Medical instrument with articulatable section

Abstract

Certain aspects relate to systems and techniques for medical devices. The medical device can include an elongated shaft having a proximal end, a distal end, and a bendable section between the proximal end and the distal end. The medical device can include a tip assembly at the distal end of the elongated shaft. The tip assembly includes a control member and a distal tip component attached to the control member. At least one cable can extend through the elongated shaft and be anchored to the control member. The at least one cable can be configured to cause the bendable section to bend based on a force applied thereto. At least one electronic component can be embedded in the distal tip component.

Description

[0001] Cross-references to related applications

[0002] This application claims the benefit of U.S. Provisional Patent Application No. 62 / 786133, filed December 28, 2018, and U.S. Provisional Patent Application No. 62 / 868801, filed June 28, 2019, the entire contents of which are incorporated herein by reference. Technical Field

[0003] The systems and methods disclosed herein relate to medical devices, and more specifically to medical devices having flexible segments and end-effectors. Background Technology

[0004] Medical procedures, such as colonoscopy, duodenoscopy, bronchoscopy, and ureteroscopy, may involve the use of medical instruments with curved segments to access internal areas of a patient. Attached Figure Description

[0005] 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.

[0006] Figure 1 An implementation scheme of a cart-based robotic system deployed for the diagnosis and / or treatment of bronchoscopy procedures is shown.

[0007] Figure 2 Depicting Figure 1 Another aspect of robotic systems.

[0008] Figure 3 The setup for ureteroscopy is shown. Figure 1 The implementation plan for the robot system.

[0009] Figure 4 The diagram shows the arrangement used for vascular procedures. Figure 1 The implementation plan for the robot system.

[0010] Figure 5 An implementation scheme of a table-based robotic system deployed for bronchoscopy procedures is shown.

[0011] Figure 6 Provided Figure 5 An alternative view of the robot system.

[0012] Figure 7 An exemplary system configured to retract a robotic arm is shown.

[0013] Figure 8 An implementation scheme of a table-based robotic system constructed for ureteroscopy procedures is shown.

[0014] Figure 9 An implementation scheme of a table-based robotic system constructed for laparoscopic procedures is shown.

[0015] Figure 10 It shows a pitch or tilt adjustment. Figures 5-9 Implementation plan for platform-based robot system.

[0016] Figure 11 Provided Figures 5-10 A detailed view of the interface between the platform and the column in a platform-based robotic system.

[0017] Figure 12 An alternative implementation of a stage-based robotic system is shown.

[0018] Figure 13 It shows Figure 12 An end view of a platform-based robotic system.

[0019] Figure 14 An end view of a platform-based robotic system with a robotic arm attached is shown.

[0020] Figure 15 An exemplary device driver is shown.

[0021] Figure 16 An exemplary medical device with paired instrument drivers is shown.

[0022] Figure 17 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.

[0023] Figure 18 An instrument with an instrument-based insertion architecture is shown.

[0024] Figure 19 An example controller is shown.

[0025] Figure 20 The figure depicts an estimate based on an exemplary implementation. Figures 1-10 The location of one or more components of a robotic system (such as...) Figures 16-18 A block diagram of a positioning system for the location of the instrument.

[0026] Figure 21A An embodiment of a medical device having a series of articulated movement segments in a flexural configuration is shown.

[0027] Figure 21B A series of implementation schemes for articulated movement segments are shown.

[0028] Figure 22A and Figure 22B It shows Figure 21B Various views of a series of articulated motion segments.

[0029] Figure 22C It shows Figure 22A and Figure 22B A series of joint-moving segments.

[0030] Figure 23A and Figure 23B Various views of the implementation scheme of the distal end section are shown.

[0031] Figure 24A and Figure 24B Various views of the implementation of the proximal end section are shown.

[0032] Figure 25 An exemplary embodiment of a medical device having a distal end segment, a proximal end segment, and an articulated segment is shown.

[0033] Figure 26A An embodiment of a support member for articulated movement segments is shown.

[0034] Figure 26B Another embodiment of the support member for articulated movement sections is shown.

[0035] Figure 26C Another embodiment of the support member for articulated movement sections is shown.

[0036] Figure 27A A portion of a medical device with articulated joint segments and cables is shown.

[0037] Figure 27B The end portion of the medical device is shown.

[0038] Figure 28A and Figure 28B Various views of a medical device in a joint motion configuration are shown.

[0039] Figure 29A and Figure 29B Various views of the end components of a medical device are shown. Detailed Implementation

[0040] 1. Overview .

[0041] 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.

[0042] 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.

[0043] 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.

[0044] A. Robotic System – Trolley .

[0045] 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 a diagnostic and / or therapeutic bronchoscopy procedure 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 a GI procedure 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.

[0046] Continue to refer to Figure 1Once the trolley 11 is correctly positioned, the robotic arm 12 can robotically, manually, or in combination thereof insert the maneuverable endoscope 13 into the patient. As shown, the maneuverable endoscope 13 may include at least two telescopic portions, such as an inner guide portion and an outer sheath portion, each portion being coupled to a separate instrument actuator from a set of instrument actuators 28, each instrument actuator being 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 maneuvering 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.

[0047] 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.

[0048] 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 the potential cancerous tissue. In some cases, diagnostic and therapeutic procedures can 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.

[0049] 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 of functionality 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.

[0050] 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.

[0051] Tower 30 may also include pumps, flow meters, valve controllers, and / or fluid passages to provide controlled flushing and suction capabilities to systems 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.

[0052] 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.

[0053] 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.

[0054] 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.

[0055] Tower 30 can be connected to cart 11 and endoscope 13 via one or more cables or connectors (not shown). In some embodiments, support functions 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.

