Stuck instrument management

Abstract

A method of detecting a stuck basket condition involves retracting a scope within an anatomical cavity of a patient, the scope having a basketing device disposed at least partially within a working channel thereof, determining that a force reading associated with at least one of the basketing device and the scope exceeds a predetermined threshold, and determining that the basketing device is in a stuck condition based at least in part on determining that the force reading exceeds the predetermined threshold.

Description

[0001] Related applications

[0002] This application claims priority to U.S. Provisional Application 63 / 033,089, filed June 1, 2020, entitled “Stuck Instrument Management,” the disclosure of which is incorporated herein by reference in its entirety. Technical Field

[0003] This disclosure pertains to the fields of medical devices and procedures. Background Technology

[0004] Related technologies

[0005] Various medical procedures involve the use of one or more medical devices in anatomical cavities. Retraction and / or removal of such devices from anatomical cavities can lead to certain complications, resulting in damage to biological tissues, instrument components, and / or other adverse consequences. Summary of the Invention

[0006] This article describes systems, devices, and methods for facilitating the management and / or identification of jammed device conditions associated with the execution of certain medical procedure steps, such as device retraction.

[0007] In some embodiments, this disclosure relates to a method for detecting a stuck basket device. The method includes: retracting an endoscope within a patient's anatomical cavity, the endoscope having a basket device at least partially disposed within its working channel; determining that a force reading associated with at least one of the basket device and the endoscope exceeds the predetermined threshold; and determining that the basket device is stuck based at least in part on the determination that the force reading exceeds the predetermined threshold.

[0008] The method may further include axially shaking the basket device, wherein while shaking the basket device, determining that the force reading associated with at least one of the basket device and the endoscope exceeds the predetermined threshold is performed. The method may further include: entering the anatomical cavity via the endoscope through the patient's urinary tract anatomy; advancing the basket device from the working channel of the endoscope; capturing an object disposed within the anatomical cavity through the basket device; determining that at least one of the basket device and the endoscope has entered a danger zone; and in response to determining that at least one of the basket device and the endoscope has entered the danger zone, initiating axial shaking of the basket device. For example, determining that at least one of the basket device and the endoscope has entered a danger zone is at least partially based on robot actuator data generated by one or more robot actuators configured to actuate one or more of the endoscope and the basket device. In some embodiments, determining that at least one of the basket device and the endoscope has entered a danger zone is based, at least in part, on position sensor data associated with one or more of the endoscope and the basket device. In some embodiments, the danger zone includes the ureteropelvic junction of the patient's kidney. Shaking of the basket device may be relative to the distal end of the endoscope. Shaking of the basket device may involve shaking the endoscope.

[0009] The method may further include reducing the retraction speed of the endoscope based at least in part on the determined jamming condition of the basket device. In some embodiments, the force reading indicates the axial force experienced at the proximal end of the sheath of the basket device. In some embodiments, the force reading indicates the axial force on one or more teeth of the basket device. In some embodiments, the force reading indicates the axial force experienced at the proximal portion of the endoscope. The method may also include causing a warning to be presented in response to the determined jamming condition.

[0010] In some embodiments, this disclosure relates to a robotic system comprising: one or more robotic arms; one or more instrument manipulators coupled to a corresponding robotic arm in the one or more robotic arms; one or more actuators associated with at least one of the one or more instrument manipulators and configured to cause axial movement of at least one of an endoscope, a sheath of a basket-like device at least partially disposed within the endoscope, and the teeth of the basket-like device; one or more sensors associated with the one or more instrument manipulators and configured to generate signals indicating forces experienced by the one or more actuators; and control circuitry communicatively coupled to the one or more instrument manipulators and the one or more sensors and configured to: cause the basket-like device to advance and retract with a jittering motion; receive from the one or more sensors signals indicating forces experienced by the one or more actuators when the basket-like device moves with a jittering motion; determine that the force is greater than the predetermined threshold; and perform a responsive action in response to the determination that the force is greater than the predetermined threshold.

[0011] The response action may involve providing a warning to the user indicating that the basket device is stuck. In some embodiments, the response action involves reducing the retraction speed of the endoscope. In some embodiments, the response action involves pausing the retraction of the endoscope. The one or more actuators may include one or more basket sheath actuators. In some embodiments, the one or more actuators include one or more basket tooth actuators. In some embodiments, the one or more actuators include one or more endoscope actuators. The one or more sensors may be configured to determine at least one of the insertion force and retraction force associated with the endoscope.

[0012] In some specific implementations, this disclosure relates to a method for detecting a stuck condition of a medical device. The method includes: determining that a force on a component of the medical device is greater than a predetermined force threshold when the medical device retracts with a vibrating motion; starting a timer in response to the determination that the force is greater than the predetermined threshold; determining that the timer has exceeded a predetermined time threshold; and initiating a response action in response to the determination that the timer has exceeded the predetermined time threshold.

[0013] The response action may involve generating a warning indicating that the medical device is stuck. The response action may involve pausing the retraction of the medical device. The method may also include initiating vibration of one or more components of the medical device in response to determination that a portion of the medical device is positioned within a stuck danger zone. For example, the method may further include determining the stuck danger zone based at least in part on the location of the distal end of a sheath on which the medical device is at least partially disposed.

[0014] In some embodiments, this disclosure relates to a computing device including: a robot system interface; and control circuitry communicatively coupled to the robot system interface and including one or more processors and one or more data storage devices. The control circuitry can be configured to: cause a basket-like device to vibrate relative to a working channel of an endoscope in which the basket-like device is at least partially disposed; and while the basket-like device is vibrating, determine a jamming state of the basket-like device by forces experienced by one or more components of the basket-like device.

[0015] The determination of the stuck state can be based on one or more of data indicating the driving behavior of the user actuating the endoscope and the size of the object captured by the basket device. In some embodiments, the control circuit is further configured to disable jitter of the basket device in response to a determination that the basket device and the endoscope have retracted into the sheath. In some embodiments, the control circuit is further configured to suspend the movement of the endoscope in response to the stuck state.

[0016] For the purposes of summarizing this disclosure, specific aspects, advantages, and novel features have been described. It will be understood that not all such advantages may be realized according to any particular embodiment. Therefore, the disclosed embodiments may be implemented by achieving or optimizing one or more advantages taught herein without necessarily achieving other advantages that may be taught or proposed herein. Attached Figure Description

[0017] Various embodiments are depicted in the accompanying drawings for illustrative purposes and should in no way be construed as limiting the scope of the invention. Furthermore, various features of different disclosed embodiments may be combined to form additional embodiments that are part of this disclosure. Throughout the drawings, reference numerals may be repeated to indicate correspondences between reference elements.

[0018] Figure 1 An embodiment of a medical system comprising one or more basket components is shown according to one or more embodiments.

[0019] Figure 2 The following are examples of implementations available according to one or more embodiments. Figure 1 Medical system components implemented in medical systems.

[0020] Figure 3 A ureteroscope, placed in a portion of a patient's urinary system according to one or more embodiments, is shown, the ureteroscope including a basket device in its working channel.

[0021] Figures 4A to 4E Basket loading systems in various configurations according to one or more embodiments are shown.

[0022] Figure 5 Various medical devices, including certain basket-loading device components, are shown that are disposed in portions of a patient's renal anatomy according to one or more embodiments.

[0023] Figure 6A The field of view of an endoscope camera according to one or more embodiments is shown, in which the basket loading device is visible.

[0024] Figure 6B A side view of a medical device assembly according to one or more embodiments is shown, the medical device assembly corresponding to Figure 6A The basket loading device relative to the configuration of the endoscope camera.

[0025] Figure 7A The field of view of an endoscope camera according to one or more embodiments is shown, in which a basket loading device in a stuck state is visible.

[0026] Figure 7B A side view of a medical device assembly according to one or more embodiments is shown, the medical device assembly corresponding to Figure 7A The basket loading device relative to the configuration of the endoscope camera.

[0027] Figure 8 An image recognition architecture for stuck devices according to one or more embodiments is shown.

[0028] Figure 9-1 and Figure 9-2 A flowchart illustrating a process for managing stuck device conditions according to one or more implementation schemes is shown.

[0029] Figure 10-1 and Figure 10-2 The diagram shows the correspondence with one or more embodiments. Figure 9-1 and Figure 9-2 The specific images of various boxes, states, and / or operations associated with the process.

[0030] Figure 11 This is a flowchart illustrating a process for handling a stuck device situation according to one or more implementation schemes.

[0031] Figure 12 This is a flowchart illustrating a process for managing false alarm sensor readings on an inserted axis, according to one or more embodiments.

[0032] Figure 13 This is a flowchart illustrating a process for managing false alarm sensor readings on an inserted axis, according to one or more embodiments.

[0033] Figure 14This is a diagram illustrating false alarm remediation actions according to one or more implementation schemes.

[0034] Figure 15 This is a flowchart illustrating a process for adjusting the jitter zone / range according to one or more implementation schemes.

[0035] Figure 16 The diagram shows the correspondence with one or more embodiments. Figure 15 The process is associated with various frames, states, and / or certain images of operations.

[0036] Figure 17 This is a flowchart illustrating a process for adjusting the jitter zone / range according to one or more implementation schemes.

[0037] Figure 18 The diagram shows the correspondence with one or more embodiments. Figure 17 The process is associated with various frames, states, and / or certain images of operations.

[0038] Figure 19 This is a flowchart illustrating a process for managing false alarm sensor readings on an open axis, according to one or more implementation schemes.

[0039] Figure 20 This is a flowchart illustrating a process for managing false alarm sensor readings on an open axis, according to one or more implementation schemes. Detailed Implementation

[0040] The headings provided herein are for convenience only and do not necessarily affect the scope or meaning of the claimed invention. Although specific preferred embodiments and examples are disclosed below, the subject matter of the invention extends beyond the specifically disclosed embodiments to other alternative embodiments and / or uses, as well as modifications and equivalents thereof. Therefore, the scope of the claims that may appear herein is not limited to any particular embodiment of the specific embodiments described below. For example, in any method or process disclosed herein, the actions or operations of the method or process may be performed in any suitable sequence and are not necessarily limited to any particular disclosed sequence. Various operations may then be described as multiple discrete operations in a manner that may aid in understanding a particular embodiment. However, the order of description should not be construed as implying that these operations depend on the order. Additionally, the structures, systems, and / or apparatuses described herein may be embodied as integrated components or separate components. Specific aspects and advantages of these embodiments are described for the purpose of comparing the various embodiments. Not all such aspects or advantages are necessarily achieved by any particular embodiment. Therefore, for example, various embodiments may be performed by implementing or optimizing one or a set of advantages taught herein without necessarily achieving other aspects or advantages that may also be taught or proposed herein.

[0041] Specific standard anatomical terms are used herein to refer to anatomical structures of animals, and the animal being referred to in relation to the preferred embodiment is a human. Although specific spatial relative terms, such as “external,” “internal,” “upper,” “lower,” “below,” “above,” “vertical,” “horizontal,” “top,” “bottom,” and similar terms, are used herein to describe the spatial relationship of one device / element or anatomical structure to another device / element or anatomical structure, it should be understood that these terms are used herein for descriptive convenience to describe the positional relationship between elements / structures, as illustrated in the accompanying figures. It should be understood that spatial relative terms are intended to cover different orientations of elements / structures in use or operation other than those depicted in the accompanying figures. For example, an element / structure described as “above” another element / structure may indicate a position below or beside such other element / structures relative to the subject patient or alternative orientation of the element / structure, and vice versa.

[0042] Overview

[0043] This disclosure relates to systems, devices, and methods for managing the retraction and / or advancement of medical devices within a patient's anatomy, such as during the execution of medical procedures. While specific aspects of this disclosure are described in detail herein within the context of renal, urinary, and / or kidney procedures (such as kidney stone removal / treatment procedures), it should be understood that this context is provided for convenience and clarity, and that the jammed device identification and / or device retraction / advancement concepts disclosed herein are applicable to any appropriate medical procedure. However, as stated below, a description of renal / urinary anatomy and associated medical problems and procedures is presented to aid in the description of the inventive concepts disclosed herein.

[0044] Kidney stones (also known as urolithiasis) are a medical condition involving the formation of solid masses in the urinary tract, called “kidney stones” (also known as renal calculi, renal lithiasis, or nephrolithiasis) or “urinary stones.” Urinary stones can form and / or be found in the kidneys, ureters, and bladder (called “bladder stones”). These stones can form due to the concentration of minerals in the urine, and once they reach a size large enough to obstruct the flow of urine through the ureter or urethra, they can cause significant abdominal pain. Urinary stones can be formed from calcium, magnesium, ammonia, uric acid, cysteine, and / or other compounds or combinations thereof.

[0045] Several methods exist for treating patients with kidney stones, including observation, medical treatments (such as expulsion therapy), non-invasive treatments (such as extracorporeal shock wave lithotripsy (ESWL)), and surgical treatments (such as ureteroscopy and percutaneous nephrolithotomy (“PCNL”)). In surgical methods (e.g., ureteroscopy and PCNL), a physician gains access to the object to be removed (e.g., a kidney stone), breaks it into smaller pieces or fragments, and mechanically extracts relatively small stone fragments / particles from the kidney.

[0046] To remove urinary stones from the bladder and ureters, a surgeon inserts a ureteroscope into the urinary tract through the urethra. Typically, a ureteroscope includes a speculum / camera at its distal end, configured to visualize the urinary tract. The ureteroscope may also include a lithotripsy device for capturing or breaking up the urinary stones. During a ureteroscopy procedure, one physician / technician controls the position of the ureteroscope while another physician / technician controls the lithotripsy device.

[0047] To remove relatively large stones from the kidneys, physicians may use percutaneous nephrolithotomy (“PCNL”) techniques, which involve inserting a nephroscope through the skin (i.e., percutaneously) and intervening in the tissue to provide access to a treatment site for breaking up and / or removing the stones. Percutaneous access instruments (e.g., nephroscopes, sheaths, and / or catheters) used to provide access to the target anatomical site (and / or directly to the endoscope) may include one or more fluid channels for providing a flow of flushing fluid to the target site and / or aspirating fluid from the target site (e.g., by passive outflow and / or active aspiration).

[0048] Robotic devices and / or systems can be incorporated into various medical procedures, such as kidney stone removal procedures, where robotic tools enable physicians / urologists to perform endoscopic (e.g., ureteroscopy) target access, percutaneous access / treatment, or other aspects of the medical procedure. Advantageously, aspects of this disclosure relate to systems, apparatus, and methods for utilizing robotic devices and systems to detect and manage stuck instrument conditions. The terms “stuck instrument,” “stuck basket,” “stuck stone,” “captured instrument,” “captured basket,” and “captured stone” are used herein in their broad and common sense and can refer to any condition or event in which at least a portion of a medical device or condition (e.g., a kidney stone or other object for removal) becomes at least partially obstructed, blocked, blocked, captured, inhibited, or otherwise prevented from continuous movement during its advancement or retraction in a certain manner.

[0049] During ureteroscopy, the advancement and retraction of the ureteroscope and / or the associated basket device can result in damage to a component of one or more medical instruments used in the procedure and such anatomical features. For example, in the case of retrieving or attempting to retrieve a kidney stone or other object, where the stone / object is larger than one or more of its dimensions relative to the size of the ureter and / or the ureteral entry sheath used to access the target anatomical structure, at least in part due to, for example, the size of the stone / object, tearing or other damage to the ureteral / kidney tissue may occur at or near the location where the stone / object and / or the basket-like component used to capture the stone / object contacts the tissue.

[0050] In several examples described herein, the object removal procedure involves the removal of kidney stones from the kidney. However, this disclosure is not limited to kidney stone removal and related instrumentation. For example, the following description may also be applied to other surgical or medical procedures or protocols involving the removal of objects from a patient's body, including any object that can be removed from a treatment site or patient cavity (e.g., esophagus, urinary catheter, intestine, eye, etc.) via percutaneous and / or endoscopic access, such as gallbladder stone removal, lung (lung / transthoracic) tumor biopsy, or cataract removal. That is, the stuck device management concept disclosed herein applies to devices that may become stuck during any such procedure.

