Dynamic pulley system

Abstract

Certain aspects relate to systems and techniques for robotic medical instrument systems. The medical system can include an elongated shaft configured for insertion into a patient. The system can also include a pull wire extending along the elongated shaft. The pull wire can be actuatable to articulate the elongated shaft. The medical system can include a dynamic pulley coupled to the pull wire, the dynamic pulley configured to collapse in a first direction during rotation and to expand in a second direction opposite the first direction during rotation.

Description

[0001] Cross Reference to Related Applications

[0002] This application claims the benefit of U.S. provisional application 62 / 956,001, filed December 31, 2019, which is hereby incorporated by reference in its entirety. TECHNICAL FIELD

[0003] The systems and methods disclosed herein relate to medical instrument systems, and more particularly to dynamic pulley systems for robotic medical procedures. BACKGROUND

[0004] Medical procedures such as endoscopy can involve accessing and visualizing the interior of a patient’s anatomy for diagnostic and / or therapeutic purposes. For example, gastroenterology, urology, and bronchoscopy involve medical procedures that allow a physician to examine a patient’s lumens such as the ureter, gastrointestinal tract, and airways (bronchi and bronchioles). During these procedures, a thin, flexible, tubular tool or instrument such as an endoscope or catheter is inserted into the patient through an orifice (such as a natural orifice) and is advanced toward a tissue site identified for subsequent diagnosis and / or treatment. The medical instrument can be controllable and articulatable to facilitate navigation through the anatomy. BRIEF DESCRIPTION OF DRAWINGS

[0005] The disclosed aspects will be described below with reference to the accompanying drawings, which are provided herein to illustrate, but not to limit the disclosed aspects, in which like reference characters indicate like elements.

[0006] Figure 1 Embodiments of a cart-based robotic system arranged for diagnostic and / or therapeutic bronchoscopy are shown.

[0007] Figure 2 Further aspects of the robotic system of Figure 1 are depicted.

[0008] Figure 3 Embodiments of the robotic system of Figure 1 arranged for ureteroscopy are shown.

[0009] Figure 4 Embodiments of the robotic system of Figure 1 arranged for vascular procedures are shown.

[0010] Figure 5 Embodiments of a table-based robotic system arranged for bronchoscopy procedures are shown.

[0011] Figure 6 Alternative views of the robotic system of Figure 5 are provided.

[0012] Figure 7 An example system configured to stow a robotic arm is shown.

[0013] Figure 8 An embodiment of a table-based robotic system configured for a ureteroscopy procedure is shown.

[0014] Figure 9 An embodiment of a table-based robotic system configured for a laparoscopy procedure is shown.

[0015] Figure 10 An embodiment of a table-based robotic system with pitch and tilt adjustment is shown. Figures 5-9

[0016] A detailed illustration of an interface between a table and a column of a table-based robotic system is provided. Figure 11 Figures 5-10 An alternative embodiment of a table-based robotic system is shown.

[0017] Figure 12 An end view of a table-based robotic system is shown.

[0018] Figure 13 Figure 12 An end view of a table-based robotic system with a robotic arm attached thereto is shown.

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

[0020] Figure 15 An example instrument driver is shown.

[0021] Figure 16 An example medical instrument with a paired instrument driver is shown.

[0022] Figure 17 An alternative design of an instrument driver and instrument is shown, in which the axis of the drive unit is parallel to the axis of the elongated shaft 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 A block diagram depicting a positioning system that estimates the position of one or more elements of a robotic system, such as the position of an instrument, is depicted in accordance with an example embodiment. Figures 1-10 Figures 16-18

[0026] Figure 21A ​​​​A dynamic pulley system with two pulleys connected together in a first configuration is shown.

[0027] Figure 21B It shows Figure 21A The two pulleys of the dynamic pulley system are positioned side by side in a first configuration.

[0028] Figure 22A It shows Figure 21A The two deployable pulleys of the dynamic pulley system are connected together in a second configuration.

[0029] Figure 22B It shows Figures 21A-22A The dynamic pulley system is positioned side by side in the second configuration.

[0030] Figure 23 A perspective front view of the dynamic pulley system is shown.

[0031] Figure 24 It shows Figure 23 A perspective rear view of a dynamic pulley system.

[0032] Figure 25 It shows Figures 23-24 Front view of a dynamic pulley system.

[0033] Figure 26 It shows Figures 23-25 Rear view of the dynamic pulley system.

[0034] Figure 27 It shows Figures 23-26 A perspective top view of the blades of a dynamic pulley system.

[0035] Figure 28 It shows Figure 27 A perspective side view of the blade.

[0036] Figure 29 It shows Figure 23 A perspective front view of a dynamic pulley system, in which lines extend above the blades and the blades are in an unfolded configuration.

[0037] Figure 30 It shows Figure 29 A perspective front view of a dynamic pulley system, in which lines extend above the blades and the blades are in a collapsed configuration.

[0038] Figure 31 It shows Figure 23 A perspective side view of a dynamic pulley system, with a pair of lines extending above the blades.

[0039] Figure 32 A medical device with a dynamic pulley system having four pulleys is shown. Detailed Implementation

[0040] 1. SUMMARY .

[0041] Aspects of the present disclosure can be integrated into a robotically-enabled medical system that is capable of performing a wide variety of medical procedures, including both minimally invasive procedures such as laparoscopy, as well as non-invasive procedures such as endoscopy. In endoscopy procedures, the system can be capable of performing bronchoscopy, ureteroscopy, gastroscopy, etc.

[0042] In addition to performing a wide variety of procedures, the system can provide additional benefits such as enhanced imaging and guidance to assist the physician. Additionally, the system can provide the physician the ability to perform procedures from an ergonomic position without the need for awkward arm movements and positions. Additionally, the system can provide the physician the ability to perform procedures with improved ease of use such that one or more of the instruments of the system can be controlled by a single user.

[0043] For illustrative purposes, various embodiments will be described below with reference to the accompanying drawings. It should be understood that numerous other implementations can be devised by those skilled in the art that will implement the disclosed concepts in a manner that can differ from the specific implementations disclosed. The title headings included herein are for reference only and are not intended to limit the scope of the concepts described. Such concepts can have applicability in a wide variety of contexts.

[0044] A. Robotic System - Cart .

[0045] A robotically-enabled medical system can be configured in a variety of ways, depending on the particular procedure. Figure 1 An embodiment of a cart-based robotically-enabled system 10 arranged for diagnostic and / or therapeutic bronchoscopy is shown. During bronchoscopy, the system 10 can include a cart 11 having one or more robotic arms 12 to deliver a medical instrument such as a steerable endoscope 13 (which can be a procedure-specific bronchoscope for bronchoscopy) to a natural orifice entry point (i.e., the mouth of the patient positioned on a table in the present example) to deliver diagnostic and / or therapeutic tools. As shown, the cart 11 can be positioned proximate the upper torso of the patient in order to provide access to the entry point. Similarly, the robotic arms 12 can be actuated to position the bronchoscope relative to the entry point. The arrangement in Figure 1 may also be utilized when performing a GI procedure with a gastroscope (a specialized endoscope for gastrointestinal (GI) procedures). Figure 2 An exemplary embodiment of a cart is depicted in greater detail.