[0056] 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.

[0057] 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.

[0058] 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.

[0059] 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).

[0060] 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.

[0061] 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 remain stationary. For example, the trolley base 15 includes rollable wheel-shaped casters 25 that allow the trolley to move easily 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.

[0062] 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, for example, 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.

[0063] 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.

[0064] 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.

[0065] 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.

[0066] B. Robot System – Unit .

[0067] 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.

[0068] 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 other brackets. While the brackets 43 need not be circular or even encircling column 37, the annular shape shown facilitates rotation of the brackets 43 about 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.

[0069] 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).

[0070] 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.

[0071] 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.

[0072] 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 access 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 a user interface such as a keyboard and / or the tower 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 holder for gas cylinders to be used for inflatation.

[0073] 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.

[0074] 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.

[0075] 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.

[0076] 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 base plate 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 portion 60 that allows vertical extension of column 37 to prevent platform 38 from contacting the floor or colliding with base 46.

[0077] 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.

[0078] For example, pitch adjustment is particularly useful when attempting to position the table in the Trendrenburg 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.

[0079] Figure 12 and Figure 13 Isometric and end views of an alternative embodiment of a stage-based surgical robot system 100 are shown. The surgical robot system 100 includes one or more robotic arms (see, for example) that can be configured to support a stage 101 relative to it. Figure 14 One or more adjustable arm supports 105 are provided. In the illustrated embodiment, a single adjustable arm support 105 is shown, but additional arm supports may be positioned on opposite sides of the platform 101. The adjustable arm support 105 may be configured such that it is movable relative to the platform 101 to adjust and / or change the orientation of the adjustable arm support 105 and / or any robotic arm attached to it relative to the platform 101. For example, the adjustable arm support 105 may be adjusted with one or more degrees of freedom relative to the platform 101. The adjustable arm support 105 provides high flexibility to the system 100, including the ability to easily retract one or more adjustable arm supports 105 and any robotic arms attached thereto under the platform 101. The adjustable arm support 105 may be raised from a retracted orientation to an orientation below the upper surface of the platform 101. In other embodiments, the adjustable arm support 105 can be raised from a retracted position to a position above the upper surface of the platform 101.

[0080] The adjustable arm support 105 provides several degrees of freedom, including lifting, lateral translation, and tilting. Figure 12 and Figure 13 In the exemplary embodiment, the arm support 105 is configured to have four degrees of freedom, which are in Figure 12The arrows indicate the first degree of freedom, which allows adjustment of the adjustable arm support 105 in the z-direction (“Z-lift”). For example, the adjustable arm support 105 may include a bracket 109 configured to move up or down along or relative to the column 102 of the support platform 101. The second degree of freedom allows the adjustable arm support 105 to tilt. For example, the adjustable arm support 105 may include a rotary joint that allows the adjustable arm support 105 to be aligned with the bed in a Trendlemberg position. The third degree of freedom allows the adjustable arm support 105 to “pivot upwards”, which can be used to adjust the distance between one side of the platform 101 and the adjustable arm support 105. The fourth degree of freedom allows the adjustable arm support 105 to translate along the longitudinal length of the platform.

[0081] Figure 12 and Figure 13 The surgical robot system 100 may include a platform supported by a column 102 mounted to a base 103. The base 103 and the column 102 support the platform 101 relative to a support surface. A floor axis 131 and a support axis 133 are... Figure 13 As shown in the image.

[0082] The adjustable arm support 105 can be mounted to the column 102. In other embodiments, the arm support 105 can be mounted to the platform 101 or the base 103. The adjustable arm support 105 may include a bracket 109, a rod or rail connector 111, and a rod or rail 107. In some embodiments, one or more robotic arms mounted to the rail 107 can translate and move relative to each other.

[0083] The bracket 109 can be attached to the post 102 via a first connector 113, which allows the bracket 109 to move relative to the post 102 (e.g., such as up and down movement along a first axis or vertical axis 123). The first connector 113 can provide a first degree of freedom (“Z-lift”) to the adjustable arm support 105. The adjustable arm support 105 may include a second connector 115, which provides a second degree of freedom (tilt) to the adjustable arm support 105. The adjustable arm support 105 may include a third connector 117, which provides a third degree of freedom (“upward pivot”) to the adjustable arm support 105. An additional connector 119 may be provided (in... Figure 13 (As shown in the diagram), the additional joint mechanically constrains the third joint 117 to maintain the orientation of the guide rail 107 as the guide rail connector 111 rotates about the third axis 127. The adjustable arm support 105 may include a fourth joint 121 that can provide a fourth degree of freedom (translation) for the adjustable arm support 105 along the fourth axis 129.

[0084] Figure 14An end view of a surgical robot system 140A according to one embodiment, having two adjustable arm supports 105A, 105B mounted on opposite sides of a stage 101, is shown. A first robotic arm 142A is attached to a rod or rail 107A of the first adjustable arm support 105B. The first robotic arm 142A includes a base 144A attached to the rail 107A. The distal end of the first robotic arm 142A includes an instrument drive mechanism 146A that can be attached to one or more robotic medical instruments or tools. Similarly, a second robotic arm 142B includes a base 144B attached to the rail 107B. The distal end of the second robotic arm 142B includes an instrument drive mechanism 146B. The instrument drive mechanism 146B can be configured to be attached to one or more robotic medical instruments or tools.

