System and method for dynamic adjustment based on load input to a robotic system

Abstract

Systems and methods for dynamic adjustment based on load input of a robotic system are provided. In one aspect, a robotic system comprises: a first robotic arm having at least one joint; a set of one or more processors; and at least one computer-readable memory in communication with the set of one or more processors and having computer-executable instructions stored thereon. The computer-executable instructions cause the one or more processors to determine a first external load threshold for the at least one joint based on a maximum safe load capacity of the first robotic arm, and adjust the first external load threshold during a medical procedure.

Description

[0001] Cross Reference to Related Applications

[0002] This application claims the benefit of U.S. Provisional Application 62 / 992,010, filed March 19, 2020, which is hereby incorporated by reference in its entirety. TECHNICAL FIELD

[0003] The systems and methods disclosed herein relate to systems and methods for adjusting robot arm parameters, and more particularly to adjusting an external load threshold and a remote center of motion. BACKGROUND

[0004] Medical procedures, such as laparoscopy, can involve using one or more robot arms to access an internal region of a patient to insert a medical instrument into the internal region of the patient. In laparoscopic procedures, the medical instrument can be inserted into the internal region of the patient through a cannula.

[0005] In certain procedures, a robot-enabled medical system can be used to control the insertion and / or manipulation of one or more medical instruments. To avoid injury to the patient, it can be important for the medical system to reduce the risk of the medical instrument exerting excessive force on the patient. SUMMARY

[0006] The systems, methods, and devices of the present disclosure each have several innovative aspects, no single one of which is solely responsible for the desired attributes disclosed herein.

[0007] In one aspect, a robotic system is provided, the robotic system comprising: a first robot arm having at least one joint; a set of one or more processors; and at least one computer-readable memory in communication with the set of one or more processors and having stored thereon computer-executable instructions to cause the one or more processors to: determine a first external load threshold for the at least one joint based on a maximum safe load capacity of the first robot arm, and adjust the first external load threshold during a medical procedure.

[0008] In certain implementations, the computer-executable instructions further cause the one or more processors to: determine a load applied to the at least one joint due to at least one of a gravity and an inertia of the first robot arm.

[0009] In certain implementations, the first external load threshold is further determined based on the maximum safe load capacity minus the at least one of the gravity load and the inertia load.

[0010] In certain implementations, the first external load threshold is adjusted in response to a change in a pose of the first robot arm.

[0011] In certain implementations, the robotic system further includes a second robotic arm, wherein: the computer-executable instructions further cause the one or more processors to determine a second external load threshold for the second robotic arm, and the first external load threshold is different than the second external load threshold.

[0012] In certain implementations, the maximum safe load capacity is fixed.

[0013] In certain implementations, the maximum safe load capacity varies based on time or temperature.

[0014] In certain implementations, the first robotic arm includes one or more sensors configured to detect an external load.

[0015] In certain implementations, the one or more sensors include one or more torque sensors.

[0016] In certain implementations, the one or more sensors include an end effector load sensor.

[0017] In certain implementations, the computer-executable instructions further cause the one or more processors to: determine, based on a signal received from the one or more sensors, that the external load of the at least one joint exceeds the first external load threshold, and in response to determining that the external load of the at least one joint exceeds the first external load threshold, limit or prevent further movement of the first robotic arm.

[0018] In certain implementations, the first robotic arm includes one or more brakes configured to maintain a pose of the first robotic arm, the one or more brakes have a set holding torque, and the first external load threshold is further determined based on the holding torque of the one or more brakes.

[0019] In certain implementations, the one or more brakes are further configured to maintain the pose of the first robotic arm when the robotic arm is powered off or the robotic arm is in a fault state.

[0020] In another aspect, a robotic system is provided, comprising: a first robotic arm having a series of joints; one or more processors; and at least one computer-readable memory in communication with the one or more processors and having stored thereon a maximum safe load capacity of each of the joints of the first robotic arm and computer-executable instructions to cause the one or more processors to: determine a load applied to each of the joints due to at least one of a gravitational force or an inertia of the first robotic arm, and set a first maximum external load threshold for each of the joints based on the maximum safe load capacity of the corresponding joint and the at least one of the gravitational load and the inertial load.

[0021] In certain implementations, the computer-executable instructions further cause the one or more processors to adjust the first maximum external load threshold for one or more of the joints during a medical procedure.

[0022] In certain implementations, the first maximum external load threshold is adjusted in response to a change in a pose of the first robotic arm.

[0023] In certain implementations, the robotic system further comprises a second robotic arm, wherein: the computer-executable instructions further cause the one or more processors to determine a second maximum external load threshold for the second robotic arm, and the first maximum external load threshold is different than the second maximum external load threshold.

[0024] In certain implementations, the maximum safe load capacity of at least one of the joints is fixed.

[0025] In certain implementations, the maximum safe load capacity varies based on time or temperature.

[0026] In certain implementations, the first robotic arm comprises one or more sensors configured to detect an external load.

[0027] In certain implementations, the one or more sensors comprise one or more torque sensors.

[0028] In certain implementations, the one or more sensors comprise an end effector load sensor.

[0029] In certain implementations, the computer-executable instructions further cause the one or more processors to: determine, based on signals received from the one or more sensors, that the external load of at least one of the joints exceeds the corresponding first maximum load external threshold, and in response to determining that the external load of the at least one joint exceeds the first maximum external load threshold, limit or prevent further movement of the first robotic arm.

[0030] In certain implementations, the first robotic arm includes a series of brakes respectively positioned at the joints and configured to maintain a pose of the robotic arm, the brakes having a set holding torque, and the first maximum external load threshold is further determined based on a maximum acceptable force of the brakes.

[0031] In certain implementations, the series of brakes are further configured to maintain the pose of the robotic arm when the robotic arm is powered off or the robotic arm is in a fault state.

[0032] In certain implementations, the computer-executable instructions further cause the one or more processors to: determine, based on a combination of the first maximum external load thresholds of the joints, a maximum safe load capacity of the first robotic arm.

[0033] In yet another aspect, a robotic system is provided, the robotic system comprising: a robotic arm configured to be coupled to a cannula; a set of one or more processors; and at least one computer-readable memory in communication with the set of one or more processors and having computer-executable instructions stored thereon to cause the set of one or more processors to: control the robotic arm to pivot the cannula about a remote center of motion; and adjust a position of the remote center of motion.

[0034] In certain implementations, the computer-executable instructions further cause the set of one or more processors to: measure a force exerted on the cannula by a body wall of a patient, and adjust the position of the remote center of motion based on the measured force between the cannula and the body wall of the patient.

[0035] In certain implementations, the computer-executable instructions further cause the one or more processors to: adjust the position of the remote center of motion within a predetermined region.

[0036] In certain implementations, the predetermined region is spherical.

[0037] In certain implementations, the computer-executable instructions further cause the one or more processors to: adjust the position of the remote center of motion based on kinematic constraints.

[0038] In certain implementations, the kinematic constraint is a collision.

[0039] In certain implementations, the computer-executable instructions further cause the one or more processors to adjust the position of the remote center of motion as the surgical procedure is performed.

[0040] In certain implementations, the computer-executable instructions further cause the one or more processors to adjust the position of the remote center of motion to provide additional degrees of freedom to avoid a collision.

[0041] In certain implementations, the computer-executable instructions further cause the one or more processors to adjust the position of the remote center of motion to increase a reach of the robotic arm. BRIEF DESCRIPTION OF DRAWINGS

[0042] The disclosed aspects will be described with respect to the following figures, which are provided to illustrate rather than to limit the disclosed aspects, wherein like reference numerals indicate like elements.

[0043] Figure 1 Embodiments of a cart-based robotic system arranged for diagnostic and / or therapeutic bronchoscopy are shown.

[0044] Figure 2 Additional aspects of the robotic system of Figure 1 are depicted.

[0045] Figure 3 Embodiments of the robotic system of Figure 1 arranged for ureteroscopy are shown.

[0046] Figure 4 Embodiments of the robotic system of Figure 1 arranged for vascular procedures are shown.

[0047] Figure 5 Embodiments of a table-based robotic system arranged for bronchoscopy procedures are shown.

[0048] Figure 6 Alternative views of the robotic system of Figure 5 are provided.

[0049] Figure 7 An exemplary system configured to stow one or more robotic arms is shown.

[0050] Figure 8 Embodiments of a table-based robotic system arranged for ureteroscopy procedures are shown.

[0051] Figure 9An implementation scheme of a stage-based robotic system configured for laparoscopic procedures is shown.

[0052] Figure 10 It shows Figures 5-9 An implementation scheme for a platform-based robot system with pitch and tilt adjustment.

[0053] Figure 11 Provided Figures 5-10 A detailed diagram of the interface between the platform and the column of the platform-based robotic system.

[0054] Figure 12 An alternative implementation of a stage-based robotic system is shown.

[0055] Figure 13 It shows Figure 12 An end view of a platform-based robotic system.

[0056] Figure 14 An end view of a platform-based robotic system with a robotic arm attached is shown.

[0057] Figure 15 An exemplary device driver is shown.

[0058] Figure 16 An exemplary medical device with paired instrument drivers is shown.

[0059] Figure 17 An alternative design of the instrument actuator and the instrument is shown, wherein the axis of the actuator is parallel to the axis of the slender axis of the instrument.

[0060] Figure 18 An instrument with an instrument-based insertion architecture is shown.

[0061] Figure 19 An example controller is shown.

[0062] Figure 20 A block diagram according to an exemplary embodiment is depicted, illustrating the estimation Figures 1-10 The location of one or more components of a robotic system (such as...) Figures 16-18 A positioning system for the location of instruments.

[0063] Figure 21 An exemplary device actuator configured to couple to a cannula inserted into the body wall of a patient is shown according to aspects of this disclosure.

[0064] Figure 22 An exemplary robotic system for performing exemplary surgical procedures according to various aspects of this disclosure is shown.

[0065] Figure 23A andFigure 23B An example robotic arm is shown that can be used as part of a robotic system for dynamic adjustment of an external load threshold in accordance with aspects of the present disclosure.

[0066] Figure 24A and Figure 24B An example implementation of a load sensor is shown in accordance with aspects of the present disclosure.

[0067] Figure 25 is an example graph showing dynamic adjustment of an external load threshold in accordance with aspects of the present disclosure.

[0068] Figure 26 is one example configuration of an instrument driver and cannula with an adjustable remote center in accordance with aspects of the present disclosure.

[0069] Figure 27 is another example configuration of an instrument driver and cannula with an adjustable remote center in accordance with aspects of the present disclosure.

[0070] Figure 28 is yet another example configuration of an instrument driver and patient guide with an adjustable remote center in accordance with aspects of the present disclosure. DETAILED DESCRIPTION

[0071] 1. SUMMARY .

