Systems and methods for constrained motion control for medical instruments

Abstract

Systems and methods for constrained motion control of a medical instrument are provided. In one aspect, a robotic system includes an instrument having an end effector, a robotic arm configured to control movement of the instrument and the end effector, and an input device configured to receive input for controlling movement of the instrument and the end effector. The instrument is movable in a different number of degrees of freedom (DOF) than the input device. The system is configured to determine a Jacobian matrix relating the input of the input device to robotic arm commands for effecting motion of the end effector indicated by the input, modify the Jacobian matrix via discarding at least one row of the Jacobian matrix, and determine robotic arm commands for effecting the motion of the instrument indicated by the input based on the modified Jacobian matrix.

Description

[0001] Cross-references to related applications

[0002] This application claims the benefit of U.S. Provisional Application 63 / 000,093, filed on March 26, 2020, which is incorporated herein by reference in its entirety. Technical Field

[0003] The systems and methods disclosed herein relate to systems and methods for controlling medical devices, and more specifically to constrained motion control of medical devices. Background Technology

[0004] Medical procedures (such as laparoscopy) may involve using one or more robotic arms to access a patient's internal area to insert a medical device. In laparoscopic procedures, the medical device may be inserted into the internal area via a laparoscopic cannula. In some procedures, a robot-enabled medical system may be used to control the insertion and / or manipulation of one or more medical devices. The robot-enabled medical system may have user input configured to be manipulated by a user with many degrees of freedom (DOF). Depending on the specific medical device under input control, the number of DOFs the device can move may differ from the number of DOFs that the input can control, command, and / or move. Summary of the Invention

[0005] The systems, methods, and apparatuses disclosed herein each have several innovative aspects, none of which are solely responsible for the desired properties disclosed herein.

[0006] In one aspect, a robotic system is provided, comprising: an apparatus having an end effector; a robotic arm configured to control movement of the apparatus and the end effector; an input device configured to receive input for controlling movement of the apparatus and the end effector, wherein the apparatus is capable of movement with a different number of degrees of freedom (DOF) than the input device; at least one processor; and at least one computer-readable storage device communicating with one or more processors and storing computer-executable instructions thereon such that at least one processor: determines a Jacobian matrix that associates the input of the input device with a robotic arm command for implementing movement of the end effector indicated by the input, modifies the Jacobian matrix by discarding at least one row of the Jacobian matrix, and determines a robotic arm command for implementing movement of the apparatus indicated by the input based on the modified Jacobian matrix.

[0007] In another aspect, a method for controlling the movement of an end effector of a medical device is provided, the method comprising: receiving, via an input device, an input for controlling the movement of the device having a different number of DOFs than the input device; determining a Jacobian matrix that associates the input of the input device with a robotic arm command for implementing the movement of the end effector indicated by the input; modifying the Jacobian matrix by discarding at least one row of the Jacobian matrix; and determining a robotic arm command for implementing the movement of the device indicated by the input based on the modified Jacobian matrix.

[0008] In another aspect, a robotic system is provided, comprising: an apparatus having an end effector; a robotic arm configured to control movement of the apparatus and the end effector; an input device configured to receive input commands for controlling movement of the end effector, wherein the apparatus is capable of movement with fewer degrees of freedom (DOF) than the input device; at least one processor; and at least one computer-readable storage device communicating with one or more processors and storing computer-executable instructions thereon such that at least one processor: receives input commands for controlling movement of the end effector from the input device, modifies the input commands by discarding a portion of the input commands corresponding to unachievable movement of the end effector, and determines a robotic arm movement for controlling the movement of the end effector based on the modified input commands.

[0009] In another aspect, a method for controlling the movement of an end effector of a medical device is provided, the method comprising: receiving, via an input device, an input command for controlling the movement of the end effector, the end effector having fewer DOFs than the input device; transforming the input command into an end effector coordinate system; determining an end effector Jacobian matrix in the end effector coordinate system; modifying the end effector Jacobian matrix by discarding at least one row of the end effector Jacobian matrix; and determining, based on the modified Jacobian matrix, a robotic arm command for implementing the movement of the end effector indicated by the input.

[0010] In another aspect, a robotic system is provided, comprising: an apparatus having an end effector; a robotic arm configured to control movement of the apparatus and the end effector; an input device configured to receive input for controlling movement of the apparatus and the end effector, wherein the apparatus is capable of moving at a different number of degrees of freedom (DOF) than the input device; at least one processor; and at least one computer-readable storage device communicating with one or more processors and storing computer-executable instructions thereon such that at least one processor: determines a Jacobian matrix that associates the input of the input device with a robotic arm command for implementing movement of the end effector indicated by the input, the Jacobian matrix associating the reference frame of the end effector with the world reference frame of the robotic system; modifies the Jacobian matrix by discarding at least one row of the Jacobian matrix; and determines a robotic arm command for implementing movement of the apparatus indicated by the input based on the modified Jacobian matrix. Attached Figure Description

[0011] The disclosed aspects will be described below in conjunction with the accompanying drawings, which are provided to illustrate and not limit the disclosed aspects, wherein similar reference numerals denote similar elements.

[0012] Figure 1 An implementation scheme of a cart-based robotic system deployed for diagnostic and / or therapeutic bronchoscopy is shown.

[0013] Figure 2 Depicting Figure 1 Another aspect of robotic systems.

[0014] Figure 3 The setup for ureteroscopy is shown. Figure 1 The implementation plan for the robot system.

[0015] Figure 4 The diagram shows the arrangement used for vascular procedures. Figure 1 The implementation plan for the robot system.

[0016] Figure 5 An implementation scheme of a table-based robotic system deployed for bronchoscopy procedures is shown.

[0017] Figure 6 Provided Figure 5 An alternative view of the robot system.

[0018] Figure 7 An exemplary system configured to retract one or more robotic arms is shown.

[0019] Figure 8An implementation scheme of a table-based robotic system configured for ureteroscopy procedures is shown.

[0020] Figure 9 An implementation scheme of a stage-based robotic system configured for laparoscopic procedures is shown.

[0021] Figure 10 It shows Figures 5 to 9 An implementation scheme for a platform-based robot system with pitch and tilt adjustment.

[0022] Figure 11 Provided Figures 5 to 10 A detailed diagram of the interface between the platform and the column of the platform-based robotic system.

[0023] Figure 12 An alternative implementation of a stage-based robotic system is shown.

[0024] Figure 13 It shows Figure 12 An end view of a platform-based robotic system.

[0025] Figure 14 An end view of a platform-based robotic system with a robotic arm attached is shown.

[0026] Figure 15 An exemplary device driver is shown.

[0027] Figure 16 An exemplary medical device with paired instrument drivers is shown.

[0028] 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.

[0029] Figure 18 An instrument with an instrument-based insertion architecture is shown.

[0030] Figure 19 An example controller is shown.

[0031] Figure 20 A block diagram according to an exemplary embodiment is depicted, illustrating the estimation Figures 1 to 10 The location of one or more components of a robotic system (such as...) Figures 16 to 18 A positioning system for the location of instruments.

[0032] Figure 21 Examples of underactuated devices that can be controlled by a robotic system according to various aspects of this disclosure are shown.

[0033] Figure 22A and Figure 22BThe images show the open and closed positions, respectively. Figure 21 The end effector of the instrument.

[0034] Figure 23 An exemplary input device is shown that can be used to control the movement of a medical device via one or more robotic arms, according to various aspects of this disclosure.

[0035] Figure 24 The various aspects shown in this disclosure are as follows Figure 23 A close-up view of one of the handles shown.

[0036] Figure 25 An exemplary block diagram is shown, illustrating how inverse kinematics can be used to determine the joint orientation of a robot arm according to various aspects of this disclosure.

[0037] Figure 26 Five-DOF medical devices relative to different reference frames are shown according to various aspects of this disclosure.

[0038] Figure 27 This is a flowchart illustrating an exemplary method, according to aspects of the present disclosure, that can be operated by a robotic system or a component thereof to perform constrained motion control of a medical device.

[0039] Figure 28 This is a flowchart illustrating an exemplary method, according to aspects of the present disclosure, for aligning an input device and an end effector of a medical device by operation of a robotic system or its components. Detailed Implementation

[0040] 1. Overview .

[0041] The aspects of this disclosure can be integrated into robot-enabled medical systems capable of performing a variety of medical procedures, including minimally invasive procedures such as laparoscopy and non-invasive procedures such as endoscopy. In endoscopic procedures, the system may be able to perform bronchoscopy, ureteroscopy, gastroscopy, etc.

[0042] In addition to executing a wide range of procedures, the system can provide additional benefits such as enhanced imaging and guidance to assist physicians. Furthermore, the system allows physicians to execute procedures from an ergonomic orientation, eliminating the need for cumbersome arm movements and positioning. Additionally, the system provides physicians with improved ease of use, enabling one or more instruments within the system to be controlled by a single user.

[0043] For illustrative purposes, various embodiments will be described below in conjunction with the accompanying drawings. It should be understood that many other specific embodiments of the disclosed concepts are possible, and various advantages can be achieved using the disclosed specific embodiments. Titles are included herein for reference and to aid in locating the various sections. These titled sections are not intended to limit the scope of the concepts described therein. Such concepts may be applicable throughout the specification.

[0044] A. Robotic System – Cart .