[0046] With continued reference 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 coupled to a separate instrument actuator from a set of instrument actuators 28, each instrument actuator coupled to the distal end of a separate robotic arm. This linear arrangement of the instrument actuators 28, which facilitates coaxial alignment of the guide portion and the sheath portion, creates a “virtual track” 29 that can be repositioned in space by maneuvering one or more robotic arms 12 to different angles and / or positions. 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 trolley 11 via support cables to provide control, electronic, fluid, optical, sensor, and / or electrical support to the trolley 11. Placing such functionality in the tower 30 allows for a smaller form factor trolley 11 that can be more easily adjusted and / or repositioned by the operating physician and his / her staff. Additionally, the division of functionality between the trolley / table and the support tower 30 reduces operating room clutter and facilitates improved clinical workflow. While the trolley 11 can be positioned close to the patient, the tower 30 can be retracted 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, a motor in the joint 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 a system that can be deployed via endoscope 13. These components may also be controlled using a computer system of tower 30. In some embodiments, flushing and suction capabilities may be delivered directly to endoscope 13 via a separate cable.

[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 mobile 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 operation of system 10, 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 coupled to cart 11 and endoscope 13 via one or more cables or connectors (not shown). In some embodiments, support functionality from tower 30 can be provided to cart 11 via a single cable, thereby simplifying the operating room and eliminating clutter. In other embodiments, specific functions can be coupled in separate wiring and connections. For example, while power can be provided to cart 11 via a single cable, support for controls, optics, fluid, and / or navigation can also be provided via separate cables.

[0056] Figure 2 Provided from Figure 1 The illustration shows a detailed depiction of an embodiment of a cart 11 in 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 17 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, individually configurable arm mounts on the bracket 17 allow the robotic arm base 21 of the robotic arm 12 to be configured at various angles.

[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 12. Each robotic arm in the robotic arm 12 may have seven joints, and thus provide seven degrees of freedom. Multiple joints result in multiple degrees of freedom, thus allowing for “redundant” degrees of freedom. Having redundant degrees of freedom allows the robotic arm 12 to position its corresponding end effector 22 in a specific orientation, orientation, and trajectory in space using different joint positions 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 joint to a clinically advantageous orientation away from the patient to achieve greater proximity while avoiding arm collisions.

[0061] The cart base 15 balances the weight of the counterweight 14, bracket 17, and robotic arm 12 on the floor. Therefore, the cart base 15 houses heavier components such as electronics, motors, power supplies, and components that enable the cart 11 to move and / or be secured. For example, the cart base 15 includes rollable wheel-shaped casters 25 that allow the cart 11 to easily move around the room before the procedure. Once in the correct orientation, the casters 25 can be secured using wheel locks to hold the cart 11 in the correct orientation 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 4An embodiment of a robot-enabled system 10 for vascular procedures is illustrated similarly. 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 access 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 access 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 access points, such as the carotid and brachial arteries near the shoulder and wrist.

[0066] B. Robotic System - Table .

[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 system 36 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] The robotic arm 39 can be mounted on the bracket 43 via a set of arm mounts 45 comprising a series of joints that can be individually rotated and / or telescopically extended to provide additional configurability 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 stage 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 bracket 43. Internally, column 37 may be equipped with a lead screw for guiding the vertical translation of the bracket, and a motor for mechanizing the lead screw-based translation of bracket 43. Column 37 may also transmit power and control signals to bracket 43 and the robotic arm 39 mounted thereon.

[0071] Platform base 46 has with Figure 2The trolley base 15 in the illustrated trolley 11 functions similarly, 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 requires movement.

[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 a variety of 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 table base 46 for potential retraction of the robotic arm 39. The tower may also include a main controller or console that provides both a user interface (such as a keyboard and / or widgets) for user input and a display screen (or touchscreen) for preoperative and intraoperative information (such as real-time imaging, navigation, and tracking information). In some embodiments, the tower may also include a gripper for a gas canister to be used for inflatation.

[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 robotic arm 50 around a post 53, and to close to retract the bracket, arm mount, and robotic arm for protection when not in use. The base cover 52 can be sealed along the edges of its opening using 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 one or more small incisions in the abdominal wall. In some embodiments, the minimally invasive instruments include elongated rigid components, such as axes, for accessing the anatomical structures within the patient. After the patient's abdominal cavity is inflated, the instruments can be guided to perform surgical or medical tasks, such as grasping, cutting, ablation, suturing, etc. In some embodiments, the instruments may include endoscopes, such as laparoscopes. Figure 9 An implementation of a table-based, robot-enabled system configured for laparoscopic procedures is shown. 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 another part. Additionally, arm mount 45 can rotate to match the tilt, ensuring that robot 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 platform 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 is achieved 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 may 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 a head-down, feet-up position (i.e., positioning the patient's lower abdomen higher than their upper abdomen above the floor) for lower abdominal surgery. The head-down, feet-up position causes the patient's internal organs to slide down to their 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 head-down, feet-up 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 may include: (i) an instrument actuator (alternatively referred to as an "instrument drive mechanism" or "instrument device manipulator") incorporating electromechanical devices for actuating medical devices; and (ii) a removable or detachable medical device, which may lack any electromechanical components, such as motors. This dichotomy may be driven by the need 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, medical devices may 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 an 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 Instrument .

[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 an instrument actuator 75 extending through the distal end of a 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 actuator 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 a connector wrist formed by a connecting fork having at least one degree of freedom and a surgical tool or medical instrument (such as, for example, a gripper or scissors), 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 bending segment that articulates and bends based on torque received from the drive output 74 of the instrument actuator 75.

[0093] Torque from the instrument actuator 75 is transmitted along the elongated shaft 71 using tendons. These individual tendons (e.g., traction cables) may be individually anchored to a separate drive input 73 within the instrument handle 72. From the handle 72, the tendons are guided downward along one or more traction chambers of the elongated shaft 71 and anchored at the distal portion of the elongated shaft 71, or at the wrist at the distal portion of the elongated shaft. During surgical procedures such as laparoscopy, endoscopy, or mixed procedures, these tendons may be coupled to a distally mounted end effector, such as a wrist, gripper, or scissors. In such an arrangement, torque applied to the drive input 73 transmits tension to the tendons, thereby actuating the end effector in a certain way. In some embodiments, during surgery, the tendons may cause the connector to rotate about the axis, thereby causing the end effector to move in one direction or the other. Alternatively, the tendons may be connected to one or more jaws of a gripper at the distal end of the elongated shaft 71, wherein tension from the tendons causes the gripper to close.

[0094] During endoscopy, tendons can be coupled via adhesives, control rings, or other mechanical fasteners to flexural or articulated segments positioned along an elongated axis 71 (e.g., at the distal end). When fixedly attached to the distal end of a flexural segment, torque applied to the drive input 73 is transmitted down the tendon, causing the softer flexural segment (sometimes referred to as an articulated segment or region) to flex or articulate. Along non-flexural segments, it can be advantageous to helve or coil individual traction cavities that guide individual tendons along the wall (or inside) of the endoscope axis to balance radial forces caused by tension in the traction lines. For specific purposes, the angle of the helices and / or the spacing between them can be varied or designed, with tighter helices exhibiting less axial compression under load, while a lower amount of helix causes greater axial compression under load but restricts flexion. Alternatively, traction cavities can be guided parallel to the longitudinal axis of the elongated axis 71 to allow controlled articulation in the desired flexural or articulated segment.

