Robotic arm and method for tissue resection and imaging

Abstract

The invention relates to a robotic arm and method for tissue resection and imaging. A system for treating target tissue of a patient includes a first robotic arm coupled to a treatment probe for treating the target tissue of the patient and a second robotic arm coupled to an imaging probe for imaging the target tissue of the patient. The system also includes one or more computing devices operably coupled with the first robotic arm and the second robotic arm, the one or more computing devices configured to execute instructions for controlling movement of one or more of the first robotic arm or the second robotic arm.

Description

[0001] This application is a divisional application of an application with an application date of March 9, 2020, application number 202080033167.1, and invention name “Robotic arm and method for tissue resection and imaging”.

[0002] CROSS-REFERENCE TO RELATED APPLICATIONS

[0003] This application claims the benefit of U.S. Provisional Application No. 62 / 933,793, filed on November 11, 2019, and U.S. Provisional Application No. 62 / 814,966, filed on March 7, 2019, under 35 U.S.C. 119(e), the disclosures of which are incorporated by reference in their entirety.

[0004] The subject matter of this application is related to the following patents and patent applications: U.S. Provisional Application No. 11 / 968,445, filed on January 2, 2008, now U.S. Patent No. 7,882,841; U.S. Provisional Application No. 12 / 399,585, filed on March 6, 2009, now U.S. Patent No. 8,814,921; U.S. Provisional Application No. 14 / 334,247, filed on July 17, 2014, now U.S. Patent No. 9,364,251; and International Application No. PCT / US2015 / 048695, filed on September 4, 2015; the entire contents of which are incorporated herein by reference. background

[0006] The field of the present disclosure relates to treating tissue with energy, and more particularly to treating organs (eg, the prostate) with fluid energy.

[0007] Existing methods and devices for treating subjects (e.g., patients) may result in less than ideal tissue removal in at least some cases. For example, existing methods of prostate surgery may result in longer than ideal healing times and suboptimal results in at least some cases.

[0008] Existing methods and apparatus for imaging tissue may be less than ideal for imaging treated tissue. For example, existing ultrasound methods and apparatus may not be well suited for viewing the treatment site during treatment, and alignment of diagnostic images with treatment images may be less than ideal. In addition, at least some existing treatment methods and apparatus for treating tissue may not be well suited for forming a combination with prior art imaging systems. In at least some cases, it would be helpful to provide improved imaging of tissue during surgery, such as providing real-time imaging of tissue, which would allow a user to adjust treatment based on the real-time image of the tissue. At least some existing methods and apparatus for imaging tissue during surgery may be cumbersome to use and may result in delays in patient treatment.

[0009] Existing methods and devices for treating organs (e.g., prostates) may provide user interfaces that are somewhat inconvenient for users and may provide less than ideal surgical plans. In addition, at least some existing methods and devices for treating tissues (e.g., prostate tissue) may be slightly less accurate than ideal. In at least some cases, existing methods and devices may provide a less than ideal user experience. In addition, at least some existing interfaces may provide less than ideal coupling of the treatment device to the tissue structure.

[0010] Existing methods and devices for treating tissue with robotic instruments may be less than ideal during treatment. The robotic arms and surgical probes of a robotic surgical system may be aligned with each other and with the patient prior to treatment. In some cases, the robotic arms and surgical probes are first manually moved and positioned before they are coupled to each other and locked in place for further controller-based adjustments. For example, a surgical probe or other tool coupled to a robotic arm may be manually guided through the anatomical structure to reach a target site, such as through the anus and rectum in the case of transrectal ultrasound ("TRUS") or through a tortuous path of the urethra, prostate, and bladder neck (a tortuous path involves sharp turns through sensitive anatomical structures). In at least some cases, maintenance of the desired alignment and stability of the robotic arms after manual adjustments and during treatment may be less than ideal. For example, existing robotic arms and distal surgical probes may be held too rigidly - which could potentially result in tissue damage associated with patient movement, or may be held with less than ideal support strength - which could result in less than ideal alignment with a target site if the robotic arm and surgical probe are disturbed, for example when bumped or released from a user's grasp after coupling.

[0011] Work related to the present disclosure has shown that existing ways of aligning a probe with a robotic arm may be less than ideal in at least some circumstances.

[0012] While these aforementioned methods and devices may be very effective and may represent a significant advancement over existing cavity tissue treatment modalities, it would be desirable to provide improvements that facilitate more accurate tissue removal in both fully automated and physician-assisted modes of operation. The invention described hereinafter will achieve at least some of these goals.

[0013] Overview

[0014] Embodiments of the present disclosure provide improved methods and apparatus for performing tissue treatment (e.g., tissue resection). In some embodiments, an image-guided treatment system includes a treatment probe and an imaging probe. The imaging probe may be configured to provide an image of a target site when the treatment probe performs resection of the target tissue. In some embodiments, the treatment probe and the imaging probe are each coupled to a robotic arm under the control of one or more computing devices. The treatment probe may be coupled to a first robotic arm, which is configured to provide computer-controlled movement of the treatment probe during tissue resection with the treatment probe. The imaging probe may be coupled to a second robotic arm, which is configured to provide computer-controlled movement of the imaging probe during scanning of the target site with the imaging probe, before and / or during a tissue resection process with the treatment probe. One or more computing devices may be configured to execute instructions for operating the robotic arm in a passive mode, in which the robotic arm is configured to be manually adjusted to position the treatment probe and the imaging probe to a manually set position, such as for imaging the same or different tissue sites and processing on the same or different tissue sites. One or more computing devices may be configured to execute instructions for maintaining the manually set positioning of the probe after the robotic arm is released from manual adjustment. The robotic arm may be configured to maintain the manually set positioning with one or more of a certain tolerance on one or more of the translational or rotational axes. In some embodiments, the rotational angle is maintained to within 5°, and the translational positioning is maintained to within 5 mm or less. In some embodiments, the rotational angle and translational positioning are maintained for each of the three axes, which can improve the accuracy of imaging and processing with the probe.

[0015] One or more computing devices operably coupled to the first robotic arm and the second robotic arm can be configured to automatically control the movement of the treatment probe and / or imaging probe, for example, based on a pre-planned or programmed scanning profile or according to various pre-programmed parameters. For example, the automatically controlled movement of the treatment probe along the treatment profile can perform treatment of the target site. For example, the automatically controlled movement of the imaging probe along the imaging profile can generate a three-dimensional rendering of the target site. The automatic, computer-controlled scanning of the target site using the robotic arm with the imaging probe can also be used to generate useful information about the target site for additional treatment. For example, the imaging probe can be configured to perform a color / Doppler scan of the target site after the resection process to find out the bleeding site within the target site that needs hemostasis. The three-dimensional scanning of the target site using the imaging probe can also be used to identify tissue abnormalities at the target site, such as tumors.

[0016] Alternatively or additionally, the one or more computing devices may be configured to control movement of the treatment probe and / or imaging probe in response to user input, for example, through a graphical user interface of the processing device. In some embodiments, the one or more computing devices may be configured to limit movement of the treatment probe and / or imaging probe to an allowable range of motion that may be programmed into the first robotic arm and / or the second robotic arm prior to commencing use of the first robotic arm or the second robotic arm under computer control.

[0017] The first robotic arm and / or the second robotic arm can be configured to adjust the positioning and / or orientation of the first arm and / or the second arm to maintain proper positioning or alignment of the treatment probe and the imaging probe, and / or prevent collision or interference between the treatment probe and the imaging probe outside the patient's body.

[0018] The first robotic arm and / or the second robotic arm may include one or more feedback sensing mechanisms. For example, the first robotic arm and / or the second robotic arm may be operably coupled to a force sensor configured to detect compression of tissue in front of the treatment probe and / or the imaging probe. One or more computing devices may include instructions for controlling the movement of the robotic arm in response to the force detected by the sensor, such as instructions for preventing excessive compression of the anterior tissue and resulting damage to the tissue and / or the probe. Another exemplary feedback sensing mechanism may include a positioning and / or motion sensor operably coupled to the first robotic arm and / or the second robotic arm. One or more computing devices may include instructions for controlling the movement of the robotic arm in response to the positioning and / or motion detected by the sensor, such as instructions for adjusting the positioning of the treatment probe and / or the imaging probe in response to patient movement during the treatment and / or scanning process.

[0019] These and other embodiments are described in more detail in the following description which relates to the accompanying drawings.

[0020] Incorporated by Reference

[0021] All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference. BRIEF DESCRIPTION OF THE DRAWINGS

[0023] The novel features of the present invention are particularly set forth in the appended claims. A better understanding of the features and advantages of the present disclosure will be obtained by reference to the following detailed description and accompanying drawings which set forth illustrative embodiments in which the principles of the present disclosure are utilized, in which:

[0024] Figure 1shows a front view of a system for performing tissue resection within a patient according to some embodiments;

[0025] Figure 2 schematically illustrates a system for performing tissue resection within a patient according to some embodiments;

[0026] Figure 3A and Figure 3B shows a perspective view of a common base or foundation for supporting one or more robotic arms according to some embodiments;

[0027] Figure 4A and Figure 4B A perspective view and a side view, respectively, are shown of a system including a movable base for performing tissue resection within a patient according to some embodiments;

[0028] Figure 5A and Figure 5B A top view of a coupler between a processing probe and a first robotic arm is shown according to some embodiments, wherein Figure 5A shows the uncoupled processing probe and the first robot arm, and Figure 5B showing a coupled processing probe and a first robotic arm;

[0029] Figure 6 A flow chart illustrating a method of operating a robotic arm coupled to a processing probe according to some embodiments;

[0030] Figure 7 A method for operating a robotic arm coupled to an imaging probe according to some embodiments is shown;

[0031] Fig. 8A illustrates the configuration of a treatment probe and an imaging probe during treatment of a patient according to some embodiments;

[0032] Figure 8B is a schematic diagram of a probe and a robot arm with a force detection sensor according to some embodiments;

[0033] Fig. 9A , Fig. 9B and Fig. 9C schematically illustrates alignment of a treatment probe axis with a sagittal plane of an imaging probe according to some embodiments;

[0034] Fig.10 shows an intraoperative image of a surgical field including identification of a bleeding site according to some embodiments;

[0035] Fig.11A , Fig. 11B and Fig. 11Cside, front, and perspective views, respectively, of a system for performing tissue resection in a patient, the system including a processing station coupled to a system of sliders and mounts for positioning imaging probes and processing probes, according to some embodiments;

[0036] Fig.12 shows a perspective view of a treatment system for performing tissue resection in a patient, the system including a mobile cart having a display and a common robotic arm base for actuating robotic arms of an imaging probe and a treatment probe, according to some embodiments;

[0037] Fig.13 shows a perspective view of a processing system for performing tissue resection according to some embodiments;

[0038] Fig.14A , Fig. 14B and Fig. 14C shows a perspective view of a fixture for use with a processing system according to some embodiments;

[0039] Fig.15A , Fig. 15B , Fig. 15C and Fig.15D illustrates an internal perspective view of a fixture for use with a processing system according to some embodiments;

[0040] Fig.16A , Fig. 16B , Fig. 16C and Fig.16D shows a side interior view of a fixture for use with a processing system according to some embodiments;

[0041] Fig.17A , Fig. 17B and Fig. 17C showing a rear perspective view, a side view, and a front perspective view, respectively, of a clamping system according to some embodiments;

[0042] Fig.18A and Fig.18B shows a perspective view of a beam having a base for use with a processing system according to some embodiments;

[0043] Fig.19A and Fig.19B shows a perspective view of a beam having a base for use with a processing system according to some embodiments;

[0044] Fig. 20 shows a perspective view of a control handle according to some embodiments;

[0045] Fig.21shows a plan view of an imaging probe and a treatment probe coupled to respective control handles and showing coplanarity according to some embodiments;

[0046] Fig. 22 shows a perspective view of a system for positioning an imaging probe and a processing probe, the system including a fixture, a support, and a robotic arm according to some embodiments;

[0047] Fig.23 shows a side view of a system for positioning an imaging and processing probe according to some embodiments;

[0048] Fig.24 shows a perspective view of a processing system including a wheel probe mounting and adjustment assembly according to some embodiments;

[0049] Fig.25 A system for positioning and calibrating one or more probes according to some embodiments is shown;

[0050] Fig.26 shows an arm coupled to a sheath, a robotic arm coupled to a treatment probe, and an arm coupled to an ultrasound probe, according to some embodiments;

[0051] Fig. 27 Shown include Fig.26 A system of a robotic arm coupled to a processing probe and an arm coupled to a sheath is shown.

[0052] Fig.28A A coupler coupling the robotic arm to the processing probe is shown;

[0053] Fig.28B It is shown that Fig.28A The coupler in the apparatus provides movement of the treatment probe, endoscope, irrigation lumen, and aspiration lumen; and

[0054] Fig.29 A method of processing according to some embodiments is shown. Detailed Description

[0056] Embodiments of the present disclosure provide improved methods and devices for performing tissue treatments, such as tissue resections (e.g., prostate tissue resections). The methods and devices disclosed herein are well suited for many types of surgical procedures and can be incorporated into many existing systems and methods. Although some embodiments of the present disclosure are intended for transurethral treatment of the prostate, some aspects of the present disclosure may also be used to treat and modify other tissues and related organs, such as the brain, heart, lungs, intestines, eyes, skin, kidneys, liver, pancreas, stomach, uterus, ovaries, testicles, bladder, ears, nose, mouth, soft tissues (e.g., bone marrow, adipose tissue, muscle, glandular and mucosal tissues, spinal cord and neural tissues, cartilage), hard biological tissues (e.g., teeth, bones), and body cavities and passages (e.g., sinuses, ureters, colon, esophagus, lung passages, blood vessels, and throat). The devices disclosed herein may be inserted through existing body cavities, or may be inserted through openings created in body tissues.

[0057] The methods and devices disclosed herein are very suitable for treating various types of tissues with energy sources. For example, tissues may include soft tissues (e.g., glandular tissue or capsular tissue) or hard tissues (e.g., bone) or obstructions (e.g., kidney stones). The energy source may include one or more of the following: laser beams, water jets, electrodes, ultrasound, high-intensity focused ultrasound, mechanical vibrations, radio frequency (RF) energy, ultrasonic transducers, microwave energy, cavitation energy (e.g., cavitating water jets or ultrasonic cavitation), radiation (e.g., ionizing radiation from radioisotopes) or ion energy from ionizing electrodes or plasma energy from plasma electrodes. For example, the methods and devices disclosed herein are very suitable for performing lithotripsy to break up kidney stones. The methods and devices disclosed herein are very suitable for treating with radiation (e.g., radioisotopes on treatment probes). For example, for the treatment of cancer, radiation treatment may be provided on the probe and removed with the probe, or implanted from the treatment probe.

[0058] In some embodiments, an image-guided treatment system includes a treatment probe and an imaging probe. The imaging probe can be configured to provide an image of a target site while the treatment probe performs resection of the target tissue. The treatment probe and the imaging probe can each be coupled to a robotic arm under the control of one or more computing devices to enable more precisely controlled movement of one or both arms and improve the safety and efficiency of treatment performed using the treatment system.

[0059] The robot arm can be configured in a variety of ways. Work related to the present disclosure shows that the TRUS probe can exert a force on the robot arm. In some embodiments, the force is related to the force from the patient against the probe. In some embodiments, the force is related to the force caused by the practicing surgeon moving the probe against the tissue and moving the tissue for the purpose of improving imaging or relative to the tissue position of the intended treatment. The length of the probe can result in a corresponding torque on the robot arm.

[0060] The current inventors have conducted experiments to determine the amount of force that can be applied to the robot arm from the TRUS probe. For example, the force can be measured on a motor base outside the patient's body. The force can range from 0 to about 5 kilograms, depending on the surgical position of the probe and the patient. In some embodiments, the distance from the arm to the point of contact with the prostate corresponds to the amount of torque on the arm.

[0061] According to some embodiments disclosed herein, instrument positioning can have three types of motion control and capabilities. These three types of motion generally include: 1) gross motion capabilities for movement, storage, and preparation for surgery, 2) intermediate motion capabilities for aligning the probe with the patient and inserting the probe into the patient, and 3) fine motion capabilities corresponding to position tolerances for accurate surgery.

[0062] For example, gross motion capabilities allow for reserve under and adjacent to an operating table and during patient positioning.

[0063] For example, when the system is prepared and positioned for patient entry, the intermediate motion allows the instrument to be positioned relative to the patient on a surgical support structure (e.g., an operating room ("OR") operating table). The typical position range of a TRUS probe or any suitable surgical invasive probe has free motion for insertion into the patient, which can be described by an X, Y, Z coordinate system. Using an appropriate coordinate reference system, the entrance to the patient's cavity can correspond to a value of 0,0,0 in the X, Y, Z coordinate system. The coordinate reference can also include an angular coordinate reference of X', Y', Z'. The entrance to the cavity can include the patient's anus. In the case where the anus entrance is at 0,0,0 and the probe is colinear with the patient axis, the intermediate motion can include an X motion tolerance of + / -2 to 15 cm, a Y motion tolerance of + / -2 to 15 cm, and a Z motion tolerance of + / -2 to 30 cm. In some embodiments, the X and Y motions correspond to translations of the probe along the X and Y coordinate references. The Z-axis position corresponds to movement along the axis of the cavity, and can correspond to advancement and retraction of the probe along the body cavity, such as translational movement into and out of the patient. With X', Y', Z' angle adjustments, the angular position capabilities may include X' + / - 0 to 30 degrees, Y' + / - 0 to 30 degrees, Z' + / - 0 to 30 degrees relative to the patient's natural axes. Work related to the present disclosure has shown that a probe with these angle capabilities can be manipulated by a user for insertion into a patient.

[0064] In some embodiments, the fine movement capability and tolerance correspond to the configuration of the robot probe and arm when the probe is positioned in the patient, for example, during tissue resection and imaging. When the system is used with an instrument positioned for diagnosis and treatment, the sensors and controls described herein can be configured to prevent tissue damage, and also position the treatment probe and imaging probe to obtain reliable images, such as optimal images, and the treatment probe and imaging probe can be accurately positioned and firmly held in place against tissue pressure. The X, Y, Z reference system can be centered at 0, 0, 0 with the cavity entrance (and the probe is colinear with the patient axis). In some embodiments, the X motion tolerance is + / -0 to 5cm; the Y motion tolerance is + / -0 to 5cm; and the Z motion tolerance is + / -0 to 15cm. The X and Y motions generally correspond to the translation of the probe, and the Z axis corresponds to the advancement and retraction of the probe in and out of the patient. The corresponding angular adjustment range of X', Y', Z' is X'+ / -0 to 10 degrees, Y'+ / -0 to 10 degrees and Z'+ / -0 to 15 degrees relative to the patient's natural axis (e.g., relative to the patient's midline, and the Z axis extends along the patient's midline). Although the above values ​​represent the range of motion, the robot arm and the surgical probe can provide a more stringent tolerance for the fixed position configuration of the probe. For example, when the probe is expected to be kept in a fixed position, the rotation tolerance can maintain one or more of X', Y', and Z' within a tolerance of + / -5° or less (e.g., + / -3°). Regarding translational movement, for example, for one or more of X, Y, and Z axes, the manually set positioning can be maintained to a position tolerance of 5mm or less, 3mm or less, or 2mm or less. In some embodiments, for each of X, Y, Z and X', Y', and Z', these tolerances are maintained. In some embodiments, the probe is manually set, and the translation and rotation tolerances are maintained within the above values, which can improve the accuracy of tissue processing and related imaging. For example, these tolerances may correspond to the maximum structural slack or load of the arm on which the probe is mounted.

[0065] The probe can be manipulated and inserted into the patient in a variety of ways. For example, the probe can be manipulated manually, and the robotic arm is moved to align with and couple to the probe, the probe maintains the above tolerance when released by the user, and the arm then supports the full load of the patient and the probe. The arm can be aligned with the probe manually or with at least some automatic operation (wherein sensors and guidance circuits are used to align the arm with the probe held by the user). The arm may include a coupling structure that engages the probe with 6 degrees of freedom, so that the coupling structure on the arm can be accurately aligned with the coupling structure on the probe. In response to detecting the alignment, the coupling structures can then engage and couple to each other. In some embodiments, a sensor is provided on one or more of the arm or the probe to detect the alignment between the arm and the probe, and the coupling structure is engaged in response to the detected alignment. The robotic arm may include a linkage coupled to a processor, wherein the processor controls the movement of the arm and aligns the arm with the probe held by the user.

[0066] In some embodiments, the urethral probe has similar size, motion, and tolerance capabilities as a TRUS probe.

[0067] In some embodiments, the probe comprises a mass within a range from approximately 250 grams to 1500 grams, and the arm maintains the tolerances described herein and the probe comprises a mass within this range.

[0068] As described herein, the robot arm can improve the alignment between the treatment probe and the imaging probe, and the imaging probe can include the sagittal plane of the imaging TRUS probe. For example, the treatment probe can be aligned substantially coplanarly along the sagittal plane of the imaging probe. This coplanarity can provide clear imaging and coordinate alignment of the treatment probe and the imaging probe. In some embodiments, the tolerance of this coplanarity is related to the combination of the width of the treatment probe and the width of the imaging plane capability (for example, the width of the image captured by ultrasonic beam forming). The relative positioning of the TRUS to the treatment probe can be substantially parallel and aligned within the angle tolerance. The alignment can be in the range of from + / -0 degrees (parallel) to about 30 degrees. In some embodiments, the elongated axes of the treatment probe and the TRUS probe are aligned in a substantially coplanar configuration, and the spacing distance between the probes varies along the length of the imaging probe and the treatment probe. For example, the distal tip of the treatment probe can be farther from the TRUS probe, and the proximal end is closer to the TRUS probe, wherein the two probes are tilted relative to each other, but are substantially coplanar. The tilt between the two probes can be related to the tissue constraints of the natural orifice of each unique person. The distance between the entrances of the naturally available orifices may vary, for example, in the range from about 5 cm to about 25 cm intervals.

[0069] In some embodiments, the imaging probe and the treatment probe are aligned so that the treatment probe is within the field of view of the imaging probe. In some embodiments, the alignment is configured to maintain the treatment probe within the field of view of the imaging probe. In some embodiments, the treatment probe is configured to move to a position and the imaging probe is configured to maintain the treatment probe within the field of view.

[0070] Figure 1 An exemplary embodiment of a system 400 for performing tissue resection in a patient is shown. The system 400 may include a treatment probe 450 and an imaging probe 460. The treatment probe 450 may be coupled to a first arm 442, and the imaging probe 460 is coupled to a second arm 444. One or both of the first arm 442 and the second arm 444 may include a robotic arm, and the movement of the robotic arm may be controlled by one or more computing devices operably coupled to the arm. The treatment probe 450 may include a device for removing target tissue from a target site in the patient. The treatment probe 450 may be configured to deliver energy sufficient to remove the target tissue from the treatment probe 450 to the target tissue. For example, the treatment probe 450 may include an electrosurgical ablation device, a laser ablation device, a transurethral needle ablation device, a water jet ablation device, or any combination thereof. The imaging probe 460 may be configured to deliver energy sufficient to image the target tissue from the imaging probe 460 to the target tissue. For example, the imaging probe 460 may include an ultrasound probe, a magnetic resonance probe, an endoscope, or a fluoroscopic probe. The first arm 442 and the second arm 444 can be configured to be independently adjustable, adjustable according to a fixed relationship, adjustable according to a user-selected relationship, independently lockable or simultaneously lockable or any combination thereof. The first arm 442 and the second arm 444 can have multiple degrees of freedom (e.g., six degrees of freedom) to manipulate the treatment probe 450 and the imaging probe 460, respectively. The treatment system 400 can be used to perform tissue resection in an organ of a patient (e.g., a patient's prostate). The patient can be positioned on a patient support 449 (e.g., a bed, an operating table, a chair, or a platform). The treatment probe 450 can be inserted into the patient's target site along an entry axis that coincides with the elongated shaft 451 of the treatment probe. For example, the treatment probe 450 can be configured to be inserted into the patient's urethra so that the energy delivery region of the treatment probe is positioned in the patient's prostate. The imaging probe 460 can be inserted into the patient's body along an entry axis that coincides with the elongated shaft 461 of the imaging probe at the target site or at a site adjacent to the patient's target site. For example, imaging probe 460 may include a transrectal ultrasound (TRUS) probe configured to be inserted into the rectum of a patient to view the patient's prostate and surrounding tissue. Figure 1As shown, the first arm 442 and the second arm 444 can be covered with sterile drapes to provide a sterile operating environment, maintain the robot arm clean, and reduce the risk of damage to the robot arm. Additional details about various components of the system 400 suitable for incorporation into the embodiments disclosed herein can be found in U.S. Pat. No. 7,882,841, U.S. Pat. No. 8,814,921, U.S. Pat. No. 9,364,251, and PCT Publication No. WO2013 / 130895, the entire disclosures of which are incorporated herein by reference.

[0071] Figure 2 An exemplary embodiment of a system 400 for performing tissue resection in a patient is schematically illustrated. The system 400 includes a treatment probe 450 and may optionally include an imaging probe 460. The treatment probe 450 is coupled to a console 420 and a coupling device 430. The coupling device 430 may include one or more components of a robotic arm 442. The imaging probe 460 is coupled to an imaging console 490. For example, the imaging probe may be coupled to a second robotic arm 444. The patient treatment probe 450 and the imaging probe 460 may be coupled to a common base 440. The patient is supported by a patient support 449. The treatment probe 450 is coupled to the base 440 with a first arm 442. The imaging probe 460 is coupled to the base 440 with a second arm 444. As described in more detail herein, one or both of the first arm 442 and the second arm 444 may include a robotic arm, the movement of which may be controlled by one or more computing devices operably coupled to the arms.

[0072] Although reference is made to a common base, the robotic arm may be coupled to a bed trail, console, or any suitable support structure that supports the base of the robotic arm.

[0073] In some embodiments, system 400 includes a user input device 496 coupled to processor 423 for user manipulation of surgical instruments on the robot arm. User input device 496 can be located in any suitable place, such as on a console, on a robot arm, on a mobile base, and there can be one, two, three, four or more user input devices used in combination with system 400 to provide redundant paths, unique input commands or combinations of inputs. In some embodiments, the user input device includes a controller to move the end of a treatment probe or imaging probe in response to the mechanical movement of the user input device and in the case of movement. The end of the probe can be displayed on display 425, and the user can manipulate the end of the probe. For example, the user input device can include a 6-degree-of-freedom input controller, in which the user can move the input device with 6 degrees of freedom, and the distal end of the probe moves in response to the movement of the controller. In some embodiments, 6 degrees of freedom include three translational degrees of freedom and three rotational degrees of freedom. The processor can be configured with instructions for switching between the automatic image-guided processing using an energy source and the processing using the energy source with the user movement of the user input device.

[0074] The patient is placed on the patient support 449 so that the treatment probe 450 and the ultrasound probe 460 can be inserted into the patient's body. The patient can be placed in one or more of many positions (e.g., prone, supine, upright or inclined). In some embodiments, the patient is placed in the lithotomy position, and stirrups, for example, can be used. In some embodiments, the treatment probe 450 is inserted into the patient's body in a first direction on the first side of the patient, and the imaging probe is inserted into the patient's body in a second direction on the second side of the patient. For example, the treatment probe can be inserted into the patient's urethra from the front side of the patient, and the imaging probe can be inserted into the patient's intestines from the rear side of the patient through the rectum. The treatment probe and the imaging probe can be placed in the patient's body, wherein one or more of the urethral tissue, urethral wall tissue, prostate tissue, intestinal tissue, or intestinal wall tissue extends between the treatment probe and the imaging probe.

[0075] Treatment probe 450 and imaging probe 460 can be inserted into the patient in one or more of many ways. During insertion, each of the first arm and the second arm can include a substantially unlocked configuration so that the treatment probe or imaging probe can be rotated and translated well to insert the probe into the patient. When the probe is inserted into the desired position, the arm can be locked. In the locked configuration, the probe can be oriented relative to each other (e.g., parallel, skewed, horizontal, tilted or non-parallel) in one or more of many ways. In order to map the image data of the imaging probe to the treatment probe coordinate reference, it may be helpful to determine the orientation of the probe using an angle sensor as described herein. Mapping tissue image data to the treatment probe coordinate reference space can allow the operator (e.g., doctor) to accurately aim and process the tissue identified for treatment.

[0076] In some embodiments, the treatment probe 450 is coupled to the imaging probe 460 so as to align with the treatment probe 450 based on the image from the imaging probe 460. As shown, the coupling can be achieved with a common base 440. Alternatively or in combination, the treatment probe and / or the imaging probe can include a magnet to keep the probe aligned through the patient's tissue. In some embodiments, the first arm 442 is a movable and lockable arm so that the treatment probe 450 can be positioned at a desired position in the patient's body. When the probe 450 has been positioned at the desired position of the patient, the first arm 442 can be locked with an arm lock 427. The imaging probe can be coupled to the base 440 with a second arm 444, which can be used to adjust the alignment of the imaging probe when the treatment probe is locked in place. For example, the second arm 444 can include a lockable and movable probe under the control of an imaging system or console and user interface. The movable arm 444 can be microactuated so that the imaging probe 460 can be adjusted with a small movement of, for example, about 1 mm relative to the treatment probe 450.