[0045] Robot-enabled medical systems can be configured in a variety of ways, depending on specific procedures. Figure 1 An embodiment of a cart-based, robot-enabled system 10 arranged for diagnostic and / or therapeutic bronchoscopy is illustrated. During bronchoscopy, system 10 may include a cart 11 having one or more robotic arms 12 to deliver medical instruments, such as a manipulable endoscope 13 (which may be a procedure-specific bronchoscope for bronchoscopy), to a natural orifice entry point (i.e., the patient's mouth positioned on the table in this example) to deliver diagnostic and / or therapeutic tools. As shown, cart 11 may be positioned near the patient's upper torso to provide access to the entry point. Similarly, robotic arms 12 may be actuated to position the bronchoscope relative to the entry point. This can also be utilized when performing GI procedures with a gastroscope (a dedicated endoscope for gastrointestinal (GI) procedures). Figure 1 The layout within. Figure 2 An exemplary implementation of the cart is described in more detail.

[0046] Continue to refer to Figure 1Once the trolley 11 is correctly positioned, the robotic arm 12 can robotically, manually, or in combination thereof insert the maneuverable endoscope 13 into the patient. As shown, the maneuverable endoscope 13 may include at least two telescopic portions, such as an inner guide portion and an outer sheath portion, each coupled to a separate instrument actuator from a set of instrument actuators 28, each instrument actuator coupled to the distal end of a separate robotic arm. This linear arrangement of the instrument actuators 28, which facilitates coaxial alignment of the guide portion and the sheath portion, creates a “virtual track” 29 that can be repositioned in space by maneuvering one or more robotic arms 12 to different angles and / or positions. The virtual track described herein is depicted using dashed lines in the accompanying drawings, and therefore the dashed lines do not depict any physical structure of the system. Translation of the instrument actuators 28 along the virtual track 29 causes the inner guide portion to extend or retract relative to the outer sheath portion, or to advance or retract the endoscope 13 from the patient. The angle of the virtual track 29 can be adjusted, translated, and pivoted based on clinical application or physician preference. For example, in bronchoscopy, the angle and orientation of the virtual track 29 shown in the figure represent a trade-off between providing the physician with access to the endoscope 13 and minimizing friction caused by the endoscope 13 bending into the patient's mouth.

[0047] After insertion, endoscope 13 can be guided downwards through the patient's trachea and lungs using precise commands from the robotic system until the target destination or surgical site is reached. To enhance navigation through the patient's lung network and / or reach the desired target, endoscope 13 can be manipulated to telescopically extend the inner guide portion from the outer sheath portion to achieve enhanced joint movement and a larger radius of flexion. The use of separate instrument actuators 28 also allows the guide portion and sheath portion to be driven independently of each other.

[0048] For example, endoscope 13 can be guided to deliver a biopsy needle to a target, such as a lesion or nodule in a patient's lung. The needle can be deployed downwards along the working channel, which extends the length of the endoscope to obtain a tissue sample to be analyzed by a pathologist. Depending on the pathological findings, additional tools can be deployed downwards along the working channel of the endoscope for additional biopsies. After the nodule is identified as malignant, endoscope 13 can be used to deliver endoscopic tools to remove the potential cancerous tissue. In some cases, diagnostic and therapeutic procedures can be delivered in a separate procedure. In these cases, endoscope 13 can also be used to deliver a reference point to "mark" the location of the target nodule. In other cases, diagnostic and therapeutic procedures can be delivered during the same procedure.

[0049] System 10 may also include a movable tower 30, which can be connected to the trolley 11 via support cables to provide control, electronic, fluid, optical, sensor, and / or electrical support to the trolley 11. Placing such functionality in the tower 30 allows for easier adjustment and / or repositioning of the smaller form factor of the trolley 11 by the operating physician and his / her staff. Additionally, the division of functionality between the trolley / table and the support tower 30 reduces operating room clutter and facilitates improved clinical workflow. While the trolley 11 can be positioned close to the patient, the tower 30 can be retracted in a remote location to avoid obstructing the path during procedural procedures.

[0050] To support the aforementioned robotic system, tower 30 may include components of a computer-based control system that stores computer program instructions in a non-transitory computer-readable storage medium such as a permanent magnet memory drive, a solid-state drive, etc. Whether execution occurs within tower 30 or cart 11, the execution of these instructions can control the entire system or its subsystems. For example, when executed by the processor of the computer system, the instructions can cause components of the robotic system to actuate relevant brackets and arm mounts, actuate the robotic arm, and control medical devices. For instance, in response to receiving a control signal, motors in the joints of the robotic arm can position the arm into a specific posture.

[0051] Tower 30 may also include pumps, flow meters, valve controllers, and / or fluid passages to provide controlled flushing and suction capabilities to a system that can be deployed via endoscope 13. These components may also be controlled using a computer system of tower 30. In some embodiments, flushing and suction capabilities may be delivered directly to endoscope 13 via a separate cable.

[0052] Tower 30 may include voltage and surge protectors designed to provide filtered and protected power to trolley 11, thereby avoiding the need to place power transformers and other auxiliary power components in trolley 11, resulting in a smaller and more mobile trolley 11.

[0053] Tower 30 may also include support devices for sensors deployed throughout the robotic system 10. For example, tower 30 may include optoelectronic devices for detecting, receiving, and processing data received from optical sensors or cameras throughout the robotic system 10. In conjunction with a control system, such optoelectronic devices can be used to generate real-time images for display in any number of consoles deployed throughout the system (including displays within tower 30). Similarly, tower 30 may also include electronic subsystems for receiving and processing signals received from deployed electromagnetic (EM) sensors. Tower 30 may also be used to house and position EM field generators for detection by EM sensors in or on a medical device.

[0054] In addition to other consoles available in the rest of the system (e.g., a console mounted on top of a cart), tower 30 may also include console 31. Console 31 may include a user interface and display, such as a touchscreen, for physician operators. Consoles in system 10 are generally designed to provide both robot control and preoperative and real-time information for procedures, such as navigation and positioning information for endoscope 13. When console 31 is not the only console available to the physician, it may be used by a second operator (such as a nurse) to monitor the patient's health or vital signs and operation of system 10, as well as to provide procedure-specific data, such as navigation and positioning information. In other embodiments, console 30 is housed in a separate body from tower 30.

[0055] Tower 30 can be coupled to cart 11 and endoscope 13 via one or more cables or connectors (not shown). In some embodiments, support functionality from tower 30 can be provided to cart 11 via a single cable, thereby simplifying the operating room and eliminating clutter. In other embodiments, specific functions can be coupled in separate wiring and connections. For example, while power can be provided to cart 11 via a single cable, support for controls, optics, fluid, and / or navigation can also be provided via separate cables.

[0056] Figure 2 Provided from Figure 1 The illustration shows a detailed depiction of an embodiment of a cart 11 in a cart-based robot-enabled system. The cart 11 typically includes an elongated support structure 14 (often referred to as a "post"), a cart base 15, and a console 16 at the top of the post 14. The post 14 may include one or more brackets, such as those for supporting one or more robotic arms 12. Figure 2 The bracket 17 (or alternatively, "arm support") is deployed in three configurations. The bracket 17 may include a separately configurable arm mount that rotates along a vertical axis to adjust the base of the robotic arm 12 for better positioning relative to the patient. The bracket 17 also includes a bracket interface 19 that allows the bracket 17 to translate vertically along the post 14.

[0057] The bracket interface 19 is connected to the column 14 via a slot, such as slot 20, positioned on the opposite side of the column 14 to guide the vertical translation of the bracket 17. Slot 20 includes a vertical translation interface to position and hold the bracket 17 relative to the trolley base 15 at various vertical heights. The vertical translation of the bracket 17 allows the trolley 11 to adjust the reach of the robotic arm 12 to accommodate various table heights, patient sizes, and physician preferences. Similarly, individually configurable arm mounts on the bracket 17 allow the robotic arm base 21 of the robotic arm 12 to be configured at various angles.

[0058] In some embodiments, slot 20 may be supplemented with a slot cover flush and parallel to the slot surface to prevent dust and fluid from entering the internal cavity of column 14 and the vertical translation interface during the vertical translation of bracket 17. The slot cover can be deployed via a pair of spring reels positioned near the vertical top and bottom of slot 20. The cover is coiled within the reels until it is deployed to extend and retract from its coiled state during the vertical up-and-down translation of bracket 17. The spring loading of the reels provides a force to retract the cover into the reels as bracket 17 translates toward the reels, while maintaining a tight seal as bracket 17 translates away from the reels. The cover can be attached to bracket 17 using, for example, a bracket in bracket interface 19, to ensure proper extension and retraction of the cover during the translation of bracket 17.

[0059] The column 14 may internally include mechanisms such as gears and motors, which are designed to mechanically translate the bracket 17 using vertically aligned lead screws in response to control signals generated in response to user input (e.g., input from the console 16).

[0060] A robotic arm 12 typically includes a robotic arm base 21 and an end effector 22 separated by a series of links 23 connected by a series of joints 24, each joint including an independent actuator, and each actuator including an independently controllable motor. Each independently controllable joint represents an independent degree of freedom available to the robotic arm 12. Each robotic arm in the robotic arm 12 may have seven joints, and thus provide seven degrees of freedom. Multiple joints result in multiple degrees of freedom, thus allowing for “redundant” degrees of freedom. Having redundant degrees of freedom allows the robotic arm 12 to position its corresponding end effector 22 in a specific orientation, orientation, and trajectory in space using different joint positions and joint angles. This allows the system to locate and guide medical devices from desired points in space, while allowing physicians to move the arm joints to a clinically advantageous orientation away from the patient to achieve greater proximity while avoiding arm collisions.