[0095] In endoscopic procedures, the elongated shaft 71 accommodates multiple components to assist in robotic procedures. The shaft 71 may include, at its distal end, a working channel for deploying surgical instruments (or medical devices), rinsing and / or aspirating the surgical area. The shaft 71 may also be adapted with wires and / or optical fibers to transmit signals to / from optical components at its distal end, which may include an optical camera. The shaft 71 may also be adapted with optical fibers to carry light from a proximal light source (such as a light-emitting diode) to the distal end of the shaft 71.

[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 axis of the drive input, is orthogonal to the axis of the elongated shaft 71. 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 tendon as it extends from the drive input 73 and enters the traction cavity within the elongated shaft 71. Such tendon tangling can disrupt any control algorithms designed to predict the movement of the flexible elongated shaft 71 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 80. 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 device 86, including the instrument base 87 and the instrument shaft 88, rotates in combination with the rotating assembly 83 about the instrument driver axis 85. Since the instrument shaft 88 is positioned at the center of the instrument base 87, it is coaxial with the instrument driver axis 85 when attached. Therefore, rotation of the rotating assembly 83 causes the instrument shaft 88 to rotate about its own longitudinal axis. Furthermore, when the instrument base 87 rotates together with the instrument shaft 88, any tendons connected to the drive input portion 89 in the instrument base 87 do not become entangled during rotation. Therefore, the parallelism of the axes of the drive output portion 81, the drive input portion 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 illustrated. Instrument 150 is coupleable 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 coupled 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 the grooves. 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 compliant assembly robot 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 handle 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 able to operate 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 1-4 The trolley 11 shown Figures 5-14 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 whole, image-based models of the anatomical cavities, spaces, and structures of the patient’s anatomical structures, such as the patient’s lung network, can be generated. Techniques such as centerline geometry can be determined and approximated from CT images to form a three-dimensional volume of the patient’s anatomy, which is referred to as model data 91 (also referred to as “preoperative model data” when generated using only preoperative CT scans). The use of centerline geometry is discussed in U.S. Patent Application 14 / 523,760, the contents of which are incorporated herein by reference in their entirety. Network topology models can also be derived from CT images and are particularly well-suited for bronchoscopy.

[0115] In some implementations, the instrument may be equipped with a camera to provide visual data (or image data) 92. A positioning module 95 may process the visual data 92 to enable one or more vision-based (or image-based) position tracking modules or features. For example, preoperative model data 91 may be used in conjunction with the visual data 92 to enable computer vision-based tracking of a medical instrument (e.g., an endoscope or an instrument propelled through the working channel of an endoscope). For example, using the preoperative model data 91, a robotic system may generate a library of expected endoscopic 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. During surgical procedures, the robotic system may 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 motion 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 from joint movement commands can be determined during preoperative calibration. During surgical procedures, 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. Dynamic Tensioning of Multi-strand Input .

[0124] Examples of this disclosure relate to systems and techniques for use in robotic medical devices. In some aspects, robotic medical devices can be integrated with robot-enabled medical systems (such as those referenced above). Figures 1-20 (Those described herein) may be used together. Examples of medical devices may include instruments configured to be controlled by a robotic arm, such as flexible endoscopes or catheters. In some aspects, medical devices may include wrist-actuated medical tools, cameras (e.g., having optical fibers), gripper tools, basket tools, blade tools, laser tools (e.g., having optical fibers), and / or other instruments described herein. In some aspects, medical devices may be configured for endoscopic procedures. For example, medical devices may be configured for ureteroscopy, gastroscopy, bronchoscopy, or other endoscopic procedures. In some examples, medical devices may be configured for laparoscopic procedures or other types of medical procedures (e.g., open surgery).

[0125] Medical devices can be articulated to navigate through a patient's anatomy, thereby accessing, visualizing, diagnosing, and / or treating conditions in various organs (such as the kidney in ureteroscopy) through orifices and lumens. To navigate through the orifices and lumens of various organs (such as the kidney), medical devices should be flexible and deflectable in one or more directions. Medical devices can also be elongated to allow them to reach desired target areas within the patient's anatomy.

[0126] The medical device can be attached to a device drive mechanism positioned at the end of a robotic arm or other device positioning device. The device drive mechanism may include one or more robot drive outputs that engage one or more robot drive inputs or drive shafts to robotically control the medical device. The physician can use a controller (e.g., such as...) Figure 19 (As shown) is a system used to control the robot's enablement.

[0127] In some aspects, a medical device may include a tool having a wrist that can be actuated to control and manipulate the tool. In some aspects, a medical device may include an instrument handle that may include one or more rotary drive inputs or drive shafts. The drive shaft may use one or more deployable pulleys to actuate one or more pull wires. One or more pull wires may be actuated to articulate the elongated shaft or wrist of the tool.

[0128] Medical devices may include an elongated shaft and an instrument handle (or instrument base). The elongated shaft may be configured for insertion into a patient's anatomy during medical procedures. In some aspects, the elongated shaft is inserted into a patient's anatomy through a natural orifice. In other aspects, the elongated shaft is inserted into a patient's anatomy through an incision or other surgical opening. The elongated shaft may be flexible. The elongated shaft may be articulated and controllable. This allows an operator (such as a physician) to control the articulated movement of the elongated shaft to navigate and manipulate the medical device through the patient's anatomy. Controlling the articulated movement of the elongated shaft may include deflecting or bending the articulated portion of the elongated shaft, and in some embodiments, causing the elongated shaft to roll or rotate about its longitudinal axis.

[0129] In some aspects, the articulated portion may be the distal portion of the elongated shaft. The articulated portion may perform joint movements with one or more degrees of freedom. These degrees of freedom may be linear or rotational. For example, the first degree of freedom may be translation along a first axis, the second degree of freedom may be translation along a second axis perpendicular to the first axis, and the third degree of freedom may be translation along a third axis perpendicular to both the first and second axes. Additional or alternative degrees of freedom may exist, such as rotation about one or more of the first, second, and / or third axes, and / or rotation within the first, second, and / or third planes. Actuation of the elongated shaft may be controlled at the base of the instrument.

[0130] The instrument base or handle may be connected to the elongated shaft, such as at a proximal or distal portion. The instrument base may include one or more rotary drive inputs or drive shafts. The elongated shaft may be coupled to a drive input to control articulated movement of one or more portions of the elongated shaft. The elongated shaft may include one or more traction cables extending along its length. The one or more traction cables may be actuable to articulate the elongated shaft. One or more drive inputs coupled to one or more deployable pulleys via one or more traction cables may be configured to bend the shaft in various directions, such as at the distal end. The medical device may include a drive input, which may also be referred to as a rotary drive input, input, drive shaft, rotary drive shaft, or shaft. The drive input may be located in the handle of the medical device.

