to the force sensor 112. The operator applies a force to the handle 104 (e.g., by moving the handle 104), which is measured by the force sensor 112 and used for admittance control in a positioning platform (not shown). However, as shown, the operator also contacts a portion 153 of the gimbal, which is located proximal to the force sensor 112, causing a mechanical short circuit. The force applied to portion 153 is also measured by the force sensor 112, resulting in unintentional and uncontrollable movement.

[0165] In some implementations, a mechanical short circuit produces unintended movement because the system assumes the operator is applying all force at the handle 104, when this is not actually the case, for example, due to proximal contact with the force sensor 112. The operator can safely access any part of the controller or gimbal located distal to the force sensor 112. Contact with the controller proximal to the force sensor 112 can cause an unintended mechanical short circuit.

[0166] To reduce the risk of mechanical short circuits and increase the operator's safe access to portions of the controller without causing a mechanical short circuit, in some embodiments, a housing or cover may be provided above the force sensor 112. For example, for a connector including the force sensor 112, the cover may be attached to the connector only on the distal side of the force sensor 112, but extend over (without contacting) the portion of the connector located proximal to the force sensor 112. Since the cover is only attached to the distal side of the force sensor 112, contact with the cover is unlikely to cause a mechanical short circuit. In some embodiments, the cover may be molded over a lower component. In other embodiments, the cover may be a slider formed over a lower component.

[0167] Figure 20B A second embodiment of the universal joint 106 is shown (e.g., as shown in the figure). Figure 19A and Figure 19B The embodiment shown illustrates a cross-sectional view of a cover 154 including a third connector 126 for a force sensor 112. As shown, the force sensor 112 is positioned within the third connector 126. Therefore, a portion of the third connector 126 is positioned distal to the force sensor 112, and a portion 126P of the third connector 126 is positioned proximal to the force sensor 112. Contact with the proximal portion 126P of the third connector 126 would cause a mechanical short circuit. To reduce the possibility of a mechanical short circuit, the cover 154 extends over and covers the proximal portion 126P. For the universal joint 106 (… Figure 18 In the first embodiment, a similar cover can be implemented on the first connector 122.

[0168] Figure 20C and Figure 20D The first and second embodiments of the universal bracket 106 are shown, along with several portions thereof (in...). Figure 18 and Figure 19A (As shown in the figures), it can be touched without causing a mechanical short circuit. In these figures, the darker shaded areas can be touched without causing a mechanical short circuit. For example... Figure 20CAs shown, in a first embodiment of the gimbal 106, the handle 104 and the first connector 122 can be contacted without causing a mechanical short circuit. This is likely because the cover can extend over the first connector 122, which includes the force sensor 112. Figure 20D As shown, in a second embodiment of the gimbal 106, the handle 104, the first connector 122, the second connector 124, and the third connector 126 can be contacted without causing a mechanical short circuit. This is likely because the cover can extend over the third connector 123, which includes the force sensor 112. (Comparison) Figure 20C and Figure 20D Second Implementation Plan ( Figure 20D It can provide a solution that is superior to the first implementation scheme. Figure 20C A larger area to prevent mechanical short circuits. This reflects the trade-off between the two designs. Although the first implementation scheme ( Figure 20D The first embodiment can be perceived as lighter (because the force sensor 112 is positioned near the distal connector of the gimbal), but it can also have a larger area to withstand short circuits. In contrast, while the second embodiment ( Figure 20D The former may be perceived as heavier (because the force sensor 112 is positioned close to the proximal connector of the gimbal), but it can have a more protected area against short circuits. In any case, both designs offer a controller that is considered lighter than those relying solely on impedance control and feature novel covers that prevent the risk of mechanical short circuits. Those skilled in the art will appreciate that both embodiments offer specific advantages and are suitable for a variety of situations.

[0169] D. Exemplary Controller Method

[0170] Figure 21 This is a flowchart illustrating an exemplary method 210, in which a controller (e.g., a master device) controls a medical device (e.g., a slave device). Method 210 can be configured for hybrid control using both impedance control and admittance control. Although shown in sequence, the blocks of method 210 can be implanted in other sequences, or one or more of the blocks can occur substantially simultaneously. Method 210 begins at block 212, where a user can drive rotation of the controller via impedance control. At block 214, the user can also drive translation of the controller via admittance control. In some embodiments, admittance control can be enabled by one or more force sensors positioned in a gimbal of the controller.

[0171] At block 216, an output signal from the controller is delivered via a processor. The output signal may be based on impedance control and / or admittance control of the controller. At block 218, the motion of the robotic medical device is driven based on the output signal.