[0061] The cart base 15 balances the weight of the counterweight 14, bracket 17, and robotic arm 12 on the floor. Therefore, the cart base 15 houses heavier components such as electronics, motors, power supplies, and components that enable the cart 11 to move and / or be secured. For example, the cart base 15 includes rollable wheel-shaped casters 25 that allow the cart 11 to easily move around the room before the procedure. Once in the correct orientation, the casters 25 can be secured using wheel locks to hold the cart 11 in the correct orientation during the procedure.

[0062] The console 16, positioned at the vertical end of column 14, allows both a user interface for receiving user input and a display screen (or dual-purpose device, such as, for example, touchscreen 26) to provide both preoperative and intraoperative data to the physician user. Potential preoperative data on touchscreen 26 may include preoperative planning, navigation, and mapping data derived from preoperative computed tomography (CT) scans and / or records from preoperative patient interviews. Intraoperative data on the display screen may include optical information from tools and sensors, coordinate information from sensors, and important patient statistics such as respiration, heart rate, and / or pulse. The console 16 can be positioned and tilted to allow the physician to access it from the side of column 14 opposite to bracket 17. From this orientation, the physician can operate the console 16 from behind cart 11 while observing the console 16, robotic arm 12, and patient. As shown, the console 16 also includes a handle 27 to aid in manipulating and stabilizing cart 11.

[0063] Figure 3 An embodiment of a robot-enabled system 10 arranged for ureteroscopy is shown. In a ureteroscopy procedure, a trolley 11 is positioned to deliver a ureteroscope 32 (a procedure-specific endoscope designed to traverse the patient's urethra and ureter) to the patient's lower abdominal region. During ureteroscopy, it is desirable to align the ureteroscope 32 directly with the patient's urethra to reduce friction and force on sensitive anatomical structures in that region. As shown, the trolley 11 can be aligned at the foot of the table to allow the robotic arm 12 to position the ureteroscope 32 for direct linear access into the patient's urethra. The robotic arm 12 can insert the ureteroscope 32 directly into the patient's lower abdomen through the urethra from the foot of the table along a virtual track 33.

[0064] After insertion into the urethra, using control techniques similar to those used in bronchoscopy, the ureteroscope 32 can be navigated to the bladder, ureter, and / or kidney for diagnostic and / or therapeutic applications. For example, the ureteroscope 32 can be guided into the ureter and kidney to break up accumulated kidney stones using a laser or ultrasonic lithotripsy device deployed downwards along the working channel of the ureteroscope 32. After lithotripsy is complete, the resulting stone fragments can be removed using a basket deployed downwards along the ureteroscope 32.

[0065] Figure 4An embodiment of a robot-enabled system 10 similarly arranged for vascular procedures is shown. In vascular procedures, system 10 can be configured such that a trolley 11 delivers a medical device 34 (such as a manipulable catheter) to an entry point in the femoral artery in the patient's leg. The femoral artery presents both a large diameter for navigation and a relatively less circuitous and tortuous path to the patient's heart, which simplifies navigation. As in ureteroscopy procedures, trolley 11 can be positioned toward the patient's leg and lower abdomen to allow robotic arm 12 to provide a virtual track 35 for direct linear access to the femoral artery entry point in the patient's thigh / hip region. After insertion into the artery, the medical device 34 can be guided and inserted via translational device actuator 28. Alternatively, the trolley can be positioned around the patient's upper abdomen to reach alternative vascular entry points, such as the carotid and brachial arteries near the shoulder and wrist.

[0066] B. Robot System – Unit .

[0067] Implementation plans for robot-enabled medical systems can also incorporate patient-integrated tables. Integrating tables reduces the amount of capital equipment in the operating room by removing trolleys, allowing for greater accessibility to the patient. Figure 5 An embodiment of such a robot-enabled system deployed for a bronchoscopy procedure is shown. System 36 includes a support structure or column 37 for supporting a platform 38 (shown as a “table” or “bed”) on a floor. Much like a trolley-based system, the end effector of the robotic arm 39 of system 36 includes an instrument actuator 42, which is designed to manipulate elongated medical instruments, such as… Figure 5 The bronchoscope 40 is used in the bronchoscopy. In practice, the C-arm used to provide fluorescence imaging can be positioned above the patient's upper abdominal region by placing the transmitter and detector around the stage 38.

[0068] Figure 6An alternative view of system 36 without a patient and medical devices is provided for discussion purposes. As shown, column 37 may include one or more brackets 43, shown as annular in system 36, upon which one or more robotic arms 39 may be based. The brackets 43 may translate along a vertical column interface 44 extending along the length of column 37 to provide different vantage points from which the robotic arms 39 may be positioned to reach the patient. The brackets 43 may be rotated about column 37 using mechanical motors positioned within column 37 to allow the robotic arms 39 to access multiple sides of table 38, such as both sides of the patient. In embodiments with multiple brackets, the brackets may be individually positioned on the column and may translate and / or rotate independently of other brackets. While the brackets 43 need not be circular or even encircling column 37, the annular shape shown facilitates rotation of the brackets 43 about column 37 while maintaining structural balance. Rotation and translation of the brackets 43 allow system 36 to align medical devices such as endoscopes and laparoscopes to different access points on the patient. In other embodiments (not shown), system 36 may include a patient examination table or bed with an adjustable arm support, which takes the form of a rod or rail extending beside the patient examination table or bed. One or more robotic arms 39 (e.g., via a shoulder with an elbow joint) may be attached to the adjustable arm support, which can be vertically adjusted. By providing vertical adjustment, the robotic arms 39 can advantageously be compactly stored under the patient examination table or bed and subsequently raised during procedures.

[0069] The robotic arm 39 can be mounted on the bracket 43 via a set of arm mounts 45 comprising a series of joints that can be individually rotated and / or telescopically extended to provide additional configurability to the robotic arm 39. Additionally, the arm mounts 45 can be positioned on the bracket 43 such that, when the bracket 43 is properly rotated, the arm mounts 45 are positioned on the same side of the platform 38 (e.g., ...). Figure 6 As shown), on the opposite side of platform 38 (as shown) Figure 9 (as shown) or on the adjacent side of platform 38 (not shown).

[0070] Column 37 structurally supports platform 38 and provides a path for the vertical translation of bracket 43. Internally, column 37 may be equipped with a lead screw for guiding the vertical translation of the bracket, and a motor for mechanizing the lead screw-based translation of bracket 43. Column 37 may also transmit power and control signals to bracket 43 and the robotic arm 39 mounted thereon.

[0071] Platform base 46 has with Figure 2The trolley base 15 in the illustrated trolley 11 functions similarly, accommodating heavier components to balance the table / bed 38, column 37, bracket 43, and robotic arm 39. The table base 46 may also incorporate rigid casters to provide stability during operation. Casters deployed from the bottom of the table base 46 can extend in opposite directions on either side of the base 46 and retract when the system 36 requires movement.

[0072] continue Figure 6 System 36 may also include a tower (not shown) that divides the functionality of system 36 between the table and the tower to reduce the form factor and volume of the table. As in previously disclosed embodiments, the tower may provide the table with a variety of support functions, such as processing, computing and control capabilities, electrical, fluid and / or optical, and sensor processing. The tower may also be movable to be positioned away from the patient, thereby improving physician access and eliminating clutter in the operating room. Additionally, placing components in the tower allows for more storage space in the table base 46 for potential retraction of the robotic arm 39. The tower may also include a main controller or console that provides both a user interface (such as a keyboard and / or widgets) for user input and a display screen (or touchscreen) for preoperative and intraoperative information (such as real-time imaging, navigation, and tracking information). In some embodiments, the tower may also include a gripper for a gas canister to be used for inflatation.

[0073] In some implementations, the base can be retracted and stored when not in use. Figure 7 A system 47 for retracting a robotic arm is illustrated in an embodiment of a platform-based system. In system 47, a bracket 48 can be vertically translated into a base 49 to retract the robotic arm 50, arm mount 51, and bracket 48 within the base 49. A base cover 52 can be translated and retracted to open to deploy the bracket 48, arm mount 51, and robotic arm 50 around a post 53, and to close to retract the bracket, arm mount, and robotic arm for protection when not in use. The base cover 52 can be sealed along the edges of its opening using a membrane 54 to prevent dust and fluid from entering when closed.

[0074] Figure 8An embodiment of a robot-enabled table-based system configured for a ureteroscopy procedure is illustrated. During ureteroscopy, table 38 may include a rotating portion 55 for positioning the patient at an angle to the column 37 and table base 46. The rotating portion 55 may rotate or pivot about a pivot point (e.g., below the patient's head) to position the lower portion of the rotating portion 55 away from the column 37. For example, pivoting of the rotating portion 55 allows a C-arm (not shown) to be positioned above the patient's lower abdomen without competing for space with the column (not shown) below table 38. By rotating a bracket 35 (not shown) about the column 37, a robotic arm 39 can insert a ureteroscope 56 directly into the patient's groin region along a virtual track 57 to reach the urethra. During ureteroscopy, stirrups 58 may also be fixed to the rotating portion 55 of table 38 to support the orientation of the patient's legs during the procedure and allow full access to the patient's groin region.

