Medical device systems, methods, and computer-readable media for operating the medical device systems

Abstract

A robotic medical device system includes a robotic medical device and a controller. The controller is configured to control movement of the robotic medical device in response to one or more control signals received via a network to maintain substantially constant overshoot of different step responses of the robotic medical device system independent of changes in latency associated with control of the robotic medical device.

Description

Technical Field

[0001] One or more example embodiments relate to robotic medical device systems, remote communication and control systems for devices for robotic interventional procedures, methods for operating said systems, and / or non-transitory computer-readable media. Background Technology

[0002] Catheters (and other slender medical devices) can be used in minimally invasive medical procedures for the diagnosis and treatment of various vascular system diseases, including neurovascular intervention (NVI) (also known as neurointerventional surgery), percutaneous coronary intervention (PCI), and peripheral vascular intervention (PVI). Robotic catheterization systems can be used to assist physicians in performing catheter insertion procedures, such as those mentioned above. Summary of the Invention

[0003] At least one example embodiment provides a robotic medical device system including a robotic medical device and a controller. The controller is configured to control the movement of the robotic medical device in response to one or more control signals to maintain a substantially constant overshoot of different step responses of the robotic medical device system, independent of variations in delays associated with the control of the robotic medical device, said one or more control signals being received via a network.

[0004] At least one example embodiment provides a robotic medical device system, including: a robotic medical device; and components for controlling the movement of the robotic medical device in response to one or more control signals to maintain a substantially constant overshoot of different step responses of the robotic medical device system, independent of variations in delays associated with the control of the robotic medical device, said one or more control signals being received via a network.

[0005] According to one or more example embodiments, the delay may include at least one of command delay or image feedback delay.

[0006] The controller can be configured to control the movement of the robotic medical device to maintain a generally constant maximum overtravel distance of the robotic medical device.

[0007] Delay can be at least partially based on network transmission latency.

[0008] The movement of a robotic medical device may include at least one of linear or rotational movement.

[0009] The controller can be configured to control the speed of the robotic medical device to maintain a generally constant overshoot.

[0010] The controller can be configured to control the speed of the robotic medical device to limit the maximum overtravel distance of the robotic medical device.

[0011] The speed can be linear or rotational.

[0012] The control components may include those for controlling the movement of the robotic medical device to maintain a substantially constant maximum overtravel distance of the robotic medical device.

[0013] The control components may include those used to control the speed of the robotic medical device to maintain a substantially constant overshoot.

[0014] The control components may include those used to control the speed of the robotic medical device to limit the maximum overtravel distance of the robotic medical device.

[0015] At least one example embodiment provides a method for operating a robotic medical device system including a robotic medical device and a controller, the method comprising: controlling movement of the robotic medical device in response to one or more control signals to maintain a substantially constant overshoot of different step responses of the robotic medical device system, independent of delay variations associated with the control of the robotic medical device, said one or more control signals being received via a network.

[0016] At least one example embodiment provides a non-transitory computer-readable storage medium storing computer-readable instructions that, when executed by a controller and / or one or more processors at a robotic medical device system, cause the robotic medical device system to perform a method comprising: controlling movement of the robotic medical device in response to one or more control signals to maintain a substantially constant overshoot of different step responses of the robotic medical device system, independent of delay variations associated with the control of the robotic medical device, said one or more control signals being received via a network.

[0017] According to one or more example embodiments, the delay may include at least one of command delay or image feedback delay.

[0018] The control device can control the movement of the robotic medical device to maintain a generally constant maximum overtravel distance.

[0019] Delay can be at least partially based on network transmission latency.

[0020] The movement of a robotic medical device may include at least one of linear or rotational movement.

[0021] Control may include controlling the speed of the robotic medical device to maintain a generally constant overshoot.

[0022] Controlling speed can include controlling the speed of the robotic medical device to limit its maximum overtravel distance.

[0023] The speed can be linear or rotational.

[0024] At least one other example embodiment provides a robotic medical device system including a robotic medical device and a controller. The controller is configured to control the movement of the robotic medical device in response to one or more control signals to maintain a substantially constant maximum overtravel distance of the robotic medical device independently of delay variations associated with the control of the robotic medical device, said delay being between a maximum acceptable delay threshold and a disable threshold, and said one or more control signals are received via a network.

[0025] At least one other example embodiment provides a robotic medical device system, comprising: a robotic medical device; and components for controlling the movement of the robotic medical device in response to one or more control signals to maintain a substantially constant maximum overtravel distance of the robotic medical device independently of delay variations associated with the control of the robotic medical device, the delay being between a maximum acceptable delay threshold and a disable threshold, and the one or more control signals being received via a network.

[0026] According to one or more example embodiments, the controller can be configured to disable the operation of the robotic medical device in response to a delay greater than a disable threshold.

[0027] The control device may include components for disabling the robotic medical device in response to a delay exceeding a disable threshold.

[0028] The controller can be configured to constrain the speed of the robotic medical device to maintain a substantially constant maximum overtravel distance in response to latency between a maximum acceptable latency threshold and a disable threshold.

[0029] The control components may include a maximum overtravel distance that constrains the speed of the robotic medical device to maintain a substantially constant range between a maximum acceptable delay threshold and a disable threshold in response to delay.

[0030] The speed of robotic medical devices can be unrestricted in response to latency less than the maximum acceptable latency threshold.

[0031] At least one other example embodiment provides a method of operating a robotic medical device system including a robotic medical device and a controller, the method comprising: controlling the movement of the robotic medical device in response to one or more control signals to maintain a substantially constant maximum overtravel distance of the robotic medical device independently of delay variations associated with the control of the robotic medical device, the delay being between a maximum acceptable delay threshold and a disable threshold, the one or more control signals being received via a network.

[0032] At least one example embodiment provides a non-transitory computer-readable storage medium storing computer-readable instructions that, when executed by a controller and / or one or more processors at a robotic medical device system, cause the robotic medical device system to perform a method comprising: controlling movement of the robotic medical device in response to one or more control signals to maintain a substantially constant maximum overtravel distance of the robotic medical device independently of delay variations associated with the control of the robotic medical device, the delay being between a maximum acceptable delay threshold and a disable threshold, and the one or more control signals being received via a network.

[0033] According to one or more example embodiments, the method may further include disabling the robotic medical device in response to a delay greater than a disable threshold.

[0034] The method may further include constraining the speed of the robotic medical device to maintain a substantially constant maximum overtravel distance in response to latency between a maximum acceptable latency threshold and a disabled threshold.

[0035] The speed of robotic medical devices can be unrestricted in response to latency less than the maximum acceptable latency threshold. Attached Figure Description

[0036] The exemplary embodiments will be more fully understood in light of the detailed description and accompanying drawings given below, wherein similar elements are indicated by similar reference numerals, which are merely illustrative and therefore do not limit this disclosure.

[0037] Figure 1 This is a perspective view of a conduit procedure system according to an example embodiment.

[0038] Figure 2 This is a schematic block diagram of a conduit procedure system according to an example embodiment.

[0039] Figure 3 This is a block diagram of the communication and control system of a robotic medical device system according to an example embodiment.

[0040] Figure 4 This is a block diagram of the communication and control system of a robotic medical device system according to an example embodiment.

[0041] Figure 5 The illustration depicts a method for controlling the operation of a robotic medical device system according to an example embodiment.

[0042] Figure 6 An example graphical user interface for the control center according to an example embodiment is shown.

[0043] Figure 7An example graphical user interface for a robotic medical device system according to an example embodiment is shown.

[0044] Figure 8 An example display of data and images of a robotic medical device system at a local site according to an example embodiment is shown.

[0045] Figure 9 An example display of a control center at a remote site with hemodynamic data, according to an example embodiment, is shown.

[0046] Figure 10 An example display of the control center at a remote site is shown according to an example embodiment.

[0047] Figure 11 An example user interface is shown according to an example embodiment when the control center or robotic medical device system does not control the robotic medical device.

[0048] Figure 12 An example user interface is shown when a robotic medical device system controls a robotic medical device, according to an example embodiment.

[0049] Figure 13 An example user interface is shown when a control center controls a robotic medical device, according to an example embodiment.

[0050] Figure 14 An example display of the control center at a remote site is shown according to an example embodiment.

[0051] Figure 15 An example display of the control center at a remote site is shown according to an example embodiment.

[0052] Figure 16 This is a block diagram illustrating a many-to-many configuration of multiple control centers and multiple robotic medical device systems according to an example embodiment.

[0053] Figure 17 This is a flowchart illustrating a method according to an example embodiment.

[0054] Figure 18 This is a flowchart illustrating another method according to an example embodiment.

[0055] Figure 19 This is a diagram illustrating an example step response of a robotic medical device system according to an example embodiment.

[0056] Figure 20 The illustration shows an example graphical user interface display of a robotic medical device system according to an example embodiment.

[0057] Figure 21Other example graphical user interface displays of a robotic medical device system according to an example embodiment are illustrated.

[0058] Figure 22 This is an example graph illustrating the attenuation gain versus total delay time of a robotic medical device system according to an example embodiment.

[0059] Figures 23A-23C An example two-dimensional step response diagram of a robotic medical device system according to an example embodiment is illustrated.

[0060] Figure 24 The illustration shows another example graph of the step response versus total delay of the robotic medical device system according to an example embodiment.

[0061] Figure 25 The illustration shows another example graph of percentage overshoot versus total delay for a robotic medical device system according to an example embodiment.

[0062] It should be noted that these figures are intended to illustrate the general characteristics of the methods, structures, and / or materials utilized in certain exemplary embodiments and to supplement the written description provided below. However, these figures are not drawn to scale and may not accurately reflect the precise structural or performance characteristics of any given embodiment, and should not be construed as limiting or restricting the range of values ​​or properties covered by the exemplary embodiments. The use of similar or identical reference numerals in the various figures is intended to indicate the presence of similar or identical elements or features. Detailed Implementation

[0063] Various exemplary embodiments will now be described more fully with reference to the accompanying drawings, some of which illustrate exemplary embodiments.

[0064] Detailed illustrative embodiments are disclosed herein. However, the specific structural and functional details disclosed herein are merely representative for the purpose of describing exemplary embodiments. These exemplary embodiments may be embodied in many alternative forms and should not be construed as being limited to the embodiments set forth herein.

[0065] Therefore, while various modifications and alternatives are possible to the exemplary embodiments, the embodiments are shown by way of example in the accompanying drawings and will be described in detail herein. However, it should be understood that the exemplary embodiments are not intended to be limited to the specific forms disclosed. Rather, the exemplary embodiments are intended to cover all modifications, equivalents, and alternatives falling within the scope of this disclosure. Throughout the description of the figures, similar numbers refer to similar elements.

[0066] Catheters (and other slender medical devices) are used in minimally invasive medical procedures to diagnose and treat a variety of vascular system diseases, including neurovascular intervention (NVI) (also known as neurointerventional surgery), percutaneous coronary intervention (PCI), and / or peripheral vascular intervention (PVI). These procedures typically involve navigating a guidewire through the vascular system and advancing a working catheter via the guidewire to deliver the therapy. The catheter insertion procedure begins with the insertion of a sheath or guide catheter into the appropriate vessel, such as an artery or vein, using standard percutaneous techniques. The sheath or guide catheter is then advanced over the diagnostic guidewire to the primary location, such as the internal carotid artery for NVI, the coronary ostium for PCI, or the superficial femoral artery for PVI. The guidewire, appropriate for the vascular system, is then navigated through the sheath or guide catheter to the target location within the vascular system. In some cases, such as in convoluted anatomy, a support catheter or microcatheter is inserted over the guidewire to aid in its navigation. A physician or operator may use an imaging system (such as a fluoroscope) to obtain a film with contrast agent injection and select a fixed frame as a route map to navigate the guidewire or catheter to the target location, such as a lesion.

[0067] Contrast-enhanced images can also be obtained when a physician delivers a guidewire or catheter, allowing the physician to verify that the device is moving along the correct path to the target location. When using fluoroscopy to visualize anatomical structures, the physician manipulates the proximal end of the guidewire or catheter to guide the distal end into the appropriate vessel toward the lesion and avoids advancing into collateral vessels.

[0068] Robotic catheterization systems can be used to assist physicians in performing catheter insertion procedures such as NVI, PCI, and PVI. Examples of NVI catheterization procedures include coil embolization of aneurysms, fluid embolization of arteriovenous malformations, and mechanical thrombectomy for large vessel occlusion in cases of acute ischemic stroke.

[0069] In NVI (Neurovascular Illness), physicians use robotic systems to deliver therapy to restore normal blood flow and gain access to the lesion by manipulating neurovascular guidewires and microcatheters. Access is achieved via a sheath or guiding catheter, but intermediate catheters may be needed for more distant areas or to provide adequate support for the microcatheters and guidewires. Depending on the type of lesion and the treatment, the distal end of the guidewire is navigated into or across the lesion.

[0070] To treat an aneurysm, a microcatheter is advanced into the lesion, and a guidewire is removed. Several coils are then deployed into the aneurysm via the microcatheter for embolization.