[0077] In some embodiments, the treatment probe 450 and the imaging probe 460 are coupled to angle sensors so that treatment can be controlled based on the alignment of the imaging probe 460 and the treatment probe 450. A first angle sensor 495 can be coupled to the treatment probe 450 with the support 438. A second angle sensor 497 can be coupled to the imaging probe 460. The angle sensor can include one or more of many types of angle sensors. For example, the angle sensor can include a goniometer, an accelerometer, and a combination thereof. In some embodiments, the first angle sensor 495 includes a three-dimensional accelerometer to determine the orientation of the treatment probe 450 in three dimensions. In some embodiments, the second angle sensor 497 can include a three-dimensional accelerometer to determine the orientation of the imaging probe 460 in three dimensions. Alternatively or in combination, the first angle sensor 495 can include a goniometer to determine the angle of the treatment probe 450 along the elongated axis 451 of the treatment probe. The second angle sensor 497 can include a goniometer to determine the angle of the imaging probe 460 along the elongated axis 461 of the imaging probe 460. The first angle sensor 495 is coupled to the controller 424 of the treatment console 420. The second angle sensor 497 of the imaging probe is coupled to the processor 492 of the imaging system 490. Alternatively or in combination, the second angle sensor 497 may be coupled to the controller 424 of the processing console 420.

[0078] The console 420 includes a display 425 coupled to a processor system in a component for controlling the treatment probe 450. The console 420 includes a processor 423 having a memory 421. A communication circuit 422 is coupled to the processor 423 and the controller 424. The communication circuit 422 is coupled to the imaging console 490 via the communication circuit 494 of the imaging console. The arm lock 427 of the console 420 can be coupled to the first arm 442 to lock the first arm 442 or allow the first arm 442 to be freely movable to insert the probe 450 into the patient.

[0079] Optionally, console 420 may include components of an endoscope 426 that is coupled to anchor 24 of treatment probe 450. Endoscope 426 may include components of console 420 and the endoscope may be inserted with probe 450 to treat a patient.

[0080] Optionally, the console 420 may include one or more modules operably coupled to the treatment probe 450 to control aspects of the treatment performed using the treatment probe. For example, the console 420 may include one or more of the following: an energy source 22 that provides energy to the treatment probe, a balloon inflation control 26 that enables inflation of a balloon used to anchor the treatment probe at a target treatment site, an infusion / irrigation control 28 that controls infusion and irrigation of the probe, an aspiration control 30 that controls suction performed by the probe, an insufflation control 32 that controls insufflation of a target treatment site (e.g., a prostate), or a light source 33 (e.g., a source of infrared, visible, or ultraviolet light) that provides light energy to the treatment probe.

[0081] The processor, controller and control electronics and circuitry may include one or more of a number of suitable components, such as one or more processors, one or more field programmable gate arrays (FPGAs), and one or more memory storage devices. In some embodiments, the control electronics control a control panel of a graphical user interface (hereinafter "GUI") to provide pre-operative planning according to user-specified processing parameters and to provide user control of the surgical procedure.

[0082] The treatment probe 450 includes an anchor 24. When energy is delivered to the energy delivery region 20 with the probe 450, the anchor 24 may anchor the distal end of the probe 450. The probe 450 may include a nozzle 200.

[0083] The treatment probe 450 can be coupled to the first arm 442 with a coupling device 430. The coupling device 430 can include components that move the energy delivery region 20 to a desired target location of the patient, for example, based on an image of the patient. The coupling device 430 can include a first portion 432, a second portion 434, and a third portion 436. The first portion 432 can include a substantially fixed anchor portion. The substantially fixed anchor portion 432 can be fixed to a support 438. The support 438 can include a reference frame for the coupling device 430. The support 438 can include a rigid chassis or frame or housing to rigidly and securely couple the first arm 442 to the treatment probe 450. The first portion 432 can remain substantially fixed, while the second portion 434 and the third portion 436 can move to direct energy from the probe 450 to the patient. The first portion 432 can be fixed to a substantially constant distance 437 from the anchor 24. The substantially fixed distance 437 between the anchor 24 and the fixed first portion 432 of the coupling device allows the treatment to be accurately placed. The first portion 432 may include a linear actuator to accurately position the high pressure nozzle 200 in the energy delivery region 20 at a desired axial location along the elongated shaft 451 of the treatment probe 450 .

[0084] The elongated shaft 451 of the treatment probe 450 generally extends between a proximal portion of the probe 450 near the coupling device 430 to a distal end to which the anchor 24 is attached. The third portion 436 can control the rotation angle 453 about the elongated shaft 451. During treatment of a patient, the distance 439 between the energy delivery region 20 and the first portion 432 of the coupling device can vary relative to the anchor 24. The distance 439 can be adjusted in a manner 418 in response to computer control to set a target position along the elongated shaft 451 of the treatment probe relative to the anchor 24. The first portion of the coupling device remains fixed, while the second portion 434 adjusts the positioning of the energy delivery region 20 along the axis 451. The third portion of the coupling device 436 adjusts the angle 453 about the axis in response to the controller 424, so that the distance along the axis can be very accurately controlled relative to the anchor 24 at the angle of treatment. The probe 450 can include a rigid member, such as a spine, extending between the support 438 and the anchor 24 so that the distance from the coupling device 430 to the anchor 24 remains substantially constant during treatment. As described herein, the treatment probe 450 is coupled to the treatment component to allow treatment with one or more forms of energy, such as mechanical energy from a jet, electrical energy from an electrode, or light energy from a light source, such as a laser source. The light source can include infrared light, visible light, or ultraviolet light. The energy delivery region 20 can be moved under the control of the coupling device 430 so as to deliver the desired form of energy to the target tissue of the patient.

[0085] The imaging console 490 may include a memory 493, a communication circuit 494, and a processor 492. The processor 492 in corresponding circuits is coupled to the imaging probe 460. An arm controller 491 is coupled to the arm 444 to precisely position the imaging probe 460. The imaging console may also include a display 425.

[0086] To facilitate precise control of the treatment probe and / or imaging probe during treatment of the patient, each of the treatment probe and imaging probe may be coupled to a robotic, computer-controllable arm. Figure 2In the illustrated system 400, one or both of the first arm 442 coupled to the treatment probe 450 and the second arm 444 coupled to the imaging probe 460 may include a robotic, computer-controllable arm. The robotic arm may be operably coupled to one or more computing devices configured to control the movement of the robotic arm. For example, the first robotic arm 442 may be operably coupled to the processor 423 of the console 420, or the second robotic arm 444 may be operably coupled to the processor 492 of the imaging console 490 and / or the processor 423 of the console 420. One or more computing devices (e.g., processors 423 and 492) may include computer executable instructions for controlling the movement of one or more robotic arms. The first robotic arm and the second robotic arm may be substantially similar in construction and function, or they may be different to accommodate specific functional requirements for controlling the movement of the treatment probe and the imaging probe.

[0087] The robotic arm may comprise 6 or 7 or more joints to allow the arm to move under computer control. Suitable robotic arms are commercially available from a number of manufacturers, such as RoboDK, Kinova and a number of other manufacturers.

[0088] One or more computing devices operably coupled to the first robotic arm and the second robotic arm can be configured to automatically control the movement of the treatment probe and / or imaging probe. For example, the robotic arm can be configured to automatically adjust the positioning and / or orientation of the treatment probe and / or imaging probe during treatment of the patient according to one or more pre-programmed parameters. The robotic arm can be configured to automatically move the treatment probe and / or imaging probe along a pre-planned or programmed treatment or scanning profile, which can be stored in a memory of the one or more computing devices. Alternatively or additionally to the automatic adjustment of the robotic arm, the one or more computing devices can be configured to control the movement of the treatment probe and / or imaging probe in response to user input (e.g., through a graphical user interface of the processing device). Alternatively or additionally to automatic adjustment of the robotic arm, one or more computing devices may be configured to control movement of the treatment probe and / or imaging probe in response to real-time positioning information, such as anatomical structures identified in one or more images captured by the imaging probe or other imaging source (from which an allowable range of motion of the treatment probe and / or imaging probe may be established) and / or positioning information of the treatment probe and / or imaging probe from one or more sensors coupled to the probe and / or the robotic arm.

[0089] Figure 3A and Figure 3BAn exemplary embodiment of a common base or pedestal 440 for supporting one or more robotic arms of an image-guided processing system as disclosed herein is shown. Figure 3A A patient support 449 is shown that includes one or more rails 452. The patient support 449 may include a surgical table or platform. One or more robotic arms associated with one or more of the treatment probes or imaging probes may be mounted to the rails 452 so that the rails function as a common base 440. Figure 3B Common base 440 is shown to include a floor support 454 configured to be coupled to a first robotic arm connected to a treatment probe and / or a second robotic arm connected to an imaging probe. Floor support 454 may be positioned between the patient's legs during a treatment procedure.

[0090] Figure 4A and Figure 4B An exemplary embodiment of a processing system 400 including a mobile base 470 as described herein is shown. Figure 4A is a front view of the processing system 400 and Figure 4B 4 is a side view of a treatment system 400. The treatment system 400 includes a treatment probe 450 coupled to a first robotic arm 442 and an imaging probe 460 coupled to a second robotic arm 444. The first robotic arm 442 and the second robotic arm 444 each include a proximal end and a distal end, the distal end being coupled to the treatment probe 450 and the imaging probe 460, respectively, and the proximal end being coupled to a common base 440 including a mobile base 470. The first robotic arm 442 may include a first arm coupling structure 504 coupled to the treatment probe 450, and the second robotic arm 444 may include a second arm coupling structure 505 coupled to the imaging probe 460. The treatment probe 450 may be coupled to the distal end of the first robotic arm 442 via an attachment device 500, which may include a coupling device configured to enable movement (e.g., rotation, translation, pitch, etc.) of the treatment probe as described herein. The coupling of the treatment probe 450 to the first robotic arm 442 may be fixed, releasable, or user-adjustable. Similarly, the coupling of the imaging probe 460 to the second robotic arm 444 may be fixed, releasable, or user-adjustable.

[0091] The first robotic arm 442 may be articulated at one or more first arm joints 443. The imaging arm 444 may be articulated at one or more second arm joints 445. Each arm joint 443 or 445 may be operably coupled to a computer-controllable actuator (e.g., a stepper motor) to achieve movement at the joint. Each arm joint 443 or 445 may include one of a variety of kinematic joints, including but not limited to prismatic, post-rotational, parallel cylindrical, cylindrical, spherical, planar, edge slider, cylindrical slider, point slider, spherical slider, or cross-cylindrical joint or any combination thereof. In addition, each arm joint 443 or 445 may include a linear, orthogonal, rotational, torsional, or post-rotational joint or any combination thereof.

[0092] As described herein, the system 400 may also include a console 420, which may be supported by a mobile support 480 separate from the mobile base 470. The console 420 may be operably coupled to the mobile base 470 via a power and communication cable 475 to allow control of a treatment probe 450 coupled to the mobile base via a first robotic arm. The treatment console 420 includes a processor and a memory (the memory having computer executable instructions stored thereon for execution by the processor) to control various modules or functions of the treatment console, such as energy source, infusion / irrigation control, aspiration control, and as described herein with reference to Figure 2 The other components described. The treatment console 420 may also include a display 425 in communication with the processor. The display 425 may be configured to display, for example, one or more of the following items: subject vital signs, such as heart rate, respiratory rate, temperature, blood pressure, oxygen saturation, or any physiological parameter or any combination thereof; the status of the surgical procedure; one or more previously captured images or image sequences of the treatment site from one or more views; one or more real-time images or image sequences of the treatment site from one or more views acquired by the imaging probe 460; a set of treatment parameters, including but not limited to treatment mode (e.g., cutting or coagulation), treatment intensity, time elapsed during treatment, time remaining during treatment, treatment depth, area or volume of the treatment site that has been treated, area of ​​the treatment site to be treated, area or volume of the treatment site that will not be treated, position information of the treatment probe 450 or the imaging probe 460 or both; treatment adjustment control, such as means for adjusting treatment depth, treatment intensity, position and / or orientation of the treatment probe 450, imaging depth, or position and / or orientation of the imaging probe 460 or any combination thereof; or system configuration parameters.

[0093] The mobile base 470 may also include one or more computing devices to control the operation of the one or more robotic arms. For example, the mobile base may include a processor and a memory having computer executable instructions stored thereon for execution by the one or more processors. The memory may have instructions stored thereon for operating one or more robotic arms coupled to the mobile base. The processor may be operably coupled to the robotic arm via suitable electromechanical components to effectuate movement of the robotic arm. For example, each of the one or more joints of the robotic arm may include a stepper motor, and the processor may be operably coupled to the stepper motor at each joint to actuate the motor in a specified direction by a specified increment. Optionally, the one or more robotic arms may be coupled to one or more processors of the console 420 or a separate imaging console (e.g., Figure 2 The imaging console 490 shown in FIG. 4 is operably coupled to the imaging console 490, wherein one or more console processors can be configured to execute instructions for controlling the movement of one or more robotic arms and can communicate with each other via communication circuits (e.g., Figure 2 The communication circuit 422 of the console 420 or the communication circuit 494 of the console 490 as shown transmits the instructions to the robotic arm. The computer executable instructions for controlling the movement of the robotic arm may be pre-programmed and stored in a memory, or may be provided by a user via one or more user inputs prior to or during treatment of a patient using the treatment system.

[0094] One or more computing devices operably coupled to the first and / or second robotic arms may be configured to control movement of the arms to adjust the pitch, yaw, roll and / or linear positioning of the treatment probe and / or imaging probe along the target site.

[0095] The mobile base 470 may include one or more user input devices to enable a user to control the movement of the robot arm under computer instructions. Figure 4A and Figure 4BAs shown, the mobile base may include a keyboard 474 and / or a foot switch 471, which is operably coupled to the mobile base via a foot switch cable 472. The keyboard 474 and the foot switch 471 can be configured independently or in combination to control the operation of the first robot arm 442 and / or the second robot arm 444, for example, via the articulation of one or both robot arms at one or more joints. The keyboard and the foot switch can communicate with one or more processors configured to control the movement of the robot arms. When a user enters instructions into the keyboard and / or the foot switch, the user instructions can be received by the one or more processors, converted into electrical signals, and the electrical signals can be transmitted to one or more computer-controlled actuators operably coupled to the one or more robot arms. The keyboard and / or the foot switch can control the movement of one or both arms toward or away from a processing location, a location of interest, a predetermined location, or a user-specified location, or any combination thereof.

[0096] Optionally, the keyboard 474 and the foot switch 471 can be configured, independently or in combination, to control the operation of the treatment probe 450 and / or the imaging probe 460. For example, the keyboard 474 and / or the foot switch 471 can be configured to start, stop, pause, or restart a treatment performed with the treatment probe. The keyboard 474 and / or the foot switch 471 can be configured to start imaging or freeze, save, or display on the display 425 an image or image sequence previously or currently acquired by the imaging probe.

[0097] The mobile support 480 of the mobile base 470 and the console 420 can be independently positioned around the patient supported by the patient support 449 (e.g., platform). For example, the mobile base 470 supporting the first and second robot arms and the processing probe and the imaging probe can be positioned between the patient's legs, while the mobile support 480 supporting the console 420 and the display 425 can be positioned to the side of the patient, such as near the patient's torso. The mobile base 470 or the mobile support 480 can include one or more movable elements that enable the base or support to move, such as a plurality of wheels. The mobile base 470 can be covered with a sterile drape during the entire treatment process to prevent contamination and fluid entry.

[0098] Figure 5A-5B An exemplary coupler between the processing probe 450 and the first robotic arm 442 is shown. Figure 5A The handling probe is shown decoupled from the robot arm. Figure 5BA treatment probe coupled to a robotic arm is shown. As shown, the treatment probe 450 can be coupled to the robotic arm 442 with an attachment device 500, which can include a reusable motor pack. The treatment probe 450 can be removably coupled to the attachment device 500. The attachment device can also include a connector 502 configured to couple to the robotic arm and lock the attachment device in place. The robotic arm 442 can include a coupling structure 504 arranged at the distal end of the arm that is configured to lockingly receive the connector 502 of the attachment device 500. Once the treatment probe and the robotic arm are coupled together, movement of the treatment probe can be controlled by moving the robotic arm (e.g., by articulating one or more joints of the robotic arm under computer control).

[0099] In some embodiments, the treatment probe is coupled to the robotic arm via a quick release mechanism so that the coupling between the probe and the robotic arm can be quickly disconnected to prevent injury to the patient if the robotic arm loses its position or otherwise fails to operate properly. The treatment probe and the robotic arm can be coupled to each other in a number of ways, such as mechanically (e.g., a broom clip) and / or magnetically. For example, in Figure 5A and Figure 5B In the illustrated embodiment, the coupling structure 504 may include a slot 506 having a magnet 508 disposed therein, and the connector 502 may include a ferromagnetic fixture configured to fit within the slot 506 to engage the magnet 508. The coupling structure 504 may also include a latching mechanism 510 to selectively engage or disengage the connector 502 with the magnet 508. For example, Figure 5A and Figure 5B As shown, the locking mechanism 510 may include a rotatable knob that can be rotated to achieve engagement of the magnet 508 of the coupling structure 504 with the connector 502 of the attachment device 500. The locking mechanism may be engaged or disengaged automatically or manually by a user to couple or decouple the attachment device 500 and thus the processing probe 450 coupled thereto to or from the robotic arm 442, respectively. In some embodiments, the coupling structure 504 may be operably coupled to one or more computing devices configured to control the robotic arm, and the one or more computing devices may include instructions to release the coupling of the coupling structure to the probe when an error is detected in the operation of the robotic arm.

[0100] In some embodiments, the first robotic arm 442 can be configured to automatically position the treatment probe 450 in response to sensor position data from one or more of the attachment device 500 or the coupling structure 504. For example, the first robotic arm 442 can be operated in a "seek" mode to locate the attachment device 500. In some embodiments, the probe includes one or more reference targets, and the robotic arm includes corresponding sensors with sufficient resolution and positioning to identify the relative position of the probe in 3D space. In some embodiments, the processor is configured with instructions for performing the following operations: when the user holds the probe, such as when the probe is positioned in the patient's body, use the mounting structure on the robotic arm to find the treatment probe or imaging probe.

[0101] The sensors on the robot arm (e.g., the first robot arm 442) and the sensors on the probe (e.g., the processing probe) can be arranged in a variety of ways, for example, as Figure 8B shown.

[0102] The processor may be coupled to a sensor near the end of the robot arm or on the probe to dynamically update the relative position during movement of the robot arm while looking for the probe to engage with the arm. The sensor on the robot arm may include a plurality of sensors including one or more of the following: capacitive, capacitive displacement, Doppler, inductive, magnetic, optical, radar, sonar, ultrasonic or Hall effect sensors to determine the relative distance between the robot arm and the probe. In some embodiments, the probe includes a plurality of targets, and the sensor is configured to generate a signal in response to the distance from the plurality of targets. Alternatively or in combination, the sensor may be located on the probe and the target on the robot arm. In some embodiments, the sensor includes a close contact mechanical sensor to confirm the docking of the probe on the robot arm or near the arm, for example, sensing the positioning of the probe relative to the robot arm when the probe and the arm are within a few millimeters of docking with each other. The close contact mechanical sensor may include one or more of the following: a micro switch, a whisker-type touch sensor or a pinhole contact switch. In some embodiments, the probe and the robot arm include an integrated locking mechanism to provide a non-moving locked engagement at the final contact position. As will be appreciated by one of ordinary skill in the art, the integrated locking mechanism may include one or more of a magnetic element, an electromagnetic element, a latch, a screw (e.g., a multi turn latching screw or a quarter turn locking screw), a vacuum, or other mechanical means of reversible attachment.

[0103] In some embodiments, multiple sensors are used, such as one or more sensors for close spacing between the probe and the robot arm, one or more sensors for medium spacing between the probe and the robot arm, and one or more sensors for long spacing between the probe and the robot arm. A coarse position sensor can be used to determine the approximate position of the probe (e.g., a beacon). One or more sensors can be used for fine position positioning of the probe relative to the robot arm, such as a proximity sensor. In some embodiments, one or more markers on the probe are used with a camera and machine vision to detect one or more markers.

[0104] In some embodiments, a coarse position sensor may be provided, which may be an infrared (IR) beacon that enables coarse positioning of spatial position for use in homing detection of the robot arm to the probe. In some cases, homing beacons (e.g., IR beacons) allow homing over greater distances than sensors that may rely on visual recognition of reference points.

[0105] In some embodiments, the docking detection sensor confirms that the robot arm has engaged or is extremely close to the probe. As an example, a Hall effect sensor can be used in combination with a permanent magnet to realize sensor output. In some embodiments, the Hall effect sensor is noise-resistant, contactless, and has a consistent detection range. Any of many different types of Hall sensors can be utilized, and in many cases the sensor plays a simple switch and linear range measurement and detection role, wherein the total output voltage is set by the power supply voltage and changes proportionally with the intensity of the magnetic field. This results in the distance measurement between the sensor and the positioning magnet, and can be used to measure the distance between the robot arm and the probe, and helps docking. The sensor and beacon can be located in the corresponding housing of the robot arm and the probe.

[0106] In some embodiments, the positioning sensing of the robot arm is performed by an inertial measurement unit (IMU) which may include up to 9-axis detection. In some cases, a 6-axis IMU may be used for motion detection, vibration detection, positioning orientation information, redundancy and backup of the main encoder signals that may be located in the joints of the robot arm. As described herein, the IMU may perform the dual functions of finding a probe for docking with the robot arm as well as force detection and motion compensation. The described sensors may be used in conjunction with any robot arm or probe described herein.

[0107] According to some embodiments, the process for docking a robot arm with a probe may include an IR beacon that provides a rough positioning and spatial position for homing detection, an optical sensor for a reference point and an observation reference point on the arm or probe (which can be used to allow fine alignment of the positioning position in the XY plane), and a Hall effect sensor that detects the Z direction proximity about docking. The IR beacon allows a larger distance search for the original positioning of the robot arm relative to the probe. The reference point and the optical sensor can allow for fast, low-latency detection of the 2D position and 2D orientation of the probe by the robot arm. A user interface that can be located on the robot arm, on the probe, or on the robot arm control unit can indicate distance, positioning, docking status, or other information. In some embodiments, the user interface includes one or more visual cues, such as an LED indicator, to indicate the relative positioning and / or docking status of the arm and the probe.

[0108] Although Figure 5A and Figure 5B The coupling mechanism shown is described in the context of coupling a treatment probe to a first robotic arm, but substantially similar mechanisms may also be used to couple an imaging probe to a second robotic arm 444. For example, the coupling structure of the second robotic arm 444 may include a similar coupling mechanism for engaging an attachment device connected to an imaging probe.

[0109] Figure 6 A method 600 for operating a robotic arm coupled to a processing probe is shown in accordance with some embodiments.

[0110] In step 605, the treatment probe is manually, semi-automatically or automatically inserted into the patient, and the robot arm is on standby on one side of the patient. For example, for the prostate tissue resection system, the treatment probe can be manually inserted into the patient's urethra towards the prostate. The treatment probe can be manipulated to be advanced to track the tortuous path of the urethra, prostate and bladder neck. After entering the urethra, the treatment probe can be rotated (for example 90 degrees) before further advancing through the urethral bulb. The user can be provided with an instruction to perform such rotation, or when the insertion is automatic or semi-automatic, the robot arm can be instructed to perform such rotation in response to image, positioning and / or force feedback data. In certain embodiments, the treatment probe is inserted into the patient's body simultaneously with the imaging probe or after the imaging probe, and in some cases, the treatment probe insertion can be guided according to the image data from the inserted imaging probe.

[0111] At step 610, the robotic arm is coupled to the processing probe. While the robotic arm is maintained in a passive or "zero gravity" mode, a user may manually align the robotic arm coupling structure with the attachment device of the processing probe as described herein. The attachment device and the coupling structure of the robotic arm may be coupled together to attach the robotic arm to the processing probe.

[0112] At step 615, the allowable range of motion of the robotic arm is programmed. For example, when the probe is connected to the robotic arm while the robotic arm is still in the passive mode, the user can manually move, rotate, and change the angle of the treatment probe to set the limits of the allowable range of motion of the treatment probe. The user can set the limits based on a combination of cystoscopy, ultrasound, and tactile feedback. Optionally, the limits can be based on anatomical structures, such as anatomical models or tissue conditions. A processor operably coupled to the robotic arm can detect and store the limits of the allowable range of motion so that the robotic arm can use these limits to avoid moving outside the allowable range of motion when switching to the active mode.

[0113] In some embodiments, the treatment probe is manually inserted into the penile urethra and is placed about 1 cm past the middle lobe at the distal end and in the patient's bladder. The probe can be imaged, for example, with ultrasound (e.g., a TRUS probe). The image of the probe can show that the probe is manually positioned near the final position in the patient's anatomical structure, for example, about 1 cm past the middle lobe in the bladder. In some embodiments, the range of motion is manually calibrated by a medical practitioner by the following operations: manipulating the probe parallel to the angle of initial insertion, docking the treatment probe upward in the pubic bone or urethral arch, and limiting the motion to a range from about 3 mm to about 5 mm in the X plane horizontally, and from about 0 mm to about 10 mm downward in the Y plane. The trained motion about the Z plane (entering and leaving the patient) will be set to zero cm inwardly toward the patient and completely withdrawn from the patient. For example, a 30 cm probe can be retracted up to 30 + cm to remove it from the patient, and if adjusted for the effective area of ​​clinical treatment, it is retracted much less. Angularly, as measured from the doctor's fully inserted positioning, the safe range of motion in the patient's body depends on the anatomical structure, such as tissue elasticity and bone structure. For example, in the example of angular positioning with a fulcrum at the pelvic notch bony structure, the allowable range of angular motion can be set to range from about 0 degrees to about + / - 5 degrees in the lateral X direction, from about 0 degrees to + / - 25 degrees in the vertical direction along the Y plane, or a combination of motion within these ranges depending on the patient's anatomy.

[0114] Alternatively or additionally, in response to automatic analysis of image data of a target site, such as from an imaging probe or other imaging source (e.g., a cystoscope, an external ultrasound source, a CT scanner, an MRI system, a fluoroscopic imaging system, etc.), one or more system processors can be used to automatically or semi-automatically determine the limits of the allowable range of motion of the treatment probe. The image data can be generated in real time. For example, one or more system processors can be instructed to identify anatomical structures (e.g., prostate, external sphincter, spermatic caruncle, bladder neck, etc.) in the image data and in some cases identify the treatment probe and / or imaging probe, and in response determine the limits of the allowable range of motion. Alternatively or additionally, in response to positioning and / or force feedback data of the treatment probe from one or more positioning and / or force sensors on the treatment probe and / or treatment probe robot arm, one or more system processors can be used to automatically or semi-automatically determine the limits of the allowable range of motion of the treatment probe. For example, one or more force sensors on the treatment probe and / or treatment probe robot arm can provide tissue pressure data, which can indicate areas where the probe is relatively resisted and can present a risk of tissue damage.

[0115] In some embodiments, the joint sensor in the robot arm includes a force feedback sensor to detect the force acting on the probe inserted into the patient. Alternatively or in combination, the sensor coupled to the processor can be located at one or more probes or at the interface between the probe and the robot arm. For example, the probe sensor in the probe can sense the pressure near the distal end of the probe. The processor can be configured with instructions for performing the following operations: adjusting the distal end of the probe in translation or rotation in response to the sensed distal pressure. The sensor can include one or more multi-plane strain gauge elements positioned along the probe to sense the pressure of the probe against the tissue. The processor can be configured with instructions for performing the following operations: implementing threshold limits to avoid undesirable tissue damage. The multi-plane strain gauge element can include one or more of the following: a conductive film sensor, a semiconductor sensor, a piezoresistor, a nanoparticle-based strain sensor, a capacitive sensor, an optical ring resonator, an optical fiber sensor, or a conductive fluid in an elastomer. In some embodiments, the probe shaft includes a spring constant and embedded strain gauges at periodic positions along the shaft to measure the curvature and the axial pressure at a specific point along the shaft. These sensor measurements can be combined with the arm joint sensor. In some embodiments, the processor is configured with instructions for performing the following operations: Identifying a source of pressure resistance, such as one or more of the following: bone constraints associated with proximity to bone, a tough tissue entry fulcrum, or whether the distal tip of the probe is forced against internal anatomical tissue. Alternatively or in combination, the probe may include a resilient tubular sheath having an exposed "contact area" coupled to a pressure sensor that reports information from an element (e.g., a ring around the probe, a linear side structure, or a button sensor element near the distal end of the probe).