[0051] healthcare system

[0052] Figure 1 Exemplary medical system 100 for performing various medical procedures according to aspects of this disclosure is illustrated. Medical system 100 can be used for, for example, endoscopic (e.g., ureteroscopy) procedures. As mentioned and described above, a particular ureteroscopy procedure involves the treatment / removal of kidney stones. In some specific implementations, kidney stone treatment may benefit from specific robotic technologies / devices (such as those similar to...). Figure 1 Robotic medical solutions offer assistance (as shown in the examples and described in detail below). Compared to fully manual procedures, robotic medical solutions can provide relatively higher precision, better control, and / or better hand-eye coordination relative to a particular instrument. For example, robotic-assisted ureteroscopic access to the kidney, according to certain procedures, can advantageously enable urologists to perform both endoscopic control and basket control.

[0053] although Figure 1System 100 is presented in the context of ureteroscopy procedures, but it should be understood that the principles disclosed herein can be implemented in any type of endoscopy and / or percutaneous procedure. Furthermore, several examples described herein relate to object removal procedures involving the removal of kidney stones from the kidney. However, this disclosure is not limited to kidney stone removal. For example, the following description can also be applied to other surgical or medical procedures or procedures involving the removal of objects from a patient's body, including any object that can be removed from a treatment site or patient cavity (e.g., esophagus, urinary catheter, intestine, eye, etc.) via percutaneous and / or endoscopic access, such as gallbladder stone removal, lung (lung / transthoracic) tumor biopsy, or cataract removal.

[0054] Medical system 100 includes a robotic system 10 (e.g., a mobile robotic cart) configured to engage and / or control a medical device 40 (e.g., a ureteroscope) to perform direct access procedures on patient 7. The term "direct access" is used herein according to its broad and general meaning and may refer to any instrumented access through a natural or artificial opening in the patient's body. For example, see reference... Figure 1 The endoscope 40 can be directly inserted into the urinary tract of the patient 7 through the urethra 65.

[0055] It should be understood that the direct access device 40 can be any type of medical device, including endoscopes (such as ureteroscopes), catheters (such as steerable or non-steerable catheters), nephroscopes, laparoscopes, or other types of medical devices. Embodiments of this disclosure relating to basket-loading solutions implemented in conjunction with ureteroscopic procedures for removing kidney stones via a ureteroscopic access sheath (e.g., ureteroscopic access sheath 90) are also suitable for solutions for removing objects via percutaneous access (such as via a percutaneous access sheath). For example, an instrument may be percutaneously accessed into the kidney via, for example, a percutaneous access sheath to capture and remove kidney stones; the instrument used to capture such stones may become stuck in the internal renal anatomy and / or on the percutaneous access sheath (e.g., at the opening of the percutaneous access sheath). The term “percutaneous access” is used herein according to its broad and general meaning and may refer to access such as through punctures and / or small incisions to allow the instrument to pass through the patient’s skin and any other body layers necessary to reach the target anatomical location associated with the procedure (e.g., the calyx network of the kidney 70).

[0056] Medical system 100 includes a control system 50 configured to interface with robotic system 10, providing information about procedures and / or performing various other operations. For example, control system 50 may include one or more displays 56 configured to present specific information to assist physician 5 and / or other technicians or individuals. Medical system 100 may include a table 15 configured to support patient 7. System 100 may also include an electromagnetic (EM) field generator 18, which may be held by one or more robotic arms 12 of robotic system 10, or may be a stand-alone device. Although various robotic arms are shown in various positions and coupled to various instruments, it should be understood that such configurations are shown for convenience and illustrative purposes, and such robotic arms may have different configurations over time and / or at different points during medical procedures. Furthermore, robotic arms 12 may be coupled to… Figure 1 The instruments shown are different instruments, and in some cases or at some time, one or more of the arms may not be used or connected to the medical device (e.g., instrument manipulator / connector).

[0057] In an exemplary use case, if patient 7 has a kidney stone 80 located in kidney 70, a physician may perform a procedure to remove stone 80 through the urinary tract (63, 60, 65). In some embodiments, physician 5 may interact with control system 50 and / or robotic system 10 to cause / control robotic system 10 to advance and navigate medical device 40 (e.g., endoscope) from urethra 65, through bladder 60, up ureter 63 into renal pelvis 71 and / or the calyx network of kidney 70 where stone 80 is located. Physician 5 may also interact with control system 50 and / or robotic system 10 to cause / control basket device 30 to advance through the working channel of device 40, wherein basket device 30 is configured to facilitate capture and removal of kidney stone. Control system 50 may provide information associated with medical device 40 and / or other instruments of system 100, such as real-time endoscopic images captured by the medical device, via display 56 to assist physician 5 in navigating / controlling such instrumentation.

[0058] The renal anatomy is described herein with reference to specific medical protocols relevant to aspects of the present invention. Generally speaking... Figure 1 The kidneys 70, as shown in the typical anatomical position, generally comprise two bean-shaped organs located on the left and right sides of the retroperitoneal space. In adult humans, the height / length of a kidney is typically about 11 cm. The kidneys receive blood from paired renal arteries 69; blood exits the kidneys via paired renal veins 67. Each kidney 70 is fluidly connected to a corresponding ureter 63, which generally comprises a tube carrying the secreted urine from the kidney 70 to the bladder 60.

[0059] The kidney is typically positioned relatively high in the abdominal cavity and at a slight angle to the retroperitoneum. Intra-abdominal asymmetry, usually caused by the position of the liver, usually results in the right kidney (in...) Figure 1 (See detailed diagram) Slightly lower and smaller than the left kidney, and positioned slightly more centrally than the left kidney. The adrenal gland (not shown) is located at the top of each kidney. The upper portion of the kidney 70 is partially protected by the 11th and 12th ribs (not shown). Each kidney and its adrenal gland are generally surrounded by two layers of fat: perirenal fat located between the renal fascia and the renal capsule, and pararenal fat above the renal fascia.

[0060] The kidney (renal glands) are involved in controlling various fluid compartments, fluid osmotic pressure, acid-base balance, electrolyte concentrations, and the amount of toxins removed. The kidney provides filtration by secreting specific substances and reabsorbing others. Examples of substances secreted into urine include hydrogen, ammonium, potassium, and uric acid. In addition, the kidney performs various other functions, such as hormone synthesis.

[0061] The concave region at the concave boundary of kidney 70 is the renal hilum 81, where the renal artery 69 (not shown in the detailed view of kidney 70) enters kidney 70, and where the renal vein 67 (not shown in the detailed view) and ureter 63 exit. Kidney 70 is surrounded by tough fibrous tissue, and renal capsule 74 itself is surrounded by perirenal fat, renal fascia, and pararenal fat. The anterior (frontal) surface of these tissues is peritoneum, and the posterior (backward) surface is transversalis fascia.

[0062] The functional substances or parenchyma of the kidney (70) are divided into two main structures: the external renal cortex (77) and the internal renal medulla (87). These structures are shaped like multiple general conical renal valves, each containing a portion of the renal cortex surrounding the medulla, called the renal pyramid (72). Between the renal pyramids (72) are cortical processes called renal columns (73). Nephronium ( Figure 1 (Not shown in detail) (the functional structures of the kidney that produce urine) span the cortex 77 and medulla 87. The initial filtration portion of the nephron is the renal corpuscle, which is located in the cortex and followed by the renal tubules that extend from the cortex into the medullary pyramid. The portion of the renal cortex, namely the medullary rays, is the collection of renal tubules that drain into individual collecting ducts.

[0063] The apex / apex or papilla 79 of each renal pyramid empties urine into the corresponding minor calyx 75; the minor calyx 75 empties into the major calyx 76, and the major calyx 76 empties into the renal pelvis 71, which then transitions into the ureter 63. This manifold-like assembly of minor and major calyces may be referred to herein as the "calyx network" of the kidney. At the hilum 81, the ureter 63 and renal vein 67 exit the kidney, and the renal artery 69 enters. These structures are surrounded by hilar fat and lymphatic tissue with lymph nodes. The hilar fat is adjacent to a fat-filled cavity called the renal sinus. The renal sinus collectively contains the renal pelvis 71 and the renal calyces 75, 76 and separates these structures from the renal medulla. The funnel-shaped / tubular anatomical structures associated with the calyces may be referred to as the infundibulum / infundibula. That is, the infundibulum generally leads to the termination of the calyces, where the papillae are exposed within the calyces.

[0064] Referring further to medical system 100, medical device 40 (e.g., endoscope, direct access device, etc.) can be advanced into kidney 70 via the urinary tract. Specifically, ureteral access sheath 90 can be positioned within the urinary tract in an area near kidney 70. Medical device 40 can pass through ureteral access sheath 90 to access the internal anatomy of kidney 70, as shown. Once at the site of kidney stone 80 (e.g., within the target calyx 75 of kidney 70 through which stone 80 is accessible), basket device 30 can be used to deliver / guide basket device 30 to the target location. Once stone 80 has been captured in the distal basket portion 35 of basket device 30, kidney stone 80 can be extracted from patient 7 using the utilized ureteral access path.

[0065] System 100 can be advantageously configured to implement certain stuck device detection / determination functions as detailed herein. Such stuck device detection / determination can advantageously provide effective detection / determination of stuck device conditions, generation of user warnings and / or specification of stuck device conditions, and / or, in some cases, prevention or reduction of the risk of stuck medical devices during retraction. Stuck device detection functions according to various aspects of this disclosure can advantageously provide a layer of safety relative to at least partially robotic basketing implementations. For example, as detailed herein in conjunction with various embodiments, robot-assisted stuck device detection can provide an additional layer of stuck device detection beyond the attention and judgment of the operating physician or technician, thereby providing the patient with improved safety and / or reducing the risk of device damage. Furthermore, the systems / implementations of this disclosure that provide enhanced stuck basket detection based on device actuator force readings, compared to certain manual basketing solutions, allow the user to operate the basketing device to safely retract the captured object / stone, wherein such solutions require only a single operator while providing the same or greater protection against damage from stuck device conditions using visual and force feedback from the robotic system.

[0066] The various endoscopic instruments disclosed herein (such as endoscope 40 of system 100) can be configured to navigate within human anatomical structures, such as within natural openings or cavities of human anatomical structures. The terms "endoscope" and "scope" are used herein according to their broad and general meaning and can refer to any type of elongated medical device having image generation, viewing, and / or capture capabilities and configured to be introduced into any type of organ, cavity, lumen, chamber, or space of the body. Endoscopes may include, for example, ureteroscopes (e.g., for access to the urinary tract), laparoscopes, nephroscopes (e.g., for access to the kidneys), bronchoscopes (e.g., for access to airways, such as bronchi), colonoscopes (e.g., for access to the colon), arthroscopes (e.g., for access to joints), cystoscopes (e.g., for access to the bladder), colonoscopes (e.g., for access to the colon and / or rectum), tubular endoscopes, etc. In some cases, endoscopes may include rigid or flexible tubes and may be sized to pass through an outer sheath, catheter, guide, or other lumen-type device, or may be used without such devices.

[0067] Reference is made to one or more embodiments according to this disclosure. Figure 1 Exemplary implementation of the control system 50 Figure 1 and Figure 2 The control system 50 can be configured to provide various functions to assist in the execution of medical procedures. In some embodiments, the control system 50 can be coupled to and cooperate with the robotic system 10 to perform medical procedures on the patient 7. For example, the control system 50 can communicate with the robotic system 10 via a wireless or wired connection (e.g., to control the robotic system 10). Furthermore, in some embodiments, the control system 50 can communicate with the robotic system 10 to receive position data associated with the distal end of the endoscope 40, the entry sheath 90, or the basket device 30. Such position data associated with the position of the endoscope 40, the entry sheath 90, or the basket device 30 can be derived using one or more electromagnetic sensors associated with the respective components. Additionally, in some embodiments, the control system 50 can communicate with the tabletop 15 to position the tabletop 15 in a specific orientation or otherwise control the tabletop 15. In some embodiments, the control system 50 can communicate with an EM field generator 18 to control the generation of an EM field in the area surrounding the patient 7.

[0068] Figure 2 One or more embodiments according to this disclosure are also shown. Figure 1An exemplary embodiment of the robotic system 10 is provided. The robotic system 10 can be configured to at least partially facilitate the execution of medical procedures. The robotic system 10 can be configured in various ways, depending on the specific procedure. The robotic system 10 may include one or more robotic arms 12 configured to engage and / or control, for example, an endoscope 40 and / or a basket system 30, to perform one or more aspects of the procedure. As shown, each robotic arm 12 may include multiple arm segments 23 coupled to a joint 24, which provide multiple degrees of motion / freedom. Figure 1 In the example, the robotic system 10 is positioned close to the patient's leg, and the robotic arm 12 is actuated to engage and position the endoscope 40 for insertion into an access opening, such as the urethra 65 of the patient 7. When the robotic system 10 is correctly positioned, the endoscope 40 can be inserted into the patient 7 by the robot using the robotic arm 12, manually by the physician 5, or a combination of both. An endoscope actuator instrument coupling 11 (i.e., an instrument device manipulator (IDM)) can be attached to the distal portion of one of the arms 12b to facilitate robotic control / propulsion of the endoscope 32. The other arm 12c may have an associated instrument coupling / manipulator 19 configured to facilitate the advancement and manipulation of the basket assembly 30. The endoscope 40 may include one or more working channels through which additional tools, such as lithotripters, basket assemblies, forceps, etc., can be introduced into the treatment site.

[0069] The robotic system 10 can be coupled to any component of the medical system 100, such as the control system 50, the worktable 15, the EM field generator 18, the endoscope 40, the basket system 30, and / or percutaneous access instruments (e.g., needles, catheters, nephroscopes, etc.). In some embodiments, the robotic system 10 is communicatively coupled to the control system 50. For example, the robotic system 10 may be configured to receive control signals from the control system 50 to perform certain operations, such as positioning one or more robotic arms 12 in a particular manner, manipulating the endoscope 40, manipulating the basket system 30, etc. In response, the robotic system 10 may use specific control circuitry 211, actuators 217, and / or other components of the robotic system 10 to control components of the robotic system 10 to perform operations. In some embodiments, the robotic system 10 and / or the control system 50 are configured to receive from the endoscope 40 representations of the internal anatomy of the patient 7 (i.e., information about the patient's internal anatomy). Figure 1 Images and / or image data of a specific depiction of the urinary system, and / or images displayed based thereon.

[0070] refer to Figure 2The robot system 10 generally includes an elongated support structure 14 (also referred to as a "pillar"), a robot system base 25, and a console 13 at the top of the pillar 14. The pillar 14 may include supports for one or more robotic arms 12 (in... Figure 2 One or more elbow supports 17 (also referred to as “brackets”) are deployed (three are shown in the figure). Elbow supports 17 may include individually configurable arm mounts that rotate along a vertical axis to adjust the base of the robotic arm 12 for desired positioning relative to the patient.

[0071] Elbow support 17 can be configured to translate vertically along post 14. In some embodiments, elbow support 17 is connected to post 14 via slot 20, which is positioned on opposite sides of post 14 to guide vertical translation of elbow support 17. Slot 20 includes a vertical translation interface to position and hold elbow support 17 relative to robot system base 25 at various vertical heights. Vertical translation of elbow support 17 allows robot system 10 to adjust the range of robot arm 12 to accommodate various table heights, patient body shapes, and physician preferences. Similarly, individually configurable arm supports on elbow support 17 allow robot arm base 21 of robot arm 12 to be angled in various configurations.

[0072] 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 linked arm segments 24, each joint including one or more independent actuators 217. Each actuator may include an independently controllable motor. Each independently controllable joint 24 provides or represents an independent degree of freedom available to the robotic arm. In some embodiments, each arm of the arm 12 has seven joints and thus provides seven degrees of freedom, including “redundant” degrees of freedom. Redundant degrees of freedom allow the robotic arm 12 to position its corresponding end effector 22 in a specific orientation, orientation, and trajectory in space using different link orientations and joint angles. This allows the system to locate and guide medical devices from desired points in space, while allowing physicians to move the arm joint to a clinically advantageous orientation away from the patient to achieve greater proximity while avoiding arm collisions.