[0172] Figure 22This is a flowchart illustrating an exemplary controller method 220. Method 220 can be configured for hybrid control using both impedance control and admittance control. Although shown in sequence, the blocks of method 220 can be implemented in reverse order or can occur substantially simultaneously. Method 220 begins at block 222, where the handle of the controller is manipulated via impedance control to induce corresponding manipulation of the robotic medical device. In some embodiments, the handle is manipulated in one or more rotational degrees of freedom. In some embodiments, the handle is manipulated in at least three rotational degrees of freedom. In some embodiments, the handle is manipulated in at least pitch, roll, and yaw. In some embodiments, the manipulating handle includes a manipulating a gimbal.

[0173] At frame 224, the handle is manipulated via admittance control to induce corresponding manipulation of the robotic medical device. In some embodiments, the handle is manipulated in one or more positional or translational degrees of freedom. In some embodiments, the handle is manipulated in at least three positional or translational degrees of freedom. In some embodiments, the handle is manipulated in the x, y, and z directions. In some embodiments, the handle includes a manipulation positioning platform.

[0174] E. Hybrid controller with degree-of-freedom constraints

[0175] The hybrid controller described above typically uses impedance-controlled gimbal and admittance-controlled positioning platform. That is, for the hybrid controller described above, all three rotational degrees of freedom of the gimbal can be controlled by impedance, and all three positional degrees of freedom of the positioning platform can be controlled by admittance.

[0176] This section describes an additional type of hybrid controller that may include an impedance-controlled gimbal (e.g., with three rotational degrees of freedom) and a positioning platform under admittance control in one degree of freedom (e.g., on the vertical translation axis) and impedance control in the other two degrees of freedom. Therefore, for this type of hybrid controller, there may be a constraint on one degree of freedom of admittance control. That is, admittance control is limited or constrained to only one degree of freedom, such as the vertical translation degree of freedom.

[0177] As described here, this can be achieved by providing a force sensor with one degree of freedom in the gimbal (as opposed to the force sensor 112 with the three degrees of freedom mentioned above). A hybrid controller with degree-of-freedom constraints can lead to many advantages, such as greater stability, robustness, and reduced cost.

[0178] In some embodiments, the hybrid controller constrained to only one degree of freedom may include the same or similar kinematic structure as the controller 102 described above. For example, a hybrid controller constrained to only one degree of freedom may include a gimbal 106 and a positioning platform 108 as shown above, the positioning platform including multiple connectors joined by joints. However, for a hybrid controller constrained to only one degree of freedom, the force sensor 112 will be a one-degree-of-freedom force sensor that measures force in only a single direction. In some embodiments, the force sensor 112 is configured to measure force only in the direction of gravity or along the axis of column 114 (see [link to relevant documentation]). Figure 16C ).

[0179] In one implementation scheme Figure 18 The force sensor 112 shown can be a force sensor with one degree of freedom. In another embodiment, Figure 19A and Figure 19B The force sensor 112 shown can be a force sensor with one degree of freedom. In another embodiment, the force sensor 112 can be placed behind (e.g., proximal) the fourth joint 134 of the universal joint 106 (see [reference]). Figure 18 and Figure 19A This implementation may have an increased mass on the distal side of the force sensor 112 (when compared with the implementation described above). In some implementations, a larger distal mass and / or lower stiffness of the force sensor 112 introduces a lower frequency of mechanical vibration, resulting in poorer admittance control performance and / or stability. By switching to a force sensor 112 with only one degree of freedom, this type of hybrid controller has the potential to reduce package size, mass, and cost while increasing the stiffness, range, and accuracy of the force sensor 112, which can lead to better admittance performance and / or stability.

[0180] In some embodiments, the positioning platform 108 of the hybrid controller with degree-of-freedom constraints may be similar to the positioning platform 102 shown in FIG. 16. For example, the positioning platform may include a prism base axis aligned with the vertical direction of the workspace. The positioning platform may also include two rotary joints arranged in a SCARA configuration, which provide planar motion perpendicular to the prism joints. In some embodiments, the prism axis may be implemented using a lead screw actuator or a linear actuator. In some embodiments, the use of a linear actuator can reduce backlash, decrease noise during actuation, and have lower motor inertia.

[0181] Furthermore, in some embodiments, the direct drive current can also be used for more accurate vertical force measurement and / or estimation. To enhance impedance control of the planar SCARA portion, the motor driving the SCARA portion can be highly reverse-driven. In some embodiments, the motor associated with the elbow of the SCARA can be remotely positioned in column 114. These improvements reduce the inertia of the planar connectors of the positioning platform, thereby reducing the mass in the planar positioning degree of freedom of impedance control.