[0072] 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.

[0073] 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.

[0074] For purposes of illustration, various embodiments will be described below in connection with the accompanying drawings. It should be understood that many other specific implementations of the disclosed concepts can be made, and that the described implementations are merely exemplary. Headings are included in this document to help organize the various sections and are not meant to be limiting. Such concepts can have applicability in all parts of this document.

[0075] A. Robotic System - Cart .

[0076] Robotic-enabled medical systems can be configured in a variety of ways, depending on the particular procedure. Figure 1 An embodiment of a cart-based, robotic-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 access point (i.e., the mouth of a patient positioned on a table in the present example) to deliver diagnostic and / or therapeutic tools. As shown, the cart 11 can be positioned near the upper torso of the patient in order to provide access to the access point. Similarly, the robotic arms 12 can be actuated to position the bronchoscope relative to the access point. The arrangement in Figure 1 can also be utilized when performing a gastrointestinal (GI) procedure with a gastroscope (a specialized endoscope for GI procedures). Figure 2 An exemplary embodiment of a cart is depicted in greater detail.

[0077] With continued reference to Figure 1 Once the cart 11 is properly positioned, the robotic arms 12 can insert the steerable endoscope 13 into the patient robotically, manually, or in a combination thereof. As shown, the steerable endoscope 13 can include at least two telescoping portions, such as an inner guide portion and an outer sheath portion, each coupled to a separate instrument driver from a set of instrument drivers 28, each coupled to a separate distal end of a robotic arm. This linear arrangement of instrument drivers 28, which facilitates coaxial alignment of the guide portion with the sheath portion, creates a “virtual rail” 29 that can be repositioned in space by manipulating one or more of the robotic arms 12 to different angles and / or positions. The virtual rail described herein is depicted in the drawings using dashed lines, and thus the dashed lines do not depict any physical structure of the system. Translation of the instrument drivers 28 along the virtual rail 29 telescopes the inner guide portion relative to the outer sheath portion, or advances or retracts the endoscope 13 from the patient. The angle of the virtual rail 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 rail 29 as shown represents a compromise between providing the physician access to the endoscope 13 while minimizing friction caused by bending the endoscope 13 into the mouth of the patient.

[0078] After insertion, the endoscope 13 can be directed down 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 to reach the desired target, the endoscope 13 can be manipulated to telescopically extend the inner guide portion from the outer sheath portion to obtain enhanced articulation and greater bend radii. Using separate instrument drivers 28 also allows the guide portion and the sheath portion to be driven independently of one another.

[0079] For example, the endoscope 13 can be directed to deliver a biopsy needle to a target, such as a lesion or nodule within the patient's lung. The needle can be deployed down the working channel, which extends the length of the endoscope, to obtain a tissue sample to be analyzed by a pathologist. Depending on the pathology results, additional tools can be deployed down the working channel of the endoscope for additional biopsies. After a nodule is identified as malignant, the endoscope 13 can deliver tools through the endoscope to resect the underlying cancerous tissue. In some cases, the diagnostic and therapeutic treatments can be delivered in separate procedures. In these cases, the endoscope 13 can also be used to deliver a fiducial to "mark" the location of the target nodule. In other cases, the diagnostic and therapeutic treatments can be delivered during the same procedure.

[0080] The system 10 can also include a movable tower 30 that can be connected to the cart 11 via support cables to provide control, electronic, fluid, optical, sensor, and / or power support to the cart 11. Placing such functionality in the tower 30 allows for a smaller form factor cart 11 that can be more easily adjusted and / or repositioned by the operating physician and his / her staff. Additionally, dividing functionality between the cart / table and the support tower 30 reduces operating room clutter and facilitates improved clinical workflow. While the cart 11 can be positioned close to the patient, the tower 30 can be stowed in a remote location to not get in the way during the procedure.

[0081] To support the robotic system described above, the tower 30 can include components of a computer-based control system that stores computer program instructions, for example, in a non-transitory computer readable storage medium such as a permanent magnetic storage drive, a solid state drive, or the like. Execution of these instructions, whether occurring in the tower 30 or in the cart 11, can control the entire system or subsystems thereof. For example, when executed by a processor of the computer system, the instructions can cause components of the robotic system to actuate the relevant carriages and arm mounts, actuate the robotic arms, and control the medical instruments. For example, in response to receiving a control signal, a motor in a joint of the robotic arm can position the arm into a particular pose.

[0082] Tower 30 can also include pumps, flow meters, valve controllers, and / or fluid passageways to provide controlled irrigation and suction capabilities to systems that can be deployed through endoscope 13. These components can also be controlled using the computer system of tower 30. In some embodiments, irrigation and suction capabilities can be delivered directly to endoscope 13 through a separate cable.

[0083] Tower 30 can include a voltage and surge protector designed to provide filtered and protected power to cart 11, avoiding the placement of power transformers and other auxiliary power components in cart 11, resulting in a smaller, more mobile cart 11.

[0084] Tower 30 can also include support equipment for sensors deployed throughout robotic system 10. For example, tower 30 can include optoelectronic equipment for detecting, receiving, and processing data received from optical sensors or cameras throughout robotic system 10. In conjunction with the control system, such optoelectronic equipment can be used to generate real-time images for display in any number of consoles deployed throughout the system, including display in tower 30. Similarly, tower 30 can also include electronic subsystems for receiving and processing signals received from deployed electromagnetic (EM) sensors. Tower 30 can also be used to house and position EM field generators for detection by EM sensors in or on medical instruments.

[0085] In addition to other consoles available throughout the rest of the system (e.g., consoles mounted on top of the cart), tower 30 can include console 31. Console 31 can include a user interface and display screen, such as a touchscreen, for a physician operator. Consoles in system 10 are generally designed to provide both robotic control and preoperative and real-time information for the procedure, such as navigation and positioning information for endoscope 13. When console 31 is not the only console available to the physician, it can 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 main body separate from tower 30.

[0086] Tower 30 can be coupled to cart 11 and endoscope 13 through one or more cables or connections (not shown). In some embodiments, support functions from tower 30 can be provided to cart 11 through a single cable, simplifying the operating room and eliminating clutter in the operating room. In other embodiments, specific functions can be coupled in separate wiring and connections. For example, while power can be provided to cart 11 through a single cable, support for controls, optics, fluids, and / or navigation can also be provided through separate cables.

[0087] Figure 2 provisioning ofFigure 1 Detailed illustration of the illustrated embodiment of the cart 11 of the cart-based robot-enabled system. The cart 11 generally includes an elongated support structure 14 (often referred to as a “column”), a cart base 15, and a control console 16 at the top of the column 14. The column 14 can include one or more carriages, such as a carriage 17 (alternatively “arm support”) for the deployment of one or more robotic arms 12 (three shown). The carriage 17 can include an individually 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 carriage 17 also includes a carriage interface 19 that allows the carriage 17 to vertically translate along the column 14. Figure 2

[0088] The carriage interface 19 is connected to the column 14 through slots, such as slots 20, positioned on opposite sides of the column 14 to guide the vertical translation of the carriage 17. The slots 20 include vertical translation interfaces to position and hold the carriage 17 at various vertical heights relative to the cart base 15. The vertical translation of the carriage 17 allows the cart 11 to adjust the reach of the robotic arms 12 to satisfy various table heights, patient sizes, and physician preferences. Similarly, the individually configurable arm mount on the carriage 17 allows the robotic arm base 21 of the robotic arms 12 to be angled in multiple configurations.

[0089] In some embodiments, the slots 20 can be supplemented with slot covers that are flush and parallel with the slot surfaces to prevent dust and fluids from entering the interior cavity of the column 14 and the vertical translation interfaces as the carriage 17 vertically translates. The slot covers can be deployed through a pair of spring reel positioned near the vertical top and bottom of the slots 20. The covers are coiled within the reels until deployed to extend and retract from their coiled state as the carriage 17 vertically translates up and down. The spring loading of the reels provides the force to retract the covers into the reels as the carriage 17 translates towards the reels, while also maintaining a tight seal as the carriage 17 translates away from the reels. The covers can be connected to the carriage 17 using, for example, a bracket in the carriage interface 19 to facilitate the proper extension and retraction of the covers as the carriage 17 translates.

[0090] The column 14 can internally include mechanisms, such as gears and motors, designed to mechanically translate the carriage 17 using vertically aligned lead screws in response to control signals generated in response to user input (e.g., from the control console 16).

[0091] ​The robotic arms 12 can generally include 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, each actuator including an independently controllable motor. Each independently controllable joint represents an independent degree of freedom available to the robotic arm 12. Each of the robotic arms 12 can have seven joints and thus provide seven degrees of freedom. The plurality of joints results in a plurality of degrees of freedom, allowing for "redundant" degrees of freedom. Having redundant degrees of freedom allows the robotic arms 12 to position their respective end effectors 22 at a particular position, orientation, and trajectory in space using different link positions and joint angles. This allows the system to position and steer the medical instrument from a desired point in space while allowing the physician to articulate the arms joints to a clinically advantageous position away from the patient to create greater access while avoiding arm collisions.

[0092] The cart base 15 balances the weight of the column 14, the cradle 17, and the robotic arms 12 on the floor. Thus, the cart base 15 houses the heavier components, such as electronics, motors, power supplies, and components that enable the cart 11 to move and / or be immobilized. For example, the cart base 15 includes rollable caster wheels 25 that allow the cart 11 to be easily moved around the room prior to a procedure. After reaching the appropriate position, the caster wheels 25 can be immobilized using a wheel lock to keep the cart 11 in the appropriate position during the procedure.

[0093] The console 16 positioned at the vertical end of the column 14 allows both a user interface for receiving user input and a display screen (or dual-purpose device such as, for example, a touchscreen 26) to provide the physician user with both pre-operative and intra-operative data. Potential pre-operative data on the touchscreen 26 can include pre-operative plans, navigation and mapping data derived from pre-operative computed tomography (CT) scans and / or records from a pre-operative patient interview. Intra-operative data on the display can include optical information provided from tools, sensors and coordinate information from sensors as well as 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 the console 16 from the side of the column 14 opposite the cradle 17. From this position, the physician can observe the console 16, the robotic arms 12, and the patient while operating the console 16 from behind the cart 11. As shown, the console 16 also includes a handle 27 to aid in maneuvering and stabilizing the cart 11.