[0085] In some embodiments, one or more of the robotic arms 142A and 142B include an arm with seven or more degrees of freedom. In some embodiments, one or more of the robotic arms 142A and 142B may include eight degrees of freedom, including an insertion axis (including one degree of freedom for insertion), a wrist (including three degrees of freedom for wrist pitch, yaw, and roll), an elbow (including one degree of freedom for elbow pitch), a shoulder (including two degrees of freedom for shoulder pitch and yaw), and a base 144A and 144B (including one degree of freedom for translation). In some embodiments, the insertion degree of freedom may be provided by the robotic arms 142A and 142B, while in other embodiments, the instrument itself provides insertion via an instrument-based insertion architecture.

[0086] C. Instrument drivers and interfaces .

[0087] 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") incorporating electromechanical devices for actuating the medical device, and (ii) a removable or detachable medical device that may not contain any electromechanical components, such as motors. This dichotomy may be driven by the need to sterilize 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.

[0088] Figure 15An example instrument actuator is shown. 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., as...) to the medical device. Figure 15 Four 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.

[0089] 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, thus preserving sterility. Therefore, an exemplary sterile adapter may include a series of rotary inputs and rotary 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 connected to the sterile adapter and 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).

[0090] D. Medical devices .

[0091] Figure 16An example 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 mate with a drive output 74 on a drive interface extending through the distal end of the robotic arm 76. When physically connected, latched, and / or coupled, the mating drive input 73 of the instrument base 72 can 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 mate with a socket on the drive input 73.

[0092] 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 bendable segment that articulates and flexes based on torque received from the drive output 74 of the instrument actuator 75.

[0093] Torque from the instrument actuator 75 is transmitted downwards along shaft 71 to the elongated shaft 71 via tendons. These individual tendons (e.g., drawstrings) may be individually anchored to individual drive inputs 73 within the instrument handle 72. From the handle 72, the tendons are guided downwards 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 distally mounted end effectors, such as wrists, grippers, 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 some 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 coupled 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.

[0094] In endoscopic examinations, tendons can be attached 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 securely attached to the distal end of the flexible segment, torque applied to drive input 73 is transmitted down the tendon, causing the softer, flexible segment (sometimes referred to as an articulated segment or region) to flex or articulate. Advantageously, individual traction cavities can be helically or coiled along an inflexible segment, guiding 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.

[0095] In endoscopic procedures, the elongated shaft 71 houses multiple components to assist in robotic procedures. The shaft may include a working channel for deploying surgical instruments (or medical devices), irrigation components, and / or suction components to an operating area at the distal end of the shaft 71. The shaft 71 may also house wires and / or optical fibers to transmit signals to / from optical components at the 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.

[0096] 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.

[0097] exist Figure 16 In the example, the axis of the drive shaft, and therefore the drive input axis, is orthogonal to the axis of the elongated shaft. However, this arrangement complicates the rolling capability of the elongated shaft 71. Rolling the elongated shaft 71 along its axis while keeping the drive input 73 stationary can cause undesirable tangling of the tendons as they extend from the drive input 73 and enter the traction cavity within the elongated shaft 71. Such tangling of tendons can disrupt any control algorithms designed to predict the movement of the flexible elongated shaft during endoscopic procedures.

[0098] Figure 17 An 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.

[0099] Similar to previously disclosed embodiments, the instrument 86 may include an elongated shaft portion 88 and an instrument base 87 (shown as having a transparent outer surface for discussion purposes), 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... Figure 16 It is orthogonal as in the design.

[0100] When coupled to the rotating assembly 83 of the instrument driver 80, the medical instrument 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.

[0101] Figure 18 An instrument with an instrument-based insertion architecture according to some embodiments is shown. Instrument 150 is connectable to any of the instrument drivers described above. Instrument 150 includes an elongated shaft 152, an end effector 162 connected to the shaft 152, and a shank 170 connected to the shaft 152. The elongated shaft 152 includes a tubular member having a proximal portion 154 and a distal portion 156. The elongated shaft 152 includes one or more channels or grooves 158 along its outer surface. The grooves 158 are configured to receive one or more wires or cables 180 passing through them. Thus, one or more cables 180 extend along the outer surface of the elongated shaft 152. In other embodiments, the cables 180 may also pass through the elongated shaft 152. Manipulation of the one or more cables 180 (e.g., via an instrument driver) actuates the end effector 162.

[0102] The instrument handle 170 (also referred to as the instrument base) typically includes an attachment interface 172 having one or more mechanical inputs 174, such as jacks, pulleys, or spools, which are designed to reciprocately engage with one or more torque couplers on the attachment surface of the instrument actuator.

[0103] In some embodiments, the instrument 150 includes a series of pulleys or cables that enable the elongated shaft 152 to translate relative to the handle 170. In other words, the instrument 150 itself includes an instrument-based insertion architecture that adapts to the insertion of the instrument, thereby minimizing reliance on a robotic arm to provide the insertion of the instrument 150. In other embodiments, the robotic arm may be largely responsible for the instrument insertion.

[0104] E. Controller .

[0105] Any of the robotic systems described herein may include an input device or controller for manipulating a device attached to a robotic arm. In some embodiments, the controller may be coupled to the device (e.g., communicatively, electronically, electrically, wirelessly, and / or mechanically) such that manipulation of the controller, for example via master-slave control, causes corresponding manipulation of the device.

[0106] Figure 19 This is a perspective view of an embodiment of controller 182. In this embodiment, controller 182 includes a hybrid controller that may have both impedance and admittance control. In other embodiments, controller 182 may utilize only impedance or passive control. In other embodiments, controller 182 may utilize only admittance control. By being a hybrid controller, controller 182 advantageously has lower perceived inertia during use.

[0107] In the illustrated embodiment, controller 182 is configured to allow manipulation of two medical devices and includes two handles 184. Each handle 184 is connected to a universal joint 186. Each universal joint 186 is connected to a positioning platform 188.