[0075] In laparoscopic procedures, minimally invasive instruments are inserted into the patient's anatomical structures through one or more small incisions in the abdominal wall. In some embodiments, the minimally invasive instruments include elongated rigid components, such as axes, for accessing the anatomical structures within the patient. After the patient's abdominal cavity is inflated, the instruments can be guided to perform surgical or medical tasks, such as grasping, cutting, ablation, suturing, etc. In some embodiments, the instruments may include endoscopes, such as laparoscopes. Figure 9 An implementation of a stage-based, robot-enabled system configured for laparoscopic procedures is shown. For example... Figure 9 As shown, the bracket 43 of system 36 can be rotated and vertically adjusted to position the pair of robotic arms 39 on opposite sides of table 38, so that the instrument 59 can be positioned through the smallest incision on both sides of the patient to reach his / her abdominal cavity using arm mount 45.

[0076] To accommodate laparoscopic procedures, the robot-enabled platform system can also tilt the platform to the desired angle. Figure 10 An implementation scheme for a robot-enabled medical system with pitch or tilt adjustment is shown. For example... Figure 10 As shown, system 36 can adapt to the tilt of platform 38 to position one part of the platform at a greater distance from the base plate than another part. Additionally, arm mount 45 can rotate to match the tilt, ensuring that robot arm 39 maintains the same planar relationship with platform 38. To accommodate steeper angles, column 37 may also include a telescopic portion 60 that allows vertical extension of column 37 to prevent platform 38 from contacting the floor or colliding with platform base 46.

[0077] Figure 11Detailed illustrations are provided of the interface between platform 38 and column 37. The pitch-rotation mechanism 61 can be configured to change the pitch angle of platform 38 relative to column 37 in multiple degrees of freedom. The pitch-rotation mechanism 61 is achieved by positioning orthogonal axes 1 and 2 at the column interface, each axis being actuated by separate motors 3 and 4 in response to electrical pitch angle commands. Rotation along one screw 5 enables tilt adjustment along axis 1, while rotation along another screw 6 enables tilt adjustment along another axis 2. In some embodiments, ball joints may be used to change the pitch angle of platform 38 relative to column 37 in multiple degrees of freedom.

[0078] For example, pitch adjustment is particularly useful when attempting to position the table in a head-down, feet-up position (i.e., positioning the patient's lower abdomen higher than their upper abdomen above the floor) for lower abdominal surgery. The head-down, feet-up position causes the patient's internal organs to slide down to their upper abdomen by gravity, clearing the abdominal cavity to allow minimally invasive instruments to enter and perform lower abdominal surgical or medical procedures, such as laparoscopic prostatectomy.

[0079] Figure 12 and Figure 13 Isometric and end views of an alternative embodiment of a stage-based surgical robot system 100 are shown. The surgical robot system 100 includes one or more robotic arms (see, for example) that can be configured to support 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.

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

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

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

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

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

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

[0086] C. Instrument drivers and interfaces .

[0087] The end effector of the system's robotic arm may include: (i) an instrument actuator (alternatively referred to as an "instrument drive mechanism" or "instrument device manipulator") incorporating electromechanical devices for actuating medical devices; and (ii) a removable or detachable medical device, which may lack any electromechanical components, such as motors. This dichotomy may be driven by the need to sterilize medical devices used in medical procedures, and the inability to adequately sterilize expensive capital equipment due to its complex mechanical components and sensitive electronics. Therefore, medical devices may be designed to be detached, removed, and interchanged from the instrument actuator (and thus from the system) for individual sterilization or disposal by a physician or physician staff. In contrast, the instrument actuator does not need to be altered or sterilized and can be covered for protection.

[0088] Figure 15An exemplary instrument actuator is illustrated. The instrument actuator 62, positioned at the distal end of a robotic arm, includes one or more drive units 63 arranged parallel to an axis to provide controlled torque to a medical device via a drive shaft 64. Each drive unit 63 includes a separate drive shaft 64 for interacting with the device, a gear head 65 for converting motor shaft rotation into desired torque, a motor 66 for generating drive torque, an encoder 67 for measuring the speed of the motor shaft and providing feedback to control circuitry, and control circuitry 68 for receiving control signals and actuating the drive unit. Each drive unit 63 is independently controlled and motorized, and the instrument actuator 62 can provide multiple (e.g., as...) to the medical device. Figure 15 Four independent drive outputs are shown. In operation, the control circuit 68 receives control signals, transmits motor signals to the motor 66, compares the motor speed measured by the encoder 67 with the desired speed, and modulates the motor signals to generate the desired torque.

[0089] For procedures requiring a sterile environment, the robotic system can incorporate a drive interface, such as a sterile adapter connected to a sterile cover, positioned between the instrument actuator and the medical device. The primary purpose of the sterile adapter is to transmit angular motion from the drive shaft of the instrument actuator to the drive input of the device, while maintaining physical separation between the drive shaft and the drive input, thus preserving sterility. Therefore, an exemplary sterile adapter may include a series of rotary inputs and rotary outputs designed to mate with the drive shaft of the instrument actuator and the drive input on the device. The sterile cover, composed of a thin, flexible material (such as transparent or translucent plastic), is connected to the sterile adapter and designed to cover capital devices, such as instrument actuators, robotic arms, and trolleys (in trolley-based systems) or tables (in table-based systems). The use of the cover allows the capital device to be positioned near the patient while still within an area that does not require sterilization (i.e., a non-sterile area). On the other side of the sterile cover, the medical device can dock with the patient in an area that requires sterilization (i.e., a sterile area).

[0090] D. Medical devices .

[0091] Figure 16An exemplary medical device with paired instrument actuators is shown. Similar to other devices designed for use with robotic systems, the medical device 70 includes an elongated shaft 71 (or elongated body) and an instrument base 72. The instrument base 72, also referred to as the “instrument handle” due to its intended design for manual interaction by a physician, typically includes a rotatable drive input 73 (e.g., a socket, pulley, or reel) designed to mate with a drive output 74 on a drive interface extending through the distal end of the robotic arm 76. When physically connected, latched, and / or coupled, the mating drive input 73 of the instrument base 72 may share a rotational axis with the drive output 74 in the instrument driver 75 to allow torque to be transmitted from the drive output 74 to the drive input 73. In some embodiments, the drive output 74 may include a spline designed to mate with a socket on the drive input 73.

[0092] The elongated shaft 71 is designed to be delivered through an anatomical opening or cavity (e.g., as in endoscopy) or through a minimally invasive incision (e.g., as in laparoscopy). The elongated shaft 71 can be flexible (e.g., having endoscope-like properties) or rigid (e.g., having laparoscopy-like properties), or a customized combination of both flexible and rigid portions. When designed for laparoscopy, the distal end of the rigid elongated shaft can be connected to an end effector extending from a connector wrist formed by a connecting fork having at least one degree of freedom and a surgical tool or medical instrument (such as, for example, a gripper or scissors), which can be actuated based on forces from a tendon when the drive input rotates in response to torque received from the drive output 74 of the instrument actuator 75. When designed for endoscopy, the distal end of the flexible elongated shaft can include a manipulable or controllable bending segment that articulates and bends based on torque received from the drive output 74 of the instrument actuator 75.

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

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

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

[0096] At the distal end of the instrument 70, the distal end may further include an opening for delivering tools for diagnosis and / or treatment, and for a working channel for rinsing and aspirating the surgical site. The distal end may also include a port for a camera (such as a fiberoptic endoscope or digital camera) to capture images of the internal anatomical space. Relatedly, the distal end may also include a port for a light source used to illuminate the anatomical space when the camera is used.

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

[0098] Figure 17 An alternative design of the instrument actuator and instrument is shown, wherein the axis of the drive unit is parallel to the axis of the slender axis of the instrument. As shown, the circular instrument actuator 80 includes four drive units whose drive outputs 81 are aligned parallel to each other at the end of the robot arm 82. The drive units and their respective drive outputs 81 are housed in a rotating assembly 83 of the instrument actuator 80, driven by one of the drive units within assembly 83. In response to torque provided by the rotating drive unit, the rotating assembly 83 rotates along a circular bearing that connects the rotating assembly 83 to the non-rotating portion 84 of the instrument actuator 80. Electrical and control signals can be transmitted from the non-rotating portion 84 of the instrument actuator 80 to the rotating assembly 83 via electrical contacts, which can be maintained by rotation of a brush slip ring connection (not shown). In other embodiments, the rotating assembly 83 may be responsive to a separate drive unit integrated into the non-rotating portion 84 and therefore not parallel to the other drive units. The rotation mechanism 83 allows the instrument actuator 80 to allow the drive units and their respective drive outputs 81 to rotate as a single unit about the instrument actuator axis 85.

[0099] Similar to previously disclosed embodiments, the instrument 86 may include an elongated shaft portion 88 and an instrument base 87 (shown as having a transparent outer surface for discussion purposes), the instrument base including a plurality of drive inputs 89 (such as sockets, pulleys, and reels) configured to receive drive outputs 81 in the instrument driver 80. Unlike previously disclosed embodiments, the instrument shaft 88 extends from the center of the instrument base 87, and the axis of the instrument base is substantially parallel to the axes of the drive inputs 89, rather than... Figure 16 It is orthogonal as in the design.

[0100] When coupled to the rotating assembly 83 of the instrument driver 80, the medical device 86, including the instrument base 87 and the instrument shaft 88, rotates in combination with the rotating assembly 83 about the instrument driver axis 85. Since the instrument shaft 88 is positioned at the center of the instrument base 87, it is coaxial with the instrument driver axis 85 when attached. Therefore, rotation of the rotating assembly 83 causes the instrument shaft 88 to rotate about its own longitudinal axis. Furthermore, when the instrument base 87 rotates together with the instrument shaft 88, any tendons connected to the drive input portion 89 in the instrument base 87 do not become entangled during rotation. Therefore, the parallelism of the axes of the drive output portion 81, the drive input portion 89, and the instrument shaft 88 allows the shaft to rotate without causing any control tendons to become entangled.