[0131] In some aspects, one of the drive inputs is configured to provide bidirectional deflection control to an elongated axis of the medical device. Bidirectional deflection control allows the elongated axis to deflect in two directions. In some embodiments, these two directions can be opposite, such as up and down or left and right. This can also be referred to as bidirectional deflection control in a single plane (such as an up-down plane or a left-right plane). Directional terms (e.g., up, down, left, right, etc.) are used broadly to indicate different directions relative to the orientation of the medical device. Because the medical device can be constantly repositioned in various orientations, directional terms should not be interpreted as limiting. For example, directions referred to as up, down, left, and right may vary depending on the orientation of the device. In some aspects, controlling or operating a manual or robotic drive input along a first direction causes the elongated axis to deflect along the first direction (e.g., up), and manipulating a manual or robotic drive input along a second direction causes the elongated axis to deflect along the second direction (e.g., down). In some aspects, the medical device may include additional drive inputs configured to allow for additional bidirectional deflection control. For example, the first drive input can allow bidirectional deflection control in opposite directions (such as up and down), and the second drive input can allow bidirectional deflection control in both left and right directions. Alternatively, the first drive input can allow bidirectional deflection control in any two directions (such as up and left), and the second drive input can allow bidirectional deflection control in the other two directions (such as down and right). This would allow for four-way deflection control of the slender shaft using two drive inputs.

[0132] In some aspects, the drive input is configured to allow four-way deflection control. In some aspects, four-way deflection control allows articulation of an elongated shaft in four different directions. In some aspects, these directions can be four orthogonal directions, such as up, down, left, and right. In some aspects, the drive input configured for four-way deflection control may include two robot drive inputs. These two drive inputs may be configured to engage with two corresponding drive outputs on a machine drive mechanism. Each drive input can rotate in two opposite directions (e.g., clockwise and counterclockwise). Rotation of the first drive input in one direction (e.g., clockwise) allows articulation in one of the four directions (e.g., up). Rotation of the first drive input in the opposite direction (e.g., counterclockwise) allows articulation in another of the four directions (e.g., down). Rotation of the second drive input in one direction (e.g., clockwise) allows articulation in another of the four directions (e.g., right). Furthermore, rotation of the second drive input in the opposite direction (e.g., counterclockwise) allows joint movement in another of the four directions (e.g., left). Therefore, two drive inputs can be used to achieve four-way deflection control. In some aspects, the drive inputs are configured to provide other numbers of directional deflection controls, such as bidirectional deflection control, tridirectional deflection control, etc.

[0133] As described above (e.g., reference) Figures 15-18 In some aspects, the medical device may include one or more traction lines extending along an elongated axis (e.g., extending over or through at least a portion of the elongated axis). The traction lines may be attached to an actuation mechanism, such as one or more deployable pulleys, within the device handle. The actuation mechanism may then be connected to a drive input such that actuation of the drive input operates the actuation mechanism to pull the traction lines, thereby causing articulation of the elongated axis. In some aspects, one or more drive inputs are each connected to the same actuation mechanism (e.g., pulley, winch, and / or pulley assembly) within the device handle, such that the drive input can be used to actuate the same actuation mechanism.

[0134] Physicians can control medical devices by manipulating or operating the drive inputs or drive shafts. It may be advantageous to wire and control two lines or cables on a single drive shaft, allowing for bidirectional control. This can be advantageous because it is more efficient and frees up other drive shafts for other purposes (e.g., to control other types of joint movements or functions). One of the challenges in enabling joint movements in medical devices is the slack management of the traction or control lines around pulleys or winches. Each of the two traction lines can be attached to a pulley. The two pulleys can each be coupled to the same single drive shaft. The two pulleys can be driven by a single drive shaft, allowing the single drive shaft to control joint movement or deflection in two directions. However, the challenge of wiring two lines (via two pulleys) on a single drive shaft can lead to excessive slack, which can result in excessive hysteresis in joint movement response, resulting in a substandard robotic driving experience when the user attempts to navigate internal anatomy. For example, as the pulleys rotate, one of the lines becomes taut while the other, which is not taut, becomes slack. When the pulley rotates in the opposite direction, the slack in the untensioned line can cause the aforementioned undesirable hysteresis.

[0135] Control lines can be used in instruments or to move slender shafts (such as catheters) into joints. In either of these applications, it is desirable to use a single pulley to control two control lines on a single drive shaft, but this can lead to undesirable hysteresis. Therefore, it is even more desirable to drive two pulleys on a single drive shaft, each pulley connected to one of the two control lines, which reduces slack and minimizes response hysteresis.

[0136] Figures 21A-21B as well as Figures 22A-22B An exemplary embodiment of a dynamic pulley system 200 having two deployable pulleys 210, 220 is shown. Figure 21A A dynamic pulley system 200 is shown having two deployable pulleys 210, 220 connected together in a first configuration. Figure 21B The two deployable pulleys 210 and 220 of the dynamic pulley system 200 are shown to be separated and positioned side by side in a first configuration. Figure 22A It shows Figures 22A-22B The two deployable pulleys 210 and 220 of the dynamic pulley system 200 are connected together in a second configuration. Figure 22B It shows Figure 22A The two deployable pulleys 210, 220 of the dynamic pulley system 200 are positioned side by side in a first configuration. The dynamic pulley system 200 can also be regarded as a single pulley with two sides 210, 220, wherein each side of the pulley is engaged with a separate pull line 212, 222. Figures 21A-22B The dynamic pulley system 200 can be used to control pull lines 212, 222 that can be connected to and actuated as described above for conduits or tools. Figures 21A-22BThe dynamic pulley system 200 has two deployable pulleys 210, 220 that can be actuated to pull lines 212, 222 connected to a conduit or tool.

[0137] During bidirectional drive actuated by the drive shaft, each attached pulley 210, 220 can expand and contract to maintain minimum tension on each tension line 212, 222, thereby managing and preventing any excessive slack along the path of each pulley 210, 220. The first pulley 210 and the second pulley 220 are configured to expand or collapse to address the problem of response hysteresis, which can occur when multiple lines are driven by a single drive shaft. For example, when the drive shaft changes direction, the first pulley 210 and the second pulley 220 can expand to dynamically tension and maintain minimum tension on each corresponding tension line 212, 222, tightening any slack.

[0138] The first deploying pulley 210 may include a first pull line 212 wound around the first deploying pulley 210 in one direction, such as counterclockwise 240. The second deploying pulley 220 may include a second pull line 222 wound around the second deploying pulley 220 in another direction, such as clockwise 230.

[0139] The first deploying pulley 210 is configured to deploy when rotated in a first direction (e.g., counterclockwise direction 240) and collapse when rotated in a second direction (e.g., clockwise direction 230). The second deploying pulley 220 is configured to collapse when rotated in the first direction (e.g., counterclockwise direction 240) and deploy when rotated in the second direction (e.g., clockwise direction 230). The first direction corresponds to the direction in which the first deploying pulley 210 pushes or releases the tension on the first tension line 212, and the second direction corresponds to the direction in which the first deploying pulley 210 pulls or increases the tension on the first tension line 212. Regarding the second deploying pulley 220, the first direction corresponds to the direction in which the second deploying pulley 220 pulls or increases the tension on the second tension line 222, and the second direction corresponds to the direction in which the second deploying pulley 220 pushes or releases the tension on the second tension line 222. The first deploying pulley 210 can rotate from its deploying configuration in a second direction (e.g., clockwise 230) to increase the tension in the first tension line 212. As the first deploying pulley 210 rotates and applies tension to the first tension line 212, the first deploying pulley 210 collapses. Simultaneously, the second deploying pulley 220 can decrease the tension in the second tension line 222 from its collapsed configuration. As the second deploying pulley 220 rotates and releases the tension on the second tension line 222, the second deploying pulley 220 can deploy to tighten the slack on the second tension line 222.