[0073] The robot system base 25 balances the weight of the column 14, elbow support 17, and arm 12 on the floor. Therefore, the robot system base 25 can accommodate certain relatively heavy components, such as electronics, motors, power supplies, and components that selectively enable the robot system to move and / or be fixed in place. For example, the robot system base 25 includes wheeled casters 28 that allow the robot system to move easily around the operating room before the procedure. Once in place, the casters 28 can be secured using wheel locks to hold the robot system 10 in place during the procedure.

[0074] A console 13, positioned at the upper end of column 14, provides both a user interface for receiving user input and a display screen 16 (or a dual-purpose device, such as a touchscreen) for providing preoperative and intraoperative data to the physician user. Potential preoperative data on the console / display 16 or display 56 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 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 13 may be positioned and tilted to allow the physician to access it from the side of column 14 opposite elbow support 17. From this position, the physician can view the console 13, robotic arm 12, and patient while operating the console 13 from behind the robotic system 10. As shown, the console 13 may also include a handle 27 to assist in manipulating and stabilizing the robotic system 10.

[0075] Each end effector 213 of the robotic arm 12 may include an instrument device manipulator (IDM) configured to couple to the IDM, which may be attached using a mechanism converter interface (MCI). In some embodiments, the IDM may be removed and replaced with a different type of IDM; for example, a first type 11 IDM may manipulate an endoscope, while a second type 19 IDM may manipulate a basket device. Another type of IDM may be configured to hold an electromagnetic field generator 18. The MCI may provide a power and control interface. For example, the interface may include connectors for transmitting pneumatic pressure, power, electrical signals, and / or optical signals from the robotic arm 12 to the IDM. The IDM 213 may be configured to manipulate medical instruments (e.g., surgical instruments / devices) such as endoscope 40 using techniques including, for example, direct drive, harmonic drive, gear drive, belt and pulley, magnetic drive, etc. In some implementations, the medical device manipulator 213 may be attached to a corresponding robotic arm in the robotic arm 212, wherein the robotic arm 212 is configured to insert a corresponding coupled medical device into or retract from the treatment site.

[0076] As referenced above, system 100 may include specific control circuitry configured to perform the specific functions described herein, including control circuitry 211 of robot system 10 and control circuitry 251 of control system 50. That is, the control circuitry of system 100 may be robot system 10, control system 50, or a combination thereof. Therefore, any reference herein to control circuitry may refer to robot systems, control systems, or medical systems (such as those in…). Figure 1The term "control circuitry system" is used herein in its broad and general sense and may refer to any collection of: processors, processing circuitry systems, processing modules / units, chips, dies (e.g., semiconductor dies comprising one or more active and / or passive devices and / or connectivity circuitry systems), microprocessors, microcontrollers, digital signal processors, microcomputers, central processing units, field-programmable gate arrays, programmable logic devices, state machines (e.g., hardware state machines), logic circuitry systems, analog circuitry systems, digital circuitry systems, and / or any means of manipulating signals based on hard-coded circuitry systems and / or operating instructions. The control circuitry system mentioned herein may also include one or more circuit substrates (e.g., printed circuit boards), conductive traces and vias and / or mounting pads, connectors, and / or components. The control circuitry system mentioned herein may also include one or more memory devices, which may be embodied in a single memory device, multiple memory devices, and / or embedded circuitry systems. Such data storage devices may include read-only memory, random access memory, volatile memory, non-volatile memory, static memory, dynamic memory, flash memory, cache, data storage registers, and / or any device for storing digital information. It should be noted that in embodiments where the control circuitry system includes hardware and / or software state machines, analog circuitry systems, digital circuitry systems, and / or logic circuitry systems, the data storage device / register storing any associated operational instructions may be embedded within or outside the circuitry system including the state machine, the analog circuitry system, the digital circuitry system, and / or the logic circuitry system.

[0077] Control circuits 211, 251 may include a computer-readable medium that stores and / or is configured to store hard-coded and / or operational instructions corresponding to at least some of the steps and / or functions shown in one or more of the figures shown in this document and / or described herein. In some cases, such a computer-readable medium may be included in an article of manufacture. Control circuits 211 / 251 may be maintained / located entirely locally or may be at least partially located remotely (e.g., communicatively coupled indirectly via a local area network and / or a wide area network). Either control circuits 211, 251 may be configured to perform any aspect of the various processes disclosed herein, including those shown in Figure 9 and Figure 11 The process shown is described below.

[0078] Regarding robot system 10, at least a portion of control circuitry 211 may be integrated with the base 25, column 14, and / or console 13 of robot system 10, and / or with another system communicatively coupled to robot system 10. Regarding control system 50, at least a portion of control circuitry 251 may be integrated with the console base 51 and / or display unit 56 of control system 50. It should be understood that any description herein of functional control circuitry or related functions is to be construed as embodied in robot system 10, control system 50, or any combination thereof, and / or at least partially embodied in one or more other local or remote systems / devices.

[0079] Further reference Figure 2 The control system 50 may include various I / O components 258 configured to assist physician 5 or others in performing medical procedures. For example, input / output (I / O) components 258 may be configured to allow user input to control / navigate the endoscope 40 and / or the basket system within the patient 7. In some embodiments, for example, physician 5 may provide input to the control system 50 and / or the robotic system 10, wherein, in response to such input, control signals may be sent to the robotic system 10 to manipulate the endoscope 40 and / or the catheter basket system 30. The control system 50 may include one or more display devices 56 to provide various information about the procedures. For example, the display 56 may provide information about the endoscope 40 and / or the basket system 30. For example, the control system 50 may receive real-time images captured by the endoscope 40 and display these real-time images via the display 56. Additionally or alternatively, the control system 50 may receive signals (e.g., analog signals, digital signals, electrical signals, acoustic / sound signals, pneumatic signals, tactile signals, hydraulic signals, etc.) from medical monitors and / or sensors associated with the patient 7, and the display 56 may present information about the patient 7's health or environment. Such information may include information displayed via medical monitors, including, for example, information related to heart rate (e.g., ECG, HRV, etc.), blood pressure / blood rate, muscle biosignals (e.g., EMG), body temperature, blood oxygen saturation (e.g., SpO2), CO2, brain waves (e.g., EEG), environmental and / or local or core body temperature, etc.

[0080] To facilitate the functionality of control system 50, the control system may include various components (sometimes referred to as "subsystems"). For example, control system 50 may include control electronics / circuit 251, and one or more power supplies / interfaces 259, pneumatic devices, light sources, actuators, data storage devices, and / or communication interfaces 254. In some embodiments, control system 50 is mobile, while in other embodiments, control system 50 is a substantially stationary system. Although various functions and components are discussed as being implemented by control system 50, any of such functions and / or components may be integrated into and / or performed by other systems and / or devices, such as robot system 10, basket system 30, tabletop 15, etc.

[0081] Further reference Figure 1 The medical system 100 offers a variety of benefits, such as providing guidance to assist physicians in performing procedures (e.g., instrument tracking, instrument alignment information, etc.), enabling physicians to perform procedures from ergonomic positions without requiring inconvenient arm movements and / or positions, enabling a single physician to perform procedures with one or more medical instruments, avoiding radiation exposure (e.g., radiation exposure associated with fluorescein microscopy), enabling procedures to be performed in a single operating environment, and providing continuous suction for more efficient removal of objects (e.g., removal of kidney stones). For example, the medical system 100 can provide guidance to assist physicians in using various medical instruments to access target anatomical features while minimizing bleeding and / or damage to anatomical structures (e.g., critical organs, blood vessels, etc.). Furthermore, the medical system 100 can provide radiation-free navigation and / or positioning technologies to reduce radiation exposure for physicians and patients and / or reduce the number of devices in the operating room. Additionally, the medical system 100 can provide functionality distributed between the control system 50 and the robotic system 10, which can move independently. Such a distribution of functions and / or mobility allows the control system 50 and / or the robotic system 10 to be placed in an optimal location for a particular medical procedure, which maximizes the work area around the patient 7 and / or provides an optimal location for the physician 5 to perform the procedure.

[0082] Various components of system 100 can be communicatively coupled to each other over a network, which may include a wireless network and / or a wired network. Exemplary networks include one or more Personal Area Networks (PANs), Local Area Networks (LANs), Wide Area Networks (WANs), Internet Area Networks (IANs), cellular networks, the Internet, Body Area Networks (BANs), etc. For example, Figure 2The system's various communication interfaces can be configured to communicate with one or more devices / sensors / systems, such as via wireless and / or wired network connections. In some embodiments, the various communication interfaces can implement wireless technologies such as Bluetooth, Wi-Fi, and Near Field Communication (NFC). Furthermore, in some embodiments, various components of system 100 can be connected via one or more support cables, conduits, etc., for data communication, fluid exchange, power exchange, etc.

[0083] The control system 50, the basket loading system 30, and / or the robot system 10 include specific user controls (e.g., control 55), which may include any type of user input (and / or output) device or device interface, such as one or more buttons, keys, joysticks, handheld controllers (e.g., video game type controllers), computer mice, touchpads, trackballs, control pads, and / or sensors for capturing gestures and finger postures (e.g., motion sensors or cameras), touchscreens, and / or interfaces / connectors for them. Such user controls are communicatively and / or physically coupled to the corresponding control circuitry.

[0084] In some implementations, a user can manually manipulate the robotic arm 12 of the robotic system 10 without using electronic user controls. For example, during setup in a surgical operating room, the user can move the robotic arm 12 and / or any other medical instruments to provide desired access to the patient. The robotic system 10 may rely on force feedback and inertial control from the user to determine the appropriate configuration of the robotic arm 12 and associated instruments.

[0085] The basket loading system 30 includes various hardware and control components. For example, such as... Figure 2 As shown, the processing system 30 may include a basket 35 formed by one or more wire teeth 36. For example, the basket system 30 may include four wire teeth disposed along its length within a basket sheath 37, wherein the teeth protrude from the distal end of the sheath 37 to form the basket shape 35. The teeth 36 further extend from the proximal end of the sheath 37. The teeth 36 may be configured to slide within the basket sheath 37, subject to a certain amount of frictional resistance. The teeth 36 and the sheath 37 may be coupled to corresponding actuators 75 of the basket container component 32. Reference is made below. Figures 4A to 4E The relationship between the actuator 75 of the basket container 32 and the serrations 36 and sheath 37 is described in detail. The basket container 32 may be physically and / or communicatively coupled to the handle portion / component 31 of the basket loading system 30. The handle portion 31 may be configured to assist basket loading control manually or via robot control.

[0086] The basket loading system 30 can be powered via power interface 39 and / or controlled via control interface 38, each or both of which can interface with the robotic arm / component of the robotic system 10. The basket loading system 30 may also include one or more sensors 72, such as pressure and / or other force reading sensors, which can be configured to generate signals indicating forces experienced / by experienced at one or more actuators 75 and / or other couplings of the basket loading system 30. Such sensor readings can be used to determine a basket jamming condition, as described in detail herein. In some embodiments, the sensors 72 include one or more sensors configured to directly measure forces at or near the basket portion 35 of the fangs 36. For example, force sensors at the apex of the basket 35 and / or at the apex of the entry sheath through which the basket loading device 30 enters the target anatomy can be used to directly detect forces on the basket 35 caused by the basket 35 jamming on the anatomy or at an opening at the end of the entry sheath.

[0087] Basket control

[0088] Figure 3 A ureteroscope 40, placed in a portion of a patient's urinary system according to one or more embodiments of this disclosure, is shown. As mentioned above, ureteroscopic procedures can be performed to examine and / or treat abnormalities of the human ureter. For example, ureteroscopic procedures can be performed to treat and / or remove kidney stones. Such procedures can be performed at least partially manually and / or at least partially using robotic techniques (such as...). Figure 1 The robotic system 10 shown in the figure is used to perform the procedure. For example, using robotic devices and / or systems for a particular endoscopic procedure can provide relatively better accuracy, control, and / or coordination compared to a completely manual procedure. In some embodiments, the endoscope 40 includes a working channel 44 for deploying a basket assembly 30 (e.g., a basket-shaped component 35) to an operating area at the distal end of the endoscope.

[0089] In addition to capturing objects / stones in basket 35 when their size is not too large, the access sheath 90 through which the endoscope 40 enters the target anatomy may advantageously have a diameter sufficient to pull the endoscope 40 within it. The access sheath 90 can be advanced via the ureter 63 to a position near the renal pelvis 71 and / or the ureteropelvic junction 71. The distal end of the access sheath 90 may be positioned at a location within the ureter 63 and / or the renal pelvis 71, wherein such positioning may depend at least partially on the anatomy. That is, the access sheath 90 may be positioned as far into the renal anatomy as possible, as permitted by the urinary tract path, which may be somewhat tortuous in some sections. Typically, the access sheath 90 may not be articulated to the extent that the endoscope 40 can be articulated, and therefore, navigating / driving the access sheath 90 into the kidney may be impractical.

[0090] The endoscope 40 may be articulated (e.g., relative to at least the distal portion of the endoscope), allowing it to be steered within the body's anatomy. In some embodiments, the endoscope 40 is configured to articulate with, for example, five degrees of freedom, including XYZ coordinate translation, as well as pitch and yaw. In some embodiments, the endoscope 40 may articulate with six degrees of freedom, including XYZ coordinate translation, as well as pitch, yaw, and roll. The position sensor of the endoscope 40 (e.g., an electromagnetic sensor) may similarly have similar degrees of freedom relative to the position information generated / provided by that position sensor.

[0091] For a specific robotic implementation, the robotic arm of the robotic system may be configured / can be configured to manipulate the endoscope 40 using elongated moving members. This elongated moving member may include one or more drawstrings (e.g., pull wires or push wires), cables, fibers, or flexible shafts. For example, the robotic arm may be configured to actuate multiple drawstrings coupled to the endoscope 40 to deflect the tip 42 of the endoscope 40. The drawstrings may include any suitable or desired material, such as metallic and non-metallic materials, such as stainless steel, Kevlar, tungsten, carbon fiber, etc. In some embodiments, the endoscope 40 is configured to exhibit nonlinear behavior in response to forces applied by the elongated moving members. This nonlinear behavior may be based on the endoscope's stiffness and compressibility, as well as the variability in relaxation or stiffness between the different elongated moving members.

[0092] The endoscope (e.g., an endoscope / ureteroscope) 40 may include a tubular flexible medical device configured for insertion into a patient's anatomy to capture images of that anatomy. In some embodiments, the endoscope 40 may house wires and / or optical fibers to transmit signals to / from the optical components and a distal end 42 of the endoscope 40, which may include an imaging device 48, such as an optical camera. The endoscope 40 may also include a light source 49, such as an LED or a fiber optic light source / lens.

[0093] Camera / imaging device 48 can be used to capture images of internal anatomical spaces, such as the internal renal calyces of kidney 70. Endoscope 40 may also be configured to house optical fibers to deliver light from a proximal light source (such as a light-emitting diode) to the distal end 42 of the endoscope. The distal end 42 of the endoscope 40 may include a port for illuminating the anatomical space when using the camera / imaging device. In some embodiments, endoscope 40 is configured to be controlled by a robotic system that is similar in one or more respects to... Figure 1 and Figure 2 The robotic system 10 is shown in the figure. The imaging device 48 may include optical fibers, an optical fiber array, and / or a lens. The optical components move together with the tip of the endoscope 40, such that the movement of the tip of the endoscope causes a change in the image captured by the imaging device 48.

[0094] In some embodiments, the medical device (e.g., endoscope) 40 includes a sensor configured to generate sensor position data and / or transmit the sensor position data to another device or generate a detectable distortion or feature in an electromagnetic field. The sensor position data may indicate the position and / or orientation of the medical device 40 (e.g., its distal end 42), and / or may be used to determine / infer the position / or orientation of the medical device. For example, the sensor (sometimes referred to as a “position sensor”) may include other forms / implementations of electromagnetic (EM) sensors having coils or antennas made of conductive material. In some embodiments, the endoscope 40 includes an electromagnetic sensor encapsulated in the distal end 42 of the endoscope 40. The electromagnetic sensor (not shown) may include a terminal of a wire or other conductive element configured to induce a current in the presence of an electromagnetic field. Furthermore, the medical device / endoscope 40 and / or basket assembly 30 may include other types of sensors, such as shape-sensing fiber optics, accelerometers, gyroscopes, satellite-based positioning sensors (e.g., Global Positioning System (GPS) sensors), radio frequency transceivers, etc. In some implementations, sensors on the medical device can provide sensor data to the control system, which is then used to determine the position and / or orientation of the medical device. Position data derived using one or more position sensors associated with the endoscope 40 or basket assembly 30 can be used to determine when the endoscope and / or basket 35 is in or near a jamming device danger zone, as described in detail herein.