[0116] In step 620, the robot arm is manipulated under computer control by user input. The user can manipulate the robot arm movement via input provided to the graphical user interface of the image-guided processing system (e.g., user interface software provided by the processing console as described herein). For example, the user can implement the adjustment of the rotation, translation and / or pitch angle of the processing probe. When in active mode, the robot arm can be configured to move only within the limits of the allowable range of motion as set in step 615. The robot arm can be configured to retract the processing probe from the patient's body when in active mode, but not to advance the processing probe into the patient's body to ensure the safety of the patient; any advancement of the probe into the patient's body can be performed manually by the user. During the retraction of the probe, the robot arm can be programmed to maintain the probe on a linear track so that the z-axis positioning of the probe is maintained substantially constant. The robot arm and the processing probe can be manipulated under computer control to perform a treatment plan, which can be automated. In some embodiments, the tissue resection process is automatically planned based on image data from an imaging probe or other imaging source. For example, one or more system processors may be instructed to identify the prostate or other relevant anatomical structure thereof, generate a treatment plan responsive to the anatomical structure and the location of the probe, and allow a user to modify and / or accept the treatment plan before the treatment plan is implemented by manipulating the robotic arm and / or the treatment probe.

[0117] In step 625, the robotic arm is automatically manipulated under computer control to adjust the positioning of the treatment probe. The positioning of the treatment probe can be adjusted according to pre-programmed parameters, user instructions, real-time feedback (e.g., from imaging, positioning and / or force feedback data), or a combination thereof. For example, the imaging system can be configured to detect the position of the treatment probe during treatment, using intelligent image recognition, for example, based on an ultrasound image of the target site obtained with an ultrasound imaging probe. Based on the detected position of the treatment probe, the robotic arm can be automatically manipulated to adjust the positioning and / or orientation of the treatment probe so as to align the treatment probe with the patient's target tissue and / or imaging probe and / or to compensate for patient movement.

[0118] The treatment probe is decoupled from the robotic arm at step 630. When the treatment procedure is complete, the user may detach the treatment probe from the robotic arm, manually move the robotic arm to one side, and then remove the treatment probe from the patient.

[0119] One or more steps of method 600 may be performed by circuitry as described herein, such as one or more of a processor or logic circuitry of a system described herein. The circuitry may be programmed to provide one or more steps of method 600, and the program may include program instructions stored on a computer readable memory or programmed steps of a logic circuit such as a programmable array logic or a field programmable gate array.

[0120] Although the above steps illustrate a method 600 of operating a robotic arm coupled to a processing probe according to some embodiments, those of ordinary skill in the art will recognize many variations based on the teachings described herein. For example, the steps may be completed in a different order. One or more steps may be added or omitted. Some steps may include sub-steps. Many steps may be repeated whenever necessary or desired.

[0121] Figure 7 A method 700 for operating a robotic arm coupled to an imaging probe is shown in accordance with some embodiments.

[0122] In step 705, the imaging probe is manually, semi-automatically or automatically inserted into the patient's body, and the robot arm is on standby on one side of the patient. For example, for an image-guided prostate tissue resection system, the imaging probe may include a TRUS probe and may be manually inserted into the patient's rectum. In some embodiments, the imaging probe is inserted simultaneously with the treatment probe or before the treatment probe. The imaging probe may provide one or more images along the transverse plane. The imaging probe may provide one or more images along the sagittal plane, which may be generated when the imaging probe (and / or the imaging transducer in the imaging probe) is advanced and / or retracted. Transverse and / or sagittal images may be combined to generate a three-dimensional image.

[0123] At step 710, the robotic arm is coupled to the imaging probe. For example, the robotic arm and the imaging probe may be coupled together using a coupling mechanism substantially similar to that described herein with reference to the processing probe.

[0124] At step 715, the allowable range of motion of the robotic arm is programmed. For example, while the probe is connected to the robotic arm while the robotic arm is still in passive mode, the user can manually move, rotate, and change the angle of the imaging probe to set the limits of the allowable range of motion of the imaging probe. The user can set the limits based on a combination of cystoscopy, ultrasound, and tactile feedback.

[0125] In some embodiments, the probe is manually positioned near the final position in the patient's rectal anatomy. For example, the range of motion is manually calibrated by the practitioner manipulating the probe substantially parallel to the initial insertion angle. The practitioner moves the inserted probe within an allowable range of motion (e.g., an allowable range of motion with a limit in the range of about 3cm to about 5cm along one or more of the transverse X plane or the vertical Y plane). In some embodiments, the practitioner moves the probe (entering and leaving the patient) along the Z plane. In some embodiments, the range of motion along the Z plane can be within the range of 0cm (zero) inwardly toward the patient (to avoid unintentional rectal damage caused by the robot) to being completely withdrawn from the patient. For example, a 10cm probe can be retracted 10+cm to remove it from the patient. When measured angularly from the doctor's complete insertion positioning, the safe range of motion in the patient depends on the anatomical structure, such as tissue elasticity and bone structure. In an example of angular positioning of the probe with a fulcrum at the tissue surface (or alternatively at a plane defined by bone structure), the allowable range of motion can be set from 0 degrees to about + / - 15 degrees, such as from about 0 degrees to about + / - 30 degrees in one or more of the X or Y planes. In some embodiments, the angular limits may include a combination of motions corresponding to tracking a cone within these limits.

[0126] A processor operably coupled to the robotic arm can detect and store the limits of the permissible range of motion so that the robotic arm can use these limits to avoid moving outside the permissible range of motion when switching to the active mode. Optionally or additionally, in response to automatic analysis of image data of a target site, such as from an imaging probe or other imaging source (e.g., a cystoscope, an external ultrasound source, a CT scanner, an MRI system, a fluoroscopic imaging system, etc.), the limits of the permissible range of motion of the imaging probe can be automatically or semi-automatically determined by one or more system processors. The image data can be generated in real time. For example, one or more system processors can be instructed to identify anatomical structures (e.g., prostate, external sphincter, caruncle, bladder neck, etc.) in the image data and in some cases identify the processing probe and / or the imaging probe, and in response determine the limits of the permissible range of motion. Optionally or additionally, in response to positioning and / or force feedback data of the imaging probe from one or more positioning and / or force sensors on the imaging probe and / or the imaging probe robotic arm, the limits of the permissible range of motion of the imaging probe can be automatically or semi-automatically determined by one or more system processors. For example, one or more force sensors on an imaging probe and / or an imaging probe robotic arm may provide tissue pressure data that may indicate areas where probe advancement is more resisted and may present a risk of tissue damage.

[0127] At step 720, the robotic arm is automatically manipulated under computer control to scan the tissue. For example, during the planning of a treatment procedure, the robotic arm may be pre-programmed to automatically scan the target site to render a three-dimensional image of the target site. When in active mode, the robotic arm may be configured to move only within the limits of the allowable range of motion as set in step 715. The robotic arm may be configured to retract the treatment probe from the patient's body when in active mode, but not advance the treatment probe into the patient's body to ensure the safety of the patient; any advancement of the probe into the patient's body may be performed manually by the user. During retraction of the probe, the robotic arm may be programmed to maintain the probe on a linear track so that the z-axis positioning of the probe remains substantially constant.

[0128] In step 725, the robotic arm is manipulated under computer control via user input. The user can manipulate the robotic arm movement via input provided to a graphical user interface of the image-guided processing system (e.g., through user interface software provided by a processing or imaging console as described herein). For example, the user can effect adjustment of the rotation, translation, and / or pitch angle of the imaging probe. When in active mode, the robotic arm can be configured to move only within the limits of the allowable range of motion as set in step 715. The robotic arm can be configured to retract the treatment probe from the patient when in active mode, but not to advance the treatment probe into the patient to ensure the safety of the patient; any advancement of the probe into the patient can be performed manually by the user.

[0129] In step 730, the robotic arm is automatically manipulated under computer control to adjust the positioning of the imaging probe. The positioning of the imaging probe can be adjusted according to pre-programmed parameters, user instructions, real-time feedback (e.g., from imaging, positioning and / or force feedback data), or a combination thereof. For example, the imaging system can be configured to detect the position of the treatment probe during treatment, using intelligent image recognition, for example, based on an ultrasound image of the target site obtained with an ultrasound imaging probe. Based on the detected position of the treatment probe, the robotic arm can be automatically manipulated to adjust the positioning and / or orientation of the imaging probe so as to align the imaging probe with the treatment probe and / or to compensate for patient movement.

[0130] The imaging probe is decoupled from the robotic arm at step 735. When the procedure is complete, the user may detach the imaging probe from the robotic arm, manually move the robotic arm to one side, and then remove the imaging probe from the patient.

[0131] One or more steps of method 700 may be performed by circuitry as described herein, such as one or more of a processor or logic circuitry of a system described herein. The circuitry may be programmed to provide one or more steps of method 700, and the program may include program instructions stored on a computer readable memory or programmed steps of a logic circuit such as a programmable array logic or a field programmable gate array.

[0132] Although the above steps illustrate a method 700 of operating a robotic arm coupled to an imaging probe according to some embodiments, those of ordinary skill in the art will recognize many variations based on the teachings described herein. For example, the steps may be completed in a different order. One or more steps may be added or omitted. Some steps may include sub-steps. Many steps may be repeated whenever necessary or desired.

[0133] Fig. 8A The configuration of a treatment probe 450 and an imaging probe 460 during treatment of a patient with a treatment system as described herein is shown. In some embodiments, it is desirable to ensure that the treatment probe and the imaging probe outside the patient's body do not collide with each other or otherwise interfere with each other during use of the system, thereby maintaining the accuracy of the movement of the probes and the sterility of the system. The robotic arms as described herein that are coupled to the treatment probe and the imaging probe and configured to control their movement can be configured to maintain a boundary to prevent collision or interference between the two probes. For example, one or both of the first robotic arm coupled to the treatment probe and the second robotic arm 444 coupled to the imaging probe can be configured to sense a distance 520 between the two probes and maintain the distance substantially constant or greater than a minimum threshold to prevent collision. Optionally or additionally, as described in reference Figure 6 and Figure 7 As described in the illustrated method, a user may program the allowable range of motion of one or both of the treatment probe and the imaging probe in order to set limits on the range of motion that prevent collision or interference between the probes.

[0134] For example, before the robotic arm switches to active mode, the user may rotate one or both of the probes within the range of allowable pitch angles 525 of the probes to program the allowable range of motion of the probes within which the two probes do not contact each other.

[0135] Additional references Figure 8B, as described herein, the robot arm 442 is coupled to the motor group 802. The motor group 802 can be coupled to the hand piece 804 of the probe 450. In some embodiments, one or both of the robot arms coupled to the treatment probe and the imaging probe can include one or more feedback sensing mechanisms. For example, the first robot arm 442 and / or the second robot arm 444 can be operably coupled to a force sensor configured to detect the compression of the tissue before the treatment probe and / or the imaging probe. In some embodiments, the force applied by the imaging probe is in the range of 0 to 4 kg to apply compression to the tissue upward to achieve visualization of the treatment probe and the target tissue area. In some embodiments, the force applied by the treatment probe is related to the positioning of the probe in the cavity (e.g., urethra). In some embodiments, the force is related to the pivot point at the urethral notch and the pivot of the target anatomical structure. These forces can be respectively in the range of 0 to 10 kg force against the bone structure and in the range of 0 to 2 kg force on the target anatomical structure (e.g., prostate).

[0136] According to some embodiments, one or more X-direction force sensors 810, one or more Y-direction force sensors 812, and / or one or more Z-direction force sensors 814 may be disposed on the robot arm 442, the handpiece 804, and / or the probe 450. For example, one or more force sensors may include strain gauges, pressure sensors, or piezoelectric transducers. In some embodiments, the strain gauge includes any of a variety of configurations of a Wheatstone bridge. The Wheatstone bridge circuit converts a small change in resistance into a measurable voltage difference, which can be equivalent to the applied force. The force sensor may be coupled to a handpiece, such as any of the handpiece embodiments described herein. In some cases, one or more force sensors are operatively coupled to an imaging probe, a processing probe, or both.

[0137] In some embodiments, the circuitry used to operate the force sensor is insulated and isolated from the imaging probe and the treatment probe. This allows the probe to meet any patient leakage current requirements and reduces any noise picked up by the probe, thereby enhancing the signal-to-noise ratio (S / N) of the force sensor. In some embodiments, the signal lines from the force sensor can be twisted together and optionally shielded to maintain signal integrity, improve noise immunity, and maintain a sufficient S / N ratio. The force sensor can be formed of any suitable material, and in some cases, for portions of the sensor that may come into contact with the patient before, during, or after treatment, it is formed of a biocompatible material.

[0138] In some embodiments, one or more force sensors are sized to be mounted on or within a probe shaft (e.g., an imaging probe or a treatment probe shaft). The force sensor can be configured with any suitable strain sensitivity "k", which is a proportionality factor between relative changes in resistance. Strain sensitivity is a dimensionless number and is referred to as a gauge factor ("GF"). Linear mode strain gauges can be used to measure strain in a single direction on a handpiece. Conductive signal lines can be bonded to pads of the sensor, which transmit the signal to an input amplifier. One or more sensors can be bonded to one or more probes on a carrier substrate, which can insulate the sensor from any metal of the probe (e.g., a metal probe shaft).

[0139] The displacement of the handpiece in the Z direction can be detected by the spring and sensor 814. With this configuration, the entire probe assembly can be able to slide a suitable distance to provide protection to prevent the probe from being driven into the tissue wall. The probe assembly can be arranged on a sliding cart 820, which can be rebounded against a simple spring to provide a constant and known force "K" spring constant. It is possible to make accurate distance measurements of the handpiece (such as the displacement of the cart) in a short distance (such as less than 2 inches) with a suitable arrangement. Other position encoder linear sensors can be used in combination or optionally. For example, a linear variable differential transformer (LVDT) is an electromechanical sensor for converting mechanical motion into a variable current and can be used to measure the resistance to the insertion force of the probe. Any one of an optical encoder or many suitable inductive linear encoders. The sensor can measure force based on an inductive linear encoder 824 and can be arranged to be non-contact to ensure high reliability. For a linear resolution between about 15 microns for a digital encoder and about 54 microns for an analog encoder, a high-resolution encoder 824 can be provided.

[0140] One or more sensors may be provided on one or more robot arms to measure positioning, orientation, force or some other parameters. In some cases, two sensors may be part of a robot arm assembly and may be used to determine unexpected movement. These sensors may be internal encoders located at one or more joints of the robot arm and may be an inertial measurement unit (IMU) 822. An IMU is an electronic sensor device that measures and reports one or more parameters (e.g., force, angular rate, and / or orientation of the sensor) and may use a combination of accelerometers, gyroscopes, and / or magnetometers. Some IMUs suitable for incorporation into one or more robot arms may have a full-scale acceleration range of ±2 / ±4 / ±8 / ±16g (the "g" value is related to the acceleration due to gravity) and a wide angular velocity range of ±125 / ±250 / ±500 / ±1000 / ±2000 / ±4000 degrees per second ("dps"). The IMU may detect forces on the robot arm and transmit the magnitude and / or direction of the external force to a computing device, such as a robot control system. One or more IMUs 822 may provide feedback that may be used to control one or more robotic arms to compensate for vibration, positional awareness, and stability compensation.

[0141] As described herein, the robotic arm 442 can interface with the probe 450 through the use of sensors to assist in one or more of coarse position alignment, intermediate position alignment, and fine position alignment. For example, the probe can be associated with a beacon 830 (e.g., an IR beacon), and the robotic arm 442 can support an IR receiver 832 that can detect emissions from the IR beacon 830 for coarse alignment. One or more alignment reference points 834 can be associated with the probe 450, and one or more alignment sensors 836 can be associated with the robotic arm 442. As described herein, the alignment sensor 836 can detect the location of the alignment reference points and thereby determine the location of the robotic arm 442 relative to the probe 450. In some embodiments, a proximity sensor (e.g., a Hall Effect sensor) or a proximity switch is used to detect alignment between the probe and the arm so as to engage the probe with the arm, such as to lock the probe to the arm when the arm is properly manipulated into position.

[0142] In some embodiments, when processing has been completed, the arm may be decoupled from the probe while the user holds the probe, and the arm is drawn away from the probe, such as automatically.

[0143] One or more computing devices (e.g., a processor of console 420 or console 490 as described herein) operably coupled to the robotic arm may include instructions for performing the following operations: controlling the movement of the robotic arm in response to the force detected by the sensor, such as preventing excessive compression of the anterior tissue and the resulting damage to the tissue and / or probe. In an exemplary use case of a treatment system for prostate tissue resection, the treatment probe is ideally positioned at the anterior center of the patient's prostate cavity, but does not over-compress the anterior prostate to prevent unintentional damage to the urethra / prostate (e.g., excessive bleeding, necrosis, perforation of the tissue) and / or damage to one or both of the imaging probe and the treatment probe. Similarly, the imaging probe, which may be a TRUS probe, is ideally positioned in the patient's rectum with sufficient anterior compression to observe the prostate and the treatment probe, but does not over-compress the tissue to avoid unintentional damage to the rectum (e.g., bleeding or perforation of the tissue) and / or damage to one or both of the imaging probe and the treatment probe. The treatment probe, the first robotic arm coupled thereto, the imaging probe, and / or the second robotic arm 444 coupled thereto may be provided with a force sensor configured to detect anterior compression of the probe against tissue. The detected force level may be transmitted to a processor operably coupled to the robotic arm and compared with a force threshold value pre-programmed or stored in a memory of the computing system. If the detected force exceeds the threshold value, the movement of the robotic arm may be adjusted to move the probe away from the anterior tissue, thereby at least partially alleviating the compression of the anterior tissue.

[0144] Another exemplary feedback sensing mechanism may include a positioning and / or motion sensor operably coupled to the first robot arm and / or the second robot arm 444. One or more computing devices operably coupled to the robot arm may include instructions for performing the following operations: controlling the movement of the robot arm in response to the positioning and / or motion detected by the sensor, such as adjusting the positioning of the treatment probe and / or imaging probe in response to the patient's movement during the treatment and / or scanning process. When a rigid element (such as a treatment probe or an imaging probe) is positioned inside the patient's body, patient movement may potentially cause harm to the patient, and the probe may need to be removed during the movement and subsequent repositioning of the probe. A robotic arm that automatically adjusts the positioning of the probe in response to the patient's sensed movement can improve the safety and efficiency of the surgical procedure. One or more positioning or motion sensors (such as coils and / or accelerometers) can be attached to the patient, and the sensor can be operably coupled to the computing device that controls the robot arm. For example, the sensor can be configured to generate a small local electromagnetic field or other signal to help determine the patient's position and / or movement. The processor can receive the detected patient movement data and adjust the movement of the robotic arm accordingly to substantially match the patient movement so that the probe coupled to the robotic arm can be maintained within an acceptable positioning range relative to the tissue or patient organ. In some embodiments, the processor is configured to interrupt processing if the force to the sensor exceeds a threshold amount.

[0145] Optionally, in some embodiments, the robot arm can be configured to move automatically in a linkage manner. For example, if the user of the system moves the first robot arm, the second robot arm 444 can be configured to automatically adjust its positioning accordingly. In the exemplary use case of the processing system for prostate tissue resection, the patient's prostate may not be symmetrical in the anatomical structure, and the user may need to adjust the positioning or orientation of the processing probe accordingly (for example, push the probe to one side, adjust the pitch angle of the probe, etc.). The robot arm coupled to the imaging probe can be configured to automatically detect the adjustment made to the robot arm coupled to the processing probe, and make corresponding adjustments to the positioning and / or orientation of the imaging probe. Such linkage movement of the two robot arms may be useful for maintaining the desired positional relationship between the processing probe and the imaging probe relative to each other, such as the elongated axis of the processing probe is substantially aligned with the elongated axis of the imaging probe.

[0146] Figures 9A-9C The alignment of the treatment probe axis 451 with the sagittal plane 950 of the imaging probe 460 is schematically shown. Fig. 9A950 is a side view of a treatment probe 450 tilted relative to an imaging probe 460. The treatment probe 450 includes an elongated shaft 451, and the imaging probe 460 includes an elongated shaft 461 that provides a reference for images generated by the imaging probe. The elongated shaft 461 can at least partially define a sagittal image plane 950. Fig. 9B 4 is a top view of the treatment probe 450 substantially aligned with the sagittal image plane 950. When the treatment probe axis 451 is substantially aligned with the sagittal image plane 950, a substantial portion of the treatment probe is within the field of view of the ultrasound probe and is visible in the sagittal image. In some embodiments, the two probes are substantially aligned when the elongated axes are aligned to within about 5 degrees of each other relative to a plane perpendicular to the sagittal image plane. For situations where there is a larger tilt angle between the probes, the treatment probe will extend transverse to the field of view of the ultrasound probe, and only the portion of the probe within the field of view of the ultrasound probe is visible in the ultrasound image.

[0147] When the probe is aligned substantially in the sagittal image plane but in a Fig. 9A When tilted at the angle shown, the treatment probe and tissue may appear to be rotated in the sagittal image, and the acceptable amount of rotation may be greater than, for example, 5 degrees. Fig. 9C is a top view of the treatment probe 450 across the sagittal image plane 950. When the imaging probe is not fully aligned with the treatment probe, the treatment probe may appear to be distorted in the sagittal plane image, with only a portion of the treatment probe extending through the sagittal field appearing in the image. In some embodiments, the treatment probe and the imaging probe may include one or more sensors to confirm the desired alignment (parallel and / or coplanar) of the probes with respect to each other. For example, the system may include a first orientation sensor 473 and a second orientation sensor 476 on the treatment probe 450 and the imaging probe 460, respectively. In some embodiments, the first orientation sensor and the second orientation sensor 476 include magnetic elements, Hall effect sensors, dials, variable resistors, potentiometers, accelerometers, or any combination thereof that can indicate the relative positioning and orientation of the probes with respect to each other. In some embodiments, the angle of the sagittal plane of the ultrasound imaging probe can be rotated by rotating the ultrasound imaging probe around the elongated axis of the ultrasound imaging probe. For example, in some patients, the prostate is not symmetrical, or the urethral notch is deformed, and the imaging probe and treatment probe may be located on opposite sides of the patient's body or at least offset relative to each other about the patient's midline, and rotation of the imaging probe about its elongated axis may rotate the sagittal plane of the ultrasound probe and bring the treatment probe and tissue treatment area into the field of view of the ultrasound imaging probe. The alignment, orientation, and relative positioning of the treatment probe and imaging probe may continue to be monitored during the treatment procedure.

[0148] When the treatment probe and the imaging probe are not adequately aligned, the user can use an image of the treatment probe obtained with the imaging probe to align the treatment probe and the imaging probe, for example, by providing user input into the GUI for controlling a robotic arm coupled to the treatment probe or the imaging probe. Optionally or additionally, as described herein, the robotic arm can be programmed to automatically adjust movement to maintain adequate probe alignment. For example, when the user adjusts the positioning or orientation of the treatment probe by controlling a first robotic arm coupled to the treatment probe, a second robotic arm 444 coupled to the imaging probe can automatically detect the adjustment made to the first robotic arm and make corresponding adjustments to substantially match the pitch, roll, yaw, and / or linear positioning of the treatment probe along the treatment probe axis.

[0149] In order to provide automatic coordinated movement of the two robotic arms, a calibration step can be added to the process, in which each arm identifies its position relative to the other arm. For example, each robotic arm can include a "target" on the arm at a known position; during the calibration process, the user can manipulate the first arm with the first arm coupling structure to touch the target located on the second arm, and manipulate the second arm with the second arm coupling structure to touch the target located on the first arm. Therefore, the automatic coordinated movement of the two robotic arms can facilitate the process by eliminating the need for the user to separately adjust the movement of the second arm after moving the first arm. In addition, as described herein, in the event that the patient moves when the probe is inserted into the patient's body, the coordinated movement of the two arms can help in improving the safety and efficiency of the process.

[0150] Optionally, in some embodiments, a robotic arm coupled to a treatment probe can be configured to move the treatment probe along a pre-programmed treatment profile for performing treatment of a target site. For example, the treatment profile can include a tissue resection profile of a target site, which can be programmed by a user of the treatment system and stored in a memory of one or more computing devices operably coupled to the robotic arm. Additional details about automated treatment using programmed treatment profiles can be found in PCT Publication No. WO2013 / 130895, previously incorporated herein by reference.

[0151] Optionally, in some embodiments, a robotic arm coupled to an imaging probe can be configured to move the imaging probe along a pre-programmed imaging profile before and / or during treatment with a treatment probe to generate a three-dimensional rendering of a target site. A three-dimensional image of a target site can be obtained from a dual-plane imaging probe by: 1) rotating the imaging probe in situ while the imaging probe captures a sagittal view image of the target site, then interpolating the sagittal view image, or 2) translating the imaging probe across the target site (along the z-axis of the probe) while the imaging probe captures a transverse view image of the target site, then interpolating the transverse view image. In order to improve the efficiency of 3D image rendering and the resolution of the resulting 3D image, the robotic arm can be configured to quickly scan the target site along a pre-programmed imaging profile, and the 3D image can be generated using software to render a 3D image of the treatment site in substantially real time. The pre-programmed imaging profile can be stored on a memory of one or more computing devices, and can include multiple sagittal view scans performed at predetermined time intervals while the imaging probe is rotated in situ and / or multiple transverse view scans performed at predetermined time intervals while the imaging probe (along the z-axis or elongated axis of the imaging probe) is translated across the target site.

[0152] Automated computer-controlled scanning of the target site with the imaging probe using the robotic arm can also be used to generate useful information about the target site for additional treatment. For example, the imaging probe can be configured to perform a color / Doppler scan of the target site after the ablation process to locate bleeding sites within the target site that require hemostasis.

[0153] In some embodiments, the Doppler ultrasound image displays blood moving away from the ultrasound probe as blue and blood moving toward the ultrasound probe as red. In some embodiments, the tissue resection profile can be adjusted prior to tissue resection to reduce and in some cases avoid resection of blood vessels present in the Doppler ultrasound image. For example, the ultrasound image can include a 3D ultrasound image and a 3D resection profile that is adjusted to reduce or avoid blood vessels.

[0154] Fig.10High blood perfusion sites 810 are shown identified from an ultrasound image 800 of a patient's tissue 805. As described herein, when the imaging probe is operated in a Doppler imaging mode, a robotic arm coupled to the imaging probe can automatically move to obtain a scan from the imaging probe. High blood perfusion sites 810 can be identified from the resulting Doppler scan image based on the detection of blood flowing closer to or farther from the imaging plane of the imaging probe. In some cases, high blood perfusion sites 810 include bleeding sites, and based on the Doppler information, the user can effectively find the bleeding and treat the bleeding, such as by using local cauterization or hemostatic agents (such as gels and matrices), thereby reducing bleeding, cauterization time, heat, or other effects on the tissue. In some cases, high blood perfusion sites 810 may also include abnormal or even cancerous tissue growth. These areas can be marked or identified for subsequent treatment. For example, normal tissue can be excised around the abnormal tissue to leave islands of abnormal tissue, which are then treated, for example, with local drug delivery.

[0155] Three-dimensional scanning of a target site using an imaging probe can also be used to identify tissue abnormalities, such as tumors, at the target site. For example, a tumor can be identified from an image of the target site obtained from an automated scan of the target site using an imaging probe based on the difference between high-echoic and low-echoic areas of the imaged tissue. Robotic scanning of the target site can increase the speed of image analysis and, therefore, improve the accurate detection of tissue abnormalities. In addition, the imaging probe can be operated in a Doppler imaging mode during automated scanning to identify areas of higher blood flow, which may correspond to the location of potential cancers. A biopsy can be performed at the identified tissue area to improve the detection of cancer.

[0156] Fig.11A , Fig. 11B and Fig. 11C An exemplary embodiment of a treatment system 1100 including a treatment station is shown. System 1100 may include one or more components of system 400 and may include a coupling structure on a probe base and may pivot to couple an arm to one or more of imaging probe 460 and treatment probe 450 after one or more probes are inserted into a patient. Fig.11A is a side view of the processing system 1100, Fig. 11B is a front view of the processing system 1100, and Fig. 11C is a perspective view of the treatment system showing the positioning of a patient P. Figures 11A-11CA three-dimensional coordinate system legend including an X-axis, a Y-axis, and a Z-axis is also shown, wherein each of the X-axis, the Y-axis, and the Z-axis is perpendicular to each other, the X-axis and the Z-axis are orthogonal horizontal axes, and the Y-axis is a vertical axis to facilitate viewing and describing the system 1100. The processing system 1100 may include a processing probe 450, an imaging probe 460, a platform 1113, and a probe mounting and adjustment assembly 1120. The probe mounting and adjustment assembly 1120 may include a probe base 1104, a pivot 1105, a vertical rotating frame 1106, a first horizontal slider 1107 for translating the vertical rotating frame 1106 along a first Z translation direction 1133 (i.e., along the Z axis or an axis parallel thereto), a pair of first horizontal arms 1108 oriented along the Z direction, a pair of vertical arms 1111 oriented along the Y direction (i.e., along the Y axis or an axis parallel thereto), a pair of first locking mechanisms 1110 for the pair of vertical arms 1111, and a pair of second locking mechanisms 1110 for translating the pair of vertical arms 1111 along a second Z translation direction 1131 (i.e., along the Z axis or an axis parallel thereto). A horizontal slider 1112, a patient support (e.g., a platform 1113) having the pair of second horizontal sliders 1112 coupled thereto, a pair of second horizontal arms 1114 oriented along the X direction (each second horizontal arm 1114 coupled to a corresponding first horizontal arm 1108), a pair of second locking mechanisms 1115 for the pair of first horizontal arms 1108, a horizontal adjuster 1116 for the vertical turret 1106, a third locking mechanism 1117 for the vertical turret 1106, and a third horizontal slider 1118 for translating the first horizontal slider 1107 in a first X translation direction 1136 (i.e., along the X axis or an axis parallel thereto). These arms, sliders, and locking mechanisms can be one or more of the following: mechanically or manually actuated or repositioned relative to each other. As described herein, the treatment probe 450 and the imaging probe 460 can be aligned to be one or more of the following: parallel or coplanar with each other. One or more of the processing probe 450, the imaging probe 460, the various arms, the various slides, or the various mechanisms may be covered with one or more protective drapes to facilitate performing one or more of the following operations for the various components of the system 1100: providing a sterile operating environment or minimizing subsequent cleanup.