[0140] Figures 21A-21BA dynamic pulley system 200 rotating in a first direction (such as counterclockwise direction 240) is shown. Figures 22A-22B A dynamic pulley system 200 is shown that rotates in a second direction (such as clockwise direction 230). The second direction (e.g., clockwise direction 230) may be opposite to the first direction (e.g., counterclockwise direction 240).

[0141] like Figure 21A and Figure 22A As shown, the first pulley 210 and the second pulley 220 can be positioned such that the centers of the pulleys are aligned through the center of the pulley. Drive shaft 260 (e.g.) Figure 21A and Figure 22A (As shown) It can be connected to the first pulley 210 and the second pulley 220. The drive shaft 260 can be similar to... Figure 15 One or more drive shafts 64 are shown. (e.g.) Figure 15 As shown, the drive unit 63 may include one or more drive shafts 64 that can be arranged with parallel axes. The one or more drive shafts 64 may be connected to one or more pulleys to provide controlled torque to the medical device via the drive shafts 64. The drive shafts 64 may thus simultaneously rotate the first pulley 210 and the second pulley 220. Figures 21A-21B As shown, as the drive shaft 260 rotates in the first direction 240, the first pulley 210 unfolds and the second pulley 220 collapses. Figures 22A-22B As shown, as the drive shaft 260 rotates in the second direction 230, the first pulley 210 collapses and the second pulley 220 unfolds.

[0142] Figures 21A-21B A pulley system 200 in a first configuration is shown, wherein a first pulley 210 is in an extended configuration 210A, wherein the diameter (“D1”) of the extended first pulley is extended or extended. The first pulley 210 is configured to extend when the first pulley 210 rotates in a first direction (such as counterclockwise direction 240). Figures 21A-21B A pulley system 200 in a first configuration is shown, wherein a second pulley 220 is in a collapsed configuration 220A, wherein the diameter (“D2”) of the collapsed second pulley is contracted or collapsed. The second pulley 220 is configured to contract when the second pulley 220 rotates in a first direction (such as counterclockwise direction 240). A first deployable pulley 210 is available from, for example... Figure 21A The deployment configuration 210A shown increases the tension in the first tension line 212 or applies tension to the first tension line by rotating in the second direction 230. As the first deployment pulley 210 rotates and tension is applied to the first tension line 212, the first deployment pulley 210 collapses, as... Figures 22A-22B As shown. The second unfolding pulley 220 can be drawn from, as shown Figure 21AThe collapsed configuration 220A shown reduces or releases tension in the second tension line 222 by rotating in the second direction 230. As the second deployment pulley 220 rotates and releases tension in the second tension line 222, the second deployment pulley 220 can... Figures 22A-22B The slack on the second tension line 222 is stretched as shown.

[0143] Figures 22A-22B A pulley system 200 in a second configuration is shown, wherein the first pulley 210 is in a collapsed configuration 210B, wherein the diameter (“D1”) of the collapsed first pulley is collapsed or contracted. The first pulley 210 is configured to collapse when the first pulley 210 rotates in a second direction (such as clockwise direction 230). Figures 22A-22B A pulley system 200 in a second configuration is shown, wherein a second pulley 220 is in an extended configuration 220B, wherein the diameter (“D2”) of the extended second pulley 220B is extended. The second pulley 220 is configured to extend when the second pulley 220 rotates in a second direction (such as clockwise direction 230). A first extended pulley 210 is available from, for example... Figures 22A-22B The collapsed configuration 210B shown reduces or releases tension in the first tension line 212 by rotating along the first direction 240. The second unfolding pulley 220 can be accessed from... Figures 22A-22B The unfolded configuration 220B shown increases the tension in the second tension line 222 or applies tension to the second tension line by rotating in the first direction 240.

[0144] In some aspects, the first traction wire 212 and the second traction wire 222 may extend along an elongated shaft (not shown), such as from a distal end to a proximal end of the elongated shaft. The first traction wire 212 and the second traction wire 222 may be configured to bend the shaft in two opposite directions. The two opposite directions may be left and right or front and back. The two opposite directions may also be up and down or low and high. In some aspects, the first traction wire 212 and the second traction wire 222 may bend the shaft in any two directions, such as up and right or down and left. One or more drive inputs may also be configured to rotate or linearly translate the elongated shaft about its longitudinal axis. The instrument base may include two drive inputs. Each drive input may receive a dynamic tension pulley system including two deploying pulleys. Each dynamic pulley may be coupled to a traction wire. Each drive input in the drive inputs may control the elongated shaft in two directions and cause the elongated shaft to articulate. Thus, the two drive inputs may control four traction wires, thereby controlling the four-way articulation of the elongated shaft. For example, the first and second pulleys may be connected to the first drive input, while the third and fourth pulleys may be connected to the second drive input. The first pull wire 212 and the second pull wire 222 may also be actuated in other environments, such as tools attached to the wrist (e.g., clamps, grippers, cutters, or any other tools).

[0145] As described above, a dynamic pulley system may include one or more pulleys configured to expand or contract. Various mechanisms can be used to expand and contract the diameter of the pulleys. For example, in some aspects, one or more pulleys may be made of compressible or deformable materials. In some examples, the outer surface of the pulley is supported by one or more springs. Figure 23 An example of a dynamic pulley system is shown, which utilizes deformable blades to change the diameter of at least a portion of the dynamic pulley system. As described, because the dynamic pulley is configured to collapse or expand against the tension lines, it can dynamically tension one or more tension lines. The dynamic tension of the expanding pulley can be generated by deformable blades, which may also be referred to as vanes or tabs, radially positioned around the expanding pulley.

[0146] Figure 23 A perspective front view of the dynamic pulley system is shown. Figure 25 It shows Figure 23 A front view of a dynamic pulley system. The front side of the dynamic pulley system can be considered as a first pulley 300. In some aspects, the front side of the dynamic pulley system can be considered as a first side 300 of a single pulley. The first pulley or first side 300 includes a central hub 320 having a central or central bore 310. The central bore 310 may be shaped and configured to receive a drive shaft (not shown). In some aspects, the central bore 310 may include a series of grooves or recesses corresponding to the shape of the drive shaft, such that the drive shaft, when placed in the central bore 310, can actuate the rotation of the first pulley 300.

[0147] The first pulley 300 includes a series of blades 350, which may also be referred to as flaps or fins. Each blade 350 extends outward from the hub 320. Although the first pulley 300 includes as... Figure 23 and Figure 25 The four blades 350 shown are not shown, but the first pulley 300 may include any number of blades 350, such as 1, 2, 3, 4, 5, 6 or more. Each blade in the series of blades 350 may be attached to a point on or adjacent to the hub 320.

[0148] The hub 320 may include a series of protruding surfaces 322, 324 that serve as stops to limit the range of rotation of each tab 350. For example, a first protruding surface 322 serves as a stop to limit the rotation of the tab 350 in a first direction 240, and a second protruding surface 324 serves as a stop to limit the rotation of the tab 350 in a second direction 230.