[0071] To treat arteriovenous malformations, a fluid embolization is injected into the malformation via a microcatheter.

[0072] Mechanical thrombectomy for vascular occlusion can be performed via aspiration or using a stent retrieval device. Aspiration can be performed directly through a microcatheter or with a larger diameter aspiration catheter. Once the aspiration catheter is at the lesion site, negative pressure is applied to remove the clot through the catheter. Alternatively, a stent retrieval device can be deployed via a microcatheter to remove the clot. Once the clot has been incorporated into the stent retrieval device, it is retrieved by withdrawing the stent retrieval device and microcatheter into a guide catheter.

[0073] In PCI, physicians use robotic systems to gain access to lesions by manipulating coronary guidewires to deliver therapy and restore normal blood flow. Access is achieved by placing a guide catheter in the coronary ostium. The distal end of the guidewire is navigated across the lesion, and for complex anatomy, microcatheters can be used to provide adequate support for the guidewire. Blood flow is restored by delivering and deploying a stent or balloon at the lesion site. The lesion may require preparation before stent implantation, pre-dilation of the lesion by delivering a balloon, or atherosclerosis resection using, for example, a laser or rotary atherectomy catheter and a balloon on the guidewire. Diagnostic imaging and physiological measurements can be performed using imaging catheters or FFR measurements to determine the appropriate therapy.

[0074] In PVI, physicians use a robotic system to deliver the therapy and restore blood flow using techniques similar to NVI. The distal end of the guidewire is navigated across the lesion, and microcatheters can be used to provide sufficient support for the guidewire to handle complex anatomy. Blood flow is restored by delivering and deploying a stent or balloon to the lesion. As with PCI, lesion preparation and diagnostic imaging can also be used.

[0075] In one example, the operator of the robotic system used for a medical procedure is located in the same or adjacent room as the patient and the robotic system. In another example, the operator might be located in a remote location (e.g., a different building, a different city, etc.) to operate the robotic system to perform the medical procedure. A system that allows operators to control and operate robotic medical procedure systems from a remote location provides patients in, for example, smaller communities with access to medical specialists that may not be available locally. Furthermore, patients requiring urgent medical procedures can be treated by specialists located at a remote location in a local hospital, which can reduce the time required before the interventional procedure. For example, interventional procedures treating patients with acute ischemic stroke due to large vessel occlusion (LVO) or patients with ST-segment elevation myocardial infarction (STEMI) can be performed more quickly.

[0076] Figure 1 This is a perspective view of a conduit procedure system according to an example embodiment.

[0077] refer to Figure 1The catheter procedure system 100 can be used to perform catheter-based medical procedures, including, for example, percutaneous interventional procedures such as percutaneous coronary intervention (PCI), neurovascular interventional procedures (e.g., treatment of large vessel occlusion (LVO)), PCI for ST-segment elevation myocardial infarction, peripheral vascular interventional procedures, etc.

[0078] Catheter-based medical procedures may also include diagnostic catheter insertion procedures, during which one or more catheters (or other elongated medical devices) are used to aid in the diagnosis of a patient's condition. For example, in at least one exemplary embodiment of a catheter-based diagnostic procedure, contrast agent is injected through a catheter into one or more coronary arteries, and images of the patient's heart are taken.

[0079] Catheter-based medical procedures may also include catheter-based treatment procedures (e.g., angioplasty, stent placement, treatment of peripheral vascular disease, etc.) during which a catheter (or other thin medical device) is used to treat the disease.

[0080] It should be noted that those skilled in the art will recognize that certain specific percutaneous interventional devices or components (e.g., guidewire type, catheter type, etc.) can be selected based on the type of procedure to be performed. The catheter procedure system 100 is capable of performing any number of catheter-based medical procedures with minor adjustments to suit the specific percutaneous interventional device used in the procedure. In particular, while the exemplary embodiments of the catheter procedure system 100 described herein are primarily explained with respect to the diagnosis and / or treatment of coronary artery disease, the catheter procedure system 100 can be used to diagnose and / or treat any type of disease or condition diagnosed and / or treated according to catheter-based procedures.

[0081] The catheterization procedure system 100 includes a laboratory unit 106 and a workstation 116. A robotic catheterization system, shown as a bedside system 110, is located within the laboratory unit 106 adjacent to the patient 102. The patient 102 is supported on a table 108. Generally, the bedside system 110 may be equipped with appropriate percutaneous interventional devices or other components (e.g., guidewires, guiding catheters, working catheters (such as balloon catheters and stent delivery systems), contrast agents, medications, diagnostic catheters, etc.) to allow the user to perform catheter-based medical procedures via the robotic system by operating various controls (such as controls located at workstation 116). The bedside system 110 may include any number and / or combination of components to provide the functionality described herein.

[0082] Among other components, the bedside system 110 particularly includes a drive assembly 111 supported by a robotic arm 112. The drive assembly 111 includes a housing 114 mounted on a robotic actuator 113, which can be used to drive elongated medical devices 115, such as catheters or guidewires. For example, the drive assembly 111 can be used to automatically feed a guidewire into a guiding catheter placed in an artery in the patient 102.

[0083] The bedside system 110 communicates with the workstation 116, allowing the user of the workstation 116 to input production signals to the bedside system 110 to control various functions of the bedside system 110. The bedside system 110 can also provide feedback signals (e.g., operating conditions, warning signals, error codes, etc.) to the workstation 116. The bedside system 110 can be connected via communication link 140 (… Figure 2 (As shown in the diagram) is connected to workstation 116. Communication link 140 can be a wireless connection, a cable connection, or any other means that allows communication between workstation 116 and bedside system 110.

[0084] Workstation 116 includes a user interface 126 configured to receive user input to operate various components or systems of catheter procedure system 100. User interface 126 includes controls 118 that allow the user to control bedside system 110 to perform catheter-based medical procedures. For example, controls 118 may be configured to enable bedside system 110 to perform various tasks using various percutaneous interventional devices (e.g., elongated medical devices) that bedside system 110 may be equipped with, such as advancing, retracting, or rotating guidewires, advancing, retracting, or rotating working catheters, advancing, retracting, or rotating guide catheters, inflating or deflating balloons located on catheters, positioning and / or deploying stents, injecting contrast agents into catheters, injecting drugs into catheters, or performing any other functions that may be performed as part of a catheter-based medical procedure. Drive assembly 111 includes various drive mechanisms to cause movement (e.g., axial and rotational movement) of components of bedside system 110, including percutaneous interventional devices.

[0085] In at least one example embodiment, the controller 118 includes a touchscreen 124, one or more joysticks 128, and buttons 130, 132. The joysticks 128 can be configured to advance, retract, or rotate various components and percutaneous interventional devices, such as guidewires, guiding catheters, or working catheters. Buttons 130, 132 may include, for example, an emergency stop button and a multiplier button. When the emergency stop button is pressed, a relay is triggered to cut off power to the bedside system 110.

[0086] The multiplier button is used to increase or decrease the speed of movement of an associated component in response to manipulation of control 118. In an example embodiment, control 118 may include one or more controls or icons (not shown) displayed on touchscreen 124, which, when activated, cause operation of components of the conduit program system 100.

[0087] Control 118 may also include airbag or support controls configured to inflate or deflate the airbag and / or support. Each control may include one or more buttons, joysticks, touchscreens, etc., which may be desired by a specific component dedicated to controlling that control. Furthermore, touchscreen 124 may display one or more icons (not shown) associated with the various parts of control 118 or the various components of the catheter procedure system 100.

[0088] User interface 126 may include a first monitor or display 120 and a second monitor or display 122. In other embodiments, user interface 126 may include one or more displays. The first monitor 120 and the second monitor 122 may be configured to display information or patient-specific data to a user located at workstation 116. For example, the first monitor 120 and the second monitor 122 may be configured to display image data (e.g., X-ray images, MRI images, CT images, ultrasound images, etc.), hemodynamic data (e.g., blood pressure, heart rate, etc.), and patient record information (e.g., medical history, age, weight, etc.). Furthermore, the first monitor 120 and the second monitor 122 may be configured to display procedure-specific information (e.g., procedure duration, catheter or guidewire position, amount of delivered medication or contrast agent, etc.). Monitors 120 and 122 may be configured to display information regarding the position of the guide catheter. Additionally, monitors 120 and 122 may be configured to display information to provide communication with controller 134 ( Figure 3 (As shown in the figure) associated functions. In another example embodiment, user interface 126 includes a single screen of sufficient size to display one or more display components and / or touchscreen components discussed herein.

[0089] The catheterization procedure system 100 also includes an imaging system 104 located within the laboratory unit 106. The imaging system 104 can be any medical imaging system that can be used in conjunction with catheter-based medical procedures, such as non-digital X-rays, digital X-rays, CT, MRI, ultrasound, etc. In an example embodiment, the imaging system 104 is a digital X-ray imaging device that communicates with workstation 116. In an example embodiment, the imaging system 104 may include a C-arm (not shown) that allows the imaging system 104 to rotate partially or completely around the patient 102 to acquire images (e.g., sagittal views, tail views, anterior and posterior views, etc.) at different angular positions relative to the patient 102.

[0090] Imaging system 104 can be configured to take X-ray images of appropriate areas of patient 102 during a specific procedure. For example, imaging system 104 can be configured to take one or more X-ray images of the heart to diagnose cardiac conditions.

[0091] The imaging system 104 can also be configured to capture one or more X-ray images (e.g., real-time images) during catheter-based medical procedures to assist the user of workstation 116 in correctly positioning guidewires, guiding catheters, stents, etc., during the procedure. The images(s) can be displayed on the first monitor 120 and / or the second monitor 122. Specifically, the images can be displayed on the first monitor 120 and / or the second monitor 122 to allow the user, for example, to accurately move the guiding catheter into the correct position.

[0092] refer to Figure 2 A block diagram of a catheterization system 100 is shown according to an example embodiment. The catheterization system 100 may include a controller 134. The controller 134 may be a workstation 116 ( Figure 1 As shown in the diagram. Controller 134 may generally be an electronic control unit adapted to provide the various functions described herein for catheterization procedure system 100. For example, controller 134 may be an embedded system, special-purpose circuitry, a general-purpose system programmed with the functions described herein, etc. Controller 134 communicates with one or more bedside systems 110, controller 118, monitors 120 and 122, imaging system 104, and patient sensors 136 (e.g., electrocardiogram (“ECG”) devices, electroencephalogram (“EEG”) devices, blood pressure monitors, temperature monitors, heart rate monitors, respiratory monitors, etc.). In an example embodiment, controller 134 may also communicate with contrast agent injection system 152 and intravascular ultrasound (IVUS) system 154. Controller 134 may also communicate with other medical systems 156, such as, for example, OCT systems, FFR systems, or suction pumps. In various example embodiments, controller 134 is configured to generate control signals based on user interaction with control 118 and / or based on information accessible to controller 134, enabling medical procedures to be performed using catheterization system 100. Furthermore, controller 134 can communicate with hospital data management system or hospital network 142 and one or more additional output devices 138 (e.g., printers, disk drives, CD / DVD writers, etc.).

[0093] Communication between the various components of the catheterization system 100 can be accomplished via communication link 140. Communication link 140 can be a dedicated wired or wireless connection. Communication link 140 can also represent communication over a network. The catheterization system 100 can be connected to or configured to include any other systems and / or devices not explicitly shown. For example, the catheterization system 100 may include an image processing engine, a data storage and archiving system, an automated balloon and / or stent inflation system, a drug injection system, a drug tracking and / or recording system, a user log, an encryption system, a system for restricting access to or use of the catheterization system 100, etc.

[0094] As mentioned, controller 134 communicates with bedside system 110 and can provide control signals to bedside system 110 to control the operation of motors and drive mechanisms used to drive percutaneous interventional devices (e.g., guidewires, catheters, etc.). For example, bedside system 110 may include a guidewire axial drive mechanism for providing guidewire advance and / or retraction, a working catheter axial drive mechanism for providing working catheter advance and / or retraction, and a guidewire rotation drive mechanism configured to rotate the guidewire about its longitudinal axis. In an example embodiment, the various drive mechanisms are housed in drive assembly 114 ( Figure 1 (as shown in the image).

[0095] It can remotely control robotic medical equipment systems, such as those mentioned above. Figure 1 and Figure 2 The example conduit program system described.

[0096] Figure 3 This is a perspective view of the communication and control system of a robotic medical device system according to an example embodiment. The communication and control system 10 includes a control center 12 at a remote site or location and a robotic medical device system 14 at a local site or location. As used herein, the local site is the location of the robotic medical device system and the patient or subject, and the remote site is the location of the operator (e.g., a physician) and the control center for remotely controlling the robotic medical device system. The control center 12 and the robotic medical device system 14 communicate via a network 16 (such as, for example, the Internet). In the example embodiment, the remote site and the local site are geographically distant from each other, for example, different rooms in the same building, different buildings in the same city, different cities, or other different locations, where the remote site cannot physically access the robotic medical device system or the patient at the local site. The control center 12 and the robotic medical device system 14 communicate via the network 16 (e.g., data, images, commands, and control signals).