[0095] The endoscope 40 and / or basket loading device 30 can be controlled in any suitable or desired manner, based on manual manipulation of the handle components, electronic user input, or automatic control. For example, Figure 311 illustrates an exemplary robotic control configuration for controlling the endoscope 40 and / or basket loading device 30, while Figure 312 illustrates an exemplary manual control configuration. In some embodiments, a two-hand controller 55 may be used to control the endoscope 40 and / or basket loading device 30, such as... Figure 1 As shown. Although controller 55 is shown as a handheld controller, user input can be received using any type of I / O device, such as a touchscreen / pad, mouse, keyboard, microphone, etc.

[0096] Figures 4A to 4D Basket loading control systems in various configurations according to one or more embodiments are shown. Various embodiments in conjunction with this disclosure, such as... Figures 4A to 4D As shown, basket loading can be performed, at least in part, using one or more robotic instrumentation devices (IDMs) such as the endoscope actuator IDM 11 and the basket loading IDM 19. IDMs 11 and 19 can be coupled to one or more robotic arms of the robotic system. Control signals for controlling the various actuators associated with IDMs 11 and 19 can be provided using a control interface between the IDM and the corresponding robotic arm coupled thereto.

[0097] In some embodiments, the basket loading IDM 19 may include a handle component 31 and a basket loading compartment component 32. The handle component 31 may be coupled to the endoscope 40 at a proximal end of the endoscope and may include a basket loading device sheath 37 through which a passage of the endoscope 40 can be accessed, wherein the basket loading sheath 37 (together with basket loading teeth disposed there) may be at least partially disposed within the working channel 44 of the endoscope 40, as described above relative to... Figure 3 The endoscope 40 and the basket assembly 30 are typically in a relatively fixed position at the handle component 31, wherein the relative position between the endoscope 40 and the basket 30 can be changed by actuation of one or more of the actuators 33, 34 of the basket compartment 32. Actuation of the basket sheath actuator 33 can cause the basket assembly 30 to be inserted and retracted relative to the endoscope 40.

[0098] In some embodiments, during the retraction process of the endoscope and / or basket, the basket assembly 30 may be jittered relative to the endoscope 40 for various purposes, including improving the sensitivity of jammed instrument detection and / or preventing instrument jamming. As described in detail below in conjunction with the various jammed instrument detection schemes disclosed herein, the jittering motion of the basket assembly 30 may be achieved at least in part by sliding the basket sheath actuator 33 back and forth in an oscillating manner (e.g., distally and proximally) to move the basket 35 back and forth relative to the distal end of the endoscope 40.

[0099] The endoscope 40 can be advanced from the distal end of the housing 90 by actuating one or more actuators 38 associated with the endoscope actuator IDM 11. For example, such actuators 38 may include wheel-type actuators, etc. Actuators 38 can be used to advance and retract the endoscope 40. Figure 4EAs shown, during a kidney stone removal procedure, actuator 38 can be used to retract endoscope 40 after the kidney stone 80 has been successfully captured in basket 35. In some embodiments, the access sleeve 90 is fixedly coupled to the endoscope actuator IDM 11 using sleeve coupling member 91.

[0100] The basket hopper 32 may include a plurality of actuators 33, 34. For example, actuators 33, 34 may include sliding, carriage-type actuators. Specifically, the hopper 32 may include a first actuator 33 fixed to a sheath member 37 of the basket assembly 30 and a second actuator 34 fixed to a wire / tooth 36 of the basket assembly 30, wherein the tooth 36 may pass through the basket sheath 37 and / or otherwise at least partially disposed within the basket sheath. In some embodiments, the basket 35 is formed by the tooth 36 extending from the distal end of the basket sheath 37 at its distal portion.

[0101] By sliding the sheath actuator 33, the basket loading device 30 can protrude from the distal end of the endoscope 40. For example, as Figure 4B As shown, actuator 30 can slide forward to produce corresponding forward propulsion of basket assembly 30 and basket 35. Basket actuator 34 can be used to open basket 35 by pulling the fangs proximally, thereby causing the distal end 39 of basket 35 to be pulled toward the distal opening of sheath 37, thereby causing the basket-shaped portion 35 of the fangs to bend / expand outward. When the fangs 35 are in Figure 4B In the extended / open position shown, the basket 35 can be placed around the stone / object 80 so as to capture the stone / object 80 within the basket fangs 35.

[0102] like Figure 4C As shown, the basket 35 can collapse around the stone 80 to capture the stone therein. For example, the basket tooth actuator 34 can be advanced relative to the sheath actuator 33 by a certain amount to push the basket teeth further out of the sheath 37 at their distal ends, thereby elongating / extending the basket 35 and bringing the teeth closer to the axis of the basket-loading device 30. The sheath actuator 33 can be pulled proximally to return the basket-loading device 30 closer to the distal end of the endoscope 40. For example, it may be desirable to position the basket 35 close to / adjacent to the distal end of the endoscope 40 during the retraction of the endoscope and the basket-loading device 30.

[0103] In some implementations, the basket 35 can be further tightened / collapsed around the stone 80 by further pulling the fangs 36 proximally, thereby pulling the fangs 35 further into the sheath 37 and reducing the length of the fangs protruding distally from the distal end of the basket sheath 37. Figure 4D A basket 35 with reduced size is shown due to the movement of actuator 34 proximally relative to actuator 33.

[0104] like Figure 4E As shown, once the stone 80 is captured and the basket 35 is brought to the desired position near the distal end of the endoscope 40, the actuator 38 can be engaged to retract the endoscope 40 through the opening 93 of the entry sheath 90 and further through the entry sheath 90. In some embodiments, the basket assembly 30 may retract with the endoscope 40 when the endoscope 40 is pulled proximally. For example, friction between the basket sheath 37 and the working channel 44 of the endoscope 40 may cause the basket assembly 30 to accompany the endoscope 40 during the retraction / movement of the endoscope.

[0105] One or more force sensors can be used with Figures 4A to 4E The illustrated basket loading system may be associated with one or more of the actuators and / or coupling interfaces. For example, a force sensor (e.g., a pressure sensor) may be associated with one or more of the basket tooth actuator 34, the basket sheath actuator 33, the endoscope actuator 38, and / or the access sheath coupling 91. For example, in some embodiments, the presence and / or sensing of a force at the basket tooth actuator 34 may indicate a stuck instrument condition, wherein the basket tooth 35 is caught and / or pulled distally on the actuator 34 during retraction of the endoscope 40. In some embodiments, a force reading at the basket sheath actuator 33 may indicate a stuck instrument condition. For example, such force / friction may be at least partially manifested at the sheath actuator 33 when the basket tooth 35 is pulled against the distal opening of the basket sheath 37 and / or along one or more portions thereof. Therefore, embodiments of this disclosure may involve evaluating / analyzing sensor readings associated with the basket sheath actuator 33 to determine / identify jammed instrument conditions. Typically, movement of the sheath actuator 33 causes the basket sheath 37 and the serrations 36 to move back and forth.

[0106] In some embodiments, a sensor associated with the endoscope actuator 38 can provide a signal indicating an instrument jamming condition. For example, in the event that the basket 35 is jammed on an anatomical structure or at the opening into the sheath 90, retraction of the endoscope can be suppressed due to friction between the basket assembly 30 and the working channel 44 of the endoscope 40. For example, in some embodiments, the basket assembly 30 may be clamped or otherwise secured to one or more portions of the endoscope 40, such as at or near a portion of the handle assembly 31. Thus, the force associated with the jamming of the basket can be sensed and / or read at the actuator 38 coupled to the endoscope 40. In some embodiments, the force experienced by the entry into the sheath 90 (which can be sensed / detected at least partially at the sheath coupling 91) can provide an indication of an instrument jamming condition. It should be understood that any of the embodiments disclosed herein can be implemented to determine the stuck instrument condition based on sensor readings associated with the basket tooth actuator 34, the basket sheath actuator 33, the endoscope driver actuator 38 and / or the sheath coupling 91 or any combination thereof.

[0107] In some embodiments, such as at the distal end 39 of the basket 35, the basket-like portion 35 of the teeth 36 of the basket assembly 30 may have one or more force sensors associated therewith. Such sensors provide signals with reduced frictional losses compared to signals experienced / generated at more proximal components / locations associated with other actuators / connectors of the basket assembly system. Therefore, embodiments of this disclosure implementing force sensors associated with the distal basket-like portion 35 of the basket assembly 30 can provide relatively sensitive readings indicating the condition of a stuck device. In some embodiments, one or more force sensors may be located at or near the distal opening of the basket sheath 37 at the base of the basket 35. Such sensors can provide readings that can be used as a basis for determining a stuck device according to embodiments of this disclosure.

[0108] Figure 5 Various medical devices, including certain basket-loading device components, are shown, disposed in portions of a patient's renal anatomy according to one or more embodiments. Specifically, Figure 5 The endoscope 40 and basket device 30 at various locations associated with stone / object capture and removal procedures are shown according to various aspects of this disclosure.

[0109] As mentioned above, attempting to remove relatively large stones can result in tearing or other damage to the ureter and / or other anatomical features. Relative to Figure 5As shown in the diagram, if the stone 80 is too large to fit within the entry sheath 90 (e.g., a ureteral entry sheath), causing the basket 35c to be trapped at the distal end or other portion of the entry sheath 90, the retrieval force on the endoscope 40 and / or the basket device 30 may cause the entry sheath 90 to move, potentially resulting in abrasion on the inner wall of the ureter 63. Furthermore, if an attempt is made to pull the basket 35 within the entry sheath 90 without it fitting cleanly due to the size of the stone 80 trapped within it, the basket teeth 35 may be damaged or broken.

[0110] In cases where the target stone / object 80 is too large for various reasons to retract cleanly through the ureteropelvic junction 78 and into the entry sheath 90, embodiments of this disclosure can provide an effective solution for detecting device entrapment conditions or risks, or device entrapment / capture. As an exemplary use case, when a target stone / object fractures (e.g., using a laser as part of a lithotripsy procedure), the operating physician may not be able to confidently determine the precise size or diameter of the stone and / or whether the stone / fragment is small enough to pass through the ureter and / or into the sheath. According to some manual procedures, the physician may attempt to fire a laser at the stone / object based on personal experience with such procedures to produce stone fragments small enough to cleanly fit through the ureteropelvic junction 78 and the entry sheath 90. However, such physicians may encounter device entrapment conditions over time during the procedure. In manual procedures, when an instrument becomes stuck, the physician holding the ureteroscope and monitoring the real-time endoscopic camera image may be able to identify / notic on the camera that the stone / basket appears further away from the endoscopic camera view than expected. This could be because the basket / stone is already stuck on a specific anatomical structure and / or at the opening into the sheath 90. Furthermore, when the basket control is also manually operated, the stuck instrument / stone condition may be tactilely felt on the control instrument in the form of a force opposing the retraction of the endoscope and / or the basket.

[0111] As described above, the size of stone 80 relative to one or more of its dimensions can cause stone 80 to become lodged in the patient's anatomy and / or at the opening into the sheath 90, into which the endoscope 40, basket 35, and object 80 captured in the basket are pulled. However, depending on certain solutions, the precise size of stone 80 cannot be determined by location and / or system. Therefore, in some cases, the risk of instrument lodging / capture may not be completely avoided. Furthermore, compared to robot-assisted ureteroscopy procedures, although camera views from the endoscope camera are available for monitoring by a physician / technician, where the endoscope and / or basket device are robotically controlled rather than held by a human surgeon, the human user may not feel force feedback. Therefore, in some aspects of robot-implemented endoscope-driven and / or basket-loading procedures, the detection / determination of lodged instrument / stone conditions may be more difficult.

[0112] In the event that the stone 80 and / or basket 35 is lodged in the patient's anatomy, further retraction of the basket 35 from its lodged position may result in tissue tearing (e.g., ureteral tear). Furthermore, in the event that the basket 35c is lodged at the opening of the access sheath 90, further retraction of the basket 35c and / or endoscope 40c may result in movement / displacement of the access sheath 90 from its parking position and / or damage to the basket 35.

[0113] Embodiments of this disclosure provide for the detection of stuck instruments based on force readings associated with actuators and / or couplings linked to one or more components of the access sleeve 90, endoscope 40, and / or basket assembly 30. For example, when the endoscope 40 retracts once the object 80 has been captured by the basket 35, force readings on one or more components of the instrument can be analyzed to determine whether such forces exceed a predetermined threshold indicating a stuck instrument condition. In some embodiments, the sensitivity of such stuck instrument determination can be improved by implementing basket jitter according to embodiments of this disclosure.

[0114] Basket shaking can be achieved when the speculum 40 and / or basket 35 enters the danger zone 99, where the danger zone 99 can be an area where the risk of instrument entrapment / capture is relatively high. For example, the entrapment danger zone 99 can typically cover the area at or near the ureteropelvic junction 78 and / or immediately before (i.e., distally) the opening of the entry sheath 90, which can generally be associated with a higher risk of capture at the urinary tract anatomy and the opening of the entry sheath 90, respectively. For example, the narrowing of the urinary tract as the anatomy moves from the renal pelvis 71 into the ureter 63 can result in a narrowing of the channel / lumen for instrument capture, where the basket 35 and / or the stone / object 80 captured therein has a width / diameter or other size greater than some size of the anatomy channel. Furthermore, the opening of the entry sheath 90 is typically narrower than the opening of the basket 35 to the anatomy of the entry sheath 90 through its retraction. Therefore, the entry sheath 90 represents a relatively narrow passage where the basket 35 and / or the stone / object 80 trapped therein may become stuck if its size is larger than the diameter of the entry sheath opening. Thus, the danger zone 99 advantageously includes one or both of the narrow region of the ureteropelvic junction 78 and the region immediately preceding the opening 93 of the entry sheath 90. In some embodiments, the area of ​​the danger zone 99 may be determined at least in part based on the location of the opening / distal end of the entry sheath 90, such that the danger zone 99 occupies an area at a predetermined distance anterior to the entry sheath 90.

[0115] Basket jitter can be implemented to amplify the difference in force signals between jammed and non-jammed conditions. For example, slightly advancing and retracting the basket while the endoscope and basket retract can help ensure that jammed instrument sensor readings can be clearly identified. For example, as described in detail herein, the use of basket jitter can result in reduced noise and / or improved force reading sensitivity on various instruments. For example, by implementing basket jitter, in which the basket 35 advances and retracts a certain distance in an oscillating manner, the effects of static friction can be reduced or eliminated. Typically, static friction may be present when the basket 35 is in a relatively stationary position and in contact with the wall of the anatomical structure. When the basket 35 moves in an oscillating manner, the friction experienced on the instrument can be primarily in the form of kinetic friction, which is generally associated with a smaller coefficient of friction compared to static friction. Therefore, the signal-to-noise ratio of the forces applied to various instrument components can be relatively high when basket jitter is used, compared to a solution in which the endoscope 40 and / or basket 35 retract without basket jitter.

[0116] As the basket retracts into and passes through danger zone 99, force feedback readings on actuators associated with one or more components of the basket loading system 30, endoscope 40, and / or sheath 90 can be analyzed to determine when such forces increase in a manner consistent with a jammed instrument condition and / or the associated risk. When such a determination is made, such as when the force reading rises above a given threshold level, the retraction rate of endoscope 40 and / or basket 30 can be automatically reduced, thereby guiding the user / operator to continue operation and / or to retract the endoscope with increased caution.