[0149] although Figure 23 and Figure 25A series of blades 350 are shown positioned on one side of the first pulley 300, but the blades 350 may be positioned anywhere on the first pulley 300, such as on the opposite side of the first pulley 300 as shown, or positioned to completely surround the first pulley 300. The first pulley 300 may also include a fixing portion 380. The outer or distal surface of the fixing portion 380 may be curved to match the outer circumference of the first pulley 300 and engage with a line wound around the first pulley 300.

[0150] A blade 350 is attached to or adjacent to a hub 320 at an attachment point 326, which defines the axis of rotation or pivot point of the blade 350. The blade 350 may be attached to or adjacent to the hub 320 in various ways, such as by a pin. The blade 350 rotates about the axis of rotation or pivot point defined by the attachment point 326. Each blade 350 has a length from the point 326 where it is attached to the hub 320 to the outermost portion of the blade 350.

[0151] Each blade 350 is movable between an extended position and a collapsed position. The blade 350 may hinge with the hub 320. In some respects, the blade 350 may rotate as a hinge as it rotates about the attachment point 326. The blade 350 may receive a spring 330 to bias the blade 350 in the extended position. The spring 330 may be a torsion spring 330. A portion of the spring 330 may be positioned against a first protruding surface 322. Another portion of the spring 330 may be received within a recess in the blade 350.

[0152] Figure 24 A perspective rear view of a dynamic tension pulley system is shown. Figure 26 A rear view of the dynamic pulley system is shown. The rear side of the dynamic pulley system can be considered as a second pulley 400. In some aspects, the second pulley 400 may be fixed or coupled to the first pulley 300. In some aspects, the second pulley 400 may be integral with the first pulley 300. In some aspects, the first pulley 300 and the second pulley 400 may be positioned back-to-back. In some aspects, the first pulley 300 and the second pulley 400 may be positioned back-to-back and located on the same drive input. In some aspects, the rear side of the dynamic pulley system can be considered as a second side 400 of a single pulley positioned opposite to the first side 300 of the single pulley.

[0153] Similar to the first pulley 300, the second pulley 400 includes a central hub 420 having a central bore 410. The second pulley 400 includes a series of blades 450 extending outwardly from the hub 420. Similar to the first pulley 300, the second pulley 400 may include a fixed portion 480. The blades 450 may be hinged to the central hub 420. The blades 450 may receive a spring 430 to bias the blades 450 in an extended position. As described herein, the second pulley 400 may be a generally mirror image of the first pulley 300. When the first pulley 300 and the second pulley 400 are positioned back-to-back, the central bore 410 of the second pulley 400 may be aligned with the central bore 310 of the first pulley 300.

[0154] Figures 27-28 A blade 350 of a first pulley 300 is shown. The blade 350 may include a proximal or radially inner portion 354 and a distal or radially outer portion 356. The diameter of the blade 350 may increase from the proximal portion 354 to the distal portion 356. The proximal portion 354 may be considered the innermost portion, while the distal portion 356 may be considered the outermost portion. The proximal portion 354 may be narrow, while the distal portion 356 may be wide. The distal portion 356 may extend on one side, such that the blade 350 is asymmetrical and has an overall "L" shape. The distal portion 356 may include a sloped or angled outer edge. The distal outer portion of the blade 350 may be radially inwardly sloped in a first direction (such as a first rotational direction 240).

[0155] The sloping outer edge may include a distal recess or groove 360 ​​for receiving a portion of a pull wire (also referred to as a line or cable). In this way, the wire can engage with the outermost portion 356 of the blade 350. The proximal portion 354 may include a hole 352 to allow for engagement at the attachment point 326 (such as adjacent to the center hub 320, e.g.) Figure 23 and Figure 25 (As shown) The blade 350 is attached or anchored to the pulley 300. The proximal portion 354 may include at least a portion of the spring 330 (as shown). Figure 23 and 25 The proximal recess or groove 358 (as shown in the figure) may be located on the first side of the blade 350. The distal groove 360 ​​may be positioned on the second side of the blade 350 opposite to the first side. The distal groove 360 ​​may be located from the second side of the blade 350 (e.g., the first side of the blade 350). Figure 27 (as shown) extends to the distal end of blade 350 (e.g. Figure 28 (As shown).

[0156] As described herein, the second pulley 400 can be a mirror image of the first pulley 300. The blade 450 of the second pulley 400 (e.g., Figure 24 and Figure 26 (As shown) can be used with blade 350 (e.g.) Figure 23 , Figure 25, Figure 27 and Figure 28 (As shown) is essentially similar but a mirror image. Thus, the outer side of the blade 450 can be radially inward in a second direction (such as the second rotational direction 230 of the pulley 300).

[0157] Figure 29 A perspective front view of a dynamic pulley system is shown, in which line 500 connects to blade 350 in an unfolded configuration. Figure 30 A perspective front view of a dynamic pulley system is shown, in which line 500 is connected to blades 350 in a collapsed configuration. As the dynamic pulley system rotates and the pulleys increase the tension on the line, blades 350 subsequently collapse. As the dynamic pulley system rotates in different directions, the pulleys decrease the tension on line 500, and blades 350 subsequently unfold to tighten the slack in line 500.

[0158] A line 500 may be coupled to a pulley 300 and extend around one or more blades 350. One end of the line 500 may be attached to the pulley 300 at a termination point. The pulley 300 may also include a ratchet 370 configured to pretension the line 500. The ratchet 370 may receive one end of the line 500. One end of the line 500 may terminate at the ratchet 370, such that the ratchet 370 may be considered a termination point. The line 500 extends from the termination point around the outermost portion 356 of a series of blades 350. The line 500 may then extend along the elongated shaft or wrist of a tool coupled to a medical device, as previously described. The line 500 may then be actuated to articulate the elongated shaft or wrist of the tool of the medical device.

[0159] As described herein, a series of blades 350 may each have a distal groove 360 ​​to receive a line 500. When the line 500 is received in the distal groove 360 ​​of the blade 350, the line 500 is configured to compress the edge of the blade 350 to cause the blade 350 to collapse. The blade will collapse under tension on the line 500, where the tension increases as the pulley 300 rotates. The blade 350 may be biased into an unfolded configuration (e.g., with a spring) such that the blade 350 will unfold due to the decrease or release of tension as the pulley 300 rotates. With the series of blades 350 radially positioned around a central hub 320, the orientation of the extensions of the distal portions 356 may be aligned with each other and may each point in a direction of rotation, such as counterclockwise 240. The line 500 may be wound around the series of blades 350 in a second direction of rotation (such as clockwise 230).

[0160] like Figure 15As shown, the drive unit 63 may include one or more drive shafts 64 that can be arranged to have parallel axes. The one or more drive shafts 64 may be connected to one or more pulleys to provide controlled torque to the medical device via the drive shafts 64. As described herein, the drive shaft 64 may be inserted into a central bore 310 of the first pulley 300. The drive shaft 64 may subsequently drive rotation of the pulley 300 to rotate in a first direction and a second direction, such as counterclockwise 240 and clockwise 230. In various other configurations, a gear train or any other mechanical connection may be used between the drive shaft 64 and the pulley, such that the drive shaft drives rotation of the pulley. As described herein, each blade 350 may extend outward from the hub 320 and may be movable from an deployed position and a collapsed position. The blade 350 may be rotatable between the deployed and collapsed positions. As described herein, the blade 350 may pivot about an attachment point 326 to which the blade 350 is attached to the pulley 300. The blades 350 are configured to collapse in a first direction during rotation and expand in a second direction, opposite to the first direction. For example, the first direction could be counterclockwise 240 and the second direction could be clockwise 230.