[0157] The treatment probe 450 and the imaging probe 460 can be aligned substantially vertically and rigidly (e.g., rigidly) and adjustably connected to one or more probe coupling mounts 1104, wherein the probe coupling mounts 1104 can rotate about an axis defined by a pivot 1105 in a first rotational direction 1135 (i.e., about an X-axis or an axis parallel thereto) relative to a vertical turret 1106, e.g., in a YZ plane (or a plane parallel thereto), as shown. Figures 11A-11CAs shown. In some embodiments, the positioning of the elongated shaft 451 of the treatment probe 450 relative to the elongated shaft 461 of the imaging probe 460 can be set by adjusting the positioning of the treatment probe 450 relative to the probe base 1104 and by adjusting the positioning of the imaging probe 460 relative to the probe base 1104. In some embodiments, the treatment probe 450 and the imaging probe 460 are each removably mounted to the probe coupling base 1104 by a fastener, which includes a screw, a nut, a washer, a bolt, a pin, a pivot, a hinge, a bearing, a clamp, a band, a thumb screw, a latch, a chuck, a dovetail, a channel, a spring, a magnet, a thread, a key, a groove, a gear, a pulley, a rack, a pinion, or any combination thereof. In some embodiments, the treatment probe 450 is removably mounted to the first probe coupling base 1104, and the imaging probe 460 is removably mounted to the second probe coupling base 1104. In some embodiments, the probe coupling base 1104 includes an electrical connector to transfer power and / or data to or from the treatment probe 450 and / or imaging probe 460 to a computer or processor. In some embodiments, the probe coupling base 1104 includes a hose connector to transfer liquids and / or gases to the treatment probe 450. In some embodiments, the fastener, electrical connector, and hose connector comprise a single component. In some embodiments, the fastener and electrical connector comprise multiple components. In some embodiments, the positioning of the treatment probe 450 relative to the probe coupling base 1104 and the positioning of the imaging probe 460 relative to the probe coupling base 1104 are adjusted manually or by driving an actuator, or both. In some embodiments, the positioning of the treatment probe 450 relative to the probe base 1104 and the positioning of the imaging probe 460 relative to the probe base 1104 are adjusted by thumb screws, pivots, hinges, pins, slots, bearings, pulleys, racks, pinions, linear actuators, motors, solenoids, or any combination thereof.

[0158] In some embodiments, the probe coupling base 1104 also includes a manual actuation feature that allows a user to manually manipulate its positioning. In some embodiments, the manual actuation feature includes a handle, a knob, a hilt, a bar, a grip, or any combination thereof.

[0159] In some embodiments, the probe coupling base 1104 can be rotated about the first rotational direction 1135 at least about 315 degrees, at least about 300 degrees, at least about 280 degrees, at least about 260 degrees, at least about 240 degrees, at least about 220 degrees, at least about 200 degrees, at least about 180 degrees, at least about 160 degrees, at least about 140 degrees, at least about 120 degrees, at least about 100 degrees, or at least about 80 degrees.

[0160] In some embodiments, the probe coupling base 1104 further includes a cable guide tube, a cable release member, a slip ring, or any combination thereof to constrain and protect any cables leading out of the treatment probe 450 or the imaging probe 460 .

[0161] In some embodiments, the substantially vertical turret 1106 is additionally extended and retracted in a first Y translation direction 1132 (i.e., along the Y axis or an axis parallel thereto) to set the height of the probe base 1104 relative to the first horizontal slider 1107. The turret may include an extension joint that allows extension and retraction, such as a telescoping sliding tube or a threaded assembly and a combination thereof. In some embodiments, the positioning of the vertical turret 1106 is adjusted manually or by a driven actuator or both. The rotation of the probe base 1104 relative to the vertical turret 1106 may be robotically controlled or manually set. In some embodiments, the rotation of the vertical turret 1106 in a second rotation direction 1134 (i.e., around the Y axis or an axis parallel thereto) about its vertical axis of symmetry may be set and locked by a third locking mechanism 1117. In some embodiments, the pair of first horizontal sliders 1107 are capable of translating the treatment probe 450 and the imaging probe 460 toward or away from the patient P. In some embodiments, the first horizontal slider 1107 includes a manual actuator, a driven actuator, or both. In some embodiments, the positioning of the vertical turret 1106 toward or away from the patient is changed by a horizontal slider 1107. A horizontal adjuster 1116 can translate the robotic arm in the X direction transverse to the patient support. The horizontal adjuster 1116 can be operated by a manual actuator, a driven actuator, or both.

[0162] In some embodiments, the third horizontal slider 1118 allows the first horizontal slider 1107, and thus the treatment probe 450 and the imaging probe 460, to translate in a horizontal direction (i.e., along the X-axis) toward the left or right side of the patient, wherein one or more third locking mechanisms 1117 can engage and disengage the ability of the vertical turret 1106 to translate horizontally along the third horizontal slider 1118. In some embodiments, each end of the third horizontal slider 1118 is attached to a second horizontal arm 1114, wherein each second horizontal arm 1114 can be vertically attached to the first horizontal arm 1108, and wherein each first horizontal arm 1108 can be vertically attached to the vertical arm 1111. In some embodiments, each vertical arm 1111 is attached to a second horizontal slider 1112 on the platform 1113, wherein the second horizontal slider 1112 is capable of translating one or more vertical arms 1111 in a horizontal direction (i.e., along the Z-axis) toward or away from the patient, and wherein one or more first locking mechanisms 1110 set the positioning of one or more vertical arms 1111 relative to the platform 1113.

[0163] In some embodiments, one or more exemplary embodiments of components of the processing system 1100 are comprised of metal, plastic, fabric, cloth, foam, wood, carbon fiber, fiberglass, glass, or combinations thereof.

[0164] In some embodiments, the vertical turret 1106, the first horizontal slider 1107, the second horizontal slider 1112, and the third horizontal slider 1118 include an actuator, a bearing, a shaft, a worm drive, a rack, a pinion, a gear, a belt, a chain, a pulley, a slider, a ring, a shaft, or any combination thereof. In some embodiments, at least one of the vertical turret 1106, the first horizontal slider 1107, the second horizontal slider 1112, and the third horizontal slider 1118 further includes an encoder, wherein the encoder measures translational or rotational displacement.

[0165] In some embodiments, first locking mechanism 1110 , second locking mechanism 1115 , and third locking mechanism 1117 include cams, screws, handles, knobs, shafts, clamps, or any combination thereof.

[0166] In some embodiments, the slide, turret, and vertical extension joint each include an actuator coupled to a processor to control the positioning and angle of the coupled structure. In some embodiments, the coupler between the horizontal arm 1108 and the second horizontal arm 1114 includes a powered joint. In some cases, the powered joint is under robotic control of the processor and can be actuated to move the hardware out of the way to assist in extraction of the patient from the patient support.

[0167] In some embodiments, the system includes a coupling device coupled to a processor, and the coupling device includes one or more of the following: a slider, a turret, and a vertical extension joint. Each of these one or more components may include an actuator coupled to the processor to control the position and angle of the coupling structure on the arm in response to a control signal from the processor.

[0168] For example, the arm may include a plurality of arms and a slider.

[0169] In some embodiments, one or more exemplary embodiments of components of the processing system 1100 may be detachable, portable, or both. In some embodiments, the processing system 1100 further includes cable management members, wheels, a step stool, a power source, a mounting member, or any combination thereof.

[0170] One or more imaging sensors 1145 can be arranged at one or more positions in various parts of processing system 1100, and can be arranged on first horizontal arm and / or second horizontal arm.One or more imaging sensors can be used to obtain the image of the fiducial mark on imaging probe 460 or processing probe 450 or both, to help in the alignment and / or docking of robot arm and probe, or to detect the positioning, orientation or alignment of probe.User interface 1140 can be arranged on robot arm, probe or both to indicate the docking state of robot arm and probe.In some cases, user interface is one or more visual indicators, such as LED indicator.One or more visual indicators can convey additional operation or status information of robot arm or probe.

[0171] Fig.12 An exemplary embodiment of a processing system 1200 including a processing platform is shown. System 1200 may include one or more components of system 400 or system 1100 as described herein. Fig.12 12 is a perspective view of a processing system 1200. The processing system 1200 may include a processing cart 1210. The cart 1210 may include a housing 1213, a common robotic arm 1214 (which may perform one or more of the following operations: rotate or translate relative to the housing 1213), a fluid container hanger 1215, a fluid container 1216 for, e.g., saline, a push handle 1217, one or more wheels 1218, a support 1219, one or more display screens 1220, a processing probe robotic arm 442 (which may perform one or more of the following operations: rotate or translate relative to the common robotic arm 1214), a processing probe 450 coupled to the processing probe robotic arm 442, an imaging probe robotic arm 444 (which may perform one or more of the following operations: rotate or translate relative to the common robotic arm 1214), and an imaging probe 460 coupled to the imaging probe arm 444.

[0172] In some embodiments, the processing probe robot arm 442 and the imaging probe robot arm 444 cooperate with the common robot arm 1214 to position the processing probe 450 and the imaging probe 460 to align with each other (i.e., parallel and / or coplanar alignment). In some embodiments, the housing 1213 contains a power supply, a pressure source, a communication member, a power cable, a drug, or any combination thereof. In some embodiments, the common robot arm 1214 can pivot or translate relative to the housing 1213 about one or more degrees of freedom. In one example, the common robot arm 1214 can pivot about an angle of about 220 degrees around a vertical axis perpendicular to the floor. In some embodiments, the common robot arm 1214 can extend and contract. In some embodiments, the cart 1210 is transportable, wherein the cart 1210 can include a push handle 1217 and one or more wheels 1218 and a support 1219 to maintain the stability of the cart 1210 during patient treatment. In some embodiments, the cart 1210 also includes a fluid container hanger 1215 that can support a saline or fluid container 1216 that stores a certain amount of fluid or saline for use with the treatment probe 450, which can provide a pressurized fluid jet for tissue removal. In some embodiments, the cart 1210 also includes one or more screens 1220 that can display information from the imaging probe 1202 or other sources to the practitioner or patient. In some embodiments, the treatment system 1200 also includes a container for storing removed tissue and spent saline fluid.

[0173] Fig.13 An exemplary embodiment of a probe mounting and adjustment assembly 1600 is shown. The probe mounting and adjustment assembly 1600 is attached to a patient support by a plurality of clamps 1302. According to some embodiments, the patient support is a bed, an operating table, or a platform, and the clamps are attached to the patient support, for example, by mechanically clamping to the rails of the patient support. The probe mounting and adjustment assembly 1600 may include 2, 3, 4, 6, or more clamps 1302 for attaching to the patient support. In some embodiments, the mounting assembly 1600 supports the first robotic arm 442 on which the first probe 460 is mounted and the second robotic arm 444 on which the second probe 450 is mounted in a substantially "collision-proof" configuration, so that a medical professional bumping into one or more of the mounting assembly 1600, the first robotic arm 442, the first probe 460, the second robotic arm 444, or the second probe 450 causes a clinically acceptable amount of movement of the probe inserted into the patient, for example, no more than about 5 mm of movement.

[0174] Although the mounting assembly 1600 can be configured in a variety of ways, in some embodiments the mounting assembly is configured to limit the movement of the elongated support 1310 relative to the first track and the second track to no more than 5 mm in response to a 150 kg load on the elongated support 1310 (e.g., the crossbeam 1310). As used herein, the terms "elongated support" and "crossbeam" are used interchangeably. In some embodiments, in response to a 100 kg load on the elongated support 1310, the movement is no more than 3 mm. In some embodiments, the elongated support 1310, the first clamp 1302, the first arm 442, the second clamp 1304, and the second arm 444 can be configured to limit the movement of the elongated support 1310 to no more than 5 mm in response to a 150 kg load on the elongated support 1310, and the movement can be no more than 3 mm in response to a 100 kg load on the elongated support 1310. In some embodiments, the probe to be inserted into the patient comprises a distance in a range from about 20 cm to about 60 cm, and the mounting assembly 1600 is configured to move the distal end of the probe by no more than 6 mm in response to a load on the elongated support 1310 .

[0175] The probe mounting and adjustment assembly 1600 can be a modular system consisting of a foldable universal surgical table mounting system and a pair of lockable positioning arms mounted to a universal base. The universal base is easy and intuitive to adjust and accommodates most commonly used surgical tables, including different sized mounting tracks, different table widths, and tables with removable and foldable leg supports. It provides a rigid platform that enables the mounting arms 1312, 1314 to be optimized for weight, stiffness, smooth movement, and range of motion to provide excellent surgical planning capabilities.

[0176] The two robotic arms 442, 444 allow for smooth, fluid motion within a defined surgical planning field. They provide tactile feedback of the patient's anatomy to minimize the risk of injury while facilitating probe alignment to simplify the surgical planning process. When locked, the robotic arms 442, 444 provide a rigid interface that holds both the imaging probe and the treatment probe in the position the operator wants them to be positioned. During surgical procedure setup and takedown, the probe mounting and adjustment assembly 1600 can be divided into compact, easily manageable components that can be deployed by one person and mounted in / on a console for storage.

[0177] According to some embodiments, the probe mounting and adjustment assembly 1600 includes two similar, e.g., substantially identical rail clamps 1302, 1304 and a crossbar 1310. The rail clamps 1302, 1304 can be adjusted and configured to fit all commonly used operating table rail sizes and are installed / removed with a simple push of a lever 1406. The lever 1406 is the main contact point for the rail clamps and allows them to be installed in a single motion with one hand. The crossbar 1310 docks into two sockets 1316 of the rail clamps 1302, 1304 to complete the operating table mounting system and folds flat for storage. It is unfolded by squeezing two control triggers, one in each hand. The control trigger unlocks the corner pivot, which enables folding for storage and fine width adjustment for mounting to a patient support. The control trigger also unlocks the mechanism that secures the crossbar 1310 to the rail clamps. According to some embodiments, the mechanism on the crossbeam 1310 automatically engages when pushed into place, and self-locks to minimize the possibility of incorrect assembly. The crossbeam 1310 can also have a width adjustment mechanism for rough adjustment for different surgical operating table widths. The components can be positioned in a symmetrical form to create an isosceles trapezoidal geometry relative to the OR operating table. In some embodiments, the track fixtures 1302, 1304 can be placed on different Z positionings, the patient can be placed on different X positionings, and tilted at a Z' angle on the operating table, producing multiple asymmetries. The design of the mounting assembly 1600 including the track fixtures 1302, 1304, the track fixture socket 1316, and the lockable crossbeam mounting arms 1312, 1314 and the crossbeam 1310 (with an arm rotating around the Y axis) provides adjustment to the arm structure, allowing accurate positioning of the imaging probe 460 and the treatment probe 450 to adapt to all the following variables: equipment settings, patient anatomy, and patient positioning.

[0178] According to some embodiments, the mechanical arms 442, 444 include two similar arms (e.g., substantially identical arms) and a lateral adjustment mechanism. Each arm may include three rotating / lockable joints coupled together by arm segments, an interface firmly mounted to the crossbeam 1310 on the bottom, and a control handle 1318 and a stepper base 1320 at the top. The joint may be configured to rotate around the X axis. The control handle 1318 is the primary contact point for manipulation, and enables single-handed positioning and adjustment of each probe 450, 460. The stepper base 1320 provides a drape-safe interface for mounting a stepper, which is used for fine control of the imaging probe 460 and the processing probe 450. Each mechanical arm 442, 444 may be covered with a surgical drape to minimize contamination and simplify cleaning after the surgical procedure. The control handle 1318 may have a two-stage actuation mechanism, the first stage being used to unlock all joints together and keep them unlocked, and the second stage being used to relock the system when in the desired positioning. This can reduce the need to hold each arm tightly for improved tactile feel and more precise control during operation.In some embodiments, the control handle 1318 includes a handle for manipulating the robotic arm, and a button or switch engages or disengages a locking mechanism within the joint to allow or prohibit manual manipulation of the robotic arm.

[0179] The clamps 1302, 1304 are connected to the socket 1316 by a clamp coupler 1324. The clamp coupler 1324 can allow a degree of freedom between the clamp 1302 and the socket 1316, thereby allowing adjustment of the orientation or positioning of the clamp 1302 to facilitate clamping to the patient support. The socket 1316 is connected to the mounting arm 1312. In some embodiments, the socket 1316 defines a groove, and the mounting arm 1312 is coupled to the socket 1316 by fitting within the groove and can be secured by any suitable mechanical interaction (e.g., a ball lock pin, a friction fit, a set screw, a thumb screw, a pin slot, a boss and a recess, a pin, an interference structure, or some other suitable connection structure). In some embodiments, the mounting arm 1312 includes a lever that pivots a locking pin to allow a secure connection between the mounting arm 1312 and the socket 1316. In an exemplary use, according to some embodiments, the mounting arm 1312 can be inserted into a groove of the socket 1316, and the locking pin can be retracted when the mounting arm 1312 engages the inner surface of the socket 1316. When fully inserted, the locking pin or other protruding structure that can be biased to extend away from the mounting arm 1312 can snap outward from the mounting arm into a groove, cavity, hole, or pocket formed in the socket 1316 to securely connect the mounting arm 1312 to the socket 1316. A lever on the mounting arm 1312 can be coupled to the protruding structure so that when the lever is depressed, the protruding structure is withdrawn into the mounting arm 1312 to facilitate withdrawal of the mounting arm 1312 from the socket 1316.

[0180] The mounting arm 1312 is connected to the cross beam 1310, for example, by a cross beam coupler 1326. The cross beam coupler 1326 can allow pivotal movement between the mounting arm 1312 and the cross beam 1310. As shown, a pair of mounting arms 1312, 1314 can be connected to the cross beam 1310 at either end of the cross beam 1310. The pair of mounting arms 1312, 1314 can rotate or pivot about the cross beam coupler 1326 to change the distance between the clamps 1302, 1304. In this way, the distance between the clamps 1302, 1304 can be adjusted to mount on a variety of different sized patient supports.

[0181] The crossbeam 1310 supports a robotic arm base 1328. The robotic arm base 1328 may be slidably connected to the crossbeam 1310, which allows the robotic arm base 1328 to slide along the X-axis and move horizontally left and right relative to the patient. The robotic arm base 1328 may be secured to the crossbeam 1310 in any suitable manner, such as by screws, thumb screws, cams, levers, locks, twist locks, or any suitable structure for securing the robotic arm base 1328 to the crossbeam 1310.

[0182] The mechanical arm base 1328 provides an attachment point for one, two or more mechanical arms 442, 444. As shown, in some embodiments, two mechanical arms are connected to the mechanical arm base 1328. The mechanical arms 442, 444 can be connected by any type of secure connection (e.g., screws, sliding locks, clips or other suitable connectors). The components of the probe mounting and adjustment assembly 1600 can be formed of any suitable material, and in some embodiments, one or more components are formed of metals such as stainless steel, titanium, tantalum, platinum, palladium or any suitable alloy. For example, the components of the probe mounting and adjustment assembly 1600 can be alternatively or additionally formed of any suitable polymer (e.g., one or more of the following: polyvinyl chloride (PVC), polypropylene (PP), polyethylene (PE), polystyrene (PS) and nylon, polyethylene terephthalate (PET), polyimide (PA), polycarbonate (PC), acrylonitrile-butadiene (ABS), polyetheretherketone (PEEK) or polyurethane (PU)).

[0183] In some embodiments, the fixture 1302, fixture coupler 1324, socket 1316, mounting arm 1312, beam coupler 1326, beam 1310, robot base 1328, or robot arm 444 includes an actuator, a bearing, a shaft, a worm drive, a rack, a pinion, a gear, a belt, a chain, a pulley, a slider, a collar, a shaft, or any combination thereof. In some embodiments, at least one of the fixture 1302, fixture coupler 1324, socket 1316, mounting arm 1312, beam coupler 1326, beam 1310, robot base 1328, or robot arm 444 includes an encoder, wherein the encoder measures translational or rotational displacement or positioning.

[0184] The robotic arms 442, 442 may be provided with one or more segments separated by joints that provide degrees of freedom between the segments. For example, the robotic arm may have two, three, four or more segments 1330, each coupled to one another by joints 1332 that allow relative pivotal or rotational movement between adjacent segments 1330. The robotic arm itself may be coupled to a robotic arm base 1328 by joints that allow rotation of the robotic arm about one or more axes.

[0185] The robotic arm 442 supports a probe base 1334 to which the probe 450 can be mounted. As shown, the first robotic arm 442 supports the imaging probe 460, and the second robotic arm 444 supports the processing probe 450. In some embodiments, the probe base 1334 includes a lifter 1336 configured to lift a probe, such as the processing probe 450, in the Y direction so that the processing probe 450 is higher than the imaging probe 460. Thus, in the case where the processing probe 450 and the imaging probe 460 are vertically aligned with each other, the lifter 1336 facilitates the processing probe 450 to avoid contact with the imaging probe 460 because they are vertically spaced relative to each other.

[0186] The processing probe 450 has an elongated axis along the shaft of the processing probe 450, and similarly, the imaging probe 460 has an elongated axis along the shaft of the imaging probe 460. In some configurations, the processing probe axis and the imaging probe axis are aligned in a plane. That is, the axes are parallel relative to each other, thereby making them coplanar. In some embodiments, the configuration of the mechanical arms 442, 444 and the probe base 1334 can position the processing probe axis and the imaging probe axis coplanar with each other in a vertical plane. In other words, the two axes can be aligned vertically, with one probe directly above the other probe.

[0187] According to some embodiments, the probe is movable in the X, Y, and Z directions within the surgical planning field and has rotational motion around any of these axes. In some cases, the imaging probe 460 and the treatment probe 450 are independently positionable in the YZ plane, and in some cases there is limited relative motion along the X axis. According to some embodiments, the imaging probe 460 has a limited range of translational motion and is positioned approximately ±2 inches from the center in the X direction in some cases; approximately -3 inches to +4 inches from the center in the Y direction; approximately -9 inches to +2 inches from the center in the Z direction (and an additional 100mm in the Z direction with fine control of the stepper motor). The imaging probe 460 can have a limited range of rotational motion and, in some embodiments, can be rotated around the X axis at any angle between 0° and approximately 45°, around the Y axis by ±15°, and around the Z axis by ±32°.

[0188] According to some embodiments, treatment probe 450 may have a limited range of motion, which may be approximately ±2 inches from center along the X-axis, approximately 3 inches to 12 inches from the top of the patient support, and approximately -9 inches to 2 inches in the Z direction (plus an additional approximately 100 mm under stepper motor control). In some embodiments, treatment probe 450 may, for example, rotate approximately ±30° about the X-axis, ±15° about the Y-axis, and have only very minor adjustments about the Z-axis.

[0189] The manipulator may also include a control handle 1318. According to some embodiments, the control handle 1318 is coupled to one or more manipulators and allows an operator to manually position the manipulators 442, 444 and concomitantly position the probe supported by the manipulator. The control handle 1318 may be any suitable configuration that provides a way to manually adjust or move the manipulator. In some embodiments, the control handle 1318 includes a lever that disengages a clutch in one or more joints of the segments separating the manipulators. In some cases, when depressed, the lever of the control handle 1318 disengages one, two, three or more joints to allow the joints to pivot, rotate or allow the operator to manually position a combination of the manipulators. The control handle 1318 may be connected to the probe slider 1340, or may be integrally formed with the probe slider 1340. The probe slider 1340 allows the imaging probe 460 or the treatment probe 450 or both to translate into and out of the patient's body substantially in the Z direction. The probe slider 1340 may be manually operated, automatically operated or a combination of both.

[0190] In use, the clamps 1302, 1304 are coupled to a patient support. There may be two clamps, four clamps, six clamps, or more clamps coupled to a patient support, which in some cases is a bed. The clamps may include a clamp adjuster 1342 that allows the jaws within the clamp to be spaced apart. The handle 1408 on each clamp is manipulated by the operator, and the jaws of the clamp securely grasp the patient support. The socket 1316 can be manipulated to position the socket 1316 in an orientation configured to couple with the mounting arm 1312 of the probe mounting and adjustment assembly 1600. The mounting arms 1312, 1314 are then coupled to the socket 1316 and secured to the mounting arm in any suitable manner.

[0191] The crossbeam 1310 can be connected to the mounting arm 1312; however, in some embodiments, the crossbeam 1310 and the mounting arms 1312, 1314 are not removable from each other, and the coupling of the mounting arms to the socket 1316 places the crossbeam 1310 in the proper position for treatment of the patient. Once the crossbeam 1310 is in the proper position, the robotic arms 442, 444 can be secured to the robotic arm base 1328 of the crossbeam 1310. The imaging probe 460, the treatment probe 450, or both are then coupled to the probe support 1334. The operator can then manually manipulate the robotic arms 442, 444, such as by using the control handle 1318, to position the imaging probe 460 and the treatment probe 450.

[0192] Mechanical arms 442, 444 can then be mechanically controlled, or can be manually controlled during part or all of the process of the surgical procedure. In certain embodiments, mechanical arms 442, 444 are placed in the initial positioning. The modular nature of probe installation and adjustment assembly 1600 allows parts to be separated, easily managed and independently set. The configuration shown also allows treatment planning by automatically aligning imaging probe 460 and processing probe 450 in the same plane, and realizes the stable tactile positioning and adjustment of probe. In addition, in certain embodiments, mechanical arms realize the positioning and compression adjustment of probe, and the stepper motor in the joint allows the computer-controlled Z-direction positioning and angle adjustment of probe. Although this description mentions the parts of single mechanical arm 442, mounting arm 1312 and accompanying hardware in certain embodiments, it should be appreciated that additional mechanical arms can have identical or similar hardware.

[0193] Fig.14A , Fig. 14B and Fig. 14C An exemplary embodiment of a clamp 1302 that can be used with a probe mounting and adjustment assembly 1600 is shown. The clamp 1302 has a fixed jaw 1402, a movable jaw 1404, and a lever 1406 that changes the distance between the fixed jaw 1402 and the movable jaw 1404. The lever 1406 includes a handle 1408 configured to grasp and manipulate the clamp. The lever 1406 is mechanically coupled to the movable jaw 1404, and when the handle 1408 is in an upward position relative to the clamp 1302, the jaws are spaced apart, and when the lever 1406 is moved downward relative to the clamp 1302, the movable jaw 1404 is brought closer to the fixed jaw 1402 from a first position 1410 to a second position 1412. In some cases, both upper jaw 1402 and lower jaw 1404 are movable relative to each other, but in the illustrated embodiment, upper jaw 1402 is shown as being fixed and lower jaw 1404 is movable.

[0194] The clamp 1302 includes a clamp coupler 1324 that secures the clamp to the socket 1316. In some embodiments, the socket 1316 has a recess 1420 that is configured to receive a portion of the mounting arm 1312 therein to facilitate a secure attachment between the socket 1316 and the mounting arm 1312. The clamp coupler 1324 provides for rotational movement of the socket 1316 relative to the clamp 1302. This allows the clamp 1302 to be coupled to the patient support at any angle or configuration and allows the socket 1316 to be aimed in the proper orientation to receive the mounting arm 1312. While the illustrated embodiment shows a rotational coupler between the socket 1316 and the clamp 1302, other forms of attachment are contemplated, such as a ball joint, hinge, pivot, or other structure that allows the socket to move relative to the clamp 1302.

[0195] A clamp adjuster 1342 is provided to provide initial adjustment of the clamp 1302. For example, the clamp adjuster 1342 can be used to move the movable jaw 1404 to a first position 1410. The handle 1408 can then be used to move the movable jaw 1404 to a second position 1412, wherein the patient support is gripped between the fixed jaw 1402 and the movable jaw 1404. In the event that the grip on the patient support is not tight enough, the clamp 1302 can be disengaged from the patient support, and the clamp adjuster 1342 can be used to reposition the movable jaw 1404 to the first position 1410. The lever 1406 can then be used to move the movable jaw 1404 to the second position 1412 to tightly engage the fixed jaw 1402 and the movable jaw 1404 to the patient support. As used herein, a first position 1410 of the movable jaw 1404 is associated with a clamp in a disengaged configuration, and a second position 1412 of the movable jaw 1404 is associated with a clamp in an engaged configuration. The clamp adjuster 1342 can be used to change the first position 1410, which has the effect of changing the clamping force when the movable jaw 1404 is moved to the second position 1412.