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

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

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

[0104] E. Controller .

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

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

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

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

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

[0110] F. Navigation and Control .

[0111] Traditional endoscopy can involve the use of fluoroscopy (e.g., delivered via a C-arm) and other forms of radiation-based imaging modalities to provide intracavitary guidance to the operating physician. In contrast, the robotic system envisioned in this disclosure can provide radiation-free navigation and positioning, reducing physician exposure to radiation and the amount of equipment required in the operating room. As used herein, the term "positioning" can refer to determining and / or monitoring the orientation of an object in a reference coordinate system. Techniques such as preoperative mapping, computer vision, real-time EM tracking, and robot command data can be used individually or in combination to achieve a radiation-free operating environment. In other cases where radiation-based imaging modalities are still used, preoperative mapping, computer vision, real-time EM tracking, and robot command data can be used individually or in combination to improve upon information obtained solely through radiation-based imaging modalities.

[0112] Figure 20 This is a block diagram illustrating a positioning system 90 for estimating the position of one or more components of a robotic system (such as the position of a machine) according to an exemplary embodiment. The positioning system 90 may be one or more computer devices configured to execute one or more instructions. The computer devices may be embodied by a processor (or multiple processors) and computer-readable storage among the components discussed above. By way of example and not limitation, the computer devices may be located in… Figure 1 Tower 30 shown Figures 1 to 4 The trolley 11 shown Figures 5 to 14 The bed, etc. shown.

[0113] like Figure 20 As shown, the positioning system 90 may include a positioning module 95 that processes input data 91-94 to generate position data 96 for the distal end of a medical device. The position data 96 may be data or logic representing the position and / or orientation of the distal end of the device relative to a reference frame. The reference frame may be relative to a patient's anatomy or a known object (such as an EM field generator) (see the discussion of EM field generators below).

[0114] The various input data are now described in more detail 91-94. Preoperative mapping can be accomplished using a collection of low-dose CT scans. The preoperative CT scans are reconstructed into three-dimensional images, which are visualized, for example, as “slices” of cross-sectional views of the patient’s internal anatomy. When analyzed in whole, image-based models of the anatomical cavities, spaces, and structures of the patient’s anatomical structures, such as the patient’s lung network, can be generated. Techniques such as centerline geometry can be determined and approximated from CT images to form a three-dimensional volume of the patient’s anatomy, which is referred to as model data 91 (also referred to as “preoperative model data” when generated using only preoperative CT scans). The use of centerline geometry is discussed in U.S. Patent Application 14 / 523,760, the contents of which are incorporated herein by reference in their entirety. Network topology models can also be derived from CT images and are particularly well-suited for bronchoscopy.

[0115] In some implementations, the instrument may be equipped with a camera to provide visual data (or image data) 92. A positioning module 95 may process the visual data 92 to enable one or more vision-based (or image-based) position tracking modules or features. For example, preoperative model data 91 may be used in conjunction with the visual data 92 to enable computer vision-based tracking of a medical instrument (e.g., an endoscope or an instrument propelled through the working channel of an endoscope). For example, using the preoperative model data 91, a robotic system may generate a library of expected endoscopic images based on the model, with each image linked to a location within the model, based on the expected path of the endoscope's movement. During surgical procedures, the robotic system may refer to this library to compare real-time images captured at a camera (e.g., a camera at the distal end of the endoscope) with those images in the image library to aid in positioning.

[0116] Other computer vision-based tracking techniques use feature tracking to determine camera motion, and thus, endoscope motion. Some features of the localization module 95 can identify circular geometries corresponding to anatomical cavities in the preoperative model data 91 and track changes in those geometries to determine which anatomical cavity has been selected, as well as track the relative rotation and / or translational motion of the camera. The use of a topology map can further enhance vision-based algorithms or techniques.

[0117] Optical flow (another computer vision-based technique) can analyze the displacement and translation of image pixels in a video sequence within visual data 92 to infer camera motion. Examples of optical flow techniques can include motion detection, object segmentation computation, brightness, motion compensation coding, stereo parallax measurement, and more. Through multiple iterations and comparisons of multiple frames, the motion and position of the camera (and therefore the endoscope) can be determined.

[0118] The positioning module 95 can use real-time EM tracking to generate the real-time position of the endoscope in a global coordinate system that can be registered to the patient's anatomy represented by a preoperative model. In EM tracking, an EM sensor (or tracker), including one or more sensor coils embedded in one or more locations and orientations within the medical instrument (e.g., an endoscopic tool), measures changes in the EM field generated by one or more static EM field generators positioned at known locations. The positional information detected by the EM sensor is stored as EM data 93. The EM field generator (or transmitter) can be placed close to the patient to generate a low-intensity magnetic field detectable by the embedded sensor. The magnetic field induces a small current in the sensor coil of the EM sensor, which can be analyzed to determine the distance and angle between the EM sensor and the EM field generator. These distances and orientations can be "registered" to the patient's anatomy (e.g., a preoperative model) during surgery to determine the geometric transformations that align a single location in the coordinate system with its orientation in the preoperative model of the patient's anatomy. Once registered, an embedded EM tracker in one or more orientations of the medical device (e.g., the distal end of an endoscope) can provide real-time indication of the medical device’s progress through the patient’s anatomy.

[0119] Robot commands and kinematic data 94 can also be used by the positioning module 95 to provide orientation data 96 for the robotic system. Device pitch and yaw from joint movement commands can be determined during preoperative calibration. During surgical procedures, these calibration measurements can be combined with known insertion depth information to estimate the instrument's orientation. Alternatively, these calculations can be analyzed in conjunction with EM, vision, and / or topology modeling to estimate the medical device's orientation within the network.

[0120] like Figure 20 As shown, the positioning module 95 can use multiple other input data. For example, although in Figure 20 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.

[0121] The localization module 95 can use the input data 91-94 in combination. In some cases, such combination can use a probabilistic method, where the localization module 95 assigns confidence weights to the location determined based on each of the input data 91-94. Therefore, in cases where the EM data may be unreliable (e.g., in the presence of EM interference), the confidence of the location determined by the EM data 93 may be reduced, and the localization module 95 may rely more heavily on the visual data 92 and / or robot commands and kinematic data 94.

[0122] As discussed above, the robotic systems discussed in this paper can be designed as a combination of one or more of the technologies mentioned above. The computer-based control system of a robotic system located in a tower, bed, and / or trolley can store computer program instructions in, for example, a non-transitory computer-readable storage medium (such as a permanent magnetic storage drive, a solid-state drive, etc.). When executed, these computer program instructions cause the system to receive and analyze sensor data and user commands, generate control signals for the entire system, and display navigation and positioning data, such as the instrument's orientation in a global coordinate system and anatomical diagrams.

[0123] 2. Restrained motion control of medical devices .

[0124] Embodiments of this disclosure relate to systems and techniques for constrained motion control of medical devices. As described herein, robotic systems (e.g., Figure 1 System 10 or Figure 14 The system 140A can be used with an input device (e.g., Figure 19 The controller 182 shown controls one or more medical devices (e.g., Figure 1 13. Maneuverable endoscope Figure 4 Medical devices 34 or Figure 18 The instrument 150) is configured to receive user input for controlling the movement of the instrument.

[0125] Different medical devices may be capable of movement with different numbers of degrees of freedom (DOF). When the number of DOFs a medical device can move in differs from the number of DOFs that the input device can manipulate by the user, challenges may arise in mapping the movement of the input device to commands for moving the medical device with the DOFs it is capable of moving. For certain specific implementations, a medical device may be capable of movement with fewer DOFs than the input device. When a medical device is constrained to move with fewer DOFs than might be beneficial for a particular task, it can be described as “underactuated.” For example, orientation and orientation can be considered 6-DOF tasks (e.g., including x, y, z, pitch, yaw, and roll DOFs), and some medical devices may be constrained to move with 5 or fewer DOFs, and therefore, these medical devices can be considered “underactuated.”

[0126] Figures 21 to 22B An example of an underactuated device 200 controllable by a robotic system according to various aspects of this disclosure is shown. Specifically, Figure 21 An overall view of instrument 200 is provided, while Figure 22A and Figure 22B The end effector 215 of the device 200 is shown in the open and closed positions, respectively.

[0127] Device 200 may include a surgical suture that can benefit from being able to move only at 5-DOF instead of 6-DOF. For example, a 5-DOF medical suture may be designed to have thicker and stiffer components than a corresponding 6-DOF suture. Since surgical sutures can be used to clamp relatively thick materials, it may be advantageous for the surgical suture to have thicker and stiffer components to handle the increased load associated with clamping relatively thick materials. Another example of an underactuated medical device is an inhalation irrigator, which may be constrained to move at 5-DOF or even 4-DOF, depending on the specific implementation. In other specific implementations, an underactuated medical device may be implemented as a direct harmonic tool or an articular motion harmonic tool. The advantages of this application extend to the control of underactuated devices (including sutures and inhalation irrigators) beyond those contemplated herein, including any other devices currently and in the future that are commercially available.

[0128] exist Figure 21 In the illustrated embodiment, medical device 200 includes a shaft 205, a handle 210, and an end effector 215. Device 200 may be coupled to any of the device actuators described above. One or more cables (not shown) may extend along the outer surface of shaft 205, and / or one or more cables may extend through the elongated shaft 205. Manipulation of one or more cables (e.g., via a device actuator) results in actuation of the end effector 215.