[0117] In some embodiments, the basket 35 includes one or more electromagnetic sensors, wherein such sensors can provide sensor signals and / or otherwise indicate the position of the basket 35, wherein such position information can be used as a basis for determining when the basket 35 is in or near the danger zone 99. Furthermore, the position information determined using the electromagnetic sensors associated with the basket 35 can be used to trigger a jitter initiation for jammed instrument detection.

[0118] To provide effective detection of device jamming and reduce the incidence of false alarms related to device jamming detection (which can cause annoyance or distraction to the user), a device jamming danger zone 99 may be configured to cover areas identified as particularly prone to device jamming risk. For example, the danger zone 99 may be configured based on the location of the entry sheath 90, wherein the danger zone 99 covers a specific distance before and / or around the distal opening of the entry sheath 90. The shaking motion of the basket 30c around the entry sheath 90 can advantageously improve the sensitivity of detecting a jammed basket 35c at the entrance / opening of the entry sheath 90, while the shaking motion of the basket 35b further away from the entry sheath 90 can improve the sensitivity of detecting a jammed basket condition at or near the relatively narrow opening of the ureteropelvic junction 78.

[0119] In some cases, the precise location of the endoscope 40 and / or the entry sleeve 90 is unknown. For example, the estimation of the endoscope and / or sleeve location may be based on one or more of the robot arm / mechanism locations; knowledge / data indicating the endoscope length, sleeve length, and / or other known data; the endoscope being longer / further than intended; the feed roller arm holding the UAS adding uncertainty; the determined position data being based on data generated using one or more position sensors; camera image analysis, etc. However, in some cases, such measurements may not be associated with sufficiently tight tolerances. Typically, it may be desirable to consider the entire relevant tolerance chain to ensure that the jamming device determination features disclosed herein are achieved in the area / region including the distal end of the entry sleeve 90, to ensure that such features are achieved until the basket is safely within the entry sleeve.

[0120] In some implementations, image processing can be implemented to identify the endoscope 40 within the entry sheath 90 before terminating certain stuck device detection mechanisms. For example, termination of one or more of the stuck device identification mechanisms disclosed herein can be triggered at least in part by visual recognition (e.g., by physician / technician analysis or digital image processing) of one or more features associated with the interior and / or distal end of the entry sheath.

[0121] In cases where the entry sleeve position tolerance results in a range of areas where the distal end of the entry sleeve may be located, it may be desirable to operate according to a relatively expanded danger zone to ensure that the entry sleeve is at least partially positioned therein. Therefore, although the danger zone 99 shown is depicted as terminating at or near the actual location of the opening 93 of the entry sleeve 90, it should be understood that in some specific embodiments, certain areas of the disclosing jamming device determination mechanism disclosed herein may be comparable. Figure 5 The device extends further into the ureter 63 and / or covers the area overlapping with the distal end of the entry sheath 90. In some embodiments, the danger zone 99, where certain clamping device determining mechanisms are performed, includes the area corresponding to the extent of the endoscope 40. That is, the danger zone 99 may extend into the extent within the kidney 70 as the endoscope 40 and / or basket 30 can and / or actually reach.

[0122] As described in detail herein, force readings that can be used as inputs for determining the condition of a stuck instrument may include force readings indicating force present on one or more of the following: endoscope drive (i.e., insertion and / or retraction) actuators / pulleys, insertion sheath couplings, basket sheath insertion / retraction actuators, basket tooth insertion / retraction actuators, and / or torque sensors on one or more robotic arms or other robotic components (e.g., insertion / retraction track-type systems). For example, return to reference. Figures 4A to 4E The force on the distal drive feed roller / pulley 38 can be analyzed to determine the jammed instrument condition. Although force sensors are described throughout this disclosure, it should be understood that such sensors can be any type of sensor configured to generate and / or provide signals indicating the forces experienced on actuators, couplings, and / or other mechanical components of mechanical and / or robotic systems / apparatus, including direct torque sensors, current sensors, etc.

[0123] In conjunction with any of the disclosed embodiments, a jammed instrument condition can be determined based on sensor readings indicating forces on any type of insertion and / or retraction mechanism, regardless of whether such mechanism drives insertion and / or retraction into a sheath, endoscope, basket sheath, basket tines, or other component of the surgical system. For example, the sensor data upon which the jammed instrument condition determination is based may be generated and / or provided by sensors associated with a track-based instrument drive system. Such sensor data can advantageously indicate drag forces on one or more components of the system. In some embodiments, such insertion / retraction mechanisms may be implemented as virtual or physical track systems, wherein such systems are configured to produce linear (i.e., track-type) movement of one or more components of the surgical system. Insertion / retraction forces detected using such sensors can serve as the basis for determining the jammed instrument condition.

[0124] Vision-based identification of stuck devices

[0125] In some implementations, endoscopic camera images can provide a basis for identifying stuck instruments. This type of vision-based stuck instrument identification can be achieved through the control circuitry of a medical system that utilizes certain image processing techniques. Figure 6A The field of view 701 of an endoscope camera according to one or more embodiments of the present disclosure is shown, in which the basket assembly 35 is visible. Figure 6B A side view of a medical device assembly according to one or more embodiments is shown, the medical device assembly corresponding to Figure 6A The basket device 35 for capturing image 701 is configured relative to the endoscope camera 48. In image 701, because the basket 35 is close to the endoscope camera 48, the basket 35 and the stone 80 appear relatively large in the field of view.

[0126] Figure 7A The field of view 702 of an endoscope camera 48 according to one or more embodiments of the present disclosure is shown, in which the basket device 35 in a stuck state is visible. Figure 7B The following are illustrated according to one or more implementation schemes. Figure 6B A side view of a medical device assembly, which corresponds to Figure 7A The basket assembly 35 is shown in relation to the endoscope camera 48. Figure 6A Compared to images 701 (basket-like structure 35) and 80 (stone), [the image shows the comparison]. Figure 7AThe images of the basket 35 and the stone 80 in image 702 are smaller in size and positioned higher in image frame 702. Such changes in image size and / or position may be caused by the basket 35 becoming stuck when the endoscope 40 retracts, and provide an indication of it. Therefore, an image processing mechanism configured to identify substantial changes in the image size and / or position relative to the basket teeth and / or the captured object can be realized to determine the condition of the stuck instrument.

[0127] Unlike solutions where the basket system actuator force is specifically designed to detect / determine the condition of a stuck instrument, some embodiments of this disclosure involve implementing visual analysis / processing to determine the condition of a stuck instrument. For example, images captured by an endoscope camera can provide information about the condition of a stuck instrument. For instance, endoscope images can be processed to determine and / or estimate the distance between the distal end / apex of endoscope 40 (which is typically associated with camera 48 of the endoscope and therefore with camera viewing windows 701, 702 presented to the user) and the basket 35 or a portion thereof or the stone 80.

[0128] and Figure 6A The associated endoscopic image 701 may represent an image captured by endoscope 40, wherein basket 35 is not obstructed and is therefore visible in field of view 701 as camera 48 relatively close to endoscope 40. For example... Figure 6B As shown (which can generally be considered to correspond to) Figure 6A The image 701 captured by the endoscope camera 48 shown can be the stone 80 at a distance relatively close to the distal end of the endoscope 40. d 1 .

[0129] Figure 7A Image 702 shows a larger distance from the end of the endoscope 40. d 2 The stone was located at 80 cm. This type of stone is located at a greater distance. d 2 It is possible that the basket 35 and / or the stone 80 has become stuck on some anatomical structure or instrument, and therefore the retraction of the endoscope 40 causes the basket device 30 to be pulled out of the working channel 44 of the endoscope 40. Therefore, in image 702, the stone 80 and the basket 35 are shown in a relatively small size, indicating that the position of the stone 80 and the basket 35 is further away from the endoscope camera 48 due to the increased distance of the stone 80 and the basket 35 from the endoscope camera 48.

[0130] In some implementations, the control circuitry of the medical device or system may be configured to determine the shape and / or size associated with features of stones and / or basket-like structures visible in a camera view, wherein such shape and / or distance information can be used to determine changes in the distance to the stones and / or basket-like structures, and / or their absolute distance relative to the camera of the endoscope. Therefore, the determination that the basket-like structures and / or stones are smaller in subsequent images compared to previously captured images may indicate the presence of an instrument jamming condition. Certain remedial actions, as described in detail herein, may be implemented in response to such determinations.

[0131] In some embodiments, electromagnetic sensors or other position sensors associated with basket 35 and / or basket loading device 30 may be used to determine the position of basket 35 relative to endoscope 40, which may be indicated by a position sensor associated with the distal end of endoscope 40. Such position information may be used to determine the distance between basket 35 and endoscope 40, where such distance may indicate a jammed instrument condition.

[0132] In some embodiments, the basket-like teeth may have color-dependent characteristics, at least in part, dependent on stress. For example, such teeth may be configured such that changes in the visual characteristics of the basket are apparent in the presence of stress loads caused by a jammed basket condition, as visible in the field of view of an endoscope's camera. That is, the camera image presented to the user may have color characteristics that indicate to the user the stress experienced by the basket, and thus indicate the jammed instrument condition. In some embodiments, optical fibers may be used to provide shape sensing functionality. For example, the basket may be coupled with a relatively thin optical fiber having a level that can be interrogated by, for example, a light pulse train, wherein the system's control circuitry is configured to interpret such readings and make a jammed instrument determination, at least in part, based on these readings.

[0133] Figure 8 An instrument jamming architecture 800 according to one or more embodiments is illustrated. According to one or more embodiments of this disclosure, architecture 800 provides a framework (e.g., a feature recognition and / or force sensor analysis framework) for recognizing one or more instruments, anatomical structures, and / or stone / object features in endoscopic camera images and / or one or more robotic actuator / connector forces associated with one or more components of a robotic surgical system to dynamically determine / identify jammed instrument conditions based on their characteristics. Framework 800 may be embodied in a particular control circuitry system including one or more processors, data storage devices, connectivity features, substrates, passive and / or active hardware circuitry, chips / dies, etc. For example, framework 800 may be at least partially embodied in… Figure 2The control circuitry 251 and / or control circuitry 211 described above are shown in the diagram. Architecture 800 may employ machine learning capabilities to perform automated instrument entrapment determination / detection on ureteroscopic images of, for example, internal renal anatomy, where the images include certain instrument components and / or kidney stones or other objects. Additionally or alternatively, architecture 800 may employ machine learning capabilities to perform automated instrument entrapment determination / detection on, for example, robotic endoscope and / or basket actuator forces, as detailed herein.

[0134] Frame 800 can be configured to operate on specific image type data structures, such as image data representing at least a portion of a treatment site associated with one or more medical procedures and / or instrument components used in such procedures. In some embodiments, frame 800 can be configured to operate on robot actuator force distribution data, as described herein. Such input data / data structures can be manipulated in some way by a specific transformation circuitry 820 associated with the image processing portion of frame 800. Transformation circuitry 820 may include any suitable or desirable transformation and / or classification architecture, such as any suitable or desirable artificial neural network architecture.

[0135] The transformation circuit 820 can be trained based on known images and / or actuator / connector force distributions 812. For example, the image data may include representations of medical device components (e.g., baskets) or kidney stones or other objects as input / output pairs, and target labels 832 corresponding to the respective images 812, wherein the transformation / classification framework 820 is configured to adjust one or more parameters or weights associated therewith to correlate the known input and output image data. Additionally or alternatively, the data 812 may include robot actuator / connector force reading distributions, which may be provided as input to the transformation / classification framework 820, wherein the transformation circuit is configured to correlate the known force distributions with known stuck device output labels. For example, a labeled dataset and / or machine learning (e.g., a convolutional neural network) can be used to train the transformation circuit system 820. In some specific implementations, the machine learning framework may be configured to perform learning / training in any suitable or desirable manner.

[0136] The known target marker 832 can be generated at least in part by manually marking the image and / or force distribution as associated with or not associated with a stuck device condition. For example, manual marking can be determined by relevant medical experts and / or applied to mark, for example, the location of a basket-like component / structure in the image and / or whether the representation of the basket-like component / structure and / or force distribution indicates a stuck device condition. The known input / output pairs can indicate parameters of the transformation circuitry system 820, which can be dynamically updated in some embodiments.

[0137] The known stuck device marker 832 can identify the boundary and / or internal region of a target device feature present therein, and / or can indicate whether a related image corresponds to a stuck device condition. In some embodiments, the frame 800 can be configured to generate a real-time target marker 835 in a manner that allows a binary indication of whether a particular image and / or force distribution of the real-time data 815 indicates a stuck device condition.

[0138] The frame 800 may be further configured to use a trained version of the transformation circuit system 820 to generate a real-time target marker 835 associated with the real-time endoscopic image 815. For example, during the retraction of a medical device (e.g., a basket and / or endoscope) during a medical procedure, the transformation circuit 820 may be used to process the real-time endoscopic image showing the medical device to generate a real-time target marker 835 that identifies the presence of a stuck device in the real-time image. For example, in some implementations, the transformation circuit 820 may process a ureteroscope image to identify a stuck basket. User notification may be provided in response to the real-time stuck device marker determination 835.

[0139] The transformation framework 820 may include artificial neural networks, such as convolutional neural networks. For example, the framework 820 may implement a deep learning architecture that accepts an input image and assigns learnable weights / biases to various aspects / objects in the image to distinguish them from each other. The filters / features of the framework 820 may be hand-designed or learned through machine learning.

[0140] Frame 820 may include multiple neurons 825 (e.g., neuron layers, such as those corresponding to overlapping regions of the input image that cover visual regions of the input image) Figure 8(As shown). Frame 820 can be further manipulated to flatten the input image or portions thereof in some way. Frame 820 can be configured to capture spatial and / or temporal dependencies in the input image 815 by applying specific filters. Such filters can be performed in various convolutional operations to achieve the desired output data. Such convolutional operations can be used to extract features such as edges, contours, etc. Frame 820 can include any number of convolutional layers, with more layers providing recognition of higher-level features. Frame 820 may also include one or more merging layers, which can be configured to reduce the spatial size of the convolutional features, which can be used to extract rotationally and / or positionally invariant features, such as specific anatomical features. Once prepared through flattening, merging, and / or other processes, the image data can be processed by a multi-level perceptron and / or a feedforward neural network. Furthermore, backpropagation can be applied to each iteration of training. The frame can distinguish between major and specific low-level features in the input image and classify them using any suitable or desirable technique. In some implementations, the neural network architecture includes any of the following known convolutional neural network architectures: LeNet, AlexNet, VGGNet, GoogLeNet, ResNet, or ZFNet.

[0141] A sufficient amount of driving data (such as endoscopic image data) can be used to train the framework 800, where a truth table can be generated based on known labels of jammed and non-jammed instrument conditions. During operation, real-time images 815 and / or other driving information can be used as input to system 820 to provide real-time jammed instrument prediction / outcome as output 835.

[0142] Management process of stuck stones

[0143] Figure 9-1 and Figure 9-2 A flowchart illustrating a process 900 for managing stuck device conditions according to one or more embodiments is shown. Figure 10-1 and Figure 10-2 The diagram shows the correspondence with one or more embodiments. Figure 9-1 and Figure 9-2The process 900 is characterized by specific images of various frames, states, and / or operations associated with it. When performing process 900 of Figure 9, the user can provide certain control via a control system coupled to the robotic basket system (e.g., a robotic system having one or more instrument device manipulators (IDMs) coupled to it for controlling the basket assembly and / or endoscope). Such a control system can provide real-time endoscopic camera images and / or other information relevant to the procedure. In some embodiments, one or more aspects of process 900 may be implemented by control circuitry coupled to and / or associated with the robotic basket system's control system. Various force sensor readings associated with the various operational steps of process 900 may be provided by the robotic system, which may be configured to determine torque / force readings on one or more actuators of the robotic basket system.

[0144] At frame 901, process 900 involves capturing the stone within the patient's anatomical cavity using basket 35. For example, as... Figure 10-1 As shown in image 1001, a stone 80 can be captured in a region of the kidney anatomy beyond the ureteropelvic junction 78. At frame 902, procedure 900 involves retracting the endoscope 40 and / or basket 35 into the instrument-trapping danger zone 99, as... Figure 10-1 Image 1003 is shown.