[0196] Fig.15A , Fig. 15B , Fig. 15C and Fig.15D The inner workings of an exemplary fixture 1302 that may be used with embodiments of the probe mounting and adjustment assembly 1600 described herein are shown. Fig.15A and Fig. 15B The clamp is shown in a disengaged configuration, and Fig. 15C and Fig.15D The clamp is shown in an engaged configuration. The clamp 1302 includes a lever 1406 having a handle 1408 formed therein. The lever 1406 is pivotally coupled to the fixed jaw 1402 by a lever shaft 1502 and is configured to pivot between an upper disengaged orientation and a lower engaged orientation. The lever shaft 1502 is coupled to a lever arm 1504, which in turn is coupled to an adjuster block 1506. The adjuster block 1506 is connected to the adjuster post 1508, for example, by forming internal threads in the adjuster block 1506 that mate with threads formed on the adjuster post 1508.

[0197] In some embodiments, lever shaft 1502 is pivotally connected to lever arm 1504 at lever arm upper coupler 1510 and pivotally connected to adjuster block 1506 at lever arm lower coupler 1518, and movement of lever 1406 about lever shaft 1502 causes movement of lever arm upper coupler 1510 about lever shaft 1502. Lever arm 1504 is pivotally coupled to adjuster block 1506, and pivotal movement of lever arm 1504 about lever shaft 1502 causes translational movement of adjuster block 1506, and thus, adjuster column 1508.

[0198] The movable jaw 1404 includes a through hole that captures a pair of jaw posts 1512, which allows the movable jaw 1404 to be slidably moved on the jaw posts 1512. The jaw posts 1512 extend between the clamp base 1514 and the fixed jaw 1402. The adjuster block 1506 includes a protrusion of a jaw mover 1516, which is configured to contact the movable jaw 1404, and when the adjuster block 1506 is moved upward, the jaw mover 1516 contacts the movable jaw 1404 and moves the movable jaw 1404 between a first position and a second position. The adjuster post 1508 can be rotated, for example, by a thumb screw or knob on the clamp adjuster 1342 to change the first position of the adjuster block 1506 according to the size of the patient support to which the clamp is to be attached. In some embodiments, the clamp 1302 can have a marking corresponding to a first position of the movable jaw 1404 so that the adjustment of the adjuster post 1508 and the adjuster block 1506 can be repeated for subsequent clamps or subsequent surgical procedures. For example, once the first clamp 1302 is adjusted to apply an appropriate amount of clamping force to the patient support, the marking can visually indicate the position or setting of the clamp adjuster 1342, which can be used to adjust subsequent clamps, such as the second clamp 1304, the third clamp, the fourth clamp, etc., so that all clamps have similar clamping forces to the patient support. This clamping method relies on an eccentric high stress coupling device to achieve high clamping force and prevent loosening (although a latching locking feature [not shown] can be used to prevent loosening). In some embodiments, when clamped to the bed rail, as the lever 1406 is lowered, the jaw gap (the distance between the fixed jaw 1402 and the movable jaw 1404) is closed and the jaws contact the rail before the lever 1406 is in its "home position". At this point, the coupling and the (fixed and movable) jaws are subjected to forces that cause them to move within the elastic deformation range of the material. This elastic deformation increases the "feel" of the force on the closing lever 1406 but at a point where the design of the coupling provides a significant lever arm mechanical advantage. When the clamp is closed, all metal is stressed and the coupling traverses the maximum deformation distance and moves to a smaller (but still significant) deformation position. This smaller distance requires force to move it back within the maximum distance in order to release the clamp 1302. Related to the performance of this clamping is the consideration of the material properties of the fixed and movable jaws (linear springs), lever arm 1504 (c-shaped or s-shaped springs), lever shaft 1502, including design considerations for the spring constant (k), material modulus, and preventing the material from reaching elastic yield (which would cause permanent deformation of the components). Additionally, if the above components are a completely rigid system, this may require a spring element to be designed into the adjuster block 1506.

[0199] Fig.16A , Fig. 16B , Fig. 16C and Fig.16D Side views of a clamp that may be used with probe mounting and adjustment assembly 1600 according to some embodiments are shown sequentially as handle 1408 is moved through its full range of motion from a disengaged position, to halfway, to three quarters of the way, and to a fully engaged position, respectively. In use, clamp adjuster 1342 is used to establish an initial first position of lower jaw 1404 by rotating clamp adjuster 1342 to advance adjuster block 1506 along a threaded portion of adjuster post 1508. This allows an initial first position of movable jaw 1404 to be established while lever 1406 is maintained in a disengaged position.

[0200] The lever arm upper coupler 1510 is offset by a distance M relative to the lever shaft 1502, and the lever arm upper coupler 1510 rotates around the lever shaft 1502. It should be noted that Fig.16A As shown, the movable jaw 1404 is free to move downward away from the fixed jaw 1402 until it contacts the adjuster block 1506, which limits the movement of the movable jaw 1404 in the direction away from the fixed jaw 1402. Fig.16A The positioning shown moves to Fig.16D In the position shown, the lever arm upper coupler 1510 rotates about the lever shaft 1502 and moves from a position generally below the lever shaft 1502 to a position generally directly above the lever shaft 1502. This movement results in a linear translation of the adjuster block 1506 by a distance of 2M. Accordingly, the adjuster block 1506 and the movable jaw 1404 also move a linear distance equal to 2M. For example, in Fig.16D1504) and the movable jaw 1408). In FIG. 1508, the top pin is A (lever arm upper coupler 1510), the middle pin is B (lever shaft 1502), and the bottom pin is C (lever arm lower coupler 1518). B is located in space and is immovable relative to the fixed jaw 1402. A rotates about B, causing the lever arm 1504 to rotate about C. Movement of the lever arm 1504 causes C to translate in the Y axis (causing the movable jaw to move). It can be imagined that points B and C remain collinear and move along the Y axis (the axis called BCY), and A traverses arcs of different radii around B and C. Each of A, B, and C has an imaginary parallel X line Ax, Bx, Cx passing through them, and the distance between them changes when the handle 1408 is moved. In addition, the distance between Ax and Cx is Drotate (many positioning), Dmax (A is the highest) (this is the maximum force obtained), and Dlocked (A crosses the BC Y axis) (this is the continuous clamping force). The locking mechanism of this design relies on the locked position A being reached when the distance between Ax and Cx reaches a maximum distance Dmax during closure of handle 1408, and when lever 1406 is further closed, the distance between Ax and Cx is less than Dmax reaching Dlocked. This position relies on A crossing axis BCY.

[0201] The components of the clamp 1302 can be formed of any suitable material, and in some embodiments, the fixed jaw 1402 and the movable jaw 1404 are formed of a suitable metal (e.g., any of various steels or steel alloys, aluminum, or other types of metals or metal alloys). The lever 1406 and the handle 1408 can be formed of any suitable material, and can be a polymeric material, and in some cases a reinforced polymer. The fixed jaw 1402 and the movable jaw 1404 can be any suitable shape, and in some embodiments, one or more of the fixed jaw 1402 and the movable jaw 1404 is wedge-shaped, U-shaped, L-shaped, or some other suitable cross-sectional shape to clamp onto various patient supports. In some cases, the fixed jaw 1402 and the movable jaw 1404 are configured to clamp onto a track shaped as a tube, a flat rod, an oval tube, or a track having some other geometric shape. In use, the clamp can be fixed to a patient support as a first step in preparation for a surgical procedure. The beam 1310 may then be mounted to the fixture via the mounting arms and sockets 1316 .

[0202] Fig.17A , Fig. 17B and Fig. 17C The clamp 1302 is shown fixed to the track 1702 in the rear perspective view, the side view and the front perspective view, respectively. The clamp 1302 shown is substantially as described elsewhere in this document, such as with respect to Figures 16A-16DAs described. The patient support 1113 includes a track 1702 along one side thereof. The track 1702 can be spaced a certain distance from the patient support 1113 to allow people and objects to grasp the track 1702 and / or be mounted thereon. The clamp 1302 can be mounted to the track with sufficient clamping force to produce a secure engagement with the track 1702 and the patient support 1113. In some embodiments, the clamp 1302 has a low profile and does not extend above the upper surface of the patient support 1113. As used herein, the term "low profile" is used to describe a clamp 1302 that does not extend upward above the top surface of the patient support 1113. This facilitates attaching the clamp 1302 to the patient support 1113 before the patient is placed on the patient support 1113. The low profile clamp does not hinder the patient from being placed on the patient support.

[0203] In some embodiments, the sensor 1399 is coupled to one or more fixtures as described herein, such as a fixture configured to be coupled to a track. In some embodiments, the sensor 1399 includes multiple sensors coupled to a fixture on each side of the track. The sensor can be configured to measure the load of one or more of the fixtures, tracks, or supports coupled to a robotic arm as described herein.

[0204] Fig.18A and Fig.18B A perspective view of an exemplary embodiment of a cross-beam 1310 with attached mounting arms 1312, 1314 is shown, which mounting arms 1312, 1314 can be used in conjunction with a probe mounting and adjustment assembly 1600 as described herein. The cross-beam 1310 has a first end and a second end, both of which can be connected to the mounting arm 1312. A cross-beam coupler 1326 connects the mounting arm 1312 to the cross-beam 1310 and provides for pivotal movement of the mounting arm 1312 relative to the cross-beam 1310. The cross-beam coupler 1326 allows for pivotal movement of the mounting arm 1312 during setup of the probe mounting and adjustment assembly 1600 to allow the clamp 1302 to be properly positioned on the patient support 1113 for clamping, and in some embodiments, can be tightened to resist pivotal movement of the mounting arm 1312 relative to the cross-beam 1310. The cross-beam coupler 1326 can be any suitable coupler that allows adjustability of the mounting arm 1312, and can include an actuator, a bearing, a shaft, a worm drive, a rack, a pinion, a gear, a belt, a chain, a pulley, a slider, a collar, or any combination thereof. The cross-beam coupler 1326 can also include a locking mechanism to selectively fix the relative positioning of the mounting arm 1312 and the cross-beam coupler 1326. In some embodiments, the locking mechanism includes a cam, a screw, a handle, a knob, a shaft, a clamp, or any combination thereof.

[0205] The robot base 1328 can be slidably disposed on the beam 1310 and configured to selectively slide along the length of the beam 1310. The robot base 1328 can be selectively secured to the beam 1310 at a desired location by any mounting mechanism, such as screws, cams, handles, knobs, clamps, or any combination thereof. In some embodiments, the robot base 1328 is rigidly secured to the beam 1310 and is immovable along the beam 1310. The robot base 1328 includes one, two, three, or more arm mounts 1802 configured to receive and hold a robot arm 442, which can be a robotic arm, a manually actuated arm, or a combination of mechanical and robotic actuation.

[0206] In some embodiments, the robotic arm base 1328 includes a first arm base 1802 and a second arm base 1804, which are configured to be coupled to the first robotic arm and the second robotic arm. The first robotic arm and the second robotic arm can support the processing probe 450 and the imaging probe 460, respectively. The first arm base and the second arm base can be spaced a fixed distance from each other along the crossbeam 1310. In some cases, the fixed and known spacing between the arm bases and thus the robotic arms can be used by the controller to align the processing probe 450 and the imaging probe 460 relative to each other. For example, with the fixed position of the arm bases 1802, 1804, the controller can determine the original position of the probes relative to each other, which can also facilitate the correct alignment of the processing probe axis relative to the imaging probe axis.

[0207] The robotic arm is secured to the arm base by any suitable mechanism (e.g., screws, knobs, cams, clips, pawls, clamps, or any combination thereof). In some embodiments, the robotic arm base 1328 provides a base for two robotic arms to be secured, and the arm bases 1802, 1804 may be spaced a fixed distance apart. This facilitates orientation and alignment of the probe mounted on the robotic arm, and also aids in calibrating the positioning of the probe.

[0208] Additional references Fig.19A and Fig.19B, an exemplary embodiment of a crossbeam 1310 is shown, and the range of motion of the mounting arms is shown along with mounting configurations on various sizes of patient supports. The mounting arms are attached to the crossbeam 1310 by crossbeam couplers 1326, which allow pivotal movement of the mounting arms relative to the crossbeam 1310. The mounting arms are selectively movable between a first position 1902, which can be used for storage or during transportation of the probe mounting and adjustment assembly 1600, and a second position 1904, in which the mounting arms are rotated away from the crossbeam 1310 and stretched relative to each other for installation on the patient support. The mounting arms 1312, 1314 are selectively movable across an angle α and can be fixed in any orientation. In some embodiments, the range of motion α is at least 90°, and in some embodiments, the range of motion of the mounting arms is 100°, 110°, 120°, 130°, 140°, 150°, 160°, 170°, or 180°. In some embodiments, mounting arms 1312, 1314 are not symmetrically positioned, and therefore, angle α is not consistent between mounting arms. For example, first mounting arm 1312 may be positioned at an angle α of 100°, and second mounting arm 1314 may be positioned at an angle α of 125°.

[0209] like Fig.19B As shown, mounting arms 1312, 1314 are shown as having a clamp 1302 attached thereto, and the mounting arms can be stretched to accommodate patient supports having different widths. For example, a first patient support 1906 has a first width, and the mounting arms can be stretched a first distance to position a clamp coupled to the mounting arms to be mounted on the patient support. When the mounting arms rotate across the entire range of motion to accommodate the width of the patient support, the clamps can be rotated so that the jaws of the clamps are lined up with the patient support. When mounted to a second patient support 1908 having a width greater than that of the first patient support, the mounting arms can be further stretched to accommodate this larger size of patient support. As shown, the farther the mounting arms are stretched, the closer the crossbar 1310 is to the patient support. By providing the mounting arms with a range of pivotal motion relative to the crossbar 1310 and allowing the clamp 1302 to pivot relative to the mounting arms, the probe mounting and adjustment assembly 1600 can be mounted on many different sizes of patient supports. In some embodiments, the clamp 1302 may be secured to a longer mounting arm that may be used with the crossbar 1310 for even greater adjustability to accommodate wider sized patient supports.

[0210] Fig. 20An exemplary embodiment of a mechanical arm 442 with a control handle 1318 is shown. The mechanical arm 442 can be a robotic arm and allows precise movement of the robotic arm and a probe attached thereto under the control of one or more computing devices. The robotic arm can be articulated with two, three or more segments 2002 coupled by joints 2004. The segments 2002 can be coupled by joints 2004 that allow rotation between adjacent segments 2002. The joints 2004 can be any suitable joints and can include locking mechanisms to allow selective movement of the mechanical arm 442 and locking of the mechanical arm. The joints 2004 can include cone clutch locking joints and can include hydraulic devices for facilitating movement of the mechanical arm. Other suitable joints include single-plate clutches, multi-plate clutches, locking cam interfaces, interlocking gear teeth, hydraulic actuation, push rod actuation, electric actuation, and cable actuation. Each joint 2004 may include one of a variety of kinematic joints, including but not limited to prismatic, swivel, parallel cylindrical, cylindrical, spherical, planar, edge slider, cylindrical slider, point slider, spherical slider, or cross cylindrical joints or any combination thereof. Additionally, each joint 2004 may include a linear, orthogonal, rotational, torsional, or swivel joint or any combination thereof. In some embodiments, the joint 2004 has a limited range of motion to reduce the chance of a crush hazard.

[0211] The robot arm 442 includes a mounting clamp 2006 to facilitate attachment of the robot arm 442 to a robot arm base 1328 ( Fig.13 ). The robotic arm 442 also includes a base 2008 configured to receive the probe slider 1340. The probe slider 1340 may include a motor that allows a probe attached thereto to be advanced or retracted in the Z direction under computer control. The probe slider 1340, which may include a stepper motor in some embodiments, may be configured to provide fine control of the probe attached thereto. In some embodiments, the probe mounting and adjustment assembly 1600 includes two robotic arms, each having a probe mounted thereto, and each probe may be advanced in a controlled Z direction by a computing device and instructions to activate the stepper motor of the probe slider 1340.

[0212] The control handle 1318 is attached to the mechanical arm 442 and can be used to manually manipulate the mechanical arm 442. A control lever 2010 is coupled to each joint 2004 in the mechanical arm. The control lever 2010 can be mechanically coupled to the joint, for example, by a pull line, a belt, a chain, or the like. Alternatively, the control lever 2010 can be electronically coupled to the joint 2004. As described herein, the joint 2004 can include an actuator to allow robotic actuation of the mechanical arm 442. In some embodiments, the control lever 2010 is operable to disengage the actuator and allow manual manipulation of the mechanical arm 442. For example, the joint 2004 can include a clutch mechanism that selectively disengages the actuator in the joint 2004. Therefore, when the operator pulls the control lever 2010, the clutch in the joint disengages the actuator and allows the operator to move the mechanical arm 442 by applying force on the handle 1318. The robotic arm 442 can provide movement about the axis of each joint 2004, and can also allow rotational movement about the robotic arm base 1328. Manual actuation of the robotic arm 442 allows an operator to position the robotic arm 442 and an attached probe in the Y direction (e.g., vertical) and the Z direction (e.g., closer to or farther from the patient). The operator can manually position the probe attached to the robotic arm, calibrate the positioning of the probe tip, and instruct one or more computing devices to operate the robotic arm according to a treatment plan.

[0213] In some embodiments, the geometry of the robotic arm 442 includes three rotation joints 2004 and enables smooth movement within a restricted surgical planning field area. In some embodiments, the robotic arm 442 includes three rotation joints 2004, all of which allow movement of the segment 2002 of the robotic arm around the X-axis. Thus, the robotic arm 442 can move freely in the YZ plane and is limited in its ability to be manipulated in the XY plane. In some cases, the joints 2004 can be unlocked to allow smooth movement with low resistance, which allows precise positioning and tactile feedback of the patient's anatomy.

[0214] Fig.21Two robotic arms with attached probes are shown, wherein the two probes are aligned in a vertical plane. A first arm 442 and a second arm 444 are coupled to a common base, such as a robotic arm base 1328 supported on a crossbar 1310 of a probe mounting and adjustment assembly 1600. The first arm and the second arm are mounted and spaced apart a distance, which can be a fixed distance specified by the robotic arm base 1328. The first arm supports an imaging probe 460 having an imaging probe axis 2102. The second arm 444 supports a treatment probe 450 having a treatment probe axis. If necessary, the robotic arm is adjusted to orient the imaging probe axis 2102 to be parallel to the treatment probe axis. In some embodiments, the imaging probe axis 2102 and the treatment probe axis are coplanar in the vertical plane, which can facilitate the proper positioning of the imaging probe 460 and the treatment probe 450 relative to the anatomy of a patient undergoing a surgical procedure. As described with respect to Fig.13 As described, the second arm 444 can incorporate a lifter 1336 in the probe base to lift the treatment probe 450 above the imaging probe 460 so that when the imaging probe axis 2102 and the treatment probe axis are aligned in a vertical plane, the first arm and the second arm 444 do not interfere with each other. The imaging probe axis 2102 and the treatment probe axis can be coplanar in a non-vertical plane and can be substantially vertical, and they can be aligned under computer control of the first arm and the second arm 444.

[0215] Fig. 22 An exemplary embodiment of a probe mounting and adjustment assembly 1600 attached to a patient support 1113 is shown. A crossbeam 1310 supports two mechanical arms 442, 444, which are independently attached to the crossbeam 1310 and can therefore move independently along the crossbeam 1310. The crossbeam 1310 can also include additional support structures, such as legs 2202, brackets 2204, stretchers 2206, cross brackets 2208, and feet 2210. In some embodiments, the crossbeam 1310 is coupled to one or more legs 2202 extending from the crossbeam 1310 to the floor. The legs 2202 can be adjustable and configured to support a large percentage of the weight of the probe mounting and adjustment assembly 1600. One or more legs 2202 can include feet 2210 to distribute the load to the ground, and can include anti-slip material to reduce the tendency of the legs 2202 to slide on the floor. One or more struts 2206 may be disposed between two or more legs 2202 to reduce the tendency of the legs to spread apart in response to oblique forces.

[0216] One or more brackets 2208 may be attached between the legs 2202 to provide rigidity of the support structure. One or more brackets 2204 may be provided to increase the stiffness of the clamp coupler 1324, for example by attaching one or more brackets from the top of the legs to a location near where the clamp is attached to the mounting arm. The use of legs, cross brackets, braces, brackets, and any combination thereof may be selected to increase the stiffness and rigidity of the probe mounting and adjustment assembly 1600 compared to a probe mounting and adjustment assembly without additional support structures. In some embodiments, the support structure reduces relative motion between the probe mounting and adjustment assembly and the patient support.

[0217] Additionally or alternatively, one or more additional clamps 1302 may be connected to the legs, braces, crossbeam 1310 or cross braces at appropriate locations. In addition to the clamps that have been shown and described as being connected to the ends of crossbeam 1310, additional clamps may also be used and may provide additional attachment points between the probe mounting and adjustment assembly 1600 and the patient support.

[0218] Fig.23 A probe installation and adjustment assembly 1600 utilizing a second fixture on one side of a patient support is shown. The fixture assembly can include a first fixture 1302 and a second fixture 1304 coupled together with a bracket and spaced apart by a fixed distance. The fixture assembly is configured to allow the first fixture 1302 and the second fixture 1304 to be clamped to a track 1702 on the same side of a patient support 1113, for example, by clamping on the same track of the patient support. The first fixture 1302 and the second fixture 1304 can be rigidly spaced apart, or can have adjustability in terms of their relative spacing to accommodate the clamping of different patient support structures. In those embodiments where the spacing between the first fixture and the second fixture is adjustable, once the relative spacing is selected, the spacing between the fixtures can be rigidly fixed. For example, the spacing can be rigidly fixed by screws, cams, locks, knobs, or some other fixed structure.

[0219] Similar clamp assemblies may be provided for the opposite side of the patient support and coupled to the crossbar 1310. In this configuration, there may be four clamps coupling the probe mounting and adjustment assembly 1600 to the patient support. The multiple attachment points to the patient support may reduce relative movement between the patient support and the probe mounting and adjustment assembly 1600 compared to using fewer clamps. It should be appreciated that any other structure shown or described (e.g., Fig. 22 The structure shown, including one or more of legs, braces, brackets, cross braces and the like) is used in combination Fig.23 Clamp assembly shown.

[0220] In some embodiments, sensor 1399 is coupled to one or more fixtures configured to be coupled to the track. In some embodiments, sensor 1399 includes multiple sensors coupled to the fixtures on each side of the track. The sensor can be configured to measure the load of one or more of the fixtures, tracks, or supports coupled to the robot arm. One or more sensors can be located in any suitable position to measure, for example, the load on the fixture, an extension coupled to the fixture, or a support (e.g., a beam) to which one or more robot arms are coupled. In some embodiments, as described herein, the fixture is operatively coupled to one or more computing devices. In some embodiments, the processor is configured to generate an alert to the user when the load exceeds a threshold amount. In some embodiments, for example, the sensor is located on the jaws of the fixture or another locking structure of the fixture. In some embodiments, for example, a pressure sensor, a piezoelectric sensor, or a strain gauge as described herein.

[0221] Fig.24 An exemplary embodiment of a processing system 2400 as described herein is shown that includes a mobile base 2402. The processing system includes a processing probe 450 coupled to a first robotic arm 442 and an imaging probe 460 coupled to a second robotic arm 444. In some cases, the processing probe 450 and the imaging probe 460 can be coupled to the same robotic arm and can have a probe mount that provides relative movement and alignment between the two probes.

[0222] The first robotic arm 442 and the second robotic arm 444 each include a proximal end and a distal end, the distal ends are coupled to the treatment probe 450 and the imaging probe 460, respectively, and the proximal ends are coupled to a common base including the mobile base 2402. The first robotic arm 442 may include a first arm coupling structure coupled to the treatment probe 450, and the second robotic arm 444 may include a second arm coupling structure coupled to the imaging probe 460. The treatment probe 450 may be coupled to the distal end of the first robotic arm 442 via a probe base, which may include a coupling device configured to allow movement (e.g., rotation, translation, pitch, etc.) of the treatment probe 450 as described herein. The coupling of the treatment probe 450 to the first robotic arm 442 may be fixed, releasable, or user-adjustable. Similarly, the coupling of the imaging probe 460 to the second robotic arm 444 may be fixed, releasable, or user-adjustable.

[0223] The first robot arm 442 can be articulated at one or more arm joints 2004. The imaging arm can be articulated at one or more second arm joints. Each arm joint can be operably coupled to a computer-controllable actuator (e.g., a stepper motor) to achieve movement at the joint. Each arm joint can include one of a variety of motion joints (including but not limited to prismatic, post-rotation, parallel cylindrical, cylindrical, spherical, plane, edge slider, cylindrical slider, point slider, spherical slider or cross cylindrical joint or any combination thereof). In addition, each joint 2004 can include a linear, orthogonal, rotational, torsion or post-rotation joint or any combination thereof. In some examples, the first robot arm 442 and the second robot arm 444 provide an arm joint 2004, which allows the processing probe 450 and the imaging probe 460 to move with six degrees of freedom and in some cases with more degrees of freedom. The movement of the imaging probe 460 and the processing probe 450 can be completed manually, mechanically under computer control, or a combination of the two.

[0224] The processing system may also include a console (not shown) as described herein. The console may be operably coupled to the mobile base 2402 via power and communication cables to allow control of the processing probe 450 coupled to the mobile base via the first robot arm 442. The processing console includes a processor and a memory having computer executable instructions for execution by the processor stored thereon to control various modules or functions of the processing console, such as energy sources, infusion / flushing controls, suction controls, and other components as described elsewhere herein. The processing console may also include a display in communication with the processor. The display can be configured to display, for example, one or more of the following: subject vital signs, such as heart rate, respiratory rate, temperature, blood pressure, oxygen saturation, or any physiological parameter or any combination thereof; the status of a surgical procedure; one or more previously captured images or image sequences of the treatment site from one or more views; one or more real-time images or image sequences of the treatment site from one or more views acquired by imaging probe 460; a set of treatment parameters, including but not limited to treatment mode (e.g., cutting or coagulation), treatment intensity, time elapsed during treatment, time remaining during treatment, treatment depth, area or volume of the treatment site that has been treated, area of ​​the treatment site to be treated, area or volume of the treatment site to be not treated, position information of treatment probe 450 or imaging probe 460 or both; treatment adjustment controls, such as means for adjusting treatment depth, treatment intensity, position and / or orientation of treatment probe 450, imaging depth, or position and / or orientation of imaging probe 460 or any combination thereof; or system configuration parameters.

[0225] The mobile base 2402 may also include one or more computing devices to control the operation of one or more robotic arms. For example, the mobile base may include a processor and a memory having computer executable instructions stored thereon for execution by the one or more processors. The memory may have instructions stored thereon for operating one or more robotic arms coupled to the mobile base. The processor may be operably coupled to the robotic arm via suitable electromechanical components to achieve movement of the robotic arm. For example, each of the one or more joints of the robotic arm may include a stepper motor, and the processor may be operably coupled to the stepper motor at each joint to actuate the motor in a specified direction by a specified increment. Alternatively, the one or more robotic arms may be operably coupled to one or more processors of a console or a separate imaging console, wherein the processor of one or more consoles may be configured to execute instructions for controlling the movement of the one or more robotic arms, and the instructions may be transmitted to the robotic arm via a communication circuit. The computer executable instructions for controlling the movement of the robotic arm may be pre-programmed and stored on the memory, or may be provided by a user via one or more user inputs before or during treatment of a patient using the treatment system.

[0226] One or more computing devices operably coupled to the first and / or second robotic arms may be configured to control movement of the arms to adjust the pitch, yaw, roll, and / or linear positioning of the treatment probe 450, the imaging probe 460, or both along the target site.

[0227] The processing system may include one or more user input devices to enable a user to control the movement of a robot arm, a mobile base, an imaging probe 460, a processing probe 450, or any operable component associated with the processing system under computer instructions. For example, the mobile base may include a keyboard, a mouse, a touch screen, a digital pen, a touch pad, a voice control input, and / or a foot switch. The user input device may be configured to control the operation of the first robot arm 442 and / or the second robot arm 444, for example, via the articulation of one or two robot arms at one or more joints. The user input device may communicate with one or more processors configured to control the movement of the robot arm. The user input device may be located at any suitable position, for example, on a console, on a robot arm, on a mobile base, and may have one, two, three, four or more user input devices used in conjunction with the processing system to provide redundant input pathways, unique input commands, discrete parts of the control processing system, or a combination thereof. In use, when a user inputs commands via a user input device, the user commands may be received by one or more processors, converted into electrical signals, and the electrical signals may be transmitted to one or more computer-controllable actuators operably coupled to one or more robotic arms. The user input device may control movement of one or both arms toward or away from a processing location, a location of interest, a predetermined location, or a user-specified location, or any combination thereof.