[0094] Figure 3An embodiment of a robot-enabled system 10 arranged for a ureteroscopy is shown. In a ureteroscopy procedure, a cart 11 can be positioned to deliver a ureteroscope 32, a procedure-specific endoscope designed to traverse a patient's urethra and ureter, to the patient's lower abdominal region. In a ureteroscopy, it can be desirable for the ureteroscope 32 to be directly aligned with the patient's urethra to reduce friction and force on sensitive anatomy in this region. As shown, the cart 11 can be aligned at the foot of a table to allow a robotic arm 12 to position the ureteroscope 32 for direct linear access to the patient's urethra. The robotic arm 12 can insert the ureteroscope 32 directly into the patient's lower abdomen through the urethra along a virtual track 33 from the foot of the table.

[0095] After insertion into the urethra, using similar control techniques as in bronchoscopy, the ureteroscope 32 can be navigated into the bladder, ureter, and / or kidney for diagnostic and / or therapeutic applications. For example, the ureteroscope 32 can be directed into the ureter and kidney to break up an accumulated kidney stone using a laser or ultrasound lithotripsy device deployed down the working channel of the ureteroscope 32. After lithotripsy is complete, the resulting stone fragments can be removed using a basket deployed down the ureteroscope 32.

[0096] Figure 4 An embodiment of a robot-enabled system 10 similarly arranged for a vascular procedure is shown. In a vascular procedure, the system 10 can be configured such that the cart 11 can deliver a medical instrument 34, such as a steerable catheter, to an access point in the femoral artery of the patient's leg. The femoral artery presents both a larger diameter for navigation and a relatively less circuitous and tortuous path to the patient's heart, which simplifies navigation. As in the ureteroscopy procedure, the cart 11 can be positioned toward the patient's leg and lower abdomen to allow the robotic arm 12 to provide a virtual track 35 of direct linear access to the femoral artery access point in the patient's thigh / hip region. After insertion into the artery, the medical instrument 34 can be steered and inserted by translating the instrument driver 28. Alternatively, the cart 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.

[0097] B. Robotic System - Table .

[0098] Embodiments of the robot-enabled medical system can also incorporate a table for the patient. Incorporating the table reduces the amount of fixed equipment within the operating room by removing the cart, which allows more access to the patient. Figure 5An embodiment of such a robot-enabled system arranged for a bronchoscopy procedure is shown. The 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 the cart-based system, the end effectors of the robotic arms 39 of the system 36 include instrument drivers 42 designed to manipulate an elongated medical instrument, such as a bronchoscope 40 in Figure 5 In practice, a C-arm for providing fluoroscopic imaging can be positioned over the patient's upper abdominal region by placing the emitter and detector around the table 38.

[0099] Figure 6 An alternative view of the system 36 without a patient and medical instruments is provided for discussion purposes. As shown, the column 37 can include one or more carriages 43 shown as annular in the system 36 from which the one or more robotic arms 39 can be based. The carriages 43 can translate along a vertical column interface 44 that extends along the length of the column 37 to provide different vantage points from which the robotic arms 39 can be positioned to reach the patient. The carriages 43 can rotate about the column 37 using a mechanical motor positioned within the column 37 to allow the robotic arms 39 to access multiple sides of the table 38, such as both sides of the patient. In embodiments with multiple carriages, the carriages can be individually positioned on the column and can translate and / or rotate independently of the other carriages. While the carriages 43 need not encircle the column 37 or even be circular, the annular shape as shown facilitates rotation of the carriages 43 about the column 37 while maintaining structural balance. Rotation and translation of the carriages 43 allow the system 36 to align medical instruments such as endoscopes and laparoscopes into different access points on the patient. In other embodiments (not shown), the system 36 can include a patient table or bed with adjustable arm supports in the form of bars or rails that extend alongside the patient table or bed. One or more robotic arms 39 (e.g., via a shoulder with an elbow joint) can be attached to the adjustable arm supports, which can be adjusted vertically. By providing vertical adjustment, the robotic arms 39 are advantageously able to be stored compactly underneath the patient table or bed and subsequently raised during a procedure.

[0100] The robotic arms 39 can be mounted on the carriages 43 through a set of arm mounts 45 that include a series of joints that can individually rotate and / or telescopically extend to provide additional configurability to the robotic arms 39. Additionally, the arm mounts 45 can be positioned on the carriages 43 so that when the carriages 43 are appropriately rotated, the arm mounts 45 can be positioned on the same side of the table 38 (as shown in Figure 6 ), on opposite sides of the table 38 (as shown in Figure 9 ), or on adjacent sides of the table 38 (not shown).

[0101] 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.

[0102] Platform base 46 has with Figure 2 The 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.

[0103] Continue to refer to 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.

[0104] 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.

[0105] Figure 8Embodiments of a robot-enabled table-based system configured for a ureteroscopy procedure are shown. In a ureteroscopy, the table 38 can include a swivel portion 55 for positioning the patient at an offset angle from the column 37 and table base 46. The swivel portion 55 can rotate or pivot about a pivot point (e.g., located below the patient's head) in order to position the bottom portion of the swivel portion 55 away from the column 37. For example, the pivoting of the swivel portion 55 allows a C-arm (not shown) to be positioned over the patient's lower abdomen without competing for space with the column (not shown) below the table 38. By rotating the carriage 35 (not shown) about the column 37, the robotic arms 39 can insert a ureteroscope 56 directly into the patient's groin area along a virtual rail 57 to reach the urethra. In a ureteroscopy, a stirrup 58 can also be secured to the swivel portion 55 of the table 38 to support the position of the patient's legs during the procedure and allow full access to the patient's groin area.

[0106] In a laparoscopy procedure, a minimally invasive instrument can be inserted into a patient's anatomy through one or more small incisions in the patient's abdominal wall. In some embodiments, the minimally invasive instrument includes an elongate rigid member, such as a shaft, for accessing an anatomical structure within the patient. After the patient's abdominal cavity is inflated, the instrument can be guided to perform a surgical or medical task, such as grasping, cutting, ablating, suturing, etc. In some embodiments, the instrument can include a scope, such as a laparoscope. Figure 9 Embodiments of a robot-enabled table-based system configured for a laparoscopy procedure are shown. As shown, Figure 9 The carriage 43 of the system 36 can be rotated and vertically adjusted to position the pair of robotic arms 39 on opposite sides of the table 38 so that the instruments 59 can be positioned through minimal incisions on both sides of the patient to reach his / her abdominal cavity, as shown.

[0107] To accommodate a laparoscopy procedure, the robot-enabled table system can also tilt the platform to a desired angle. Figure 10 Embodiments of a robot-enabled medical system with pitch or tilt adjustment are shown. As shown, Figure 10 The system 36 can accommodate a tilt of the table 38 to position one portion of the table at a greater distance from the floor than another portion, as shown. Additionally, the arm mounts 45 can be rotated to match the tilt so that the robotic arms 39 maintain the same planar relationship with the table 38. To accommodate steeper angles, the column 37 can also include a telescoping portion 60 that allows the vertical extension of the column 37 to prevent the table 38 from contacting the floor or colliding with the table base 46.

[0108] 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.

[0109] 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.

[0110] 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 relative to a stage 101. 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.

[0111] 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 first degree of freedom allows adjustment of the adjustable arm support 105 in the z-direction ("Z-lift"). For example, the adjustable arm support 105 can include a carriage 109 configured to move up or down along or relative to a column 102 of the support table 101. The second degree of freedom can allow the adjustable arm support 105 to tilt. For example, the adjustable arm support 105 can include a rotary joint that can allow the adjustable arm support 105 to align with the bed in a Trendelenburg position. The third degree of freedom can allow the adjustable arm support 105 to "pivot up," which can be used to adjust the distance between a side of the table 101 and the adjustable arm support 105. The fourth degree of freedom can allow the adjustable arm support 105 to translate along the longitudinal length of the table.

[0112] Figure 12 and Figure 13 The surgical robotic system 100 in Figure 13 is shown in FIG. 1. The surgical robotic system 100 can include a table supported by a column 102 mounted to a base 103. The base 103 and column 102 support the table 101 relative to a support surface. A floor axis 131 and a support axis 133 are shown in

[0113] The adjustable arm support 105 can be mounted to the column 102. In other embodiments, the arm support 105 can be mounted to the table 101 or the base 103. The adjustable arm support 105 can include a carriage 109, a bar or rail connection 111, and a bar or rail 107. In some embodiments, one or more robotic arms mounted to the rail 107 can translate and move relative to one another.

[0114] The carriage 109 can be attached to the column 102 by a first joint 113 that allows the carriage 109 to move relative to the column 102 (e.g., such as up and down along a first or vertical axis 123). The first joint 113 can provide a first degree of freedom ("Z-lift") to the adjustable arm support 105. The adjustable arm support 105 can include a second joint 115 that provides a second degree of freedom (tilt) to the adjustable arm support 105. The adjustable arm support 105 can include a third joint 117 that can provide a third degree of freedom ("pivot up") to the adjustable arm support 105. An additional joint 119 (shown in Figure 13 The carriage 109 can be attached to the column 102 by a first joint 113 that allows the carriage 109 to move relative to the column 102 (e.g., such as up and down along a first or vertical axis 123). The first joint 113 can provide a first degree of freedom ("Z-lift") to the adjustable arm support 105. The adjustable arm support 105 can include a second joint 115 that provides a second degree of freedom (tilt) to the adjustable arm support 105. The adjustable arm support 105 can include a third joint 117 that can provide a third degree of freedom ("pivot up") to the adjustable arm support 105. An additional joint 119 (shown in

[0115] Figure 14An end view of a surgical robotic system 140A is shown having two adjustable arm supports 105A, 105B mounted on opposite sides of a table 101, according to one embodiment. A first robotic arm 142A is attached to a bar or rail 107A of the first adjustable arm support 105B. The first robotic arm 142A includes a base 144A attached to the rail 107A. A distal end of the first robotic arm 142A includes an instrument drive mechanism 146A that can attach to one or more robotic medical instruments or tools. Similarly, a second robotic arm 142B includes a base 144B attached to a rail 107B. A distal end of the second robotic arm 142B includes an instrument drive mechanism 146B. The instrument drive mechanism 146B can be configured to attach to one or more robotic medical instruments or tools.

[0116] In some embodiments, one or more of the robotic arms 142A, 142B include an arm having seven or more degrees of freedom. In some embodiments, one or more of the robotic arms 142A, 142B can include eight degrees of freedom, including an insertion axis (including 1 degree of freedom of insertion), a wrist (including 3 degrees of freedom of wrist pitch, yaw, and roll), an elbow (including 1 degree of freedom of elbow pitch), a shoulder (including 2 degrees of freedom of shoulder pitch and yaw), and a base 144A, 144B (including 1 degree of freedom of translation). In some embodiments, the insertion degree of freedom can be provided by the robotic arm 142A, 142B, while in other embodiments, the instrument itself provides insertion via an instrument-based insertion architecture.

[0117] C. Instrument Drivers and Interfaces .