[0182] The frequency of mechanical vibration increases due to the reduction in inertia and the removal or reduction of gearbox compliance, thereby also improving the performance and / or stability of vertical admittance control. In terms of perceived mass, across the planar degrees of freedom of the positioning platform (e.g., SCARA), they are similar and relatively uniform, dominated by the mass of the gimbal. The original mass along the vertical axis can be higher, but admittance control can be tuned to match the perceived mass of the other degrees of freedom for more uniform performance throughout the workspace. When the accuracy of current-based force measurements is insufficient, a one-degree-of-freedom force sensor 112 can be used to measure the vertical force at the prism actuation location. Combined with calibration and force measurement at the distal end of the gimbal, this information can estimate the additional vertical external force at any point distal to the vertical actuation. Therefore, all mechanical short circuits and accidental collisions can be detected and prevented, enhancing safety.

[0183] 3. Implementation System and Terminology .

[0184] The embodiments disclosed herein provide systems, methods, and apparatus for robot-enabled medical systems. Various embodiments described herein include controllers for robot-enabled medical systems.

[0185] It should be noted that, as used herein, the terms “couple,” “coupling,” “coupled,” or other variations of the word “coupled” can indicate an indirect or direct connection. For example, if a first component is “coupled” to a second component, the first component may be indirectly connected to the second component or directly connected to the second component via another component.

[0186] The position estimation and robot motion actuation functions described herein can be stored as one or more instructions on a processor-readable or computer-readable medium. The term "computer-readable medium" means any available medium that can be accessed by a computer or processor. By way of example, and not limitation, such a medium may include random access memory (RAM), read-only memory (ROM), electrically erasable programmable read-only memory (EEPROM), flash memory, compact disk read-only memory (CD-ROM) or other optical disk storage devices, magnetic disk storage devices or other magnetic storage devices, or any other medium that can be used to store desired program code in the form of instructions or data structures and that can be accessed by a computer. It should be noted that a computer-readable medium can be tangible and non-transitory. As used herein, the term "code" can mean software, instructions, code, or data that can be executed by a computing device or processor.

[0187] The methods disclosed herein include one or more steps or actions for implementing the methods. The method steps and / or actions may be interchanged without departing from the scope of the claims. In other words, the order and / or use of specific steps and / or actions may be modified without departing from the scope of the claims unless proper operation of the described method requires a specific order of steps or actions.

[0188] As used herein, the term "multiple" means two or more. For example, multiple components indicates two or more components. The term "determine" encompasses a variety of actions, and therefore, "determine" can include calculation, operation, processing, derivation, investigation, lookup (e.g., searching in a table, database, or another data structure), ascertainment, etc. Additionally, "determine" can include receiving (e.g., receiving information), accessing (e.g., accessing data in memory), etc. Furthermore, "determine" can include parsing, selecting, picking, building, etc.

[0189] Unless otherwise explicitly stated, the phrase “based on” does not mean “based on only”. In other words, the phrase “based on” describes both “based on only” and “based on at least”.

[0190] As used herein, the term “about” or “approximately” refers to a range of measurements of length, thickness, quantity, time period, or other measurable values. Such ranges encompass variations of + / -10% or less, preferably + / -5% or less, more preferably + / -1% or less, and even more preferably + / -0.1% or less relative to a specified value, provided that such variations are appropriate for functioning in the disclosed apparatus, systems, and techniques.

[0191] The foregoing description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the general principles defined herein may be applied to other embodiments without departing from the scope of the invention. For example, it should be understood that those skilled in the art will be able to employ numerous corresponding alternatives and equivalent structural details, such as equivalent methods of fastening, mounting, coupling, or engaging tool components, equivalent mechanisms for generating specific actuating movements, and equivalent mechanisms for delivering electrical energy. Therefore, the invention is not intended to be limited to the embodiments shown herein, but is endowed with the widest scope consistent with the principles and novel features disclosed herein.

Claims

1. A robot-enabled remote operation system, comprising: A controller and a robotic tool capable of being manipulated by the controller, wherein the controller includes: A handle, the handle being configured to be actuated by an operator; A gimbal, which is coupled to the handle and configured to allow manipulation of the handle in multiple degrees of freedom, wherein the gimbal is configured for impedance control such that manipulation of the handle causes corresponding manipulation of the robotic tool. A positioning platform is attached to the gimbal and configured to allow manipulation of the handle in multiple degrees of freedom, wherein the positioning platform is configured for admittance control such that manipulation of the handle causes corresponding manipulation of the robotic tool.

2. The system of claim 1, wherein the robotic tool is a medical device.

3. The system according to claim 1, wherein the universal joint is connected to the positioning platform via a rotary joint.

4. The system of claim 1, wherein the universal joint allows the handle to be manipulated in at least three rotational degrees of freedom.

5. The system of claim 1, wherein the positioning platform allows the handle to be manipulated in at least three degrees of freedom.