[0161] like Figure 29 As shown in the diagram, the outermost portion 356 of the blade 350 is positioned furthest from the central hub 320. (As indicated...) Figure 30 As shown in the collapsed position, the outermost position 356 of the blade 350 is positioned closest to the center hub 320.

[0162] The blade 350 can be configured to expand radially outward toward the expanded position as the pulley rotates. The blade 350 can also be configured to collapse radially inward toward the collapsed position as the pulley rotates in different directions. When the blade 350 is connected to point 326 on the hub 320, the blade 350 rotates as a hinge around point 326 on the hub 320 between the expanded and collapsed positions. Thus, since a series of blades 350 can be positioned around the pulley 300 and can move between the expanded and collapsed positions, the pulley 300 can be considered as both expanding and collapsing.

[0163] When the blade 350 is connected to the line 500, the blade 350 is configured to unfold against the line 500 as the pulley 300 rotates. Each blade in a series of blades 350 is configured to unfold against the line 500 as the pulley 300 rotates. Each blade 350 is configured to unfold to push the line away from the hub 320, thereby tightening the slack portion in the line 500.

[0164] The blades 350 of pulley 300 can be biased into an deployed configuration (e.g., using spring 330). As pulley 300 rotates, one or more blades 350 may come into contact with line 500. As pulley 300 rotates to pull and actuate line 500, blades 350 will subsequently and sequentially collapse. Thus, when one or more blades 350 are in the deployed position, one or more blades 350 may be in a fully or partially collapsed position. In some embodiments, the pulley may be configured to “switch” line 500 to one or more blades. In such embodiments, at a given time, at least one blade 350 is in contact with line 500 and at least one blade 350 is not in contact with line 500. As the pulley rotates, as the already contacted blades rotate further with the pulley, the pulley may cause the non-contacting blades to come into contact with the line and may begin to collapse. Such a switching sequence may contribute to providing a smooth response to actuation of line 500 as the pulley rotates. As the pulley 300 rotates in the direction of the pulling line 500 (e.g., counterclockwise 240), at least one of the blades 350 collapses and at least another blade of the series of blades 350 comes into contact with the line 500.

[0165] The fixed portion 380 can be considered as a fixed blade or a crescent-shaped profile. The fixed portion 380 can increase the diameter of the first pulley 300. The increased diameter can result in less slack and reduce the required rotation of the pulley 300. When a series of blades 350 have collapsed, the fixed portion 380 can contact the line 500. As the pulley 300 continues to rotate, the blades 350 can subsequently switch or transfer the line 500 to the fixed portion 380 of the pulley 300, such that the outer edge of the fixed portion 380 now contacts the line 500. In some embodiments, the pulley 300 can be configured such that the switching from the blades 350 to the fixed portion 380 occurs before the blades 350 have fully collapsed. The switching of the line 500 from a series of blades 350 to the fixed portion 380 mitigates the problem of premature collapse of the blades 350 under higher tension below the line 500. As each blade 350 collapses, the remaining blades 350 that remain extended and in contact with the line 500 are subjected to increased tension below the line 500. When the pulley 300 rotates and the stationary part 380 comes into contact with the line 500, the tension from the line 500 can then be distributed to the stationary part 380 and reduce or mitigate the problem of premature collapse of the blade 350.

[0166] In some embodiments, during rotation of pulley 300, switching of line 500 may occur between blade 350 and stationary portion 380, as described above. In other embodiments, during rotation of pulley 300, switching of line 500 may also occur between blades 350, as some blades 350 contact line 500 while others do not. For example, as each blade 350 collapses under tension from line 500, line 500 may be transferred from one blade 350 to another, and the next blade 350 in the offset deployment configuration contacts line 500. As pulley 300 rotates in the direction pulling line 500, deployed blades 350 will contact line 500 as other blades 350 begin to collapse. In some embodiments, there is no switching of line 500.

[0167] The second pulley 400 can be a mirror image of the first pulley 300. The second pulley 400 can be configured to operate in a similar manner to pulley 300 but in the opposite direction. Figure 31 A perspective side view of the dynamic pulley system is shown, with certain components shown as transparent to reveal the first series of blades 350 and the second series of blades 450. The first pulley 300 can be coupled to or stacked on top of the second pulley 400. The first pulley 300 can be positioned back-to-back with the second pulley 400. When the first pulley 300 and the second pulley 400 are positioned back-to-back, their corresponding center holes 310, 410 can be aligned. A single rotary drive input (such as the same drive shaft 64 as described above) can pass through the aligned center holes 310, 410 of the first pulley 300 and the second pulley 400. The rotary drive input can be coupled to the pulleys 300 and 400 to simultaneously drive both pulleys 300 and 400 together. As described herein, the rotary drive input can drive the first pulley 300 and the second pulley 400 in a first direction 240 and a second direction 230.

[0168] As described herein, the system can also be considered as a single pulley with two sides 300, 400. A first series of blades 350 is attached to the first side 300 of the pulley, and a second series of blades 450 is also attached to the second side 400 of the pulley. The outer surface of each blade in the first series of blades 350 is inclined in a first rotational direction 240. A line 500 may terminate at the pulley 300 and is wound around the outermost portion 356 of the blades 350 in a second rotational direction 230. The outer surface of each tab in the second series of tabs 450 is inclined in a second rotational direction 230, opposite to the first rotational direction 240. A second line 600 may terminate at the second pulley 400 and is wound around the outermost portion 456 of the second series of blades 450 in the first rotational direction 240.

[0169] A first pulley 300 can rotate in a first rotation direction 240 to pull a first line 500 connected to it. The first pulley 300 can also rotate in a second rotation direction 230, opposite to the first rotation direction. When the first pulley 300 rotates in the second rotation direction 230, it can deploy. As the first pulley 300 rotates in the second rotation direction 230, slack is released in the tension line 500. The first pulley 300 may include a first series of blades or vanes 350. When the first pulley 300 is deployed, the first series of vanes 350 can move to an deployed position. When the pulley 300 rotates in the first rotation direction 240, the first series of vanes 350 can move to a collapsed position.

[0170] The second pulley 400 can be connected to the first pulley 300. Since the second pulley 400 is a mirror image of the first pulley 300, the second pulley 400 can operate in a similar manner during unfolding and collapsing, but in the opposite direction to the first pulley 300.

[0171] The second pulley 400 can rotate in a second rotation direction 230 to pull a second line 600 connected to the second pulley 400. The second pulley 400 can rotate in a first rotation direction 240 opposite to the second rotation direction. When the second pulley 400 rotates in the first direction 240, the second pulley 400 can be deployed. As the second pulley 400 rotates in the first rotation direction 240, the deployment of the second pulley 400 tightens the slack in the second line 600. The second pulley 400 may include a second series of blades or vanes 450. When the second pulley 400 is deployed, the second series of vanes 450 can move in an deployed position. When the pulley 400 rotates in the second rotation direction 230, the second series of vanes 450 can move in a collapsed position.