[0145] The determination that the basket 35 has entered the instrument-clamping danger zone 99 may be based at least in part on one or more basket positioning mechanisms, which can be used to position the basket 35 within the anatomical structure and / or at certain stages of the procedure. The danger zone 99 may include, for example, the ureteropelvic junction 78 and / or the area immediately distal / anterior to the opening 93 of the access sheath 90. The determination that the basket 35 is in the danger zone 99 can be achieved in any suitable or desired manner. In some embodiments, the position of the basket 35 may be indicated by commands from a robotic system controlling the endoscope 40 and / or the basket 35. For example, additional known information relating to the position of the endoscope 40 relative to the distal end 93 of the sheath 90 may provide information indicating the position of the basket 35 and / or the distal end of the endoscope 40. The position of the basket 35 may be determined using any suitable or desired positioning mechanism. In some implementations, basket jerking and / or basket positioning may be triggered when basket 35 and / or endoscope 40 enter the ureteropelvic junction 78 and / or danger zone 99. In some specific implementations, basket positioning and / or basket jerking may be automatically triggered in response to confirmation of successful capture of gem 80.

[0146] At frame 904, process 900 involves activating the jitter of basket 35, such as... Figure 10-1Image 1005 illustrates this. Such jittering can advantageously improve the sensitivity of force sensor readings associated with one or more actuators / connectors of the robotic mechanism used to control the endoscope 40 and / or basket device 30. The jittering can be implemented according to any of the embodiments disclosed herein. For example, jittering can involve relatively slow movement of the basket 35 relative to the endoscope 40 during propulsion and retraction. The jittering distance can advantageously be relatively short to minimize the impact of jittering on user control / experience. The implemented jittering speed can be set to a speed slower than the normal drive speed of the endoscope 40. Furthermore, the jittering distance can be set as a fraction of the entire basket travel range / distance to avoid interfering with or confusing the operating physician / technician during basket retraction.

[0147] Although the flowchart in Figure 9 depicts the retraction of the basket 35 into the danger zone 99, in some embodiments, basket jerking and / or other jamming instrument detection functions may be automatically triggered when the stone 80 is captured by the basket 35, and / or such functions may be deactivated once the basket 35 has safely entered the access sleeve 90. In some embodiments, jamming basket determination based on force readings from sensors associated with robot control actuators or couplings can be achieved without basket jerking. That is, any embodiment of jamming instrument determination disclosed herein can be performed / implemented with or without basket jerking.

[0148] In some implementations, certain preventative measures / functions can be implemented to prevent instrument jamming. For example, some implementations provide a mechanism in which a robotic system is configured to cause a basket to slide / propel forward in a manner mimicking or similar to manual basket adjustment when a jamming force is detected. In this way, the jamming force, which could potentially cause physiological and / or instrument damage, can be set to be greater than such a sliding force, wherein after a jamming condition has been detected, the user can manually resolve the jamming condition and return the basket to a non-sliding position.

[0149] At frame 906, process 900 involves retracting the distal end of basket 35 and / or endoscope 40 through the ureteropelvic junction / ureteral transition region / orifice. For example, as shown in image 1005, retraction associated with the operation of frame 906 can be performed when basket 35 is vibrating, which can provide the desired sensor sensitivity for jammed instrument detection. If a force detected at one or more actuators associated with basket 30 and / or endoscope 40 indicates a jammed instrument condition, process 900 can proceed to frame 910, where some jammed instrument remedy action can be performed.

[0150] Jammed device detection can be based on one or more torque / force readings on one or more axes / actuators associated with the robotic basket loading system, such as the torque / force experienced at the basket insertion driver / actuator (e.g., engaging with the basket sheath). In some implementations, the determination of a jammed device condition can be based on determining that the basket insertion axis force experienced at one or more actuators associated with the basket sheath and / or basket teeth is greater than a predetermined threshold duration. For example, in some implementations, when a first force and / or time threshold is met, remedial action involves slowing the endoscope retraction speed to allow sufficient time for the jammed device detection function to be realized and / or reducing the force generated by the jammed basket to reduce the magnitude and / or risk of resulting injury. In some implementations, after the retraction speed has been slowed, if the basket force continues to increase beyond another predetermined threshold level (such as a failure threshold level), endoscope retraction can be paused to prevent damage and allow correction of the jammed device condition.

[0151] In one embodiment, the remedial action associated with frame 910 involves pausing / stopping endoscope retraction in response to an identified instrument jamming condition. Such action can be used to prevent or reduce the risk of user error, such as when a physician / technician does not give sufficient attention to the endoscopic image and / or tactile sensation of the instrument while retracting endoscope 40 and / or basket 30.

[0152] When it is determined that there is no stuck instrument condition, process 900 proceeds to frame 908, wherein the distal end of basket 35 and / or endoscope 40 is retracted into access sleeve 90 through distal opening 93 of access sleeve. If a stuck instrument condition is detected in conjunction with the retraction into sleeve 90, process 900 may proceed to frame 910, wherein remedial actions associated with the stuck instrument condition may be performed in any suitable or desired manner.

[0153] The remedial action associated with box 910 allows the user to clear a stuck instrument malfunction, reposition the basket / stone, and, where possible, continue retraction. Following a remedial action in box 910, process 900 may continue to any subsequent steps of the process and / or may cause the process to terminate at box 916. Following a successful remedial action in conjunction with box 910, further force readings exceeding a relevant threshold level may cause a re-triggering of the remedial action at box 910 and / or a return to that remedial action.

[0154] At box 912, process 900 involves deactivating basket jitter. For example, this jitter deactivation can be triggered by determining that the distal end of basket 35 and / or endoscope 40 has entered the access sleeve 90. At box 914, process 900 involves retracting the basket through the access sleeve 90. In some embodiments, this retraction through the access sleeve 90 can be accelerated. That is, once inside the access sleeve 90, the retraction speed can be increased to reduce procedure time and / or for other purposes related to convenience and / or efficiency. Once the basket has been retracted through the access sleeve 90, process 900 may terminate at box 916.

[0155] Figure 11 This is a flowchart illustrating a process 600 for handling a stuck instrument situation according to one or more embodiments. At block 602, process 600 involves retracting a basket in which an object (e.g., a stone) is trapped towards the ureteral inlet sheath. For example, the basket may be retracted together with the endoscope, wherein the basket is positioned within the working channel of the endoscope.

[0156] At box 604, process 600 involves determining whether the basket is in a jammed instrument condition based on force readings from sensors associated with the robotic endoscope and / or basket control actuators. For example, the determination at box 604 may involve determining that the force readings at one or more actuators of the basket system are greater than a predetermined jammed instrument detection threshold. In some embodiments, the determination at box 604 may be performed while the basket is operating with a jittery motion, which can provide relatively higher sensitivity for jammed instrument detection / determination, as described in detail herein.

[0157] The determination of whether the force experienced at one or more actuators of the basket loading system and / or robotic system indicates a stuck device condition may be supplemented and / or informed by certain other information / data related to the procedure and / or the user. For example, information related to the patient's specific anatomy, the operator's driving behavior, and / or stone size information may be used as input to determine, in conjunction with decision box 604, whether the current condition indicates a stuck device condition. In some embodiments, the control circuitry configured to determine a stuck device condition may be at least partially adaptive and configured to predict possible stuck device conditions and adjust the input parameters associated with such determination to further improve the accuracy of stuck device detection.

[0158] If the force readings analyzed in box 604 indicate a jammed device condition, a timer can be started at box 605. The timer can run for a period of time until the force readings exceed a relevant threshold. That is, the time period associated with box 605 corresponds to the period during which the force readings associated with one or more actuators of the robotic basket loading system remain above the jammed device threshold level.

[0159] If the force applied to the relevant actuator remains above a predetermined threshold for a period of time greater than a fault threshold, as determined at decision box 607, process 600 may proceed to box 608. For example, if the amount of time the force on the basket and / or endoscope, as indicated by the stuck instrument timer, exceeds the stuck instrument threshold is greater than the fault threshold, a minor fault may be thrown, in which the operator is not allowed to further retract the basket / endoscope until the stuck instrument condition is resolved at box 608.

[0160] If the force on the actuator is greater than the jammed device threshold for a period of time that is not long enough to trigger the fault condition associated with box 608, but is greater than a predetermined warning threshold, then process 600 proceeds to box 610, where a warning or other notification may be generated and / or provided to the user to indicate the jammed device condition and / or its risk. Such a warning may prompt the operator / user to adjust the basket and / or carefully continue the basket's retraction.

[0161] In addition to providing user warnings, in some implementations, process 600 involves reducing the retraction speed of the endoscope and / or basket assembly in response to one or more of the following: determination of a jammed instrument condition at frame 604, determination of a timer period exceeding a warning threshold at frame 609, and / or determination of a timer period exceeding a fault threshold at frame 607. Reducing the retraction speed helps prevent forces from peaking before there is sufficient time to stop retraction and prevents physiological and / or instrument damage. In some implementations, the jammed instrument timer may be reset whenever the detected force drops below a predetermined jammed instrument force threshold to reduce the risk that noise data will be filtered and a single peak in the basket force will trigger a false alarm. At frame 612, process 600 involves retracting the basket and endoscope into the access sleeve.

[0162] If a stuck device condition is met at either box 607 or 609, or if no stuck device condition is determined at box 604, process 600 may proceed to box 606, whereby a stuck device timer is stopped if it is currently running. At decision box 611, process 600 involves determining whether the distal end of the basket and / or endoscope is within the stuck device danger zone. If so, process 600 involves activating basket jitter according to various aspects of the present disclosure at box 613. If the distal end of the basket and / or endoscope is not yet within the stuck device danger zone, process 600 may return to box 602, where retraction of the basket / endoscope toward the ureteral entry sheath continues.

[0163] False alarm handling

[0164] Figure 12This is a flowchart illustrating a process 1200 for managing false alarm sensor readings on the insertion axis of a basket device according to one or more embodiments. At block 1202, process 1200 involves capturing stones within a patient's kidney using a basket device. For example, fragments of a plurality of stone fragments may be captured. Stones may be captured by actuating an open axis of the basket device, which can be controlled by extending and / or retracting the serrations / lines from and / or retracting into the sheath of the basket device. Stone capture may also involve actuating the insertion axis of the basket device, which may result in actuation of the sheath of the basket, thereby causing insertion and / or retraction of the basket relative to an endoscope in which (e.g., within the working channel of an endoscope) the basket device is disposed.

[0165] At sub-process block 1204, process 1200 involves retracting the endoscope and basket while jigglering the basket relative to the distal end of the endoscope, as described in detail herein. This jiggle can be performed within the choking danger zone, where the jigging process is implemented for choking stone detection, as described in detail throughout this disclosure. Endoscope retraction can involve retracting the endoscope and basket proximally within an access sheath (e.g., a ureteral access sheath) and / or retracting a distance distal / lateral to the distal end / opening of the access sheath, during which the basket insertion axis can be jiggled forward and backward to provide better sensitivity for choking instrument detection, as described in detail above. Generally, the jiggle distance / range of motion can be set to a relatively small distance so that it is not noticeable to the user, while still producing dynamic movement of the basket insertion axis to provide improved sensitivity for choking instrument detection.

[0166] At frame 1206, it is determined whether a lifting force is detected on the insertion axis associated with the basket assembly. For example, one or more force sensors associated with the sheath of the basket assembly may indicate a lifting force that could potentially indicate a stuck stone condition. The insertion axis may be associated with a slider / actuator of the handle / cabin associated with the basket assembly, wherein the slider actuator may be configured to control the insertion and retraction of the basket and / or its sheath relative to the endoscope when the basket is positioned within the working channel of the endoscope.

[0167] As described in detail above, torque sensing of a robotic manipulator (e.g., a robotic instrument device manipulator (IDM), end effector, etc.) can be used as an input source for jammed instrument detection. For example, jammed instrument detection functionality according to various aspects of this disclosure can be implemented to detect peak / level of insertion axis force that may occur when a genuine jammed instrument condition exists, such that the user can be notified of a potential jammed instrument condition before damage or injury to the instrument and / or anatomical structure occurs. Elevation force detection associated with block 1206 may involve the force on the insertion axis rising sufficiently high to reach a threshold level at which endoscope deceleration can, in some cases, be implemented as a jammed instrument remedial action; the endoscope retraction speed can be reduced to prevent the insertion axis force from rising too quickly to allow the system to throw a fault that triggers a jammed instrument remedial action. If no elevation force is detected on the insertion axis at block 1206, process 1200 proceeds to block 1216, where captured stones, such as those proximal to the access sheath used to access the target anatomical structure, are collected.

[0168] If a lifting force is detected on the insertion axis at box 1206, process 1200 proceeds to decision box 1208, where it is determined whether a soft stop position (e.g., a soft stop position providing a buffer distance from a possible hard stop position) has previously been set relative to the insertion axis (e.g., a soft stop position associated with the movement of the insertion axis slider / actuator). For example, a soft stop position can serve as a software limitation on the movement (e.g., proximal and / or retraction movement) of the basket slider / actuator configured to control the insertion axis (e.g., basket sheath insertion / retraction). Therefore, if a soft stop position has already been set, jitter and / or other movements (e.g., retraction) of the insertion axis of the basket loading device can be artificially limited to a location that is not a physical hard stop position. In some specific implementations, the detection of a lifting force on the insertion axis triggers the recording / setting of a hard stop insertion axis actuator position for future reference as a position associated with a potential physical hard stop.

[0169] If a soft stop position has been previously set, process 1200 proceeds to box 1210, where a jammed instrument remediation action is performed. That is, if a lifting force is detected on the insertion axis after a soft stop position has been previously set, the lifting force on the insertion axis indicates a true jammed instrument condition, thus ensuring a remediation action. The jammed instrument remediation action may involve slowing endoscope retraction to prevent the insertion axis force from rising too quickly to allow the system to trigger a malfunction. If the insertion axis force continues to rise while slow endoscope retraction is achieved, a jammed instrument warning / malfunction may be triggered to notify the user of the potential jammed instrument condition and to trigger an interruption / stop of endoscope retraction. The jammed instrument remediation action may involve requesting confirmation from the user / physician regarding the jammed instrument condition and / or their decision.

[0170] If the soft stop position has not been previously set / recorded, certain operations can be performed at frame 1206 to determine whether the lift force detected on the insertion axis indicates a false alarm condition that is not actually a result of a jammed instrument condition, but may be caused by contact between the insertion axis actuator and a physical hard stop. For example, the slider / actuator may strike a physical restraint (e.g., a rear / proximal restraint) of the track in which it slides / actuates. The basket loading device / system may include a proximal basket loading compartment / handle comprising one or more actuators, such as an insertion axis actuator and / or an open axis actuator (controlling the movement of the basket teeth within the basket sheath, referred to below). Figure 19 and Figure 20 (Described in more detail). When the basket / handle is coupled or engaged with a robot manipulator (e.g., an end effector), the position of the actuators can be unknown or can be in arbitrary or offset positions, such that they may or may not be within close range of a hard stop position in their respective orbits during various stages of process 1200. Thus, when a force to raise the insertion axis is sensed and a soft stop position has not previously been set, process 1200 proceeds to frame 1212, where the insertion axis and / or basket can be biased forward by a predetermined distance / amount relative to the endoscope. That is, the basket can be advanced forward by an amount (e.g., a nominal amount) to offset the basket and associated actuators from the position where the force to raise the insertion axis is detected. In the case where the raising force is caused by contact with a hard stop on the insertion axis, the forward bias of the insertion axis can cause the insertion axis actuators to move further away from the true hard stop boundary, resulting in the basket protruding relatively further from the distal end of the endoscope.

[0171] In addition to advancing / biasing the basket relative to the distal end of the endoscope, process 1200 may involve setting a soft stop position at frame 1214 associated with the position of the insertion axis / basket when a lifting force is detected on the insertion axis. For example, the soft stop position may be at a determined / suspected hard stop position, or the recorded soft stop position may be advantageously positioned a buffer distance away from the determined / suspected hard stop position (i.e., a soft stop buffer). That is, the set / recorded soft stop position may be a position distal (i.e., further insertion) relative to the basket position at the time / point of detection of the lifting force. The soft stop position can thus be set at a location that provides a buffer between the soft stop position and a potential hard stop position where a lifting force is detected. Setting the soft stop prevents the insertion axis actuator from moving to the position where a lifting insertion axis force is detected, which may be associated with a physical hard stop of the insertion axis actuator / slider.