[0108] like Figure 19 As shown, each positioning platform 188 includes a SCARA arm (selective compliance assembly arm) 198 connected to a post 194 via a prism joint 196. The prism joint 196 is configured to translate along the post 194 (e.g., along guide rail 197) to allow each handle 184 to translate in the z-direction, thus providing a first degree of freedom. The SCARA arm 198 is configured to allow the handles 184 to move in the xy-plane, thus providing two additional degrees of freedom.

[0109] In some embodiments, one or more load sensors are located within the controller. For example, in some embodiments, load sensors (not shown) are located within the body of each gimbal in gimbal 186. By providing load sensors, portions of controller 182 are capable of operating under admittance control, thereby advantageously reducing the sense inertia of the controller during use. In some embodiments, positioning platform 188 is configured for admittance control, while gimbal 186 is configured for impedance control. In other embodiments, gimbal 186 is configured for admittance control, while positioning platform 188 is configured for impedance control. Thus, for some embodiments, the translational or orientational degrees of freedom of positioning platform 188 may depend on admittance control, while the rotational degrees of freedom of gimbal 186 may depend on impedance control.

[0110] F. Navigation and Control .

[0111] 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.

[0112] Figure 20 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 to 4 The trolley shown Figures 5 to 14 The bed, etc. shown.

[0113] like Figure 20 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).

[0114] 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 bulk, 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 No. 14 / 523760, 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.

[0115] 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.

[0116] 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.

[0117] 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 motion. Examples of optical flow techniques can include motion detection, object segmentation computation, 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.

[0118] 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.

[0119] 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, derived 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.

[0120] like Figure 20 As shown, the positioning module 95 can use multiple other input data. For example, although in Figure 20 Although not shown, the device using shape sensing fibers can provide shape data, which the positioning module 95 can use to determine the position and shape of the device.

[0121] 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.

[0122] 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.

[0123] 2. Introduction to medical devices with flexible segments

[0124] Embodiments of this disclosure relate to systems and technologies related to medical devices, which may include flexible segments capable of joint movement via cables.

[0125] Figure 21A An exemplary embodiment of a medical device 200 is shown, comprising a flexible segment 202 and a distal end 204. The flexible segment 202 is coupled to the distal end 204 such that bending of the flexible segment 202 allows articulation of the distal end 204 of the medical device 200. The flexible segment 202 is shown and described herein with respect to the illustrated medical device 200, which can be any of a variety of instruments, including but not limited to endoscopes, gastroscopes, bronchoscopes, and / or ureteroscopes. The distal end 204 of the medical device 200 may include instruments and end effectors, such as, but not limited to, one or more clamps, guidewires, cutters, sutures, brushes, spoons, imaging devices, etc., and may include one or more channels for delivering such instruments and / or for delivering and / or removing fluids. While the flexible segment 102 is described in the context of certain embodiments of a medical device or robotic system, the flexible segment 102 can be used with other medical devices and non-robotic systems.

[0126] Figure 21B Showing more details Figure 21A The medical device 200 includes a flexible segment 202. As shown, the flexible segment 202 may be formed from a series of articulated segments 206. The flexible segment 202 may have a length defining an axis about which it is capable of bending. The series of articulated segments 206 may be operatively coupled together to form the flexible segment 202 such that articulation of the articulated segments 206 causes the flexible segment 202 to bend with at least one degree of motion. In some examples, the series of articulated segments 206 may allow the flexible segment 202 to have at least two degrees of motion.

[0127] In some examples, the flexible segment 202 of the medical device 200 may include one or more cables 250. The cables 250 of the flexible segment 202 and the articulated movement segment 206 will be described further in the following paragraphs.

[0128] Joint movement range

[0129] Figure 22A and Figure 22B It shows Figure 21B Different views of the articulated segment 206. The articulated segment 206 may include a body 216, one or more recesses 208, one or more protrusions 210, and one or more passages 254. The body 216 may be annular and may include an opening 218 to allow the inner axis 260 of the medical device 200 (e.g., as shown in the image). Figure 25 (As shown) extends through. The body 216 of the articulated segment 206 may be substantially circular in shape. In some examples, the opening 218 may be circular. The inner shaft 260 may be a tubular element through which other components may extend.

[0130] One or more recesses 208 may be formed and / or connected to the distal or proximal side of the articulated segment 206. One or more protrusions 210 may be formed and / or connected to the distal or proximal side of the articulated segment 206. For example, one or more recesses 208 may be formed on the distal side of the articulated segment 206, while one or more protrusions 210 may be formed on the proximal side of the articulated segment 206. In another example, one or more recesses 208 and one or more protrusions 210 may be formed on opposite sides of the articulated segment 206. Alternatively, one or more recesses 208 and one or more protrusions 210 may be positioned and / or formed on the same side of the articulated segment 206.

[0131] In some examples, each articulated segment 206 may include two recesses 208 and two protrusions 210, such as Figure 22A and Figure 22B As shown. Two recesses 208 may be formed on a first side of the articulated segment 206, while two protrusions 210 may be formed on a second side of the articulated segment 206. The two recesses 208 may be positioned offset from each other by 180 degrees. Similarly, the two protrusions 210 may be positioned offset from each other by 180 degrees. The recesses 208 and protrusions 210 may be positioned such that one of the recesses 208 (or one of the protrusions 210) is offset from the protrusion 210 (or the recess 208) by 90 degrees.

[0132] The articulated segment 206 may be connected to an adjacent articulated segment 206 via its recess 208 and protrusion 210. For example, the recess 208 of the first articulated segment 206 may be connected to the protrusion 210 of the second articulated segment 206. In some examples, the second articulated segment 206 may be rotatably offset by 90 degrees from the first articulated segment 206. Similarly, the recess 208 of the second articulated segment 206 may be connected to the protrusion 210 of the third articulated segment 206, the protrusion 210 being rotatably offset by 90 degrees from the second articulated segment 206.