[0097] An operator at a remote site can use control center 12 to control and operate the robotic medical device system 14 at a local site to perform medical procedures. In an example embodiment, multiple control centers 12 can communicate with one robotic medical device system 14 via network 16, and each control center 12 can be used to control the robotic medical device system 14 from a separate location. In another example embodiment, multiple control centers 12 can communicate with multiple robotic medical device systems 14 via network 16, wherein each control center 12 can be used to control each robotic medical device system 14.

[0098] The robotic medical device system 14 may be, for example, a catheterization system or other medical device system, which can be controlled by a robot to perform procedures. In an example embodiment, network 16 is a secure network, such as, for example, a Virtual Private Network (VPN). Control center 12 may include, for example, a workstation with a user interface. In an example embodiment, control center 12 includes a user interface similar to the user interface provided in the robotic medical device system 14. For example, if the robotic medical device system 14 is a catheterization system, as described above... Figure 1 and 2 In the described system, control center 12 may include a workstation with a user interface and controls, similar to workstation 116, user interface 126, and controls 118 of catheterization system 100. In another example embodiment, control center 12 includes a workstation or user interface that is part of a robotic medical device system at a remote site. Control center 12 is configured to allow an operator to operate various components of robotic medical device system 14 from a remote site. Information such as data, images, and command and control signals is transmitted from control center 12 to robotic medical device system 14 via network 16, and information such as data and images is transmitted from robotic medical device system 14 to control center 12 via network 16.

[0099] Figure 4 This is a block diagram of a communication and control system for a robotic medical device system according to an example embodiment. The communication and control system 200 includes a control center 202 at a remote site and a robotic medical device system 204 at a local site. The control center 202 and the robotic medical device system 204 communicate via a network 206. The network may include or communicate with an NTP (Network Time Protocol) pool. In one example embodiment, network 206 is a secure network established using a remote firewall 208 in the control center 202 and a local firewall 210 in the robotic medical device system 204. For example, network 206 may be a VPN. Network 206 is configured to receive and transmit data, images, and command and control signals. Figure 4In the system 200 shown, a control center 202 and a robotic medical device system 204 are illustrated. In an example embodiment, multiple control centers 202 may communicate with a robotic medical device system 204 via a network 206, and each control center 202 may be used from a separate location to control one or more medical devices 246 using a robotic system 245 within the robotic medical device system 204. The robotic system 245 may be, for example, a robotic arm, a robotic actuator, and / or other robotic devices that can be used to drive medical devices. In an example embodiment where the robotic medical device system is a catheter system, the robotic system 245 may be as described above regarding... Figure 1 The described robotic arm 112 and drive assembly 111. In another example embodiment, multiple control centers 202 may communicate with multiple robotic medical device systems 204 via a network 206, wherein each control center 202 may be used to control one or more medical devices 246 using a robotic system 245 in each robotic medical device system 204.

[0100] Control center 202 also includes a remote command and control module 212 and a remote controller 216, which are coupled to and communicate with the remote firewall 208. In an example embodiment, the remote firewall 208, the remote command and control module 212, and the remote controller 216 are implemented on separate hardware (e.g., a computer system). In another example embodiment, the remote firewall 208, the remote command and control module 212, and the remote controller 216 are implemented as separate software components or logical subsystem components on the same computer system. In yet another example embodiment, the remote command and control module 212 and the remote controller 216 may be implemented as a single component (software and / or hardware) or logical subsystem component on the same or distributed computer system. The remote command and control module 212 and the remote controller 216 may be collectively referred to as a controller or a remote controller. The software component or logical subsystem component may be implemented using, for example, a microkernel, a virtual machine, or a traditional operating system with real-time scaling. In another example embodiment, the remote controller 216 and the remote firewall 208 may be implemented as software programs that execute on the remote command and control module 212. The remote command and control module 212 receives commands and control signals from the control center console 236. The console 236 is configured to receive user input from operators at remote sites for operation of the robotic medical device system 204 and other systems and devices at local sites. For example, the console 236 may include displays and controls such as touchscreens, one or more joysticks, and buttons. A first display 240 in the control center 202 is coupled to the remote command and control module 212 and can be used to display data and images received from the robotic medical device system 204. The remote command and control module 212 can be configured to decompress images received from the robotic medical device system 204.

[0101] The remote command and control module 212 is also coupled to a time synchronization reference clock, such as, for example, remote reference clock 220, and receives time information from remote reference clock 220. Remote reference clock 220 may be, for example, a grandmaster clock. As discussed further below, the time information can be used to calculate delays in the transmission of signals and data (e.g., command and control signals and images) between the remote and local stations. Remote reference clock 220 is coupled to antenna 232 to receive time information from an external time source (such as, for example, a satellite-based time source or an external network) and to provide timestamp information to remote command and control module 212. In an example embodiment, the time information is provided from the Global Positioning System (GPS). In another example embodiment, the time information is provided from a Satellite Time and Position (STL) system. Remote switch 224 may be coupled to remote reference clock 220. In an example embodiment, remote reference clock 220, remote switch 224, and remote command and control module 212 use a Precision Time Protocol (PTP) network. The remote command and control module 212 uses timestamp information from the remote reference clock 220 to timestamp command and control signals received from the console 236. The timestamped command and control signals can be transmitted via network 206 to the local command and control module 214 in the robotic medical device system 204. The local command and control module 214 is configured to provide command and control signals via network 206 to, for example, the robotic system 245 in the robotic medical device system 204 to control the operation of one or more medical devices 246. The timestamps provided by the remote command and control module 212 on the command and control signals based on information from the remote reference clock 220 can be used to monitor and control the delay in the transmission of command and control signals over network 206 during medical procedures performed using one or more medical devices 246. The local command and control module 214 is configured to determine the delay in receiving command and control signals from the control center 202 based on the timestamps and take appropriate actions based on the amount of delay, as follows: Figure 5 Further discussion is needed.

[0102] Local command and control module 214 and local controller 218 are coupled to and communicate with local firewall 210. In an example embodiment, local firewall 210, local command and control module 214, and local controller 218 are implemented on separate hardware (e.g., a computer system). In another example embodiment, local firewall 210, local command and control module 214, and local controller 218 are implemented as separate software components or logical subsystem components on the same computer system. In yet another example embodiment, local command and control module 214 and local controller 218 may be implemented as a single component (software and / or hardware) or logical subsystem component on the same or distributed computer system. Local command and control module 214 and local controller 218 may be collectively referred to as controller or local controller. The software component or logical subsystem component may be implemented using, for example, a microkernel, a virtual machine, or a traditional operating system with real-time scaling. In another example embodiment, local controller 218 and local firewall 210 may be implemented as software programs that execute on local command and control module 214. The local command and control module 214 can also receive command and control signals from the robotic medical device system console 238. The console 238 is configured to receive user input from an operator at a local site for operating the robotic medical device system 204 at that site. For example, the console 238 may include a display and controls such as a touchscreen, one or more joysticks, and buttons. The display 241 is coupled to the local command and control module 214 and can be used to display data and images. The local command and control module 214 also receives images from the imaging system 248 and hemodynamic data from the patient sensor 250. The robotic medical device system 204 is referenced above. Figure 2 and 3 In an example embodiment of the described catheterization procedure system, a local controller 218 may be coupled to displays 120, 122, or a touchscreen 124. Images from imaging system 248 may be captured and scaled using a first video capture and scaling device 242, and hemodynamic data may be captured and scaled using a second video capture and scaling device 244. A local command and control module 214 may be configured to compress image data before transmission to control center 202, and the local controller 218 may be configured to compress hemodynamic data before transmission to control center 202. In another example embodiment, the local command and control module 214 is coupled to and receives data from an intravascular ultrasound (IVUS) system 254. Data from IVUS system 254 may be transmitted to control center 202.

[0103] The local command and control module 214 is also coupled to a time synchronization reference clock, such as, for example, local reference clock 226, and receives time information from local reference clock 226. For example, the local reference clock could be a master control clock. The time information can be used to calculate delays in the transmission of signals and data (e.g., command and control signals and images) between the remote and local stations. Local reference clock 226 is coupled to antenna 234 to receive time information from an external time source (such as, for example, a satellite-based time source) and provide timestamp information to local command and control module 214. In an example embodiment, the time information is provided from the Global Positioning System (GPS). In another example embodiment, the time information is provided from a Satellite Time and Position (STL) system. Local switch 230 can be coupled to local reference clock 226. In at least one example embodiment, local reference clock 226, local switch 230, and local command and control module 214 use a precise time protocol network. Local command and control module 214 uses the timestamp information from local reference clock 226 to timestamp image data received from first video capture and scaling device 242. In another example embodiment, the local controller 218 may use timestamp information from the local reference clock 226 to timestamp hemodynamic data received from the second video capture and scaling device 244. The timestamped images and hemodynamic data may then be transmitted via network 206 to the remote command and control module 212 in the control center 202.

[0104] Despite Figure 4 As shown, however, the second video capture and zoom device 244 and the patient sensor 250 may be omitted in other example embodiments.

[0105] The remote command and control module 212 is configured to provide images to display 240 in control center 202 and to provide hemodynamic data to display 240 or another display in control center 202. Timestamps provided by local command and control module 214 on the images and hemodynamic data based on information from local reference clock 226 can be used to monitor and control latency in the transmission of images and hemodynamic data over network 206 during medical procedures performed using control center 202 to control robotic system 245 and(one or more) medical devices 246. Based on latency in the transmission of images and / or hemodynamic data, various components of system 200 can be suspended or stopped, or the transmission system between control center 202 and robotic medical device system 204 can be controlled.

[0106] As described above, control center 202 may include a remote reference clock 220 that can use a precise time protocol, and robotic medical device system 204 may include a local reference clock 226 that can use a precise time protocol. Remote reference clock 220 and local reference clock 226 can communicate with a public external time source, such as a satellite-based time source (such as GPS or STL), to receive time information. At least this example embodiment enables control center 202 and robotic medical device system 204 to communicate via a secure tunnel over network 206 (e.g., the Internet) and calculate command latency and round-trip latency to help ensure safe and reliable operation. Each site uses a dedicated reference clock (e.g., reference clocks 220 and 226 respectively) and an isolated Ethernet for time synchronization. In this example embodiment, NTP or PTP may be used for synchronization. By using a dedicated reference clock at each site on an isolated network, the attack surface of network attacks targeting Internet-accessible time references can be reduced and / or eliminated. Such weaknesses include, but are not limited to, denial-of-service (DoS) attacks that render the GMC unusable, and stack overflows that put command and control modules under adversary control. See below for more details. Figure 16 Further discussion, in the example embodiment, the firewall can be used to establish an IPSec encrypted tunnel with dedicated hardware between two nodes, the IPSec encrypted tunnel having a private key for a relatively high level of security and to reduce (e.g., minimize) the impact of latency on communication.

[0107] In another example embodiment, the control center 202 and the robotic medical device system 204 may not include their own reference clocks. Instead, the control center 202 and the robotic medical device system 204 may be configured to receive time information using NTP and an NTP pool that communicate with a single network master clock. As described above, the time information can be used to generate timestamps for command and control signals, as well as other data such as images and hemodynamic data. In at least one example embodiment, the timestamps are provided by a common time source (e.g., GPS or STL) to determine the delay in the transmission of the sum of command and control signals. In another example embodiment, the timestamps are provided by a single time source (e.g., a network master clock or an internal clock) to determine the delay in the transmission of the sum of command and control signals. In this example embodiment, the timestamps from the “remote” site will be used, and then the round-trip delay of the command and control signals and the image will be calculated when the timestamps from the image transmission are received back from the “local” site.

[0108] As described above, operators at remote sites can use control center 202 to operate and control robotic medical device system 204 and other systems and devices at local sites. In an example embodiment, control center 202 can provide command and control signals to imaging system 248 or contrast agent delivery system 252 via network 206. For example, control center 202 can be used to control image capture by imaging system 248. In another example, control center 202 can be used to control contrast agent injection by contrast agent injection system 252. In other instances, control center 202 can be used to control the actuation of aspiration pumps or the deployment of stent retrieval devices.