[0172] In addition to setting a soft-stop position and / or as a result of setting a soft-stop position, process 1200 may further include, as a way of determining whether the lifting force on the insertion axis originates from a hard stop of the insertion axis actuator / slider and thus potentially as a false reading that does not indicate a true jammed instrument condition, shifting the range of jitter motion forward to achieve this when the basket is jittered away from the soft-stop position. The modified jitter zone may be limited at one end (e.g., the proximal end) by the recorded soft-stop position and / or the identified hard-stop position.

[0173] After the basket is forward biased, a soft stop position is set, and / or the jitter area is forward shifted, process 1200 can return to subprocess 1204, where the basket and endoscope are retracted while the basket jitter is achieved, or process 1200 can proceed to a jammed instrument recovery operation at frame 1210. Although Figure 12 The flowchart describes subprocess 1204 as involving basket jitter, but it should be understood that process 1200 can be implemented without basket jitter and / or displacement of the jitter area. Process 1200 can continue from subprocess 1204, where, since a soft stop position has been previously established, if a lifting force is subsequently detected on the insertion axis at block 1206, process 1200 will proceed to a remedial action operation at block 1210, where this lifting force can be interpreted as an indication of a real jammed instrument condition. If no further lifting force is detected after forward biasing the insertion axis / basket, it can be determined that the previously detected lifting force is associated with a real hard stop condition relative to the insertion axis actuator. In some specific implementations, the hard stop position relative to the insertion axis can be recorded / maintained in some way, at least for the duration of the connection between the basket / handle and the robot manipulator (e.g., end effector) until it is disengaged.

[0174] After collecting the captured stones at box 1216, it can be determined at box 1218 whether additional stones and / or stone fragments should be collected. If so, the process proceeds to box 1220, where any previously set soft stop positions can be cleared / reset, and / or the jitter area can be returned / reset to the default range / zone. At box 1222, the endoscope and basket are inserted back into the target anatomical structure, after which additional stones / fragments are captured at box 1202.

[0175] Figure 13This is a flowchart illustrating a process 1300 for managing false alarm sensor readings on the insertion axis of a basket device according to one or more embodiments. At block 1302, process 1300 involves capturing stones within a patient's kidney using a basket device. For example, fragments of a plurality of stone fragments may be captured. Stones may be captured by actuating an open axis of the basket device, which can be controlled by extending and / or retracting the serrations / lines from and / or retracting into the sheath of the basket device. Stone capture may also involve actuating the insertion axis of the basket device, which may result in actuation of the sheath of the basket, thereby causing insertion and / or retraction of the basket relative to an endoscope in which (e.g., within the working channel of an endoscope) the basket device is disposed.

[0176] Further reference Figure 13 The steps 1305 and 1307 of process 1300 can be implemented to reset the jitter zone of the basket assembly by jitter actuation relative to the insertion axis of the basket assembly if the user has moved the basket outside (or inside) the initially set jitter zone. At decision block 1305, it is determined whether the user has inserted or retracted the basket from the default position. For example, the determination at block 1305 may involve determining whether the user has actuated the insertion axis of the basket assembly, such as by manually or robotically manipulating the insertion axis actuator / slider. For example, when the endoscope is retracted, the basket can typically jitter within a predetermined jitter zone / range. If the user inserts or retracts the basket for some reason unrelated to the jittering motion of the basket and subsequently continues endoscope retraction, it may be desirable to modify the range of the jitter zone.

[0177] If the basket has been inserted or retracted by the user, process 1300 can proceed to box 1307, where the jitter area of ​​the basket can be modified / set to compensate for the insertion or retraction of the basket by the user. For example, if the user has inserted the basket a certain amount, the jitter area can be moved forward by a corresponding amount; a similar modification can be made for the case of retraction.

[0178] At sub-process block 1304, process 1300 involves retracting the endoscope and basket while jigglering the basket relative to the distal end of the endoscope, as described in detail herein. This jiggle can be performed within the danger zone of a stuck instrument, wherein the jiggle process is implemented for the detection of stuck stones, as described in detail throughout this disclosure. Endoscope retraction can involve retracting the endoscope and basket together proximally within an access sheath (e.g., a ureteral access sheath) for accessing the target anatomical structure and / or retracting a distance distal / lateral to the distal end / opening of the access sheath, during which the basket insertion axis can be jiggled forward and backward to provide better sensitivity for detecting stuck instruments, as described in detail above. Generally, the jiggle distance / range of motion can be set to a relatively small distance so that it is not noticeable to the user, while still producing dynamic movement of the basket insertion axis to provide improved sensitivity for detecting stuck instruments. Although Figure 13 The flowchart describes subprocess 1304 as involving basket jitter, but it should be understood that process 1300 can be implemented without basket jitter and / or shifting the jitter area.

[0179] At frame 1306, it is determined whether a lifting force is detected on the insertion axis associated with the basket assembly. For example, one or more force sensors associated with the sheath of the basket assembly may indicate a lifting force that could potentially indicate a stuck stone condition. The insertion axis may be associated with a slider / actuator of the handle / cabin associated with the basket assembly, wherein the slider actuator may be configured to control the insertion and retraction of the basket and / or its sheath relative to the endoscope when the basket is positioned within the working channel of the endoscope.

[0180] As described in detail above, torque sensing of a robotic manipulator (e.g., a robotic instrument device manipulator (IDM), end effector, etc.) can be used as an input source for jammed instrument detection. For example, jammed instrument detection functionality according to various aspects of this disclosure can be implemented to detect peak / level of insertion axis force that may occur when a genuine jammed instrument condition exists, such that the user can be notified of a potential jammed instrument condition before damage or injury to the instrument and / or anatomical structure occurs. Elevation force detection associated with block 1306 may involve the force on the insertion axis rising sufficiently high to reach a threshold level at which endoscope deceleration can, in some cases, be implemented as a jammed instrument remedial action; the endoscope retraction speed can be reduced to prevent the insertion axis force from rising too quickly to allow the system to throw a fault that triggers a jammed instrument remedial action. If no elevation force is detected on the insertion axis at block 1306, process 1300 proceeds to block 1316, where captured stones, such as those proximal to the access sheath used to access the target anatomical structure, are collected.

[0181] If a rising force is detected on the insertion axis at box 1306, process 1300 proceeds to decision box 1308, where it is determined whether a hard stop position (e.g., a hard stop position associated with movement of the insertion axis slider / actuator) has been previously set / recorded relative to the insertion axis. The referenced hard stop position may be an actual confirmed physical hard stop limit or another position limit identified as a potential hard stop limit.

[0182] If a hard stop position has been previously set, process 1300 proceeds to box 1310, where a jammed instrument remediation action is performed. That is, if an elevation force is detected on the insertion axis after a hard stop position has been previously recorded, the elevation force on the insertion axis indicates a true jammed instrument condition and thus warrants a remediation action. The jammed instrument remediation action may involve slowing endoscope retraction to prevent the insertion axis force from rising too quickly to allow the system to trigger a malfunction. If the insertion axis force continues to rise while slow endoscope retraction is achieved, a jammed instrument warning / malfunction may be triggered to notify the user of the potential jammed instrument condition and to trigger an interruption / stop of endoscope retraction. The jammed instrument remediation action may involve requesting confirmation from the user / physician regarding the jammed instrument condition and / or their decision.

[0183] If no hard stop limits / positions have been previously set / recorded, certain operations can be performed to account for the possibility that a raised force detected at frame 1306 on the insertion axis indicates a false alarm condition that is not actually a result of a jammed instrument condition, but may be caused by contact between the insertion axis actuator and the physical hard stop. For example, the slider / actuator may strike a physical constraint (e.g., a rear / proximal constraint) on the track in which it slides / actuates. The basket loading device / system may include a proximal basket loading compartment / handle comprising one or more actuators, such as an insertion axis actuator and / or an open axis actuator (for controlling the movement of the basket teeth within the basket sheath, referred to below). Figure 19 and Figure 20(Described in more detail). When the basket / handle is coupled or engaged with a robot manipulator (e.g., an end effector), the position of the actuators can be unknown or can be in arbitrary or offset positions, such that they may or may not be within close proximity to the hard stop position in their respective orbits during various stages of process 1300. Thus, when a force to raise the insertion axis is sensed and a potential hard stop limit position has not been previously set, process 1300 proceeds to frame 1312, where the insertion axis and / or basket can be biased forward by a predetermined distance / amount relative to the endoscope. That is, the basket can be advanced forward by an amount to offset the basket and associated actuators from the position where the force to raise the insertion axis is detected (i.e., the potential hard stop limit). In the case where the raising force is caused by contact with a hard stop on the insertion axis, the forward bias of the insertion axis can cause the insertion axis actuators to move further away from the actual hard stop boundary, resulting in the basket protruding relatively further from the distal end of the endoscope. The forward bias of the basket can provide a buffer (or greater buffer) for the basket relative to the proximal physical hard stop of the insertion axis.

[0184] In addition to advancing / biasing the basket relative to the distal end of the endoscope, process 1300 may involve recording a potential hard stop position at frame 1314 associated with the position of the insertion axis / basket when a lifting force on the insertion axis is detected. Process 1300 may also involve forward-shifting the jitter zone / range of motion to accommodate jittering the basket to a more distal region. This distance may be a buffer distance away from the recorded hard stop position, such that the proximal limit of the jitter zone / range is a soft stop position separated from the hard stop position by a buffer distance. After recording the potential hard stop position, the recorded hard stop position may be modified accordingly if it is subsequently determined that the insertion axis can be driven beyond such limits without physical hard stop.

[0185] After forward biasing of the basket, recording of the hard stop position, and / or forward displacement of the jitter zone, process 1300 may proceed to the remedial action associated with frame 1310 and ultimately further allow continued retraction of the endoscope in conjunction with frame 1304. Process 1300 may continue from subprocess 1304, where, since the hard stop position has been previously recorded, if a lifting force is subsequently detected on the insertion axis at frame 1306, process 1300 will proceed to the remedial action at frame 1310, where this lifting force can be interpreted as an indication of a true instrument jamming condition. If no further lifting force is detected after forward biasing of the insertion axis / basket, process 1300 may continue to collection without incident. At frame 1310, the system may throw a fault, which the user can then verify (frame 1311) to confirm the existence of a true instrument jamming condition. Once the fault is verified, the user can be allowed to actuate the endoscope again (e.g., return to frames 1302 or 1304).

[0186] After collecting the captured stones at box 1316, it can be determined at box 1318 whether additional stones and / or stone fragments need to be collected. If so, the procedure can proceed to box 1322, where the endoscope and basket are inserted back into the target anatomical structure, after which additional stones / fragments are captured at box 1302.

[0187] Figure 14 This is a diagram illustrating the remedial action of hard stop force detection according to one or more implementation schemes. Figure 14 The diagram includes a time axis and an insertion axis. The time axis moves from the top of the page to the bottom, in which time progresses, while the insertion axis travels from left to right and increases, representing the relative distance of the basket to the distal end of the endoscope. The zigzag motion of line 1401 indicates the jittering motion of the basket relative to the endoscope caused by the actuation of the insertion axis actuator / slider, as described in detail herein. During the first time window 1409, the jittering motion of the basket is within a predetermined jittering zone / range of motion 1405.

[0188] At point 1402, representing a specific time point in time at which the basket and / or the corresponding basket insertion position 1403 vibrates, a lifting force is detected on the insertion axis. This lifting force may be caused by a genuine jamming condition of the instrument, or it may be a false reading caused by the insertion axis actuator / slider striking a physical hard stop position. For example, the slider / actuator may strike the back of the track in which it slides / actuates / is physically restrained. In response, the location where the lifting force on the insertion axis is detected may be stored, set, and / or otherwise recorded as a hard stop position.

[0189] In response to the detected lifting force on the insertion axis, the basket can be biased forward by a distance equal to the distance shown. D 1 And / or related thereto, wherein this forward offset of the basket is represented by at least a portion of line segment 1407 and / or line segment 1408. A soft stop insertion axis position 1404 can be set and / or forced / enabling, wherein this soft stop basket insertion position 1404 can be the same as the hard stop position 1403, or can be forward offset relative to the hard stop position 1403 by a distance. D 1 As shown in the figure. In addition, the jitter area / range of motion for jittering the basket can be forward biased as a modified area / range 1406, wherein the modified jitter area / range 1406 can be determined and / or positioned such that the nearest side insertion position during the associated jittering action does not cross the soft stop boundary 1404.

[0190] Figure 15A flowchart illustrating a process 1500 for adjusting a jitter zone / range according to one or more embodiments of the present disclosure is shown, such as that which may be implemented in conjunction with processes 1200 and 1300 described above. Figure 16 The diagram shows the correspondence with one or more embodiments. Figure 15 The process involves 1500 associated images of various boxes, states, and / or operations. Figure 16 In the diagram, the single-sided arrow can indicate the movement of the basket, such as the movement relative to the endoscope 103.

[0191] Process 1500 provides adjustment of the jitter zone, such as when the jittering motion of the basket travels along the basket insertion axis to a distal hard stop during endoscope retraction. For example, frame 1502 involves the user retracting the endoscope while jittering the basket; the user may or may not be aware of the basket jittering because it is automatically performed as a response system process. Figure 1602 shows the distal end of the basket serration 101 and / or basket sheath 102 jittering in the jitter zone. The distal end 102 of the basket sheath and / or one or more portions of the basket 101 distal to the sheath 102 are referred to hereinafter as basket 104; such references may refer to any such component / part.

[0192] At box 1504, process 1500 involves detecting a hard stop during forward insertion of the basket in conjunction with a jerking motion. For example, it is understood that the increased insertion axis force reading generated during basket insertion may or certainly be a result of actuator hard stop contact; a true stone-jammed condition during basket insertion may not typically generate relatively high forces. At box 1505, process 1500 involves recording the insertion axis position 105 associated with the hard stop.

[0193] At frame 1506, process 1500 involves adjusting the jitter zone proximally. In some embodiments, this jitter zone adjustment may include a buffer between the hard stop position 105 and the distal end 106 of the adjusted jitter zone. For example, with respect to the adjusted jitter zone, the insert axis may be driven rearward a distance to release tension on the actuator of the insert axis actuator (e.g., a robot manipulator / end effector actuator driven in a drive engagement manner with the input of the basket / handle). Distance D 2 This can be considered a soft stop buffer, meaning that the basket 104 is driven back to release tension on the device and prevent continuous impacts to the physical limits of the device / system.

[0194] Figure 17 A flowchart illustrating a process 1700 for adjusting a jitter zone / range according to one or more embodiments of the present disclosure is shown, such as that which may be implemented in conjunction with processes 1200 and 1300 described above. Figure 18 The diagram shows the correspondence with one or more embodiments. Figure 17 The process 1700 is associated with various frames, states, and / or operations in certain images. Figure 18 In the diagram, the single-sided arrow can indicate the movement of the basket, such as the movement relative to the endoscope 103.

[0195] Process 1700 provides adjustment of the jitter zone, such as when the jittering motion of the basket travels along the basket insertion axis to a proximal hard stop during endoscope retraction. For example, frame 1702 involves the user retracting the endoscope while jittering the basket; the user may or may not be aware of the basket jittering because it can be performed automatically as a response system process. Figure 1802 shows the distal end of the basket serration 101 and / or basket sheath 102 jittering in the jitter zone. The distal end 102 of the basket sheath and / or one or more portions of the basket 101 distal to the sheath 102 are referred to hereinafter as basket 104; such references may refer to any such component / part.

[0196] At frame 1704, process 1700 involves changing the jitter direction from forward insertion to backward retraction as the basket 104 reaches the distal end boundary of the jitter area. At frame 1706, process 1700 involves detecting a hard stop as the basket retracts backward in conjunction with the jitter motion. At frame 1705, process 1700 involves recording the insertion axis position 107 associated with the hard stop.