[0118] The end effector of a robotic arm of the system can include (i) an instrument drive (alternatively referred to as an “instrument drive mechanism” or “instrument device manipulator”) incorporating electromechanical devices for actuating a medical instrument, and (ii) a removable or detachable medical instrument that can be free of any electromechanical components, such as motors. This dichotomy can be driven by the need to sterilize medical instruments used in medical procedures, and the inability to adequately sterilize expensive fixed equipment due to the complex mechanical components and sensitive electronics of the expensive capital equipment. Thus, the medical instrument can be designed to be detached, removed, and interchanged from the instrument drive (and thus from the system) for individual sterilization or disposal by the physician or the physician’s staff. In contrast, the instrument drive need not be changed or sterilized and can be draped for protection.

[0119] Figure 15An exemplary instrument driver is shown. An instrument driver 62 positioned at the distal end of a robotic arm includes one or more drive units 63 arranged with parallel axes to provide controlled torque to a medical instrument via drive shafts 64. Each drive unit 63 includes a separate drive shaft 64 for interacting with the instrument, a gear head 65 for converting motor shaft rotation to a desired torque, a motor 66 for generating the drive torque, an encoder 67 to measure the speed of the motor shaft and provide feedback to a control circuit, and a control circuit 68 for receiving control signals and actuating the drive unit. Each drive unit 63 is independently controlled and motorized, and the instrument driver 62 can provide multiple (e.g., four, as shown) independent drive outputs to a medical instrument. In operation, the control circuit 68 will receive control signals, transmit motor signals to the motor 66, compare the resulting motor speed measured by the encoder 67 to a desired speed, and modulate the motor signal to generate the desired torque. Figure 15 An exemplary instrument driver is shown. An instrument driver 62 positioned at the distal end of a robotic arm includes one or more drive units 63 arranged with parallel axes to provide controlled torque to a medical instrument via drive shafts 64. Each drive unit 63 includes a separate drive shaft 64 for interacting with the instrument, a gear head 65 for converting motor shaft rotation to a desired torque, a motor 66 for generating the drive torque, an encoder 67 to measure the speed of the motor shaft and provide feedback to a control circuit, and a control circuit 68 for receiving control signals and actuating the drive unit. Each drive unit 63 is independently controlled and motorized, and the instrument driver 62 can provide multiple (e.g., four, as shown) independent drive outputs to a medical instrument. In operation, the control circuit 68 will receive control signals, transmit motor signals to the motor 66, compare the resulting motor speed measured by the encoder 67 to a desired speed, and modulate the motor signal to generate the desired torque.

[0120] For procedures requiring a sterile environment, the robotic system can incorporate a drive interface, such as a sterile adapter connected to a sterile drape, which sits between the instrument driver and the medical instrument. The primary purpose of the sterile adapter is to transfer angular motion from the drive shaft of the instrument driver to the drive input on the instrument, while maintaining physical separation between the drive shaft and the drive input and thus maintaining sterility. Thus, an exemplary sterile adapter can include a series of rotary inputs and rotary outputs designed to mate with the drive shaft of the instrument driver and the drive input on the instrument. A sterile drape composed of a thin, flexible material, such as clear or translucent plastic, connected to the sterile adapter is designed to cover the fixed equipment, such as the instrument driver, the robotic arm, and the cart (in a cart-based system) or table (in a table-based system). The use of the drape will allow the fixed equipment to be positioned in the vicinity of the patient, while still being located in an area that does not require sterilization (i.e., the non-sterile zone). On the other side of the sterile drape, the medical instrument can be interfaced with the patient in an area that requires sterilization (i.e., the sterile zone).

[0121] D. Medical Instruments .

[0122] Figure 16An example medical instrument with paired instrument drivers is shown. Like other instruments designed for use with robotic systems, the medical instrument 70 includes an elongated shaft 71 (or elongated body) and an instrument base 72. The instrument base 72, also referred to as an “instrument handle” due to its intended design for manual interaction by a physician, can generally include a rotatable drive input 73 (e.g., a socket, pulley, or spool) designed to mate with a drive output 74 of a drive interface on an instrument driver 75 extending through a 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 an axis of rotation with the drive output 74 in the instrument driver 75 to allow torque to be transferred from the drive output 74 to the drive input 73. In some embodiments, the drive output 74 can include splines designed to mate with a socket on the drive input 73.

[0123] The elongated shaft 71 is designed to be delivered through an anatomical opening or lumen (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., with properties similar to an endoscope) or rigid (e.g., with properties similar to a laparoscope), or contain a customized combination of both flexible and rigid portions. When designed for laparoscopy, the distal end of a rigid elongated shaft can be connected to an end effector extending from a joint wrist formed by a connecting fork with at least one degree of freedom and a surgical tool or medical instrument (such as, for example, a grasper or scissors) that can be actuated based on forces from the tendon when the drive input is rotated in response to torque received from the drive output 74 of the instrument driver 75. When designed for endoscopy, the distal end of a flexible elongated shaft can include a steerable or controllable bending segment that is articulated and bent based on torque received from the drive output 74 of the instrument driver 75.

[0124] Tendons along the elongated shaft 71 transmit torque from the instrument driver 75 along the elongated shaft 71. These individual tendons (e.g., pull wires) can be individually anchored to individual drive inputs 73 within the instrument handle 72. From the handle 72, the tendons are guided down one or more pull lumens along the elongated shaft 71 and anchored at a distal portion of the elongated shaft 71, or in a wrist at the distal portion of the elongated shaft. During a surgical procedure such as laparoscopic, endoscopic, or hybrid surgery, these tendons can be coupled to a distally mounted end effector such as a wrist, grasper, or scissors. Under such an arrangement, torque placed on the drive inputs 73 transmits tension to the tendons, causing the end effector to actuate in some manner. In some embodiments, during a surgical procedure, the tendons can cause a joint to rotate about an axis, causing the end effector to move in one direction or another. Alternatively, the tendons can connect to one or more jaws of a grasper at a distal end of the elongated shaft 71, where tension from the tendons causes the grasper to close.

[0125] In endoscopy, the tendons can be coupled to a bending or articulating segment positioned along the elongated shaft 71 (e.g., at the distal end) via adhesive, control ring, or other mechanical fixture. When fixedly attached to the distal end of the bending segment, torque placed on the drive inputs 73 will be transmitted down the tendon, causing the softer bending segment (sometimes referred to as an articulatable segment or region) to bend or articulate. Along the unbending segment, it can be advantageous to have individual pull lumens spiraled or coiled that guide individual tendons along (or inside) the wall of the endoscope shaft to balance the radial forces caused by tension in the pull wires. The angle of the spirals and / or the spacing between them can be varied or designed for specific purposes, with tighter spirals exhibiting less shaft compression under load forces, while lower amounts of spiraling cause greater shaft compression under load forces, but limit bending. In another instance, the pull lumens can be routed parallel to the longitudinal axis of the elongated shaft 71 to allow for controlled articulation in the desired bending or articulatable segment.

[0126] In endoscopy, the elongated shaft 71 houses a number of components to assist in the robotic procedure. The shaft 71 can include a working channel at the distal end of the shaft 71 for deployment of surgical tools (or medical instruments), irrigation, and / or suction of the surgical area. The shaft 71 can also accommodate wires and / or optical fibers to transmit signals to / from an optical assembly at the distal tip, which can include an optical camera. The shaft 71 can also accommodate optical fibers to carry light from a light source located proximally, such as a light-emitting diode, to the distal end of the shaft 71.

[0127] At the distal end of instrument 70, the distal tip can also include openings for delivery of tools for diagnosis and / or treatment, working channels for irrigation and suction of the surgical site. The distal tip can also include a port for a camera, such as a fiberscope or digital camera, to capture images of the internal anatomical space. Relatedly, the distal tip can also include a port for a light source to illuminate the anatomical space when using the camera.

[0128] In Figure 16 In the example of FIG. 8, the drive shaft axis and thus the drive input axis is orthogonal to the axis of the elongated shaft 71. However, this arrangement complicates the roll ability of the elongated shaft 71. Rolling the elongated shaft 71 along its axis while keeping the drive input 73 stationary causes undesirable tangling of the tendon as it extends out of the drive input 73 and into the pull lumen within the elongated shaft 71. The resulting tangling of the tendon can disrupt any control algorithm intended to predict the motion of the flexible elongated shaft 71 during an endoscopic procedure.

[0129] Figure 17 An alternative design of an instrument driver and instrument is shown in which the axis of the drive units is parallel to the axis of the elongated shaft of the instrument. As shown, a circular instrument driver 80 includes four drive units whose drive outputs 81 are aligned in parallel at the end of a robotic arm 82. The drive units and their respective drive outputs 81 are housed in a rotating assembly 83 of the instrument driver 80 driven by one of the drive units within the 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 a non-rotating portion 84 of the instrument driver 80. Power and control signals can be transmitted from the non-rotating portion 84 of the instrument driver 80 to the rotating assembly 83 through electrical contacts that can be maintained through rotation of a brush slip ring connection (not shown). In other embodiments, the rotating assembly 83 can be responsive to a separate drive unit integrated into the non-rotatable portion 84 and thus not parallel to the other drive units. The rotating mechanism 83 allows the instrument driver 80 to allow the drive units and their respective drive outputs 81 to rotate as a single unit about an instrument driver axis 85.

[0130] Similar to the previously disclosed embodiments, the instrument 86 can include an elongated shaft portion 88 and an instrument base 87 (shown with a transparent outer skin for discussion purposes) that includes a plurality of drive inputs 89 (such as sockets, pulleys, and spools) configured to receive the drive outputs 81 in the instrument driver 80. Unlike the previously disclosed embodiments, the instrument shaft 88 extends from the center of the instrument base 87 whose axis is substantially parallel to the axis of the drive inputs 89 rather than orthogonal as in the design of FIG. 8. Figure 16 ​

[0131] When coupled to the rotating assembly 83 of the instrument driver 80, the medical instrument 86, including the instrument base 87 and the instrument shaft 88, rotates about the instrument driver axis 85 in combination with the rotating assembly 83. Since the instrument shaft 88 is positioned at the center of the instrument base 87, the instrument shaft 88 is coaxial with the instrument driver axis 85 when attached. Thus, rotation of the rotating assembly 83 causes the instrument shaft 88 to rotate about its own longitudinal axis. Furthermore, any tendons connected to the drive input 89 in the instrument base 87 are not tangled during rotation when the instrument base 87 is rotated with the instrument shaft 88. Thus, the parallelism of the axes of the drive output 81, the drive input 89, and the instrument shaft 88 allows the shaft to rotate without tangling any control tendons.