[0109] Control center 202 includes a telepresence module 260, and robotic medical device system 204 includes a telepresence module 262. Each telepresence module 260, 262 is configured to provide audio and video communication (e.g., telepresence, teleconferencing) between an operator at a remote site and a user or local employee at a local site. In at least one example embodiment, such as Figure 4As shown, telepresence modules 260 and 262 are independent modules and can be coupled to remote firewall 208 and local firewall 210, respectively. In at least one other example embodiment, elements of telepresence modules 260 and 262 may be software programs executing on remote controller 216 or local controller 218, respectively. Telepresence modules 260 and 262 may include, for example, a camera, a monitor, a speaker, and one or more microphones. In one example embodiment, a video conference can be established between telepresence module 260 at a remote site and telepresence module 262 at a local site, allowing an operator at the remote site to operate one or more medical devices 246 using robotic system 245 at the local site via control center 202, view the procedure room and equipment during procedure execution, and communicate via audio and video with personnel supporting the procedure at the local site (e.g., as technicians, doctors, etc.). In an example embodiment, a dedicated audio and video communication system can be used to establish audio and video communication between a remote presentation module 260 at a remote site and a remote presentation module 262 at a local site. This dedicated audio and video communication system establishes secure communication via a computer network (e.g., a cloud network). For example, the remote presentation module 260 at the remote site can be configured to transmit audio (e.g., voice) and video from the remote site in an encrypted format (e.g., SRTP / AES-128), and is configured to receive and decrypt audio (e.g., voice) and video from the remote presentation module 262 at the local site. The remote presentation module 262 at the local site can be configured to transmit audio (e.g., voice) and video from the local site in an encrypted format (e.g., SRTP / AES-128), and is configured to receive and decrypt audio (e.g., voice) and video from the remote presentation module 260 at the remote site. Signaling and routing between the remote presentation modules 260 and 262 can be established using a cloud network. In at least one example embodiment, encrypted audio and video data can be transmitted between a remote firewall 208 and a local firewall 210 without further encryption (e.g., the audio and video data can be whitelisted).

[0110] Figure 5 The illustration depicts a method for controlling the operation of a robotic medical device system according to an example embodiment.

[0111] refer to Figure 4 and Figure 5 At box 302, for example, the local command and control module 214 at the local site receives command and control signals from the control center 202 at the remote site.

[0112] At box 304, for example, the delay in receiving command and control signals is determined by the local command and control module 214 based on timestamp information.

[0113] At box 306, the delay is compared to a threshold. In the example embodiment, the threshold is a given (or alternatively, expected or predetermined) value, for example, based on user-perceptible content. In one example, the threshold could be 250 ms. In another example embodiment discussed further below, the threshold could be determined at box 316 based on at least one parameter of the robotic medical device system, such as the procedure being performed by the robotic medical device system, the patient's anatomy, the type of medical device, and the location of the medical device.

[0114] At box 308, if the delay is greater than a threshold, a corrective action can be performed at box 314. In at least one example embodiment, one or more medical devices 246 and other components of the robotic medical device system 204 can be paused or stopped. In one example of pausing, if the delay is greater than a threshold and then the delay is lower than the threshold, the device or component can be paused and then resumed once the delay is higher than the threshold again. In another example, if the delay is too large, the movement of the device or component can be paused until the delay becomes low enough to resume operation. In another example embodiment, the speed or rate of the components of the robotic medical device system (e.g., during propulsion, retraction, or rotation) can be slowed down. If a network connection has been lost or the speed of network 206 has slowed down to below a given (or expected or predetermined) rate, control center 202 can relinquish control of robotic system 245 and one or more medical devices 246 to robotic medical device system 204. An emergency stop can also be provided, allowing a user at a local site to stop the procedure in an emergency. In the example embodiment, the threshold is a range of threshold values. If control center 202 already controls robot system 245 and(one or more) medical devices 246, and the delay of command and control signals is greater than a first threshold and less than a second threshold, then console 236 (e.g., joystick) of control center 202 can be disabled, but console 236 retains control over robot system 245 and(one or more) medical devices 246. If control center 202 already controls robot system 245 and(one or more) medical devices 246, and the delay of command and control signals is greater than the second threshold, then control center 202 can be disabled.

[0115] At box 308, when control center 202 has already controlled robot system 245 and(one or more) medical devices 246, if the delay of command and control signals is less than a threshold, then at box 310, control center 202's console 236 can be used to control and operate robotic medical device system 204, which includes robot system 245 and(one or more) medical devices 246.

[0116] At box 312, the speed of medical device 246 can be adjusted based on the delay of command and control signals, as it is being controlled by control center 202. If control center 202 has already controlled both robot system 245 and medical device 246, and the delay of command and control signals ( t 延迟 ) less than the defined threshold amount ( t 预确定 If the value is greater than zero, then the command speed ( ) is the speed of the commands and control signals received from the console 236 (e.g., joystick). v 命令 The speed of the device is scaled to 246. v 设备 The speed decreases as the delay increases toward the threshold. In this example embodiment, the speed of the device can be given by equation (1) shown below: .

[0117] For example, if there is a delay t 延迟 equal to threshold amount t 预确定 Half of that, then the speed of the equipment v 设备 Will be the command speed v 命令 Half of it. With the delay t 延迟 Slowing down device 246 by increasing its speed can help ensure system stability and mitigate risks associated with device control, such as avoiding over-propelling or retracting the device. If the delay... t 延迟 Amount greater than the predetermined threshold t 预确定 (Box 308) then the speed of the device v 设备 The value is zero, and the movement of device 246 stops (box 314). In another example embodiment, the speed of the device can be adjusted based on the total network latency. v 设备 Total network latency includes the latency of command and control signals. t 延迟 and the delay of images received from the robotic medical device system 204 t图像延迟 In this example, the speed of the device. v 设备 It can be given by equation (2) shown below: .

[0118] Based on total network latency t 总 = ( t 延迟 + t 图像延迟 Scaling device command speed v 命令 This ensures stable operation and robust performance of the device positioning control. Despite any total latency, stability can be ensured by tuning one or more example embodiments given above for scaling command speed. If the latency is unknown, instability may occur if it is too large.

[0119] The frequency response of the open-loop system with a fixed total delay can be given by equation (3) shown below: .

[0120] According to the Nyquist stability criterion, to ensure the stability of unit-proportional feedback, the total network delay must satisfy the following constraint: Seconds. Using the scaling in equation (2) above, where the threshold... This results in the frequency response given by equation (4) shown below: In other example embodiments, a predetermined threshold can be calculated. t 预确定Other optimal values ​​are used to scale Equation (2). According to Equation (4), stability of the unity proportional feedback can be ensured since the gain margin of unity proportional feedback is now infinite. Other methods can be used in a similar manner to ensure stability when the feedback delay is known. An example of a method to ensure stability using wave variables when the feedback delay is unknown and when the position of the device is controlled by speed commands is described in “Design of Networked Control Systems Using Passivity”, IEEE Transactions on Control Systems Technology, vol. 21, no. 3, pp. 649-665, May 2013, which is incorporated herein by reference in its entirety.

[0121] As described above, at box 316, a delay threshold can be determined based on at least one parameter of the robotic medical device system 204, including, for example, the procedure being performed by the robotic medical device system. For example, the robotic medical device system 204 may be a catheter procedure system that controls the movement and manipulation of elongated medical devices (e.g., catheters, guidewires, balloon catheters, microcatheters, etc.). The acceptable amount of delay can vary depending on various parameters of the catheter procedure system. The value of the delay threshold can be based on, for example, the type of procedure being performed, the patient's anatomy, the type of elongated medical device (e.g., catheter, balloon catheter, guide catheter, guidewire, microcatheter, or the like), the position of the elongated medical device, the distance between the elongated medical device (e.g., the tip or distal end of the device) and the target location, or the type of movement initiated by the elongated medical device (e.g., forward, rotation, retraction, etc.). For example, a greater delay may be permissible when the elongated medical device (e.g., the tip of the elongated medical device) is moving away from the target location, when the elongated medical device is retracting, or if the elongated medical device is a device traveling on a lead (e.g., a microcatheter or balloon catheter) or guidewire.

[0122] In at least one example embodiment, the remote controller 216 ( Figure 4 (as shown) and local controller 218 ( Figure 4 (As shown in the figure) Each generates and displays a similar graphical user interface.

[0123] Figure 6 An example graphical user interface for the control center according to an example embodiment is shown. Figure 7 Another example graphical user interface of a robotic medical device system according to an example embodiment is shown.

[0124] exist Figure 6 and Figure 7 In this example, graphical user interfaces 460 and 462 are used to control the sample catheterization procedure system. Graphical user interface 460 for the control center and graphical user interface 462 for the robotic medical device system are configured to show, for example, the same measurements, speeds, saved settings, and which controls on the console are being actuated at the site (e.g., the control center at a remote site or the robotic medical device system at a local site). Each graphical user interface 460 and 462 displays the latency 464 and 466 of the image transmission from the robotic medical device system to the console, and the latency 468 and 470 of the command and control signals from the control center to the robotic medical device system.

[0125] As mentioned above Figure 4 As discussed, the display 240 of the control center 202 can be used to display data and images received from the robotic medical device system 204 via the network 206.

[0126] Figure 8 An example display of data and images of a robotic medical device system according to an example embodiment is shown.

[0127] refer to Figure 8 The display 500 includes data and images captured at the robotic medical device system 204, such as, for example, hemodynamic data 502 related to the operation of procedures performed by the robotic medical device, reference images 506, and real-time images 508. Specifically, in Figure 8 In the example embodiment shown, the data and images relate to catheter procedures. The robotic medical device system 204 can be configured to select portions or areas of interest on the display 500 for transmission to a control center 202 at a remote site.

[0128] Therefore, the display 500 can be cropped so that, for example, hemodynamic data 502, reference image 506, and real-time image 508 can be transmitted separately. The selected portion or region of interest can have any shape to capture the desired information for transmission. Cropping the display 500 can reduce the bandwidth required to transmit images and data.

[0129] Figure 9 An example display of a control center at a remote site with a selected region of interest including hemodynamic data, according to an example embodiment, is shown.

[0130] exist Figure 9 In the display 600, hemodynamic data received from the robotic medical device system 204 is included.

[0131] In another example embodiment, the remote controller 216 and the display 240 may be configured to allow the operator to selectively cycle buffer up to a given time (or alternatively, a desired time or a predetermined time) (e.g., 10 seconds) of real-time image data (e.g., fluorescence image data for catheterization procedures), such as... Figure 10 As shown in the illustration. For example, a user can actuate the control to begin capturing and create a pre-defined loop buffer for playback. Figure 10 In the example embodiments shown, the playback image shown on display 700 is scaled to the same ratio as the live image 704. Playback 702 can be performed in real time at a given (or alternatively, desired or predetermined) number of frames per second. In at least one example embodiment, controls are provided that allow the operator to pause, advance, and rewind the playback image 702.

[0132] Playback images can be used, for example, to facilitate the generation of roadmaps and capture the progression of cases.

[0133] In another example embodiment, the image display at the remote site (e.g., in...) Figure 4 The display 240 shown can be configured to display image delay time and command and control signal delay time, such as Figure 14 As shown in the figure.

[0134] exist Figure 14 In this embodiment, display 1100 includes playback image 1102 and live image 1104. The display of the live image includes the display of delays 1106 in the transmission of the image from the robotic medical device system to the console and delays 1108 in the display of command and control signals from the control center to the robotic medical device system. In another example embodiment, image display at a remote site (e.g., at...) Figure 4 The display 240 shown can be configured to display total latency, such as Figure 15 As shown in the diagram, the total latency is the sum of the image latency and the command and control signal latency. In another example, the total latency can be displayed as a drop-down overlay on monitor 240.

[0135] exist Figure 15In this embodiment, display 1200 includes playback image 1202 and live image 1204, which may include additional real-time information about the program, such as the total latency and frame rate of images acquired by the imaging system associated with robotic medical device system 204 at a local site. In at least one example embodiment, playback image 1202 can be scrolled to a region of interest after an image is captured. The display of live image 1204 includes the display of total latency 1206 and frame rate 1208. Frame rate 1208 can be calculated based on frames received per second. Total latency 1206 and frame rate 1208 can be updated in real time and / or filtered to an appropriate bandwidth to improve the viewer's perception of these values.

[0136] As mentioned above Figure 4 The communication and control system 200 is configured to allow an operator (e.g., a doctor) at a remote site to control and operate the robotic medical device system 204 at a local site. System 200 is also configured to allow an operator at the local site to control and operate the robotic medical device system 204. A control management process is provided to manage whether the control center 202 or the robotic medical device system 204 has control over the robotic system 245 and(one or more) medical devices 246. The control management system is configured to, for example, prevent deadlock between the remote and local sites. In at least one example embodiment, a control token is used to determine whether the control center 202 or the robotic medical device system 204 has control over the operation of the procedure. The control token is a virtual token implemented in software. The system possessing the control token (e.g., the control center 202 or the robotic medical device system 204) is granted control over the robotic system 245 and(one or more) medical devices 246 of the robotic medical device system 204, while another system is disabled and prevented from controlling the robotic system 245 and(one or more) medical devices 246. In the first state, the control token is "free" and can be obtained by the control center 202 or the robotic medical device system 204.

[0137] Figure 11 An example user interface is shown according to an example embodiment when the control center or robotic medical device system is not controlling the robotic medical device. The illustrated graphical user interfaces 802, 804 are used to control the example catheterization procedure system (e.g., Figure 2 and 3The catheterization system 100 shown is illustrated. When the control token is "free," the robotic medical device system does not have a control token, and the robotic medical device system can acquire control by, for example, actuating the "Enable All" button in the graphical user interface 802 of the robotic medical device system. The control center also does not have a control token and can acquire control by, for example, actuating the "RCL Disable" button of the robotic medical device system in the graphical user interface 804 of the control center. In at least one example embodiment, the "Enable All" button of the graphical user interface 804 can be indicated by a background or color that indicates that the control center has no control; for example, the text and background of the button can be gray.