[0133] In some examples, the flexible segment 202 may include a series of articulated segments 206, wherein each subsequent articulated segment 206 is offset from each previous articulated segment 206 by a predetermined angle. The predetermined offset angle may be between about 10 degrees and about 90 degrees, between about 20 degrees and about 80 degrees, between about 30 degrees and about 70 degrees, between about 40 degrees and about 60 degrees, or about 10 degrees, 20 degrees, 30 degrees, 40 degrees, 50 degrees, 60 degrees, 70 degrees, 80 degrees, 90 degrees, or within any two of the foregoing values.

[0134] like Figure 22A and Figure 22B As shown, passage 254 may be associated with recess 208 and protrusion 210 of articulated segment 206. Passage 254 may extend through the width of articulated segment 206, where the width corresponds to the longitudinal thickness of segment 206. Passage 254 of articulated segment 206 may allow cable 250 (see...) Figure 21B The flexible segment 202 extends through the medical device 200. In some examples, the access 254 may be a closed opening, such as... Figure 22A and Figure 22B As shown. In other examples, passage 254 may be partially closed to form a groove.

[0135] Figure 22C A series of articulated segments 206 are shown, which can be connected in series as described above. Figure 22A and Figure 22B The structure is described above. The dimensions of the recesses 208 and protrusions 210 of the articulated segment 206 can be designed to connect to form hinges 212. For example, the recess 208 of the first articulated segment 206 can connect with a corresponding protrusion of a second articulated segment 206 adjacent to the first articulated segment 206. Each pair of adjacent articulated segments 206 may include at least two hinges 212. As described above, the protrusions 210 and recesses 208 may include passages 254 to allow cables 250 (see...) Figure 27AThe cable 250 extends through. In this respect, each hinge in hinge 212 may include a passage 254 to allow the cable 250 to extend through. Figure 22C In the example shown, the passage 254 can be formed using a pair of vertical cuts or gaps at each passage 254 extending through the body. Figure 22C As shown, a cut on one side of segment 206 can provide a recess 208 for the hinge, while a vertical cut on the opposite side of segment 206 can extend through the protrusion 210 and intersect with the opposite cut to open a passage 254 extending through the hinge.

[0136] The recess 208 and the protrusion 210 can be positioned such that the hinge 212 can be positioned between each of the adjacent articulated segments 206. The hinge 212 allows the articulated segments 206 to articulate (e.g., rotate) about an axis transverse to the length of the flexible segment 202. As described above, the hinge 212 connecting each pair of adjacent articulated segments 206 allows a series of articulated segments to articulate the flexible segment 202 to bend and / or articulate in one or more degrees of motion.

[0137] In some examples, each pair of adjacent articulated segments 206 may include a gap 214 formed between the articulated segments. The gap 214 may advantageously allow adjacent articulated segments 206 to articulate freely without contacting each other, thereby limiting and / or reducing the articulation angle of the flexible segment 202.

[0138] distal end segment and proximal end segment

[0139] Figure 23A and Figure 23B Different views of a distal end section 220 are shown, which may form part of or otherwise connect to the aforementioned flexible segment 202. The distal end section 220 may include one or more recesses 208 and / or one or more protrusions 210. One or more recesses 208 or one or more protrusions 210 may be formed and / or positioned on the proximal side of the distal end section 220. The distal end section 220 may include one or more passages 254. Passages 254 may be associated with recesses 208 and / or protrusions 210. In some examples, passages 254 may be formed within recesses 208 and / or protrusions 210, allowing a cable 250 to extend through them. The distal end section 220 may include a cavity for an inner shaft 260 of a medical device 200.

[0140] Figure 24A and Figure 24BDifferent views are shown of an exemplary proximal end section 230 that may form part of or otherwise connect to a flexible segment 202 in some embodiments. The proximal end section 230 may include one or more recesses 208 and / or one or more protrusions 210. One or more recesses 208 or one or more protrusions 210 may be formed and / or positioned on the distal side of the proximal end section 230. One or more recesses 208 and / or one or more protrusions 210 may connect with one or more protrusions and / or one or more recesses of an articulated segment 206. The proximal end section 230 may include one or more passages 254. Passages 254 may be associated with recesses 208 and / or protrusions 210. In some examples, passages 254 may be formed within recesses 208 and / or protrusions 210, allowing a cable 250 to extend through the recesses 208 and / or protrusions 210. The proximal end section 230 may include a cavity for the inner shaft 260 of the medical device 200.

[0141] In some examples, the proximal end segment 230 and the distal end segment 220 may have a cross-sectional area substantially the same as that of the articulated segment 206 of the flexible segment 202. In other examples, the proximal end segment 230 and the distal end segment 220 may have a cross-sectional shape substantially the same as or similar to that of the articulated segment 206. The distal end segment 220 and the proximal end segment 230 may provide ends for the flexible portion 202 and may be connected to other components of the medical device 200. In some embodiments, the distal end segment 220 and / or the proximal end segment 230 may be omitted from the flexible segment 202, and / or portions of these segments may be combined with the most distal or most proximal articulated segment.

[0142] Figure 25 The distal portion of an exemplary medical device 300 is shown, which includes the distal end segment 220, the proximal end segment 230, and the articular movement segment 206 as described above. Figure 25 In the illustration shown, the intermediate articulated segment 206 has been shown as removed to better show the cable 250.