[0228] Optionally, the user input device can be configured to control the operation of the treatment probe 450 and / or the imaging probe 460. For example, the user input device can be configured to start, stop, pause or restart treatment with the treatment probe 450 or to start, stop, freeze, save or display images with the imaging probe 460.

[0229] The mobile base can also have one or more expandable supports 2404 to stabilize the treatment system by generating contact with the floor. For example, one, two, three or more expandable supports can extend from the mobile base and contact the ground once the mobile base is rolled into place with wheels. The expandable supports 2404 can extend downward from the mobile base so that the wheels of the mobile base 2402 are lifted from the floor to reduce the possibility that the treatment system may move during the surgical procedure. When the treatment system is in its position, the expandable supports 2404 can be manually actuated or deployed by a motor. In some cases, the expandable supports 2404 are manually actuated by a foot pedal pressed by the user to expand and lock the expandable supports in place.

[0230] The processing system may include a mobile power system (e.g., a battery power source) electrically coupled to the processing probe 450, the imaging probe 460, the display, the one or more computing devices, the first robotic arm and the second robotic arm, and other devices associated with the processing system to allow the processing system to be mobile and wheeled from room to room in a self-contained processing system.

[0231] The treatment system may include one or more sensors configured to detect movement due to impact with the treatment system or patient support, increased pressure on the treatment system or operating table support, movement of the patient support, or movement of the patient. The sensors may be configured to adjust the positioning of the imaging probe 460 and / or the treatment probe 450 in response to sensed movement of the treatment system, the patient support, or the patient. In addition, an alarm may be configured to alert the operator if there is movement of the patient support, and may be configured to provide an audible, visual, or combined alarm if movement of the patient support or the patient exceeds a threshold movement amplitude.

[0232] In some embodiments, the mobile base is provided with casters, and may include three, four, five or more casters. The casters may include brakes, which may be manual or electric, for limiting the movement of the mobile base. One or more casters may have a motor therein to allow movement of the mobile base, for example, under the control of one or more computing devices. The casters allow the mobile base to transport the treatment system throughout the hospital and within a treatment room (e.g., an operating room) for positioning the treatment system for a surgical procedure.

[0233] The base supports the cross beam 1310 to mount the robotic arm and two, three, four or more clamps to the patient support. In some embodiments, the two clamps are held by opposing adjustable mounting arms to allow the clamps to be positioned on the lateral sides of the patient support. According to some embodiments, additional clamps are provided to increase the number of engaging supports between the treatment system and the patient support to increase the stiffness of the coupler between the treatment system and the patient support. For example, one or more clamps 1302 can be coupled to the cross beam 1310 and clamped to the proximal portion of the patient support. Additional clamps can be coupled to the cross beam 1310 and clamped to other portions of the patient support (e.g., a base, legs, supports, frame, crossbar, or other structure of the patient support).

[0234] The illustrated and described embodiments provide numerous advantages not previously seen. The deployment of the probe mounting and adjustment assembly 1600 is efficient, can be easily manipulated by one person, and the flexible design works with a variety of patient supports, patient presentations, and provides the ability to be mounted offset from the end of the patient support to facilitate mounting stirrups on the end of the patient support.

[0235] According to some embodiments, the various components of probe mounting and adjustment assembly 1600 once disassembled have a weight of less than about 8 lbs, or less than about 10 lbs, or less than about 12 lbs.

[0236] Fig.25 A system 2500 is shown for one or more of the following operations: positioning a probe, calibrating a probe, or training a system with calibrated probe movement. In some embodiments, a calibration device 2502 includes a socket for receiving a treatment probe 450 and an imaging probe 460. The socket is sized and shaped to receive the probe and allow the probe to be moved to a position that can be used during surgery. The positioning of the arm and probe can be monitored during the calibrated movement before the probe is placed in the patient.

[0237] In some embodiments, the processor is configured to receive the mechanical movement of the probe to establish, for example, one or more limits for collision avoidance with another probe or another robot arm. In some embodiments, the processor is configured to implement a "teaching period" to establish limits before one or more probes are placed in the patient. During the teaching period, a sterile protective calibration guide 2502, also referred to as a calibration device, can be provided, and the imaging probe 460 can be inserted therein and used to measure geometric positioning data for merging into the positioning database of the robot arm. In some embodiments, the guide includes one or more of the following: a capture cavity 2504 for receiving the imaging probe 460, a contact point 2506 for identifying the top of the processing probe 450, one or more double notch structures 2508, 2510 for identifying the linear shaft position relative to the imaging probe 460, or a plane surface identifying a "non-intersecting" anatomical plane. Alternatively or in combination, multiple cameras and machine vision software instructions can be used to measure the positioning of the probe relative to their corresponding origins in 3D space, and create a database of allowable relative positioning between the two probes.

[0238] The calibration device 2502 can be aseptically provided with features that enable positioning onto the first probe 460 and placement for calibration of the second probe 450 relative to the first probe 460. The capture cavity 2504 or open structure allows a way to position the first probe 460 to a known position and orientation. The first probe 460 can be moved within the capture cavity 2504 at a controlled depth of placement within the calibration device 2502, and an envelope of the spatial boundaries, such as a bounding volume, can be created and saved to a database.

[0239] In some embodiments, the calibration device 2502 includes a tip location pocket 2506 to detect contact with the tip of the second probe 450. When the second probe 450 is advanced to the contact point 2506, the first notch structure 2508 provides a guide for the shaft of the second probe 450. Therefore, the combination of the first notch structure 2508 and the touch point 2506 provides a guide path for the placement of the second probe 450, and the location of the second probe 450 can be stored in a location database, which also stores the relative positions of the first probe 460 and the second probe 450.

[0240] With the tip of the second probe in the tip position hole of the calibration device 2502, the shaft of the second probe can be positioned relative to the shaft of the first probe, and a signal can be sent to the processor to record the positioning of the two arms holding the first and second probes.

[0241] Similarly, the shafts of first probe 460 and second probe 450 may be moved to another spatial orientation relative to each other, such as by advancing second probe 450 along second notch structure 2510, and a calibration signal may be sent to a processor to store the relative positioning of the first and second probes.

[0242] Additionally, the calibration device 2502 may be configured to receive a second probe feature to detect and determine rotational alignment of the second probe 450 and similarly detect and determine rotational positioning of the first probe 460, which may be used to align the treatment probe nozzle relative to both the transverse and sagittal planes of ultrasound, for example.

[0243] The calibration device 2502 can thus provide a safe physical capture area to ensure simple placement and docking of the tip against the calibration device 2502, the position and orientation of the calibration device 2502 can be stored in a spatial database to teach the robotic arm controller system the acceptable spatial envelope of the relative position and orientation of the first probe 460 relative to the second probe 450.

[0244] The methods and devices disclosed herein can be configured in a variety of ways, and can include reference points and a processor configured with instructions for providing guidance and surgical guidance to a user (e.g., a surgeon). For example, one or more of an imaging probe 460 (e.g., a TRUS probe), a processing probe 450, a proximal end of a processing probe 450, a proximal end of an imaging probe 460, or a robot arm may include a guide reference point. These guide reference points can be detected with sensors to provide positioning and orientation information of the processing probe 450 and the imaging probe 460 relative to the patient and a fixed reference system (e.g., a base as described herein). The reference points may include, for example, a reflective structure, an energy emitting structure, a coil, a magnet, or a visual reference. These reference points can provide positioning information to a computational navigation system to notify the user of erroneous movement. Positioning information can be used to measure and control the position and movement of processing and imaging probes. Position information can also be displayed on a display visible to the user. For example, a processor may include instructions for displaying a processing reference point associated with a target position on a patient on a display and registering a real-time image of the patient with a target processing profile in real time.

[0245] In some embodiments, positioning information is used to monitor relative motion and as a feedback loop for controlling intentional motion or responding to unintentional motion.

[0246] Fig.26 A system 2600 is shown, which includes an arm 2610 coupled to a sheath 2620, a robotic arm 2630 coupled to a treatment probe 2640, and an arm 2670 coupled to an ultrasound probe 2680. The arm is coupled to a base 2690, which can, for example, include any suitable base as described herein, such as a crossbar coupled to a track of a patient support. The arm 2610 can include any arm as described herein, and can, for example, include a robotic arm or a manually adjustable arm configured to lock in place. The sheath 2610 is configured to be inserted into a cavity (e.g., a urethra) of a patient, and can, for example, include a rigid sheath or a flexible sheath. The robotic arm 2630 can include any suitable robotic arm as described herein. The treatment probe 2640 can include any suitable treatment probe as described herein. The arm 2670 can include any suitable arm as described herein, and can include a manually lockable arm or a robotic arm as described herein. The ultrasound probe 2680 can include any suitable ultrasound probe as described herein, such as a TRUS probe. The robotic arm, treatment probe, and ultrasound probe are operatively coupled to a processor as described herein.

[0247] Fig. 27 As shown in Fig.26A robotic arm 2630 coupled to a treatment probe 2640 and an arm 2610 coupled to a sheath 2620. The sheath 2620 is coupled to the arm 2610. In some embodiments, the sheath 2620 includes an irrigation cavity 2622 extending to one or more openings 2624 to irrigate the surgical site. The irrigation cavity can be connected to a source of irrigation fluid (e.g., saline). The sheath can include a cavity 2626 sized to receive the treatment probe. The cavity 2626 includes a proximal opening 2625 and extends to a distal opening 2627. In some embodiments, the sheath 2620 includes a suction channel 2629 extending to an opening in the cavity 2620 to fluidically couple the cavity 2626 to a suction pump to remove the resection product. The treatment probe 2640 is coupled to an energy source (e.g., a laser, a water pump, or a power supply) as described herein, and includes an energy release structure (e.g., a nozzle, an optical fiber end, a hole, or an electrode) to direct energy toward the tissue. The treatment probe is configured to translate 2646 and rotate 2648 energy 2644 from the treatment probe. An endoscope 2650 extends into the sheath. The endoscope includes a viewing port configured to translate 2654, such as a viewing port for an endoscopic camera 2652. The endoscope is coupled to a video display to endoscopically view the treatment probe and treatment site.

[0248] The coupler 2700 is coupled to the end portion of the robotic arm 2630. The coupler 2700 includes one or more engagement structures 2710 to couple to the end portion of the robotic arm. The robotic arm 2630 includes one or more corresponding engagement structures 2712 to connect the coupler 2700 to the robotic arm. In some embodiments, the coupler 2700 includes internal structures, such as a coupling device and an actuator as described herein, to translate one or more of the treatment probe, endoscope, irrigation cavity, or suction cavity relative to the robotic arm. In some embodiments, the coupler 2700 is configured to rotate the treatment probe independently of the endoscope, the irrigation cavity, and the suction cavity. In some embodiments, the coupler 2700 includes a structure to receive the treatment probe and define the orientation of the treatment probe relative to the coupler. The structure to receive the treatment probe may include, for example, one or more of the holes or channels coupled to the coupling device. In some embodiments, the coupler 2700 includes an engagement structure to couple to the end portion of the robotic arm, thereby establishing the orientation of the treatment probe relative to the end portion of the robotic arm.

[0249] In some embodiments, one or more of the arms or sheaths include sensors 2750 to determine the orientation of the sheath when placed in a patient. In some embodiments, the robotic arm 2630 includes an orientation sensor 2752 to determine the orientation of a treatment probe 2640 coupled to the robotic arm. Alternatively or in combination with the sensors, the joint state of the robotic arm 2630 can be used to determine the orientation of the treatment probe, and the joint state of the arm 2610 can be used to determine the orientation of the sheath.

[0250] In some embodiments, the treatment probe includes an elongated shaft and the sheath includes an elongated shaft to receive the treatment probe.

[0251] The system can be configured in a variety of ways to treat a patient in a variety of ways. In some embodiments, the sheath is sized and shaped to be inserted into the patient. The sheath includes an elongated shaft, and the arm is coupled to the sheath. The treatment probe includes an energy source and an elongated shaft. The treatment probe is sized and shaped to be inserted into the lumen of the sheath. The robotic arm is coupled to the treatment probe and is configured to align the elongated shaft of the treatment probe with the elongated shaft of the sheath and advance the treatment probe into the sheath. The robotic arm coupled to the treatment probe is configured to align the axis of the treatment probe with the axis of the sheath before advancing the treatment probe into the sheath.

[0252] In some embodiments, the robotic arm includes a sensor to determine the orientation of the treatment probe, and the sensor includes one or more of an accelerometer, a gyroscope, or an inertial measurement unit (IMU). Optionally or in combination, the arm coupled to the sheath includes a sensor to determine the orientation of the sheath. The sensor may include one or more of an accelerometer, a gyroscope, or an IMU.

[0253] In some embodiments, the sheath includes a proximal opening for receiving the treatment probe and a distal opening, and the treatment probe includes a length sufficient to extend to at least the distal opening. In some embodiments, when the treatment probe is advanced into the sheath, the size of the treatment probe is designed to extend the energy source to at least the distal opening.

[0254] In some embodiments, with a gap between the end portion of the robotic arm and the sheath, the energy source extends at least to the distal opening.

[0255] Although reference is made to a coupling structure that rotates the processing probe, in some embodiments the robotic arm 2630 is configured to rotate the processing probe.

[0256] The processor may be coupled to one or more of arm 2610, arm 2630, or arm 2720. In some embodiments, the processor is configured with instructions to advance the treatment probe into the sheath, which may facilitate alignment of the treatment probe with the sheath. In some embodiments, the processor is configured to align the elongated axis of the treatment probe with the elongated axis of the sheath. In some embodiments, the processor is configured to receive an input indicating that the elongated axis of the treatment probe has been aligned with the elongated axis of the sheath and to advance the treatment probe along the elongated axis of the treatment probe in response to the input. The input may include a user input, or the input may include an input from sensor data. In some embodiments, the arm coupled to the rigid sheath includes a sensor operatively coupled to the processor to determine the orientation of the sheath, and the processor is configured with instructions to orient the treatment probe with the sheath in response to the orientation of the rigid sheath measured with the sensor. In some embodiments, the robotic arm includes a sensor to determine the orientation of the treatment probe. Alternatively or in combination, the orientation of the treatment probe may be determined from the joint state of the robotic arm. In some embodiments, the orientation of the sheath is determined from the joint state of the arm coupled to the rigid sheath.

[0257] Fig.28A A coupler 2700 is shown coupling the robotic arm 2630 to the treatment probe 2640. In some embodiments, the coupler 2700 is configured to couple the treatment probe 2740, the endoscope 2650, the flushing cavity 2812, and the suction cavity 2814 to the robotic arm. Each of these cavities can be defined by an elongated tube defining a cavity. In some embodiments, the flushing cavity and the suction cavity comprise cavities of a double lumen tube (e.g., a catheter). Alternatively, the flushing cavity and the suction cavity can comprise separate catheters.

[0258] Fig.28B It is shown that Fig.28A The coupler shown provides for movement of the treatment probe 2640, the endoscope 2650, the irrigation chamber 2812, and the suction chamber 2814. The irrigation chamber 2812 extends to the opening 2813 to release the irrigation fluid. The suction chamber 2814 extends to the opening 2814 to receive the resection product. The sheath 2620 is sized to receive these chambers and the corresponding structure defining the chamber (e.g., tube). The sheath 2620 is sized to receive the treatment probe. In some embodiments, the sheath 2620 is sized to receive the endoscope 2650.

[0259] Coupler 2700 can be configured in a variety of ways to move one or more of a treatment probe, endoscope, flushing chamber, or suction chamber. In some embodiments, coupler is connected to robot arm 2630, and the robot arm provides motion to the treatment probe. For example, the robot arm can be configured to rotate the treatment probe. Alternatively or in combination, the robot arm can be configured to rotate and translate the treatment arm.

[0260] In some embodiments, the coupler 2700 is configured to rotate the treatment probe. For example, the coupler can be configured to rotate 2648 the treatment probe. The robotic arm can be configured to translate 2646 the treatment probe as the coupler 2700 rotates the treatment probe. In some embodiments, the endoscope 2750 is configured to translate 2654 with the treatment probe. In some embodiments, the irrigation lumen and the aspiration lumen are configured to translate with the treatment probe.

[0261] In some embodiments, the coupler 2700 is configured to provide independent translational movement to a treatment probe and one or more of the following: an endoscope, an irrigation lumen, or an aspiration lumen. In some embodiments, the coupler is configured to provide independent translational movement to a treatment probe, an endoscope, and one or more of the following: an irrigation probe or an aspiration probe.

[0262] Fig.29 A processing method 2900 is shown according to some embodiments.

[0263] At step 2910, the orientation of the sheath is determined. The orientation of the sheath may be determined from one or more sensors coupled to the sheath (eg, an orientation sensor on an arm coupled to the sheath) or from a joint state of an arm coupled to the sheath.

[0264] The orientation of the processing probe is determined at step 2920. The orientation of the processing probe may be determined from one or more sensors coupled to the processing probe (e.g., an orientation sensor on an arm coupled to the processing probe) or from a joint state of an arm coupled to the processing probe.

[0265] At step 2930, the elongated axis of the treatment probe is aligned with the elongated axis of the sheath. This alignment may be performed manually. Alternatively, the processor may be configured with instructions to align the elongated axis of the treatment probe with the elongated axis of the sheath.

[0266] At step 2940, input is received indicating that the elongated axis of the treatment probe and the elongated axis of the sheath are aligned. The input may include user input based on visualization or input from sensor data, or a combination thereof.

[0267] At step 2950, ​​in response to the input, the treatment probe is advanced along the elongated axis of the sheath.

[0268] As described herein, the computing devices and systems described and / or illustrated herein broadly represent any type or form of computing device or system capable of executing computer-readable instructions (such as those contained within the modules described herein). In their most basic configuration, these computing devices may each include at least one memory device and at least one physical processor.

[0269] As used herein, the term "memory" or "memory device" generally refers to any type or form of volatile or non-volatile storage device or medium capable of storing data and / or computer-readable instructions. In one example, a memory device can store, load, and / or maintain one or more modules described herein. Examples of memory devices include, but are not limited to, random access memory (RAM), read-only memory (ROM), flash memory, hard disk drive (HDD), solid-state drive (SSD), optical drive, cache, variations or combinations of one or more of them, or any other suitable memory.

[0270] In addition, the term "processor" or "physical processor" as used herein generally refers to a processing unit of any type or form of hardware implementation that can interpret and / or execute computer-readable instructions. In one example, the physical processor can access and / or modify one or more modules stored in the above-mentioned memory device. Examples of physical processors include, but are not limited to, a microprocessor, a microcontroller, a central processing unit (CPU), a field programmable gate array (FPGA) implementing a soft-core processor, an application-specific integrated circuit (ASIC), a portion of one or more of them, a variation or combination of one or more of them, or any other suitable physical processor.

[0271] Although shown as separate elements, the method steps described and / or illustrated herein may represent portions of a single application. In addition, in some embodiments, one or more of these steps may represent or correspond to one or more software applications or programs that, when executed by a computing device, may cause the computing device to perform one or more tasks, such as method steps.

[0272] Furthermore, one or more devices described herein may convert data, physical devices, and / or representations of physical devices from one form to another. Additionally or alternatively, one or more modules described herein may convert a processor, volatile memory, non-volatile memory, and / or any other portion of a physical computing device from one form of computing device to another form of computing device by executing on the computing device, storing data on the computing device, and / or otherwise interacting with the computing device.

[0273] The term "computer-readable medium" as used herein generally refers to any form of device, carrier, or medium capable of storing or carrying computer-readable instructions. Examples of computer-readable media include, but are not limited to, transmission-type media such as carrier waves and non-transitory media such as magnetic storage media (e.g., hard drives, tape drives, and floppy disks), optical storage media (e.g., compact disks (CDs), digital video disks (DVDs), and Blu-ray disks), electronic storage media (e.g., solid-state drives and flash memory media), and other distribution systems.

[0274] Those of ordinary skill in the art will recognize that any process or method disclosed herein may be modified in a variety of ways. The process parameters and step sequences described and / or illustrated herein are given as examples only and may be changed as needed. For example, although the steps illustrated and / or described herein may be shown or discussed in a particular order, these steps do not necessarily need to be performed in the order illustrated or discussed.

[0275] The various exemplary methods described and / or shown herein may also omit one or more steps described or shown herein, or include additional steps in addition to those disclosed steps. In addition, the steps of any method disclosed herein may be combined with any one or more steps of any other method disclosed herein.

[0276] A processor as described herein may be configured to perform one or more steps of any method disclosed herein.Alternatively or in combination, a processor may be configured to combine one or more steps of one or more methods as disclosed herein.

[0277] Unless otherwise indicated, the terms "connected to" and "coupled to" (and their derivatives) as used in the specification and claims should be interpreted as allowing both direct and indirect (i.e., via other elements or components) connections. In addition, the terms "a" or "an" as used in the specification and claims should be interpreted as "at least one of..." Finally, for ease of use, the terms "including" and "having" (and their derivatives) as used in the specification and claims are interchangeable with the word "comprising" and should have the same meaning as the word "comprising".

[0278] A processor as disclosed herein may be configured with instructions to perform any one or more steps of any method as disclosed herein.

[0279] It will be understood that although the terms "first", "second", "third", etc. may be used herein to describe various layers, elements, components, regions or sections without reference to any particular order or sequence of events. These terms are only used to distinguish one layer, element, component, region or section from another layer, element, component, region or section. A first layer, element, component, region or section as described herein may be referred to as a second layer, element, component, region or section without departing from the teachings of the present disclosure.

[0280] As used herein, the term "or" is used inclusively to refer to alternative and combinations of items.

[0281] As used herein, characters (eg, numbers) refer to similar elements.

[0282] As used herein, the terms "rough" and "coarse" are used interchangeably.

[0283] As used herein, the terms "one or more computing devices" and "processor" are used interchangeably.

[0284] This disclosure includes the following numbered clauses.

[0285] Item 1. A system for processing or imaging tissue of a patient, the system comprising: a probe sized to be inserted into the patient; a robotic arm configured to couple to the probe; one or more computing devices operatively coupled to the robotic arm and configured with instructions for: establishing an allowable range of motion of the probe, the allowable range of motion being stored on a memory of the one or more computing devices; processing or imaging the target tissue of the patient with the probe; and moving the robotic arm to effect movement of the probe within the allowable range of motion of the probe.

[0286] Clause 2. The system of clause 1, wherein the probe is configured to couple to the robotic arm when the robotic arm is in a passive mode.

[0287] Clause 3. The system of clause 1, wherein the allowable range of motion of the probe is established when the robotic arm is in a passive mode.

[0288] Clause 4. The system of Clause 1, wherein establishing the allowable range of motion of the probe comprises establishing the allowable range of motion of the probe in response to user input.

[0289] Clause 5. The system of Clause 1, wherein establishing the allowable range of motion of the probe comprises establishing the allowable range of motion of the probe in response to positioning of the probe.

[0290] Clause 6. The system of Clause 5, wherein the position of the probe relative to the target tissue is determined in response to one or more tissue markers in one or more images of the target tissue.

[0291] Clause 7. The system of clause 1, further comprising updating the allowable range of motion of the probe in real time.

[0292] Clause 8. The system of clause 1 further comprises a user input device operably coupled to one or more computing devices to provide one or more user instructions for controlling movement of the robotic arm, and wherein moving the robotic arm under the control of the one or more computing devices comprises moving the robotic arm in response to the one or more user instructions for controlling movement of the robotic arm.

[0293] Clause 9. A system according to clause 8, wherein the user input device includes one or more of: a controller near the end of the robotic arm, a user interface on a display screen, a user interface on a console, or a controller that responds to a force provided by the user on the end of the robotic arm to guide a probe on the robotic arm into position.

[0294] Clause 10. The system of Clause 1, further comprising one or more force sensors operably coupled to the probe and one or more computing devices to detect compression of the patient's tissue by the probe.

[0295] Clause 11. The system of Clause 10, wherein the one or more computing devices include a processor configured with instructions to interrupt the processing in response to the detected compression of the tissue exceeding a predetermined compression threshold level.

[0296] Clause 12. The system of clause 10, wherein the one or more force sensors are operatively coupled to the robotic arm.

[0297] Clause 13. The system of clause 12, further comprising one or more motion sensors operably coupled to the probe and the one or more computing devices to detect movement of the patient, and wherein the one or more computing devices are configured to adjust the positioning of the probe in response to the detected movement of the patient.

[0298] Clause 14. The system of clause 1, wherein the robotic arm includes a passive mode to manually adjust the probe to a manually set position.

[0299] Clause 15. A system according to clause 14, wherein in the passive mode the probe is supported by the robotic arm, and the probe includes a plurality of sensors at an interface between the robotic arm and the probe to receive user input from a handle coupled to the plurality of sensors for the user to guide the probe.

[0300] Clause 16. A system according to clause 15, wherein a handle coupled to the multiple sensors is configured to receive user manipulation of the handle, and the multiple sensors at the interface are coupled to a processor of the one or more computing devices to manipulate the probe in response to the user manipulation of the handle.

[0301] Clause 17. A system according to clause 16, wherein the plurality of sensors are configured to detect user manipulation of the handle in six degrees of freedom, and wherein the processor is configured to move the probe in six degrees of freedom with movements corresponding to the six degrees of freedom in response to the user manipulation.

[0302] Clause 18. The system of Clause 14, wherein manually adjusting the robotic arm in the passive mode comprises manually adjusting the probe in one or more of at least one rotational axis or at least one translational axis.

[0303] Clause 19. A system according to Clause 18, wherein the at least one rotation axis includes a first rotation axis, a second rotation axis orthogonal to the first rotation axis, and a third rotation axis orthogonal to the first rotation axis and the second rotation axis, and wherein the at least one translation axis includes a first translation axis, a second translation axis orthogonal to the first translation axis, and a third translation axis orthogonal to the first translation axis and the second translation axis.

[0304] Clause 20. A system according to clause 19, wherein the first rotation axis includes a pitch axis, the second rotation axis includes a yaw axis, the third rotation axis includes a roll axis, the first translation axis includes an X axis, the second translation axis includes a Y axis, and the third translation axis includes a Z axis.

[0305] Clause 21. The system of clause 14, wherein the manually set position of the probe is maintained after the robotic arm is released from manual adjustment.

[0306] Clause 22. A system according to clause 21, wherein the robotic arm is configured to maintain the manually set position with a tolerance on one or more of the rotational axes or the translational axes, and optionally, wherein the tolerance is within 5° for rotation around one or more of the three axes, and within 5 mm for translation along one or more of the three axes and optionally for each of the three axes, and optionally, wherein the rotational tolerance is within 3°, and optionally, wherein the translational tolerance is within 3 mm and optionally within 2 mm.

[0307] Clause 23. The system of Clause 21, wherein the probe comprises an imaging probe.

[0308] Clause 24. A system according to clause 21, wherein the probe includes a treatment probe and the robotic arm includes a first robotic arm, the system further comprising: an imaging probe sized to be inserted into the patient; a second robotic arm coupled to the imaging probe; and wherein the one or more computing devices are configured with instructions for establishing an allowable range of motion of the imaging probe.

[0309] Clause 25. A system according to clause 24, wherein the imaging device is configured to image the target area of ​​the patient with the imaging probe, and wherein the second robotic arm is configured to move under the control of the one or more computing devices to achieve movement of the imaging probe within the allowable range of motion of the imaging probe.

[0310] Clause 26. The system of Clause 1, wherein the one or more computing devices include instructions for imaging and processing the tissue.

[0311] Item 27. A method for treating a target tissue at a target site of a patient, the method comprising: manually inserting a probe into the patient's body; coupling the probe to a robotic arm; establishing an allowable range of motion of the probe, the allowable range of motion being stored on a memory of one or more computing devices operably coupled to the robotic arm; treating or imaging the target tissue of the patient with the probe; and moving the robotic arm under the control of the one or more computing devices operably coupled to the probe to effect movement of the probe within the allowable range of motion of the probe.

[0312] Clause 28. The method of clause 27, wherein the probe is coupled to the robotic arm when the robotic arm is in a passive mode.

[0313] Clause 29. The method of clause 27, wherein the allowable range of motion of the probe is established when the robotic arm is in a passive mode.

[0314] Clause 30. The method of Clause 27, wherein establishing the allowable range of motion of the probe comprises establishing the allowable range of motion of the probe in response to user input.

[0315] Clause 31. The method of Clause 27, wherein establishing the allowable range of motion of the probe comprises establishing the allowable range of motion of the probe in response to positioning of the probe.

[0316] Clause 32. The method of Clause 31, wherein the position of the probe relative to the target tissue is determined in response to one or more tissue markers in one or more images of the target tissue.

[0317] Clause 33. The method of Clause 27, further comprising updating the allowable range of motion of the probe in real time.

[0318] Clause 34. The method according to Clause 27 further includes receiving one or more user instructions for controlling the movement of the robotic arm from a user input device operably coupled to one or more computing devices, and wherein moving the robotic arm under the control of the one or more computing devices includes moving the robotic arm in response to the one or more user instructions for controlling the movement of the robotic arm.