[0138] In the second state, the control token has been acquired by the robotic medical device system 204.

[0139] Figure 12 An example user interface is shown when a robotic medical device system controls a robotic medical device according to an example embodiment. The illustrated graphical user interfaces 902, 904 are used to control an example catheterization system (e.g., Figure 2 and 3 The catheter procedure system 100 shown is given control when the control token has been acquired by the robotic medical device system, and can be used to operate the robotic medical device.

[0140] exist Figure 12 In the graphical user interface 902 of the robotic medical device system, once the system has gained control using a control token, the "Enable All" button is disabled and changed to "Disable All". The operator can return the control token to "Freedom" by activating the "Disable All" button. In the graphical user interface 904 of the control center, the "Disable" button of the robotic medical device system is disabled. In an example embodiment, the "Enable All" and "RCL Enable" buttons in the graphical user interface 904 can be indicated with a background or color that suggests no control in the control center; for example, the text and background of the buttons could be gray.

[0141] In the third state, control center 202 has obtained the control token. Figure 13 An example user interface is shown when a control center controls a robotic medical device according to an example embodiment. The illustrated graphical user interfaces 1002 and 1004 are used to control an example catheterization procedure system (e.g., Figure 2 and 3 The catheter procedure system 100 shown is given control when the control token has been acquired by the control center, and can be used to operate the robotic medical device.

[0142] exist Figure 13 In the graphical user interface 1004 of the control center, when the control center has acquired control with a control token, the "Enable All" button is enabled. Additionally, the "RCL Disable" button in the graphical user interface 1004 is enabled. In an example embodiment, the "RCL Disable" button in the graphical user interface 1004 can be highlighted, highlighted, or colored to indicate that the control center has control. For example, the graphical user interface 1004 shows an underline under "RCL Disable". In another example embodiment, the "RCL Disable" button is shown in a color such as green. In the graphical user interface 1002 of the robotic medical device system, the "Enable All" button is disabled, and the robotic medical device system cannot acquire a control token. In an example embodiment, the "Enable All" button in the graphical user interface 1002 can be shown with a background or color indicating that the robotic medical device system has no control; for example, the button's text and background can be gray.

[0143] In the example embodiments, in the second and third states, when either the control center or the robotic medical device system has a control token, a site without a control token can have a request token or a forced request token. A request token or a forced request token is a virtual token implemented in software. Request tokens and forced request tokens can be used to request or enforce a change in control. For example, if the control center has a control token, the robotic medical device system can send a request token to the control center to request that the control token be "freed" and made available to the robotic medical device system. In response to receiving the request token, the control center can, for example, free the control token, choose to retain the control token, or time out and retain the control token. In another example, if the control center has a control token, the robotic medical device system can send a forced request token to the control center to request that the control token be "freed" and made available to the robotic medical device system. In response to the forced request token, the control center can, for example, free the control token, choose to retain the control token, or time out and release the control token.

[0144] As mentioned above Figure 3 and Figure 4 The multiple control centers 202 discussed can communicate with multiple robotic medical device systems 204 via network 206 (e.g., many-to-many configuration).

[0145] Figure 16 This is a block diagram illustrating a many-to-many configuration of multiple control centers and multiple robotic medical device systems according to an example embodiment.

[0146] exist Figure 16In this embodiment, the first control center 1302, the second control center 1304, the first robotic medical device system 1306, and the second robotic medical device system 1308 communicate via network 1350. In this embodiment, each station (i.e., the first control center 1302, the second control center 1304, the first robotic medical device system 1306, and the second robotic medical device system 1308) can be located at different locations and can be geographically distant from each other. The first control center 1302 is located at a first remote station, the second control center 1304 is located at a second remote station, the first robotic medical device system 1306 is located at a first local station, and the second robotic medical device system 1308 is located at a second local station. The first control center 1302 can be used to control either the first robotic medical device system 1306 or the second robotic medical device system 1308. The second control center 1304 can be used to control either the first robotic medical device system 1306 or the second robotic medical device system 1308.

[0147] The first control center 1302 includes a first remote firewall 1310, the second control center 1304 includes a second remote firewall 1312, the first robotic medical device system 1306 includes a first local firewall 1314, and the second robotic medical device system 1308 includes a second local firewall 1316. The first remote firewall 1310 is coupled to a first remote controller 1318, the second remote firewall 1312 is coupled to a second remote controller 1320, the first local firewall 1314 is coupled to a first local controller 1322, and the second local firewall 1316 is coupled to a second local controller 1324. The first remote firewall 1310 includes a LAN port 1334 and a WAN port 1336. The second remote firewall 1312 includes a LAN port 1332 and a WAN port 1330. The first local firewall 1314 includes a LAN port 1340 and a WAN port 1338. The second local firewall 1316 includes a LAN port 1326 and a WAN port 1328.

[0148] Firewalls 1310, 1312, 1314, and 1316 are configured to establish and tear down secure connections with another site. Preferably, the control and management of establishing and tearing down secure connections are handled automatically by each firewall and are separate from other hardware and software functions at each site. In at least one example embodiment, a command-line interface (CLI) and Secure Shell (SSH) protocols are used to establish a secure connection between the two sites. In this example embodiment, each firewall 1310, 1312, 1314, and 1316 has a unique static IP address. The following discussion will describe establishing a secure connection between the second control center 1304 and the second robotic medical device system 1308; however, the methods described herein can be used to establish and tear down connections between any combination of sites in a many-to-many configuration. In at least one example embodiment, a centralized approach is used. In the centralized approach, WAN port 1330 of the second control center 1304 and WAN port 1328 of the second robotic medical device system 1308 are open for SSH login. In this configuration, either site (e.g., the second control center 1304 and the second robotic medical device system 1308) can create a tunnel via a LAN port of its local firewall and a WAN port of the other site. For example, the second local controller 1324 of the second robotic medical device system 1308 can SSH to the local LAN port 1326 of the second local firewall 1316, and the second local controller 1324 can SSH to the WAN port 1330 of the second remote firewall 1312 of the second control center 1304 to establish a tunnel. In another centralized approach example, the second remote controller 1320 of the second control center 1304 can SSH to the WAN port 1328 of the second local firewall 1316 of the second robotic medical device system 1308, and the second remote controller 1320 of the second control center 1304 can SSH to the local LAN port 1332 of the second remote firewall 1312.

[0149] In another example embodiment, a distributed approach is used. In this distributed approach, SSH login is not allowed on the WAN port 1330 of the second control center 1304 and the WAN port 1328 of the second robotic medical device system 1308. In this example embodiment, each site establishes its corresponding tunnel connection via the LAN port of its respective local firewall, allowing the WAN port to remain closed to SSH login for enhanced security. For example, the second local controller 1324 can SSH to LAN port 1326, and the second remote controller 1320 can SSH to LAN port 1332.

[0150] In another example embodiment, a secure connection can be established using a junction box with direct routing, where physical direct wiring is used between all stations (or nodes) on the junction box. The connected port can be switched when a connection to a specific station is required.

[0151] In yet another example embodiment, a secure connection can be established using two static IP addresses for all sites (or nodes). The same two static IP addresses are retained on the routers for all sites. Sites are only plugged into the system (by the user) while in use and unplugged from the Ethernet port when not in use.

[0152] In another example implementation, a secure connection can be established using the same static IP address for all sites (or nodes). The static IP address and Ethernet port mapping can be manually reconfigured on the router.

[0153] In another example embodiment, the secure tunnel established between the two firewalls is a secure virtual private network, such as, for example, an IPSec tunnel. To establish the IPSec tunnel, in one example, the first control center 1302 and the first robotic medical device system 1306 have a shared key. The first local firewall 1314 of the first robotic medical device system 1306 constructs a tunnel to the first remote firewall 1310 of the first control center 1302. The first remote firewall 1310 then constructs a tunnel to the first local firewall 1314. In this example, neither site has its WAN port open to accept SSH logins. In another example, to establish the IPSec tunnel, the first local firewall 1314 allows SSH logins. The first remote firewall 1310 uses SSH to log in to the first local firewall 1314. The first remote firewall 1310 then constructs the tunnel at the end of the first local firewall 1314, pointing to the first remote firewall 1310. The first remote firewall 1310 points its tunnel to the first local firewall 1314. The first remote firewall 1310 can then determine the keys of the two sites. In the example implementation, there is a priori network topology map that makes all local and remote sites aware of their network location.

[0154] In another example embodiment, cloud computing can be used to manage multiple systems and connections in a many-to-many configuration. For example, a cloud-based infrastructure management solution can be used to manage firewalls at each site (or node). Each firewall (e.g., Figure 16 The first remote firewall 1310, the second remote firewall 1312, the first local firewall 1314, and the second local firewall 1316 shown are connected to the Internet and the cloud for management. Cloud-based management allows operators at one of the sites or at locations separate from the various sites to monitor and manage the firewalls.

[0155] One or more example embodiments also provide telemedicine device systems, methods, and / or non-transitory computer-readable storage media configured to limit and / or maintain a constant maximum overtravel of the robotic medical device while maintaining system stability. This maximum overtravel is caused by delays and / or jitter in the transmission of, for example, control signals (including movement commands) and images. Overtravel (also referred to herein as overtravel distance) refers to the distance between the actual (or desired) location of the robotic medical device within the patient and the user-perceived (or displayed) location of the robotic medical device at a remote control center.

[0156] In cases where image feedback and / or speed (movement) commands (e.g., linear and / or rotation) to a robotic medical device are delayed, overtravel can be the result of a closed loop by the user at the desired position on the robotic medical device.

[0157] One or more example embodiments also provide telemedicine device systems, methods, and / or non-transitory computer-readable storage media configured to maintain a constant or substantially constant percentage overshoot of the step response, independent of the total delay caused by delays and / or jitter in the transmission of control signals and images between, for example, a control center and the telemedicine device system.

[0158] According to the example embodiments discussed below, a robotic medical device system can be a catheterization system that controls the movement and manipulation of elongated medical devices (e.g., catheters, guidewires, balloon catheters, microcatheters, etc.). Therefore, a robotic medical device can be one or more elongated medical devices, each capable of linear and / or rotational movement. Linear and rotational movements can be separate, concurrent, or simultaneous. For clarity, example embodiments will be discussed with respect to robotic medical devices.

[0159] Although discussed separately, aspects of the example embodiments discussed herein can be combined.

[0160] Reference Figure 4 The communication and control system 200 shown, according to an example embodiment, allows the local command and control module 214 to apply a speed control function to it. G(T 延迟 ) The movement of the remote medical device 246 is controlled by attenuating the speed of the requested speed (speed command or command speed), which can be axial (linear) or rotational. In one example, the speed control function... G(T 延迟 ) It could be the total delay T 延迟 A nonlinear function that takes values ​​between 0 and 1 (0 < 1). G(T 延迟 ) ≤1). In other examples, the speed control function G(T 延迟 ) It can take values ​​between 0 and 2 (0 < 2). G(T 延迟 ) ≤2). However, the example embodiments should not be limited to these examples.

[0161] From a risk mitigation perspective, speed control function G(T 延迟 ) It can be determined based on the limit of maximum overtravel.

[0162] Total delay T 延迟 It could be a command delay. T 命令 and image feedback delay T 图像 The sum is given in equation (5) shown below: In at least this example embodiment, command delay T 命令 This refers to the delay or latency in the transmission of command and control signals from control center 202 to robotic medical device system 204. As discussed above, in one example, local command and control module 214 can determine command latency based on timestamps provided on command and control signals from remote command and control module 212. T 命令 For example, command delay. T 命令 It can be calculated as the difference between the time when the user issues a command at control center 202 and the time when the robotic medical device system 204 receives the command.

[0163] Image feedback delay T 图像 This refers to the latency or waiting time associated with the transmission of image and / or hemodynamic data from the robotic medical device system 204 to the control center 202 for display to a remote user (e.g., at display 240 and / or stored in memory). Despite image feedback latency... T 图像 This may include images and / or hemodynamic data, but for the sake of brevity, example embodiments will be discussed in relation to image data.

[0164] In one example, the image feedback delay can be calculated at the remote command and control module 212. T图像 It then signals the local command and control module 214 to calculate the total delay. T 延迟 In another example, the local command and control module 214 can determine the round-trip delay of image data as discussed above or in any suitable manner (e.g., based on transmission time information and reception acknowledgment information at the local command and control module 214). In yet another more specific example, image feedback delay... T 图像 It can be calculated as the time to capture an image frame ( T 患者侧 (e.g., indicated by a timestamp) and the time when the captured image frame was received at control center 202. T 控制侧 ） The difference between them.

[0165] In at least one other example embodiment, the total delay T 延迟 The calculation can be performed as follows.