[0132] Figure 18 An instrument with an instrument-based insertion architecture is shown in accordance with some embodiments. The instrument 150 can be coupled to any of the instrument drivers described above. The instrument 150 includes an elongated shaft 152, an end effector 162 connected to the shaft 152, and a handle 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 therethrough. Thus, the one or more cables 180 extend along the outer surface of the elongated shaft 152. In other embodiments, the cables 180 can also pass through the elongated shaft 152. Manipulation of the one or more cables 180 (e.g., via the instrument driver) causes actuation of the end effector 162.

[0133] The instrument handle 170 (also referred to as an instrument base) can generally include an attachment interface 172 having one or more mechanical inputs 174, such as receptacles, pulleys, or spools, designed to reciprocally mate with one or more torque couplers on the attachment surface of the instrument driver.

[0134] 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 accommodates insertion of the instrument, thereby minimizing reliance on a robotic arm to provide for insertion of the instrument 150. In other embodiments, the robotic arm can be largely responsible for instrument insertion.

[0135] E. Controller .

[0136] Any of the robotic systems described herein can include an input device or controller for manipulating an instrument attached to a robotic arm. In some embodiments, the controller can be coupled (e.g., communicatively, electronically, electrically, wirelessly, and / or mechanically) with the instrument such that manipulation of the controller causes corresponding manipulation of the instrument, e.g., via master-slave control.

[0137] Figure 19 is a perspective view of an embodiment of the controller 182. In this embodiment, the controller 182 includes a hybrid controller that can have both impedance and admittance control. In other embodiments, the controller 182 can utilize impedance or passive control only. In other embodiments, the controller 182 can utilize admittance control only. By being a hybrid controller, the controller 182 advantageously can have lower perceived inertia in use.

[0138] In the illustrated embodiment, the controller 182 is configured to allow manipulation of two medical instruments and includes two handles 184. Each of the handles 184 is connected to a gimbal 186. Each gimbal 186 is connected to a positioning platform 188.

[0139] As shown in Figure 19 Each positioning platform 188 includes a SCARA arm (selectively compliant assembly robotic arm) 198 coupled to a column 194 by a prismatic joint 196, as shown in

[0140] In some embodiments, one or more load sensors are positioned in the controller. For example, in some embodiments, a load sensor (not shown) is positioned in the body of each of the gimbals 186. By providing a load sensor, portions of the controller 182 are able to operate under admittance control, advantageously reducing the perceived inertia of the controller in use. In some embodiments, the positioning platforms 188 are configured for admittance control, while the gimbals 186 are configured for impedance control. In other embodiments, the gimbals 186 are configured for admittance control, while the positioning platforms 188 are configured for impedance control. Thus, for some embodiments, the translational or orientational degrees of freedom of the positioning platforms 188 can rely on admittance control, while the rotational degrees of freedom of the gimbals 186 rely on impedance control.

[0141] F. Navigation and Control .

[0142] Traditional endoscopy can involve the use of fluoroscopy (e.g., as can be delivered through a C-arm) and other forms of radiation-based imaging modalities to provide endoluminal guidance to the operating physician. In contrast, the robotic systems contemplated by the present disclosure can provide non-radiation-based navigation and localization means to reduce physician exposure to radiation and reduce the amount of equipment within the operating room. As used herein, the term“localization” can refer to determining and / or monitoring the position of an object in a reference coordinate system. Techniques such as preoperative mapping, computer vision, real-time EM tracking, and robotic 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 robotic command data can be used individually or in combination to improve the information obtained through radiation-based imaging modalities alone.

[0143] Figure 20 is a block diagram illustrating a localization system 90 that estimates the position of one or more elements of a robotic system, such as the position of an instrument, in accordance with example embodiments. The localization system 90 can be a set of one or more computer devices configured to execute one or more instructions. The computer devices can be embodied by a processor (or processors) and computer-readable memory in one or more components discussed above. By way of example and not limitation, the computer devices can be located in the tower 30, Figure 1 the cart 11, Figures 1-4 the bed, etc. Figures 5-14

[0144] As Figure 20 illustrated, the localization system 90 can include a localization module 95 that processes input data 91-94 to generate position data 96 for the distal tip of a medical instrument. The position data 96 can be data or logic that represents the position and / or orientation of the distal end of the instrument relative to a reference frame. The reference frame can be a reference frame relative to patient anatomy or a known object, such as an EM field generator (see discussion below for EM field generators).

[0145] ​The various input data 91-94 are now described in more detail. Preoperative mapping can be accomplished by using a collection of low-dose CT scans. The preoperative CT scans are reconstructed into three-dimensional images that are visualized, for example, as "slices" of a cross-sectional map of the patient's internal anatomy. When analyzed in the aggregate, an image-based model of the anatomical lumens, spaces, and structures for the patient's anatomy, such as the patient's lung network, can be generated. Techniques such as centerline geometry can be determined and approximated from the CT images to form a three-dimensional volume of the patient's anatomy, 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 in their entirety. Network topology models can also be derived from the CT images and are particularly suitable for bronchoscopy.

[0146] In some embodiments, the instrument can be equipped with a camera to provide visual data (or image data) 92. The localization module 95 can process the visual data 92 to implement one or more vision-based (or image-based) location tracking modules or features. For example, the preoperative model data 91 can be used in conjunction with the visual data 92 to implement computer vision-based tracking of the medical instrument (e.g., an endoscope or an instrument advanced through a working channel of an endoscope). For example, using the preoperative model data 91, the robotic system can generate a library of expected endoscope images from the model based on the expected path of travel of the endoscope, each image linked to a location within the model. As the surgical procedure is performed, the robotic system can reference the library in order to compare real-time images captured at the camera (e.g., a camera at the distal end of the endoscope) to those in the image library to assist in localization.

[0147] Other computer vision-based tracking techniques use feature tracking to determine the motion of the camera, and thus the endoscope. Some features of the localization module 95 can recognize circular geometries in the preoperative model data 91 that correspond to anatomical lumens and track changes in those geometries to determine which anatomical lumens are selected, as well as track the relative rotational and / or translational motion of the camera. The use of a topology map can further enhance the vision-based algorithms or techniques.

[0148] Optical flow (another computer vision-based technique) can analyze the displacement and translation of image pixels in a video sequence in the visual data 92 to infer camera motion. Examples of optical flow techniques can include motion detection, object segmentation calculations, brightness, motion compensated encoding, stereo disparity measurement, etc. Through multiple iterations of multi-frame comparisons, the motion and location of the camera (and thus the endoscope) can be determined.

[0149] 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.

[0150] 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.

[0151] like Figure 20 As shown, the positioning module 95 can use multiple other input data. For example, although in Figure 20 Not shown, but an instrument using shape sensing fibers can provide shape data that a positioning module 95 can use to determine the position and shape of the instrument.

[0152] 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.

[0153] 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 position in a global coordinate system, anatomical diagrams, etc.

[0154] 2. Adjustment of External Load Thresholds .

[0155] Implementations of this disclosure relate to adjusting robotic surgical systems (e.g., Figure 1 System 10 or Figure 14 The system and technology for external load thresholds of one or more robotic arms (System 140A). Figure 21 An exemplary instrument actuator 202, according to various aspects of this disclosure, is shown that is configured to couple to a cannula 204 inserted into a patient's body wall 208. As described below, the cannula 204 can be inserted into the body wall 208 at an incision 210 and can be configured to pivot about a remote center of motion 206.

[0156] It can be used, for example, during laparoscopic procedures. Figure 21 The configuration shown provides access to the patient's internal tissues. In some specific implementations, the robotic system can be used to control laparoscopic instruments during surgical procedures via instrument actuators 202 inserted into the patient through cannula 204, such as... Figure 21 As shown.

[0157] During the surgical procedure, as the robotic arm moves through the workspace, it can apply significant forces to the patient's body wall 208. An instrument actuator 202 can be attached to the distal end of the robotic arm, allowing the robotic arm to control the movement of a medical device via the instrument actuator 202. The medical device can be inserted into the patient's body through a cannula 204. During the surgical procedure, the robotic arm can pivot the cannula 204 around the patient's incision 210. The incision 210 defines the location where the cannula 204 and the medical device intersect with the body wall 208.

[0158] The point at which the cannula 204 and medical instrument are pivotable can be generally referred to as a remote center of motion 206 (also simply referred to as a "remote center" or "RCM"). In certain implementations, the remote center of motion 206 can be a static point in space at which the system constrains the motion of the cannula 204 and medical instrument using mechanical constraints and / or software constraints. By constraining the motion of the medical instrument and cannula 204, the system is able to reduce the force exerted on the body wall 208 due to movement of the medical instrument and cannula 204, thereby preventing or reducing trauma to the patient (e.g., tearing, bruising, etc. of the body wall 208).

[0159] During a surgical procedure, it can be desirable for the system to detect when the amount of load (e.g., generated by a force or torque) between the cannula 204 and the body wall 208 exceeds an external load threshold. In some embodiments, the external load threshold can be based on a load threshold for the entire robotic arm, individual joints of the robotic arm, or any combination thereof, which can advantageously vary during a procedure. For example, for safety considerations, the external load threshold can be set to a value that is used to prevent the force or torque exerted on the body wall 208 from causing harm to the patient. In certain robotic surgical systems, the system can use a single force threshold (e.g., about 30 N) as the external load threshold, whereby the robotic surgical system can be configured to enter a fault state if the force acting on the cannula 204 exceeds the force threshold, as detected by one or more sensors on the robotic arm. In certain implementations, the robotic system can be able to cause each of its respective robotic arms to individually enter a fault state, such that when a given robotic arm is subjected to a load that exceeds the corresponding external load threshold, the given robotic arm enters the fault state.

[0160] Each of the robotic arms can include one or more brakes that are configured to maintain the current pose of each of the robotic arms when in such a fault state. For example, in the event that the system determines that the force exerted by the robotic arm on the body wall of the patient has exceeded the force threshold (or vice versa), the brakes in the robotic arm can be actuated to maintain its joint poses, thereby preventing additional movement that can harm or cause trauma to the patient. Additionally, in some embodiments, the braking can be applied in a graduated manner, such that the amount of braking increases as the force exerted by the robotic arm on the body wall (or vice versa) approaches the force threshold. Note that in other embodiments, while the fault state can be triggered once the detected force exceeds the force threshold, the robotic arm can simply stop moving without causing the brakes to engage.