[0129] The handle 210 (also referred to as the instrument base) may typically include an attachment interface having one or more mechanical inputs, such as jacks, pulleys, or spools, which are designed to reciprocately engage with one or more torque couplers on the attachment surface of the instrument actuator.

[0130] Depending on the specific implementation of the particular device 200, the end effector 215 may be configured to perform one or more different medical and / or surgical tasks, which may be accomplished by tensioning one or more cables. In some embodiments, the device 200 includes a series of pulleys to which one or more cables are operatively coupled to enable the shaft 205 to translate relative to the handle 210.

[0131] In some embodiments, the device 200 may include an end effector 215 adapted to cut and / or seal tissue. Figures 22A to 22B An exemplary embodiment of an end effector 215 configured as a medical suture device according to various aspects of this disclosure is shown. Specifically, Figure 22A The end effector 215 is shown in the open position, while Figure 22B An end effector 215 in the closed position is shown. (Example) Figure 22A and Figure 22B As shown, the end effector 215 in the illustrated embodiment includes a lower jaw 310 and an upper jaw 315, as well as a firing mechanism 320. One or more grooves (not shown) may be formed in the upper jaw 315. Additionally, the lower jaw 310 (also referred to as a jaw slot) may include a lower jaw slot 330, and the upper jaw 315 may include an upper jaw slot 335. In some embodiments, the firing mechanism 320 may include a tab and / or an I-beam. In some embodiments, the firing mechanism 320 is configured to interact with a cartridge (not shown) that houses a plurality of staples (not shown) to drive the staples into tissue. In some embodiments, the firing mechanism may include a cantilever member or a pusher block.

[0132] As described above, the end effector 215 can be embodied as a medical suture device that can be used to seal and / or cut tissue. For example... Figure 22B As shown, once the firing mechanism 320 has been advanced laterally along the end effector 215 from its proximal end, the end effector 215 will be clamped into the closed position shown. The medical device 300 can be operated by clamping tissue between the two jaws of the medical device 300 (e.g., lower jaw 310 and upper jaw 315) and then laterally pushing the firing mechanism 320 along the lower jaw 310 and upper jaw 315 to form a staple and transversely cut the tissue. Medical staplers such as the medical device 300 can be used, for example, for gastric suturing and / or gastrojejunostomy (roux-en-y) gastric bypass procedures.

[0133] In some implementations, the medical device may have a wrist configured for articulation with a single degree of motion (DOF). For certain medical procedures, such as robot-controlled laparoscopic procedures, a 2-DOF wrist is desirable. However, design challenges associated with 2-DOF wrists used in medical sutures may exist that may not be present when designing a 1-DOF wrist. For example, guiding the magnitude of the force required to provide sufficient clamping force to the jaws via the 2-DOF wrist can be challenging. Furthermore, providing control over the 2-DOF wrist (e.g., providing pitch and yaw DOF) while also independently controlling the suture and firing mechanism independently of the 2-DOF movement of the wrist can be difficult. Additionally, sutures (whether manual or robotic) are typically designed for single use (e.g., disposable), which can increase the costs associated with them. Finally, designing medical sutures to be thin can improve maneuverability within the contraction space, but this can be challenging.

[0134] When a medical device controlled by a robotic system has a reduced number of DOFs, the number of DOFs that the medical device can move may not match the number of DOFs of the input devices used by the user when controlling the medical device. Figure 23 An exemplary input device is shown that can be used to control the movement of a medical device via one or more robotic arms, according to various aspects of this disclosure. Figure 23 The input device 410 can be similar to Figure 19 The controller 182 is shown. Specifically, the input device 410 includes a pair of handles 415 that can be directly manipulated in space by a user's hand. In some embodiments, each handle 415 may be capable of movement at 6 degrees of freedom (DOF); however, in other embodiments, the handles 415 may be capable of movement at more or fewer DOFs. For example, each of the handles 415 may be implemented as a gimbal. In some embodiments, each gimbal may include or be operatively coupled to one or more motors configured to provide force feedback to the user. Such force feedback to the user can be used to reduce or limit the DOF that the gimbal can be moved by the user.

[0135] Figure 24 The various aspects shown in this disclosure are as follows Figure 23 A close-up view of one of the handles 415 shown. In some embodiments, the handle 415 includes a button 435 and a finger grip 440. The button 435 provides a user interface that allows a user to actuate an end effector of the corresponding medical device. The finger grip 440 provides an interface that allows a user to grip the handle 415 and manipulate its orientation in three spatial DOFs. The handle 415 may also act as a gimbal, allowing a user to manipulate the handle in three orientation DOFs (e.g., pitch, yaw, and roll).

[0136] Mapping the motion of the input device to the motion that the medical device can perform can be challenging when a medical device is capable of movement with a different number of degrees of freedom (DOF) than the input device used to control its movement. In other words, controlling a medical device with a different DOF than the input device can be challenging, as the kinematics of the input device do not match the kinematics of the medical device (e.g., via a 1:1 mapping). The challenge stems from the difficulty in accurately controlling a medical device that cannot move as freely as the input device.

[0137] The aspects of this disclosure address at least two challenges of controlling a medical device using an input device capable of moving at varying degrees of DOF. One challenge involves addressing so-called “undesired movements” (e.g., movements of the input device that the medical device cannot execute), which can occur using a conventional motion chain between the main input device and the medical device. Another challenge involves providing the user with feedback regarding movements of the input device that cannot be executed by the medical device.

[0138] 2.1 Reject "undesired motions" using the modified inverse kinematics algorithm.

[0139] Robotic medical systems typically receive input via input devices (such as...) Figure 23 and Figure 24 The input device 410 shown (one of the handles 415) commands the positioning of the end effector of the medical device in the desired pose. The robotic system can use inverse kinematics algorithms to generate the desired positioning of each joint and / or actuator within one or more robotic arms to achieve the end effector pose of the command. Figure 25 An exemplary block diagram 500 is shown, illustrating how inverse kinematics 502 can be used to determine the end effector orientation of a robot arm according to various aspects of this disclosure. Specifically, input device 410 can generate an end effector pose of a command based on user manipulation of the input device 410's pose. Input device 410 provides the end effector pose of the command to inverse kinematics 502, which determines a set of robot arm end effector orientations 504 that can realize the end effector pose of the command. Inverse kinematics 502 can be executed by the robot system's processor. These robot arm end effector orientations 504 can be used to generate commands to position the robot arm to realize the desired end effector.

[0140] When performing the inverse kinematics 502 algorithm, the robot system can use one or more Jacobian matrices. A Jacobian matrix can define the dynamic relationship between two different representations of the system. The Jacobian matrix can be determined based on the time derivatives of kinematic problems that correlate the robot arm's joint orientation with the end effector pose. Therefore, the Jacobian matrix can be used to correlate the end effector velocity with the robot arm's joint angular velocity. An example of a Jacobian matrix is ​​shown in the following equation (1):

[0141]

[0142] The vector on the left side of the equation is the twist of the end effector and includes the linear velocity v and the angular velocity ω. is the joint velocity vector or joint velocity of the robot arm joint, and J is the Jacobian matrix that correlates the end effector twist with the joint velocity of the robot manipulator. The Jacobian matrix can also be expressed as shown in equation (2) below:

[0143]

[0144] Jacobian matrix representation considering linear velocity J v and angular velocity J ω The transformation between the two. Since medical procedures can be performed in a 3D reference frame with x, y, and z axes, the Jacobian matrix can ultimately be represented as follows, where V x、y、z Let ω represent linear velocity, and ω x、y、z It represents angular velocity.

[0145] The transformation performed by the Jacobian matrix can be applied to each DOF of an n-DOF system. For an end effector of a medical device, n can be a number of DOFs in which the end effector is capable of movement, where each DOF corresponds to the movement of a specific joint of the end effector system. For example, for an end effector of an instrument (e.g., a surgical stapler) capable of movement at 5-DOF, n would be equal to 5. For a surgical stapler implementation with 5-DOF, the surgical stapler may be capable of movement at roll, pitch, yaw, insertion, and instrument pitch DOFs, where the surgical stapler is not capable of movement at instrument yaw DOF. Therefore, for a 5-DOF instrument, in order to account for the transformation of each DOF n, the Jacobian matrix (shown in equation (3) below) would have five columns, where each column represents the transformation at a specific joint. In order, the columns correspond to roll, pitch, yaw, insertion, and instrument pitch.

[0146]

[0147] The Jacobian matrix described above is generalizable for medical devices with different numbers of DoFs. For example, for a medical device capable of movement in 5 DoFs, n = 5 and m = 6. Therefore, n can correspond to the number of DoFs the medical device can move, and m can correspond to the number of DoFs the input device can move.

[0148] However, using the aforementioned Jacobian matrix may be insufficient to handle unwanted motions received from the input device. Therefore, aspects of this disclosure relate to the use of a modified Jacobian matrix that can be used in inverse kinematics algorithms to reject unwanted motions included in commands received from the input device.