[0166] Local command and control module 214 records image frame capture time T f This indicates the time when the image frame was captured on the patient side (e.g., via a timestamp). The local command and control module 214 then displays the image frame capture time. T f The captured image frame is sent to control center 202. Control center 202 then, upon receiving the complete image frame packet, records the image frame capture time. T f As part of (e.g., the next or other subsequent) command packet frame (including command and control signals or signaling), it is included in the local command and control module 214. The local command and control module 214 can then reduce the total latency. T 延迟 Calculated as received command packet frames (including image frame capture time) T f Command reception time T c and time T f The difference between them (i.e., T 延迟 = T c - T f ).

[0167] Command delay T 命令 Or image feedback delay T 图像One or more of these could be the result of network latency and / or jitter between the control center 202 and the robotic medical device system 204.

[0168] In at least one example embodiment, the local command and control module 214 can transmit the speed control function. G(T 延迟 ) The command speed is applied to the commands and control signals received from control center 202. v 命令 To obtain the device speed of the mobile robotic medical device 246 v 设备 Therefore, the local command and control module 214 can be based on the speed of commands. v 命令 and speed control function G(T 延迟 ) Get or set at time t Mobile robotic medical device 246 device speed v 设备 (t) In at least one example embodiment, when the value is less than 1, the speed control function... G(T 延迟 ) Applications can attenuate and / or reduce the speed of commands as needed. v 命令 To limit and / or maintain a constant or substantially constant maximum overtravel of the robotic medical device 246.

[0169] For example, when sending speed commands using a joystick, the user can command [- v 最大 , v 最大 The linear and / or rotational speeds within the range. Under uncompensated delay control, in some instances, the speed control function can be assumed to be... G(T 延迟 ) =1. In one example, the maximum command speed for linear guidewire movement (advance or retraction). v 最大 In "Normal" mode, the speed can be approximately 12 mm / s, while in "Turbine" mode it can be approximately 60 mm / s. For rotary movement, in one example, the maximum command speed is... v 最大 It can be approximately 360 degrees per second.

[0170] In another example, the maximum command speed for the linear movement (advancement or retraction) of the guide tube. v 最大It can be approximately 24 mm / s. For rotational movement, in one example, the maximum command speed is... v 最大 It can be based on revolutions per second (for example, approximately 0.5 revolutions per second).

[0171] As discussed in this article, the speed control function G(T 延迟 ) It can also be called a speed adjustment function, speed constraint function, or speed decay function.

[0172] Based on the example embodiment, the speed control function will be discussed in more detail below. G(T 延迟 ) .

[0173] Nyquist stability analysis can be used to determine the known (e.g., calculated) command delay. T 命令 and image feedback delay T 图像 The Nyquist stability is maintained. In this analysis, it is assumed that the users in the loop (e.g., the users providing commands at control center 202) are in time... t Provides command speed for mobile robotic medical device 246 v 命令 (t) Command speed v 命令 (t) Desired device location of robotic medical device 246 r 期望 (t) and delayed feedback location x 设备 (t–T 图像 ) The difference is proportional. In this example, the delay feedback location... x 设备 (t–T 图像 ) It is a robotic medical device 246 in time (t–T 图像 ) The location.

[0174] The local command and control module 214 can apply speed control functions. G(T 延迟 ) ∈[0,∞) to attenuate the rate of delayed commands from control center 202. v 命令 (tT 延迟) ,in T 延迟 = ( T 图像 + T 命令 ), enabling the robotic medical device 246 to operate in time t speed v 设备 (Right now, v 设备 (t) The following equation (6) is given: In equation (6), r 期望 (tT 命令 ) It is a robotic medical device 246 in time (tT 命令 ) The expected position, and x 设备 (t-(T 图像 +T 命令 )) It is a robotic medical device 246 in time (t-(T 图像 +T 命令 )) = (tT 延迟 ) The location. Therefore, the robotic medical device 246 in time t speed v 设备 (t) Based on speed control function G(T 延迟 ) Desired (or anticipated) equipment location r 期望 (tT 命令 ) and in time (t-(T 图像 +T 命令 )) Actual equipment location x 设备 (t-(T 图像 +T 命令 )) It is determined. Robotic medical device 246 in time. tdevice speed v 设备 (t) It can also be characterized as a speed control function. G(T 延迟 ) and the speed of delayed commands received at the local command and control module 214 v 命令 (tT 延迟 ) To determine. As discussed in more detail later, in some example embodiments, an acceptable delay is available for values ​​greater than or equal to a threshold. t 可接受 Total delay T 延迟 Robotic medical equipment 246 in time t device speed v 设备 (t) A speed control function based on values ​​between 0 and 1 can be used. G(T 延迟 ) To attenuate (or, alternatively, adjust) the speed of delayed commands. v 命令 (tT 延迟 ) This is to determine. On the other hand, for delays less than a threshold, an acceptable delay is acceptable. t 可接受 Total delay T 延迟 Speed ​​control function G(T 延迟 ) It can take the value 1, and delay the command speed. v 命令 (tT 延迟 ) It can be unaffected by attenuation.

[0175] In a robotic medical device system according to one or more example embodiments, based on the total delay T 延迟 And as shown in equation (7) below, the forward loop transfer function H(s) It can be used to analyze the Nyquist stability of a system: .

[0176] Since the robotic medical device system does not contain any unstable poles, the expression (8) shown below is a necessary and sufficient condition for stability.

[0177] Therefore, the function 0 ≤ G(T 延迟 ) <π / (2 T 延迟 ),π / (2 T 延迟 The system satisfies the Nyquist stability if ω ≤ ω < ∞.

[0178] Although the functions mentioned above have been discussed in this paper, other functions can also satisfy the constraints. For example, if a fixed phase margin φ is desired (e.g., to ensure a relatively or substantially uniform step response with a fixed feedback delay), then the velocity control function... G(T 延迟 ) It can be given by the following equation (9): In this case, a constant phase margin of 45 degrees can be chosen, such that φ = π / 4, and G(T 延迟 ) =π / (4 T 延迟 ).

[0179] According to at least some example embodiments, the speed control function G(T 延迟 ) Values ​​greater than 1 are allowed. In instances like these, other constraints can also be added to the speed control function. G(T 延迟 ) This makes the performance acceptable. Users can add and / or select additional constraints. In one example, additional constraints could be based on the total latency. T 延迟 This makes the speed control function G (T 延迟 ) Total delay based on a given time T 延迟 The values ​​are set to different values ​​(and the command speed is decayed differently). Equation (10) below shows the addition of additional constraints to the speed control function. G(T 延迟 ) Examples.

[0180] In this example, for lower latency, the speed control function... G(T 延迟 ) The upper limit is reduced to a constant (e.g., for 0 ≤ T 延迟<π / 8 s, for 2 or 1) may be useful for practical purposes, making when G(T 延迟 ) For example, when the value is 1, the system performance feels acceptable.

[0181] Equation (10) is a relatively simple example illustrating that a phase margin can be specified and a corresponding delay can be chosen to obtain a piecewise continuous function. In one example, the gain is 2 when the delay is π / 8. Equation (10) can be based on overall stability and can be constrained by Equation (9) discussed above.

[0182] when T 延迟 ={0, 0.5, 1.0, 1.5}s and speed control function G(T 延迟 ) When ={2, π / 2, π / 4, π / 6}, the constraints in equation (10) provide Figure 19 The step response shown is illustrated. Figure 19 The diagram also illustrates the effect of nominal gain (e.g., speed control function). G(T 延迟 ) The value remains at 1.0, with a total delay of 1.5s. T 延迟 The step response at 1.5s.

[0183] like Figure 19 As shown, for G(T 延迟 ) With a unity feedback of 1, the robotic medical device system is almost unstable without any attenuation, as it reaches its maximum total latency. However, as... Figure 19 As shown in the diagram, because of the speed control function G(T 延迟 ) By maintaining a constant phase margin, the overshoot can remain constant as the step response settling time increases (independent of changes in the step response settling time).

[0184] According to one or more example embodiments, the speed control function G(T 延迟 ) It can be further constrained to satisfy both the performance constraints of the system’s desired stability and desired phase margin, while limiting the energy injected into the system, as shown in the following equation (11): .

[0185] In the example shown in equation (11), the speed control function G(T 延迟 ) Further subject to the threshold of acceptable delay t 可接受 The constraint makes the response to the total delay T 延迟 Acceptable delay greater than or equal to the threshold t 可接受 However, the delay is less than the maximum threshold. t 禁用 ( t 可接受 ≤ T 延迟 < t 禁用 ), command speed v 命令 It can be decayed. As discussed in this article, this condition can be referred to as the "medium waiting time condition".

[0186] Maximum latency threshold t 禁用 (Also known as disabled or maximum wait time threshold) can be the maximum length of time during which commands from the user (e.g., move commands) can be enabled. In the example, the maximum delay threshold... t 禁用 It can be approximately 1.0 second (1000 ms). However, the example embodiment should not be limited to this example. As discussed herein, the total delay... T 延迟 Greater than or equal to the maximum delay threshold t 禁用 This situation can be referred to as a "high waiting time condition".

[0187] In another example, as shown in equation (12) below, the device speed v 设备 (t) It can be further constrained so that if the user wants the robotic medical device 246 to return to zero motion, then for an overtravel greater than 0 ( x 超程 > 0), only the maximum change in distance occurs.

[0188] In this case, the speed control function G( T 延迟 The value of ) is further based on the maximum overtravel distance. x 最大超程 Total delay T 延迟 and maximum command speed v 最大 The ratio of the products of makes fort 可接受 and t 禁用 Total delay between T 延迟 Speed ​​control function G(T 延迟 ) The value is 1, (π-2φ) / (2 T 延迟 )and x 最大超程 / ( T 延迟 v 最大 The minimum value in ) is used to further constrain the equipment speed. v 设备 This ensures that the maximum overtravel distance only occurs when the user wants the robotic medical device 246 to stop (return to zero motion). The maximum overtravel distance can be selected by the user.

[0189] If the maximum overtravel x 最大超程 Distance based on threshold delay t 可接受 and maximum command speed v 最大 ( x 最大超程 = t 可接受 v 最大 Then equation (12) can be rewritten as equation (13) as shown below, such that for t 可接受 ≤ T 延迟 < t 禁用 s, speed control function G(T 延迟 ) It is 1, (π-2φ) / (2 T 延迟 ), t 可接受 / T 延迟 The minimum value in.

[0190] In one example, where the robotic medical device is a guidewire, for linear or axial movement, t 可接受 = 400ms and v 最大 = 12 mm / s (normal mode), maximum overtravel x 最大超程= t 可接受 v 最大 = 4.8 mm. For t 可接受 = 400 ms and v 最大 = 60 mm / s (turbo mode), maximum overtravel x 最大超程 = t 可接受 v 最大 = 24 mm.

[0191] Regarding rotational movement, the robotic medical device uses a guidewire. t 可接受 = 400 ms and v 最大 = 360 degrees / second, maximum overtravel x 最大超程 = t 可接受 v 最大 = 144 degrees.

[0192] In one example, the robotic medical device is a guide catheter, for linear or axial movement, t 可接受 = 400ms and v 最大 = 24 mm / s, maximum overtravel x 最大超程 = t 可接受 v 最大 = 9.6mm.

[0193] Regarding rotational movement, the robotic medical device in question is a guide catheter. t 可接受 = 400 ms and v 最大 = 0.5 revolutions / s, maximum overtravel x 最大超程 = t 可接受 v 最大 = 0.2 revolutions.

[0194] According to one or more example embodiments, stability analysis has been used to provide the necessary and sufficient conditions to ensure stability. Under these conditions, the velocity control function... G(T 延迟 )The value may be greater than 1.0.

[0195] By utilizing the example implementation, additional energy can be introduced while still maintaining system stability.

[0196] Furthermore, hard distance constraints can be utilized based on perceived latency to satisfy system stability without introducing additional energy into the system, and allow the maximum possible overtravel when the user wishes to stop the movement of the robotic medical device.

[0197] Now about Figure 17 and 18 The flowchart shown describes a control method for operating a remote medical device system based on the speed control function discussed above, according to an example embodiment.

[0198] For illustrative purposes, Figure 17 and 18 The example embodiments shown will be about Figure 1-4 The systems and components shown are described herein. Furthermore, in some cases, example embodiments of robotic medical device systems will be discussed, which are catheterization systems (e.g., catheterization systems for controlling the movement and operation of elongated medical devices, such as catheters, guidewires, balloon catheters, microcatheters, etc.). However, the example embodiments should not be limited to this example. Additionally, in at least some instances, example embodiments will be discussed with respect to the linear (or axial) speed (advancement or retraction) of the robotic medical device. However, it should be understood that the example embodiments are similarly applicable to angular velocity or rotational speed and / or rate.