[0319] Clause 35. A method according to clause 34, wherein the user input device includes one or more of: a controller on the end of the robotic arm, a user interface on a display screen, a user interface on a console, or a controller that responds to a force provided by the user on the end of the robotic arm to guide the probe on the robotic arm into position.

[0320] Clause 36. The method of clause 27, further comprising receiving sensor data from one or more force sensors operably coupled to the one or more computing devices, the one or more force sensors configured to detect compression of the probe on tissue of the patient.

[0321] Clause 37. The method of Clause 36, wherein the one or more computing devices include a processor configured with instructions to interrupt the processing in response to detecting compression of the tissue exceeding a predetermined compression threshold level.

[0322] Clause 38. The method of clause 36, wherein the one or more force sensors are operably coupled to the robotic arm.

[0323] Clause 39. The method of clause 38 further comprises receiving sensor data from one or more motion sensors operably coupled to the one or more computing devices and configured to detect movement of the patient, and wherein moving the robotic arm under the control of the one or more computing devices comprises adjusting the positioning of the probe in response to the detected movement of the patient.

[0324] Clause 40. The method of Clause 27, further comprising manually adjusting the robotic arm in a passive mode to manually adjust the probe to a manually set position.

[0325] Clause 41. A method according to clause 40, wherein, in the passive mode, the probe is supported by the robotic arm, and the probe includes a plurality of sensors at an interface between the robotic arm and the probe to receive user input from a handle coupled to the plurality of sensors for the user to guide the probe.

[0326] Clause 42. A method according to clause 41, wherein a handle coupled to the multiple sensors is configured to receive user manipulation of the handle, and the multiple sensors at the interface are coupled to a processor of the one or more computing devices to manipulate the probe in response to the user manipulation of the handle.

[0327] Clause 43. A method according to clause 42, wherein the plurality of sensors are configured to detect user manipulation of the handle in six degrees of freedom, and wherein the processor is configured to move the probe in six degrees of freedom with movements corresponding to the six degrees of freedom in response to the user manipulation.

[0328] Clause 44. The method of clause 40, wherein manually adjusting the robotic arm in the passive mode to manually adjust the probe comprises manually adjusting the probe in one or more of at least one rotational axis or at least one translational axis.

[0329] Clause 45. A method according to Clause 44, wherein the at least one rotation axis includes a first rotation axis, a second rotation axis orthogonal to the first rotation axis, and a third rotation axis orthogonal to the first rotation axis and the second rotation axis, and wherein the at least one translation axis includes a first translation axis, a second translation axis orthogonal to the first translation axis, and a third translation axis orthogonal to the first translation axis and the second translation axis.

[0330] Clause 46. A method according to clause 45, wherein the first rotation axis includes a pitch axis, the second rotation axis includes a yaw axis, the third rotation axis includes a roll axis, the first translation axis includes an X axis, the second translation axis includes a Y axis, and the third translation axis includes a Z axis.

[0331] Clause 47. The method of clause 40, wherein the manually set position of the probe is maintained after the robotic arm is released from manual adjustment.

[0332] Clause 48. A method according to clause 47, wherein the robotic arm is configured to maintain the manually set position with a tolerance in one or more of the rotational axes or the translational axes, and optionally, wherein the tolerance is within 5° for rotation around one or more of the three axes, and within 5 mm for translation along one or more of the three axes and optionally for each of the three axes, and optionally, wherein the rotational tolerance is within 3°, and optionally, wherein the translational tolerance is within 3 mm and optionally within 2 mm.

[0333] Clause 49. The method of Clause 27, wherein the probe comprises an imaging probe.

[0334] Clause 50. A method according to clause 47, wherein the probe includes a treatment probe and the robotic arm includes a first robotic arm, the method further comprising: manually inserting an imaging probe into the patient's body; coupling the imaging probe to a second robotic arm; and establishing an allowable range of motion of the imaging probe, the allowable range of motion being stored in a memory of one or more computing devices that are operably coupled to the first robotic arm and the second robotic arm.

[0335] Clause 51. The method of clause 50, wherein the imaging probe is coupled to the second robotic arm when the second robotic arm is in a passive mode.

[0336] Clause 52. The method of clause 50, wherein the allowable range of motion of the imaging probe is established when the second robotic arm is in a passive mode.

[0337] Clause 53. The method of Clause 50, wherein establishing the allowable range of motion of the imaging probe comprises establishing the allowable range of motion in response to a distance or alignment between the treatment probe and the imaging probe.

[0338] Clause 54. The method of Clause 50, wherein establishing the allowable range of motion of the imaging probe comprises establishing the allowable range of motion of the imaging probe in response to user input.

[0339] Clause 55. The method of Clause 50, wherein establishing the allowable range of motion of the imaging probe comprises establishing the allowable range of motion responsive to a positioning of the imaging probe relative to the target tissue.

[0340] Clause 56. The method of Clause 55, wherein the positioning of the imaging probe relative to the target tissue is determined in response to one or more tissue markers in one or more images of the target tissue.

[0341] Clause 57. The method of Clause 50, further comprising updating the allowable range of motion of the imaging probe in real time.

[0342] Clause 58. The method according to clause 50 further includes receiving one or more user instructions for controlling the movement of the second robotic arm from a user input device operably coupled to one or more computing devices, and wherein moving the second robotic arm under the control of the one or more computing devices includes moving the second robotic arm in response to the one or more user instructions for controlling the movement of the second robotic arm.

[0343] Clause 59. The method of clause 58, further comprising establishing an allowable range of motion for the second robotic arm in response to the one or more user instructions for controlling movement of the second robotic arm.

[0344] Clause 60. The method of clause 50, further comprising receiving sensor data from one or more force sensors operably coupled to the one or more computing devices and configured to detect compression of tissue of the patient with the imaging probe, and wherein moving the second robotic arm under the control of the one or more computing devices comprises moving the imaging probe away from the tissue in response to determining that the detected compression of the tissue exceeds a predetermined compression threshold level.

[0345] Clause 61. The method of clause 60, wherein the one or more force sensors are operably coupled to the second robotic arm.

[0346] Clause 62. The method of clause 50, further comprising receiving sensor data from one or more positioning sensors operably coupled to the one or more computing devices and configured to detect one or more positions of the first robotic arm, the processing probe, the second robotic arm, or the imaging probe.

[0347] Clause 63. The method of clause 50 further comprises receiving sensor data from one or more motion sensors operably coupled to the one or more computing devices and configured to detect movement of the patient, and wherein moving the second robotic arm under the control of the one or more computing devices comprises adjusting the positioning of the imaging probe in response to the detected movement of the patient.

[0348] Clause 64. The method of clause 50, further comprising calibrating the first robotic arm to identify a position of the first robotic arm relative to the second robotic arm, and calibrating the second robotic arm to identify a position of the second robotic arm relative to the first robotic arm.

[0349] Clause 65. A method according to clause 50, wherein moving the first robotic arm or the second robotic arm under the control of the one or more computing devices includes automatically adjusting the movement of the first robotic arm in response to the movement of the second robotic arm or automatically adjusting the movement of the second robotic arm in response to the movement of the first robotic arm.

[0350] Clause 66. A method according to clause 50, wherein moving the first robotic arm or the second robotic arm under the control of the one or more computing devices includes moving the first robotic arm or the second robotic arm to prevent contact between the treatment probe and the portion of the imaging probe disposed outside the patient's body.

[0351] Clause 67. The method of clause 66, wherein moving the first robotic arm or the second robotic arm under the control of the one or more computing devices comprises moving the first robotic arm or the second robotic arm to maintain alignment between the treatment probe and the imaging probe.

[0352] Clause 68. The method of clause 67, wherein the alignment maintained between the treatment probe and the imaging probe comprises a parallel alignment between the treatment probe and the imaging probe, wherein longitudinal axes of the treatment probe and the imaging probe are parallel to each other.

[0353] Clause 69. The method of clause 67, wherein the alignment maintained between the treatment probe and the imaging probe comprises a coplanar alignment between the treatment probe and the imaging probe, wherein longitudinal axes of the treatment probe and the imaging probe are coplanar with each other.

[0354] Clause 70. The method of clause 67, wherein the alignment maintained between the treatment probe and the imaging probe comprises a non-parallel alignment between the treatment probe and the imaging probe, wherein longitudinal axes of the treatment probe and the imaging probe are transverse to each other.

[0355] Clause 71. The method of Clause 50, further comprising detecting one or more of a distance or an alignment between the treatment probe and the imaging probe.

[0356] Clause 72. A method according to clause 50, wherein moving the first robotic arm or the second robotic arm under the control of the one or more computing devices includes moving the first robotic arm or the second robotic arm to automatically move the processing probe or the imaging probe along a scanning profile stored on the one or more computing devices.

[0357] Clause 73. The method of clause 72, wherein moving the first robotic arm under control of the one or more computing devices comprises moving the first robotic arm to automatically move the treatment probe according to the scanning profile that includes a treatment profile.

[0358] Clause 74. The method of clause 72, wherein moving the second robotic arm under control of the one or more computing devices comprises moving the second robotic arm to automatically move the imaging probe in the scanning profile that includes an imaging profile.

[0359] Clause 75. The method of clause 74, wherein the imaging profile comprises a plurality of transverse view scans or a plurality of sagittal view scans of the target site, and wherein the method further comprises generating a three-dimensional image of the target site.

[0360] Clause 76. The method of clause 74, wherein the second robotic arm is moved to automatically move the imaging probe according to the scanning profile that includes the imaging profile while the treatment probe treats the target tissue.

[0361] Clause 77. A method according to clause 50, wherein imaging the target site with the imaging probe includes imaging the target site with the imaging probe operating in Doppler mode, and wherein the method further includes identifying an area of ​​high blood flow in the target site based on one or more images of the target site obtained with the imaging probe.

[0362] Clause 78. The method of Clause 77, further comprising applying hemostasis to the identified area of ​​high blood flow in the target site.

[0363] Clause 79. The method of Clause 77, further comprising performing a biopsy of tissue located at the identified area of ​​high blood flow in the target site.

[0364] Clause 80. The method of clause 77, further comprising identifying areas of high blood flow as cancerous tissue.

[0365] Clause 81. The method of Clause 77, wherein imaging the target site with the imaging probe comprises rotating the imaging probe.

[0366] Clause 82. The method of Clause 50, wherein imaging the target site with the imaging probe comprises generating an intraoperative image of the target site.

[0367] Clause 83. The method of clause 82, further comprising mapping the intraoperative image of the target site with a preoperative image.

[0368] Clause 84. The method of clause 83, wherein the preoperative image of the target site comprises one or more of an X-ray image, a fluorescence image, a computed tomography (CT) image, an ultrasound image, or an MRI image.

[0369] Clause 85. The method of clause 83, wherein mapping the intraoperative image with the preoperative image comprises mapping one or more anatomical regions within the intraoperative image and the preoperative image with each other.

[0370] Clause 86. The method of Clause 85, wherein the one or more anatomical regions include one or more of: a bladder neck, an external sphincter, or a verumontanum.

[0371] Item 87. A method for operating a robotic arm to image or treat target tissue at a target site of a patient, the method comprising: coupling at least one probe to at least one robotic arm; manually adjusting the at least one robotic arm in a passive mode to manually adjust the at least one probe to a manually set position; and releasing the at least one robotic arm from the passive mode; wherein, after release from manual adjustment, the at least one robotic arm maintains the manually set position of the at least one probe; and wherein the at least one probe performs one or more of the following operations from the maintained manually set position: imaging or treating the target tissue at the target site of the patient.

[0372] Clause 88. The method of clause 87, wherein the at least one probe is coupled to the at least one robotic arm prior to inserting the at least one probe into the patient.

[0373] Clause 89. The method of clause 87, wherein the at least one probe is coupled to the at least one robotic arm after the at least one probe is inserted into the patient.

[0374] Clause 90. A method according to clause 87, wherein the at least one robotic arm maintains the manually set position of the at least one probe with a locking configuration of the at least one robotic arm, and optionally, wherein sensors of a joint of the at least one robotic arm and actuators coupled to the joint of the robotic arm maintain the manually set position of the at least one robotic arm in the locking configuration.

[0375] Clause 91. The method of clause 87, wherein manually adjusting the at least one robotic arm in the passive mode comprises manually adjusting the at least one probe in one or more of at least one rotational axis or at least one translational axis.

[0376] Item 92. A method according to Item 91, wherein the at least one rotation axis includes a first rotation axis, a second rotation axis orthogonal to the first rotation axis, and a third rotation axis orthogonal to the first rotation axis and the second rotation axis, and wherein the at least one translation axis includes a first translation axis, a second translation axis orthogonal to the first translation axis, and a third translation axis orthogonal to the first translation axis and the second translation axis.

[0377] Clause 93. A method according to clause 92, wherein the first rotation axis includes a pitch axis, the second rotation axis includes a yaw axis, the third rotation axis includes a roll axis, the first translation axis includes an X axis, the second translation axis includes a Y axis, and the third translation axis includes a Z axis.

[0378] Clause 94. A method according to clause 87, wherein the at least one robotic arm maintains the manually set position within a tolerance on one or more of the rotational axes or the translational axes, and optionally, wherein the tolerance is within 5° for rotation around one or more of the three axes, and within 5 mm for translation along one or more of the three axes and optionally for each of the three axes, and optionally, wherein the rotational tolerance is within 3°, and optionally, wherein the translational tolerance is within 3 mm and optionally within 2 mm.

[0379] Clause 95. The method of clause 87, wherein coupling the at least one probe to the at least one robotic arm comprises one or more of: coupling a processing probe to a first robotic arm or coupling an imaging probe to a second robotic arm.

[0380] Clause 96. The method of clause 95, wherein manually adjusting the at least one robotic arm in the passive mode comprises aligning the treatment probe and the imaging probe with each other.

[0381] Clause 97. The method of Clause 96, wherein the treatment probe and the imaging probe are aligned with each other to be one or more of: parallel or coplanar.

[0382] Clause 98. The method of clause 96, wherein, after release from manual adjustment, the at least one robotic arm maintains alignment between the imaging probe and the treatment probe.

[0383] Item 99. A method according to item 98, wherein alignment between the imaging probe and the treatment probe is maintained within a tolerance on one or more of the rotational axes or the translational axes, and optionally, wherein the tolerance is within 5° for rotation around one or more of the three axes, and within 5 mm for translation along one or more of the three axes and optionally for each of the three axes, and optionally, wherein the rotational tolerance is within 3°, and optionally, wherein the translational tolerance is within 3 mm and optionally within 2 mm.

[0384] Clause 100. A system comprising: a processor configured with instructions to perform the method of any of the preceding clauses.

[0385] Item 101. A system for operating a robotic arm to image or treat target tissue at a target site of a patient, the system comprising: at least one robotic arm coupled to at least one probe for one or more of the following operations: treating the target tissue of the patient or imaging the target tissue; and one or more computing devices operably coupled to the at least one robotic arm, the one or more computing devices being configured to execute instructions for the following operations: operating the at least one robotic arm in a passive mode so that the at least one robotic arm can be manually adjusted to manually adjust the at least one probe to a manually set position; after the at least one probe is manually adjusted to the manually set position, releasing the at least one robotic arm from the passive mode; and maintaining the manually set position of the at least one probe after release from manual adjustment.

[0386] Clause 102. The system of clause 101, wherein the at least one probe is configured to be coupled to the at least one robotic arm prior to inserting the at least one probe into the patient.

[0387] Clause 103. The system of clause 101, wherein the at least one probe is configured to be coupled to the at least one robotic arm after inserting the at least one probe into the patient.

[0388] Clause 104. A system according to clause 101, wherein the at least one robotic arm maintains the manually set position of the at least one probe with a locking configuration of the at least one robotic arm, and optionally, wherein sensors of joints of the at least one robotic arm and actuators coupled to the joints of the robotic arm maintain the manually set position of the at least one robotic arm in the locking configuration.

[0389] Clause 105. The system of clause 101, wherein the one or more computing devices are further configured to execute instructions for controlling movement of the at least one robotic arm.

[0390] Clause 106. The system of clause 101, wherein the at least one robotic arm is configured to be manually adjusted to manually adjust the at least one probe in one or more of at least one rotational axis or at least one translational axis.

[0391] Clause 107. A system according to clause 106, wherein the at least one rotation axis includes a first rotation axis, a second rotation axis orthogonal to the first rotation axis, and a third rotation axis orthogonal to the first rotation axis and the second rotation axis, and wherein the at least one translation axis includes a first translation axis, a second translation axis orthogonal to the first translation axis, and a third translation axis orthogonal to the first translation axis and the second translation axis.

[0392] Clause 108. A system according to clause 107, wherein the first rotation axis includes a pitch axis, the second rotation axis includes a yaw axis, the third rotation axis includes a roll axis, the first translation axis includes an X axis, the second translation axis includes a Y axis, and the third translation axis includes a Z axis.

[0393] Clause 109. A system according to clause 106, wherein the at least one robotic arm is configured to maintain the manually set position with a tolerance on one or more of the rotational axes or the translational axes, and optionally, wherein the tolerance is within 5° for rotation around one or more of the three axes, and within 5 mm for translation along one or more of the three axes and optionally for each of the one or more of the three axes, and optionally, wherein the rotational tolerance is within 3°, and optionally, wherein the translational tolerance is within 3 mm and optionally within 2 mm.

[0394] Clause 110. The system of Clause 101, wherein the at least one probe comprises one or more of a treatment probe or an imaging probe.

[0395] Clause 111. The system of clause 110, wherein the at least one probe comprises the processing probe and the imaging probe, and wherein the at least one robotic arm comprises a first robotic arm coupled to the processing probe and a second robotic arm coupled to the imaging probe.

[0396] Clause 112. The system of clause 110, wherein the at least one probe comprises the treatment probe and the imaging probe, and wherein the treatment probe and the imaging probe are configured to be manually adjusted to align the treatment probe and the imaging probe with each other.

[0397] Clause 113. The system of Clause 112, wherein the treatment probe and the imaging probe are aligned with each other to be one or more of: parallel or coplanar.

[0398] Clause 114. The system of clause 113, wherein the at least one robotic arm maintains alignment between the imaging probe and the treatment probe after being released from manual adjustment.

[0399] Clause 115. The system of clause 114, wherein alignment between the imaging probe and the treatment probe is maintained within a tolerance on one or more of a rotational axis or a translational axis.

[0400] Item 116. A system for treating a target tissue at a target site of a patient, the system comprising: a first robotic arm coupled to a treatment probe for treating the target tissue of the patient; a second robotic arm coupled to an imaging probe for imaging the target tissue of the patient; and one or more computing devices, the one or more computing devices being operably coupled to the first robotic arm and the second robotic arm, the one or more computing devices being configured to execute instructions for controlling movement of one or more of the first robotic arm or the second robotic arm.

[0401] Clause 117. A system according to clause 116, wherein the one or more computing devices are configured to execute instructions for controlling movement of the first robotic arm or the second robotic arm to adjust one or more of the pitch, yaw, roll, or linear positioning of the treatment probe or the imaging probe along an entry axis of the treatment probe or the imaging probe into the patient's body.

[0402] Clause 118. The system of clause 116, wherein the one or more computing devices are configured to execute instructions including controlling movement of the first robotic arm or the second robotic arm to retract the treatment probe or the imaging probe, respectively, along the entry axis.

[0403] Clause 119. A system according to clause 118, wherein the one or more computing devices are configured to execute instructions including controlling movement of the first robotic arm or the second robotic arm to retract rather than advance the treatment probe or the imaging probe, respectively, along the entry axis.

[0404] Clause 120. A system as described in clause 116, wherein the one or more computing devices are configured to execute instructions including controlling movement of the first robotic arm or the second robotic arm in response to user instructions received using a user input device operably coupled to the one or more computing devices.

[0405] Clause 121. A system according to clause 116, wherein the one or more computing devices are configured to execute instructions including controlling the movement of the first robotic arm or the second robotic arm to move the processing probe or the imaging probe, respectively, within an allowable range of motion of the processing probe or the imaging probe stored in the one or more computing devices.

[0406] Clause 122. The system of clause 121, wherein the one or more computing devices are configured to execute instructions including establishing the allowable range of motion of the treatment probe or the imaging probe in response to user input.

[0407] Clause 123. A system according to clause 121, wherein the one or more computing devices are configured to execute instructions including establishing the allowable range of motion of the treatment probe or the imaging probe in response to a distance or alignment between the treatment probe and the imaging probe.

[0408] Clause 124. A system according to clause 121, wherein the one or more computing devices are configured to execute instructions including establishing the allowable range of motion of the treatment probe or the imaging probe in response to the positioning of the treatment probe or the imaging probe relative to the target tissue.

[0409] Clause 125. A system according to clause 124, wherein the one or more computing devices are configured to execute instructions comprising detecting the positioning of the treatment probe or the imaging probe relative to the target tissue based on one or more images of the target tissue, the one or more images comprising one or more tissue markers.

[0410] Clause 126. The system of clause 121, wherein the one or more computing devices are configured to execute instructions for updating the allowable range of motion of the treatment probe or the imaging probe in real time.

[0411] Clause 127. A system as described in clause 116, wherein the one or more computing devices are configured to execute instructions including controlling movement of the first robotic arm or the second robotic arm to maintain alignment between the treatment probe and the imaging probe, and optionally, wherein the alignment maintains the treatment probe within a field of view of the imaging probe.

[0412] Clause 128. The system of clause 127, wherein the alignment maintained between the treatment probe and the imaging probe comprises a substantially parallel alignment between the treatment probe and the imaging probe, wherein longitudinal axes of the treatment probe and the imaging probe are substantially parallel to each other.

[0413] Clause 129. The system of clause 127, wherein the alignment maintained between the treatment probe and the imaging probe comprises a coplanar alignment between the treatment probe and the imaging probe, wherein longitudinal axes of the treatment probe and the imaging probe are coplanar with each other.

[0414] Clause 130. The system of clause 127, wherein the alignment maintained between the treatment probe and the imaging probe comprises a non-parallel alignment between the treatment probe and the imaging probe, wherein longitudinal axes of the treatment probe and the imaging probe are transverse to each other.

[0415] Clause 131. The system of clause 116, wherein the one or more computing devices are configured to execute instructions comprising detecting one or more of a distance or an alignment between the treatment probe and the imaging probe.

[0416] Clause 132. A system according to clause 116, wherein the one or more computing devices are configured to execute instructions including controlling movement of the first robotic arm or the second robotic arm to prevent contact between the treatment probe and a portion of the imaging probe disposed outside the patient's body.

[0417] Clause 133. The system of clause 116, wherein the one or more computing devices are configured to execute instructions to automatically adjust movement of the first robotic arm in response to movement of the second robotic arm.

[0418] Clause 134. A system as described in clause 116, wherein the one or more computing devices are configured to execute instructions for automatically adjusting the movement of the second robotic arm in response to the positioning of the first robotic arm, and optionally, wherein the second robotic arm moves the imaging probe in response to the positioning of the treatment probe to maintain the treatment probe within the field of view of the imaging probe.

[0419] Clause 135. A system according to clause 116, wherein the one or more computing devices are configured to execute instructions for controlling the movement of the first robotic arm or the second robotic arm to automatically move the processing probe or the imaging probe along a scanning profile stored on the one or more computing devices.

[0420] Clause 136. The system of clause 135, wherein the one or more computing devices are configured to execute instructions for controlling movement of the first robotic arm to automatically move the treatment probe along the scan profile that includes a treatment profile.

[0421] Clause 137. The system of clause 135, wherein the one or more computing devices are configured to execute instructions for controlling movement of the second robotic arm to automatically move the imaging probe along the scanning profile that includes an imaging profile.

[0422] Clause 138. A system according to clause 137, wherein the imaging profile includes multiple transverse view scans or multiple sagittal view scans of the target site, and wherein the one or more computing devices are also configured to execute instructions including generating a three-dimensional image of the target site.

[0423] Clause 139. The system of clause 137, wherein the one or more computing devices are configured to execute instructions to automatically move the imaging probe along the scanning profile including the imaging profile as the treatment probe treats the target tissue.

[0424] Clause 140. A system as described in clause 116, wherein the one or more computing devices are configured to execute instructions including controlling movement of the first robotic arm or the second robotic arm in response to sensor data received from one or more sensors operably coupled to the one or more computing devices.

[0425] Clause 141. The system of clause 140, wherein the one or more sensors are operatively coupled to one or more of the first robotic arm or the second robotic arm.

[0426] Clause 142. The system of clause 140, wherein the one or more sensors include one or more positioning sensors coupled to one or more of the first robotic arm, the processing probe, the second robotic arm, or the imaging probe.

[0427] Clause 143. A system as described in clause 140, wherein the one or more sensors include one or more force sensors configured to detect compression of tissue of the patient with the treatment probe or the imaging probe, and wherein the one or more computing devices are configured to execute instructions including moving the treatment probe or the imaging probe away from the tissue in response to determining that the detected compression of the tissue exceeds a predetermined compression threshold level.

[0428] Clause 144. A system according to clause 140, wherein the one or more sensors include one or more motion sensors configured to detect movement of the patient, and wherein the one or more computing devices are configured to execute instructions including adjusting the positioning of the treatment probe or the imaging probe in response to the detected movement of the patient.

[0429] Clause 145. A system as described in clause 116, wherein each of the first robotic arm and the second robotic arm includes a plurality of joints operably coupled to a plurality of actuators, wherein the plurality of actuators are operably coupled to the one or more computing devices, and wherein instructions for controlling movement of the first robotic arm or the second robotic arm include instructions for controlling actuation of one or more of the plurality of actuators.

[0430] Clause 146. The system of clause 116, further comprising a mobile base coupled to the first robotic arm and the second robotic arm.

[0431] Clause 147. A system as described in clause 146, wherein the mobile base includes one or more user input devices operably coupled to the one or more computing devices and configured to receive user instructions for controlling movement of one or more of the first robotic arm or the second robotic arm.

[0432] Clause 148. The system of clause 146, wherein the mobile base comprises the one or more computing devices configured to execute instructions for controlling movement of one or more of the first robotic arm or the second robotic arm.

[0433] Clause 149. A system according to clause 116, wherein the one or more computing devices are operably coupled to one or more of the processing probe or the imaging probe, and wherein the one or more computing devices are further configured to execute instructions for controlling one or more of the following operations: processing with the processing probe or imaging with the imaging probe.

[0434] Clause 150. A system according to clause 116, wherein the one or more computing devices are further configured to execute instructions including displaying one or more images of the target site obtained with the imaging probe on a display operably coupled to the one or more computing devices.

[0435] Clause 151. The system of clause 116, wherein the first robotic arm or the second robotic arm comprises a coupling structure configured to magnetically couple to the treatment probe or the imaging probe, respectively.

[0436] Item 152. A system according to item 116, wherein the first robotic arm or the second robotic arm includes a coupling structure configured to be removably coupled to the processing probe or the imaging probe, respectively, and a quick release mechanism is configured to decouple the first robotic arm or the second robotic arm from the processing probe or the imaging probe, respectively, when an error is detected in the operation of the first robotic arm or the second robotic arm.

[0437] Clause 153. The system of clause 116, further comprising a common arm, wherein the first robotic arm is operatively coupled to the common arm at a first position, and the second robotic arm is operatively coupled to the common arm at a second position.

[0438] Clause 154. The system of clause 153, further comprising a mobile base operatively coupled to the common arm.

[0439] Clause 155. The system of clause 116, wherein the imaging probe comprises an ultrasound transducer configured to capture an ultrasound image of the target tissue.

[0440] Clause 156. The system of clause 155, wherein the ultrasound transducer is configured to operate in Doppler mode so that areas of high blood flow in the target site are identifiable.

[0441] Clause 157. A system according to clause 116, wherein the one or more computing devices are configured to execute instructions for operating the first robotic arm in a passive mode, in which the first robotic arm is configured to be manually adjusted to position the processing probe to a manually set position.

[0442] Clause 158. The system of clause 157, wherein, when the first robotic arm is in the passive mode, the processing probe is configured to be manually adjusted in one or more of at least one rotational axis or at least one translational axis.

[0443] Clause 159. A system according to clause 158, wherein the at least one rotation axis includes a first rotation axis, a second rotation axis orthogonal to the first rotation axis, and a third rotation axis orthogonal to the first rotation axis and the second rotation axis, and wherein the at least one translation axis includes a first translation axis, a second translation axis orthogonal to the first translation axis, and a third translation axis orthogonal to the first translation axis and the second translation axis.

[0444] Clause 160. A system according to clause 159, wherein the first rotation axis includes a pitch axis, the second rotation axis includes a yaw axis, the third rotation axis includes a roll axis, the first translation axis includes an X axis, the second translation axis includes a Y axis, and the third translation axis includes a Z axis.

[0445] Clause 161. The system of clause 157, wherein the one or more computing devices are configured to execute instructions for maintaining the manually set position of the processing probe after the first robotic arm is released from manual adjustment.