[0149] Examples of specific implementations of the modified inverse kinematics algorithm are provided in conjunction with the 5-DOF medical devices described below. Figure 26 A 5-DOF medical device 600 relative to different reference frames is shown according to various aspects of this disclosure. Specifically, the medical device 600 includes a shaft 602 and an end effector 604, which can be inserted via a cannula (not shown) to enter a patient's lumen. The direct kinematics of the 5-DOF medical device 600 for a representative pose of the medical device 600 can be defined as follows, as shown in equations (4) to (6):

[0150]

[0151] R=Rot(q1,x)Rot(q2,Y)Rot(q3,z)Rot(q4,y) (5)

[0152]

[0153] Where qi =1,..5 are the vector components (e.g., joint orientation), and without loss of generality, l1 = 200 and l2 = 40. The operator Rot(a,b) defines a 3×3 rotation matrix associated with the angle "a" about axis "b". p is the orientation of the end effector, for example, as Figure 26 The orientation of the end effector coordinate system (X4, Y4, Z4) shown is l1 is Figure 26 The coordinate systems X2, Y2, Z2 and X3, Y3, Z3 are defined by a fixed distance, and l2 is defined by a fixed distance between X3, Y3, Z3 and the end effector coordinate system X4, Y4, Z4. These parameters are geometric parameters that define the tool dimensions. For example, l1 defines the length of the entire instrument axis and l2 defines, for example, the length of the jaws of the end effector. By changing these parameters, different tools can be designed and constructed for different applications. The system can define two Jacobian matrices used in the modified inverse kinematics algorithm to reject unwanted motions. The first Jacobian matrix 606 can be defined in the world coordinate system, while the second Jacobian matrix 608 can be defined in the end effector coordinate system.

[0154] The first Jacobian matrix 606 describes the coupling between the Cartesian velocity in the world coordinate system and the joint velocities of all joints in the kinematic chain that define the orientation of the end effector. The kinematic chain may include joints of the robotic arm controlling the medical device and joints of the medical device. The second Jacobian matrix 608 describes the coupling between the end effector's Cartesian velocity and the joint velocities. In the end effector coordinate system, due to user manipulation of the input device, for example by associating the end effector's reference frame with the robot system's world reference frame, the Cartesian velocity of the end effector 604 can be directly mapped to the motion of the input device. Therefore, the movement of the input device can ideally be mapped one-to-one with the Cartesian orientation of the end effector 604. The first Jacobian matrix 606 can define a remote center of motion (RCM) where the movement of the cannula is constrained, for example, to prevent the cannula from exerting excessive force on the patient's body wall. Therefore, each of the first Jacobian matrix 606 and the second Jacobian matrix 608 can constrain the movement of the medical device 600, with the first Jacobian matrix 606 constraining the movement of the medical device 600 to maintain the RCM, and the second Jacobian matrix 608 constraining the movement of the end effector to follow the movement of the input device.

[0155] The following are examples of the first Jacobian matrix 606 and the second Jacobian matrix 608 used for the given pose of the medical device 600. The specific values ​​of the first Jacobian matrix 606 and the second Jacobian matrix 608 will be different when the medical device 600 has different poses. The first Jacobian matrix 606 is shown in the following equation (7):

[0156]

[0157] The second Jacobian matrix 608 is shown in the following equation (8):

[0158]

[0159] The values ​​in the second Jacobian matrix 608 can relate to the ability of the end effector 604 to move from the current pose of the medical device 600. For example, for a 5-DOF medical device 600, the medical device 600 may not have the ability to move at yaw DOF. Since the medical device 600 is capable of moving at pitch DOF, the values ​​in the fifth row of the second Jacobian matrix 608 reflect the pitch capability of the medical device. Similarly, because the medical device 600 cannot move at yaw DOF, the values ​​in the fourth row of the second Jacobian matrix 608 reflect the inability of the medical device to yaw (e.g., zeros in the fourth and fifth columns of the fourth row).

[0160] In some specific implementations, the robot system can reject unwanted movements in inverse kinematics by modifying the input commands received from the input device by discarding a portion of the input commands corresponding to movements of the end effector that are unachievable. For example, the robot system can remove rows in the second Jacobian matrix 608 that will not produce any movement at the end effector. Therefore, after defining the first Jacobian matrix 606 and the second Jacobian matrix 608 for the current pose of the medical device 600, the system can modify the second Jacobian matrix 608 by discarding rows describing unwanted movements that the medical device 600 cannot perform. When the input device has n more DOFs than the medical device, the system can discard rows in the second Jacobian matrix 608 corresponding to the n DOFs that the medical device cannot move. For example, the discarded rows in the second Jacobian matrix 608 may correspond to one or more types of movements that the device cannot perform.

[0161] In the example of the second Jacobian matrix 608 provided above for a 5-DOF medical device without yaw capability, the fourth row can be discarded because the end effector 604 cannot move with yaw DOF. An example of the above-described second Jacobian matrix 608 is shown in Equation (9), where the fourth row is identified as including unwanted motion:

[0162]

[0163] An example of the second Jacobian matrix 608 modified by discarding the fourth row is shown in the following equation (10):

[0164]

[0165] In some specific implementations, it is not necessary to modify the first Jacobian matrix 606, because the medical device 600 can always be at least partially able to execute a portion of the end effector motion of the command in the world coordinate system defined by the first Jacobian matrix 606.

[0166] Figure 27 This is a flowchart illustrating an exemplary method, according to aspects of this disclosure, operable by a robotic system or its components to perform constrained motion control of a medical device. For example, Figure 27 The steps of method 700 shown may be performed by a processor and / or other components of a medical robotic system (e.g., robot-enabled system 10, or one of the robotic medical systems 200, 300, or 400 described above) or an associated system. For convenience, method 700 is described as being performed by the “system” in conjunction with the description of method 700.

[0167] Method 700 begins at block 701. At block 702, the system receives input via an input device for controlling the movement of a medical device. The device has a different number of DOFs than the input device. For example, in some embodiments, the device is capable of moving with fewer DOFs than the input device; however, in other embodiments, the device may be capable of moving with more DOFs than the input device. In some embodiments, the system may also transform the input received from the input device into an end effector coordinate system.

[0168] At box 704, the system determines a Jacobian matrix that associates the inputs from the input device with robot arm commands used to achieve the motion of the end effector indicated by the inputs. For example, the Jacobian matrix may define the dynamic relationship between the Cartesian velocity of the end effector and the joint velocities of all joints in the motion chain that define the orientation of the end effector.

[0169] At box 706, the system modifies the Jacobian matrix by discarding at least one row of the Jacobian matrix. For example, the system may discard one or more rows of the Jacobian matrix corresponding to types of movement that the device cannot perform. In some implementations, the number of rows discarded from the Jacobian matrix may correspond to the difference between the number of DOFs of the input device and the number of DOFs of the medical device. In one example, the end effector may be unable to move with yaw degrees of freedom, and the system may modify the Jacobian matrix by discarding rows of the Jacobian matrix corresponding to yaw movements.

[0170] At box 708, the system determines the robot arm command for implementing the motion of the instrument indicated by the input based on the modified Jacobian matrix. For example, the system can use inverse kinematics to determine the robot arm command by including the joint orientation of the command for the robot arm. Inverse kinematics can use the modified Jacobian matrix as part of an inverse kinematics algorithm. For example, the inverse kinematics algorithm may include inverting the modified Jacobian matrix, using the inverted modified Jacobian matrix to determine the joint velocities of all joints in the kinematic chain (e.g., using Equation (1) above), and generating the robot arm command using the determined joint velocities. In another example, the inverse kinematics algorithm may include inverting the end effector Jacobian matrix, modifying the inverted end effector Jacobian matrix by removing the angular velocity component from the inverted end effector Jacobian matrix, and determining the joint velocities of the robot arm joints based on the modified inverted end effector Jacobian matrix. Method 700 ends at box 710.

[0171] The system is configured to reject unproductive movements. This disclosure enables two fundamental tasks. First, the system can reject only movements that the medical device cannot perform at a given position. Second, the system can project user movements onto a subset of movements that the device can perform. That is, even if the user's manipulation of the input device corresponds to a movement that the medical device cannot execute, the system can map the instructed movement at the input device onto a set of movements that the medical device can perform. Therefore, the system can follow commanded movements within the capabilities of the medical device.

[0172] The method and algorithm described in this paper can be generalized to any medical device with any number of degrees of freedom less than conventional 6-DOF. Depending on the specific medical device's constraints, the correct row of the Jacobian matrix will be discarded from the end effector Jacobian matrix. For example, for a device that can yaw but not pitch, the system will discard the fifth row of the end effector Jacobian matrix.

[0173] 2.2 Alignment of input device and end effector

[0174] As discussed in this paper, some medical devices may be able to move with fewer degrees of freedom (DOF) than the input device used to control the medical device. Due to this difference, users can manipulate the input device into poses that the end effector of the medical device cannot replicate. To provide an intuitive interface for the user, the pose of the input device should match the pose of the medical device as closely as possible. However, because the input device may not be limited to the same movements as the medical device, if the user poses the input device in a way that the medical device cannot follow, the user may become disoriented and / or find it difficult to conceptualize the mismatch between the input device pose and the end effector pose of the medical device.

[0175] To address the aforementioned challenges, aspects of this disclosure relate to systems and methods for aligning the pose of an input device with the pose of an end effector. For example, a robotic system can be configured to ensure that a surgeon's hand is always aligned with the end effector of a medical device by constraining the movement of the input device. For instance, the robotic system can identify whether a movement commanded by the end effector cannot be achieved and constrain the movement of the input device.

[0176] Figure 28 This is a flowchart illustrating an example method, according to aspects of this disclosure, capable of being operated by a robotic system or its components to align an input device and an end effector of a medical device. For example, Figure 28 The steps of method 800 shown may be performed by a processor and / or other components of a medical robotic system (e.g., robot-enabled system 10, or one of the robotic medical systems 200, 300, or 400 described above) or an associated system. For convenience, method 800 is described as being performed by the “system” in conjunction with the description of method 800.