[0199] Furthermore, despite Figure 17 The example embodiments shown in and / or 18 will primarily concern operations performed at the local command and control module 214 of the robotic medical device system 204, but these example embodiments should not be limited to this example. Rather, the example embodiments may be implemented at other components (such as the remote command and control module 212) or distributed among various elements / components of the control center 202 and / or the robotic medical device system 204. For example, it should be understood that... Figure 17 And / or the example embodiments shown in 18 can be implemented with respect to the robotic medical device system 204. Figure 17 And / or one or more functions / operations shown in 18 are described similarly. In another example, Figure 17 And / or the example embodiments shown in 18 can be configured to implement Figure 17 The processor or controller described herein refers to one or more of the functions / operations shown in 18. Regarding the processor, in this case, the processor may be configured to execute computer-readable instructions to cause the robotic medical device system to perform... Figure 17 And / or one or more of the functions / operations shown in 18.

[0200] For illustrative purposes, Figure 17 and 18 Each illustration depicts an iteration of the method according to an example embodiment (e.g., in response to received commands and control signals, until a stop command is received). However, the example embodiments should not be limited to this example. Rather, it should be understood that, depending on the operation of the robotic medical device system, Figure 17 The methods shown in 18 and / or 18 may be implemented iteratively and / or periodically as desired.

[0201] Figure 17 This is a flowchart of a method for controlling the operation of a robotic medical device system according to an example embodiment.

[0202] refer to Figure 17 At S1702, the local command and control module 214 receives command and control signals from the control center 202. In at least one example embodiment, the command and control signals may include movement commands (advance, retract, rotate, etc.) and the required speed of movement (command speed). v 命令 Command and control signals may be similar to, the same as, or substantially the same as those discussed above.

[0203] At S1704, the local command and control module 214, in response to receiving command and control signals, calculates the total delay. T 延迟 As described above, the local command and control module 214 can reduce the total latency. T 延迟 Calculated as command delay T 命令 and image feedback delay T 图像 sum.

[0204] At S1706, the local command and control module 214 determines the total delay. T 延迟 Is it greater than (or, alternatively, greater than or equal to) the maximum delay threshold? t 禁用 In one example, the local command and control module 214 will reduce the total latency. T 延迟 With maximum latency threshold t 禁用 Comparison to determine total delay T 延迟 Is it greater than the maximum latency threshold? t 禁用 .

[0205] If the local command and control module 214 determines the total delay T 延迟 Less than or equal to (or alternatively, less than) the maximum delay threshold t 禁用 Then, at S1714, the local command and control module 214 operates the robotic medical device system 204 according to one or more example embodiments, in the event of speed decay. In one example, this can be based on the total delay. T 延迟 (Selectively) decay command speed v 命令 .

[0206] According to at least some example embodiments, the local command and control module 214 can utilize one or more speed control functions discussed above. G(T 延迟 ) The command speed is applied to the commands and control signals received from control center 202. v 命令 To obtain the device speed of the robotic medical device 246 in response to commands and control signals. v 设备 This allows the robotic medical device system 204 to operate (as needed) even with speed decay. In one example, the local command and control module 214 can apply the speed control function given by equation (9) or (10) discussed above. G(T 延迟 ) .

[0207] Still referencing Figure 17 If, during the movement of the robotic medical device 246, the local command and control module 214 receives a stop command at S1718, then at S1720, the local command and control module 214 stops the movement of the robotic medical device 246. The process iteration then terminates.

[0208] In one example, as discussed similarly above, the stop command could be an instruction from the remote command and control module 212 that the user no longer requires the mobile robotic medical device 246 (with the joystick in a stationary position). In another example, the stop command could be an emergency stop.

[0209] Returning to S1718, if the local command and control module 214 does not receive a stop command, the process returns to S1704, where the total delay is recalculated. T 延迟 And the process continues as discussed in this article.

[0210] Return to Figure 17 In S1706, if the total delay T 延迟 Greater than or equal to the maximum delay threshold t 禁用 At S1710, the local command and control module 214 disables remote operation of the robotic medical device system 204. The process then proceeds to step S1718 and continues as discussed herein.

[0211] In one example, at S1710, the local command and control module 214 can (e.g., temporarily) pause or stop the remote control of the medical device 246 (and its possible movement) and other components of the robotic medical device system 204.

[0212] Disabling remote operation of the robotic medical device system 204 can be temporary, as remote operation can be affected by total latency. T 延迟 Drop below the maximum latency threshold t 禁用 Reactivation (or restoration) assumes that no stop command has been received during this period.

[0213] According to at least some example embodiments, when remote operation of the robotic medical device system 204 is disabled, control of the robotic medical device system 204 can be transferred (e.g., via token passing as discussed above) to a local console 238 or the bedside. In this case, the local command and control module 214 can re-enable remote operation of the robotic medical device system 204 by transferring control back to the control center 202.

[0214] exist Figure 17 The speed control function shown in the example embodiment G(T 延迟 ) Applied to command speed v 命令 To determine the equipment speed v 设备 This eliminates the need to specify an acceptable latency threshold, above which the user considers latency to be detrimental to performance. However, according to other example embodiments, the speed control function... G(T 延迟 ) This can be achieved by considering an acceptable delay threshold. t 可接受 Further constraints are imposed to satisfy both the desired system stability and performance constraints with a given phase margin, while also limiting the energy injected into the system. This will be discussed in more detail below. Figure 18 Such example embodiments will be discussed in more detail.

[0215] Figure 18 This is a flowchart of a method for controlling the operation of a robotic medical device system according to an example embodiment.

[0216] Figure 18 The example embodiments shown are similar to Figure 17 The example embodiments shown are similar, except that the method (e.g., using the speed control function given by equations 11, 12 or 13 discussed above) is similar. G(T 延迟 ) (Method) By considering acceptable delay thresholds t 可接受 Further constraints are imposed to satisfy both the desired system stability and performance constraints with a given phase margin, while also limiting the energy injected into the system. For the sake of brevity, only a detailed discussion will be given. Figure 18 Zhongyu Figure 17 Different parts.

[0217] refer to Figure 18 At S1702, the local command and control module 214 receives command and control signals from the control center 202 at the local site.

[0218] At S1704, the local command and control module 214 responds to the above regarding... Figure 17 The total delay is calculated based on the same or substantially the same method of receiving command and control signals. T 延迟 .

[0219] At S1706, to be consistent with Figure 17 In the same or substantially the same manner as the example embodiments shown, the local command and control module 214 determines the total delay. T 延迟 Is it greater than (or, alternatively, greater than or equal to) the maximum delay threshold? t 禁用 .

[0220] In this example embodiment, if at S1706, the local command and control module 214 determines the total delay T 延迟 Less than or equal to (or alternatively, less than) the maximum delay threshold t 禁用 Then at S1708, the command and control module 214 determines the total delay. T 延迟 Is it greater than or equal to the acceptable delay threshold? t 可接受 .

[0221] If the total delay T 延迟Less than the acceptable delay threshold t 可接受 Then, at S1716, the local command and control module 214 operates the robotic medical device system without speed decay (e.g., G(T 延迟 ) = 1, 0≤ T 延迟 < t 可接受 s, as given by equations (11), (12) or (13). In this case, the local command and control module 214 causes the robotic medical device 246 to operate at the command speed indicated in the command and control signals ( v 设备 = v 命令 )move.

[0222] If the local command and control module 214 receives a stop command at step S1718, then at step S1720, the local command and control module 214 stops the movement of the robotic medical device 246. The process iteration then terminates.

[0223] Returning to S1718, if the local command and control module 214 does not receive a stop command, the process returns to S1704 to recalculate the total delay. T 延迟 And so on, as discussed in this article.

[0224] Returning to S1708, if the total delay T 延迟 Greater than the acceptable delay threshold t 可接受 ( t 可接受 ≤ T 延迟 < t 禁用 If the speed decays, then at S1714, the local command and control module 214 operates the robotic medical device system 204 according to one or more example embodiments. The process then continues to S1718 and continues as discussed herein.

[0225] In one example, at S1714, the local command and control module 214 can be configured as shown in equation (11). The command speed included in the commands and control signals received from control center 202 at S1702. v 命令 To obtain the device speed of the robotic medical device 246 in response to commands and control signals.v 设备 To operate the robotic medical device system 204 with velocity decay.

[0226] In another example, at S1714, the local command and control module 214 can be configured by applying equation (12) as given. Or as given by equation (13) To be independent of total delay T 延迟 The percentage overshoot of the maximum overtravel and / or step response of the robotic medical device system 204 is kept constant by varying the changes, thereby determining or controlling the device speed of the robotic medical device 246. v 设备 .

[0227] Return to Figure 18 In S1706, if the total delay T 延迟 Greater than or equal to the maximum delay threshold t 禁用 Then at S1710, the local command and control module 214 above... Figure 17 Remote operation of the robotic medical device system 204 is disabled in the same or substantially the same manner discussed. The process then proceeds to step S1718 and continues as discussed herein.

[0228] Figure 20 and 21 The illustration shows an example user interface display of a robotic medical device system according to an example embodiment.

[0229] exist Figure 20 and 21 In the example, a graphical user interface is displayed to control the sample conduit program system.

[0230] As shown, the graphical user interface (GUI) of the control center (and similarly, the robotic medical device system) displays, for example, the same measurements, speeds, saved settings, and which control on the console is being actuated at the active site (i.e., the control center at the remote site). Although in Figure 20 and 21 Not shown, but in the same or substantially the same manner as discussed above, each graphical user interface display may also show the transmitted images and total latency from the robotic medical device system 204 to the control center 202. T 延迟 .

[0231] refer to Figure 20 When there is no waiting time condition (e.g., T 延迟 <t 可接受 The graphical user interface display 2000 can be displayed at control center 202 (e.g., at monitor 240 or console 236). In this case, all drive controls (devices, guidewires, catheters, etc.) are available to the user at control center 202. The graphical user interface display 2000 also includes a "Disable All" button as discussed above.

[0232] The drive control of the robotic medical device 246 may include a linear speed control 0202 for controlling the propulsion or retraction speed of the robotic medical device 246. v 命令 In one example, the linear speed control 20202 may be a discrete control that causes the robotic medical device 246 to move 1 mm with each button press. However, this example embodiment should not be limited to this example.

[0233] The guidewire drive controls may include a linear speed control 20203 for controlling the advance or retraction of the guidewire, and a rotational speed control 20204 for controlling the rotational speed and direction of the guidewire. In one example, the linear speed control 20203 may be a discrete control that moves the guidewire 1 mm per button press. Similarly, the rotational speed control 20204 may be a discrete control that rotates the guidewire 225 degrees per button press. However, this example embodiment should not be limited to this example.

[0234] The drive control for the guide duct may include a linear velocity control 20206 (e.g., a discrete control that moves forward and backward by 1 mm) and a position indicator display 20208.

[0235] Still referencing Figure 20 The graphical user interface display 2000 also includes the current relative measurement position compared to the last reset value (125.8 in this case), as well as the most recently saved measurement value (34.7 in this case).

[0236] In response to the occurrence of high latency conditions (e.g., Figure 17 and / or at S1706 in 18 T 延迟 ≥ t 禁用 A high latency pop-up window 2002 can be displayed to the user at control center 202. The high latency pop-up window 2002 can override the user interface display 2000 and indicate that the current network latency has exceeded the maximum delay threshold. t 禁用 (In this case, 1 second), the remote console control has been disabled. According to at least one example embodiment, in Figure 17At S1710 in 18, the high wait time pop-up window 2002 may be accompanied by the disabling of the remote console control and the cessation of movement of the robotic medical device 246.

[0237] Once the user confirms the high latency condition (for example, by clicking or pressing the "OK" button in the high latency pop-up window 2002), the high latency pop-up window 2002 is cleared.

[0238] After clearing the high latency pop-up 2002, display the graphical user interface 2004 to the user until the high latency condition is completely resolved (e.g., until the total latency is cleared). T 延迟 Drop below the maximum latency threshold t 禁用 As shown, the graphical user interface display 2004 can indicate that console controls are disabled, and also includes a high latency condition indicator 20040. Once resolved, the robotic medical device system 204 can be remotely controlled (e.g., by manually pressing the "Enable All" button), and the user at the control center 202 can continue to operate the robotic medical device system 204.

[0239] According to one or more example embodiments, a high latency pop-up window 2002 may occur in response to the initial (e.g., first) occurrence of a high latency condition, but not thereafter. In response to subsequent high latency conditions, the graphical user interface display 2000 may directly change to the graphical user interface display 2004 to indicate the high latency condition and the disabling of remote control.

[0240] At local console 238, in response to the occurrence of a high latency condition, a graphical user interface display 2006 can be shown to the local user on the patient's side. As shown, graphical user interface display 2006 indicates that the remote console controls have been disabled.

[0241] See Figure 21 In response to the occurrence of moderate waiting time conditions (e.g., t 可接受 ≤ T 延迟 < t 禁用A medium wait time pop-up window 2100 can be displayed to the user at console 236. In this case, the medium wait time pop-up window 2100 indicates that, with the medium wait time condition present, the sensitivity of the control (e.g., joystick) is being adjusted and / or scaled (e.g., by applying speed control to attenuate command speed). Once the user confirms the medium wait time condition by clicking the "OK" button, the medium wait time pop-up window 2100 is cleared, and the user at control center 202 can continue to control the robotic medical device system 204 from the remote console 236.