[0161] While an external load threshold can be set to prevent movement of the robotic arm and / or medical instrument attached to the robotic arm in order to protect the patient, the external load threshold can also be set such that when in a fault state and / or when the robotic arm is powered off, the brakes of the robotic arm can provide sufficient braking force to maintain the current pose of the robotic arm. For example, each brake on the robotic arm can be configured to provide a predetermined braking force. The robotic system can define a set holding torque for each brake, which can be less than the predetermined braking torque or force. The amount of force required to hold a given robotic arm pose can depend on the current pose of the robotic arm as well as any external forces applied to the robotic arm (e.g., the force between the body wall 208 and the medical instrument attached to the robotic arm). Thus, the robotic system can adjust the external load threshold such that if the robot enters a fault state and the brakes are engaged, the brakes will be able to hold the robotic arm and its external load such that the robotic arm will not move.

[0162] Figure 22 An example robotic system 300 performing an example surgical procedure is shown in accordance with aspects of the present disclosure. The robotic system 300 includes a first robotic arm 302 having a first device manipulator 304, and a second robotic arm 306 having a second device manipulator 308. In the illustrated procedure, the second robotic arm 306 is positioned to perform a surgical procedure on a patient 310. The first robotic arm 302 is positioned to assist the second robotic arm 306 in performing the surgical procedure on the patient 310. Figure 22 At the stage of the illustrated procedure, the second robotic arm 306 is in a more extended pose compared to the first robotic arm 302. Due to the pose of the second robotic arm 306, the forces applied to the second device manipulator 308 of the second robotic arm 306 can result in relatively large torques on the joints of the second robotic arm 306 compared to, for example, the first robotic arm 302. In contrast, the pose of the first robotic arm 302 can apply forces to the first device manipulator 304 resulting in relatively low torques applied to the joints of the first robotic arm 302. That is, the poses of the first robotic arm 302 and the second robotic arm 306 can affect the amount of torque caused by the leverage of forces applied on the first robotic arm 302 and the second robotic arm 306.

[0163] As described above, in certain implementations, the robotic system 300 can use a single external load threshold as the maximum allowed load applied to the first device manipulator 304 and the second device manipulator 308 before the system enters a fault state. Since the first robotic arm 302 and the second robotic arm 306 can be positioned in a variety of different poses within the operating environment, the external load threshold can be set to a value such that in the event the robotic system enters a fault state (e.g., even when the first robotic arm 302 and the second robotic arm 306 are in an extended pose), the brakes of the first robotic arm 302 and the second robotic arm 306 can prevent further movement of the robotic arms 302 and 306.

[0164] In certain situations, a surgeon can wish to continue driving the robotic arm beyond a single external load threshold. For example, although Figure 21 not shown in the middle, the surgeon can command the robotic system to perform a tenting procedure, which involves driving the robotic arm to position the cannula 204 to support the body wall 208, thereby increasing the volume of the patient's body cavity. During such tenting procedures, the surgeon can wish to continue driving the robotic arm without causing the system to enter a fault state due to forces on the cannula 204 (or instrument driver 202) exceeding a single external load threshold. In systems that implement a single external load threshold, tenting procedures can cause the system to enter multiple fault states, despite the surgeon's desire to continue driving the robotic arm to provide tenting. Accordingly, aspects of the present disclosure advantageously provide techniques for dynamically adjusting an external load threshold, thereby enabling certain procedures that can otherwise be susceptible to entering one or more fault states.

[0165] Figure 23A and Figure 23B An exemplary robotic arm 400 is shown that can be used as part of a robotic system for dynamic adjustment of an external load threshold in accordance with aspects of the present disclosure. Specifically, Figure 23A The robotic arm 400 is shown in a first pose 401 A, and Figure 23B The robotic arm is shown in a second pose 401 B. With reference to Figure 23A and Figure 23B The robotic arm 400 includes a base 402, an instrument driver 404, a first joint 406, a second joint 408, a first link 410, and a second link 412. The base 402, the first link 410, and the second link 412 are connected via the first joint 406 and the second joint 408. The first joint 406 includes a first brake 414, and the second joint 408 includes a second brake 416. The first brake 414 and the second brake 416 can be positioned internally to the first joint 406 and the second joint 406, respectively.

[0166] In some implementations, the robotic system can dynamically adjust the value of the external load threshold, e.g., during a medical procedure or as a surgical procedure is being performed, rather than having a single external load threshold that defines the maximum amount of load that the robotic arm 400 can apply to the body wall before entering a fault state. Thus, the value of the load applied to the body wall by the robotic arm 400 before the robotic system enters a fault state can depend on the current adjustable value of the external load threshold. In some implementations, the robotic system can adjust the external load threshold based at least in part on the pose of the robotic arm 400. Advantageously, by adjusting the load threshold, the robotic system can reduce the number of workflow interruptions (e.g., by minimizing the number of false positives or the number of undesired entries into a fault state) while enabling a user of the robotic system to control the amount or degree of force that the robotic system can apply to a patient, e.g., during a particular type of medical procedure.

[0167] The first pose 401 A and the second pose 401 B of the robotic arm provide an exemplary scenario in which the robotic system can benefit from dynamic adjustment of the external load threshold. For example, in the first pose 401 A, the robotic arm 400 is in a relatively more upright position compared to the relatively more extended position of the robotic arm 400 in the second pose 401 B. In the second pose 401 B, the robotic arm 400 is subject to a higher gravitational load due to leverage than the robotic arm 400 in the first pose 401 A. For example, in the first pose 401 B, a first torque 424 can be applied at the first joint 414 due to a first downward force 422 acting at the instrument driver 404 at a first distance 420 from the first joint 414. In the second pose 401 B, a second torque 428 can be applied at the first joint 414 due to the first downward force 422 acting at the instrument driver 404 at a second distance 426 from the first joint 414. Because the first distance 420 and the second distance 426 are different lengths, the second torque 428 can be significantly greater than the first torque 424.

[0168] In addition to external loads applied to the robotic arm 400 (e.g., at the instrument driver 404 due to a medical instrument attached to the instrument driver and / or at other points along the robotic arm 400 due to, e.g., a collision), gravity on the robotic arm 400 will also contribute to the torque applied at the first joint 406 and the second joint 406 of the robotic arm 400. The torque experienced by the first joint 406 and the second joint 406 due to gravity can also depend on the pose of the robotic arm 400 in a similar manner to the force 422 applied to the instrument driver 404 as described above.

[0169] In addition to the load on the robotic arm 400 due to gravity, the robotic arm 400 can also experience an inertial load based on movement of the robotic arm 400. Due to the various poses that the robotic arm 400 is capable of, in addition to the load due to gravity and inertia, the robotic arm 400 can also handle different amounts of external load resulting from contact with the patient and / or the external environment. In other words, as the pose of the robotic arm 400 changes, the amount of external load 400 that the robotic arm 400 can safely handle (e.g., the acceptable amount of external load) also changes.

[0170] In aspects of the present disclosure, the robotic system can determine the gravitational load and the inertial load of the robotic arm 400 based on the pose of the robotic arm 400, and can determine the external load threshold based at least in part on the gravitational load and the inertial load. The robotic system can also determine the external load threshold of the robotic arm 400 based on a maximum safe load capacity of the robotic arm 400. For example, the maximum safe load capacity can be based on the amount of braking force that can be provided by the first brake 414 and / or the second brake 416.

[0171] In some implementations, the robotic system will use one fixed value for the maximum safe load capacity. In other implementations, the robotic system can adjust the maximum safe load capacity, for example, based on time or temperature. The maximum safe load capacity can depend on environmental factors or measurements, for example, the robotic system can adjust the maximum safe load capacity based on a measured temperature of the environment or a measured temperature of the robotic arm 400 (e.g., at one or more of the joints 406, 408). In some implementations, the robotic system can determine the external load threshold based on the maximum safe load capacity minus at least one of the gravitational load and the inertial load.

[0172] As the load applied to each of the joints 406, 408 can be different and depend on the pose of the robotic arm 400, the robotic system can set a separate external load threshold for each of the joints 406, 408 of the robotic arm 400. In setting the external load threshold, the system can determine the load applied to each of the joints 406, 408 due to at least one of the gravitational force or the inertia of the robotic arm 400, and can set the external load threshold for each of the joints 406, 408 based on the maximum safe load capacity of the corresponding joint 406, 408 and at least one of the gravitational load and the inertial load. Additionally, each of the joints 406, 408 can have a different capacity (e.g., maximum torque) for holding the current pose, and each of the joints 406, 408 can be oriented in different directions depending on the pose of the robotic arm 400. By combining the individual capacities of each of the joints 406, 408 that make up the robotic arm 400, the system can determine the maximum safe load capacity of the robotic arm 400. In some implementations, in combining the individual joint 406, 408 capacities, the system can take into account the direction of each of the joint 406, 408 capacities (e.g., taking into account the current pose of the robotic arm 400).

[0173] The specific example of values that can be determined by the robotic system will be provided in connection with Figure 22 A specific example of values that can be determined by the robotic system is provided. However, the values provided in this example are merely to illustrate one example and do not limit other aspects of the present disclosure. In this example, a given joint of each of the first robotic arm 302 and the second robotic arm 306 can support a torque of about 100 N-m, which can be considered the maximum safe load for the given joint. In this example, the weight of each of the first robotic arm 302 and the second robotic arm 306 is about 100 N.

[0174] The center of mass of the second robotic arm 306 can be located about 0.5 m laterally from the base of the second robotic arm 306. Thus, the gravitational and / or inertial load (e.g., based on the current motion of the second robotic arm 306) exerted on the joint at the base of the second robotic arm 306 can be determined to be substantially equal to a torque of about 50 N-m. As the joint can support a torque of about 100 N-m, the joint can support an additional torque of about 50 N-m exerted from other objects or forces in the environment, and thus the robotic system can set the external load threshold for the joint of the second robotic arm 306 to about 50 N / m.

[0175] Continuing the example, for the second robotic arm 302, the center of mass is laterally extended from the base of the first robotic arm 302 by about 0.2 m, such that the gravitational and / or inertial loads exerted on the joints of the first robotic arm 302 can be determined to be substantially equal to a torque of about 20 N-m. Thus, the joints of the first robotic arm 302 can now support an additional 80 N-m of torque exerted from other things in the environment, and accordingly, the robotic system can set the external load threshold for the joints of the first robotic arm 302 to be about 80 N-m.

[0176] In this example, the robotic system is able to dynamically adjust the external load threshold for the joints of each of the robotic arms depending on the current pose and position of the robotic arms, such that the external load threshold is different for each of the robotic arms. Thus, the external load threshold can be dynamically adjusted by the robotic system, and can even be adjusted by taking into account the inertial loads of the first and second robotic arms 302, 306 as the first and second robotic arms 302, 306 move.