[0172] Figure 32 Multiple dynamic pulleys connected to traction lines are shown, which are connected to an instrument or joint motion component 1100. The instrument or joint motion component 1100 can be actuated by four traction lines 500, 600, 900, and 1000. The four traction lines 500, 600, 900, and 1000 can be actuated to cause joint movement in the instrument 1100. Two traction lines 500 and 600 can be controlled and actuated by a first pulley 300 and a second pulley 400, such as... Figure 31 As shown in the figures. The other two pull lines 900 and 1000 can be controlled and actuated by the third pulley 700 and the fourth pulley 800. The third pulley 700 and the fourth pulley 800 can have the same structure as the first pulley 300 and the second pulley 400 and operate in the same manner. Although not necessarily in Figure 32 As shown in the diagram, each pair of pull lines connected to the common pulley system can be... Figure 31The pulley system is disengaged from opposite sides in a similar manner as shown. Therefore, a pair of pull lines 500, 600 can be disengaged from opposite sides or opposite directions of the first pulley 300 and the second pulley 400 (e.g., one pull line disengages clockwise and the other counterclockwise), while a pair of pull lines 900, 1000 can be disengaged from opposite sides or opposite directions of the third pulley 700 and the fourth pulley 800 (e.g., one pull line disengages clockwise and the other counterclockwise). As described above, in Figure 15 In this configuration, the drive unit 63 may include a plurality of drive shafts 64 arranged in parallel. Although one drive shaft 64 may drive the first pulley 300 and the second pulley 400 as described above, the third pulley 700 and the fourth pulley 800 may be rotated by a second drive shaft 64 parallel to the first drive shaft 64.

[0173] 3. IMPLEMENTATION SYSTEM AND TERMINOLOGY .

[0174] The embodiments disclosed herein provide systems, methods, and apparatus related to dynamic pulleys for medical devices capable of robotic control.

[0175] It should be noted that, as used herein, the terms “coupled,” “connected,” “coupled link,” or other variations of the word “coupled” can indicate an indirect or direct connection. For example, if a first component is “coupled” to a second component, the first component may be indirectly connected to the second component or directly connected to the second component via another component.

[0176] The specific processor implementations described herein may be stored as one or more instructions on a processor-readable or computer-readable medium. The term "computer-readable medium" refers to any available medium that can be accessed by a computer or processor. By way of example, and not limitation, such media 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 that can be accessed by a computer. It should be noted that computer-readable media may be tangible and non-transitory. As used herein, the term "code" may refer to software, instructions, code, or data that can be executed by a computing device or processor.

[0177] 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.

[0178] 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.

[0179] 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”.

[0180] The foregoing description of the disclosed specific embodiments is provided to enable any person skilled in the art to make or use the invention. Various modifications to these specific embodiments will be readily apparent to those skilled in the art, and the general principles defined herein may be applied to other specific embodiments without departing from the scope of the invention. For example, it should be understood that those skilled in the art will be able to employ numerous corresponding alternatives and equivalent structural details, such as equivalent methods of fastening, mounting, coupling, or engaging tool components, equivalent mechanisms for generating specific actuating motions, and equivalent mechanisms for delivering electrical energy. Therefore, the invention is not intended to be limited to the specific embodiments shown herein, but is to be endowed with the broadest scope consistent with the principles and novel features disclosed herein.

Claims

1. A medical system comprising: An elongated shaft configured for insertion into a patient's body; A traction wire extending along the elongated axis, the traction wire being actuable to cause the elongated axis to articulate; as well as A dynamic pulley connected to the pull line is configured to collapse in a first direction during rotation and expand in a second direction opposite to the first direction during rotation. One end of the pull line is fixedly connected to the pulley at the termination point.

2. The medical system according to claim 1, further comprising: An instrument base connected to the proximal end of the elongated shaft, the instrument base comprising: Rotary drive input unit, The rotary drive input is connected to the dynamic pulley and drives the dynamic pulley to rotate in the first direction and the second direction.

3. The medical system according to claim 1, further comprising: A second traction wire extending along the elongated axis, the second traction wire being actuable to cause the elongated axis to articulate; as well as A second dynamic pulley is connected to the second pull line, the second dynamic pulley being configured to collapse in the second direction during rotation and expand in the first direction during rotation. The dynamic pulley and the second dynamic pulley are controlled by a single rotary drive input. The pull wire and the second pull wire are configured to bend the elongated shaft in two directions, and The two directions mentioned are opposite directions.

4. A pulley system, comprising: A pulley, the pulley including a hub and a tab extending outward from the hub, the tab being movable between an extended position and a collapsed position; as well as One end of the line is fixedly connected to the pulley at the termination point, and the line extends around the tab. The tabs are configured to extend radially outward toward the extended position when the pulley rotates.

5. The pulley system of claim 4 further includes a series of tabs, wherein the tab is one of the series of tabs, and wherein each of the series of tabs is configured to spread against the line as the pulley rotates.

6. The pulley system of claim 4, wherein the tab has a length from the point where the tab is attached to the hub to the outermost portion of the tab, wherein the line engages with the outermost portion of the tab, and wherein the point where the tab is attached to the hub defines the axis of rotation of the tab.

7. The pulley system of claim 5, wherein the line extends from the termination point around the outermost portion of the series of tabs.

8. The pulley system of claim 5, wherein the outer surface of each of the series of tabs is radially inwardly inclined in the first rotational direction.

9. The pulley system of claim 8, wherein the series of tabs is attached to a first side of the pulley, wherein the pulley system further comprises a second series of tabs attached to a second side of the pulley, and wherein the exterior of each of the second series of tabs is inclined in a second rotational direction opposite to the first rotational direction.

10. The pulley system of claim 4, wherein the line is configured to compress the edge of the tab to cause the tab to collapse.

11. The pulley system of claim 5, wherein each of the series of tabs is configured to unfold to push the line away from the hub, thereby tightening a slack portion of the line, wherein at least one of the series of tabs is configured to contact the line to provide tension to the line, while at least another tab of the series of tabs does not contact the line, and wherein when the pulley rotates in the direction of pulling the line, at least one of the series of tabs collapses and causes at least another tab of the series of tabs to contact the line.

12. The pulley system of claim 4, wherein the tab is hinged to the hub, wherein the tab includes a spring to bias the tab to the deployed position, wherein the tab is connected to a point on the hub, wherein the tab rotates about the point on the hub between the deployed position and the collapsed position, wherein the hub is configured to be driven by a drive shaft in a first rotational direction or a second rotational direction, and wherein the pulley further includes a ratchet configured to pretension the line.

13. A method for controlling a medical system, comprising: The pulley is rotated in a first rotational direction to pull a line connected to the pulley, one end of which is fixedly connected to the pulley at a termination point; The pulley is rotated in a second rotational direction opposite to the first rotational direction. as well as While the pulley is rotated in the second rotational direction, the pulley is unfolded, wherein the unfolding of the pulley tightens the slack portion in the line as the pulley rotates in the second rotational direction.

14. The method of claim 13, wherein the pulley comprises a series of blades, the method further comprising: When the pulley is deployed, the series of blades are moved to the deployed position.

15. The method of claim 14, further comprising moving the series of vanes to a collapsed position when the pulley rotates in the first rotational direction.

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