[0242] After clearing the moderate wait time pop-up window 2100, display the graphical user interface 2102 to the user until the moderate wait time condition is fully resolved (e.g., until the total delay). T 延迟 Dropped below the acceptable latency threshold t 可接受 Until then. The graphical user interface displays something similar to 2102. Figure 20 The graphical user interface shown in Figure 2000, in addition to graphical user interface display 2102, further includes a medium wait time indicator 21020 indicating the presence of a medium wait time condition. The medium wait time condition indicator 21020 can be cleared once resolved.

[0243] and Figure 20 As with the example embodiment shown, the medium wait time pop-up window 2100 may occur in response to the initial (e.g., first) occurrence of the medium wait time condition, but not thereafter. In response to subsequent medium wait time conditions, a graphical user interface display 2102 including a medium wait time indicator 21020 may be shown to the user.

[0244] Still referencing Figure 21 In response to moderate waiting time conditions, a graphical user interface display 2104 can be shown to the local user at the local console 238 (patient side). The user interface 2104 indicates that the remote console controls are enabled, but the joystick sensitivity is being adjusted and / or scaled.

[0245] Figure 22-25 The figures are graphs illustrating various aspects of the example embodiments.

[0246] Figure 22 This is an example gain profile of a robotic medical device system according to an example embodiment. In this example, the velocity control function given by equation (11) labeled G2 and equation (13) labeled G4 is shown. G(T 延迟 ) Gain profile.

[0247] like Figure 22 The speed control function shown is given by equation (11) labeled G2. G(T 延迟 ) , in response to total delay T 延迟 Reaching approximately 433 ms ( t 可接受 = 433 ms), the decay or scaling of the command speed begins. Regarding the speed control function given by equation (13) labeled G4. G(T 延迟 ) , in response to total delay T 延迟 Reaching approximately 400 ms t 可接受 = 400ms), the decay or scaling of the command velocity begins. As shown, in both instances, the scaling or decay of the velocity is non-linear.

[0248] Figures 23A-23C The diagram shows a robotic medical device system in different... T 延迟 A graph of an example step response at a given value.

[0249] More in detail, Figure 23A The figure illustrates the application of the speed control function given by equation (11), denoted as G2. G (T 延迟 ) At that time, robotic medical device systems in different T 延迟 Example step response at the value.

[0250] Figure 23B The figure illustrates the application of the speed control function given by equation (13), labeled G4. G(T 延迟 ) At that time, robotic medical device systems in different T 延迟 Example step response at the value.

[0251] Figure 23C The illustration shows the application of a speed control function without compensation or attenuation, according to an example embodiment. G(T 延迟 ) In different situations, robotic medical device systems T 延迟 Example step response at the value.

[0252] like Figure 23A and23B and Figure 23C The comparison shows that the application of the speed control function according to the example embodiment maintains system stability, although the total delay increases.

[0253] Figure 24 This illustration shows an example response time and total delay for a step response of a robotic medical device system according to an example embodiment. T 延迟 The curve. In this example, the applied speed control function is given by equation (11) labeled G2 and equation (13) labeled G4. G(T 延迟 ) The step response is shown together with a graph of the uncompensated or attenuated step response (G=1). As illustrated, when the velocity control function according to the example embodiment is applied, the step response time of the robotic medical device system according to the example embodiment is greater than or equal to approximately 400 ms. T 延迟 It shows a stable and linear increase.

[0254] Figure 25 This diagram illustrates an example of percentage overshoot versus total delay in a step response. T 延迟 The graph shows the total delay. As shown, for an uncompensated or unattenuated system (G = 1), the total delay... T 延迟 More than approximately 400 ms t 可接受 = 400 ms) After that, the percentage overshoot increases with the total delay T 延迟 The increase is due to the continuous increase of the value. In this example, the increase is non-linear. In contrast, the speed control function is given by equation (11) labeled G2 and equation (13) labeled G4. G(T 延迟 ) The percentage overshoot remains largely constant (in the case of G4) or increases slightly (in the case of G2), and then even in the total delay... T 延迟 More than approximately 400 ms t 可接受 It also remained largely constant after 400 ms.

[0255] One or more example implementations can be used without defining an acceptable delay (e.g., approximately 400 ms) before applying a speed control algorithm (also known as a speed decay algorithm).

[0256] The example implementation provides a mechanism to achieve a constant or substantially constant phase margin (which results in constant or substantially constant overshoot for different step responses), and further constrains the gain by maximum overshoot for safety.

[0257] According to one or more example embodiments, the gain G is calculated based on limiting the maximum overtravel (e.g., from a risk mitigation perspective) rather than from a control system stability perspective. One or more example embodiments may also define when the speed control algorithm can be applied (e.g., between approximately 400 ms and approximately 1 s).

[0258] Although the terms first, second, etc., may be used herein to describe various elements, these elements should not be limited by these terms. These terms are used only to distinguish one element from another. For example, without departing from the scope of this disclosure, a first element may be referred to as a second element, and similarly, a second element may be referred to as a first element. As used herein, the term "and / or" includes any and all combinations of one or more of the associated listed items.

[0259] When one element is described as "connected" or "coupled" to another element, it can be directly connected or coupled to the other element, or there may be intermediate elements. In contrast, when one element is described as "directly connected" or "directly coupled" to another element, there are no intermediate elements. Other terms used to describe relationships between elements should be interpreted in a similar manner (e.g., "between" vs. "directly between," "adjacent" vs. "directly adjacent," etc.). The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. As used herein, the singular forms “a,” “an,” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises,” “comprising,” “includes,” and / or “including,” when used herein, specify the presence of the stated features, integers, steps, operations, elements, and / or components, but do not exclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and / or groups thereof.

[0260] It should also be noted that in some alternative implementations, the functions / actions mentioned may not occur in the order shown in the diagram. For example, depending on the functions / actions involved, two diagrams shown consecutively may actually be executed substantially simultaneously, or sometimes in reverse order.

[0261] Specific details are provided in the following description to provide a thorough understanding of the exemplary embodiments. However, those skilled in the art will understand that the exemplary embodiments can be practiced without these specific details. For example, a system may be shown in block diagrams to avoid obscuring the exemplary embodiments with unnecessary details. In other instances, well-known processes, structures, and techniques may be shown without unnecessary details to avoid obscuring the exemplary embodiments.

[0262] As discussed herein, illustrative embodiments are described using action and symbolic representations of reference operations (e.g., in the form of flowcharts, diagrams, data flow diagrams, structural diagrams, block diagrams, etc.). These operations can be implemented as program modules or functional processes, including routines, programs, objects, components, data structures, etc., performing specific tasks or implementing specific abstract data types, and can be implemented using existing hardware, such as in existing robotic medical device systems, as disclosed in U.S. Patent Application Publication No. 2021 / 0220064 and / or International Publication No. WO 2019 / 222641, the entire contents of each of which are incorporated herein by reference. Such existing hardware can be processing or control circuitry, such as, but not limited to, one or more processors, one or more central processing units (CPUs), one or more controllers, one or more arithmetic logic units (ALUs), one or more digital signal processors (DSPs), one or more microcomputers, one or more field-programmable gate arrays (FPGAs), one or more system-on-a-chip (SoCs), one or more programmable logic units (PLUs), one or more microprocessors, one or more application-specific integrated circuits (ASICs), or any one or more other devices capable of responding to and executing instructions in a defined manner.

[0263] Although flowcharts can describe operations as a sequential process, many operations can be performed in parallel, concurrently, or simultaneously. Furthermore, the order of operations can be rearranged. A process can terminate when its operations are completed, but it can also have additional steps not included in the diagram. A process can correspond to a method, function, program, subroutine, subroutines, etc. When a process corresponds to a function, its termination can correspond to the function returning to the calling function or the main function.

[0264] As described herein, the terms "storage medium," "computer-readable storage medium," or "non-transitory computer-readable storage medium" can refer to one or more devices for storing data, including read-only memory (ROM), random access memory (RAM), magnetic RAM, magnetic core memory, magnetic disk storage media, optical storage media, flash memory devices, and / or other tangible machine-readable media for storing information. The term "computer-readable medium" can include, but is not limited to, portable or fixed storage devices, optical storage devices, and various other media capable of storing, containing, or carrying one or more instructions and / or data.

[0265] Furthermore, the example embodiments can be implemented by hardware, software, firmware, middleware, microcode, hardware description languages, or any combination thereof. When implemented in software, firmware, middleware, or microcode, program code or code segments performing the necessary tasks can be stored in a machine or computer-readable medium, such as a computer-readable storage medium. When implemented in software, one or more processors will perform the necessary tasks. For example, as described above, according to one or more example embodiments, at least one memory may include or store computer program code, and said at least one memory and computer program code may be configured, together with at least one processor, to enable the robotic medical device system to perform the necessary tasks. Furthermore, the processor, memory, and example algorithms encoded as computer program code act as components for providing or causing the implementation of the operations discussed herein.

[0266] A code segment of computer program code can represent any combination of programs, functions, subroutines, routines, subroutines, modules, software packages, classes, instructions, data structures, or program statements. A code segment can be coupled to another code segment or hardware circuit by passing and / or receiving information, data, arguments, parameters, or memory contents. Information, arguments, parameters, data, etc., can be passed, forwarded, or transmitted via any suitable technology—including memory sharing, message passing, token passing, network transmission, etc.

[0267] As used herein, the terms “contains” and / or “has” are defined as including (i.e., open-ended language). As used herein, the term “coupled” is defined as a connection, although not necessarily a direct or mechanical connection. Terms derived from the word “indication” (e.g., “indicates” and “indication”) are intended to encompass all the various techniques that can be used to convey or reference an indicated object / information. Some, but not all, examples of techniques that can be used to convey or reference an indicated object / information include: the communication of the indicated object / information; the communication of an identifier of the indicated object / information; the communication of information used to generate the indicated object / information; the communication of a component or part of the indicated object / information; the communication of a derivative of the indicated object / information; and the communication of a symbol representing the indicated object / information.

[0268] According to example embodiments, one or more elements of a robotic medical device system (e.g., local and / or remote command and control modules) or such elements may be (or include) hardware, firmware, hardware-executed software, or any combination thereof. Such hardware may include processing or control circuitry, such as, but not limited to, one or more processors, one or more CPUs, one or more controllers, one or more ALUs, one or more DSPs, one or more microcomputers, one or more FPGAs, one or more SOCs, one or more PLUs, one or more microprocessors, one or more ASICs, or any one or more other devices capable of responding to and executing instructions in a defined manner.

[0269] The benefits, other advantages, and solutions to problems have been described above with respect to specific embodiments of the invention. However, the benefits, advantages, solutions to problems, and any (one or more) elements that may cause or lead to such benefits, advantages, or solutions, or cause such benefits, advantages, or solutions to become more significant, should not be construed as key, essential, or necessary features or elements of any or all claims.

[0270] Detailed reference has been made to the embodiments, examples of which are illustrated in the accompanying drawings, wherein similar reference numerals always refer to similar elements. In this respect, exemplary embodiments may take different forms and should not be construed as limited to the description set forth herein. Therefore, exemplary embodiments are described below only with reference to the figures to explain the exemplary embodiments described herein. Aspects of the various embodiments are specified in the claims.

Claims

1. A robotic medical device system, comprising: The controller is configured to perform nonlinear scaling of the speed of the robotic medical device in response to one or more control signals, independent of variations in delays associated with the control of the robotic medical device, to maintain a constant overshoot for different step responses of the robotic medical device system. The one or more control signals mentioned herein are received via a network, and Different step responses include different step response settling times for robotic medical device systems.

2. The robotic medical device system of claim 1, wherein the delay includes at least one of command delay or image feedback delay.

3. The robotic medical device system of claim 1, wherein the controller is configured to perform nonlinear scaling of the speed of the robotic medical device to maintain a constant maximum overtravel distance of the robotic medical device.

4. The robotic medical device system of claim 1, wherein the delay is at least partially based on network transmission delay.

5. The robotic medical device system according to claim 1, wherein... The speed of robotic medical devices includes at least one of linear or rotational speeds.

6. A method of operating a robotic medical device system including a robotic medical device and a controller, the method comprising: Nonlinear scaling of the speed of a robotic medical device in response to one or more control signals, independent of variations in delays associated with the control of the robotic medical device, maintains a constant overshoot for different step responses of the robotic medical device system, wherein... The one or more control signals are received via a network, and Different step responses include different step response settling times for robotic medical device systems.

7. The method of claim 6, wherein the delay includes at least one of command delay or image feedback delay.

8. The method of claim 6, wherein the speed of the performing robotic medical device is nonlinearly scaled to maintain a constant maximum overtravel distance of the robotic medical device.

9. The method of claim 6, wherein the delay is at least partially based on the transmission delay of the network.

10. The method of claim 6, wherein the speed of the robotic medical device includes at least one of linear or rotational speed.

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