[0177] In some implementations, the robotic system can be configured to measure the loads applied to the robotic arms 302, 306, 400 (e.g., loads from cannulas and other external objects). The robotic system can calculate the amount of torque that needs to be braked by the brakes 414, 416 to support or balance in the event that the robotic system enters a fault state. In response to determining that the amount of brake power or brake torque needed is close to or within a threshold of the capacity limit of the brakes 414, 416, the robotic system can prevent further movement of the robotic arms 302, 306, 400 to avoid a potentially unsafe situation (e.g., the pose of one or more robotic arms cannot be maintained using the brakes 414, 416).

[0178] The robotic system can use a variety of different techniques to determine the load on a given robotic arm 400 or portion thereof. In some implementations, the robotic arm 400 can include one or more sensors configured to detect the external load. For example, the one or more sensors can be configured to generate a signal indicative of the load on the robotic arm 400. In other embodiments, examples of sensors for determining the load on a joint can include: one or more torque sensors that can be located at the joints 406, 408; a load sensor located at the end effector 404; a load sensor positioned between the joints 406, 408. In some embodiments, sensors that detect current measurements from the motors in the joints 406, 408 can be used.

[0179] Figure 24A and Figure 24BExemplary specific embodiments of a load sensor system and component 500 according to various aspects of this disclosure are shown. The load sensor system 500 may include components arranged in a particular configuration (e.g., such as...). Figure 24B The tripod arrangement shown includes a first load sensor 502, a second load sensor 504, and a third load sensor 506. Each of the load sensors 502, 504, and 506 may include at least one flexural element and an associated strain gauge. In some embodiments, the load sensor system 500 can sense loads on multiple axes, such as, for example, six degrees of freedom (DOF). In some embodiments, each joint of the robot arm (e.g., Figure 23A and Figure 23B Joints 406, 408 can sense loads in one direction. In these specific implementations, the system can receive information about the loads sensed in each direction at each joint and combine these loads to determine, for example, the net load and direction at the end effector of the robot arm (and / or another location of the robot arm).

[0180] In some implementations, the robot arm may directly sense the load on one or more connectors 410, 412 of the robot arm 400, rather than sensing the load on joints 414, 416 of the robot arm 400. Examples of sensors that can be used to determine the load on the robot arm connectors 410, 412 include capacitive contact sensors (e.g., force bands), load sensors, etc.

[0181] Figure 25 This is an exemplary graph 600 illustrating the dynamic adjustment of external load thresholds according to various aspects of this disclosure. Specifically, the graph shows the effect applied to the device actuator 602 (e.g., Figure 23A and Figure 23B The instrument driver 404 shown has a recording line / signal for its load, static external load threshold 604, and adjustable external load threshold 606. (See diagram for reference.) Figure 25 As shown, the load applied to the instrument driver 602 may exceed the static external load threshold 604 for a specific period of time. Therefore, the static external load threshold 604 may cause the robot system to enter a fault state in response to the load applied to the instrument driver 602 exceeding the static external load threshold 604.

[0182] In contrast, the adjustable external load threshold 606 can change over time, for example, in response to a change in the robot arm's pose. Due to the change in the external load threshold 606, the load applied to the instrument actuator 602 will not exceed the adjustable external load threshold 606, where the load applied to the instrument actuator 602 will exceed the static external load threshold 604. Therefore, by using the adjustable external load threshold 606, the robot system can avoid entering a fault state that would otherwise occur when using the static external load threshold 604.

[0183] In some implementations, the robotic system can also combine the ability to dynamically adjust external load thresholds with the ability to dynamically move remote centers (e.g., via software) to minimize the load on the remote center, as will be explained in further detail below. In summary, these two techniques help the robotic system avoid workflow disruptions by dynamically adjusting the location of the remote center while increasing the reach of the robotic arm.

[0184] 3. Adjustment of Remote Center .

[0185] The embodiments of this disclosure also relate to systems and techniques for adjusting the location of remote centers. As described above and as... Figure 21 As shown, the robotic arm allows the cannula 204 to pivot around a remote center 206 through an incision 210 in the body wall 208. It is generally desirable to maintain the position of the remote center 208 mechanically or via software. However, there are cases where it may be desirable for the robotic system to adjust the position of the remote center 208 via software.

[0186] Figure 26 An exemplary configuration 700 of an instrument actuator 702 and a cannula 704 with adjustable remote centers 712, 714, according to aspects of this disclosure, is shown. In the illustrated configuration 700, the instrument actuator 702 is coupled to the cannula 704 inserted into the body wall 706 of a patient. The body wall 706 includes a muscle layer 708 and a fat layer 710. A robotic arm is configured to control the instrument actuator 702 to pivot the cannula 704 about the remote centers of motion 712, 714.

[0187] The initial position of remote center 712 can be located a predetermined distance from instrument driver 702. For example, the predetermined distance can be set based on characteristics of the body wall 706 of an average patient. However, for certain patients, such as super-obese patients and / or obese patients, the fat layer 710 of the body wall 706 can be thicker than the fat layer 710 of an average patient. Additionally, the fat layer 710 can be more easily deformed based on movement of the cannula 704 than the muscle layer 708, and the muscle layer can be more easily injured when force from the cannula 704 is applied to the muscle layer 708. Thus, if the remote center 712 is located in the fat layer 710, pivoting of the cannula 704 about the remote center 712 can result in force being applied to the muscle layer 708. To reduce the force applied to the muscle layer 708, the robotic system can adjust the position of the remote center from a first position 712 within the fat layer 710 to a second position 714 within the muscle layer 708. In some implementations, the robotic system can adjust the position of the remote center from the first position 712 while the surgical procedure is in progress.

[0188] In some implementations, the robotic system is configured to detect that the cannula 704 is applying excessive force to the patient’s anatomy and adjust the position of the remote center 712, 714 based on the detected excessive force. For example, the robotic system can measure the force exerted by the body wall 706 on the cannula 704 and determine whether the measured force is greater than a threshold force. In response to determining that the measured force is greater than the threshold force, the robotic system can adjust the position of the remote center 712, 714 based on the measured force between the cannula 704 and the body wall 706 of the patient. In some implementations, the robotic system can move the position of the remote center 712, 714 in a direction that reduces the measured force. For example, the robotic system can determine the direction of the force exerted on the cannula 704 and move the remote center 712, 714 in a direction that has a component that is opposite the direction of the force exerted on the cannula 704. Although Figure 26 Although moving the remote center 712, 714 in a direction along the longitudinal axis of the cannula 704 is shown, the robotic system can be configured to move the remote center 712, 714 in any direction.

[0189] In some implementations, the robotic system can constrain movement of the remote center 712, 714 to within a threshold distance from the initial position of the remote center 712, 714. The robotic system can also allow a user to selectively allow or disallow automatic movement of the remote center 712, 714 to reduce the force exerted on the cannula 704. It can be desirable for the robotic system to make adjustments to the position of the remote center 712, 714 to reduce the load on the patient’s body wall 706 to prevent or reduce injury. One example situation in which it can be beneficial to adjust the position of the remote center 712, 714 is when the position of the patient on the table (e.g., the patient’s body wall 706) changes during a surgical procedure. For example, the patient can shift position on the table, and the robotic system can adjust the position of the remote center 712, 714 to reduce the force exerted on the cannula 704. Figure 5and Figure 9 As the patient moves on the support platform 38), the force is caused to be applied to the cannula 704. By detecting the force applied to the cannula 704 in this case, the robotic system can trigger movement of the position of the remote center of motion 712, 714 in response to the patient’s movement on the patient platform. In some implementations, the system can alert the user to the force applied to the cannula 704 (which can be in response to the patient’s movement) and receive input from the user to adjust the position of the remote center of motion 712, 714.

[0190] Figure 27 is another example configuration 800 of an instrument driver 802 with an adjustable remote center 810 and a cannula 804, in accordance with aspects of the present disclosure. In Figure 27 In the configuration 800, the cannula 804 can be inserted between the patient’s ribs 808 through the patient’s body wall 806.

[0191] During a medical procedure, the instrument driver 802 can pivot the cannula 804 in order to access different locations. For example, the instrument driver 802 can pivot the cannula 804 from a first pose 812A to a second pose 812B relative to the remote center of motion 810. In the first pose 812A, the cannula 804 can be subjected to a force within an expected range due to a surgical procedure. However, as the cannula 804 is pivoted into the second pose 812B, the cannula 804 can hit one of the ribs 808, resulting in a larger unexpected force. The robotic system can be configured to measure the force resulting from the cannula 804 hitting the ribs 808 and adjust the position of the remote center of motion 810 based on the measured force. In some implementations, in response to detecting that the force on the cannula 804 has increased or is increasing, the robotic system can adjust the position of the remote center of motion 810 to reduce the measured / detected force on the cannula 804 before the force reaches a force threshold. By adjusting the position of the remote motion 810 before the force threshold is reached, the robotic system can avoid entering a fault state and interrupting the surgical workflow. For example, if the cannula 804 is pivoted toward the second pose 812B, the system can move the remote center of motion 810 toward the left side of the figure to avoid a collision between the cannula 804 and the ribs 808.

[0192] In some implementations, the robotic system can enter a fault state to limit or prevent further movement of the robotic arm in response to the force applied on the cannula 804 reaching a force threshold, thereby preventing potential harm to the patient. For example, limiting further movement can involve the robotic system limiting the allowed direction of motion of the robotic arm to a direction that will reduce the external load, thereby allowing the user to avoid or move away from a potential excess external load on the robotic arm.

[0193] In certain implementations, the robotic system can also be configured to automatically adjust the position of the remote center of motion 810 to enhance the reach and effective workspace of the robotic arm. For example, the robotic system can automatically move the remote center of motion 810 to enhance the reach and / or effective workspace of the robotic arm. In certain implementations, the robotic system can also enable the user to allow or disallow automatic movement of the remote center of motion 810 to enhance the reach of the robotic arm. For example, the robotic system can have global, user-defined parameters that can allow or disallow automatic movement of the position of the remote center of motion 810, and one or more user-defined parameters that can allow or disallow automatic movement of the position of the remote center of motion 810 to achieve certain goals (e.g., parameters for automatically reducing the force at the cannula 804, parameters for automatically enhancing the reach of the robotic arm, or parameters to achieve other goals via automatic remote center 810 movement).

[0194] In one example, the operator can weigh the expected hazards of moving the remote center of motion 810 against the benefits of increasing access to the operating site, and select accordingly whether to allow automatic movement of the remote center of motion 810. In this case, the remote center of motion 810 can be constrained to move within a predetermined region (e.g., within a sphere or cube of limited dimensions). Movement of the remote center of motion 810 can also be used to provide additional zero-space movement DOF(s). Zero-space movement can refer to movement of at least a portion of the robotic arm that does not affect the position of the end effector controlled by the robotic arm. Robotic arm zero-space movement can be used to facilitate or allow the robotic system to perform certain advantageous actions, such as collision avoidance, increased reach of the robotic arm, etc. In some implementations, movement of the remote center of motion 810 can provide up to three additional zero-space DOF(s), thereby widening and increasing the dimensionality of the zero-space of the robotic arm, which can or can not have other zero-space DOF(s). In some implementations, the use of remote center 810 movement to provide zero-space DOF(s) can be a user-selectable option. Additionally, the robotic system can limit the amount of movement of the remote center 810 to within a predetermined distance (in 1, 2, or 3 dimensions) from a point at which the user initially set the remote center.