[0143] like Figure 25 As shown, one or more recesses 208 and / or one or more protrusions 210 of the distal end segment 220 and the proximal end segment 230 may be coupled to one or more protrusions and / or one or more recesses of the articulated segment 206. Figure 25As shown, protrusions and recesses form a series of hinges 212 in the flexible segment 202, which connect the proximal end segment 230, the articulated movement segment 206, and the distal end segment 220. The proximal end segment 230 and the distal end segment 220 define the proximal and distal ends of the flexible segment 202. In some examples, the distal end segment 220 and the proximal end segment 230 are fixedly attached to the medical device 300, such that the flexible segment 202 is fixedly attached to the medical device 300.

[0144] support sleeve

[0145] Figures 26A-26C Different exemplary support members 240 are shown for a series of articulated segments 206. The support member 240 may enclose at least a portion of the body 216 of the articulated segment 206. In some examples, the support member 240 may enclose a single articulated segment 206. The support member 240 and the articulated segments 206 may be made of the same or different materials. Optionally, the support member 240 may be coupled to all articulated segments 206 of the medical device 200.

[0146] pull line

[0147] The medical device 200 may also include one or more cables 250. Figure 27A A medical device 200 is shown, in which a portion of an articulated segment 206 is shown to illustrate a cable 250. The cable 250 extends through the medical device 200 and can be used to articulate the medical device 200 in one or more degrees of motion (see [link to documentation]). Figure 28A and Figure 28B Cable 250 may terminate at the distal end section 220, such as... Figure 27B As shown. The distal end segment 220 may be attached to the distal end member 270 at its distal end or distal side. The distal end member 270 may provide a housing for holding one or more functional and / or electronic components. For example, one or more cameras 286, one or more illuminators 285, and / or one or more EM sensors 288 may be embedded in the distal end member 270.

[0148] The combination of traction cables 250 and / or slack cables 250 allows articulation of the articulated segment 206 of the flexible segment 202, resulting in bending of the flexible segment 202. When the cables 250 are pulled toward the proximal end of the medical device 200, they engage the hinge 212 and the articulated segment 206 to actuate (e.g., rotate) them about an axis associated with the hinge 212. In some examples, slack cables 250 can cause a series of articulated segments 206 to articulate and bend the flexible segment 202. Furthermore, cables 250 can advantageously stabilize the flexible segment 202 of the medical device 200 and provide bias and predictability for the operation of the medical device 200.

[0149] In some embodiments, cable 250 may be under a predetermined tension. In this regard, the amount by which the tension of one of the cables 250 is increased while slack (e.g., reducing tension) the opposing cables 250 can cause the articulated segment 206 to articulate and the flexible segment 202 to bend.

[0150] Figure 28A and Figure 28B Different views of the medical device 400 are shown, in which the flexible segment 202 is bent. As described above, one or more of the actuation (e.g., traction / relaxation) cables 250 can cause the flexible segment 202 to bend. Different combinations of actuation cables 250 can result in different orientations of the flexible segment 202.

[0151] Cables 250 can be actuated using human-machine interaction or a robotic system including actuators (or controllers). Actuators can be coupled to cables 250 to pull / relax cables 250. In some examples, individual actuators can be coupled to each cable 250 of the medical device 200. For example, the medical device 200 may include four cables 250 and four actuators coupled to the corresponding cables 250. In some embodiments, actuators can be coupled to two or more cables and are thus configured to actuate multiple cables 250.

[0152] In some examples, simultaneous movement of two or more degrees of motion of the flexible segment 202 can be achieved through a more complex control scheme for pulling and / or pushing the cable 250. This control scheme may involve a computer-based control system that stores computer program instructions for a master device configured to interpret the user's movements as corresponding actions of the medical device 200. The computer program may be configured to measure the rotation of the actuators (or input controllers) to calculate the length of the cable 250 and / or the electrical load required for movement. The computer program may also be configured to compensate for variations in cable elasticity, such as if the cable 250 is a polymer, by increasing / decreasing the amount of rotation required to change the length of the cable 250 by the actuators (or input controllers). Tension can be adjusted by coordinating the increase or decrease of the rotation of all actuators (or input controllers). Tension can be increased by simultaneously increasing rotation and decreased by simultaneously decreasing rotation. The computer program may also be configured to maintain a minimum tension level in the cable 250. If the tension of any cable in cable 250 is sensed to drop below the minimum tension threshold, the computer program can coordinately increase the rotation of all cables (or input controllers) until the tension of all cables in cable 250 is above the minimum tension threshold. If the tension of all cables in cable 250 is sensed to rise above the minimum tension threshold, the computer program can coordinately decrease the rotation of all actuators (or input controllers) until the tension of any cable in cable 250 is below the minimum tension threshold. The computer program can also be configured to identify the operator's grip strength based on the load of the motor actuating the actuator (or input controller) connected to cable 250.

[0153] End components

[0154] The medical device 200 may include a terminal assembly 290 that facilitates the attachment of one or more cables 250 and / or the embedding or housing of one or more functional and / or electronic components in the distal end of the device. Figures 29A-29B This is shown at the distal end of the medical device 200, for example at the elongated shaft 71 ( Figure 16 Example of end component 290 used at the distal end of ). Figure 29A The end component 290 in an unassembled configuration is shown, while Figure 29B The end component 290 is shown in an assembled configuration, wherein the end component 290 is attached to the distal end of the flexible segment 202.

[0155] The end-effector 290 includes a distal end segment 220 and a distal end member 270. The distal end segment 220 may be configured as a control member to which one or more cables 250 are anchored. Thus, the distal end segment 220 may provide terminals and anchor points for the cables 250, and may be configured to bend flexible segments to manipulate the end-effector 290 based on forces applied to the cables 250. The distal end member 270 provides a housing for retaining functional components therein. For example, one or more electronic components, such as one or more cameras, one or more LEDs, one or more optical fibers, and / or one or more EM sensors, may be embedded in the distal end member 270 to provide functionality associated with a range or other types of medical devices.