6. The system of claim 1, further comprising a robotic arm coupled to the robotic tool, wherein the robotic tool comprises at least one of a catheter, endoscope, gripper, sealer, or cutter.

7. The system according to claim 1 further includes a force sensor positioned within the universal joint.

8. The system of claim 7, wherein the admittance control of the positioning platform is based on the output signal of the force sensor.

9. The system of claim 7, wherein the universal joint includes at least a first connector, a second connector, and a third connector, the first connector, the second connector, and the third connector being arranged from distal to proximal and connected by a joint, and wherein the force sensor is positioned within the first connector.

10. The system of claim 9, wherein the joint is a rotary joint.

11. The system of claim 7, wherein the universal joint includes at least a first joint, a second joint, and a third joint, the first joint, the second joint, and the third joint being arranged from distal to proximal and connected by a connector, and wherein the force sensor is positioned distal to the second joint.

12. The system of claim 7, wherein the universal joint includes at least a first connector, a second connector and a third connector, the first connector, the second connector and the third connector being arranged from distal to proximal and connected by a joint, and wherein the force sensor is positioned within the third connector.

13. The system of claim 7, wherein the universal joint includes at least a first joint, a second joint, and a third joint, the first joint, the second joint, and the third joint being arranged from distal to proximal and connected by a connector, and wherein the force sensor is positioned proximal to the third joint.

14. The system of claim 7, wherein the universal joint includes a cover attached to the distal end of the force sensor, the cover being configured to shield a structure located proximal to the force sensor, thereby preventing a mechanical short circuit between the distal end of the force sensor and the shielded structure.

15. The system of claim 1, further comprising a motor positioned within the universal joint for controlling the joints of the universal joint.

16. The system of claim 15, wherein the motor is connected to the joint via a cable drive.

17. The system of claim 16, wherein the motor is located proximal to the joint.

18. The system of claim 1, wherein the positioning platform comprises at least one prism joint.

19. The system of claim 18, wherein the axis of motion of the prism joint is aligned with the direction of gravity.

20. The system of claim 19, wherein the universal joint is connected to the positioning platform via a joint, and wherein the axis of the joint is aligned with the direction of gravity.

21. A robot-enabled remote operation system, comprising: A controller and a robotic tool capable of being manipulated by the controller, wherein the controller includes: A handle, the handle being configured to be actuated by an operator; A gimbal, the gimbal being coupled to the handle and configured to allow manipulation of the handle in multiple degrees of freedom, the gimbal including a force sensor, wherein the movement of at least two axes of the gimbal is not based on any output signal of the force sensor; A positioning platform, which is connected to the gimbal and configured to allow manipulation of the handle in multiple degrees of freedom. The handle is configured for admittance control based at least in part on the output signal of the force sensor in the gimbal.

22. The system of claim 21, wherein the universal joint includes at least a first connector, a second connector, and a third connector, the first connector, the second connector, and the third connector being arranged from distal to proximal and connected by a joint, and wherein the force sensor is positioned within the first connector.

23. The system of claim 22 further includes a cover attached to the distal end of the force sensor, the cover being configured to shield a structure located proximal to the force sensor, thereby preventing a mechanical short circuit between the distal end of the force sensor and the shielded structure.

24. The system of claim 21, wherein the universal joint includes at least a first joint, a second joint, and a third joint, the first joint, the second joint, and the third joint being arranged from distal to proximal and connected by a connector, and wherein the force sensor is positioned distal to the second joint.

25. The system of claim 21, wherein the universal joint includes at least a first connector, a second connector, and a third connector, the first connector, the second connector, and the third connector being arranged from distal to proximal and connected by a joint, and wherein the force sensor is positioned within the third connector.

26. The system of claim 21, wherein the universal joint includes at least a first joint, a second joint, and a third joint, the first joint, the second joint, and the third joint being arranged from distal to proximal and connected by a connector, and wherein the force sensor is positioned proximal to the third joint.

27. The system of claim 21 further includes a motor positioned within the universal joint for controlling the joints of the universal joint.

28. The system of claim 27, wherein the motor is connected to the joint via a cable drive.

29. The system of claim 28, wherein the motor is located proximal to the joint.

30. A robot-enabled system, comprising: Controller, the controller includes: A handle, the handle being configured to be actuated by an operator; A gimbal, the gimbal being coupled to the handle and configured to allow manipulation of the handle in multiple degrees of freedom, wherein the gimbal is configured for impedance control; A positioning platform, which is coupled to the universal joint and configured to allow manipulation of the handle in multiple degrees of freedom, wherein the positioning platform is configured for admittance control.

31. The system of claim 30, wherein the controller manipulates a remotely operated robotic tool.

32. The system of claim 30, wherein the controller manipulates objects in the virtual environment.

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