[0195] In certain implementations, the robotic system can also be configured to adjust the position of the remote center of motion 810 based on kinematic constraints. For example, the kinematic constraint can be a collision detected by the robotic system. Thus, in response to detecting a collision (e.g., between a robotic arm and another object such as another robotic arm, a patient, a patient platform, etc.), the robotic system can adjust the position of the remote center of motion 810 to move away from the collision. In some implementations, the movement of the position of the remote center of motion 810 can be a null-space movement such that the pose of an end effector controlled by the robotic arm is not affected. The robotic system can be further configured to avoid collisions by moving the position of the remote center of motion 810, for example, by determining that a current commanded movement of the robotic arm would result in a collision.

[0196] Figure 28 Another example configuration 900 of an instrument driver 902 and a patient guide 904 with an adjustable remote center 910 is shown in accordance with aspects of the present disclosure. In this example, the instrument driver 902 is configured to manipulate a medical instrument (not shown) through the patient guide 904 to access the anatomy of a patient 906 via a natural orifice 908 (e.g., the mouth or throat of the patient). Although the instrument driver 902 is shown as a robotic arm, aspects of this configuration 900 can also be used with other types of instrument drivers, such as a manual instrument driver. Figure 28 In implementations of the instrument driver 902, the instrument driver 902 is configured to manipulate a medical instrument (not shown) through the patient guide 904 to access the anatomy of a patient 906 via a natural orifice 908 (e.g., the mouth or throat of the patient). Although the instrument driver 902 is shown as a robotic arm, aspects of this configuration 900 can also be used with other types of instrument drivers, such as a manual instrument driver. Figure 28 While implementations of the medical instrument are shown for transoral procedures, aspects of this configuration 900 can also be used to perform other types of procedures accessed through different natural orifices 908, including transanal and transvaginal procedures, among others.

[0197] As shown in FIG. 9, the instrument driver 902 is configured to manipulate a medical instrument (not shown) through the patient guide 904 to access the anatomy of a patient 906 via a natural orifice 908 (e.g., the mouth or throat of the patient). Although the instrument driver 902 is shown as a robotic arm, aspects of this configuration 900 can also be used with other types of instrument drivers, such as a manual instrument driver. Figure 28As shown, even if the patient guide 904 does not penetrate the body wall of the patient 906, the instrument driver 902 can limit movement of the patient guide 904 to pivot about the remote center of motion 910. Because the medical instrument and the patient guide 904 do not penetrate the body wall of the patient 906, there are fewer restrictions on the location of the remote center of motion 910 because adjusting the location of the remote center 910 does not exert forces on the body wall of the patient 906. Thus, the robotic system can move the remote center 910 more freely without causing trauma to the patient 906. In some implementations, the robotic system can be configured to adjust the location of the remote center 910 within a predetermined region 912. In some implementations, the predetermined region 912 can form a geometric shape, such as a cone, a sphere, a cube, etc. By providing a relatively large predetermined region 912 in which the location of the remote center 910 can be moved, the reach of the robotic arm can be improved and the movement of the remote center 910 can be used to avoid collisions (e.g., tools within the body and robotic arms or other components outside the body) to provide additional null-space DOFs as described above. Because configured multi-arm natural orifices can involve placing the robotic arms within a relatively small region, as the robotic arms can enter via the same natural orifice 908, it can be advantageous to provide these additional null-space DOFs for these procedures.

[0198] 4. Implementation Systems and Terminology .

[0199] The implementations disclosed herein provide systems, methods, and apparatuses for adjusting an external load threshold and a remote center of motion of a robotic system.

[0200] It should be noted that as used herein the term "couple," "coupling," "coupled," or other variations of the word couple can indicate either an indirect connection or a direct connection. For example, if a first component is "coupled" to a second component, then the first component can be either indirectly connected to the second component via another component or directly connected to the second component.

[0201] The external load threshold adjustment and remote center adjustment functionality described herein can 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 a medium can comprise 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 disk storage, magnetic disk storage or other magnetic storage devices, or any other medium that can be used to store desired program code in the form of instructions or data structures and that can be accessed by a computer. It should be noted that a computer-readable medium can be tangible and non-transitory. The term "code" as used herein can mean software, instructions, code or data that is / are executable by a computing device or processor.

[0202] The methods disclosed herein include one or more steps or actions for achieving the methods. The method steps and / or actions can be interchanged with one another without departing from the scope of the claims. In other words, unless a specific order is required for proper operation of the method being described, then an

[0203] As used herein, the term "plurality" denotes two or more. For example, a plurality of components indicates two or more components. The term "determining" encompasses a wide variety of actions and, therefore, "determining" can include calculating, computing, processing, deriving, investigating, looking up (e.g., looking up in a table, a database or another data structure), ascertaining and the like. Additionally, "determining" can include receiving (e.g., receiving information), accessing (e.g., accessing data in a memory) and the like. Furthermore, "determining" can include resolving, selecting, choosing, establishing and the like.

[0204] The phrase "based on" is not meant to limit to "based only on" unless specifically called out. In other words, the phrase "based on" describes both "based only on" and "based at least on."

[0205] The foregoing description of the disclosed implementations has been presented for the purposes of illustration and description. It is not intended to be exhaustive or to limit the inventive concepts to the precise forms disclosed. Many modifications and variations are possible in light of the above teachings. For example, it should be understood that any of the various components, tools, or devices disclosed herein can be combined in a variety of ways, or substituted for one another, to produce other forms of the disclosed implementations. It should also be understood that the various embodiments disclosed herein can be used alone or in any combination. It should be understood that the disclosed implementations are not intended to be limited to the particular forms disclosed, but rather, should be construed to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the disclosed implementations.

Claims

1. A robot system, comprising: A first robotic arm, the first robotic arm having at least one joint; A group of one or more processors; and At least one computer-readable storage device, which communicates with the group of one or more processors and stores computer-executable instructions thereon, causing the one or more processors to: The first external load threshold of the at least one joint is determined based on the maximum safe load capacity of the first robotic arm, and Adjust the first external load threshold during the medical procedure.

2. The robot system of claim 1, wherein the computer-executable instructions further cause the one or more processors to: Determine the load applied to the at least one joint due to at least one of the gravity and inertia of the first robotic arm.

3. The robot system of claim 2, wherein the first external load threshold is further determined based on the maximum safe load capacity minus at least one of gravity and inertia.

4. The robot system of claim 1, wherein the first external load threshold is adjusted in response to a change in the pose of the first robot arm.

5. The robot system according to claim 1, further comprising a second robot arm, wherein: The computer-executable instructions further cause the one or more processors to determine a second external load threshold for the second robotic arm, and The first external load threshold is different from the second external load threshold.

6. The robot system of claim 1, wherein the maximum safe load capacity is fixed.

7. The robot system of claim 1, wherein the maximum safe load capacity varies based on time or temperature.

8. The robot system of claim 1, wherein the first robot arm includes one or more sensors configured to detect external loads.

9. The robot system of claim 8, wherein the one or more sensors include one or more torque sensors.

10. The robot system of claim 8, wherein the one or more sensors include an end effector load sensor.

11. The robot system of claim 8, wherein the computer-executable instructions further cause the one or more processors to: Based on signals received from the one or more sensors, it is determined that the external load on the at least one joint exceeds the first external load threshold, and In response to determining that the external load on the at least one joint exceeds the first external load threshold, further movement of the first robotic arm is restricted or prevented.

12. The robot system according to claim 1, wherein: The first robotic arm includes one or more actuators configured to maintain the pose of the first robotic arm. The one or more brakes have a set holding torque, and The first external load threshold is further determined based on the holding torque of the one or more brakes.

13. The robot system of claim 12, wherein the one or more actuators are further configured to maintain the pose of the first robot arm when the robot arm is powered off or when the robot arm is in a fault state.

14. A robot system, comprising: A first robotic arm, the first robotic arm having a series of joints; One or more processors; and At least one computer-readable storage device, which communicates with the one or more processors and stores thereon the maximum safe load capacity of each joint of the first robotic arm and computer-executable instructions, such that the one or more processors: Determine the load applied to each joint of the joints due to at least one of the gravity or inertia of the first robotic arm, and A first maximum external load threshold for each joint is set based on the maximum safe load capacity of the corresponding joint and at least one of gravity and inertia.

15. The robot system of claim 14, wherein the computer-executable instructions further cause the one or more processors to: The first maximum external load threshold of one or more of the joints is adjusted during the medical procedure.

16. The robot system of claim 15, wherein the first maximum external load threshold is adjusted in response to a change in the pose of the first robot arm.

17. The robot system of claim 14, further comprising a second robotic arm, wherein: The computer-executable instructions further cause the one or more processors to determine a second maximum external load threshold for the second robotic arm, and The first maximum external load threshold is different from the second maximum external load threshold.

18. The robot system of claim 14, wherein the maximum safe load capacity of at least one of the joints is fixed.

19. The robot system of claim 14, wherein the maximum safe load capacity varies based on time or temperature.

20. The robot system of claim 14, wherein the first robotic arm includes one or more sensors configured to detect external loads.

21. The robot system of claim 20, wherein the one or more sensors include one or more torque sensors.

22. The robot system of claim 20, wherein the one or more sensors include an end effector load sensor.

23. The robot system of claim 20, wherein the computer-executable instructions further cause the one or more processors to: Based on signals received from the one or more sensors, it is determined that the external load on at least one of the joints exceeds the corresponding first maximum external load threshold. In response to determining that the external load on the at least one joint exceeds the first maximum external load threshold, further movement of the first robotic arm is restricted or prevented.

24. The robot system according to claim 14, wherein: The first robotic arm includes a series of brakes, which are respectively positioned at the joints and configured to maintain the pose of the robotic arm. The brake has a set holding torque and The first maximum external load threshold is further determined based on the maximum acceptable force of the brake.

25. The robot system of claim 24, wherein the series of brakes is further configured to maintain the pose of the robot arm when the robot arm is powered off or when the robot arm is in a fault state.

26. The robot system of claim 14, wherein the computer-executable instructions further cause the one or more processors to: The maximum safe load capacity of the first robotic arm is determined based on a combination of the first maximum external load thresholds of the joints.

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