[0156] like Figures 29A-29B As shown, the distal end component 270 can be a separate component from the distal end segment 220. By providing the distal end segment 220 and the distal end component 270 as separate components to be attached to each other, manufacturing or design constraints can be removed. For example, the cable 250 can be attached and anchored to the distal end segment 220 by soldering the cable to it, while electronic components can be embedded in the distal end component in separate operations. Thus, the housing of the electronic components is therefore freed, for example, from the constraint of needing to solder the cable 250 to it, allowing the housing to be manufactured shorter or more easily processed into complex geometries. In addition or alternatively, this configuration allows portions of the flexible segment and the distal end component to have different service lives and to be easily separated for sterilization or reuse of one component or the other. For example, this allows the distal end component 270 to be separated from the flexible segment, so that the flexible segment can be discarded, while the distal end component 270 and its functional components, such as imaging devices, position sensors, and / or other electronic components, can be reused to extend their service life. The distal end section 220 may be configured as a control ring or annular segment having an annular portion 276 and a central opening 272 extending through the annular portion 276. The distal end section 220 may include one or more slots 274 formed therein. The slots 274 may be formed in the annular portion 276 and may provide anchoring points for anchoring the cable 250 thereto. For example, the cable 250 may be bonded to the slot 274 by welding it to the annular portion 276 in the slot 274 to form a strong and secure attachment that allows the endoscope to be reused in multiple surgeries. Alternatively or in combination, the cable 250 may be anchored to the distal end section 220 via adhesive, welding, or any suitable attachment technique.

[0157] The distal end section 220 may include a recess 208 and / or a protrusion 210 to facilitate articulated and / or snap-fit ​​connections to other sections on or otherwise coupled to the elongated shaft 72. In the example shown, the proximal side of the distal end section 220 includes a protrusion 210 configured to connect to an adjacent articulated movement section 206 of the flexible segment 202. Thus, forces applied to the distal end section 220 via the control cable 250 can be transmitted to components attached to the end assembly 290 of the distal end section 220, and such forces can bend the flexible segment 206 to manipulate the end assembly 290 in a desired direction. The slot 274 may be circumferentially and axially aligned with a hinge on the proximal side of the ring, which engages with the proximal articulated movement section, to facilitate the cable 250 passing through the hinge wiring and reaching an anchor point in the slot 274.

[0158] The distal side of the distal end section 220 is also shown having a recess 208 configured to connect to a protrusion 210 on the proximal side of the distal end member 270. This protrusion connection to the distal end member 270 is advantageous in manufacturing by allowing, for example, a snap-fit ​​engagement to mechanically connect the distal end section 220 to the distal end member 270. It may be desirable to rigidly attach the distal end section 220 to the distal end member 270 such that there is no relative movement or rotation between them. This allows the distal end section 220 to function as a control member that directly manipulates the functional components within the distal end member 270 in a precise manner, where the movement of the control member substantially matches the movement of the functional components. A hinged connection can be converted into a rigid connection, for example, by making the distal side of the distal end section 220 and the proximal side of the distal end member 270 substantially flush with each other. The distal side of the distal end member 270 is substantially flush with the proximal side of the distal end member 270, which can limit relative rotation between the control member and the distal end member 270 about the hinge connection. Alternatively, such a rigid connection can be achieved by inserting a component, such as a potting adhesive, into the space near the interface between the distal end segment 220 and the distal end member 270 to secure such components together. Alternatively, such a compound can be used to provide a seal between such components and / or to provide a sealing function within the distal end member 270.

[0159] In various embodiments, the recess 208 and protrusion 210 forming the hinge connection can take on various shapes, sizes, and / or orientations. Figures 29A-29B In this embodiment, the protrusion 210 is configured as a radially extending outward in the radial direction. In various embodiments, the protrusion may extend, for example, radially inward, radially outward, longitudinally in the proximal direction, or longitudinally in the distal direction.

[0160] The distal end component 270 may be provided with one or more openings for mating with functional components therein and / or for allowing other instruments to be inserted through it. For example, the distal end component 270 may include openings for one or more ports 282 and a working channel 284. The one or more ports 282 may be configured to hold optical devices, such as a camera 286 and / or an illuminator 285, configured to facilitate visualization of the patient's internal anatomy. It is contemplated that any suitable number of one or more ports 282 may be used to hold one or more functional components. Figure 29A In the example shown, three ports 282 are illustrated. The middle port of the three ports may hold a camera 286 therein, which may have a field of view extending distally beyond the port. Each of the other two ports may hold an illuminator 285 therein, such as an LED or fiber optic, which may provide distal illumination to illuminate at least a portion of the camera's field of view. An opening in the working channel 284 allows other instruments, such as biopsy needles, grippers, and / or treatment delivery devices, to be inserted therethrough. Such other instruments may be configured to pass through the central opening 272 of the distal end section 220, the opening of the working channel 284 in the distal end member 270, and exit the distal end of the end assembly 290 upon insertion therethrough. In some embodiments, the distal end section 220 may enclose the proximal portion of one or more electronic and / or functional components embedded within the distal end member 270. For example, the EM sensor 288 may have a length such that when the distal end section 220 is manufactured as a separate component, the proximal end of the EM sensor 288 protrudes proximally beyond the proximal side of the distal end component 270. However, the distal end section 220 may be configured to surround the proximal end of the EM sensor 288 to provide a seal around such a component.