[0197] At frame 1706, process 1700 involves adjusting the jitter zone distally. In some embodiments, this jitter zone adjustment may include a buffer between the hard stop position 107 and the proximal end 108 of the adjusted jitter zone. For example, with respect to the adjusted jitter zone, the insert axis may be driven forward a distance to release tension on the actuator of the insert axis actuator (e.g., a robot manipulator / end effector actuator driven in a drive engagement manner with the input of the basket / handle). Distance D 3 This can be considered a soft stop buffer, meaning that the basket 104 is driven forward to release tension on the device and prevent continuous impacts to the physical limits of the device / system.

[0198] Figure 19This is a flowchart illustrating a process 1900 for managing false alarm sensor readings on the open axis according to one or more embodiments. As described above, a stuck device condition can result in relatively high forces being transmitted to the basket open axis, and therefore, monitoring forces on the open axis in conjunction with stuck device management can be advantageous relative to any embodiment of this disclosure. For example, an actuation of a basket slide / actuator configured to actuate basket teeth relative to the basket sheath can be implemented for stone capture. As described above, such actuation can be considered "open axis" actuation, wherein the forces and actuation associated therewith are considered to be on the "open axis" of the basket loading system.

[0199] At frame 1902, process 1900 relates to capturing stones or stone fragments via a basket device deployed from the working channel of an endoscope (referred to herein as a "scope" for convenience). For example, capturing stones via a basket may involve manipulating the open axis of the basket device to pull one or more wire teeth or other basket components into (or out of) the basket sheath and / or around the captured stone. Closure of the basket teeth around the endoscope may be achieved at least in part by actuating a basket slider / actuator proximally (or otherwise), wherein such actuators may be associated with and driven by a basket compartment associated with the proximal portion of the basket device / system. In some cases, when closing the basket teeth around the stone / fragment, the teeth wedge against the sides of the basket sheath in a manner that reduces the amount of force sensed on the open axis. However, in some cases, the fangs may not close tightly enough around the captured stone fragment, resulting in greater sensitivity to force readings on the open axis; in some such cases, a jammed instrument condition may be felt on the open axis.

[0200] In box 1904, process 1900 involves retracting the endoscope and basket together proximally toward and / or into the distal opening of the sheath through which the endoscope and basket enter the target anatomical chamber / location. Determination box 1906 involves whether a lifting force is detected on the open axis of the basketing system during the retraction of box 1904. For example, the basketing device / system may include one or more force sensors associated with the open axis and configured to generate signals indicating forces experienced on the open axis, such as a pulling force on the basket teeth.

[0201] If no lifting force is detected on the open axis, process 1900 may proceed to complete the retraction of the endoscope and basket and combine with the operation associated with frame 1912 to collect the stones / fragments. If additional stones / fragments still need to be collected, as indicated at decision frame 1919, the process may involve reinserting the endoscope and basket into the target anatomical chamber (e.g., the calyx of the kidney) through the sheath, as indicated at frame 1918, and further cycle back to subprocess 1902 involving further capture of one or more additional stones / fragments through the basket.

[0202] If a lifting force is detected on the open axis during retraction of the endoscope and basket, as determined at frame 1906, the process can continue to frame 1908, where it can be determined whether the open axis is currently in a forward-biased position. For example, forward bias of the open axis (e.g., basket teeth) may have been previously achieved in conjunction with a previously detected lifting force on the open axis.

[0203] If the open axis was not previously forward biased, as determined at box 1908, process 1900 may proceed with certain operations designed to identify and / or manage the possibility that a lifting force detected on the open axis is associated with a false alarm condition that does not indicate a true instrument jamming condition, such as the open axis actuator / slider contacting a hard stop during retraction of the endoscope and basket. Such operations may include, for example, forward biasing of the open axis, such as by actuating the open axis actuator / slider in the forward / distal direction to a predetermined distance, such as 1-5 mm, 5-10 mm, or greater, as shown at box 1910. Forward biasing of the open axis may be considered and / or implemented as setting a soft stop position associated with the forward bias position of the open axis and driving it to this position.

[0204] After forward biasing the open pathway, process 1900 may return to the retraction operation 1904 and / or stone capture operation 1902 of process 1900. If a lifting force is detected on the open axis after forward biasing of the open axis at box 1910 during stone capture and / or endoscope / basket retraction, the path from decision box 1908 may proceed to box 1916 associated with remedy for the stuck instrument. For example, if a lifting force is detected on the open axis after preventative forward biasing of the open axis actuator has been performed, the lifting force can be determined to indicate a true stuck instrument condition, and therefore process 1900 may continue to perform the operation associated with the remedy for the stuck instrument condition, as described in detail in this area.

[0205] Figure 20This is a flowchart illustrating a process 2000 for managing false alarm sensor readings on the open axis according to one or more embodiments. As described above, a stuck device condition can result in relatively high forces being transmitted to the basket open axis, and therefore, monitoring forces on the open axis in conjunction with stuck device management can be advantageous relative to any embodiment of this disclosure. For example, an actuation of a basket slide / actuator configured to actuate basket teeth relative to the basket sheath can be implemented for stone capture. As described above, such actuation can be considered "open axis" actuation, wherein the associated forces and actuation are considered to be on the "open axis" of the basket loading system.

[0206] At box 2002, process 2000 relates to capturing stones or stone fragments via a basket device deployed from the working channel of an endoscope (referred to herein as a "scope" for convenience). For example, capturing stones via a basket may involve manipulating the open axis of the basket device to pull one or more wire teeth or other basket components into (or out of) the basket sheath and / or around the captured stone. Closure of the basket teeth around the endoscope may be achieved at least in part by actuating a basket slider / actuator proximally (or otherwise), wherein such actuators may be associated with a basket compartment and driven by a robotic manipulator, and associated with a proximal portion of the basket device / system. In some cases, when closing the basket teeth around the stone / fragment, the teeth wedge against the sides of the basket sheath in a manner that reduces the amount of force sensed on the open axis. However, in some cases, the fangs may not close tightly enough around the captured stone fragment, resulting in greater sensitivity to force readings on the open axis; in some such cases, a jammed instrument condition may be felt on the open axis.

[0207] In box 2004, process 2000 involves retracting the endoscope and basket together proximally toward and / or into the distal opening of the sheath through which the endoscope and basket enter the target anatomical chamber / location. Determination box 2006 involves whether a lifting force (e.g., a force exceeding a predetermined threshold) is detected on the open axis of the basketing system during the retraction of box 2004. For example, the basketing device / system may include one or more force sensors associated with the open axis and configured to generate signals indicating the forces experienced on the open axis (such as a pulling force on the basket teeth).

[0208] If no lifting force is detected on the open axis, process 2000 may proceed to complete the retraction of the endoscope and basket and, in conjunction with the operation associated with frame 2012, collect the stones / fragments. If additional stones / fragments still need to be collected, as indicated at decision frame 2019, process 2000 may involve reinserting the endoscope and basket into the target anatomical chamber (e.g., the calyx of the kidney) by entering the sheath, as indicated at frame 2018, and further cycle back to subprocess 2002 involving further capture of one or more additional stones / fragments by the basket.

[0209] If a lifting force is detected on the open axis during retraction of the endoscope and basket, as determined at frame 2006, the process can continue to frame 2010, which may involve driving the open axis forward a predetermined soft-stop buffer distance, such as by actuating the open axis actuator / slider a predetermined distance (e.g., 1-5 mm, 5-10 mm, or greater) in the forward / distal end direction. This forward drive / biasing of the open axis can be implemented to provide a gap relative to a possible hard-stop boundary / limit associated with the lifting force detected at frame 2006.

[0210] Even if it is unknown whether the lifting force is due to a jammed device condition or simply due to a hard stop collision / contact, process 2000 may still proceed with similar jammed device-related remedial actions as in conjunction with box 2016. Forward drive of the open axis can be considered part of the jammed device remedial action associated with box 2016. In other possible cases, the remedial action associated with box 2016 may involve notifying the user of a potential jammed device condition. The user can then check the camera view and / or other parameters to confirm the existence of a real jammed device condition. If so, the user can manipulate the basket, endoscope, and / or other instruments to resolve the jammed device condition. Once the user confirms that the jammed device condition (box 2011) (if any) has been resolved, the system may allow further drive (e.g., retraction) of the endoscope. For example, process 2000 may proceed to any of boxes 2002, 2004, 2012, 2019, or terminate in some way.

[0211] In the absence of such Figure 12 , Figure 12 , Figure 20 and / or Figure 20 In the case of false alarm handling as indicated in the diagram, the increased insertion and / or opening axis force is triggered due to a physical hard stop condition relative to the corresponding actuator / slider, and a recurring fault is thrown because such an increased force is due to a erroneous assumption of a stuck instrument state. Therefore, Figures 12 to 20 The process shown in the diagram enables jammed device management according to embodiments of this disclosure, without the risk of fatal or problematic hard-stop interference / derailment.

[0212] Additional Implementation Plan

[0213] Depending on the implementation, specific actions, events, or functions of any of the processes or algorithms described herein may be performed in different orders, added, combined, or completely ignored. Therefore, in a particular implementation, not all described actions or events are necessary for the practice of the process.

[0214] Unless otherwise specifically stated or otherwise understood in the context in which they are used, the conditional language used herein, such as “may,” “can,” “possibly,” “may,” “e.g.,” etc., refers in its ordinary sense and is generally intended to convey that a particular embodiment includes a particular feature, element, and / or step that is not included in other embodiments. Therefore, such conditional language is not generally intended to imply that one or more embodiments require a feature, element, and / or step in any way, or that one or more embodiments necessarily include logic for determining, with or without the author’s input or prompting, whether such feature, element, and / or step is included in any particular embodiment or whether it will be performed in any particular embodiment. The terms “comprising,” “including,” “having,” etc., are synonymous and used in their ordinary sense, and are used inclusively in an open-ended manner, without excluding additional elements, features, actions, operations, etc. Moreover, the term “or” is used in its inclusive sense (rather than in its exclusive sense) such that when used, for example, to connect a series of elements, the term “or” refers to one, some, or all of the elements in that series. Unless otherwise specified, combined language such as “at least one of X, Y, and Z” is understood in the context of general use to convey that an item, term, element, etc., can be X, Y, or Z. Therefore, such combined language is generally not intended to imply that a particular implementation requires the presence of at least one of X, at least one of Y, and at least one of Z.

[0215] It should be understood that in the above description of the embodiments, various features are sometimes grouped together in a single embodiment, figure, or description therein in order to simplify this disclosure and aid in understanding one or more aspects of the invention. However, this approach of the disclosure should not be construed as reflecting an intention that any claim requires more features than those expressly recited in that claim. Furthermore, any component, feature, or step illustrated and / or described in the specific embodiments herein may be applied to or used with any other embodiment. Moreover, for each embodiment, no component, feature, step, or group of components, features, or steps is necessary or indispensable. Therefore, it is expected that the scope of the invention disclosed herein and claimed below is not limited to the specific embodiments described above, but should be determined solely by a fair reading of the appended claims.

[0216] It should be understood that specific ordinal terms (e.g., "first" or "second") may be provided for ease of reference and do not necessarily imply physical characteristics or ordering. Therefore, as used herein, ordinal terms used to modify elements such as structures, components, operations (e.g., "first," "second," "third," etc.) do not necessarily indicate the priority or order of that element relative to any other element, but rather serve to generally distinguish that element from another element with a similar or identical name (but used in ordinal terms). Additionally, as used herein, indefinite articles ("a (a)" and "an (an)") may indicate "one or more" rather than "one." Furthermore, an operation performed "based on" a condition or event may also be performed based on one or more other conditions or events not explicitly stated.

[0217] Unless otherwise defined, all terms used herein (including technical and scientific terms) shall have the same meaning as commonly understood by one of ordinary skill in the art to which the exemplary embodiments pertain. It will be further understood that terms, such as those defined in common dictionaries, shall be interpreted as having a meaning consistent with their meaning in the context of the relevant field and shall not be interpreted in an idealized or overly formal sense, unless expressly defined herein.

[0218] For ease of description, the spatial relative terms “external,” “internal,” “upper,” “lower,” “below,” “above,” “vertical,” “horizontal,” and similar terms are used herein to describe the relationship between one element or component illustrated in the accompanying drawings and another. It should be understood that the spatial relative terms are intended to cover different orientations of the device in use or operation other than those depicted in the drawings. For example, if the device shown in the drawings is flipped, a device located “below” or “under” another device may be positioned “above” another device. Therefore, the descriptive term “below” can include both a lower position and an upper position. The device may also be oriented in another direction, and therefore the spatial relative terms may be interpreted differently depending on the orientation.

[0219] Unless otherwise explicitly stated, comparative and / or quantitative terms, such as “less,” “more,” “greater,” etc., are intended to encompass the concept of equality. For example, “less” may mean not only “less” in the strictest mathematical sense, but may also mean “less than or equal to.”

Claims

1. A robot system, comprising: One or more robotic arms; One or more instrument manipulators, the one or more instrument manipulators being coupled to a corresponding robotic arm in the one or more robotic arms; One or more actuators, the one or more actuators being associated with at least one of the one or more instrument manipulators and configured to cause axial movement of at least one of the endoscope, the sheath of a basket-like device at least partially disposed within the endoscope, or the teeth of the basket-like device; One or more sensors, the one or more sensors being associated with the one or more instrument manipulators and configured to generate signals indicating the forces experienced by the one or more actuators; and A control circuit, communicatively connected to the one or more instrument manipulators and the one or more sensors, is configured to: The object is determined to be captured by the basket device, or at least one of the basket device or the endoscope has entered the danger zone of instrument jamming; In response to determining that the object is captured by the basket device or that at least one of the basket device or the endoscope has entered the danger zone of the stuck instrument, the basket device is propelled and retracted with a jerking motion; When the basket-shaped device moves with the jittering motion, it receives a signal from the one or more sensors indicating the force experienced by the one or more actuators; It is determined that the force is greater than a predetermined threshold; A timer is started in response to the determination that the force is greater than the predetermined threshold; Determine that the timer has exceeded a predetermined time threshold while the force remains greater than the predetermined threshold; and In response to the determination that the timer has exceeded the predetermined time threshold, a response action is initiated.

2. The robot system of claim 1, wherein the response action involves providing a warning to the user indicating that the basket-like device is stuck.

3. The robotic system of claim 1, wherein the response action involves reducing the retraction speed of the endoscope.

4. The robotic system of claim 1, wherein the response action involves pausing the retraction of the endoscope.

5. The robot system of claim 1, wherein the one or more actuators comprise one or more basket sheath actuators.

6. The robot system of claim 1, wherein the one or more actuators comprise one or more basket-shaped tooth actuators.

7. The robotic system of claim 1, wherein the one or more actuators comprise one or more endoscopic actuators.

8. The robot system of claim 1, wherein the control circuit is further configured to: Detect the hard stop force reading associated with at least one of the open axis or inserted axis associated with the basket-like device; and In response to the hard stop force reading, at least one of the one or more actuators is used to drive the open axis or the insertion axis forward.

9. A computing device, comprising: Robot system interface; and A control circuit, communicatively connected to the robot system interface and including one or more processors and one or more data storage devices, is configured to: The object is determined to be captured by a basket device that is at least partially located inside the endoscope, or at least one of the basket device or the endoscope has entered the danger zone of instrument jamming; In response to determining that the object is captured by the basket device or that at least one of the basket device or the endoscope has entered the danger zone of the stuck instrument, the basket device is caused to vibrate relative to the working channel of the endoscope in which the basket device is at least partially disposed; When the basket-shaped device is shaking, it is determined that the force experienced by one or more components of the basket-shaped device is greater than a predetermined threshold. A timer is started in response to the determination that the force is greater than the predetermined threshold; as well as The timer indicates the stuck state of the basket-shaped device.

10. The computing device of claim 9, wherein the control circuitry is further configured to disable jitter of the basket device in response to a determination that the basket device and the endoscope have retracted into the sheath.

11. The computing device of claim 9, wherein the control circuitry is further configured to suspend the movement of the endoscope in response to the jammed state.

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