[0177] Method 800 begins at block 801. At block 802, the system compares the pose of the end effector with the pose of the input device. For example, the system may determine whether there are any differences between the poses of the end effector and the input device. If the poses of the end effector and the input device are the same, the system may not need to constrain the movement of the input device.

[0178] At block 804, the system constrains the movement of the input device based on a comparison of the pose of the end effector and the pose of the input device. For example, if the pose of the input device differs from the pose of the end effector, the system can constrain further movement of the input device away from the pose of the end effector. In some embodiments, the input device can provide “force feedback” via one or more actuators included in the input device. The force feedback can be configured to move the input device toward the pose of the end effector. In some embodiments, the force feedback can provide a force that a user can feel by manipulating the input device. In other embodiments, the force feedback can prevent the user from moving the input device in a direction away from the pose of the end effector. Thus, the force feedback can be configured to constrain a clinician’s hand to move the input device in a constrained movement. The movement of the input device can be constrained with the same DOF, where the movement of the end effector is constrained.

[0179] In some implementations, the system can constrain the movement of the input device by transforming the DOF, where the end effector movement is constrained from the end effector coordinate system to the input device coordinate system. For example, the system can receive the pose of the end effector and determine the Jacobian matrix in the end effector coordinate system. Within the end effector coordinate system, the system can identify the end effector about its non-rotatable axes. Due to the physical construction of the input device, the non-rotatable axes of the end effector may not be aligned with any physical joints of the input device. Therefore, in some configurations, it may be insufficient to simply prevent rotation of a motor around the input device, as this could impede movement achievable by the end effector.

[0180] To constrain the motion of the input device corresponding to movements that the end effector cannot perform, the system can transform the DOF (Direction of Field), where the end effector is constrained to the input device's coordinate system and the motion is frozen at the transformed DOF. The system can also apply force feedback to all other DOFs in the input device's coordinate system to ensure that the input device and end effector are always aligned. Projection into the input device's coordinate system improves performance and user experience by preventing the user from moving the input device away from alignment with the end effector pose before force feedback brings it back to alignment. Without such force feedback, the user can be continuously pulled back to a certain pose, rather than being prevented from moving in a particular direction and guided along an acceptable motion trajectory.

[0181] 3. Implementation System and Terminology .

[0182] The specific implementations disclosed herein provide systems, methods, and apparatus for restrained motion control of medical devices.

[0183] It should be noted that, as used herein, the terms “couple,” “coupling,” “coupled,” or other variations of the word “coupled” can indicate an indirect or direct connection. For example, if a first component is “coupled” to a second component, the first component may be indirectly connected to the second component or directly connected to the second component via another component.

[0184] The functions described herein for restraining the movement of a medical device can be stored as one or more instructions on a processor-readable or computer-readable medium. The term "computer-readable medium" means any available medium accessible by a computer or processor. By way of example, and not limitation, such media may include random access memory (RAM), read-only memory (ROM), electrically erasable programmable read-only memory (EEPROM), flash memory, compact disk read-only memory (CD-ROM) or other optical disc storage devices, magnetic disk storage devices or other magnetic storage devices, or any other medium that can be used to store desired program code in the form of instructions or data structures and is accessible by a computer. It should be noted that computer-readable media can be tangible and non-transitory. As used herein, the term "code" can mean software, instructions, code, or data executable by a computing device or processor.

[0185] The methods disclosed herein include one or more steps or actions for implementing the methods. The method steps and / or actions may be interchanged without departing from the scope of the claims. In other words, the order and / or use of specific steps and / or actions may be modified without departing from the scope of the claims unless proper operation of the described method requires a specific order of steps or actions.

[0186] As used herein, the term "multiple" means two or more. For example, multiple components indicates two or more components. The term "determine" encompasses a variety of actions, and therefore, "determine" can include calculation, operation, processing, derivation, investigation, lookup (e.g., searching in a table, database, or another data structure), ascertainment, etc. Additionally, "determine" can include receiving (e.g., receiving information), accessing (e.g., accessing data in memory), etc. Furthermore, "determine" can include parsing, selecting, picking, building, etc.

[0187] Unless otherwise explicitly stated, the phrase “based on” does not mean “based on only”. In other words, the phrase “based on” describes both “based on only” and “based on at least”.

[0188] The foregoing description of the disclosed specific embodiments is provided to enable any person skilled in the art to make or use the invention. Various modifications to these specific embodiments will be readily apparent to those skilled in the art, and the general principles defined herein may be applied to other specific embodiments without departing from the scope of the invention. For example, it should be understood that those skilled in the art will be able to employ numerous corresponding alternatives and equivalent structural details, such as equivalent methods of fastening, mounting, coupling, or engaging tool components, equivalent mechanisms for generating specific actuating motions, and equivalent mechanisms for delivering electrical energy. Therefore, the invention is not intended to be limited to the specific embodiments shown herein, but is to be endowed with the broadest scope consistent with the principles and novel features disclosed herein.

Claims

1. A robot system, comprising: The device has an end effector: A robotic arm configured to control the movement of the instrument and the end effector; An input device configured to receive input for controlling the movement of the instrument and the end effector, wherein the instrument is capable of moving with a different number of degrees of freedom (DOF) than the input device, wherein the instrument is constrained in its movement at a remote center of motion (RCM). At least one processor; and At least one computer-readable storage device, the at least one computer-readable storage device communicating with one or more processors and storing computer-executable instructions thereon, causing the at least one processor to: Determine the end effector Jacobian matrix that associates the input of the input device with the robot arm command for implementing the movement of the end effector indicated by the input. The end effector Jacobian matrix is ​​modified by discarding at least one row of the end effector Jacobian matrix. Determine the RCM Jacobian matrix that associates the input of the input device with the robot arm command used to maintain the RCM, and The robot arm commands for implementing the motion of the instrument indicated by the input are determined based on the modified end effector Jacobian matrix and the RCM Jacobian matrix.

2. The robot system of claim 1, wherein the instrument is capable of moving with fewer DOFs than the input device.

3. The robot system of claim 2, wherein the input device has 6 DOFs and the instrument has 5 DOFs.

4. The robot system according to claim 2, wherein: The input device has n more DOFs than the instrument; and The modification of the end effector Jacobian matrix includes discarding n rows of the end effector Jacobian matrix corresponding to one or more types of movement that the instrument cannot perform.

5. The robotic system of claim 2, wherein the instrument is a surgical suture device, a suction irrigator, a direct harmonic tool, or a joint motion harmonic tool.

6. The robotic system of claim 5, wherein the instrument comprises a surgical suture device having 5 DOFs.

7. The robotic system of claim 5, wherein the device comprises a suction flusher having at least four degrees of DOF.

8. The robot system according to claim 2, wherein: The end effector cannot move with yaw degree of freedom, and The modification of the end effector Jacobian matrix includes discarding rows of the end effector Jacobian matrix corresponding to yaw movements.

9. The robot system of claim 1, wherein the input device includes a universal joint.

10. The robot system of claim 9, wherein the gimbal receives force feedback.

11. The robotic system of claim 10, wherein the force feedback constrains the clinician's hand to move the gimbal in a constrained motion.

12. The robot system of claim 11, wherein the motion of the gimbal is constrained with the same DOF, and the motion of the end effector is constrained.

13. The robot system of claim 1, wherein the RCM Jacobian matrix associates the reference frame of the end effector with the world reference frame of the robot system.

14. A method for controlling the movement of an end effector of a medical device, the method comprising: The input for controlling the movement of the instrument is received via an input device, the instrument having a different number of degrees of freedom (DOF) than the input device, wherein the movement of the instrument at the remote center of motion (RCM) is constrained. Determine the end effector Jacobian matrix that associates the input of the input device with a robot arm command for implementing the movement of the end effector indicated by the input; The end effector Jacobian matrix is ​​modified by discarding at least one row of the end effector Jacobian matrix; Determine the RCM Jacobian matrix that associates the input of the input device with the robot arm command used to maintain the RCM; as well as The robot arm commands for implementing the motion of the instrument indicated by the input are determined based on the modified end effector Jacobian matrix and the RCM Jacobian matrix.

15. The method of claim 14, wherein the instrument has fewer DOFs than the input device.

16. The method of claim 15, wherein the input device has 6 DOFs and the end effector has 5 DOFs.

17. The method of claim 15, wherein: The input device has n more DOFs than the instrument; and The modification of the end effector Jacobian matrix includes discarding n rows of the end effector Jacobian matrix corresponding to the type of movement that the instrument cannot perform.

18. The method of claim 15, wherein the instrument is a surgical suture device or a suction irrigator.

19. The method of claim 18, wherein the device comprises a surgical suture device having 5 DOFs.

20. The method of claim 18, wherein the device comprises an inhalation irrigator having four degrees of DOF.

21. The method of claim 15, wherein: The end effector cannot move with yaw degree of freedom, and The modification of the end effector Jacobian matrix includes discarding rows of the end effector Jacobian matrix corresponding to the yaw movement.

22. The method of claim 14, wherein the input device comprises a universal joint.

23. The method of claim 22, wherein the gimbal receives force feedback.

24. The method of claim 23, wherein the force feedback constrains the clinician's hand to move the gimbal in a constrained movement.

25. The method of claim 24, wherein the movement of the universal joint is constrained with the same DOF, and the movement of the end effector is constrained.

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