[0446] Clause 162. The system of clause 161, wherein the first robotic arm is configured to maintain the manually set position with a tolerance in one or more of a rotational axis or a translational axis.

[0447] Clause 163. A system as described in clause 116, wherein the one or more computing devices are configured to execute instructions for operating the second robotic arm in a passive mode, in which the second robotic arm is configured to be manually adjusted to position the imaging probe to a manually set position.

[0448] Clause 164. The system of clause 163, wherein, when the second robotic arm is in the passive mode, the imaging probe is configured to be manually adjusted in one or more of at least one rotational axis or at least one translational axis.

[0449] Clause 165. A system according to clause 164, wherein the at least one rotation axis includes a first rotation axis, a second rotation axis orthogonal to the first rotation axis, and a third rotation axis orthogonal to the first rotation axis and the second rotation axis, and wherein the at least one translation axis includes a first translation axis, a second translation axis orthogonal to the first translation axis, and a third translation axis orthogonal to the first translation axis and the second translation axis.

[0450] Clause 166. A system according to clause 165, wherein the first rotation axis includes a pitch axis, the second rotation axis includes a yaw axis, the third rotation axis includes a roll axis, the first translation axis includes an X axis, the second translation axis includes a Y axis, and the third translation axis includes a Z axis.

[0451] Clause 167. The system of clause 163, wherein the one or more computing devices are configured to execute instructions for maintaining the manually set position of the imaging probe after the second robotic arm is released from manual adjustment.

[0452] Clause 168. The system of clause 167, wherein the second robotic arm is configured to maintain the manually set position within one or more of a tolerance in one or more of a rotational axis or a translational axis.

[0453] Item 169. A system for treating a patient, the system comprising: a probe; a coupling structure that receives the probe; a support that receives the patient; an arm coupled to the support; a first slider coupled to the arm for translation in a first direction; a second slider coupled to the first slider, the arm, and the support for translation in a second direction transverse to the first direction; and an adjustable extension between the second slider and the coupling structure, the adjustable extension comprising an extension joint configured to extend and retract in a third direction transverse to the first direction and the second direction; wherein the coupling structure is supported by the arm, the first slider, the second slider, and the extension to allow the coupling structure to move within a three-dimensional volume.

[0454] Item 170. The system of Item 169 further comprising a pivot coupled to the arm and the coupling structure between the coupling structure and the extension joint, the pivot being configured to rotate the coupling structure upward and downward relative to the patient, and optionally, wherein the rotation pivot axis extends in a substantially horizontal direction, and optionally, wherein substantially horizontal includes an angle within a range of approximately 10 degrees relative to horizontal.

[0455] Item 171. The system of Item 170 further comprising a rotating frame coupled to the arm and the coupling structure between the coupling structure and the extension joint, the rotating frame being configured to allow rotation of the coupling structure about a rotation axis, and optionally, wherein the rotation axis of the rotating frame is within approximately 10 degrees relative to vertical, and optionally, wherein the rotating frame is coupled to the coupling structure and the arm between the coupling structure and the pivot.

[0456] Clause 172. A system according to clause 171, wherein each of the first slider, the second slider, the extension joint, the rotating frame and the pivot includes a brake to lock the position of the first slider, the second slider, the extension joint, the rotating frame and the pivot when the probe is inserted into the patient's body and coupled to the arm with a coupling structure to maintain the position and orientation of the probe.

[0457] Clause 173. The system of clause 171 further comprises a processor-controlled actuator coupled to one or more of the first slider, the second slider, the extension joint, the rotating frame, or the pivot to move the coupling structure toward the coupling structure of the probe when the probe is inserted into the patient's body.

[0458] Item 174. The system of Item 173 further comprises a coupling device coupled to a processor to control one or more of the positioning or orientation of the coupling structure, and wherein the coupling device comprises one or more of the first slider, the second slider, the extension joint, the rotating frame and the pivot coupled to corresponding actuators.

[0459] Clause 175. The system of clause 171, further comprising a second coupling structure coupled to a second probe, and optionally, wherein the second coupling structure is configured to support the second probe above the probe.

[0460] Item 176. The system according to Item 171 further includes a second coupling structure coupled to a second probe, the second coupling structure coupled to a second extension joint, a second rotating frame and a second pivot, the second coupling structure, the second extension joint, the second rotating frame and the second pivot are supported by the arm to support the second probe.

[0461] Clause 177. A system according to clause 169, wherein the first direction is perpendicular to the second direction.

[0462] Clause 178. A system according to any of the preceding clauses, wherein the coupling structure of the probe includes one or more protrusions or grooves on a lower surface of the probe, and the coupling structure supported by the arm includes one or more protrusions or grooves on an upper surface of the coupling structure to couple the coupling structure of the probe to the coupling structure supported by the arm.

[0463] Item 179. A mounting assembly for coupling to a patient support, comprising: a first clamp secured to a first track on a first side of the patient support; a first arm having a first end and a second end, the first end being pivotally connected to the first clamp; a second clamp secured to a second track on a second side of the patient support; and a second arm having a first end and a second end, the first end being pivotally connected to the second clamp; wherein an elongated support member extends between the first arm and the second arm to support a probe to be inserted into the patient's body.

[0464] Clause 180. The mounting assembly of clause 179, wherein the first arm and the second arm are each pivotally connected to the elongated support member to accommodate changes in the distance between the first rail and the second rail.

[0465] Item 181. A mounting assembly as described in item 180, wherein the first rail is substantially parallel to the second rail, and the first arm and the second arm are pivotally connected to the first clamp and the second clamp, respectively, to allow the first clamp and the second clamp to engage the first rail and the second rail in a substantially parallel configuration.

[0466] Clause 182. The mounting assembly according to Clause 179 further includes: a first coupler, the first coupler being pivotally connected to the first clamp and the first arm, the first coupler being configured to be releasably coupled to the first end of the first arm; and a second coupler, the second coupler being pivotally connected to the second clamp and the second arm, the second coupler being configured to be releasably coupled to the first end of the second arm.

[0467] Clause 183. A mounting assembly as described in clause 182, wherein the first coupler and the second coupler each have a longitudinal axis for receiving the first end of the arm and a pivot axis transverse to the longitudinal axis.

[0468] Clause 184. A mounting assembly as described in clause 183, wherein the first coupler defines a first hollow cavity configured to receive the first end of the first arm, and wherein the second coupler defines a second hollow cavity configured to receive the first end of the second arm.

[0469] Clause 185. A mounting assembly according to clause 179, wherein the first clamp and the second clamp each include a first jaw and a second jaw, and the first jaw and the second jaw are configured to move relative to each other between the first jaw and the second jaw to be securely connected to the rail.

[0470] Clause 186. The mounting assembly of clause 185, wherein the first jaw is movable toward the second jaw using a lever.

[0471] Clause 187. The mounting assembly of clause 179, wherein the first track and the second track comprise portions of one or more tracks of the patient support, and optionally, wherein the patient support comprises a bed.

[0472] Clause 188. A mounting assembly as described in clause 179, wherein the first arm is configured to pivot relative to the first clamp and the second arm is configured to pivot relative to the second clamp to accommodate a variable spacing between the first track on the first side of the patient support and the second track on the second side of the patient support.

[0473] Clause 189. A mounting assembly as described in clause 179, wherein the mounting assembly is configured to limit movement of the elongated support member relative to the first rail and the second rail to no more than 5 mm in response to a 150 kg load on the elongated support member, and optionally, wherein the movement is no more than 3 mm in response to a 100 kg load on the elongated support member.

[0474] Clause 190. A mounting assembly according to clause 179, wherein the slender support member, the first clamp, the first arm, the second clamp and the second arm are configured to limit the movement of the slender support member to no more than 5 mm in response to a 150 kg load on the slender support member, and optionally, wherein the movement is no more than 3 mm in response to a 100 kg load on the slender support member.

[0475] Item 191. A mounting assembly according to item 190, wherein the probe to be inserted into the patient's body comprises a distance within a range from about 20 cm to about 60 cm, and wherein the mounting assembly is configured to move the distal end of the probe by no more than 6 mm in response to the load on the slender support member.

[0476] Clause 192. The mounting assembly of clause 179, further comprising a robotic arm attached to the elongated support member.

[0477] Clause 193. The mounting assembly of clause 192, wherein the probe is connected to the robotic arm.

[0478] Clause 194. The mounting assembly of clause 193, wherein the probe comprises one or more of a processing probe or an imaging probe.

[0479] Clause 195. The mounting assembly of clause 194, wherein the robotic arm comprises a first robotic arm and a second robotic arm attached to the elongated support member.

[0480] Clause 196. The mounting assembly of clause 195, wherein the processing probe is coupled to the first robotic arm and the imaging probe is coupled to the second robotic arm.

[0481] Clause 197. The mounting assembly of clause 196, wherein the treatment probe and the imaging probe are aligned with each other to be substantially coplanar.

[0482] Clause 198. The mounting assembly of Clause 179 further comprises one or more extendable legs connected to and extending downwardly from one or more of the elongated support member, the first arm, the second arm, the first clamp, or the second clamp to engage a floor surface.

[0483] Clause 199. The mounting assembly of Clause 179, further comprising an extendable leg connected to the elongated support member and extending downwardly from the elongated support member to engage a floor surface.

[0484] Clause 200. The mounting assembly of clause 179, further comprising a first extendable leg connected to the first clamp and extending downwardly from the first clamp to engage a floor surface and a second extendable leg connected to the second clamp and extending downwardly from the second clamp to engage a floor surface.

[0485] Item 201. The mounting assembly of Item 179 further includes a third clamp engaged with the first rail and a fourth clamp engaged with the second rail, wherein the first clamp is coupled to the third clamp with a first bracket extending between the first clamp and the third clamp to distribute a first load along the first rail, and the second clamp is coupled to the fourth clamp with a second bracket extending between the second clamp and the fourth clamp to distribute the first load along the second rail.

[0486] Clause 202. The mounting assembly of clause 179, wherein the elongated support member comprises a cross-beam extending between the first arm and the second arm.

[0487] Clause 203. A system for treating target tissue at a target site of a patient, the system comprising: a mounting assembly according to any one of clauses 179 to 198; a first robotic arm, the first robotic arm coupled to the slender support; a treatment probe, the treatment probe coupled to the first robotic arm; a second robotic arm, the second robotic arm coupled to the slender support; and an imaging probe, the imaging probe coupled to the second robotic arm.

[0488] Item 204. A system according to item 203, wherein the treatment probe is coupled to a connecting device, the connecting device is configured to translate the treatment probe along the slender axis and rotate the treatment probe about the slender axis while the end of the first robotic arm remains stationary, and wherein the imaging probe is coupled to the connecting device to translate the imaging probe along the slender axis of the imaging probe while the end of the second robotic arm remains stationary.

[0489] Clause 205. A system as described in clause 203, wherein the first robotic arm includes a first plurality of joints for translating and rotating the processing probe, and wherein the second robotic arm includes a second plurality of joints for translating and rotating the processing probe.

[0490] Clause 206. A system according to clause 203, wherein each of the robotic arms includes from 5 to 7 degrees of freedom.

[0491] Item 207. A system for treating a patient, comprising: a robotic arm; a probe coupled to the robotic arm, the probe being sized and shaped to be inserted into the patient's body; a plurality of sensors coupled to the robotic arm to indicate a relative position and orientation of the probe relative to the robotic arm when the probe is decoupled from the robotic arm; and a processor operatively coupled to the robotic arm and the plurality of sensors, the processor being configured with instructions to move the robotic arm to an engagement position and orientation to engage the probe with the robotic arm.

[0492] Clause 208. The system of clause 207, wherein the processor is configured with instructions to find the probe with the robotic arm and engage the probe with the robotic arm.

[0493] Clause 209. A system according to clause 208, wherein the processor is configured with instructions to search for the probe with the robotic arm while the user is stably holding the probe with the probe inserted into the patient's body, and optionally, wherein a gap extends between the probe and the robotic arm before searching for the probe, and wherein a distal end portion of the robotic arm contacts the probe to engage the probe.

[0494] Clause 210. The system of clause 207, wherein the robotic arm includes an engagement structure to engage the probe, and the probe includes an engagement structure to engage the robotic arm using the engagement position and orientation.

[0495] Clause 211. A system according to clause 210, wherein the processor is configured with instructions to move the robotic arm to an orientation corresponding to the engagement orientation before contacting the probe and to translate the robotic arm onto the probe in the engagement orientation.

[0496] Clause 212. A system as described in clause 207, wherein the plurality of sensors includes a coarse sensor and a proximity sensor for enabling the robotic arm to sense the probe at a long distance, and optionally, wherein the plurality of sensors are located on the robotic arm.

[0497] Clause 213. The system of clause 212, wherein the coarse sensor comprises an infrared transmitter and a beacon.

[0498] Clause 214. The system of clause 212, wherein the coarse sensor comprises an infrared transmitter and a beacon.

[0499] Clause 215. A system according to clause 207, wherein the plurality of sensors includes a sensor array coupled to the robotic arm and one or more reference points on the probe to determine the position and orientation of the probe relative to the robotic arm.

[0500] Clause 216. The system of clause 207, wherein the plurality of sensors are oriented toward the probe when the probe engages the robotic arm.

[0501] Item 217. A system for treating a patient, comprising: a robotic arm; a probe coupled to the robotic arm, the probe being sized and shaped to be inserted into the patient's body; a plurality of sensors coupled to the probe between a coupling structure coupling the robotic arm and a distal end of the probe; and a processor operatively coupled to the robotic arm and the plurality of sensors, the processor being configured with instructions to move the robotic arm in response to user input detected from the plurality of sensors.

[0502] Clause 218. A system as described in clause 217, wherein the processor is configured with instructions for establishing a zero gravity mode with the probe on the robotic arm in a stand-alone configuration prior to inserting the probe into the patient, and wherein the zero gravity mode is configured to forcefully drive the joints of the robotic arm to substantially offset the weight of the robotic arm while the probe is coupled to the arm.

[0503] Clause 219. The system of clause 217, wherein the user input comprises strain detected by the plurality of sensors, and wherein the strain comprises strain associated with deflection of the stylet between the distal end and the engagement structure.

[0504] Clause 220. The system of clause 217, wherein the probe comprises an elongated probe sized and shaped for insertion into the patient.

[0505] Clause 221. A system as described in clause 220, wherein the probe includes an elongated portion for the user to grasp between the plurality of sensors and the distal end of the probe, and wherein resistance of the tissue to insertion of the probe pushes in opposition to the insertion force from the user's hand so as to reduce input to the plurality of sensors and reduce advancement of the probe into the patient's body.

[0506] Clause 222. The system of clause 221, wherein the resistance of the tissue to insertion is sensed by the user as advancement of the probe decreases.

[0507] Clause 223. The system of clause 217, wherein the plurality of sensors and the probe are arranged to provide tactile feedback to the user when the probe encounters resistance to movement.

[0508] Clause 224. A system as described in clause 217, wherein the robotic arm comprises a plurality of joints and a plurality of internal joint sensors, and wherein the processor is configured to implement a passive mode of the probe to allow the user to insert the probe into the patient, and wherein the processor is configured to provide a reaction force to the plurality of internal joints to stabilize the arm in the passive mode.

[0509] Clause 225. A system as described in clause 217, wherein one or more of the probe or the distal portion of the robotic arm includes an inertial measurement unit ("IMU") to detect movement of the probe, and optionally, wherein the processor is configured to receive output from the IMU to determine the position and orientation of the probe.

[0510] Clause 226. A system according to clause 225, wherein the probe is configured to be mounted on the arm in a predetermined position and orientation relative to the IMU so that the position and orientation of the probe can be determined in response to the position and orientation of the IMU, and optionally, wherein the IMU is coupled to the arm in a predetermined position and orientation relative to the distal end of the arm.

[0511] Clause 227. The system of clause 225, wherein the processor is configured to receive output from the IMU and output from the plurality of sensors to determine one or more of a position or an orientation of the mobile probe.

[0512] Clause 228. The system of clause 225, wherein the probe is configured for the user to grasp the probe, and the sensor and the processor are configured to determine the user input in response to the user grasping the probe.

[0513] Item 229. A system for treating a patient, the system comprising: a sheath sized and shaped to be inserted into the patient, the sheath including an elongated shaft; an arm coupled to the sheath; a treatment probe including an energy source, the treatment probe including an elongated shaft, the treatment probe sized and shaped to be inserted into a cavity of the sheath; and a robotic arm coupled to the treatment probe, wherein the robotic arm is configured to align the elongated shaft of the treatment probe with the elongated shaft of the sheath and advance the treatment probe into the sheath.

[0514] Clause 230. The system of clause 229, wherein the robotic arm coupled to the treatment probe is configured to align an axis of the treatment probe with an axis of the sheath prior to advancing the treatment probe into the sheath.

[0515] Clause 231. A system according to clause 229, wherein the robotic arm includes a sensor for determining the orientation of the processing probe, and optionally, wherein the sensor includes one or more of an accelerometer, a gyroscope, or an inertial measurement unit.

[0516] Clause 232. A system according to clause 229, wherein the arm coupled to the sheath includes a sensor for determining the orientation of the sheath, and optionally, wherein the sensor includes one or more of an accelerometer, a gyroscope, or an inertial measurement unit.

[0517] Clause 233. The system of clause 229, wherein the arm coupled to the sheath comprises a robotic arm.

[0518] Clause 234. The system of clause 229, wherein the sheath comprises a proximal opening to receive the treatment probe and a distal opening, and wherein the treatment probe comprises a length sufficient to extend to at least the distal opening.

[0519] Clause 235. The system of clause 234, wherein the treatment probe is sized such that the energy source extends at least to the distal opening when the treatment probe is advanced into the sheath.

[0520] Clause 236. The system of clause 235, wherein the energy source extends at least to the distal opening in the presence of a gap between an end portion of the robotic arm and the sheath.

[0521] Clause 237. The system of clause 229, wherein the sheath comprises a rigid sheath.

[0522] Clause 238. The system of Clause 229, wherein the sheath comprises an irrigation lumen coupled to the one or more openings to provide an irrigation fluid through the one or more openings.

[0523] Clause 239. The system of clause 229, wherein the sheath comprises a suction channel extending to an opening in the cavity to aspirate excised tissue from the cavity.

[0524] Clause 240. The system of clause 229, wherein the lumen of the sheath is sized to receive the treatment probe, endoscopic camera, and aspiration and irrigation lumens.

[0525] Clause 241. The system of clause 240, wherein the aspiration lumen extends to an opening to aspirate tissue resection products.

[0526] Clause 242. The system of clause 240, wherein the irrigation lumen extends to an opening to irrigate a treatment site.

[0527] Clause 243. The system of clause 240, wherein the aspiration lumen and the irrigation lumen comprise lumens of a double lumen tube.

[0528] Clause 244. The system of clause 229, wherein the treatment probe comprises a rigid portion for advancement into the sheath.

[0529] Clause 245. The system of clause 229, wherein the treatment probe comprises a flexible portion to be advanced into the sheath.

[0530] Clause 246. The system of clause 229, wherein the treatment probe is configured to rotate and translate the energy source.

[0531] Clause 247. A system according to clause 246, wherein the energy source includes one or more of a laser beam, a water jet, an electrode, or an ultrasonic transducer.

[0532] Clause 248. The system of clause 246, wherein the robotic arm is configured to rotate the energy source.

[0533] Clause 249. The system of clause 246, wherein the processing probe is coupled to a coupling device placed on the robotic arm to rotate the processing probe.

[0534] Clause 250. The system of clause 249, wherein the coupling device is configured to translate the processing probe.

[0535] Clause 251. The system of clause 240, wherein the endoscopic camera comprises a lens and a sensor array configured to view the treatment probe when advanced into the sheath.

[0536] Clause 252. A system according to clause 251, wherein the endoscopic camera is coupled to a connection device for advancing and retracting the endoscopic camera.

[0537] Clause 253. The system of clause 252, wherein the coupling device is coupled to the robotic arm.

[0538] Clause 254. The system of clause 252, wherein the endoscopic camera comprises a flexible extension configured to couple to the coupling device with sufficient column strength to advance and retract the endoscopic camera within a cavity.

[0539] Clause 255. A system as described in clause 252, wherein the endoscopic camera includes a rigid extension configured to couple to the coupling device.

[0540] Clause 256. The system of clause 229, further comprising an arm coupled to the ultrasound probe.

[0541] Clause 257. The system of clause 256, wherein the arm coupled to the ultrasound probe comprises a robotic arm.

[0542] Clause 258. The system of clause 257, wherein the robotic arm coupled to the ultrasound probe is configured to position a field of view of the ultrasound probe to image the treatment probe.

[0543] Clause 259. The system of clause 258, wherein the robotic arm coupled to the ultrasound probe is configured to move the ultrasound probe in response to positioning of the treatment probe.

[0544] Clause 260. The system of clause 256, wherein the ultrasound probe comprises a transrectal ultrasound (TRUS) probe.

[0545] Clause 261. The system of clause 256, wherein the ultrasound probe comprises a coupling device to translate and rotate the ultrasound probe to position the treatment probe within a field of view of the ultrasound probe.

[0546] Clause 262. The system of clause 229, further comprising a coupling assembly configured to couple to an end portion of the robotic arm, the coupling assembly configured to couple the processing probe to the robotic arm.

[0547] Clause 263. A system according to clause 262, wherein the coupling assembly is configured to couple to the end portion of the robotic arm in an orientation relative to the end portion of the robotic arm so as to establish an orientation of the processing probe relative to the end portion of the robotic arm, and optionally, wherein the orientation of the coupling assembly relative to the end portion includes a predetermined orientation.

[0548] Clause 264. A system according to clause 263, wherein the coupling assembly includes an engagement structure coupled to an end of the robotic arm, and wherein the robotic arm includes a corresponding engagement structure.

[0549] Clause 265. The system of clause 262, wherein the coupling assembly is configured to rotate the processing probe while the end portion of the robotic arm remains stationary.

[0550] Clause 266. The system of clause 265, wherein the coupling assembly is configured to translate the processing probe while the end portion of the robotic arm remains stationary.

[0551] Clause 267. The system of clause 266, wherein the coupling assembly is configured to translate the endoscopic camera while the end portion of the robotic assembly remains stationary.

[0552] Clause 268. The system of clause 266, wherein the coupling assembly is configured to translate the distal opening of the irrigation lumen while the end portion of the robotic assembly remains stationary.

[0553] Clause 269. A system as described in clause 266, wherein the coupling assembly is configured to translate the distal opening of the suction chamber while the end portion of the robotic assembly remains stationary.

[0554] Clause 270. The system of clause 262, wherein the coupling assembly is configured to translate the treatment probe, endoscopic camera, irrigation lumen, and aspiration lumen together.

[0555] Clause 271. The system of clause 262, wherein the coupling assembly is configured to independently translate the treatment probe, endoscopic camera, irrigation lumen, and aspiration lumen.

[0556] Clause 272. The system of clause 229, further comprising a processor coupled to the robotic arm.

[0557] Clause 273. The system of clause 272, wherein the processor is configured with instructions to advance the treatment probe into the sheath.

[0558] Clause 274. The system of clause 272, wherein the processor is configured to align the elongated axis of the treatment probe with the elongated axis of the sheath.

[0559] Clause 275. A system according to clause 274, wherein the processor is configured to receive input indicating that the slender axis of the treatment probe is aligned with the slender axis of the sheath and to advance the treatment probe along the slender axis of the sheath in response to the input.

[0560] Clause 276. The system of clause 272, wherein the processor is configured to determine an orientation of the rigid sheath, and wherein the processor is configured with instructions to orient the treatment probe at the orientation of the sheath.

[0561] Clause 277. The system of clause 276, wherein the arm coupled to the sheath comprises a sensor for determining an orientation of the sheath.

[0562] Clause 278. The system of clause 276, wherein the processor is configured to determine the orientation of the sheath from a joint state of the arm coupled to the sheath.

[0563] Clause 279. The system of clause 276, wherein the robotic arm comprises a sensor for determining an orientation of the processing probe.

[0564] Item 280. A coupling assembly configured to an end portion of the robotic arm, the coupling assembly comprising: a structure that receives a processing probe; and an engagement structure that couples to the end portion of the robotic arm to establish an orientation of the processing probe relative to the end portion of the robotic arm.

[0565] Clause 281. A coupling assembly as described in clause 280, wherein the orientation of the coupling assembly relative to the end portion includes a predetermined orientation to establish a predetermined orientation of the probe relative to the end portion of the robotic arm.

[0566] Clause 282. The coupling assembly of clause 280, wherein the robotic arm comprises a corresponding engagement structure.

[0567] Clause 283. The coupling assembly of clause 280, wherein the coupling assembly is configured to rotate the processing probe while the end portion of the robotic arm remains stationary.

[0568] Clause 284. The coupling assembly of clause 283, wherein the coupling assembly is configured to translate the processing probe while the end portion of the robotic arm remains stationary.

[0569] Clause 285. The coupling assembly of clause 280, wherein the coupling assembly is configured to translate the endoscopic camera while the end portion of the robotic assembly remains stationary.

[0570] Clause 286. The coupling assembly of clause 280, wherein the coupling assembly is configured to translate the distal opening of the irrigation lumen while the end portion of the robotic assembly remains stationary.

[0571] Clause 287. A coupling assembly as described in clause 280, wherein the coupling assembly is configured to translate the distal opening of the suction chamber while the end portion of the robotic assembly remains stationary.

[0572] Clause 288. A coupling assembly according to clause 280, wherein the coupling assembly is configured to translate the treatment probe, endoscopic camera, irrigation lumen, and aspiration lumen together while the end portion of the robotic arm remains stationary.

[0573] Clause 289. A coupling assembly according to clause 280, wherein the coupling assembly is configured to independently translate the treatment probe, endoscopic camera, irrigation lumen, and aspiration lumen while the end portion of the robotic arm remains stationary.

[0574] Clause 290. A coupling assembly according to clause 280, wherein the coupling assembly includes one or more connecting devices to enable the treatment probe, endoscopic camera, irrigation cavity or suction cavity to move together while the end portion of the robotic arm remains stationary.

[0575] Item 291. A method of treating a patient, the method comprising: aligning a slender axis of a treatment probe with a slender axis of a sheath; receiving input indicating that the slender axis of the treatment probe and the slender axis of the sheath are aligned; and in response to the input, advancing the treatment probe along the slender axis of the sheath.

[0576] Clause 292. A system or method as described in any of the preceding clauses, wherein the passive mode comprises a zero gravity mode.

[0577] Clause 293. A system or method as described in any of the preceding clauses, further comprising a sensor coupled to a fixture, wherein the fixture is configured to be coupled to a track, and wherein the sensor is configured to measure a load on one or more of the fixture, the track, or a support coupled to the robotic arm.

[0578] Although preferred embodiments of the present invention are shown and described herein, it will be apparent to those skilled in the art that such embodiments are provided only as examples. Those skilled in the art will now appreciate many variations, changes and substitutions without departing from the present invention. It should be understood that various alternatives of the embodiments of the present invention described herein may be adopted in practicing the present invention. The accompanying claims are considered to limit the scope of the present invention, and thus encompass methods and structures within the scope of these claims and their equivalents.

Claims

1. A system for processing or imaging tissue of a patient, the system comprising: a probe sized to be inserted into the patient; a robotic arm configured to be coupled to the probe; One or more computing devices operatively coupled to the robotic arm and configured with instructions for performing the following operations: establishing an allowable range of motion for the probe, the allowable range of motion being stored on a memory of the one or more computing devices; treating a target tissue of the patient with the probe or imaging the target tissue of the patient; as well as The robotic arm is moved to effect movement of the probe within the allowable range of motion of the probe.

2. The system according to claim 1, wherein: The probe is configured to couple to the robotic arm when the robotic arm is in a passive mode.

3. The system according to claim 1, wherein: When the robotic arm is in passive mode, the allowable range of motion of the probe is established.

4. The system according to claim 1, wherein: Establishing the allowable range of motion of the probe includes establishing the allowable range of motion of the probe in response to user input.

5. The system according to claim 1, wherein: Establishing the allowable range of motion of the probe includes establishing the allowable range of motion of the probe in response to positioning of the probe.

6. The system according to claim 5, wherein: The position of the probe relative to the target tissue is determined in response to one or more tissue markers in the one or more images of the target tissue.

7. The system of claim 1, further comprising updating the allowable range of motion of the probe in real time.

8. The system of claim 1 , further comprising a user input device operably coupled to one or more computing devices to provide one or more user instructions for controlling movement of the robotic arm, and wherein, Moving the robotic arm under control of the one or more computing devices includes moving the robotic arm in response to the one or more user instructions for controlling movement of the robotic arm.

9. The system according to claim 8, wherein: The user input device includes one or more of: a controller near the end of the robotic arm, a user interface on a display screen, a user interface on a console, or a controller that responds to force provided by a user on the end of the robotic arm to guide a probe on the robotic arm into position.

10. The system of claim 1, further comprising one or more force sensors operably coupled to the probe and one or more computing devices to detect compression of the patient's tissue by the probe.

Images