[0161] The distal end member 270 may include a proximal segment 292 and a distal segment 294. The proximal segment 292 may have a reduced outer diameter relative to the distal segment 294, such that the distal segment 294 is provided with a flange portion that projects radially relative to the outer diameter of the proximal segment 292. The distal end section 220 may also have a reduced outer diameter relative to the distal segment 294, for example, by having an outer diameter that substantially matches the outer diameter of the proximal segment 292. The reduced outer diameter of the proximal segment 292 allows a sleeve (or “jacket”) to extend around the outer surface of the proximal segment 292 (or otherwise mount onto the control member), abutting the distal segment 294 (e.g., abutting the proximal side of the flange portion), and forming an overlap with the distal segment 294 for secure attachment. Such a sleeve ( Figures 29A-29B (Not visible in the middle) It may also extend around the distal end section 220 and the articular movement section 206, thereby enclosing and / or sealing the components therein.

[0162] In the illustrated example, the distal end section 220 providing the control member and the distal end member 270 providing the housing are arranged axially, with the housing positioned distal to the control member to hold the functional component at the leading end of the device. Such an arrangement can improve the manufacturability or operability of the device. However, it is also conceivable that the control member for anchoring the cable 250 and the housing for holding the embedded element can be arranged laterally relative to each other.

[0163] 3. Implementation System and Terminology .

[0164] The specific embodiments disclosed herein provide systems and apparatus for medical devices, the medical devices including flexible segments capable of joint movement via cables.

[0165] It should be noted that, as used herein, the terms “couple,” “coupling,” “coupled,” or other variations of the word “couple” 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.

[0166] The cable pulling and / or slack functions described herein may be stored as one or more instructions on a processor-readable or computer-readable medium. The term "computer-readable medium" means any available medium accessible 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 disc read-only memory (CD-ROM) or other optical disc 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 is accessible by a computer. It should be noted that a computer-readable medium may be tangible and non-transitory. As used herein, the term "code" may mean software, instructions, code, or data executable by a computing device or processor.

[0167] 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.

[0168] 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.

[0169] 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”.

[0170] The foregoing specific embodiments of the disclosed specific implementations are provided to enable any person skilled in the art to make or use the invention. Various modifications to these specific implementations will be readily apparent to those skilled in the art, and the general principles defined herein may be applied to other specific implementations 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 specific implementations shown herein, but is endowed with the broadest scope consistent with the principles and novel features disclosed herein.

Claims

1. A medical device comprising: An elongated body having a distal end and a proximal end; A flexible segment, positioned proximally at the distal end and having at least two degrees of motion, the flexible segment comprising a series of articulated segments positioned along the flexible segment, the series of articulated segments comprising at least a pair of adjacent articulated segments, the at least a pair of adjacent articulated segments comprising a first articulated segment and a second articulated segment, the first articulated segment and the second articulated segment being connected by a first hinge and a second hinge, the first hinge being formed by a first recess or first protrusion formed on the first articulated segment and a corresponding first recess or first protrusion formed on the second articulated segment, the second hinge being formed by a second recess or second protrusion formed on the first articulated segment and a corresponding second recess or second protrusion formed on the second articulated segment, at least the first hinge including a passage extending through the first recess or first protrusion formed on the first articulated segment and the corresponding first recess or first protrusion formed on the second articulated segment; and At least one cable extends through the passage.

2. The medical device according to claim 1, wherein a gap is formed between the first articulated segment and the second articulated segment.

3. The medical device of claim 1, further comprising a third articulated segment connected to the second articulated segment, wherein the second articulated segment and the third articulated segment are connected by a third hinge and a fourth hinge, the third hinge and the fourth hinge being positioned offset by 90 degrees from the first hinge and the second hinge.

4. The medical device according to claim 3, wherein the third hinge and the fourth hinge are each formed in a recess or protrusion on the second articulated segment, and the recess or protrusion engages with a corresponding recess or protrusion formed on the third articulated segment.

5. The medical device of claim 1, wherein the first hinge and the second hinge are formed by a first recess and a second recess positioned along a first side of the first articulated segment, the first recess and the second recess engaging a first protrusion and a second protrusion on a side of the second articulated segment opposite to the first side of the first articulated segment.

6. The medical device of claim 1, wherein pulling and / or pushing the cable causes the flexible segment to articulate with at least two degrees of motion.

7. The medical device of claim 1, further comprising an external sleeve wound around at least a portion of the series of articulated segments to provide support for the flexible segments.

8. The medical device of claim 1, wherein the passage is a groove formed on the outer surface of the first articulated segment and the second articulated segment.

9. A robotic surgical system, comprising: A medical device comprising a flexible segment, the flexible segment comprising a series of articulated segments positioned along the flexible segment, the series of articulated segments comprising hinges connecting adjacent articulated segments to each other, wherein each hinge is formed by a recess or protrusion of an articulated segment, the recess or protrusion engaging a corresponding recess or protrusion formed on an adjacent articulated segment; A cable that extends longitudinally through the flexible segment and through at least one hinge formed by adjacent articulated segments; as well as An actuator for controlling the movement of the cable to bend the flexible segment.

10. The robotic surgical system of claim 9, wherein a gap is formed between adjacent articulated segments.

11. The robotic surgical system of claim 9, wherein each of the articulated segments has a first side and a second side, wherein the first side includes a protrusion that engages a corresponding recess on the articulated segment located on the first side, and wherein the second side includes a recess that engages a corresponding protrusion on the articulated segment located on the second side.

12. The robotic surgical system of claim 11, wherein the protrusion on the first side is positioned offset by 90 degrees from the recess on the second side.

13. The robotic surgical system of claim 9, wherein the hinges between consecutive pairs of adjacent articulated segments are positioned offset relative to each other by 90 degrees.

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